Implementation of an Adjunct Strategy to Reduce Blood Pressure in Blacks with Uncontrolled Hypertension: a Pilot Project.

A high prevalence of uncontrolled hypertension among Blacks is a major cause of racial health disparities in the United States. We established a community/academic partnership to improve hypertension control in Blacks receiving medical care at a federally qualified health center in Milwaukee. The defining components of our program included: six group sessions (one/month), based on the American Heart Association's Simple Seven curriculum and designed to motivate and empower patients to manage their blood pressure; active involvement of a community health worker; and ongoing participation of a community advisory board. The study design included a matched control group not exposed to the intervention. Patients in both groups received their usual medical care. Overall, compared to baseline, systolic blood pressure decreased at both 6 and 12 months (P < 0.004); however, the reduction of blood pressure in the intervention and control groups did not differ significantly (P = .62). Based on written responses to a questionnaire and structured focus group interviews after completing the six-month program, participants reported that the intervention was effective. In retrospect, they suggested that more attention might have been given to spirituality and stress reduction. Larger and longer-term studies will be required to evaluate the added value of this type of intervention.