In a cohort of South Asian Americans with uncontrolled BP, in contrast with the management group, these assigned to a group well being worker-led intervention had larger odds of reaching BP management at 6 months, researchers reported.

“We had been working closely with South Asian community leaders for decades who noted high rates of CVD risk in the community, but lack of culturally tailored resources to address this burden,” Nadia Islam, PhD, affiliate professor within the division of inhabitants well being and affiliate director on the Institute for Excellence in Health Equity at NYU Langone Health, instructed Healio. “Our early work had demonstrated the efficacy of community health worker (CHW)-led programs to improve health outcomes in diabetes. Nationally, the CDC had launched the Million Hearts campaign, which supported work with primary care practices to improve blood pressure control among patients by implementing team-based care models. Despite a large-scale campaign, many immigrant-serving practices were not fully engaged in the efforts. The IMPACT study represented our effort to integrate CHWs into South Asian-serving primary care practices to improve blood pressure control, in alignment with national efforts like Million Hearts.”

For the IMPACT trial, Islam and colleagues randomly assigned by clinic web site 303 adults (imply age, 56.8 years; 54.1% girls) of South Asian descent (Bangladesh, India, the Indo-Caribbean, Nepal, Pakistan or Sri Lanka) with uncontrolled BP (systolic BP 140 mm Hg, diastolic BP 90 mm Hg) from 14 PCPs in New York to a CHW-led intervention or the same old care.

Tailored intervention

The CHW-led intervention consisted of 5 month-to-month group well being classes selling coronary heart well being and offering schooling on BP and CVD that have been culturally and linguistically adapted to South Asian communities. The CHW adopted up biweekly with every participant by telephone or in-person to set targets and to debate points reminiscent of remedy adherence, bodily exercise and vitamin. If crucial, referrals to applications on smoking cessation, train, psychological well being and different subjects have been made. The management group obtained the same old care and have been capable of take part within the intervention after the top of the research interval.

The main final result was BP management, outlined as systolic BP lower than 140 mm Hg and diastolic BP lower than 90 mm Hg, at 6 months.

Improved odds of BP management

Islam and colleagues discovered that the first final result was achieved by 68.2% of individuals within the intervention group and 41.6% of these within the management group (P < .001).

After adjustment for baseline systolic BP, intercourse, gender, PCP and days between BP measurements, the intervention group had greater than threefold greater odds of getting BP management in contrast with the management group (OR = 3.7; 95% CI, 2.1-6.5).

“We expected to see improvements in BP control, but were pleased to see the magnitude of results,” Islam instructed Healio. “Our positive results demonstrate that culturally tailored health education, integrated into primary care, improves health outcomes. The next steps are to create mechanisms to scale and sustain this model. We hope our results provide further evidence that CHW-based models are worth investing in to improve health equity.”

For extra info:

Nadia Islam, PhD, might be reached at nadia.islam@nyulangone.org; Twitter: @nadiaislamnyc.

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