Linking community-based blood pressure measurement to clinical care: a randomized controlled trial of outreach and tracking by community health workers.
OBJECTIVE
This study assessed the effectiveness of enhanced tracking and follow-up services provided by community health workers in promoting medical follow-up of persons whose elevated blood pressures were detected during blood pressure measurement at urban community sites.


METHODS
In a randomized controlled trial, 421 participants received either enhanced or usual referrals to care. Participants were 18 years or older, were either Black or White, and had blood pressure greater than or equal to 140/90 mm Hg and income equal to or less than 200% of poverty. The primary outcome measure was completion of a medical follow-up visit within 90 days of referral.


RESULTS
The enhanced intervention increased follow-up by 39.4% (95% confidence interval [CI] = 14%, 71%; P = .001) relative to usual care. Follow-up visits were completed by 65.1% of participants in the intervention group, compared with 46.7% of those in the usual-care group. The number needed to treat was 5 clients (95% CI = 3, 13) per additional follow-up visit realized.


CONCLUSIONS
Enhanced tracking and outreach increased the proportion of persons with elevated blood pressure detected during community measurement who followed up with medical care.
Krieger
J
J
Seattle-King County Department of Public Health, Seattle, WA 98104-4099, USA. james.krieger@metrokc.gov
Collier
C
C
Song
L
L
Martin
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D001071:Appointments and Schedules; D001795:Blood Pressure Determination; D003150:Community Health Workers / Q000458:organization & administration*; D003159:Community-Institutional Relations; D005260:Female; D006302:Health Services Research; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000458:organization & administration*; D008875:Middle Aged; D011203:Poverty; D015397:Program Evaluation; D012017:Referral and Consultation / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D014861:Washington