University of Texas Southwestern Medical Center
The goal of this clinical trial is to learn if the Walk Together family-based intervention can improve hypertension self-management and blood pressure control in Black and African American primary care patients living with uncontrolled hypertension. The main questions it aims to answer are: * Do patients and family members who complete Walk Together take better care of their health? * Does Walk Together lower blood pressure? Researchers will compare the Walk Together intervention to a hypertension education intervention to see if Walk Together works to improve blood pressure. Participants will: * Complete four study sessions over 7 to 10 weeks * Measure their blood pressure at home * Answer questions about their family and their health 6 times over 8 months
Hypertension is the most significant risk factor for racial disparities in mortality and life expectancy. African Americans, in particular, are at greater risk of developing hypertension earlier and experiencing worse hypertension-related outcomes. Hypertension is also a modifiable risk factor for cardiovascular disease, in part via self-management behavior which is critical for achieving hypertension control. Black and African American individuals often report difficulties with self-management adherence due in part to challenges in sustaining necessary lifestyle changes, and environmental bar…
Inclusion Criteria: * Black or African American * Age 18 to 75 * Diagnosis of essential hypertension * Two clinic-based blood pressure values ≥ 130/ ≥ 80 in 12 months prior * Available family support person to join the study who agrees to participate * English-speaking Exclusion Criteria: * Diagnosis of hypertension is made exclusively during pregnancy * Documented cognitive impairment in patient's medical record * Presence of severe psychiatric condition (i.e., current psychotic disorder or suicidality) * Diagnosis of sustained atrial fibrillation * Past-year myocardial infarction * Diagno…
Walk Together incudes four sessions delivered in patients' primary care clinics (in-person or via telehealth) over approximately eight weeks. Sessions are dyadic (i.e., all sessions include the patient participant plus the patient's self-identified family support person), last approximately 4 hours total (ranging from 30-90 minutes each), and are facilitated by a trained behavioral interventionist with expertise in couples and family therapy. The goals of the intervention are to (a) improve family relationship quality (i.e., dyadic relationship quality and family support for hypertension self-management) and (b) improve hypertension knowledge, in order to improve hypertension self-management adherence and improve blood pressure control. All participants are provided a blood pressure monitor for remote monitoring. Environmental barriers to self-management adherence are also addressed consistent with standard care.
HypEd includes four points of contact including one dyadic (i.e., patient participants plus patient-identified family support persons) baseline session (30 minutes) that includes education on use of study-provided blood pressure monitors and accurate blood pressure monitoring, hypertension basics, and hypertension self-management goal-setting. All dyads will receive a copy of NHLBI's "On the Move to Better Heart Health for African Americans" educational booklet. Patients will then receive a phone call to check-in regarding progress in their hypertension management goal and reviewing the educational booklet at 1-2 weeks, 3-4 weeks, and 7-10 weeks. All participants will receive a blood pressure monitor for remote monitoring.
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