HypertensionNCT03515005
Using Lay Health Advisors to Improve Hypertension Management
A study testing Lay Health Advisor in people with Hypertension, run by MetroHealth Medical Center at 1 site in United States.
Trial summary
Hypertension disproportionately affects and is inadequately controlled among African American and poor populations. The investigators propose to determine the impact of using trained lay health advisors to help patients address social contextual factors that influence the management of hypertension. Read more about this study
- Who is it for?
- Ages 18 to 64 years
- Conditions the study is for
- Hypertension
- What is being tested?
- Lay Health Advisor
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 69 participants
- Where
- 1 siteUnited States
- Study dates
- 3 Dec 2018to 1 Sep 2019
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 64 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- At least 2 outpatient blood pressures with systolic >140 or diastolic >90 mm Hg in last 6 months. Separate occurrences at least 1 day apart
- Age 18-59 years
- Non-diabetic
- Preserved kidney function (glomerular filtration rate >60 ml/min)
- English speaking
Who cannot join
- Mentally incompetent
- Pregnant
- Terminal illness
- Active substance abuse
- Documented coronary, peripheral arterial, or cerebrovascular disease
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Using Lay Health Advisors to Help African Americans Address the Social Context of Hypertension Management
Hypertension disproportionately affects and is inadequately controlled among African American and poor populations. The investigators propose to determine the impact of using trained lay health advisors to help patients address social contextual factors that influence the management of hypertension.
Read the detailed description
Hypertension disproportionately affects and is inadequately controlled among African American and poor populations. Health providers generally lack the skills and resources to address social contextual factors (i.e. health and community services, social networks, social stressors, physical environment, and economic resources) that influence management of hypertension. Instead, providers tend to focus on adjusting antihypertensive medication prescriptions and exhorting patients to exercise and eat better. The investigators propose to determine the impact of using trained lay health advisors to help patients address social contextual factors that influence the management of hypertension. Helping patients address these barriers may lead not only to improved blood pressure but also to increased survival, reduced organ damage, and decreased health care costs. This project may also serve as a model of healthcare delivery innovation that could be used to address other health disparity conditions.
- Conditions
- Hypertension
- Being tested
- Lay Health Advisor
- Keywords
- Hypertension, Community Health Workers, Community-Based Participatory Research, Health Equity
- Medical subject headings
- Hypertension
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Lay Health AdvisorBehavioural
Patients will meet regularly Lay Health Advisors who will address the social context of their hypertension.
| Study group | Role | What they receive |
|---|---|---|
| Lay Health Advisors | Experimental | Intervention patients will meet monthly in small groups with a trained Lay Health Advisor. Receives: Behavioral: Lay Health Advisor |
| Usual Care | No intervention | Control patients will receive usual care from their doctors. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in systolic and diastolic blood pressure
Difference between final and initial systolic and diastolic blood pressure readings
Measured: 1 year
Secondary outcomes (1)
Change in quality of life.
Differences in quality of life between final and initial measurements using the 12 item short form survey (SF-12). The SF-12 provides physical and mental health composite scores ranging from 0 (lowest level of health) to 100 (highest level of health)
Measured: 1 year
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 May 2018
- Study start3 Dec 2018
- Primary completion1 Sep 2019
- Study completion1 Sep 2019
Why it stopped: Enrollment target not reached
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (18)Papers the sponsor has linked to this study.
- Other trials for HypertensionStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 69 participants (actual)
Sponsor and investigators
- Lead sponsor
- MetroHealth Medical Center
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Daryl Thornton, MD, MetroHealth Medical Center
- Investigators
- John D Thornton, MD, MPH, Principal investigator, MetroHealth System, Ohio
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03515005
- Sponsor's protocol ID
- IRB18-00038
- Status last verified
- Apr 2021
- First submitted
- 29 Mar 2018
- Last updated
- 14 Apr 2021
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Egan BM, Li J, Hutchison FN, Ferdinand KC. Hypertension in the United States, 1999 to 2012: progress toward Healthy People 2020 goals. Circulation. 2014 Nov 4;130(19):1692-9. doi: 10.1161/CIRCULATIONAHA.114.010676. Epub 2014 Oct 20.
PubMed 25332288James SA, Van Hoewyk J, Belli RF, Strogatz DS, Williams DR, Raghunathan TE. Life-course socioeconomic position and hypertension in African American men: the Pitt County Study. Am J Public Health. 2006 May;96(5):812-7. doi: 10.2105/AJPH.2005.076158. Epub 2006 Mar 29.
PubMed 16571689Matthews KA, Kiefe CI, Lewis CE, Liu K, Sidney S, Yunis C; Coronary Artery Risk Development in Young Adults Study (CARDIA). Socioeconomic trajectories and incident hypertension in a biracial cohort of young adults. Hypertension. 2002 Mar 1;39(3):772-6. doi: 10.1161/hy0302.105682.
PubMed 11897761Cook S, Drum ML, Kirchhoff AC, Jin L, Levie J, Harrison JF, Lippold SA, Schaefer CT, Chin MH. Providers' assessment of barriers to effective management of hypertension and hyperlipidemia in community health centers. J Health Care Poor Underserved. 2006 Feb;17(1):70-85. doi: 10.1353/hpu.2006.0021.
PubMed 16520513Mercuri M, Sherbino J, Sedran RJ, Frank JR, Gafni A, Norman G. When guidelines don't guide: the effect of patient context on management decisions based on clinical practice guidelines. Acad Med. 2015 Feb;90(2):191-6. doi: 10.1097/ACM.0000000000000542.
PubMed 25354075Borzecki AM, Oliveria SA, Berlowitz DR. Barriers to hypertension control. Am Heart J. 2005 May;149(5):785-94. doi: 10.1016/j.ahj.2005.01.047. No abstract available.
PubMed 15894958Hill MN, Bone LR, Hilton SC, Roary MC, Kelen GD, Levine DM. A clinical trial to improve high blood pressure care in young urban black men: recruitment, follow-up, and outcomes. Am J Hypertens. 1999 Jun;12(6):548-54. doi: 10.1016/s0895-7061(99)00007-2.
PubMed 10371363Dennison CR, Post WS, Kim MT, Bone LR, Cohen D, Blumenthal RS, Rame JE, Roary MC, Levine DM, Hill MN. Underserved urban african american men: hypertension trial outcomes and mortality during 5 years. Am J Hypertens. 2007 Feb;20(2):164-71. doi: 10.1016/j.amjhyper.2006.08.003.
PubMed 17261462Rose LE, Kim MT, Dennison CR, Hill MN. The contexts of adherence for African Americans with high blood pressure. J Adv Nurs. 2000 Sep;32(3):587-94. doi: 10.1046/j.1365-2648.2000.01538.x.
PubMed 11012800Russell E, Johnson B, Larsen H, Novilla ML, van Olmen J, Swanson RC. Health systems in context: a systematic review of the integration of the social determinants of health within health systems frameworks. Rev Panam Salud Publica. 2013 Dec;34(6):461-7.
PubMed 24569976Wong K, Smalarz A, Wu N, Boulanger L, Wogen J. The association between hypertension-specific care management processes and blood pressure outcomes in US-based physician organizations. J Am Soc Hypertens. 2011 Nov-Dec;5(6):505-12. doi: 10.1016/j.jash.2011.08.002. Epub 2011 Oct 1.
PubMed 21958468Jackson EJ, Parks CP. Recruitment and training issues from selected lay health advisor programs among African Americans: a 20-year perspective. Health Educ Behav. 1997 Aug;24(4):418-31. doi: 10.1177/109019819702400403.
PubMed 9247822Dye CJ, Williams JE, Evatt JH. Improving hypertension self-management with community health coaches. Health Promot Pract. 2015 Mar;16(2):271-81. doi: 10.1177/1524839914533797. Epub 2014 May 16.
PubMed 24837989Margolius D, Bodenheimer T, Bennett H, Wong J, Ngo V, Padilla G, Thom DH. Health coaching to improve hypertension treatment in a low-income, minority population. Ann Fam Med. 2012 May-Jun;10(3):199-205. doi: 10.1370/afm.1369.
PubMed 22585883Brownstein JN, Chowdhury FM, Norris SL, Horsley T, Jack L Jr, Zhang X, Satterfield D. Effectiveness of community health workers in the care of people with hypertension. Am J Prev Med. 2007 May;32(5):435-47. doi: 10.1016/j.amepre.2007.01.011.
PubMed 17478270
Study at a glance
From the registry record, last updated by the sponsor on 14 Apr 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Using Lay Health Advisors to Help African Americans Address the Social Context of Hypertension Management
- ClinicalTrials.gov ID
- NCT03515005
- Acronym / sponsor ID
- IRB18-00038
- Conditions
- Hypertension
- Keywords
- Hypertension, Community Health Workers, Community-Based Participatory Research, Health Equity
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Enrollment target not reached
- Enrolment
- 69 participants (actual)
- Lead sponsor
- MetroHealth Medical CenterUniversity, hospital or other
- Study start
- 3 Dec 2018 (actual)
- Primary completion
- 1 Sep 2019 (actual)
- Study completion
- 1 Sep 2019 (actual)
- First posted
- 3 May 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Hypertension disproportionately affects and is inadequately controlled among African American and poor populations. The investigators propose to determine the impact of using trained lay health advisors to help patients address social contextual factors that influence the management of hypertension.
Detailed description
Hypertension disproportionately affects and is inadequately controlled among African American and poor populations. Health providers generally lack the skills and resources to address social contextual factors (i.e. health and community services, social networks, social stressors, physical environment, and economic resources) that influence management of hypertension. Instead, providers tend to focus on adjusting antihypertensive medication prescriptions and exhorting patients to exercise and eat better. The investigators propose to determine the impact of using trained lay health advisors to help patients address social contextual factors that influence the management of hypertension. Helping patients address these barriers may lead not only to improved blood pressure but also to increased survival, reduced organ damage, and decreased health care costs. This project may also serve as a model of healthcare delivery innovation that could be used to address other health disparity conditions.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Lay Health Advisors | Experimental | Behavioral: Lay Health AdvisorIntervention patients will meet monthly in small groups with a trained Lay Health Advisor. |
| Usual Care | No intervention | –Control patients will receive usual care from their doctors. |
Who may qualify
- Ages
- 18 to 64 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- At least 2 outpatient blood pressures with systolic >140 or diastolic >90 mm Hg in last 6 months. Separate occurrences at least 1 day apart
- Age 18-59 years
- Non-diabetic
- Preserved kidney function (glomerular filtration rate >60 ml/min)
- English speaking
Key exclusion criteria (5 listed)
- Mentally incompetent
- Pregnant
- Terminal illness
- Active substance abuse
- Documented coronary, peripheral arterial, or cerebrovascular disease
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Lay Health AdvisorPatients will meet regularly Lay Health Advisors who will address the social context of their hypertension. | Behavioural | Lay Health Advisors |
Primary outcome
Change in systolic and diastolic blood pressure
Time frame: 1 year
Difference between final and initial systolic and diastolic blood pressure readings
1 secondary outcome
Change in quality of life.
Time frame: 1 year
Results and safety
The study was stopped early (reason given: Enrollment target not reached). Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Apr 2021.
- Background: PubMed 25332288Egan BM, Li J, Hutchison FN, Ferdinand KC. Hypertension in the United States, 1999 to 2012: progress toward Healthy People 2020 goals. Circulation. 2014 Nov 4;130(19):1692-9. doi: 10.1161/CIRCULATIONAHA.114.010676. Epub 2014 Oct 20.
- Background: PubMed 16571689James SA, Van Hoewyk J, Belli RF, Strogatz DS, Williams DR, Raghunathan TE. Life-course socioeconomic position and hypertension in African American men: the Pitt County Study. Am J Public Health. 2006 May;96(5):812-7. doi: 10.2105/AJPH.2005.076158. Epub 2006 Mar 29.
- Background: PubMed 11897761Matthews KA, Kiefe CI, Lewis CE, Liu K, Sidney S, Yunis C; Coronary Artery Risk Development in Young Adults Study (CARDIA). Socioeconomic trajectories and incident hypertension in a biracial cohort of young adults. Hypertension. 2002 Mar 1;39(3):772-6. doi: 10.1161/hy0302.105682.
- Background: PubMed 16520513Cook S, Drum ML, Kirchhoff AC, Jin L, Levie J, Harrison JF, Lippold SA, Schaefer CT, Chin MH. Providers' assessment of barriers to effective management of hypertension and hyperlipidemia in community health centers. J Health Care Poor Underserved. 2006 Feb;17(1):70-85. doi: 10.1353/hpu.2006.0021.
- Background: PubMed 25354075Mercuri M, Sherbino J, Sedran RJ, Frank JR, Gafni A, Norman G. When guidelines don't guide: the effect of patient context on management decisions based on clinical practice guidelines. Acad Med. 2015 Feb;90(2):191-6. doi: 10.1097/ACM.0000000000000542.
- Background: PubMed 15894958Borzecki AM, Oliveria SA, Berlowitz DR. Barriers to hypertension control. Am Heart J. 2005 May;149(5):785-94. doi: 10.1016/j.ahj.2005.01.047. No abstract available.
- Background: PubMed 10371363Hill MN, Bone LR, Hilton SC, Roary MC, Kelen GD, Levine DM. A clinical trial to improve high blood pressure care in young urban black men: recruitment, follow-up, and outcomes. Am J Hypertens. 1999 Jun;12(6):548-54. doi: 10.1016/s0895-7061(99)00007-2.
- Background: PubMed 17261462Dennison CR, Post WS, Kim MT, Bone LR, Cohen D, Blumenthal RS, Rame JE, Roary MC, Levine DM, Hill MN. Underserved urban african american men: hypertension trial outcomes and mortality during 5 years. Am J Hypertens. 2007 Feb;20(2):164-71. doi: 10.1016/j.amjhyper.2006.08.003.
- Background: PubMed 11012800Rose LE, Kim MT, Dennison CR, Hill MN. The contexts of adherence for African Americans with high blood pressure. J Adv Nurs. 2000 Sep;32(3):587-94. doi: 10.1046/j.1365-2648.2000.01538.x.
- Background: PubMed 24569976Russell E, Johnson B, Larsen H, Novilla ML, van Olmen J, Swanson RC. Health systems in context: a systematic review of the integration of the social determinants of health within health systems frameworks. Rev Panam Salud Publica. 2013 Dec;34(6):461-7.
- Background: PubMed 21958468Wong K, Smalarz A, Wu N, Boulanger L, Wogen J. The association between hypertension-specific care management processes and blood pressure outcomes in US-based physician organizations. J Am Soc Hypertens. 2011 Nov-Dec;5(6):505-12. doi: 10.1016/j.jash.2011.08.002. Epub 2011 Oct 1.
- Background: PubMed 9247822Jackson EJ, Parks CP. Recruitment and training issues from selected lay health advisor programs among African Americans: a 20-year perspective. Health Educ Behav. 1997 Aug;24(4):418-31. doi: 10.1177/109019819702400403.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
John D Thornton, MD, MPH principal investigator
MetroHealth System, Ohio
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Lay Health Advisor in people with Hypertension, run by MetroHealth Medical Center at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 14 Apr 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study was stopped early (reason given: Enrollment target not reached). Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in systolic and diastolic blood pressure (time frame: 1 year). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03515005, which also lists 18 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Apr 2021.