Nashville - Hypertension Management Model

Sponsor
Vanderbilt University Medical Center (Other)
Overall Status
Completed
CT.gov ID
NCT04232124
Collaborator
University of California, Los Angeles (Other), Cedars-Sinai Medical Center (Other)
36
2
1
17
18
1.1

Study Details

Study Description

Brief Summary

Black men face a shorter life expectancy than white men due to poorer health outcomes associated with many chronic diseases, most notably hypertension and its cardiovascular complications. A lack of access to healthcare resources and poor engagement with healthcare providers drive these inequities. A seminal trial conducted in the Metro Los Angeles area demonstrated the effectiveness of using collaborative care partnerships between black-owned barbershops and pharmacists to reduce blood pressure in black men.

The purpose of this study is to test the feasibility and success of implementing a single-arm, smaller-scale version of the Los Angeles study in the Nashville area to provide additional empiric support for collaborative care partnerships to treat hypertension in other geographic locations.

Condition or Disease Intervention/Treatment Phase
  • Behavioral: Hypertension Management Model
N/A

Detailed Description

Uncontrolled hypertension (HTN) is a significant risk factor for mortality among non-Hispanic black men, and black men have the highest incidence of death from HTN of any race, ethnic, or gender group in the United States. Sustained, trusting interactions with healthcare professionals and a lack of access to healthcare resources are both significant drivers of these disparities. A cluster, randomized controlled trial in the Metro Los Angeles area demonstrated that health promotion by black barbers resulted in greater reductions in blood pressure (BP) when combined with medication management by specialty-trained pharmacists, as compared to health promotion by barbers alone.

The purposes of this single arm, pre-test/post-test study are to a) establish an effective network of barbershop research hubs in Nashville, b) test the feasibility of engaging with a specialty-trained pharmacist in collaboration with a barbershop to treat blood pressure in black men, and c) create a local registry of potential subjects as a platform for enrolling black men in future studies. There is no central hypothesis in this pilot implementation study, but the study will evaluate the ability of the barbershop-based research methodology to recruit and retain black men in a study; the fidelity to the intervention by barbers, the pharmacist, and the hypertensive male participants; and the effectiveness of the intervention on systolic blood pressure reduction and patient satisfaction. All participants will also be offered the opportunity to participate in a separate research registry for recruitment into future studies.

Research staff will offer free BP screening to all adult black men entering each shop for approximately 4 weeks, or until recruitment targets have been met. Patrons with a systolic BP

140 mm Hg on two separate occasions will be eligible to participate. The patrons' existing physician or the lead physician or a study physician will sign a collaborative practice agreement for a specialty-trained pharmacist to provide care and prescribe BP medications within the study protocol. All participants in this study will execute a visit with the study physician for an evaluation to establish care, supported by the funding for this proposal.

Barbers will participate in training related to skills on BP measurement and counseling performed by either collaborating researchers from the University of California, Los Angeles-Cedars Sinai or from local study personnel. Barbers will frequently check and transmit the BP readings of their enrolled patrons and motivate them to work with the clinical pharmacist, who will meet them in their barbershops to optimize BP medication. The pharmacist will promote patient activation, intensify drug therapy under a collaborative practice agreement as permitted by Tennessee state law, send progress notes to the participant's physicians, and ensure appropriate safety monitoring after each medication change.

Study Design

Study Type:
Interventional
Actual Enrollment :
36 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Intervention Model Description:
Execute a smaller version of the LA Barbershop BP Study through the new Nashville network as the test case for: A) recruiting regular patrons with uncontrolled HTN, B) conducting a research protocol and evaluating a HTN intervention; and C) creating a local registry of potential subjects as platform for enrolling black men in future research studies.Execute a smaller version of the LA Barbershop BP Study through the new Nashville network as the test case for: A) recruiting regular patrons with uncontrolled HTN, B) conducting a research protocol and evaluating a HTN intervention; and C) creating a local registry of potential subjects as platform for enrolling black men in future research studies.
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
Implementing the Los Angeles Barber - Pharmacist Model Hypertension Management in Nashville
Actual Study Start Date :
Feb 15, 2020
Actual Primary Completion Date :
Jul 15, 2021
Actual Study Completion Date :
Jul 15, 2021

Arms and Interventions

Arm Intervention/Treatment
Experimental: Hypertension Management Model

Aim 1. Execute a smaller version of the LA Barbershop BP Study through the new Nashville network as the test case for: A) recruiting regular patrons with uncontrolled HTN, B) conducting a research protocol and evaluating a HTN intervention; and C) creating a local registry of potential subjects as platform for enrolling black men in future research studies.

Behavioral: Hypertension Management Model
Blood Pressure readings by barbers Clinical Pharmacist evaluation and counseling Blood pressure measurement Point of care basic metabolic panel measurement

Outcome Measures

Primary Outcome Measures

  1. Change in Systolic Blood Pressure [baseline and 6 months]

    The study's primary clinical outcome is the change in systolic BP assessed 6 months after enrollment.

Eligibility Criteria

Criteria

Ages Eligible for Study:
35 Years to 79 Years
Sexes Eligible for Study:
Male
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  • Adults 35-79 years old

  • Self - identify as Non-Hispanic black male

  • Patron of one of the participating barbershops (4 haircuts in the last 6 months)

  • Systolic BP> 140mm Hg on two screening days at least one day apart

Exclusion Criteria:
  • Severe cognitive impairment

  • Non-fluent in English

  • Women

  • Age < 35 years or > 79 years

  • Systolic BP < 140 mm Hg at either screening

  • Currently receiving chemotherapy for cancer

  • Organ transplant patient

  • Currently receiving dialysis

  • Other conditions the physician investigator deem unsafe to participate

  • Plans to move/relocate in next 12 months and/or travel out of area for > 1 month

Contacts and Locations

Locations

Site City State Country Postal Code
1 Masters Barbershop Nashville Tennessee United States 37218
2 Vanderbilt University Medical Center Nash Tennessee United States 37232

Sponsors and Collaborators

  • Vanderbilt University Medical Center
  • University of California, Los Angeles
  • Cedars-Sinai Medical Center

Investigators

  • Principal Investigator: David Harrison, MD, Vanderbilt University Medical Center

Study Documents (Full-Text)

More Information

Publications

None provided.
Responsible Party:
David Harrison, Primary Investigator, Vanderbilt University Medical Center
ClinicalTrials.gov Identifier:
NCT04232124
Other Study ID Numbers:
  • 191470
First Posted:
Jan 18, 2020
Last Update Posted:
Nov 16, 2021
Last Verified:
Nov 1, 2021
Individual Participant Data (IPD) Sharing Statement:
Yes
Plan to Share IPD:
Yes
Studies a U.S. FDA-regulated Drug Product:
No
Studies a U.S. FDA-regulated Device Product:
No
Additional relevant MeSH terms:

Study Results

No Results Posted as of Nov 16, 2021