- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT02321618
Cut Your Pressure Too: The Los Angeles Barbershop Blood Pressure Study
Barber-Pharmacist Coordination to Improve Blood Pressure Management in Black Men
African-American men suffer more than most other groups from hypertension (HTN) but often have less access and less contact with doctors. Previous work by the study's Principal Investigator in Dallas, Texas, and Altadena, California, showed that barbershops are an excellent place to identify black men with high blood pressure and to enlist the aid of their barbers as healthcare extenders.
The purpose of this study in Metro Los Angeles (LA) is to compare two types of barber-based patient-centered blood pressure programs to see which type is more effective in improving the customers' high blood pressure. One type emphasizes blood pressure medication and the other type emphasizes lifestyle modification for high blood pressure.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
Uncontrolled hypertension (HTN) is one of the most important causes of premature disability and death among non-Hispanic black men. Indeed, black men have the highest HTN death rate of any U.S. race, ethnic, or gender group, contributing to a lower life expectancy. The age-adjusted HTN-related death rate is 3.3-times higher among black men than white men. To address this major health disparity, the investigators designed a novel community-partnered team approach to improve HTN management among black men and prevent needless strokes, heart attacks, kidney failure, and heart failure.
HTN requires physician (or middle-level provider) interaction to optimize blood pressure (BP) medication; black men have less interaction than black women; and thus far lower rates of HTN treatment (73% vs. 86%) and control (36% vs. 50%). Black-owned barbershops are a uniquely personal setting to discuss health with influential male peers. Barbershop health outreach is well-established, but untested as a vehicle for improving HTN control. Scientific evaluation is crucial to best allocate finite healthcare dollars and avoid promoting a "community health industry" that benefits only the promoters.
Under-treatment of HTN is common in primary care due to competing demands on physicians' time. The best way to improve HTN control is with team-based approaches enlisting pharmacists. They are more accessible than physicians, more knowledgeable about medication, and receive training on patient education. The investigators' new conceptual model links the barber-based intervention to team-based care delivery.
The purpose of this research study is to compare this new conceptual model to another barber-based patient-centered blood pressure program to see which is more effective in improving high blood pressure among Black patrons of African American owned barbershops in LA. Patrons randomized to Group 1 (the new conceptual model) will provide blood pressure readings for patrons aged 35 to 79 years of age and refer those with HTN to a Clinical Pharmacist to work with their doctors in optimizing blood pressure medication.
Patrons of Group 1 shops will also be exposed to role model posters are not intended as recruitment materials, but rather are educational tools that intend to highlight positive experiences of participation. The text of the role model stories will in no way provide statements of the effectiveness of the intervention being evaluated by the present research study. Rather, they are the main health messaging tools needed to promote completion of the program in order to achieve the experiences described. Essentially the document will be used as an intervention tool for peer-based health messaging - stories from real customers in the barbershop modeling target behaviors leading that promote continued participation in the protocol by peers with the hopes of achieving to the detection, treatment, and control of high blood pressure. Each role model story will encourage one of two desired health behaviors of potential subjects with elevated BP: 1) ask the barber to check patients' BP with each haircut, 2) schedule a follow-up visit with the study pharmacist to get patient's blood pressure under control. Large posters in the barbershop will show the model customer, his barber, and the study pharmacist who facilitated the desired behavior change. The model's (participants) own words will be used on the poster.
Group 2 barbershop patrons will be exposed to up-to-date information on high blood pressure and on lifestyle topics for blood pressure and heart health including weight management, healthy cooking, cholesterol lowering, and exercise.
A pre-specified cross-sectional sub study utilized the trial's initial screening population to test for an association between self-reported nocturia (>2 nightly/voids) and elevated daytime (in-barbershop) blood pressure.
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
-
-
California
-
Los Angeles, California, Forenede Stater, 90048
- Cedars-Sinai Medical Center
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- 35 to 79 years of age
- Non-Hispanic Black men
- Long-term/frequent barbershop patronage (barbershop patrons having at least one haircut every 6 weeks in the same barbershop for the past 6 months).
- Systolic BP >140 at 2 screenings on 2 separate days
- Complete set of Baseline Data
Exclusion Criteria:
- Women
- Children
- <35 years of age
- Non-black
- Hispanic ethnicity
- New/infrequent patronage (<8 haircuts at same barbershop in last 12 months)
- Systolic BP <140 at either screening
- Currently receiving cancer chemotherapy
- On Dialysis
- Incomplete baseline data
- Serious Plan to Move in the next 1.5 years
- Plans to be out of the area for > 1 month in the next 1.5 years
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
---|---|
Eksperimentel: BP measurement & pharmacy
BP measurements performed by barber, role model poster exposure in barbershop, and BP medication management visits with study pharmacist
|
Blood pressure monitoring by barber, blood pressure medication management by pharmacist, role model posters encouraging program participation
|
Andet: BP educational materials
Exposure to hypertension educational materials in barbershop
|
Exposure to hypertension educational materials
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
---|---|---|
Primary Blood Pressure Outcome - change in systolic blood pressure
Tidsramme: 6 months
|
The pre-specified primary outcome was the change in systolic blood pressure from baseline to 6 months follow-up.
|
6 months
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
---|---|---|
Secondary Blood Pressure Outcome - change in diastolic blood pressure
Tidsramme: 6 months
|
The change in diastolic blood pressure from baseline to 6 month follow-up
|
6 months
|
The percentage of participants achieving blood pressure goal
Tidsramme: 6 months
|
The percentage of participants who achieved blood pressure goal after 6 months follow-up (140/90,135/85, 130/80)
|
6 months
|
The change in number/type of drug classes prescribed
Tidsramme: 6 months
|
The change in number/class of prescription drugs prescribed from baseline to 6 month follow-up
|
6 months
|
Adverse Drug Reactions
Tidsramme: 6 months
|
The number and type of adverse drug reactions reported from baseline to 6 month follow-up
|
6 months
|
Self-Rated Health
Tidsramme: 6 months
|
The change in self-rated health score from baseline to 6 month follow-up
|
6 months
|
Self-Rated Patient Engagement
Tidsramme: 6 months
|
The change in PACIC patient engagement score from baseline to 6 month follow-up
|
6 months
|
Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
---|---|---|
Extension Study Primary Blood Pressure Outcome - change in systolic blood pressure
Tidsramme: 12 months
|
The primary outcome of the extension study is the change in systolic blood pressure from baseline to 12 months follow-up.
|
12 months
|
Extension Study Secondary Blood Pressure Outcome - change in diastolic blood pressure
Tidsramme: 12 months
|
The change in diastolic blood pressure from baseline to 12 month follow-up
|
12 months
|
Extension Study Secondary Outcome - the percentage of participants achieving blood pressure goal
Tidsramme: 12 months
|
The percentage of participants who achieved blood pressure goal after 12 months follow-up (140/90,135/85, 130/80)
|
12 months
|
Extension Study Secondary Outcome - the change in number/type of drug classes prescribed
Tidsramme: 12 months
|
The change in number/class of prescription drugs prescribed from baseline to 12 month follow-up
|
12 months
|
Extension Study Secondary Outcome - adverse drug reactions
Tidsramme: 12 months
|
The number and type of adverse drug reactions reported from baseline to 12 month follow-up
|
12 months
|
Extension Study Secondary Outcome - self-rated health
Tidsramme: 12 months
|
The change in self-rated health from baseline to 12 month follow-up
|
12 months
|
Extension Study Secondary Outcome - self-rated patient engagement
Tidsramme: 12 months
|
The change in PACIC patient engagement score from baseline to 12 month follow-up
|
12 months
|
Samarbejdspartnere og efterforskere
Sponsor
Samarbejdspartnere
Efterforskere
- Ledende efterforsker: Ronald G Victor, MD, Cedars-Sinai Medical Center
Publikationer og nyttige links
Generelle publikationer
- Victor RG, Li N, Blyler CA, Mason OR, Chang LC, Moy NPB, Rashid MA, Weiss JP, Handler J, Brettler JW, Sagisi MB, Rader F, Elashoff RM. Nocturia as an Unrecognized Symptom of Uncontrolled Hypertension in Black Men Aged 35 to 49 Years. J Am Heart Assoc. 2019 Mar 5;8(5):e010794. doi: 10.1161/JAHA.118.010794.
- Victor RG, Blyler CA, Li N, Lynch K, Moy NB, Rashid M, Chang LC, Handler J, Brettler J, Rader F, Elashoff RM. Sustainability of Blood Pressure Reduction in Black Barbershops. Circulation. 2019 Jan 2;139(1):10-19. doi: 10.1161/CIRCULATIONAHA.118.038165.
- Victor RG, Lynch K, Li N, Blyler C, Muhammad E, Handler J, Brettler J, Rashid M, Hsu B, Foxx-Drew D, Moy N, Reid AE, Elashoff RM. A Cluster-Randomized Trial of Blood-Pressure Reduction in Black Barbershops. N Engl J Med. 2018 Apr 5;378(14):1291-1301. doi: 10.1056/NEJMoa1717250. Epub 2018 Mar 12.
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- Pro00035347
- 5R01HL117983-02 (U.S. NIH-bevilling/kontrakt)
Plan for individuelle deltagerdata (IPD)
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Kliniske forsøg med Forhøjet blodtryk
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BayerAfsluttet
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National Taiwan University Hospital Hsin-Chu BranchRekrutteringHypertension, essentiel | Hypertension, maskeretTaiwan
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Sheffield Teaching Hospitals NHS Foundation TrustUniversity of SheffieldAfsluttetIdiopatisk pulmonal arteriel hypertension | Kronisk tromboembolisk pulmonal hypertensionDet Forenede Kongerige
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University of Kansas Medical CenterRekrutteringPulmonal arteriel hypertension | Pulmonal hypertension | Kronisk tromboembolisk pulmonal hypertension | Pulmonal hypertension på grund af venstre hjertesygdom | Pulmonal hypertension, primær, 4 | Pulmonal hypertension, primær, 2 | Pulmonal hypertension, primær, 3 | Pulmonal hypertension, primær | Pulmonal...Forenede Stater
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Papworth Hospital NHS Foundation TrustMerck Sharp & Dohme LLCAfsluttet
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Centre Chirurgical Marie LannelongueUkendtKronisk trombo-embolisk pulmonal hypertension og pulmonal arteriel hypertensionFrankrig
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University of South FloridaTrukket tilbagePulmonal arteriel hypertension | Familiær primær pulmonal hypertension | Idiopatisk pulmonal arteriel hypertension | Primær pulmonal hypertensionForenede Stater
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Heidelberg UniversityMerck Sharp & Dohme LLCRekrutteringKronisk tromboembolisk pulmonal hypertension | Primær pulmonal arteriel hypertensionTyskland
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Columbia UniversityAgency for Healthcare Research and Quality (AHRQ)Aktiv, ikke rekrutterendeWhite Coat Hypertension | Hypertension, essentielForenede Stater
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Amsterdam UMC, location VUmcZonMw: The Netherlands Organisation for Health Research and DevelopmentUkendt
Kliniske forsøg med BP measurement & pharmacy
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University Hospital, GhentUniversity GhentRekrutteringSund og rask | Skulderarthropati forbundet med andre tilstandeBelgien
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Chinese University of Hong KongAfsluttet
-
Cedars-Sinai Medical CenterNational Heart, Lung, and Blood Institute (NHLBI)AfsluttetForhøjet blodtrykForenede Stater
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University of MinnesotaMayo Clinic; University of Pennsylvania; University of Alabama at Birmingham og andre samarbejdspartnereAfsluttetForhøjet blodtrykForenede Stater
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Hospital General Universitario ElcheAfsluttet
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MGB Biopharma LimitedHammersmith Medicines Research; Innovate UK; Cambridge Regulatory Services; Phases Clinical Research Limited og andre samarbejdspartnereAfsluttetSund og rask
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Vanderbilt University Medical CenterAfsluttetBlodtryk | Sygelig fedme | Præeklampsi | FødendeForenede Stater
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University of Missouri-ColumbiaTilmelding efter invitationMetabolisk syndrom | Fedme, sygelig | NASH - Ikke-alkoholisk SteatohepatitisForenede Stater
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VA Office of Research and DevelopmentRekruttering
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University of California, San FranciscoAmerican Heart Association; American Medical Association; OCHIN, Inc.; Louisiana...Aktiv, ikke rekrutterendeForhøjet blodtrykForenede Stater