Walk Together Program for High Blood Pressure

Overseen By Sarah B Woods, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Texas Southwestern Medical Center

Disqualifiers: Cognitive impairment, Severe psychiatric condition, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 4

Duration: 8 weeks

62 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the Walk Together treatment for high blood pressure?

Research shows that involving family and community support can help people manage their high blood pressure better. Programs that encourage self-management and peer support have been effective in improving blood pressure control, especially in socially disadvantaged groups. ^{1 2 3 4 5}

Is the Walk Together Program for High Blood Pressure safe for humans?

The research articles reviewed do not provide specific safety data for the Walk Together Program or its related interventions. However, community-based programs and self-monitoring interventions for blood pressure control, which are similar in nature, have been used safely in various settings to promote health behavior changes. ^{1 6 7 8 9}

How is the Walk Together Program for High Blood Pressure different from other treatments?

The Walk Together Program is unique because it focuses on family-based self-management and community involvement to help people manage high blood pressure. This approach emphasizes lifestyle changes, such as increased physical activity and healthy eating, and involves family support and community resources, which is different from traditional medication-based treatments. ^{2 7 10 11 12}

What is the purpose of this trial?

The goal of this study is to determine the feasibility and acceptability of a novel family-based hypertension self-management intervention, Walk Together, adapted from an existing empirically-supported dyadic intervention, for implementation in primary care.

Research Team

Sarah Woods, PhD

Principal Investigator

UT Southwestern Medical Center

Eligibility Criteria

This trial is for African American individuals aged 18 to 75 with high blood pressure (two readings of ≥130/≥80 in the past year). They must have a family support person who can join the intervention and both must speak English.

Inclusion Criteria

Black or African American

Two blood pressure values ≥ 130/ ≥ 80 in 12 months prior

Available family support person to join the intervention who agrees to participate

Exclusion Criteria

Presence of severe psychiatric condition (i.e., current psychotic disorder or suicidality)

My family support person is younger than 18.

Participation in prior hypertension health education intervention

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive the Walk Together intervention, which involves four dyadic sessions delivered in primary care over approximately two months

8 weeks

4 sessions (in-person)

Follow-up

Participants are monitored for adherence and family relationship quality following the intervention

11 months

Treatment Details

Interventions

• Walk Together

Trial Overview The 'Walk Together' program, a family-based hypertension self-management intervention adapted from an existing dyadic approach, is being tested for its practicality and how well it's received when used in primary care settings.

Participant Groups

Group I: Walk Together Experimental Treatment 1 Intervention

Walk Together involves four sessions delivered in patients' primary care clinic over approximately two months. Sessions are dyadic (i.e., all sessions include the patient and a family support person), last 30-90 minutes, and are delivered by a trained family therapist. The intervention is a culturally-response, family-based intervention that is strengths-based and includes components of integrative behavioral couples therapy and motivational interviewing. The goals of the intervention are to (a) optimize family support and communication, (b) improve hypertension knowledge, (c) enhance self-management goal-setting, and (d) increase shared problem-solving to address self-management adherence barriers. Environmental barriers to adherence are also addressed consistent with standard care.

Who Is Running the Clinical Trial?

University of Texas Southwestern Medical Center

Lead Sponsor

Trials

1,102

Recruited

1,077,000+

National Institute on Minority Health and Health Disparities (NIMHD)

Collaborator

Trials

473

Recruited

1,374,000+

Findings from Research

The study highlights the significant role of family dynamics in managing health behaviors, suggesting that interventions targeting multiple family members could enhance cardiovascular risk reduction efforts.

Interviews with intervention staff and participants revealed that relationships among family members, peers, and study staff are crucial for promoting healthy behaviors, indicating the need for family-oriented approaches in health interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Leveraging Delivery of Blood Pressure Control Interventions among Low-income African American Adults: Opportunities to Increase Social Support and Produce Family-level Behavior Change. Yang, TJ., Cooper, LA., Boulware, LE., et al.[2023]

A 12-week program utilizing community involvement and based on social cognitive theory significantly improved self-management strategies among 44 participants with hypertension, leading to increased self-efficacy and health-promoting behaviors.

Participants in the experimental group experienced a notable decrease in diastolic blood pressure after eight weeks, demonstrating the program's effectiveness in managing hypertension.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Self-management improvement program combined with community involvement in Thai hypertensive population: an action research. Srichairattanakull, J., Kaewpan, W., Powattana, A., et al.[2016]

A peer support program involving Veterans of Foreign Wars posts in Wisconsin effectively trained 27 peer leaders over 18 months to promote self-management of hypertension, with 93% of participating posts remaining active throughout the study.

The program resulted in peer leaders gaining health knowledge and confidence, which enhanced health support among veterans, highlighting the potential of community-based initiatives in improving chronic disease management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Preliminary description of the feasibility of using peer leaders to encourage hypertension self-management. Hayes, A., Morzinski, J., Ertl, K., et al.[2010]

A community health worker (CHW) intervention led to improved blood pressure control among socially disadvantaged African Americans, with overall BP control rising from 36% to 52% over 12 months.

While all intervention groups showed significant reductions in blood pressure, the Problem Solving group demonstrated notably higher self-care behaviors and self-efficacy, suggesting that this approach may enhance self-management skills, even though it did not lead to better BP outcomes compared to the other interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Hypertension Self-management in Socially Disadvantaged African Americans: the Achieving Blood Pressure Control Together (ACT) Randomized Comparative Effectiveness Trial. Boulware, LE., Ephraim, PL., Hill-Briggs, F., et al.[2022]

The Hypertension Disease Management Program (HDMP) significantly reduced systolic and diastolic blood pressure in participants, with systolic pressure decreasing from 137.5 mm Hg to 131.2 mm Hg and diastolic pressure from 86.0 mm Hg to 83.8 mm Hg, indicating its efficacy in managing hypertension.

Participants in the HDMP showed improved health behaviors, such as better dietary choices and regular blood pressure monitoring, but there was no significant change in medical service usage or costs compared to the control group, suggesting that while HDMP enhances lifestyle, its impact on healthcare utilization remains unclear.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of the hypertension disease management program in Korea. Kim, Y., Lee, K., Shin, E., et al.[2019]

The BUMP trial is developing self-monitoring interventions for pregnant women to help detect high blood pressure early, which is crucial for preventing complications like pre-eclampsia.

Through qualitative research, the study identified key challenges women face in adhering to self-monitoring, leading to tailored strategies that enhance engagement and explain the benefits of monitoring, ultimately aiming to improve maternal and fetal health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Intervention planning and modification of the BUMP intervention: a digital intervention for the early detection of raised blood pressure in pregnancy. Band, R., Hinton, L., Tucker, KL., et al.[2023]

Community-based programs have been effective in raising awareness and promoting healthier behaviors to control high blood pressure, emphasizing partnerships and resident involvement in screening and education.

Utilizing trained community health workers to deliver culturally sensitive education on heart health has been shown to enhance the effectiveness of these programs, potentially leading to better blood pressure management in communities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Role of community programs in controlling blood pressure. Fulwood, R., Guyton-Krishnan, J., Wallace, M., et al.[2019]

A workplace intervention program that included self-monitoring of daily salt excretion and personalized e-mail advice led to significant reductions in blood pressure among 41 hypertensive male workers over 4 weeks.

The intervention group showed greater decreases in both daily salt excretion and home blood pressure compared to the control group, indicating the program's effectiveness in managing hypertension.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of salt reduction intervention program using an electronic salt sensor and cellular phone on blood pressure among hypertensive workers. Morikawa, N., Yamasue, K., Tochikubo, O., et al.[2017]

The MyBP program, which uses automated text messaging for home blood pressure monitoring, was viewed positively by healthcare providers for its ease of use and potential to engage patients in managing their hypertension, thereby improving systematic BP monitoring.

Providers identified barriers such as the cost of BP devices and patients' social or emotional challenges, suggesting that successful implementation of MyBP requires strategies for better integration into primary care workflows and provider education.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Automated Messaging Program to Facilitate Systematic Home Blood Pressure Monitoring: Qualitative Analysis of Provider Interviews. Einhorn, J., Murphy, AR., Rogal, SS., et al.[2023]

The Blood Pressure LifeStyle Management (BLSM) program showed potential in managing hypertension, with a notable decrease in systolic blood pressure (SBP) of -6.5 mmHg in patients with hyperlipidemia, despite an overall slight increase in blood pressure for the group as a whole.

Lifestyle interventions, particularly for smokers, demonstrated significant improvements in blood pressure control, suggesting that tailored programs could enhance effectiveness and should be expanded in primary care settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A lifestyle intervention to prevent hypertension in primary healthcare settings: A Saudi Arabian feasibility study. Mushcab, H., Al Mutairi, A., Al Matroud, A., et al.[2023]

In a study of 500 hypertensive patients in Petrópolis, Brazil, blood pressure control was found to be significantly better in primary healthcare units (PHUs) at 39.23% compared to 29.2% in Family Health Program (FHP) units.

The odds of achieving controlled blood pressure were lower for patients in FHP units, with an odds ratio of 0.64, indicating that patients at PHUs had a better chance of maintaining their blood pressure below the recommended level of 140/90 mmHg.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Blood pressure control in hypertensive patients within Family Health Program versus at Primary Healthcare Units: analytical cross-sectional study. Martins, TL., Atallah, AN., Silva, EM.[2019]

Faith-based organization (FBO) interventions have shown potential in significantly reducing systolic blood pressure (SBP) by an average of -6.23 mm Hg in populations with high baseline SBP (≥140 mm Hg), indicating their effectiveness in managing hypertension in these communities.

However, the overall evidence is limited, primarily focusing on Christian communities in the US, and more research is needed to explore the long-term effects and applicability of FBO-based interventions in diverse settings and among non-hypertensive populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A systematic review and meta-analysis of the effectiveness of hypertension interventions in faith-based organisation settings. Chan, KY., Srivastava, N., Wang, Z., et al.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

Leveraging Delivery of Blood Pressure Control Interventions among Low-income African American Adults: Opportunities to Increase Social Support and Produce Family-level Behavior Change. [2023]

2. Thailand pubmed.ncbi.nlm.nih.gov

Self-management improvement program combined with community involvement in Thai hypertensive population: an action research. [2016]

3. United States pubmed.ncbi.nlm.nih.gov

Preliminary description of the feasibility of using peer leaders to encourage hypertension self-management. [2010]

4. United States pubmed.ncbi.nlm.nih.gov

Hypertension Self-management in Socially Disadvantaged African Americans: the Achieving Blood Pressure Control Together (ACT) Randomized Comparative Effectiveness Trial. [2022]

5. China pubmed.ncbi.nlm.nih.gov

Evaluation of the hypertension disease management program in Korea. [2019]

6. England pubmed.ncbi.nlm.nih.gov

Intervention planning and modification of the BUMP intervention: a digital intervention for the early detection of raised blood pressure in pregnancy. [2023]

7. United States pubmed.ncbi.nlm.nih.gov

Role of community programs in controlling blood pressure. [2019]

8. England pubmed.ncbi.nlm.nih.gov

Effect of salt reduction intervention program using an electronic salt sensor and cellular phone on blood pressure among hypertensive workers. [2017]

9. Canada pubmed.ncbi.nlm.nih.gov

Automated Messaging Program to Facilitate Systematic Home Blood Pressure Monitoring: Qualitative Analysis of Provider Interviews. [2023]

10. United States pubmed.ncbi.nlm.nih.gov

A lifestyle intervention to prevent hypertension in primary healthcare settings: A Saudi Arabian feasibility study. [2023]

11. Brazil pubmed.ncbi.nlm.nih.gov

Blood pressure control in hypertensive patients within Family Health Program versus at Primary Healthcare Units: analytical cross-sectional study. [2019]

12. Scotland pubmed.ncbi.nlm.nih.gov

A systematic review and meta-analysis of the effectiveness of hypertension interventions in faith-based organisation settings. [2023]