The implementation of a translational study involving a primary care based behavioral program to improve blood pressure control

The HTN-IMPROVE study protocol (01295)

Hayden B. Bosworth, Daniel Almirall, Bryan J. Weiner, Mathew Maciejewski, Miriam A. Kaufman, Benjamin J. Powers, Eugene Z. Oddone, Shoou Yih D Lee, Teresa M. Damush, Valerie Smith, Maren K. Olsen, Daren Anderson, Christianne L. Roumie, Susan Rakley, Pamela S. Del Monte, Michael E. Bowen, Jeffrey D. Kravetz, George L. Jackson

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Despite the impact of hypertension and widely accepted target values for blood pressure (BP), interventions to improve BP control have had limited success.Objectives: We describe the design of a 'translational' study that examines the implementation, impact, sustainability, and cost of an evidence-based nurse-delivered tailored behavioral self-management intervention to improve BP control as it moves from a research context to healthcare delivery. The study addresses four specific aims: assess the implementation of an evidence-based behavioral self-management intervention to improve BP levels; evaluate the clinical impact of the intervention as it is implemented; assess organizational factors associated with the sustainability of the intervention; and assess the cost of implementing and sustaining the intervention.Methods: The project involves three geographically diverse VA intervention facilities and nine control sites. We first conduct an evaluation of barriers and facilitators for implementing the intervention at intervention sites. We examine the impact of the intervention by comparing 12-month pre/post changes in BP control between patients in intervention sites versus patients in the matched control sites. Next, we examine the sustainability of the intervention and organizational factors facilitating or hindering the sustained implementation. Finally, we examine the costs of intervention implementation. Key outcomes are acceptability and costs of the program, as well as changes in BP. Outcomes will be assessed using mixed methods (e.g., qualitative analyses--pattern matching; quantitative methods--linear mixed models).Discussion: The study results will provide information about the challenges and costs to implement and sustain the intervention, and what clinical impact can be expected.

Original languageEnglish (US)
Article number54
JournalImplementation Science
Volume5
Issue number1
DOIs
StatePublished - Jul 16 2010

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Primary Health Care
Blood Pressure
Costs and Cost Analysis
Self Care
Facility Regulation and Control
Linear Models
Nurses
Hypertension
Delivery of Health Care
Research

ASJC Scopus subject areas

  • Health Policy
  • Medicine(all)
  • Public Health, Environmental and Occupational Health
  • Health Informatics

Cite this

The implementation of a translational study involving a primary care based behavioral program to improve blood pressure control : The HTN-IMPROVE study protocol (01295). / Bosworth, Hayden B.; Almirall, Daniel; Weiner, Bryan J.; Maciejewski, Mathew; Kaufman, Miriam A.; Powers, Benjamin J.; Oddone, Eugene Z.; Lee, Shoou Yih D; Damush, Teresa M.; Smith, Valerie; Olsen, Maren K.; Anderson, Daren; Roumie, Christianne L.; Rakley, Susan; Del Monte, Pamela S.; Bowen, Michael E.; Kravetz, Jeffrey D.; Jackson, George L.

In: Implementation Science, Vol. 5, No. 1, 54, 16.07.2010.

Research output: Contribution to journalArticle

Bosworth, HB, Almirall, D, Weiner, BJ, Maciejewski, M, Kaufman, MA, Powers, BJ, Oddone, EZ, Lee, SYD, Damush, TM, Smith, V, Olsen, MK, Anderson, D, Roumie, CL, Rakley, S, Del Monte, PS, Bowen, ME, Kravetz, JD & Jackson, GL 2010, 'The implementation of a translational study involving a primary care based behavioral program to improve blood pressure control: The HTN-IMPROVE study protocol (01295)', Implementation Science, vol. 5, no. 1, 54. https://doi.org/10.1186/1748-5908-5-54
Bosworth, Hayden B. ; Almirall, Daniel ; Weiner, Bryan J. ; Maciejewski, Mathew ; Kaufman, Miriam A. ; Powers, Benjamin J. ; Oddone, Eugene Z. ; Lee, Shoou Yih D ; Damush, Teresa M. ; Smith, Valerie ; Olsen, Maren K. ; Anderson, Daren ; Roumie, Christianne L. ; Rakley, Susan ; Del Monte, Pamela S. ; Bowen, Michael E. ; Kravetz, Jeffrey D. ; Jackson, George L. / The implementation of a translational study involving a primary care based behavioral program to improve blood pressure control : The HTN-IMPROVE study protocol (01295). In: Implementation Science. 2010 ; Vol. 5, No. 1.
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abstract = "Background: Despite the impact of hypertension and widely accepted target values for blood pressure (BP), interventions to improve BP control have had limited success.Objectives: We describe the design of a 'translational' study that examines the implementation, impact, sustainability, and cost of an evidence-based nurse-delivered tailored behavioral self-management intervention to improve BP control as it moves from a research context to healthcare delivery. The study addresses four specific aims: assess the implementation of an evidence-based behavioral self-management intervention to improve BP levels; evaluate the clinical impact of the intervention as it is implemented; assess organizational factors associated with the sustainability of the intervention; and assess the cost of implementing and sustaining the intervention.Methods: The project involves three geographically diverse VA intervention facilities and nine control sites. We first conduct an evaluation of barriers and facilitators for implementing the intervention at intervention sites. We examine the impact of the intervention by comparing 12-month pre/post changes in BP control between patients in intervention sites versus patients in the matched control sites. Next, we examine the sustainability of the intervention and organizational factors facilitating or hindering the sustained implementation. Finally, we examine the costs of intervention implementation. Key outcomes are acceptability and costs of the program, as well as changes in BP. Outcomes will be assessed using mixed methods (e.g., qualitative analyses--pattern matching; quantitative methods--linear mixed models).Discussion: The study results will provide information about the challenges and costs to implement and sustain the intervention, and what clinical impact can be expected.",
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AU - Maciejewski, Mathew

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AU - Smith, Valerie

AU - Olsen, Maren K.

AU - Anderson, Daren

AU - Roumie, Christianne L.

AU - Rakley, Susan

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AU - Kravetz, Jeffrey D.

AU - Jackson, George L.

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