A randomized community-based intervention trial comparing faith community nurse referrals to telephone-assisted physician appointments for health fair participants with elevated blood pressure

J Gen Intern Med. 2010 Jul;25(7):701-9. doi: 10.1007/s11606-010-1326-9. Epub 2010 Mar 27.

Abstract

Objective: To measure the effect of faith community nurse referrals versus telephone-assisted physician appointments on blood pressure control among persons with elevated blood pressure at health fairs.

Methods: Randomized community-based intervention trial conducted from October 2006 to October 2007 of 100 adults who had an average blood pressure reading equal to or above a systolic of 140 mm Hg or a diastolic of 90 mm Hg obtained at a faith community nurse-led church health event. Participants were randomized to either referral to a faith community nurse or to a telephone-assisted physician appointment. The average enrollment systolic blood pressure (SBP) was 149 +/- 14 mm Hg, diastolic blood pressure (DBP) was 87 +/- 11 mm Hg, 57% were uninsured and 25% were undiagnosed at the time of enrollment.

Results: The follow-up rate was 85% at 4 months. Patients in the faith community nurse referral arm had a 7 +/- 15 mm Hg drop in SBP versus a 14 +/- 15 mm Hg drop in the telephone-assisted physician appointment arm (p = 0.04). Twenty-seven percent of the patients in the faith community nurse referral arm had medication intensification compared to 32% in the telephone-assisted physician appointment arm (p = 0.98).

Conclusions: Church health fairs conducted in low-income, multiethnic communities can identify many people with elevated blood pressure. Facilitating physician appointments for people with elevated blood pressure identified at health fairs confers a greater decrease in SBP than referral to a faith community nurse at four months.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Appointments and Schedules
  • Community Health Services / methods
  • Female
  • Follow-Up Studies
  • Health Fairs / methods*
  • Humans
  • Hypertension / prevention & control
  • Hypertension / therapy*
  • Interviews as Topic / methods
  • Male
  • Middle Aged
  • Nurse's Role*
  • Physician's Role*
  • Referral and Consultation*
  • Religion and Medicine*