Our goal is to create a transdisciplinary research center that improves cardiovascular outcomes and reduces racial and ethnic disparities in care in Baltimore, Maryland. We will use community-based participatory research principles to build strong ties among researchers, healthcare provider networks, community members, and policy-makers. We are building on prior work and established relationships with the large African American population in Baltimore, and we will initially focus on hypertension. The Center will Include 3 separate but related intervention studies to improve the identification, treatment, and outcomes of African Americans with hypertension;3 integrated and complimentary Cores;an Internal Steering Committee;and a Community and Provider Advisory Board. Study 1 is a pragmatic clinical trial that examines the implementation of a multi-method quality improvement intervention in 6 community-based primary care practices. Study 2 is a randomized controlled trial to test the effectiveness and long-term sustainability of self-management and problem-solving training for patients, family and community members. Study 3 is a 3-arm randomized controlled trial of culturally-tailored nutritional advice and a mineral supplement containing potassium, magnesium, and Vitamin C. Primary outcomes for all 3 studies are systolic and diastolic blood pressure and blood pressure control. The Administrative Core will carry out the overall administration of the grant, guiding and coordinating shared resources and training activities and managing the Center's studies. The Shared Resources Core will provide infrastructure and support for study design, database development, data management and analysis, patient recruitment and retention, intervention development, standardization of measurements and dissemination of results for the Center Projects and Administrative and Training Cores. The Training Core will provide transdisciplinary training and mentorship in health disparities for pre-doctoral, post-doctoral, junior faculty, and established faculty in the Schools of Medicine, Public Health, and Nursing.
Racial disparities in hypertension prevalence, control, and related cardiovascular (CVD) complications and mortality, are persistent and extensively documented. Despite strong evidence for the efficacy of pharmacologic and lifestyle therapies in African Americans and whites, blood pressure control rates remain suboptimal, even among persons receiving regular health care. There is an urgent need to comprehensively integrate the best evidence-based sustainable, multi-level strategies to overcome hvoertension disparities
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