New grant investigates BP control in low-income, black patients in primary care

A $9.4 million grant from the Patient-Centered Outcomes Research Institute awarded to the University of Alabama at Birmingham will fund a trial to investigate ways to improve BP among black people of low socioeconomic status in the Southeast, according to a press release.

The trial, “Collaboration to Improve Blood Pressure in the U.S. Black Belt — Addressing the Triple Threat,” will be a collaborative effort between the University of Alabama, the University of North Carolina and East Carolina University.

“It is uncommon to find an African-American middle-aged or older person with diabetes who does not also have high blood pressure. The poor outcomes of diabetes are accelerated in the presence of uncontrolled blood pressure, so it is very important to pay attention to both, along with cholesterol. We have learned over the last 20 years that blood pressure and cholesterol in diabetes patients is as important as attending to blood sugar in optimizing the overall health of these patients,” Monika Safford, MD, professor of diabetes prevention and outcomes research, University of Alabama, said in a press release.

The “Black Belt” region of the United States extends from eastern Texas to Maryland, and includes many minority individuals that live in rural areas and are of low socioeconomic status. These individuals, known as “triple threats,” are most likely to have poor health outcomes, according to the release.

The trial will utilize practice facilitation and peer coaching in primary care practices to try improving patients’ cardiovascular risk factors. Finalization of practice facilitation and peer coaching interventions will be done collaboratively with primary care practices within rural locations, patients with hypertension, peer coaches and community advisory board members in both Alabama and North Carolina.

Safford and colleagues hope to enroll 80 practices, with 25 black patients with hypertension from each practice. Additionally, they will establish scalability of intervention success to use for future implementation.

“In many cases, patients do not have a good understanding of what is needed to optimize their health. Patients may not understand the need for frequent blood pressure checks, and therefore skip doctor visits. Or, they may not understand how to take their medication, or not know what the medications are supposed to do, so they don’t take them. The goal would be get more patients to take medications as directed, and to self-monitor their blood pressure,” Safford said in the release.