Abstract
Objectives: Hypertension is associated with high morbidity and mortality. The complications of hypertension disproportionately impact African American residents in Chicago’s South Side neighborhood. To inform the implementation of an evidence-based multilevel hypertension management intervention, we sought to identify community member– and clinician-level barriers to diagnosing and treating hypertension, and strategies for addressing those barriers. Methods: We conducted 5 focus groups with members of faith-based organizations (FBOs) (n=40) and 8 focus groups with clinicians and administrators (n=26) employed by community health centers (CHCs) located in Chicago’s South Side. Results: Participants across groups identified the physical environment, including lack of access to clinics and healthy food, as a risk factor for hypertension. Participants also identified inconsistent results from home blood pressure monitoring and medication side effects as barriers to seeking diagnosis and treatment. Potential strategies raised by participants to address these barriers included (1) addressing patients’ unmet social needs, such as food security and transportation; (2) offering education that meaningfully engages patients in discussions about managing hypertension (eg, medication adherence, diet, follow-up care); (3) coordinating referrals via community-based organizations (including FBOs) to CHCs for hypertension management; and (4) establishing a setting where community members managing hypertension diagnosis can support one another. Conclusions: Clinic-level barriers to the diagnosis and treatment of hypertension, such as competing priorities and resource constraints, are exacerbated by community-level stressors. Community members and clinicians agreed that it is important to select implementation strategies that leverage and enhance both community- and clinic-based resources.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 60-67 |
| Number of pages | 8 |
| Journal | Ethnicity and Disease |
| DOIs | |
| State | Published - 2023 |
Funding
The CIRCL-Chicago Implementa tion Research Center is funded through a biphasic award (UG3/UH3) from the National Heart, Lung, and Blood Insti tute of the US National Institutes of Health through the Disparities Elimina tion through Coordinated Interventions to Prevent and Control Heart and Lung Disease Risk (DECIPHeR) Alliance. CIRCL-Chicago seeks to use strategies to support the adoption, implementa tion, and sustainability of the Kaiser bundle in a Chicago community with a high burden of hypertension, obesity, diabetes, heart disease, and stroke.18,19 In an effort to promote health equity, CIRCL-Chicago uses community-engaged research and the assessment of individual\u2019s experiences of health-related social risks (HRSRs) including food and housing insecurity, which can interfere with BP control and medication adherence. CIRCL-Chicago\u2019s leadership team consists of the leader of a not-for-profit community-based organization (CBO) affiliated with a faith-based organization (FBO) that supports at-risk families in need of immediate support services; leadership from local community health center (CHC) networks where the CIRCL-Chicago intervention will be implemented; and university-based researchers with expertise in planning and evaluating intervention implementation. CIRCL-Chicago leverages Total Resource Community Development Organization (TRCDO)\u2019s Pastors for Patient-Centered Outcomes Research (Pastor4PCOR), which seeks to expand participation of underserved minority communities in research by training faith-based community facilitators.20 Together, this leadership team will use their diverse expertise and the findings from the focus groups reported here to plan, implement, and evaluate the use of the Kaiser bundle to address BP-related disparities in Chicago\u2019s South Side. This research is supported by grant UG3HL154297 from the National Heart, Lung, and Blood Institute to Abel Kho, Justin D. Smith, This research is supported by grant UG3HL154297 from the National Heart, Lung, and Blood Institute to Abel Kho, Justin D. Smith, and Paris Davis. We wish to thank the rest of the members of the CIRCL-Chicago team and all of our community partners.
Keywords
- African Americans
- Community Health Centers
- Community-Engaged Research
- Faith-Based Organizations
- Focus Groups
- Hypertension
ASJC Scopus subject areas
- Epidemiology
