Hypertension (HTN)
Conditions
Brief summary
To use practice facilitation (PF) + community health worker (CHW) facilitation as a practical and sustainable implementation strategy to support the implementation and evaluation of three multi-level evidence-based interventions \[nurse case management (NCM), remote blood pressure monitoring (RBPM), and social determinants of health (SDOH) support\] delivered as an integrated community-clinic linkage model \[Practice support And Community Engagement (PACE) to address patient-, physician-, health system-, and community-level barriers to hypertension (HTN) control in Blacks across 25 primary practices within NYU Langone Health in New York City (NYC) and, in partnership with an established Community-Clinic-Academic Advisory Board and HealthFirst (NYC's largest Medicaid payer). The goal for the UH3 Implementation Phase (Years 4-7, Intervention) is to evaluate a stepped-wedge cluster RCT of 25 primary care practices in Black patients with uncontrolled hypertension (HTN)
Interventions
OTHERPractice support And Community Engagement (PACE)
A practical and sustainable implementation strategy, referred to as Practice Facilitation And social deTerminants of health support utilizing CHWs (PATCH), to support the implementation and evaluation of three multi-level evidence-based interventions: \[nurse case management (NCM) + remote blood pressure monitoring (RBPM) + social determinants of health (SDOH) support\] delivered as an integrated community-clinic linkage model \[Practice support And Community Engagement (PACE)\]
Sponsors
NYU Langone Health
National Heart, Lung, and Blood Institute (NHLBI)
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Intervention model description
Stepped-wedge cluster RCT
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
UH3 IMPLEMENTATION PHASE (Years 4 - 7): INTERVENTION Inclusion Criteria: Patients are eligible if he/she: 1. identifies as Black (through EHR code or self-report) 2. is 18+ years of age 3. has a diagnosis of HTN (identified by ICD-10 codes for HTN) 4. prescribed an antihypertensive medication(s) 5. has a clinic BP \> 130/80 mmHg
Exclusion criteria
Patients will be ineligible for the study if they: 1. are deemed unable to comply with the study protocol (either self-selected or by indicating during screening that s/he could not complete all requested tasks) 2. participate in other hypertension-related clinical trials 3. have significant psychiatric comorbidity or reports of substance abuse (as documented in the EHR) 4. plan to discontinue care at the site within the next 12 months; or 5. are pregnant or planning to become pregnant in the next 12 months IMPLEMENTATION EVALUATION 1. NYULH Primary care provider (MD/DO, NP), Clinical Director, Site Administrator, Medical Assistant, or administrative staff employed at the participating practices and interacts with at least five patients with a diagnosis of hypertension; or 2. NYULH Nurse case manager within centralized service; or 3. Staff and leadership of community- and faith-based organizations serving the Black community; or 4. NYULH Organizational leadership; or 5. NYULH Project Staff: Community Health Workers/CHW Supervisor/Practice Facilitators; and 6. Able and willing to provide consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Nurses who adopt the PACE intervention | Month 12 | Defined at the Nurse-level who adopt both electronic health record (EHR) remote BP monitoring (RBPM) and social determinants of health (SDOH) Smartsets |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORGbenga Ogedegbe, MD, MPH
NYU Langone Health
PRINCIPAL_INVESTIGATORNadia Islam, PhD
NYU Langone Health
PRINCIPAL_INVESTIGATORAntoinette Schoenthaler, EdD
NYU Langone Health
Outcome results
None listed