Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT.
Northwestern University Feinberg School of Medicine, Chicago, IL.
Ethn Dis. 2024 Apr 24;DECIPHeR(Spec Issue):18-26. doi: 10.18865/ed.DECIPHeR.18. eCollection 2023 Dec.
Hypertension affects 1 in 3 adults in the United States and disproportionately affects African Americans. Kaiser Permanente demonstrated that a "bundle" of evidence-based interventions significantly increased blood pressure control rates. This paper describes a multiyear process of developing the protocol for a trial of the Kaiser bundle for implementation in under-resourced urban communities experiencing cardiovascular health disparities during the planning phase of this biphasic award (UG3/UH3).
The protocol was developed by a collaboration of faith-based community members, representatives from community health center practice-based research networks, and academic scientists with expertise in health disparities, implementation science, community-engaged research, social care interventions, and health informatics. Scientists from the National Institutes of Health and the other grantees of the Disparities Elimination through Coordinated Interventions to Prevent and Control Heart and Lung Disease Risk (DECIPHeR) Alliance also contributed to developing our protocol.
The protocol is a hybrid type 3 effectiveness-implementation study using a parallel cluster randomized trial to test the impact of practice facilitation on implementation of the Kaiser bundle in community health centers compared with implementation without facilitation. A central strategy to the Kaiser bundle is to coordinate implementation via faith-based and other community organizations for recruitment and navigation of resources for health-related social risks.
The proposed research has the potential to improve identification, diagnosis, and control of blood pressure among under-resourced communities by connecting community entities and healthcare organizations in new ways. Faith-based organizations are a trusted voice in African American communities that could be instrumental for eliminating disparities.
高血压影响了美国三分之一的成年人，且非裔美国人受其影响的比例过高。凯泽 Permanente 已证明，一系列基于证据的干预措施可显著提高血压控制率。本文介绍了一项多年的研究计划，即在资源匮乏的城市社区中实施凯泽方案，以解决心血管健康差异问题。本研究在该两阶段拨款的规划阶段（UG3/UH3），描述了开发试验方案的多步骤过程。
该方案由信仰社区成员、社区卫生中心实践研究网络代表以及在健康差异、实施科学、社区参与研究、社会护理干预和健康信息学方面具有专业知识的学术科学家合作制定。来自美国国立卫生研究院和其他通过协调干预消除心脏和肺部疾病风险差异（DECIPHeR）联盟的拨款接受者的科学家也为制定我们的方案做出了贡献。
该方案是一种混合类型 3 有效性-实施研究，采用平行聚类随机试验，以测试在社区卫生中心实施凯泽方案时，与没有实施促进因素的情况下，实践促进对实施的影响。凯泽方案的一个核心策略是通过信仰和其他社区组织协调实施，以招募资源并为与健康相关的社会风险提供导航。
拟议的研究有可能通过以新的方式连接社区实体和医疗保健组织，改善资源匮乏社区的血压识别、诊断和控制。信仰组织是非裔美国人社区中可信赖的声音，对于消除差异可能至关重要。
