There is one clinical trial.
In Barbados, levels of hypertension are high (40.7%) and cause of a high proportion of deaths due to cardiovascular diseases. In this study, the Stanford University-led Chronic Disease Self-Management Program (CDSMP) will be modified to form one of the basic components of a three-pronged intervention to improve blood pressure control. Our overall goal is to evaluate the effectiveness of a hypertension self-management program in community-based settings. With the advent of the Coronavirus disease 2019 (COVID-19) we recognize that it may be necessary to adapt the programme to accommodate virtual delivery. Our specific aims are to: 1. Adapt the Stanford (CDSMP) to ensure cultural appropriateness to Barbados. In view of the need to adhere to physical distance guidelines in the era of COVID-19 disease, modifications will be made to enhance virtual delivery while maintaining programme fidelity. We will engage stakeholders in performing modifications related to content, context and mode of delivery of the CDSMP program with the goal of ensuring cultural appropriateness. 2. Determine the clinical effectiveness of CDSMP combined with medication enhancement tools. We will conduct a cluster randomized trial in twelve faith-based organizations(FBOs) in Barbados. We are primarily interested in studying the changes in systolic blood pressure. Secondarily, we will also assess change in weight, medication adherence, dietary behavior and physical activity. 3. Understand the barriers and facilitators to implementation and sustainability of CDSMP plus self-monitoring tools in faith-based organizations. We will assess cost and sustainability of the intervention and qualitatively assess factors associated with barriers and facilitators of implementation in FBOs in Barbados. Impact and novelty: We aim to increase the proportion of patients with controlled hypertension leading to reduced illness and deaths from strokes and heart attacks in particular. Few studies have looked at a blended approach to CDSMP delivery and these will become more necessary in the era of COVID-19. Findings on the factors impacting implementation will be transferable to small island developing states and other predominantly black populations.
Description: We will measure systolic blood pressure before and 6 months after the interventions
Measure: Systolic blood pressure Time: Six monthsDescription: We will measure participants' weight in kilograms before and six months after the intervention
Measure: Mean weight change for intervention and control groups Time: Six monthsDescription: Changes in dietary behavior will be monitored by using the Dietary Approaches to Stop Hypertension Accordance Score. Score ranges from 0 to 9. A low score represents a poor diet for hypertension control. The higher the score the more appropriate for hypertension control.
Measure: Level of adherence to the Dietary Approaches to Stop Hypertension (DASH) Diet Time: Six monthsDescription: Using the results of the GPAQ median physical activity in MET-minutes per week will be calculated before the intervention as well as six months post intervention
Measure: Assessing physical activity levels using the Global Physical Activity Questionnaire (GPAQ) Time: Six monthsDescription: Perceived self-efficacy scores will be calculated using a tool developed by K Lorig(Stanford University School of Medicine) for measuring self-efficacy in chronic disease management programs. Score ranges from 1 to 10. A higher score is better.
Measure: Self-Efficacy for Managing Chronic Diseases 6-item Scale Time: Six months