Community Partnership to Examine Racial and Ethnic Differences in Health Care for Hypertension and Diabetes (CHAMPP)

Community, Health Center, and Academic Medicine Partnership Project (CHAMPP)

Hypertension and diabetes are among the most common chronic diseases in the United States. Racial and ethnic minority groups are more at risk for these diseases than the Caucasian population. This study will attempt to identify factors that contribute to racial and ethnic differences in hypertension and diabetes care among minority patients of community health centers (CHCs). This information will be used to design and implement programs to improve quality of care in these communities.

Study Overview

• Status: Completed
• Conditions: Hypertension; Diabetes Mellitis
• Intervention / Treatment: Behavioral: Patient Education and Support; Behavioral: Medical Practice Improvement; Other: Combination Intervention to Include Medical Practice Improvement and Patient Education and Support

Detailed Description

Hypertension and diabetes are the primary contributors to today's high rates of heart disease and stroke, which are the first and third leading causes of death in the United States, respectively. African Americans and Hispanics have a higher risk of developing hypertension and diabetes than do Caucasians. They are also less likely to know that they have high blood pressure, are more prone to organ damage, and are more likely to die as a result of these chronic conditions. A significant number of African Americans and Hispanics are uninsured and receive care through publicly supported CHCs. It is important to identify factors that contribute to healthcare differences among the lower income, uninsured, and minority populations that are typically served by CHCs. In this study, a collaborative partnership will be developed between CHCs, health service research organizations, and academic researchers. The goal of the study is to examine the barriers that minority CHC patients face in receiving appropriate hypertension and diabetes care.

This study will develop a collaborative partnership between various health organizations and seven CHCs located in Boston neighborhoods that have a large percentage of African American and Hispanic residents. Researchers will conduct focus groups with CHC patients who are receiving care for hypertension or diabetes. CHC staff members will be interviewed to collect information regarding the relationship between CHC organizational structure and disparities in heart disease risk factors among minority patients with hypertension or diabetes. Researchers will then develop, implement, and evaluate a patient- and CHC-focused intervention aimed at reducing the cardiovascular risks of minority patients at four CHCs in Boston.

• Study Type: Interventional
• Enrollment (Anticipated): 1204
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Massachusetts
    • Boston, Massachusetts, United States, 02115
      • Harvard Medical School
    • Boston, Massachusetts, United States, 02118
      • Center for Community Health Education, Research, and Service

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Diabetes
• Hypertension, as diagnosed by the average of two or more blood pressure measurements taken during two or more study visits following an initial screening
• Race is 'Black' or ethnicity is 'Hispanic'
• Patient at participating Community Health Center

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Non-Randomized
• Interventional Model: Factorial Assignment
• Masking: None (Open Label)

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: A; Patient-based intervention	Behavioral: Patient Education and Support; The details for the patient education and support intervention will be decided at a later date.
Active Comparator: B; Health center-based intervention	Behavioral: Medical Practice Improvement; The details for the medical practice improvement intervention will be decided at a later date.
Active Comparator: C; Combination of patient and health center-based intervention	Other: Combination Intervention to Include Medical Practice Improvement and Patient Education and Support; The details for this combination intervention will be decided at a later date.
No Intervention: D; Control group: Neither patient-based nor center-based intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Potential outcomes for the future intervention include systolic blood pressure, diastolic blood pressure, and hemoglobin A1c	Measured from June to August 2008

Collaborators and Investigators

• Sponsor: Harvard Medical School (HMS and HSDM)
• Collaborators: National Heart, Lung, and Blood Institute (NHLBI)
• Investigators: Principal Investigator: LeRoi S. Hicks, MD, MPH, Harvard Medical School (HMS and HSDM); Study Director: Thomas Keegan, PhD, Harvard Medical School (HMS and HSDM)

Publications and helpful links

General Publications

• Ndumele CD, Ableman G, Russell BE, Gurrola E, Hicks LS. Publication of recruitment methods in focus group research of minority populations with chronic disease: a systematic review. J Health Care Poor Underserved. 2011 Feb;22(1):5-23. doi: 10.1353/hpu.2011.0031.
• Russell BE, Gurrola E, Ndumele CD, Landon BE, O'Malley JA, Keegan T, Ayanian JZ, Hicks LS; Community Health and Academic Medicine Partnership Project. Perspectives of non-Hispanic Black and Latino patients in Boston's urban community health centers on their experiences with diabetes and hypertension. J Gen Intern Med. 2010 Jun;25(6):504-9. doi: 10.1007/s11606-010-1278-0. Epub 2010 Feb 24.
• Ndumele CD, Russell BE, Ayanian JZ, Landon BE, Keegan T, O'Malley AJ, Hicks LS. Strategies to improve chronic disease management in seven metro Boston community health centers. Prog Community Health Partnersh. 2009 Fall;3(3):203-11. doi: 10.1353/cpr.0.0080.

Study record dates

Study Major Dates

• Study Start: October 1, 2009
• Primary Completion (Actual): May 1, 2010
• Study Completion (Actual): May 1, 2010

Study Registration Dates

• First Submitted: September 20, 2006
• First Submitted That Met QC Criteria: September 20, 2006
• First Posted (Estimate): September 22, 2006

Study Record Updates

• Last Update Posted (Estimate): January 11, 2023
• Last Update Submitted That Met QC Criteria: January 9, 2023
• Last Verified: January 1, 2023

More Information

Terms related to this study

• Keywords: Diabetes; Blood Pressure, High; Community Health Centers
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Hypertension
• Other Study ID Numbers: 410; R21HL083859-01 (U.S. NIH Grant/Contract); 1R21HL083859-01 (U.S. NIH Grant/Contract)