A multi-level system quality improvement intervention to reduce racial disparities in hypertension care and control: study protocol.
Implement Sci
; 8: 60, 2013 Jun 04.
Article
en En
| MEDLINE
| ID: mdl-23734703
ABSTRACT
BACKGROUND:
Racial disparities in blood pressure control have been well documented in the United States. Research suggests that many factors contribute to this disparity, including barriers to care at patient, clinician, healthcare system, and community levels. To date, few interventions aimed at reducing hypertension disparities have addressed factors at all of these levels. This paper describes the design of Project ReD CHiP (Reducing Disparities and Controlling Hypertension in Primary Care), a multi-level system quality improvement project. By intervening on multiple levels, this project aims to reduce disparities in blood pressure control and improve guideline concordant hypertension care.METHODS:
Using a pragmatic trial design, we are implementing three complementary multi-level interventions designed to improve blood pressure measurement, provide patient care management services and offer expanded provider education resources in six primary care clinics in Baltimore, Maryland. We are staggering the introduction of the interventions and will use Statistical Process Control (SPC) charting to determine if there are changes in outcomes at each clinic after implementation of each intervention. The main hypothesis is that each intervention will have an additive effect on improvements in guideline concordant care and reductions in hypertension disparities, but the combination of all three interventions will result in the greatest impact, followed by blood pressure measurement with care management support, blood pressure measurement with provider education, and blood pressure measurement only. This study also examines how organizational functioning and cultural competence affect the success of the interventions.DISCUSSION:
As a quality improvement project, Project ReD CHiP employs a novel study design that specifically targets multi-level factors known to contribute to hypertension disparities. To facilitate its implementation and improve its sustainability, we have incorporated stakeholder input and tailored components of the interventions to meet the specific needs of the involved clinics and communities. Results from this study will provide knowledge about how integrated multi-level interventions can improve hypertension care and reduce disparities. TRIAL REGISTRATION ClinicalTrials.gov NCT01566864.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Disparidades en el Estado de Salud
/
Hipertensión
Tipo de estudio:
Clinical_trials
/
Guideline
/
Prognostic_studies
/
Qualitative_research
Aspecto:
Determinantes_sociais_saude
/
Equity_inequality
/
Patient_preference
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Implement Sci
Año:
2013
Tipo del documento:
Article
País de afiliación:
Estados Unidos