A randomized trial of peer-delivered self-management support for hypertension

Am J Hypertens. 2014 Nov;27(11):1416-23. doi: 10.1093/ajh/hpu058. Epub 2014 Apr 22.


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.

Keywords: blood pressure; hypertension; patient participation; randomized clinical trial; self-help groups..

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Blood Pressure
  • Delivery of Health Care*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Hypertension / diagnosis
  • Hypertension / physiopathology
  • Hypertension / psychology
  • Hypertension / therapy*
  • Male
  • Middle Aged
  • Patient Compliance / psychology
  • Patient Education as Topic
  • Peer Group*
  • Self Care / psychology*
  • Self-Help Groups*
  • Social Support
  • Time Factors
  • Treatment Outcome
  • Veterans / psychology*
  • Veterans Health
  • Volunteers
  • Wisconsin

Associated data

  • ClinicalTrials.gov/NCT00571038