Background: Hypertension and diabetes represent major risk factors for cardiovascular disease, placing a disproportionate burden on minorities and African Americans. Evidence suggests that interventions that improve control rates would significantly reduce cardiovascular disparities.
Aims : This proposal is based on a collaborative partnership between the Bon Secours Baltimore Health System (BSBHS) and the University of Maryland Baltimore (UMB). The research-specific aims at UMB and BSBHS are complementary and seek to improve provider and patient approaches to treatment of hypertension and diabetes, respectively. UMB also aims to modify physician related barriers to minority enrollment in clinical trials, and BSBHS to improve patient adherence to treatment plans. Through didactic training, UMB aims to build a sustainable research program at BSBHS; through cultural sensitivity training, BSBHS expects to enhance the disparities program at UMB. Methods: The relative impact of physician and/or patient interventions for controlling hypertension and diabetes is assessed. This is a hypothesis-testing, prospective study, with an experimental 2X2 factorial design; it is a four-arm randomized controlled trial. Outcomes include adherence and improved knowledge/awareness of guidelines (of patients and their physicians), as well as patient clinical and quality of life measures. The study is powered for the proportion of patients who get to goal. We target enrollment of 800 patients (each for hypertension and diabetes), to afford 80% (up to 90%) power and allow for 25% attrition. We will use logistic regression for the probability of reaching goal, multiple linear regression for relative changes in mmHg (hypertension) and HbAlc (diabetes), and survival analysis to model time to reach goal. We will also measure improved adherence of diabetes patients as a result of BSBHS actively identifying access barriers; and changes in the willingness of patients to enroll in clinical trials as a result of physician-targeted education. Discussion: We seek to demonstrate a best practice model, based on a collaborative partnership, and build a self-sustained research program at BSBHS and an enhanced cardiovascular disparities program at UMB. Community entities will have full access to resources at both institutions, which in turn will have access to invaluable input and support from community groups. We strongly expect improved outcomes/awareness of cardiovascular health among minority patients serviced by both BSBHS and UMB.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01HL079151-03
Application #
7118926
Study Section
Special Emphasis Panel (ZHL1-CSR-R (S2))
Program Officer
Desvigne-Nickens, Patrice
Project Start
2004-09-30
Project End
2009-08-31
Budget Start
2006-09-01
Budget End
2007-08-31
Support Year
3
Fiscal Year
2006
Total Cost
$627,818
Indirect Cost
Name
University of Maryland Baltimore
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
188435911
City
Baltimore
State
MD
Country
United States
Zip Code
21201
Johnson, Wallace; Shaya, Fadia T; Winston, Reed et al. (2014) Diabetes control through an educational intervention. Ethn Dis 24:182-8
Shaya, Fadia T; Chirikov, Viktor V; Daniel Mullins, C et al. (2013) Social networks help control hypertension. J Clin Hypertens (Greenwich) 15:34-40
Shaya, Fadia T; Gbarayor, Confidence M; Laird, Aurelia et al. (2011) Diabetes knowledge in a high risk urban population. Ethn Dis 21:485-9
Ezeugwu, Camellus O; Laird, Aurelia; Mullins, C Daniel et al. (2011) Lessons learned from community-based minority health care serving system participation in an NIH clinical trial. J Natl Med Assoc 103:839-44
Johnson, Wallace; Shaya, Fadia T; Khanna, Niharika et al. (2011) The Baltimore Partnership to Educate and Achieve Control of Hypertension (The BPTEACH Trial): a randomized trial of the effect of education on improving blood pressure control in a largely African American population. J Clin Hypertens (Greenwich) 13:563-70
Onwudiwe, Nneka C; Mullins, C Daniel; Winston, Reed A et al. (2011) Barriers to self-management of diabetes: a qualitative study among low-income minority diabetics. Ethn Dis 21:27-32
Flack, John M; Sica, Domenic A; Bakris, George et al. (2010) Management of high blood pressure in Blacks: an update of the International Society on Hypertension in Blacks consensus statement. Hypertension 56:780-800