Hypertension
Conditions
Keywords
Hypertension, Self-help groups, Community health networks, Health knowledge, attitudes, practice, Patient participation, Randomized clinical trial
Brief summary
The primary purpose of this project is to establish the efficacy of a novel peer support intervention to reduce hypertension among members of veteran service organizations (VSOs). Specifically, we plan to demonstrate that veterans participating in a peer support intervention, as opposed to a purely didactic educational program, will have better blood pressure (BP) control, increased engagement in blood pressure lowering activities (such as exercise), and a more active stance as patients.
Detailed description
IMPACT ON VETERANS HEALTH It is anticipated that this intervention will help participating veterans achieve optimal hypertension (HTN) control. Doing so will reduce their risks for heart disease and stroke, and improve their quality of life. It is hoped that the collaborative nature of this intervention will strengthen the Department of Veterans Affairs (VA)'s ties to the veteran community, and establish important partnerships for health. If successful, this intervention could serve as a model for managing chronic disease both within and outside the VA system. BACKGROUND/RATIONALE Despite consensus that effective hypertension treatment reduces morbidity and mortality, many patients in the United States continue to have suboptimal blood pressure control. Even with the provider resources and motivated patients inherent in a randomized clinical trial, over a third of patients participating in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) were not at their goal blood pressure of 140/90 after five years. Similarly, within the Veterans Integrated Service Network (VISN) 12 we have found that as many as 30% of patients with hypertension are above the target BP of 140/90, despite routine physician reminders to patients who are above these goals. Moreover, preliminary results of an internally funded randomized trial suggest minimal impact of further physician-focused interventions to reduce patients' blood pressure. OBJECTIVES We will have two primary objectives. First, because the intervention proposed is novel, we believe we need to demonstrate its efficacy in a methodologically rigorous fashion. Specifically we plan to demonstrate that veterans participating in a peer support intervention will have improved blood pressure control, knowledge of blood pressure treatment, both generally and for themselves, and a more active stance as patients. Second, we will carefully examine the process by which our intervention achieves these goals, including examining such key structural variables as the frequency of peer support meetings, attendance of participants at these meetings, and use of healthcare professional support by the group leaders. As part of this second objective, we also seek to understand the fidelity with which the peer leaders are to deliver the intervention, and the satisfaction of both support group participants and leaders with the intervention. METHODS There are three primary activities in the present project. First, academicians from the Clement J. Zablocki VA Medical Center (VAMC) are working with the Veterans of Foreign Wars (VFW) and other community groups to develop a community-academic partnership that follows the principles of community-based participatory research. This key activity is underway and will continue beyond the present period of funding. Second, the centerpiece of the present grant is a cluster randomized clinical trial (RCT) of the use of peer-led support groups to improve BP control in patients with hypertension. Fifty posts drawn from the VFW, American Legion, Vietnam Veterans Association, and National Association of Black Veterans will be randomly assigned to receive professionally delivered education regarding hypertension or to a peer support intervention. The third activity is an evaluation of the processes involved in delivering the peer support intervention that will allow for successful replication, or to provide insight into why the expected improvement in BP control did not occur.
Interventions
BEHAVIORALPeer Led
Post provided with blood pressure cuffs, pedometers and scale. Two post members trained as peer leaders who encourage post members to take positive steps to improve BP. Peer leader training involves 20 hours of training over 12 months, telephone/email access to clinical experts and educational materials to share with post members.
BEHAVIORALSeminar
Post provided with blood pressure cuffs, pedometers and scale. Post members, including study participants invited to didactic sessions on cardiovascular health.
Sponsors
Medical College of Wisconsin
Veterans of Foreign Wars USA
Vietnam Veterans of America
National Association of Black Veterans
Korea Veterans of America, Inc.
Disabled American Veterans
AmVETS
Jewish War Veterans of the United States of America
The American Legion Department of Wisconsin
Wisconsin Elks Association (a branch of The Benevolent and Protective order of Elks of the United States of America)
US Department of Veterans Affairs
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
1. Member of a post or auxiliary of a participating veterans' service organization or Elks Lodge in the 70 miles surrounding the Milwaukee VAMC. 2. Hypertension as established by one of: a) Average systolic blood pressure (SBP) greater than 140 or diastolic blood pressure (DBP) greater than 90 at two baseline visits; b) SBP greater than 130 or DBP greater than 90 at two baseline visits, plus patient report of diabetes mellitus and use of a hypoglycemic agent at the baseline visit; or c) self-reported hypertension plus self-reported current treatment with at least one antihypertensive drug at baseline visit. 3. Willingness to sign informed consent document.
Exclusion criteria
1. Medical or social condition preventing routine attendance at a monthly meeting. 2. Inability to communicate with other post members because of language barrier or physical limitation (e.g., prior stroke).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Systolic Blood Pressure | 9/16/2008-8/9/2010; baseline and 12 months | Mean/Standard Error (SE) change in systolic blood pressure |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Weight | 9/16/2008-8/9/2010; baseline and 12 months | Mean/SE change in weight, measured in pounds (lbs) |
| Change in BMI | 9/16/2008-8/9/2010; baseline and 12 months | Mean/SE change in Body Mass Index (BMI) (kg/m2) |
| Change in Health Status | 9/16/2008-8/9/2010; baseline and 12 months | Response to the question How would you rate your general health status?. Response options are scored as follows. 1. Excellent 2. Very Good 3. Good 4. Fair 5. Poor We report the change in health status from baseline to 12 months. |
| Change in Time Since Last Physician Visit | 9/16/2008-8/9/2010; baseline and 12 months | Change in mean # of months since last visit to a physician |
| Non-Clinic Blood Pressure Checks | 9/16/2008-8/9/2010; baseline and 12 months | % reporting non-clinic blood pressure (BP) checks at least once a month |
| Change in Number of Blood Pressure Medications | 9/16/2008-8/9/2010; baseline and 12 months | Change in mean # of prescription blood pressure medications |
| Change in Hypertension Knowledge | 9/16/2008-8/9/2010; baseline and 12 months | Mean/SE change in score on: Scale: Hypertension Evaluation of Lifestyle and Management (HELM) Construct: Knowledge of hypertension and lifestyle factors related to hypertension Minimum Score: 0 Maximum Score: 14 Interpretation of Score: Higher is better |
| Change in Hypertension Attitudes | 9/16/2008-8/9/2010; baseline and 12 months | Mean/SE change in score on: Scale: Not applicable; series of agree/disagree statements that we wrote Construct: Attitudes around blood pressure diagnosis, treatment (including lifestyle changes), and seriousness of the condition Minimum Score: 12 Maximum Score: 60 Interpretation of Score: Lower is better |
| Change in Satisfaction With Blood Pressure Treatment | 9/16/2008-8/9/2010; baseline and 12 months | Mean/SE change in score on: Scale: Modified Holmes-Ravnor Satisfaction with Decision (SWD) Construct: Satisfaction with current blood pressure treatment Minimum Score: 1 Maximum Score: 5 Interpretation of Score: Lower is better (NOTE: Original instrument's scoring is reversed; i.e., higher is better) |
| Change in Diastolic Blood Pressure | 9/16/2008-8/9/2010; baseline and 12 months | Mean/SE change in diastolic blood pressure |
| Change in Sodium Intake | 9/16/2008-8/9/2010; baseline and 12 months | Mean/SE change in score on: Scale: Hopkins Dietary Questionnaire (only the dietary salt avoidance questions) Construct: Dietary sodium intake Minimum Score: 2 Maximum Score: 12 Interpretation of Score: Higher is better |
| Change in Physical Activity Level | 9/16/2008-8/9/2010; baseline and 12 months | Mean/SE change in score on: Scale: International Physical Activity Questionnaire (IPAQ), Metabolic Equivalent of Task (MET) Construct: Total metabolic equivalents (a measure of energy expenditure) in the last 7 days Minimum Score: 0 Maximum Score: Not applicable; based on physical activity done Interpretation of Score: Higher is better |
| Change in Daily Steps | 9/16/2008-8/9/2010; baseline and 12 months | Mean/SE change in # of steps per day (self report) |
| Change in Fruit and Vegetable Intake | 9/16/2008-8/9/2010; baseline and 12 months | Mean/SE change in # of servings per day; questions taken from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) Questionnaire |
| Change in Medication Adherence | 9/16/2008-8/9/2010; baseline and 12 months | Mean/SE change in score on: Scale: Morisky Adherence; questions modified to ask specifically about blood pressure medication Construct: Adherence to prescribed medication-taking regimen Minimum Score: 0 Maximum Score: 4 Interpretation of Score: Lower is better |
| Change in Self Efficacy | 9/16/2008-8/9/2010; baseline and 12 months | Mean/SE change in score on: Scale: Schwarzer General Perceived Self-Efficacy Construct: Perceived self-efficacy Minimum Score: 10 Maximum Score: 40 Interpretation of Score: Higher is better |
| Change in Social Support | 9/16/2008-8/9/2010; baseline and 12 months | Mean/SE change in overall score on: Scale: Medical Outcomes Study (MOS) Social Support Survey Construct: Overall measure of social support, including tangible, affectionate, positive social interaction, and emotional/informational Minimum Score: 0 Maximum Score: 100 Interpretation of Score: Higher is better |
| Change in Health Opinions | 9/16/2008-8/9/2010; baseline and 12 months | Mean/SE change in overall score on: Scale: Krantz Health Opinion Survey Construct: Opinions about healthcare and healthcare providers Minimum Score: 0 Maximum Score: 16 Interpretation of Score: Higher is better |
| Change in Patient Activation | 9/16/2008-8/9/2010; baseline and 12 months | Mean/SE change in score on: Scale: Hibbard Patient Activation Measure (PAM) Construct: Level of patient activation and engagement in health care Minimum Score: 0 Maximum Score: 100 Interpretation of Score: Lower is better (NOTE: Original instrument's scoring is reversed; i.e., higher is better) |
| Change in Alcohol Use | 9/16/2008-8/9/2010; baseline and 12 months | Mean/SE change in score on: Scale: Alcohol Use Disorders Identification Test (AUDIT) Construct: Alcohol use and abuse Minimum Score: 0 Maximum Score: 12 Interpretation of Score: Lower is better |
Countries
United States
Participant flow
Recruitment details
We wrote letters to posts located within 60 miles of the study hospital and followed up with a phone call to arrange for an in-person presentation. Before and after the presentation, we measured blood pressures and asked about diagnoses of hypertension. We scheduled individual appointments with potential subjects to confirm eligibility and consent.
Pre-assignment details
Posts had to identify two potential peer leaders to be eligible for the trial. The post membership voted on whether to participate, even though many would not be followed as study members. All enrollment activities occurred before posts were assigned to an intervention. All participants within a post received the assigned intervention.
Participants by arm
| Arm | Count |
|---|---|
| Peer Led Post provided with blood pressure cuffs, pedometers and scale. Two post members trained as peer leaders who encourage post members to take positive steps to improve BP. Peer leader training involves 20 hours of training over 12 months, telephone/email access to clinical experts and educational materials to share with post members. | 219 |
| Seminar Post provided with blood pressure cuffs, pedometers and scale. Post members, including study participants invited to didactic sessions on cardiovascular health. Two or more post representatives (who were also post members) coordinated use of equipment and encouraged members to attend the didactic sessions. | 185 |
| Total | 404 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Death | 7 | 5 |
| Overall Study | Lost to Follow-up | 1 | 4 |
| Overall Study | Moved out of state | 2 | 2 |
| Overall Study | Withdrawal by Subject | 1 | 3 |
Baseline characteristics
| Characteristic | Peer Led | Total | Seminar |
|---|---|---|---|
| Age, Continuous | 68.8 years STANDARD_DEVIATION 9.97 | 68.2 years STANDARD_DEVIATION 10.1 | 67.4 years STANDARD_DEVIATION 10.3 |
| Race (NIH/OMB) American Indian or Alaska Native | 2 Participants | 3 Participants | 1 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 3 Participants | 11 Participants | 8 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 214 Participants | 389 Participants | 175 Participants |
| Region of Enrollment United States | 219 participants | 404 participants | 185 participants |
| Sex: Female, Male Female | 34 Participants | 51 Participants | 17 Participants |
| Sex: Female, Male Male | 185 Participants | 353 Participants | 168 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 219 | 0 / 185 |
| serious Total, serious adverse events | 17 / 219 | 8 / 185 |
Outcome results
Primary
Change in Systolic Blood Pressure
Mean/Standard Error (SE) change in systolic blood pressure
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Systolic Blood Pressure | -3.48 mm Hg | Standard Error 1.13 |
| Seminar | Change in Systolic Blood Pressure | -5.45 mm Hg | Standard Error 1.24 |
p-value: 0.2417Mixed Models Analysis
Secondary
Change in Alcohol Use
Mean/SE change in score on: Scale: Alcohol Use Disorders Identification Test (AUDIT) Construct: Alcohol use and abuse Minimum Score: 0 Maximum Score: 12 Interpretation of Score: Lower is better
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Alcohol Use | -0.15 survey score | Standard Error 0.097 |
| Seminar | Change in Alcohol Use | -0.19 survey score | Standard Error 0.128 |
p-value: 0.5901Kruskal-Wallis
Secondary
Change in BMI
Mean/SE change in Body Mass Index (BMI) (kg/m2)
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in BMI | -0.12 kg/m2 | Standard Error 0.1 |
| Seminar | Change in BMI | 0.17 kg/m2 | Standard Error 0.12 |
p-value: 0.0604Mixed Models Analysis
Secondary
Change in Daily Steps
Mean/SE change in # of steps per day (self report)
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Daily Steps | 2395 steps per day | Standard Error 875.5 |
| Seminar | Change in Daily Steps | 963.5 steps per day | Standard Error 735.9 |
p-value: 0.1471Kruskal-Wallis
Secondary
Change in Diastolic Blood Pressure
Mean/SE change in diastolic blood pressure
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Diastolic Blood Pressure | -1.83 mm Hg | Standard Error 0.76 |
| Seminar | Change in Diastolic Blood Pressure | -2.03 mm Hg | Standard Error 0.83 |
p-value: 0.8586Mixed Models Analysis
Secondary
Change in Fruit and Vegetable Intake
Mean/SE change in # of servings per day; questions taken from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) Questionnaire
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Fruit and Vegetable Intake | 0.096 servings of fruits & vegetables per day | Standard Error 0.109 |
| Seminar | Change in Fruit and Vegetable Intake | -0.01 servings of fruits & vegetables per day | Standard Error 0.093 |
p-value: 0.6123Kruskal-Wallis
Secondary
Change in Health Opinions
Mean/SE change in overall score on: Scale: Krantz Health Opinion Survey Construct: Opinions about healthcare and healthcare providers Minimum Score: 0 Maximum Score: 16 Interpretation of Score: Higher is better
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Health Opinions | 0.252 survey score | Standard Error 0.167 |
| Seminar | Change in Health Opinions | 0.232 survey score | Standard Error 0.188 |
p-value: 0.7314Kruskal-Wallis
Secondary
Change in Health Status
Response to the question How would you rate your general health status?. Response options are scored as follows. 1. Excellent 2. Very Good 3. Good 4. Fair 5. Poor We report the change in health status from baseline to 12 months.
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Health Status | -0.14 units on a scale (range 1-5) | Standard Error 0.052 |
| Seminar | Change in Health Status | 0.018 units on a scale (range 1-5) | Standard Error 0.054 |
p-value: 0.0438Kruskal-Wallis
Secondary
Change in Hypertension Attitudes
Mean/SE change in score on: Scale: Not applicable; series of agree/disagree statements that we wrote Construct: Attitudes around blood pressure diagnosis, treatment (including lifestyle changes), and seriousness of the condition Minimum Score: 12 Maximum Score: 60 Interpretation of Score: Lower is better
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Hypertension Attitudes | -0.24 survey score | Standard Error 0.292 |
| Seminar | Change in Hypertension Attitudes | -0.19 survey score | Standard Error 0.307 |
p-value: 0.9191Kruskal-Wallis
Secondary
Change in Hypertension Knowledge
Mean/SE change in score on: Scale: Hypertension Evaluation of Lifestyle and Management (HELM) Construct: Knowledge of hypertension and lifestyle factors related to hypertension Minimum Score: 0 Maximum Score: 14 Interpretation of Score: Higher is better
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Hypertension Knowledge | 0.529 survey score | Standard Error 0.127 |
| Seminar | Change in Hypertension Knowledge | 0.256 survey score | Standard Error 0.159 |
p-value: 0.2194Kruskal-Wallis
Secondary
Change in Medication Adherence
Mean/SE change in score on: Scale: Morisky Adherence; questions modified to ask specifically about blood pressure medication Construct: Adherence to prescribed medication-taking regimen Minimum Score: 0 Maximum Score: 4 Interpretation of Score: Lower is better
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Medication Adherence | -0.02 survey score | Standard Error 0.043 |
| Seminar | Change in Medication Adherence | 0.007 survey score | Standard Error 0.055 |
p-value: 0.5861Kruskal-Wallis
Secondary
Change in Number of Blood Pressure Medications
Change in mean # of prescription blood pressure medications
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Number of Blood Pressure Medications | 0.011 blood pressure medications | Standard Error 0.054 |
| Seminar | Change in Number of Blood Pressure Medications | 0.028 blood pressure medications | Standard Error 0.057 |
p-value: 0.8395Kruskal-Wallis
Secondary
Change in Patient Activation
Mean/SE change in score on: Scale: Hibbard Patient Activation Measure (PAM) Construct: Level of patient activation and engagement in health care Minimum Score: 0 Maximum Score: 100 Interpretation of Score: Lower is better (NOTE: Original instrument's scoring is reversed; i.e., higher is better)
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Patient Activation | 1.007 survey score | Standard Error 0.903 |
| Seminar | Change in Patient Activation | 1.254 survey score | Standard Error 0.91 |
p-value: 0.9839Kruskal-Wallis
Secondary
Change in Physical Activity Level
Mean/SE change in score on: Scale: International Physical Activity Questionnaire (IPAQ), Metabolic Equivalent of Task (MET) Construct: Total metabolic equivalents (a measure of energy expenditure) in the last 7 days Minimum Score: 0 Maximum Score: Not applicable; based on physical activity done Interpretation of Score: Higher is better
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Physical Activity Level | 260.2 METS | Standard Error 321.9 |
| Seminar | Change in Physical Activity Level | -89.5 METS | Standard Error 409.3 |
p-value: 0.3979Kruskal-Wallis
Secondary
Change in Satisfaction With Blood Pressure Treatment
Mean/SE change in score on: Scale: Modified Holmes-Ravnor Satisfaction with Decision (SWD) Construct: Satisfaction with current blood pressure treatment Minimum Score: 1 Maximum Score: 5 Interpretation of Score: Lower is better (NOTE: Original instrument's scoring is reversed; i.e., higher is better)
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Satisfaction With Blood Pressure Treatment | -0.15 survey score | Standard Error 0.052 |
| Seminar | Change in Satisfaction With Blood Pressure Treatment | -0.15 survey score | Standard Error 0.058 |
p-value: 0.9633Kruskal-Wallis
Secondary
Change in Self Efficacy
Mean/SE change in score on: Scale: Schwarzer General Perceived Self-Efficacy Construct: Perceived self-efficacy Minimum Score: 10 Maximum Score: 40 Interpretation of Score: Higher is better
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Self Efficacy | 0.450 survey score | Standard Error 0.246 |
| Seminar | Change in Self Efficacy | 0.286 survey score | Standard Error 0.275 |
p-value: 0.4489Kruskal-Wallis
Secondary
Change in Social Support
Mean/SE change in overall score on: Scale: Medical Outcomes Study (MOS) Social Support Survey Construct: Overall measure of social support, including tangible, affectionate, positive social interaction, and emotional/informational Minimum Score: 0 Maximum Score: 100 Interpretation of Score: Higher is better
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Social Support | 1.249 survey score | Standard Error 1.088 |
| Seminar | Change in Social Support | 2.227 survey score | Standard Error 1.171 |
p-value: 0.2527Kruskal-Wallis
Secondary
Change in Sodium Intake
Mean/SE change in score on: Scale: Hopkins Dietary Questionnaire (only the dietary salt avoidance questions) Construct: Dietary sodium intake Minimum Score: 2 Maximum Score: 12 Interpretation of Score: Higher is better
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Sodium Intake | -0.08 survey score | Standard Error 0.159 |
| Seminar | Change in Sodium Intake | -0.11 survey score | Standard Error 0.166 |
p-value: 0.982Kruskal-Wallis
Secondary
Change in Time Since Last Physician Visit
Change in mean # of months since last visit to a physician
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Time Since Last Physician Visit | -2.58 months (since last visit) | Standard Error 0.409 |
| Seminar | Change in Time Since Last Physician Visit | -1.65 months (since last visit) | Standard Error 1.049 |
p-value: 0.1418Kruskal-Wallis
Secondary
Change in Weight
Mean/SE change in weight, measured in pounds (lbs)
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer Led | Change in Weight | -0.85 pounds | Standard Error 0.71 |
| Seminar | Change in Weight | 1.29 pounds | Standard Error 0.78 |
p-value: 0.0432Mixed Models Analysis
Secondary
Non-Clinic Blood Pressure Checks
% reporting non-clinic blood pressure (BP) checks at least once a month
Time frame: 9/16/2008-8/9/2010; baseline and 12 months
Population: Consented, hypertensive members of participating veterans service organizations in SE Wisconsin.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Peer Led | Non-Clinic Blood Pressure Checks | 91.26 percentage of participants |
| Seminar | Non-Clinic Blood Pressure Checks | 82.74 percentage of participants |
p-value: 0.007Fisher Exact