4.3 Article

Lessons from implementing community-based group classes for severe hypertension

Journal

PUBLIC HEALTH NURSING
Volume 38, Issue 4, Pages 675-679

Publisher

WILEY
DOI: 10.1111/phn.12881

Keywords

blood pressure; community health centers; health promotion; hypertension; minority health; peer group

Funding

  1. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion/Division for Heart Disease and Stroke Prevention, Program Development and Services Branch [NU38OT000289]
  2. American College of Preventive Medicine, an award from the Lincoln Community Health Center Foundation
  3. Duke University School of Nursing
  4. Duke National Clinician Scholars Program

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Peer-based education can improve blood pressure monitoring and control in Black men with hypertension. The implementation of community-based group classes for severe hypertension at a Federally Qualified Health Center showed promising results in terms of engagement and satisfaction among participants, with a majority of attendees being Black men.
Due to the impact of persistent structural racism, Black men have low rates of hypertension treatment and control despite having high rates of hypertension-related mortality. Peer-based education can improve blood pressure monitoring and lower blood pressure in Black men with hypertension. To address this disparity, we implemented weekly community-based group classes for severe hypertension at a Federally Qualified Health Center. After 9 months, 28 classes were held and 96 individuals were served. Fifty-six percent of the person-hours of attendance have been by Black men. Seven individuals were interviewed about their perspectives and preferences for the classes. They reported that the peer-based model of the group classes was advantageous, and they would recommend the classes to a friend. Successes of implementation included (a) ability to facilitate medication adjustments for participants with blood pressure readings that were over target goal, (b) capacity to give participants take-home blood pressure monitors, (c) and the community-centered approach. Challenges included variability in attendance by participants and retention of individuals with uncontrolled hypertension in primary care. These findings have implications for other Federally Qualified Health Centers seeking to design similar health promotion programs and policy makers evaluating the funding and reimbursement models for community-based disease management programs.

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