Design and rationale of the cardiometabolic health program linked with community health workers and mobile health telemonitoring to reduce health disparities (LINKED-HEARTS) program
Hypertension and diabetes are major risk factors for cardiovascular diseases, stroke, and chronic kidney disease (CKD). Disparities in hypertension control persist among Black and Hispanic adults and persons living in poverty in the United States. The “LINKED-HEARTS Program” (a Cardiometabolic Healt...
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| Veröffentlicht in: | The American heart journal 2024-09, Vol.275, p.9-20 |
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| creator | Commodore-Mensah, Yvonne Chen, Yuling Ogungbe, Oluwabunmi Liu, Xiaoyue Metlock, Faith E. Carson, Kathryn A. Echouffo-Tcheugui, Justin B. Ibe, Chidinma Crews, Deidra Cooper, Lisa A. Himmelfarb, Cheryl Dennison |
| description | Hypertension and diabetes are major risk factors for cardiovascular diseases, stroke, and chronic kidney disease (CKD). Disparities in hypertension control persist among Black and Hispanic adults and persons living in poverty in the United States. The “LINKED-HEARTS Program” (a Cardiometabolic Health Program LINKED with Community Health WorkErs and Mobile HeAlth TelemonitoRing To reduce Health DisparitieS”), is a multi-level intervention that includes home blood pressure (BP) monitoring (HBPM), blood glucose telemonitoring, and team-based care. This study aims to examine the effect of the LINKED-HEARTS Program intervention in improving BP control compared to enhanced usual care (EUC) and to evaluate the reach, adoption, sustainability, and cost-effectiveness of the program.
Using a hybrid type I effectiveness-implementation design, 428 adults with uncontrolled hypertension (systolic BP ≥ 140 mm Hg) and diabetes or CKD will be recruited from 18 primary care practices, including community health centers, in Maryland. Using a cluster-randomized trial design, practices are randomly assigned to the LINKED-HEARTS intervention arm or EUC arm. Participants in the LINKED-HEARTS intervention arm receive training on HBPM, BP and glucose telemonitoring, and community health worker and pharmacist telehealth visits on lifestyle modification and medication management over 12 months. The primary outcome is the proportion of participants with controlled BP ( |
| doi_str_mv | 10.1016/j.ahj.2024.05.008 |
| format | Article |
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Using a hybrid type I effectiveness-implementation design, 428 adults with uncontrolled hypertension (systolic BP ≥ 140 mm Hg) and diabetes or CKD will be recruited from 18 primary care practices, including community health centers, in Maryland. Using a cluster-randomized trial design, practices are randomly assigned to the LINKED-HEARTS intervention arm or EUC arm. Participants in the LINKED-HEARTS intervention arm receive training on HBPM, BP and glucose telemonitoring, and community health worker and pharmacist telehealth visits on lifestyle modification and medication management over 12 months. The primary outcome is the proportion of participants with controlled BP (<140/90 mm Hg) at 12 months.
The study tests a multi-level intervention to control multiple chronic diseases. Findings from the study may be leveraged to reduce disparities in the management and control of chronic diseases and make primary care more responsive to the needs of underserved populations.
ClinicalTrials.gov. Identifier: NCT05321368.
[Display omitted]</description><identifier>ISSN: 0002-8703</identifier><identifier>ISSN: 1097-6744</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2024.05.008</identifier><identifier>PMID: 38759910</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Adults ; Blood levels ; Blood pressure ; Blood Pressure Monitoring, Ambulatory - methods ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - prevention & control ; Chronic illnesses ; Community health care ; Community Health Workers ; Cost effectiveness ; Design ; Diabetes ; Diabetes mellitus ; Diabetes Mellitus - epidemiology ; Diabetes Mellitus - therapy ; Disease control ; Disease management ; Female ; Glucose ; Health care access ; Health disparities ; Heart diseases ; Humans ; Hypertension ; Hypertension - epidemiology ; Hypertension - therapy ; Intervention ; Kidney diseases ; Male ; Medical personnel ; Minority & ethnic groups ; Multicenter Studies as Topic ; Patients ; Population studies ; Poverty ; Primary care ; Randomized Controlled Trials as Topic ; Remote monitoring ; Renal Insufficiency, Chronic - therapy ; Risk factors ; Smartphones ; Stroke ; Telemedicine ; Text messaging ; Web portals</subject><ispartof>The American heart journal, 2024-09, Vol.275, p.9-20</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.</rights><rights>2024. The Authors</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c376t-524a0bf7b64f184bf025bfec0c25b2305f3ec452d1d69ca6e35f38e6d0e37bed3</cites><orcidid>0000-0001-8273-0442</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002870324001236$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38759910$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Commodore-Mensah, Yvonne</creatorcontrib><creatorcontrib>Chen, Yuling</creatorcontrib><creatorcontrib>Ogungbe, Oluwabunmi</creatorcontrib><creatorcontrib>Liu, Xiaoyue</creatorcontrib><creatorcontrib>Metlock, Faith E.</creatorcontrib><creatorcontrib>Carson, Kathryn A.</creatorcontrib><creatorcontrib>Echouffo-Tcheugui, Justin B.</creatorcontrib><creatorcontrib>Ibe, Chidinma</creatorcontrib><creatorcontrib>Crews, Deidra</creatorcontrib><creatorcontrib>Cooper, Lisa A.</creatorcontrib><creatorcontrib>Himmelfarb, Cheryl Dennison</creatorcontrib><title>Design and rationale of the cardiometabolic health program linked with community health workers and mobile health telemonitoring to reduce health disparities (LINKED-HEARTS) program</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Hypertension and diabetes are major risk factors for cardiovascular diseases, stroke, and chronic kidney disease (CKD). Disparities in hypertension control persist among Black and Hispanic adults and persons living in poverty in the United States. The “LINKED-HEARTS Program” (a Cardiometabolic Health Program LINKED with Community Health WorkErs and Mobile HeAlth TelemonitoRing To reduce Health DisparitieS”), is a multi-level intervention that includes home blood pressure (BP) monitoring (HBPM), blood glucose telemonitoring, and team-based care. This study aims to examine the effect of the LINKED-HEARTS Program intervention in improving BP control compared to enhanced usual care (EUC) and to evaluate the reach, adoption, sustainability, and cost-effectiveness of the program.
Using a hybrid type I effectiveness-implementation design, 428 adults with uncontrolled hypertension (systolic BP ≥ 140 mm Hg) and diabetes or CKD will be recruited from 18 primary care practices, including community health centers, in Maryland. Using a cluster-randomized trial design, practices are randomly assigned to the LINKED-HEARTS intervention arm or EUC arm. Participants in the LINKED-HEARTS intervention arm receive training on HBPM, BP and glucose telemonitoring, and community health worker and pharmacist telehealth visits on lifestyle modification and medication management over 12 months. The primary outcome is the proportion of participants with controlled BP (<140/90 mm Hg) at 12 months.
The study tests a multi-level intervention to control multiple chronic diseases. Findings from the study may be leveraged to reduce disparities in the management and control of chronic diseases and make primary care more responsive to the needs of underserved populations.
ClinicalTrials.gov. Identifier: NCT05321368.
[Display omitted]</description><subject>Adult</subject><subject>Adults</subject><subject>Blood levels</subject><subject>Blood pressure</subject><subject>Blood Pressure Monitoring, Ambulatory - methods</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - prevention & control</subject><subject>Chronic illnesses</subject><subject>Community health care</subject><subject>Community Health Workers</subject><subject>Cost effectiveness</subject><subject>Design</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Diabetes Mellitus - therapy</subject><subject>Disease control</subject><subject>Disease management</subject><subject>Female</subject><subject>Glucose</subject><subject>Health care access</subject><subject>Health disparities</subject><subject>Heart diseases</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - 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Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Commodore-Mensah, Yvonne</au><au>Chen, Yuling</au><au>Ogungbe, Oluwabunmi</au><au>Liu, Xiaoyue</au><au>Metlock, Faith E.</au><au>Carson, Kathryn A.</au><au>Echouffo-Tcheugui, Justin B.</au><au>Ibe, Chidinma</au><au>Crews, Deidra</au><au>Cooper, Lisa A.</au><au>Himmelfarb, Cheryl Dennison</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Design and rationale of the cardiometabolic health program linked with community health workers and mobile health telemonitoring to reduce health disparities (LINKED-HEARTS) program</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2024-09</date><risdate>2024</risdate><volume>275</volume><spage>9</spage><epage>20</epage><pages>9-20</pages><issn>0002-8703</issn><issn>1097-6744</issn><eissn>1097-6744</eissn><abstract>Hypertension and diabetes are major risk factors for cardiovascular diseases, stroke, and chronic kidney disease (CKD). Disparities in hypertension control persist among Black and Hispanic adults and persons living in poverty in the United States. The “LINKED-HEARTS Program” (a Cardiometabolic Health Program LINKED with Community Health WorkErs and Mobile HeAlth TelemonitoRing To reduce Health DisparitieS”), is a multi-level intervention that includes home blood pressure (BP) monitoring (HBPM), blood glucose telemonitoring, and team-based care. This study aims to examine the effect of the LINKED-HEARTS Program intervention in improving BP control compared to enhanced usual care (EUC) and to evaluate the reach, adoption, sustainability, and cost-effectiveness of the program.
Using a hybrid type I effectiveness-implementation design, 428 adults with uncontrolled hypertension (systolic BP ≥ 140 mm Hg) and diabetes or CKD will be recruited from 18 primary care practices, including community health centers, in Maryland. Using a cluster-randomized trial design, practices are randomly assigned to the LINKED-HEARTS intervention arm or EUC arm. Participants in the LINKED-HEARTS intervention arm receive training on HBPM, BP and glucose telemonitoring, and community health worker and pharmacist telehealth visits on lifestyle modification and medication management over 12 months. The primary outcome is the proportion of participants with controlled BP (<140/90 mm Hg) at 12 months.
The study tests a multi-level intervention to control multiple chronic diseases. Findings from the study may be leveraged to reduce disparities in the management and control of chronic diseases and make primary care more responsive to the needs of underserved populations.
ClinicalTrials.gov. Identifier: NCT05321368.
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Adult Adults Blood levels Blood pressure Blood Pressure Monitoring, Ambulatory - methods Cardiovascular diseases Cardiovascular Diseases - epidemiology Cardiovascular Diseases - prevention & control Chronic illnesses Community health care Community Health Workers Cost effectiveness Design Diabetes Diabetes mellitus Diabetes Mellitus - epidemiology Diabetes Mellitus - therapy Disease control Disease management Female Glucose Health care access Health disparities Heart diseases Humans Hypertension Hypertension - epidemiology Hypertension - therapy Intervention Kidney diseases Male Medical personnel Minority & ethnic groups Multicenter Studies as Topic Patients Population studies Poverty Primary care Randomized Controlled Trials as Topic Remote monitoring Renal Insufficiency, Chronic - therapy Risk factors Smartphones Stroke Telemedicine Text messaging Web portals |
| title | Design and rationale of the cardiometabolic health program linked with community health workers and mobile health telemonitoring to reduce health disparities (LINKED-HEARTS) program |
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