The effect of a community-based self-help multimodal behavioral intervention in Korean American seniors with high blood pressure

Am J Hypertens. 2014 Sep;27(9):1199-208. doi: 10.1093/ajh/hpu041. Epub 2014 Mar 26.

Abstract

Background: Great strides have been made in improving heart health in the United States during the last 2 decades, yet these strides have not encompassed many ethnic minority populations. There are significant health disparity gaps stemming from both a paucity of valid research and a lack of culturally sensitive interventions. In particular, many Korean Americans with chronic illnesses encounter difficulty navigating the healthcare system because of limited health literacy.

Methods: The effect of a multimodal Self-Help Intervention Program on the Control of High Blood Pressure (HBP) was tested in a community-based clinical trial for Korean American seniors. Of 440 seniors enrolled, 369 completed the study (184 in the intervention group and 185 in the control group; mean age = 70.9±5.3 years). The intervention group received 6 weekly educational sessions on HBP management skill building, including health literacy training, followed by telephone counseling and home blood pressure (BP) monitoring for 12 months.

Results: Findings support that the Self-Help Intervention Program on the Control of HBP was effective in controlling BP in this ethnic/linguistic minority population. The BP control rates for the intervention and control groups were 49.5% vs. 43.2% at baseline, 58.5% vs. 42.4% at 6 months, 67.9% vs. 52.5% at 12 months, and 54.3% vs. 53.0% at 18 months. Significant changes were observed over time in some psychobehavioral outcomes, including self-efficacy for BP control, medication adherence behavior, HBP knowledge, and depression.

Conclusions: The study findings suggest that the multimodal Self-Help Intervention Program on the Control of HBP is effective at promoting optimal HBP control for this ethnic/linguistic minority population.

Clinical trials registry: NCT00406614.

Keywords: Korean Americans.; behavioral intervention; blood pressure; community-based participatory research; health disparity; health literacy; high blood pressure; hypertension.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Asian Continental Ancestry Group / psychology*
  • Blood Pressure Monitoring, Ambulatory
  • Blood Pressure*
  • Combined Modality Therapy
  • Community Health Services*
  • Counseling
  • Female
  • Health Behavior / ethnology*
  • Health Knowledge, Attitudes, Practice / ethnology*
  • Health Literacy
  • Humans
  • Hypertension / diagnosis
  • Hypertension / ethnology
  • Hypertension / physiopathology
  • Hypertension / psychology
  • Hypertension / therapy*
  • Male
  • Middle Aged
  • Minority Health / ethnology*
  • Patient Education as Topic
  • Prospective Studies
  • Republic of Korea / epidemiology
  • Self Care / psychology*
  • Telephone
  • Time Factors
  • Treatment Outcome
  • United States / epidemiology

Associated data

  • ClinicalTrials.gov/NCT00406614