Design and rationale of the cardiometabolic health program linked with community health workers and mobile health telemonitoring to reduce health disparities (LINKED-HEARTS) program.

Autor: Commodore-Mensah Y; Johns Hopkins University School of Nursing, Baltimore, MD; Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD., Chen Y; Johns Hopkins University School of Nursing, Baltimore, MD., Ogungbe O; Johns Hopkins University School of Nursing, Baltimore, MD., Liu X; Johns Hopkins University School of Nursing, Baltimore, MD., Metlock FE; Johns Hopkins University School of Nursing, Baltimore, MD., Carson KA; Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Johns Hopkins University School of Medicine, Baltimore, MD., Echouffo-Tcheugui JB; Johns Hopkins University School of Medicine, Baltimore, MD., Ibe C; Johns Hopkins University School of Medicine, Baltimore, MD., Crews D; Johns Hopkins University School of Medicine, Baltimore, MD; Johns Hopkins University Medical Institutions, Baltimore, MD., Cooper LA; Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Johns Hopkins University School of Medicine, Baltimore, MD., Himmelfarb CD; Johns Hopkins University School of Nursing, Baltimore, MD; Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: chimmelfarb@jhu.edu.
Jazyk: angličtina
Zdroj: American heart journal [Am Heart J] 2024 Sep; Vol. 275, pp. 9-20. Date of Electronic Publication: 2024 May 15.
DOI: 10.1016/j.ahj.2024.05.008
Abstrakt: Background: Hypertension and diabetes are major risk factors for cardiovascular diseases, stroke, and chronic kidney disease (CKD). Disparities in hypertension control persist among Black and Hispanic adults and persons living in poverty in the United States. The "LINKED-HEARTS Program" (a Cardiometabolic Health Program LINKED with Community Health WorkErs and Mobile HeAlth TelemonitoRing To reduce Health DisparitieS"), is a multi-level intervention that includes home blood pressure (BP) monitoring (HBPM), blood glucose telemonitoring, and team-based care. This study aims to examine the effect of the LINKED-HEARTS Program intervention in improving BP control compared to enhanced usual care (EUC) and to evaluate the reach, adoption, sustainability, and cost-effectiveness of the program.
Methods: Using a hybrid type I effectiveness-implementation design, 428 adults with uncontrolled hypertension (systolic BP ≥ 140 mm Hg) and diabetes or CKD will be recruited from 18 primary care practices, including community health centers, in Maryland. Using a cluster-randomized trial design, practices are randomly assigned to the LINKED-HEARTS intervention arm or EUC arm. Participants in the LINKED-HEARTS intervention arm receive training on HBPM, BP and glucose telemonitoring, and community health worker and pharmacist telehealth visits on lifestyle modification and medication management over 12 months. The primary outcome is the proportion of participants with controlled BP (<140/90 mm Hg) at 12 months.
Conclusions: The study tests a multi-level intervention to control multiple chronic diseases. Findings from the study may be leveraged to reduce disparities in the management and control of chronic diseases and make primary care more responsive to the needs of underserved populations.
Trial Registration: ClinicalTrials.gov. Identifier: NCT05321368.
Competing Interests: Conflict of interest The authors declare they have no financial interests. The authors have no conflict of interest to declare.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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