A randomized community-based intervention trial comparing faith community nurse referrals to telephone-assisted physician appointments for health fair participants with elevated blood pressure.
OBJECTIVE
To measure the effect of faith community nurse referrals versus telephone-assisted physician appointments on blood pressure control among persons with elevated blood pressure at health fairs.


METHODS
Randomized community-based intervention trial conducted from October 2006 to October 2007 of 100 adults who had an average blood pressure reading equal to or above a systolic of 140 mm Hg or a diastolic of 90 mm Hg obtained at a faith community nurse-led church health event. Participants were randomized to either referral to a faith community nurse or to a telephone-assisted physician appointment. The average enrollment systolic blood pressure (SBP) was 149 +/- 14 mm Hg, diastolic blood pressure (DBP) was 87 +/- 11 mm Hg, 57% were uninsured and 25% were undiagnosed at the time of enrollment.


RESULTS
The follow-up rate was 85% at 4 months. Patients in the faith community nurse referral arm had a 7 +/- 15 mm Hg drop in SBP versus a 14 +/- 15 mm Hg drop in the telephone-assisted physician appointment arm (p = 0.04). Twenty-seven percent of the patients in the faith community nurse referral arm had medication intensification compared to 32% in the telephone-assisted physician appointment arm (p = 0.98).


CONCLUSIONS
Church health fairs conducted in low-income, multiethnic communities can identify many people with elevated blood pressure. Facilitating physician appointments for people with elevated blood pressure identified at health fairs confers a greater decrease in SBP than referral to a faith community nurse at four months.
Baig
Arshiya A
AA
Department of Medicine, Section of General Internal Medicine, University of Chicago, Chicago, IL 60637, USA. abaig@uchicago.edu
Mangione
Carol M
CM
Sorrell-Thompson
Alice L
AL
Miranda
Jeanne M
JM
D000328:Adult; D000368:Aged; D001071:Appointments and Schedules; D003153:Community Health Services / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006277:Health Fairs / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000517:prevention & control / Q000628:therapy*; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D010819:Physician's Role; D012017:Referral and Consultation; D012068:Religion and Medicine