Take Control of Your Blood Pressure (TCYB) study: a multifactorial tailored behavioral and educational intervention for achieving blood pressure control.
OBJECTIVE
Evaluating a randomized controlled trial involving a tailored behavioral intervention conducted to improve blood pressure control.


METHODS
Adults with hypertension from two outpatient primary care clinics were randomly allocated to receive a nurse-administered behavioral intervention or usual care. In this ongoing study, patients receive the tailored behavioral intervention bi-monthly for 2 years via telephone; the goal of the intervention is to promote medication adherence and improve hypertension-related health behaviors. Patient factors targeted in the tailored behavioral intervention include perceived risk of hypertension and knowledge, memory, medical and social support, patients' relationship with their health care provider, adverse effects of medication therapy, weight management, exercise, diet, stress, smoking, and alcohol use.


RESULTS
The sample randomized to the behavioral intervention consisted of 319 adults with hypertension (average age=60.5 years; 47% African-American). A comparable sample of adults was assigned to usual care (n=317). We had a 96% retention rate for the overall sample for the first 6 months of the study (93% at 12 months). The average phone call has lasted 18min (range 2-51min). From baseline to 6 months, self-reported medication adherence increased by 9% in the behavioral group vs. 1% in the non-behavioral group.


CONCLUSIONS
The intervention is easily implemented and is designed to enhance adherence with prescribed hypertension regimen. The study includes both general and patient-tailored information based upon need assessment. The study design ensures internal validity as well as the ability to generalize study findings to the clinic settings.


CONCLUSIONS
Despite knowledge of the risks and acceptable evidence, a large number of hypertensive adults still do not have their blood pressure under effective control. This study will be an important step in evaluating a tailored multibehavioral intervention focusing on improving blood pressure control.
Bosworth
Hayden B
HB
Center for Health Services Research in Primary Care, Durham VAMC, United States. hboswort@acpub.duke.edu
Olsen
Maren K
MK
Neary
Alice
A
Orr
Melinda
M
Grubber
Janet
J
Svetkey
Laura
L
Adams
Martha
M
Oddone
Eugene Z
EZ
D000368:Aged; D018660:Blood Pressure Monitoring, Ambulatory; D003479:Curriculum; D005260:Female; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D020380:Needs Assessment / Q000458:organization & administration; D009657:North Carolina; D015403:Nursing Evaluation Research; D010347:Patient Care Planning / Q000458:organization & administration*; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000458:organization & administration*; D012648:Self Care / Q000379:methods / Q000523:psychology*; D013689:Telephone