The primary objective of this study is to develop and test an innovative self-help program for Korean Americans (KA) that is culturally sensitive, built on valid behavioral theories and principles, and aimed at improving the control of high blood pressure (HBP) and enhancing health related quality of life. Specifically, we will focus on the self-help aspects of HBP control by empowering patients with greater knowledge about HBP, greater self-efficacy, and enhancing self-care skills including general and HBP related problem-solving skills. We therefore propose to undertake a project to test the effectiveness of a self-help HBP control intervention program specifically designed for KA with HBP. This Self-Help Intervention Program (SHIP) will have three concurrently administered components: (1) a structured behavioral education intervention that focuses on fostering self-help skills in controlling HBP; (2) home BP monitoring with a telephone transmission system (HBPMT); and (3) telephone interaction with a bilingual nurse who will facilitate effective communication between KA with HBP and their care providers.
Our specific aims are to: (1) further develop and test a self-help intervention program (SHIP) protocol that specifies the process and content of the intervention for KA with HBP; (2) enroll 260 KA, ages 40-65, with HBP in the SHIP intervention program; (3) deliver the SHIP intervention to the study participants; (4) measure the effect of the SHIP intervention on both primary outcome, BP reduction, and on secondary cognitive behavioral outcomes, including self-efficacy, problem-solving skills, and adherence to treatment recommendations; and (5) explore relevant methodological issues, which include evaluating the dose-response association with respect to the self-help education treatment strength, level of adherence necessary to induce the desirable changes in BP levels and psychological well-being. The outcome variables will be measured before the intervention and at 12 and 24 months after the start of the intervention. This investigation will allow us to examine theoretical, logistical, and methodological issues prior to implementing the proposed community-based intervention designed to improve health care outcomes in this vulnerable minority ethnic group.
