Role of community programs in controlling blood pressure

Fulwood, Robinson; Guyton-Krishnan, Jeanette; Wallace, Madeleine; Sommer, Ellen

doi:10.1007/s11906-006-0031-x

Cited by 13 publications

(13 citation statements)

References 26 publications

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“…2,5 Based on this information, it can be concluded that, if sustained, the observed BP reductions in KOT would lead to healthier aging. The KOT model shares components of other community-based interventions for BP lowering, 11,[13][14][15][16][17][18][19][20][21]24 although the central involvement of peer volunteers is novel. The majority of programs using lay health volunteers for BP control are educationally focused, 16,24 and those that venture into the realm of monitoring, tracking, and referral often directly involve the use of health profes-sionalsFphysicians, pharmacists, nurses.…”

Section: Discussionmentioning

confidence: 99%

“…9,10 That is, BP control depends upon a number of interrelated environmental and individual factors such that efforts focused on individual contacts have limited capacity to reach entire populations. 1,11 Recognizing this, Healthy People 2010 has identified the community as a critical partner in efforts to improve chronic disease-related health outcomes. 12 A number of community models to address BP control have been advanced in the literature.…”

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confidence: 99%

“…Some have been shown to reduce BP or improve control, but the use of financial incentives, advanced technologies, and reliance upon health professions staff may limit their sustainability and expansion. 11,[13][14][15][16][17][18][19][20][21] The use of peervolunteers to run community-based blood pressure (BP) monitoring is rarely described in the literature. 16,18 This report describes Keep On Track (KOT), an enhanced and updated version of a NYC senior center-based program that aims to reduce the BP of community-dwelling older adults using peer volunteers to conduct ongoing BP monitoring.…”

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confidence: 99%

“…Visits, mean (range): 4.7(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) Months observed, mean ±SD= 3.8 ±1.Flow of Keep on Track program and participants from implementation to evaluation.…”

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confidence: 99%

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Keep on Track: A Volunteer‐Run Community‐Based Intervention to Lower Blood Pressure in Older Adults

Truncali

Dumanovsky²,

Stollman

et al. 2010

J American Geriatrics Society

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Uncontrolled hypertension in older adults is a common yet preventable threat to healthy aging. Improvements in blood pressure (BP) control and related health outcomes require innovative approaches that reach beyond the clinical environment. Keep on Track (KOT), a volunteer-run, community-based BP-monitoring program that aims to lower BP of community-dwelling older adults through senior center programming, is described and evaluated. KOT is based on a New York City (NYC) Department for the Aging program that has been in existence for more than 20 years and is evaluated in six senior centers in low- to middle-income neighborhoods in NYC. Program design includes monitoring sessions every other week to measure and record participant BP. BP education is provided using low-literacy materials, and medication adherence is encouraged. Over 6 months of observation, 244 participants enrolled (mean age 73). Of the 181 (74%) with hypertension at baseline, 92% were previously aware of their condition, 78% were treated, and 31% were controlled. BP control among the treated was 42%. Forty-three percent of enrollees (n=105) were multiple-visit participants who experienced on average a 3.9-mmHg reduction in systolic BP (SBP) between the first and last program visit (95% confidence interval (CI)=-7.6 to -0.1, P=.04). Participants with an initial SBP greater than 160 mmHg (n=20) experienced on average a 20.9-mmHg reduction in SBP (95% CI=-32.4 to -9.4, P<.001). Areas for program improvement include greater attention to peer counseling and timely communication with participants' healthcare providers. Volunteer-run, community-based BP monitoring in senior centers may provide an effective, replicable model for reducing BP in older adults.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

“…Visits, mean (range): 4.7(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) Months observed, mean ±SD= 3.8 ±1.Flow of Keep on Track program and participants from implementation to evaluation.…”

mentioning

confidence: 99%

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Keep on Track: A Volunteer‐Run Community‐Based Intervention to Lower Blood Pressure in Older Adults

Truncali

Dumanovsky²,

Stollman

et al. 2010

J American Geriatrics Society

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Implementation of Hypertension Treatment Recommendations

Shead¹

2011

PsycEXTRA Dataset

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There are currently lifestyle modifications and medications that are highly successful in controlling hypertension. Nevertheless, many hypertensive individuals do not implement lifestyle changes and fail to adhere to medication regimens (Fullwood et al., 2006;Wetzels et al., 2006). The current study sought to understand both sociodemographic and intrinsic factors associated with the implementation of recommended lifestyle modifications for treatment of hypertension. The study represents the first step in the application of the Information-Motivation-Behavioral Skills (IMB) model of health behavior and health promotion to hypertension. The primary goal was to provide a profile of the variables relevant for adherence to the multifaceted treatment recommendations for the hypertensive population. 151 participants, aged 55 to 79 with a hypertension diagnosis, completed questionnaires that assessed demographic and socioeconomic status, medical history, gross mental status, personality, self-efficacy, health locus of control, perceived social support, stage of change, and behavioral change since diagnosis of hypertension. The study examined the predictive power of these sociodemographic and intrinsic variables on the recommended lifestyle modifications (medication adherence, physical activity, diet, weight reduction or maintenance of normal weight, moderation of alcohol consumption, and smoking status), as well as total change. The results show there was no set of sociodemographic or intrinsic factors that predicted implementation of all lifestyle modifications. Although age and socioeconomic status are significant risk factors for hypertension, neither was found to be significant indicators of change. It was found that for most modifications there were intrinsic factors that had limited predictive power. Perceived instrumental social support, Conscientiousness, and Neuroticism were iii predictive of physical activity levels; perceived emotional social support and Conscientiousness were predictive of a healthy diet; and perceived emotional social support and Neuroticism were predictive of total change. In addition, a healthy diet was associated with increased physical activity, lower body mass index (BMI), and greater overall change. Hypertensive patients were also more likely to implement dietary change than other lifestyle modifications. Overall, hypertensive patients are not consistently implementing the recommended behavioral modifications, and despite reported adherence to medication regimens, their blood pressure and BMI on average remain above recommended levels. The study revealed that overall intrinsic factors do play a role in implementation of behavioral recommendations, and that the personality factors of Conscientiousness and Neuroticism along with perceived social support may be important factors to consider when addressing health-related change behavior. In the future these findings could provide researchers with individualized motivation to change information and assist in developing more individualized ...

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Nurse-led care interventions for high blood pressure control: Implications for non-communicable disease programs in Uganda

Katende

Becker

2016

International Journal of Africa Nursing Sciences

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Role of community programs in controlling blood pressure

Cited by 13 publications

References 26 publications

Keep on Track: A Volunteer‐Run Community‐Based Intervention to Lower Blood Pressure in Older Adults

Keep on Track: A Volunteer‐Run Community‐Based Intervention to Lower Blood Pressure in Older Adults

Implementation of Hypertension Treatment Recommendations

Nurse-led care interventions for high blood pressure control: Implications for non-communicable disease programs in Uganda

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