Key result
New RCT protocol tests practice facilitation for implementing the Kaiser hypertension bundle in urban clinics.
Why the study?
Hypertension disproportionately affects African Americans, prompting the need to adapt and implement an evidence-based blood pressure control bundle in under-resourced urban communities experiencing cardiovascular health disparities.
Does practice facilitation improve the implementation of the Kaiser bundle for blood pressure control in under-resourced urban communities compared to implementation without facilitation?
RCT
parallel cluster randomized
Yes
Does practice facilitation improve the implementation of the Kaiser bundle for blood pressure control in under-resourced urban communities compared to implementation without facilitation?
This paper outlines the community-engaged development of a protocol to test practice facilitation for implementing an evidence-based hypertension control bundle in under-resourced urban settings.
Objectives: Hypertension affects 1 in 3 adults in the United States and disproportionately affects African Americans. Kaiser Permanente demonstrated that a "bundle" of evidence-based interventions significantly increased blood pressure control rates. This paper describes a multiyear process of developing the protocol for a trial of the Kaiser bundle for implementation in under-resourced urban communities experiencing cardiovascular health disparities during the planning phase of this biphasic award (UG3/UH3). Methods: The protocol was developed by a collaboration of faith-based community members, representatives from community health center practice-based research networks, and academic scientists with expertise in health disparities, implementation science, community-engaged research, social care interventions, and health informatics. Scientists from the National Institutes of Health and the other grantees of the Disparities Elimination through Coordinated Interventions to Prevent and Control Heart and Lung Disease Risk (DECIPHeR) Alliance also contributed to developing our protocol. Results: The protocol is a hybrid type 3 effectiveness-implementation study using a parallel cluster randomized trial to test the impact of practice facilitation on implementation of the Kaiser bundle in community health centers compared with implementation without facilitation. A central strategy to the Kaiser bundle is to coordinate implementation via faith-based and other community organizations for recruitment and navigation of resources for health-related social risks. Conclusions: The proposed research has the potential to improve identification, diagnosis, and control of blood pressure among under-resourced communities by connecting community entities and healthcare organizations in new ways. Faith-based organizations are a trusted voice in African American communities that could be instrumental for eliminating disparities.
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Smith et al. (2023) conducted an RCT in Hypertension. Practice facilitation on implementation of the Kaiser bundle vs. Implementation without facilitation was evaluated on Impact of practice facilitation on implementation of the Kaiser bundle. A parallel cluster randomized trial protocol was developed to test practice facilitation for implementing the Kaiser hypertension bundle in under-resourced urban community health centers.
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