Cardiovascular Research Outreach Through Women's Beauty Networks (CROWN)
CROWN: Cardiovascular Research Outreach Through Women's Beauty Networks
CROWN is a two-arm, cluster-randomized Hybrid Type 2 effectiveness-implementation trial evaluating a multi-level, salon-based cardiovascular intervention among women with uncontrolled blood pressure. The intervention combines stylist-led blood pressure screening in beauty salons, home blood pressure monitoring with remote clinical oversight, community health worker coaching and social needs navigation, and clinical pharmacist medication management support.
Aperçu de l'étude
Statut
Statut
Les conditions
Les conditions
Intervention / Traitement
Intervention / Traitement
Description détaillée
CROWN is a cluster-randomized trial enrolling 16 beauty salons in the Baltimore-Washington Metropolitan Area, randomized 1:1 to the CROWN intervention or enhanced usual care in four staggered cohorts, with a 6-month active intervention period followed by a 6-month maintenance phase. In intervention salons, two stylists per salon are trained and certified as Heart Health Stylists to conduct blood pressure screenings at Heart Health Stations equipped with validated blood pressure devices and interactive educational tablets. Participants enrolled at intervention salons receive a home blood pressure monitor linked to the Luscii/Omron mobile app for remote monitoring. They also receive personalized coaching and social needs navigation from community health workers, and clinical pharmacist review with medication titration recommendations sent to their primary care clinicians. Participants at enhanced usual care salons receive a home blood pressure monitor, basic measurement instruction, and printed educational materials. Eligibility (women aged 18 to 75 years, self-reported hypertension and/or blood pressure ≥130/80 mmHg, regular salon client) will be confirmed through three standardized blood pressure measurements, medical history, medication review, and social needs assessment, conducted in private salon spaces or by phone. Assessments at baseline, 3, and 6 months include standardized blood pressure, weight, point-of-care hemoglobin A1c and lipid panels, and surveys on health behaviors, medication adherence, quality of life, and social needs. Participants will receive and keep their home monitor. Participants without a primary care provider will be linked to partner federally qualified health centers. The primary outcome is change in systolic blood pressure from baseline to 6 months. Secondary outcomes include blood pressure control rates, medication adherence, cardiovascular health behaviors, and social needs resolution. Implementation outcomes (reach, adoption, fidelity, and maintenance at 12 months) will be evaluated using the RE-AIM framework, alongside cost-effectiveness analysis and qualitative interviews with stylists, participants, salon owners, and clinical staff.
Type d'étude
Type d'étude
Inscription (Estimé)
Inscription
Phase
Phase
- N'est pas applicable
Contacts et emplacements
Coordonnées de l'étude
Coordonnées de l'étude
- Nom: Oluwabunmi Ogungbe, PhD, MPH, RN
- Numéro de téléphone: 4106141519
- E-mail: oogungb3@jh.edu
Sauvegarde des contacts de l'étude
- Nom: Yvonne Commodore-Mensah, PhD, MHS, RN
- Numéro de téléphone: 4106141519
- E-mail: ycommod1@jhmi.edu
Critères de participation
Critère d'éligibilité
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
Women are eligible if:
- Aged 18 to 75 years
- Self-reported diagnosis of hypertension and/or blood pressure ≥130/80 mmHg confirmed on repeat measurement
- Regular client at a participating salon, with at least two visits in the past 6 months
- Willing to complete follow-up assessments through 6 months
Exclusion Criteria:
Women are excluded if:
- Pregnant or planning pregnancy during the study period
- End-stage renal disease
- Have serious medical conditions limiting life expectancy to less than 12 months
- Currently participating in other cardiovascular intervention studies
- Have severe cognitive impairment, impeding informed consent
- Unable to operate blood pressure monitoring equipment after training
- Plan to relocate outside the study area within 6 months
- Have documented adverse reactions to blood pressure cuff usage.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: La prévention
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Nombre de bras
Armes et Interventions
Groupe de participants / BrasGroupe de participants / Bras |
Intervention / TraitementIntervention / Traitement |
|---|---|
|
Expérimental: CROWN Intervention Arm
Women enrolled at salons randomized to the intervention will receive the multi-level CROWN program for 6 months. It includes blood pressure screening and health education by trained Heart Health Stylists, home blood pressure monitoring with remote clinical oversight, community health worker coaching and social needs navigation, and clinical pharmacist medication management support. A 6-month maintenance phase with reduced study support follows. |
CROWN includes: 1. Heart Health Stations in each salon with a validated blood pressure device and tablet-based cardiovascular health education. 2. Blood pressure screening by stylists certified through a 7- to 8-week blended training program, with warm handoffs to community health workers. 3. Community health worker coaching, care coordination, and social needs screening and referral through The MEDI platform. 4. Clinical pharmacist review of home blood pressure trends, with medication titration recommendations sent to participants' primary care clinicians. 5. An Omron home blood pressure monitor linked to the Luscii app for remote monitoring with clinical escalation. Participants without a primary care provider are linked to partner federally qualified health centers. |
|
Comparateur actif: Enhanced Usual Care Arm
Women enrolled at salons randomized to enhanced usual care will receive in-salon blood pressure screening, a home blood pressure monitor with basic instruction, and printed cardiovascular health education materials. They will not receive community health worker coaching, pharmacist medication support, or care coordination. |
Enhanced usual care includes: 1. Blood pressure screening at the salon using a validated automated device by stylists who receive basic screening training. 2. An Omron home blood pressure monitor with basic instruction on proper measurement technique. 3. Printed educational handouts on cardiovascular health, medication adherence, and the importance of primary care follow-up. 4. A summary report of home blood pressure readings at study completion, with guidance on sharing results with their health care provider. Research staff will start the clinical escalation protocol for readings in the hypertensive urgency or emergency range. After the 6-month intervention period, salons will be offered CROWN training materials. |
Que mesure l'étude ?
Principaux critères de jugement
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Change in Systolic Blood Pressure
Délai: Baseline, 3 months, 6 months
|
Mean change in systolic blood pressure (mmHg) from baseline to 6 months, compared between CROWN and enhanced usual care arms. Blood pressure is measured with a validated automated device after 5 minutes of seated rest. Three readings are taken 1 minute apart, and the average of the second and third readings is used. |
Baseline, 3 months, 6 months
|
Mesures de résultats secondaires
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Blood Pressure Control
Délai: Baseline, 3 months, 6 months
|
Proportion of participants achieving blood pressure control, defined as systolic blood pressure <130 mmHg and diastolic blood pressure <80 mmHg, using the standardized measurement protocol. |
Baseline, 3 months, 6 months
|
|
Change in Diastolic Blood Pressure
Délai: Baseline, 3 months, 6 months
|
Mean change in diastolic blood pressure (mmHg) from baseline, using the standardized measurement protocol. |
Baseline, 3 months, 6 months
|
|
Change in Hemoglobin A1c
Délai: Baseline, 3 months, 6 months
|
Change in hemoglobin A1c (%) measured by finger-stick point-of-care testing. |
Baseline, 3 months, 6 months
|
|
Change in Lipid Panel
Délai: Baseline, 3 months, 6 months
|
Change in total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides (mg/dL) measured by finger-stick point-of-care testing. |
Baseline, 3 months, 6 months
|
|
Time to Blood Pressure Control
Délai: Baseline through 6 months
|
Time from enrollment to first achievement of blood pressure control (<130/80 mmHg). |
Baseline through 6 months
|
|
Change in Body Weight and Body Mass Index
Délai: Baseline, 3 months, 6 months
|
Change in body weight (kg) and body mass index (kg/m²) measured with calibrated equipment using standardized protocols. |
Baseline, 3 months, 6 months
|
|
Change in Medication Adherence
Délai: Baseline and 6 months
|
Measured with the Hill-Bone Compliance to High Blood Pressure Therapy Scale. Scores range from 14 to 56, and higher scores indicate poorer adherence. |
Baseline and 6 months
|
|
Change in Health-Related Quality of Life
Délai: Baseline and 6 months
|
Measured with the PROMIS-29 Profile. Domain scores are reported as T-scores (mean 50, SD 10). Higher scores indicate more of the domain measured, so higher is better for function domains and worse for symptom domains. |
Baseline and 6 months
|
Collaborateurs et enquêteurs
Parrainer
Parrainer
Collaborateurs
Collaborateurs
Les enquêteurs
Les enquêteurs
- Chercheur principal: Oluwabunmi Ogungbe, PhD, MPH, RN, Johns Hopkins School of Nursing
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Estimé)
Début de l'étude
Achèvement primaire (Estimé)
Achèvement primaire
Achèvement de l'étude (Estimé)
Achèvement de l'étude
Dates d'inscription aux études
Première soumission
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Première publication
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour publiée
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
Autres numéros d'identification d'étude
- IRB00592583
- 1R01HL189303-01 (Subvention/contrat des NIH des États-Unis)
Informations sur les médicaments et les dispositifs, documents d'étude
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