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理发店促进社区到诊所联系实施计划:预防黑人男性高血压的新型计划的原理和方案。

Barbershop-Facilitated Community-to-Clinic Linkage Implementation Program: Rationale and Protocol for a Novel Program to Prevent Hypertension Among Black Men.

机构信息

Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA.

Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA.

出版信息

Am J Hypertens. 2023 Apr 15;36(5):240-247. doi: 10.1093/ajh/hpac133.

Abstract

BACKGROUND

Black men in the United States have higher hypertension (HTN) prevalence than other groups, largely due to adverse social determinants of health, including poor healthcare access. The Community-to-Clinic Linkage Implementation Program (CLIP) is effective for HTN screening in Black-owned barbershops. However, its effect on HTN prevention among Black men is untested. Here, we describe the rationale and study protocol for the development and testing of a barbershop facilitation (BF) strategy, with trained Community Health Workers, to implement and scale CLIP for HTN prevention in Black men.

METHODS

The study is part of the American Heart Association (AHA)-funded RESTORE (Addressing Social Determinants to Prevent Hypertension) Health Equity Research Network. The study is tri-phasic: (i) pre-implementation-qualitative examination of factors affecting adoption of CLIP and development of BF strategy, (ii) implementation-cluster randomized control trial to test the effectiveness of CLIP with and without BF. We will partner with 20 barbershops and enroll 420 Black men with elevated blood pressure (BP)/Stage 1 HTN (2017 ACC/AHA HTN guidelines). Outcomes include reduction in BP, rate of CLIP adoption and linkage to care, and incidence of Stage 2 HTN. The study time frame is 12 months, (iii) post-implementation-we will evaluate program sustainability (6 months post-trial conclusion) and cost-effectiveness (up to 10 years).

CONCLUSIONS

This study harnesses community-based resources to address HTN prevention in Black men, who are more adversely impacted by HTN than other groups. It has major policy relevance for health departments and other stakeholders to address HTN prevention in Black communities.

CLINICALTRIALS.GOV IDENTIFIER: NCT05447962.

摘要

背景

美国的黑人男性高血压(HTN)患病率高于其他群体,这主要是由于健康的不利社会决定因素,包括医疗保健机会不足。社区到诊所联系实施计划(CLIP)在黑人拥有的理发店中对 HTN 筛查有效。然而,其在预防黑人男性 HTN 方面的效果尚未得到检验。在这里,我们描述了为 HTN 预防开发和测试理发店促进(BF)策略的理由和研究方案,该策略由经过培训的社区卫生工作者实施和扩大 CLIP,以预防黑人男性的 HTN。

方法

该研究是美国心脏协会(AHA)资助的 RESTORE(解决社会决定因素以预防高血压)健康公平研究网络的一部分。该研究分为三个阶段:(i)在实施前,对影响 CLIP 采用和 BF 策略制定的因素进行定性研究;(ii)实施,对 CLIP 单独和与 BF 联合应用的有效性进行聚类随机对照试验;我们将与 20 家理发店合作,招募 420 名高血压(BP)/1 期 HTN 升高的黑人男性(2017 年 ACC/AHA HTN 指南)。结果包括降低血压、CLIP 采用和与医疗保健机构建立联系的比率以及 2 期 HTN 的发生率。研究时间框架为 12 个月;(iii)实施后,我们将评估项目的可持续性(试验结束后 6 个月)和成本效益(长达 10 年)。

结论

这项研究利用社区为基础的资源来解决黑人男性的 HTN 预防问题,他们比其他群体更容易受到 HTN 的不利影响。它对卫生部门和其他利益相关者具有重要的政策相关性,以解决黑人社区的 HTN 预防问题。

临床试验.gov 标识符:NCT05447962。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0e3/11777929/a45f036482ca/nihms-2049006-f0002.jpg

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Sustainability of blood pressure reduction in black barbershops.黑人理发店中血压降低的可持续性。
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