Using Stories to Address Disparities in Hypertension

NCT ID: NCT01276197

Last Updated: 2016-12-02

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

618 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-01-31

Study Completion Date

2016-01-31

Brief Summary

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The purpose of this study is to determine if patients with high blood pressure are better able to control their blood pressure after watching a DVD about blood pressure.

Detailed Description

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This project consists of two phases: (1) Collecting of stories and creating a stories DVD; and (2) delivering the DVD in a randomized control trial (RCT). Both phases are described below.

The investigators will make two DVDs of African-American Veterans who will tell their success stories with controlling hypertension (HTN). The investigators want to help African-American Veterans control their hypertension by showing them stories that are interesting and that they can identify with, as well as giving them information about ways they can manage hypertension in their everyday lives. This is important because a disproportionate number of minority patients, including Veterans, have poorly controlled blood pressure. By showing them stories, rather than using more traditional methods of health education, the investigators hope to overcome some typical barriers to HTN control among the African-American population, including: lower levels of health literacy and numeracy, less trust in the medical system, and different (non-medical) models to explain their illness.

The Veteran storytellers will come from three VA sites (Charleston, Chicago, and Philadelphia) and their stories will be chosen based on (1) the proven effectiveness of the strategies they suggest for controlling BP and (2) how authentic they are, or how much they will "ring true" with the experiences of other Veterans, including their struggles and lessons learned.

After the DVD is complete, the investigators will conduct a randomized control trial to evaluate how effective it is in helping vets control their hypertension: 780 African-American vets with uncontrolled hypertension, from the same three VA sites, will participate. Half of them will watch the "Stories" DVD the investigators created; and the other half will watch a control, a DVD with the same medical information but without the narrative component. The investigators will measure their blood pressure (BP) just before they watch the DVD and again six months later. The investigators hypothesize that, six months after enrollment, the Veterans who watched the "Stories" DVD will have greater reduction in BP, as compared with those who watch the control. The investigators will also test the "Stories" DVD's impact on medication adherence and HTN management behaviors.

Conditions

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Hypertension

Keywords

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hypertension healthcare disparities minority health health behavior

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Participants

Study Groups

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Arm 1: Story-Telling DVD

Participant will receive a DVD with informational and story-telling components

Group Type EXPERIMENTAL

Story-Telling DVD

Intervention Type OTHER

DVD will contain both informational and story-telling components.

Arm 2: Non-Storytelling DVD

Participant will receive an informational DVD

Group Type ACTIVE_COMPARATOR

Non-Storytelling DVD

Intervention Type OTHER

DVD will contain only informational component.

Interventions

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Story-Telling DVD

DVD will contain both informational and story-telling components.

Intervention Type OTHER

Non-Storytelling DVD

DVD will contain only informational component.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* African-American
* Diagnosis of HTN
* Uncontrolled BP as defined by BP \>140/90 twice in the preceding 12 months

Exclusion Criteria

* active substance abuse
* severe mental illness
* cognitive disabilities that might prevent them from actively or reliably participating in the interviews
Minimum Eligible Age

19 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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VA Office of Research and Development

FED

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Thomas K Houston, MD MPH

Role: PRINCIPAL_INVESTIGATOR

Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA

Locations

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Jesse Brown VA Medical Center, Chicago, IL

Chicago, Illinois, United States

Site Status

Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA

Bedford, Massachusetts, United States

Site Status

Philadelphia VA Medical Center, Philadelphia, PA

Philadelphia, Pennsylvania, United States

Site Status

Ralph H. Johnson VA Medical Center, Charleston, SC

Charleston, South Carolina, United States

Site Status

Countries

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United States

References

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Houston TK, Cherrington A, Coley HL, Robinson KM, Trobaugh JA, Williams JH, Foster PH, Ford DE, Gerber BS, Shewchuk RM, Allison JJ. The art and science of patient storytelling-harnessing narrative communication for behavioral interventions: the ACCE project. J Health Commun. 2011 Aug;16(7):686-97. doi: 10.1080/10810730.2011.551997. Epub 2011 May 24.

Reference Type RESULT
PMID: 21541875 (View on PubMed)

Fix GM, Bokhour BG. Understanding the context of patient experiences in order to explore adherence to secondary prevention guidelines after heart surgery. Chronic Illn. 2012 Dec;8(4):265-77. doi: 10.1177/1742395312441037. Epub 2012 Mar 2.

Reference Type RESULT
PMID: 22387691 (View on PubMed)

Fix GM, Houston TK, Barker AM, Wexler L, Cook N, Volkman JE, Bokhour BG. A novel process for integrating patient stories into patient education interventions: incorporating lessons from theater arts. Patient Educ Couns. 2012 Sep;88(3):455-9. doi: 10.1016/j.pec.2012.06.012. Epub 2012 Jul 6.

Reference Type RESULT
PMID: 22770814 (View on PubMed)

Houston TK, Fix GM, Shimada SL, Long JA, Gordon HS, Pope C, Volkman J, Allison JJ, DeLaughter K, Orner M, Bokhour BG. African American Veterans Storytelling: A Multisite Randomized Trial to Improve Hypertension. Med Care. 2017 Sep;55 Suppl 9 Suppl 2:S50-S58. doi: 10.1097/MLR.0000000000000766.

Reference Type DERIVED
PMID: 28806366 (View on PubMed)

Other Identifiers

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IIR 10-132

Identifier Type: -

Identifier Source: org_study_id