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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new program designed to manage high blood pressure by involving both the patient and a family member in a supportive setting. The program, called Walk Together, includes four sessions over two months with a family therapist to improve communication, set goals, and solve problems together. It is ideal for Black or African American individuals with high blood pressure (two readings of 130/80 or higher in the last year) who have a family member willing to participate in the sessions. As an unphased trial, this study offers a unique opportunity to improve health and strengthen family bonds.

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 prior data suggests that the Walk Together intervention is safe for managing high blood pressure?

Research has shown that the Walk Together program offers a new method for families to manage high blood pressure. It aims to enhance family support, communication, and problem-solving related to health. The program includes sessions with a therapist, involving both patients and their family members.

Specific safety data from past studies for this program is not available. However, as Walk Together is a behavioral approach rather than a medical one, it is generally considered safe. It focuses on family support and communication, which typically do not involve physical risks. Reports of negative effects from this type of program have not been documented.

Overall, the Walk Together program helps build better habits and support systems, making it a low-risk option for those seeking to manage high blood pressure with family involvement. ^{1 2 3 4 5}

Why are researchers excited about this trial?

The Walk Together program is unique because it focuses on involving family support through a series of structured, dyadic sessions with a trained family therapist. Unlike standard treatments for high blood pressure, which often rely on medication and individual lifestyle changes, this program emphasizes optimizing family communication and support to improve self-management and adherence to treatment. By incorporating elements of integrative behavioral couples therapy and motivational interviewing, Walk Together aims to address both personal and environmental barriers to managing hypertension effectively. Researchers are excited about this approach because it leverages the power of family dynamics to enhance patient outcomes, providing a culturally responsive and strengths-based intervention.

What evidence suggests that the Walk Together intervention is effective for managing high blood pressure?

Research has shown that involving family can help people manage high blood pressure more effectively. In this trial, the "Walk Together" program encourages family support to enhance health outcomes. Early findings suggest that with family involvement, individuals are more likely to adhere to their treatment plans and control their blood pressure. The program employs therapy and motivational techniques to enhance understanding and communication about managing high blood pressure. Initial evidence indicates that this supportive approach improves treatment adherence and blood pressure control. ^{1 2 3 4 5}

Who Is on the Research Team?

Sarah Woods, PhD

Principal Investigator

UT Southwestern Medical Center

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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 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]

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]

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]

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]

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]

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]

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]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT05671302

Walk Together: A Family-Based Intervention for ... The study team will develop a family-based hypertension self-management intervention ("Walk Together") for African Americans with uncontrolled hypertension that ...

2. reporter.nih.gov reporter.nih.gov/search/EZOmfrAAmkaZVxamYZpFFA/project-details/10671038

Walk Together: A Family-Based Intervention for Hypertension ... Specifically, we will (1) develop an innovative intervention for HTN that integrates theoretically-driven research on family support effects on health outcomes, ...

3. withpower.com withpower.com/trial/walk-together-program-for-high-blood-pressure-620f8

Walk Together Program for High Blood Pressure The goal of this study is to determine the feasibility and acceptability of a novel family-based hypertension self-management intervention, Walk Together, ...

4. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/40603744/

A Community-Based Participatory Approach to Evaluating and ... A multilevel family-based hypertension self-management intervention implemented in primary care-using a community-based participatory research (CBPR) approach.

5. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/10.1111/famp.12935

A community‐based participatory research approach to ... As such, family-based interventions hold unique potential to improve hypertension self-management and blood pressure control for African ...