The overall goal of this three-year planning grant is to improve health access and status for cardiovascular disease (CVD) in Filipino Americans living in the New York City metropolitan area through the use of patient navigators. This application has four specific aims: (1) to create an infrastructure that facilitates the conduct of community-based participatory research (CBPR), (2) to conduct a descriptive study that examines the Filipino American community's knowledge, health practices, health access, and risk factors for CVD, (3) to conduct an experimental study to assess the efficacy of an intensive patient navigator intervention in improving health access and status for CVD among Filipino Americans, and (4) to evaluate CBPR as an approach for addressing and eliminating health disparities. Year 1 focuses on partnership development and creation, with community participation, of a patient navigator intervention to improve hypertension control in Filipino Americans. The Kalusugan (i.e., """"""""health"""""""" in Pilipino) Coalition-comprised of academic and community partners serving the Filipino American community-has met since 2004. A community advisory board and seven taskforces comprised of Coalition members will be created and meet during Year 1. Years 2 and 3 implement a pilot intervention to test the efficacy of the patient navigator intervention. A randomized controlled trial will be conducted. Filipino American men and women ages 25-55 identified as hypertensive during community screenings will be randomized into a more intensive (n = 108) and less intensive (n = 108) patient navigator intervention. The more intensive intervention will provide six protocolized sessions conducted by patient navigators; guided by the Health Belief Model and social support theory, sessions will focus on (a) providing information on high blood pressure and CVD, (b) linking and negotiating access to a primary care physician, (c) providing social support, and (d) assuring adherence to medication taking and appointment keeping. A baseline and two follow-up interviews will be conducted to assess client outcomes, including systolic and diastolic blood pressure and adherence to medication taking and appointment keeping.
Filipino Americans exhibit high rates of hypertension and are therefore at high risk for cardiovascular disease and stroke. However, few interventions have been developed and implemented for this population to address these concerns. A patient navigator intervention, developed with community input to ensure its cultural and linguistic appropriateness, has the potential to prevent cardiovascular disease and stroke by helping Filipino Americans control their blood pressure. ? ?
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