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A randomized trial of peer-delivered self-management support for hypertension. Am J Hypertens 2014 Nov;27(11):1416-23 PMID: 24755206 PMCID: PMC4263938

Pubmed ID

24755206

DOI

10.1093/ajh/hpu058

Abstract

BACKGROUND: Peer-led interventions to improve chronic disease self-management can improve health outcomes but are not widely used. Therefore, we tested a peer-led hypertension self-management intervention delivered at regular meetings of community veterans' organizations.

METHODS: We randomized 58 organizational units ("posts") of veterans' organizations in southeast Wisconsin to peer-led vs. professionally delivered self-management education. Volunteer peer leaders at peer-led posts delivered monthly presentations regarding hypertension self-management during regular post meetings. Volunteer post representatives at seminar posts encouraged post members to attend 3 didactic seminars delivered by health professionals at a time separate from the post meeting. Volunteers in both groups encouraged members to self-monitor using blood pressure cuffs, weight scales, and pedometers. Our primary outcome was change in systolic blood pressure (SBP) at 12 months.

RESULTS: We measured SBP in 404 participants at baseline and in 379 participants at 12 months. SBP decreased significantly (4.4mm Hg; P < 0.0001) overall; the decrease was similar in peer-led and seminar posts (3.5mm Hg vs. 5.4mm Hg; P = 0.24). Among participants with uncontrolled BP at baseline, SBP decreased by 10.1mm Hg from baseline to 12 months but was again similar in the 2 groups. This pattern was also seen at 6 months and with diastolic blood pressure.

CONCLUSIONS: Our peer-led educational intervention was not more effective than didactic seminars for SBP control. Although peer-led educational programs have had important impacts in a number of studies, we did not find our intervention superior to a similar intervention delivered by healthcare professionals.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT00571038.

Author List

Whittle J, Schapira MM, Fletcher KE, Hayes A, Morzinski J, Laud P, Eastwood D, Ertl K, Patterson L, Mosack KE

Authors

Kathlyn E. Fletcher MD Professor in the Medicine department at Medical College of Wisconsin
Purushottam W. Laud PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Katie Mosack PhD Associate Professor in the Psychology department at University of Wisconsin - Milwaukee
Leslie Ruffalo PhD Director, Assistant Professor in the Family Medicine department at Medical College of Wisconsin
Jeffrey Whittle MD Professor in the Medicine department at Medical College of Wisconsin




Scopus

2-s2.0-84908373457   9 Citations

MESH terms used to index this publication - Major topics in bold

Aged
Blood Pressure
Delivery of Health Care
Female
Health Knowledge, Attitudes, Practice
Humans
Hypertension
Male
Middle Aged
Patient Compliance
Patient Education as Topic
Peer Group
Self Care
Self-Help Groups
Social Support
Time Factors
Treatment Outcome
Veterans
Veterans Health
Volunteers
Wisconsin
jenkins-FCD Prod-321 98992d628744e349846c2f62ac68f241d7e1ea70