Church-Based Intervention Aims to Reduce Blood Pressure in African Americans
The Heart-to-Heart (H2H) study is a significant church-based intervention aimed at reducing blood pressure (BP) among African American adults with uncontrolled hypertension. This innovative program is structured around a behavioral cluster randomized trial, incorporating a cross-over design to ensure all participants benefit from both the H2H lifestyle education program and a financial education program over a 12-month period.
Program Components:
- H2H Lifestyle Education Program: Participants engage in 24 weekly virtual sessions led by dietitians, focusing on healthy eating habits and lifestyle changes. These sessions are complemented by 12 Bible studies that reinforce positive dietary behaviors from a biblical perspective, led by church pastors.
- Self-Monitoring of Blood Pressure: Participants are encouraged to monitor their BP daily, using cellular-enabled devices provided at the start of the program. This data is transmitted to study staff for monitoring and intervention if necessary.
- Community Health Worker Support: For participants struggling with medication adherence or those who do not achieve sufficient BP reduction through lifestyle changes alone, one-on-one support from a community health worker is available.
- Financial Education Program: Serving as the comparator, this program offers 14 virtual sessions on financial literacy, alongside Bible studies focusing on the biblical basis of good financial management.
Study Design and Implementation: The study aims to enroll approximately 272 participants across 34 churches, randomized to either start with the H2H program or the financial education program. The primary outcome measure is the change in systolic BP at 6 months, with follow-up assessments at 12 months. Secondary outcomes include medication adherence, dietary adherence, self-efficacy for hypertension self-care, and financial knowledge and behaviors.
Background and Significance: African Americans have the highest rates of hypertension worldwide, making interventions like H2H crucial for addressing health disparities. The program not only targets the behavioral aspects contributing to uncontrolled BP but also addresses systemic issues such as mistrust in healthcare systems by leveraging the trusted institution of the Black church.
Conclusion: The H2H study represents a comprehensive approach to reducing BP in a high-risk population, combining lifestyle education, spiritual support, and practical financial education. By addressing both the physical and socio-economic factors influencing health, the program aims to make a significant impact on the well-being of African American communities.