Community Health Worker, Food Insecurity, Hypertension, Nutrition, Healthy
Conditions
Brief summary
The goal of this study is to implement and evaluate a randomized pilot study of a 4-month Nutrition-enhanced community health worker (CHW) intervention for primary care patients with nutrition insecurity and poorly controlled hypertension. The nutrition intervention will be added to the pre-existing Massachusetts General Hospital CHW hypertension (Basic CHW) program that provides hypertension education, coaching about adherence to medications and primary care visits, and home BP cuffs and promotion of BP self-monitoring over the course of approximately 4 months.
Detailed description
The goal of this study is to implement and evaluate a randomized pilot study of a 4-month Nutrition-enhanced CHW intervention in primary care patients with nutrition insecurity and poorly controlled hypertension. The nutrition intervention will be added to the pre-existing Massachusetts General Hospital CHW hypertension (Basic CHW) that provides basic hypertension education, coaching about adherence to medications and primary care visits, and home BP cuffs and promotion of BP self-monitoring over the course of approximately 4 months. The CHW nutrition intervention curriculum is tailored to the needs and preferences of a food-insecure population with limited resources. Nutrition education materials will be provided to participants, including a booklet of nutrition information and a summarized version of key points on a brochure that they can use as a quick reference when grocery shopping. Nutrition education will focus on reducing sodium, saturated fats, and added sugars and increasing fruits, vegetables, and whole grains. Much of the educational material is based on a traffic-light system. These topics are organized into four modules: nutrition label reading, grocery shopping, meal-planning, and healthy cooking.
Interventions
BEHAVIORALNutrition-enhanced CHW
CHW provides nutrition education and skills training in addition to the usual care (Basic CHW) hypertension management.
BEHAVIORALBasic CHW
CHW provide usual care for hypertension management.
Sponsors
Massachusetts General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
21 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* Eligible to participate in the Massachusetts General Hospital CHW hypertension program (age 21 years or older, uncontrolled hypertension, patient at one of 5 participating primary care clinics; either identifies as a minoritized race/ethnicty or is low-income); speaks English or Spanish
Exclusion criteria
* declines participation in CHW hypertension program; does not speak English or Spanish
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasiblity | Baseline | Proportion of eligible participants enrolled in study |
| Feasibility of CHW nutrition intervention (intervention arm only) | 4 months | At least 70% participants complete at least 3 of 4 CHW nutrition education modules |
| Acceptability (intervention arm only) | 4 months | Average of participants' ratings of intervention components on a 10-point scale. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Diet quality | 4 months | Change in Healthy Eating Index-20 score |
| Blood pressure | 4 months | Change in systolic and diastolic blood presure |
| Secondary feasibility (intervention arm only) | 4 months | At least 70% participants complete 3 of 6 nutrition worksheets |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORAnne N Thorndike, MD, MPH
Massachusetts General Hospital
Outcome results
None listed