Keep on track: a volunteer-run community-based intervention to lower blood pressure in older adults.
Uncontrolled hypertension in older adults is a common yet preventable threat to healthy aging. Improvements in blood pressure (BP) control and related health outcomes require innovative approaches that reach beyond the clinical environment. Keep on Track (KOT), a volunteer-run, community-based BP-monitoring program that aims to lower BP of community-dwelling older adults through senior center programming, is described and evaluated. KOT is based on a New York City (NYC) Department for the Aging program that has been in existence for more than 20 years and is evaluated in six senior centers in low- to middle-income neighborhoods in NYC. Program design includes monitoring sessions every other week to measure and record participant BP. BP education is provided using low-literacy materials, and medication adherence is encouraged. Over 6 months of observation, 244 participants enrolled (mean age 73). Of the 181 (74%) with hypertension at baseline, 92% were previously aware of their condition, 78% were treated, and 31% were controlled. BP control among the treated was 42%. Forty-three percent of enrollees (n=105) were multiple-visit participants who experienced on average a 3.9-mmHg reduction in systolic BP (SBP) between the first and last program visit (95% confidence interval (CI)=-7.6 to -0.1, P=.04). Participants with an initial SBP greater than 160 mmHg (n=20) experienced on average a 20.9-mmHg reduction in SBP (95% CI=-32.4 to -9.4, P<.001). Areas for program improvement include greater attention to peer counseling and timely communication with participants' healthcare providers. Volunteer-run, community-based BP monitoring in senior centers may provide an effective, replicable model for reducing BP in older adults.
Truncali
Andrea
A
Department of Medicine, New York University School of Medicine, New York, New York 10016, USA. andrea.truncali@nyumc.org
Dumanovsky
Tamara
T
Stollman
Harriet
H
Angell
Sonia Y
SY
D000368:Aged; D000369:Aged, 80 and over; D001795:Blood Pressure Determination; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D006973:Hypertension / Q000517:prevention & control*; D008297:Male; D016730:Program Development; D015397:Program Evaluation; D014838:Volunteers