The 90-Second Intervention: a patient compliance mediated technique to improve and control hypertension.

Hypertension, a leading risk factor for cardiovascular and renal diseases, occurs in up to 50 million Americans. Despite mounting evidence of the effectiveness of prevention and treatment, physicians are still unable to get their patients to adopt and adhere to treatment protocols. This project presents an innovative approach to compliance which is based on general systems theory and its applications in family therapy. The "90-Second Intervention" ("90 SI") incorporates the use of family and friends; it utilizes the therapeutic relationship or alliance of the physician-patient; and it embraces the well-established fact that social support plays a key role in promoting health, decreasing susceptibility to disease, and facilitating recovery from illness. The physician asks the patients to identify who in their life loves or cares for them and would help them adhere to the treatment protocol. To implement the "90 SI," the physician instructs the patient to telephone, in his or her presence, the identified helper(s) who then agree to support the patients' medical regimen. Specifically, the "90 SI" seeks to create a context to support the patients in a regimen of low to moderate intensity exercise, which is proven to be a powerful, cost-effective, and safe treatment. Patients who are identified with new onset or uncontrolled hypertension at three clinics in urban Philadelphia are the target population.