PRESSURE CHECK: Find Your Path to Better Health

NCT ID: NCT06122246

Last Updated: 2025-04-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

1440 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-04-14

Study Completion Date

2027-10-31

Brief Summary

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This study seeks to develop the evidence for a sustainable, community-partnered, multi-level health system strategy to improve blood pressure control. Two team-based approaches are being tested: 1) a medical model of remote BP management (RBPM) alone, and 2) RBPM plus a social model with a community health worker (CHW). These 2 strategies are being compared with a standard community screening program with referral to primary care.

Detailed Description

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In this comparative effectiveness trial, we aim to answer the research question of whether a remote blood pressure management program (RBPM, inclusive of home blood pressure monitoring and telehealth visits with a nurse or pharmacist) alone or an RBPM program with community health worker (CHW) support is more effective than standard screening with education and referral to primary care in controlling blood pressure and addressing social determinants that lead to poor health outcomes.

This is a multisite study using a stepped wedge design. Health systems in 4 different cities are each partnered with 10 community based organizations (CBOs). CBOs are randomized into one of 4 sequences. Each sequence moves through the 3 study arms at different time points: Community Standard, RBPM alone, and RBPM+CHW.

At the CBOs, research health advocates screen for hypertension. Qualifying individuals who provide informed consent can enroll in the study and are assigned to the intervention that the CBO is in at that particular time. All participants receive a blood pressure cuff and a device that syncs their data with the research database. If enrolled in the RBPM arm, participants are scheduled for telehealth visits with the Pressure Check medical team to improve blood pressure control through lifestyle support and medication initiation/titration. If enrolled in the RBPM+CHW arm, participants additionally receive support from a CHW to help with medical visits and address social determinants of health. The primary outcome is blood pressure control at 6 months. Additional outcomes include implementation science to understand factors associated with adoption and outcomes, and 12 and 18 month blood pressure control.

In partnering with the community, health systems can extend their reach. CBO leaders support health messaging around hypertension and increase trust between the health system and their clients (patients). The two models, RBPM alone and RBPM+CHW, are based on the concept that disparities in hypertension control among Black, Latinx, and low-income populations exist because of inequities related to health system access and trust, individual-level socioeconomic and lifestyle factors, the physical/built environment, sociocultural factors, and discriminatory policies. Addressing these barriers may improve blood pressure control.

Conditions

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Blood Pressure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Community Based Organizations (CBO) will be randomized in a cluster-randomized stepped-wedge design in which CBOs will be randomized to one of 5 sequences.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Remote Blood Pressure (BP) Management Program

Participants are enrolled in a remote BP management program (RBPM) inclusive of home BP monitoring and telehealth visits with a nurse or pharmacist.

Group Type ACTIVE_COMPARATOR

Remote Blood Pressure (BP) Management Program (RBPM)

Intervention Type OTHER

Participants will receive a medical model of remote BP management (RBPM).

Remote Blood Pressure (BP) Management Program + Community Health Worker (CHW)

Participants are enrolled in a remote BP management program (RBPM) inclusive of home BP monitoring and telehealth visits with a nurse or pharmacist plus a social model with a CHW.

Group Type EXPERIMENTAL

Community Health Worker (CHW)

Intervention Type BEHAVIORAL

Participants will receive the additional support of a Community Health Worker (CHW).

Remote Blood Pressure (BP) Management Program (RBPM)

Intervention Type OTHER

Participants will receive a medical model of remote BP management (RBPM).

Usual Care

Participants receive education about hypertension and are referred to primary care for ongoing management.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Community Health Worker (CHW)

Participants will receive the additional support of a Community Health Worker (CHW).

Intervention Type BEHAVIORAL

Remote Blood Pressure (BP) Management Program (RBPM)

Participants will receive a medical model of remote BP management (RBPM).

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Elevated BP, defined as an average resting BP of \>=135/85 mmHg based on 3 consecutive blood pressure readings

Exclusion Criteria

* People who are pregnant
* Those that have end stage renal disease on dialysis
* People receiving active chemotherapy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Patient-Centered Outcomes Research Institute

OTHER

Sponsor Role collaborator

Yale University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Erica Spatz, MD

Role: PRINCIPAL_INVESTIGATOR

Yale University

Rafael Perez-Escamilla, MD

Role: PRINCIPAL_INVESTIGATOR

Yale University

Locations

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Yale

New Haven, Connecticut, United States

Site Status RECRUITING

Massachusetts General Brigham Hospital

Boston, Massachusetts, United States

Site Status NOT_YET_RECRUITING

Houston Methodist

Houston, Texas, United States

Site Status NOT_YET_RECRUITING

Sentara Health

Norfolk, Virginia, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Bonnie Garmisa, MAT

Role: CONTACT

(203) 640-2684

Jocelyn Dorney, MPH

Role: CONTACT

708-663-0053

Related Links

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https://www.pressurecheck.org/

Pressure Check website

Other Identifiers

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HM-2022C2-28354

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

2000036141

Identifier Type: -

Identifier Source: org_study_id

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