A Closer Look at African American Men and High Blood ...

[Pages:128]A Review of Psychosocial Factors and Systems-Level Interventions

A Closer Look at African American Men and High Blood Pressure Control

U.S. Department of Health and Human Services Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion

10_211234-A

Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion Division for Heart Disease & Stroke Prevention Mail Stop K?47 ? 4770 Buford Highway, NE ? Atlanta, Georgia 30341 800-CDC-INFO ? cdcinfo@ ? DHDSP

Suggested Citation:

Centers for Disease Control and Prevention. A Closer Look at African American Men and High Blood Pressure Control: A Review of Psychosocial Factors and Systems-Level Interventions. Atlanta: U.S. Department of Health and Human Services; 2010.

Photos:

The photographs used in this publication are for illustration purposes only. They show African American men from various age groups. They are not intended to depict people who have high blood pressure or who had a heart attack or stroke.

For Free Copies or Additional Information:

E-mail: cdcinfo@

Write:

Division for Heart Disease and Stroke Prevention, NCCDPHP Centers for Disease Control and Prevention 4770 Buford Highway, NE, Mailstop K-47 Atlanta, GA 30341

Phone: 1-800-CDC-INFO (232-4636)

TTY: 1-888-232-6348

Online:

The findings and conclusions in this document are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention/the Agency for Toxic Substances and Disease Registry.

Table of Contents

Chapter

Page

Acknowledgments.......................................................................................................................................3

Top 10 Considerations for Public Health Programs When Planning Systems-Level Interventions for

African American Men to Control High Blood Pressure.......................................................................5

Recommendations ......................................................................................................................................6

Preface ........................................................................................................................................................9

Chapter 1 - Introduction ..........................................................................................................................13

Chapter 2 - The Burden of High Blood Pressure.......................................................................................15

2.1 Overview......................................................................................................................................... 16

2.2 Morbidity........................................................................................................................................ 16

2.2.1 Elevated Blood Pressure ........................................................................................................ 16

2.2.2 Hypertension Awareness, Treatment, and Control ................................................................ 17

2.2.3 Heart Disease ....................................................................................................................... 19

2.2.4 Stroke ................................................................................................................................... 20

2.3 Mortality ......................................................................................................................................... 20

2.3.1 Death Rates from Hypertensive Disease................................................................................ 20

2.3.2 Death Rates from Heart Disease ........................................................................................... 23

2.3.3 Death Rates from Cerebrovascular Disease ........................................................................... 24

Chapter 3 - Psychosocial Aspects of Blood Pressure Control among African American Men ....................27

3.1 Overview......................................................................................................................................... 27

3.2 Perceived Racism, Experienced Racism, and Racial Discrimination ................................................. 27

3.3 Knowledge, Beliefs, and Attitudes about Hypertension.................................................................... 29

3.4 Access to Care ................................................................................................................................. 30

3.5 Health Insurance ............................................................................................................................. 30

3.6 Quality of Care................................................................................................................................ 31

3.7 Socioeconomic Status ...................................................................................................................... 32

3.8 Rural Residence............................................................................................................................... 33

3.9 Social Support ................................................................................................................................. 34

3.10 Depression ...................................................................................................................................... 34

3.11 Substance Abuse .............................................................................................................................. 35

3.12 Obesity............................................................................................................................................ 35

3.13 Emerging Knowledge about Disparities in Hypertension................................................................. 36

a review to address blood pressure control in african american men 1

Chapter 4 - Programs with Systems-Level Interventions...........................................................................37

4.1 Overview......................................................................................................................................... 37

4.2 Summary of Lessons Learned .......................................................................................................... 38

4.2.1 Overall Lessons..................................................................................................................... 38

4.2.2 Lessons on Program Participation by African American Men................................................ 39

4.2.3 Lessons on Cultural Competency ......................................................................................... 40

4.3 Interviewed Programs ...................................................................................................................... 40

4.3.1 Examples of Program Models ............................................................................................... 40

4.3.2 Interviewed Programs Matrix................................................................................................ 42

4.3.3 Individual Program Summaries............................................................................................. 43

4.4 Literature Search Results.................................................................................................................. 80

4.4.1 Journal Article Projects Matrix.............................................................................................. 81

4.4.2 Blood Pressure Control Programs Focusing on African American Men ................................. 83

4.4.3 Blood Pressure Control/Coronary Heart Disease Prevention Programs Focusing on the African

American Community......................................................................................................... 90

4.4.4 Other Relevant Systems-Level Health Care Programs Focusing on the African

American Community......................................................................................................... 99

Chapter 5 - General Health Resources....................................................................................................105

5.1 Overview.......................................................................................................................................... 105

References...............................................................................................................................................117

Appendix A ? Key Terms and Phrases Used to Find Programs or Interventions for African American Men with

High Blood Pressure in the Practice Literature ....................................................................................... 123

Appendix B ? Key Terms Used to Find Peer-Reviewed Articles Relevant to Systems-Level Interventions for

African American Men with High Blood Pressure .................................................................................. 125

2 african american men and blood pressure control: a closer look

Acknowledgments

This project was supported by a task order contract (200-2001-00123) between RTI International and the Division for Heart Disease and Stroke Prevention (DHDSP), National Center for Chronic Disease Prevention and Health Promotion (NCCD PHP), Centers for Disease Control and Prevention (CDC). This guide is a continua tion of previous work performed by the Program Development and Services Branch in DHDSP. We would like to thank the following people for their participation in making this document a reality:

RTI International Nancy D. Berkman, PhD* Andrea Yuen, BS* Erika Willacy, MPH Adrienne Rooks, BA* Linda Lux, MPH Shelly Harris, MPH Ben Beatty, MPH

The MayaTech Corporation Suzanne M. Randolph, PhD*

CDC Bernadette Ford Lattimore, MPH* Belinda Minta, MPH, MBA Rosanne Farris, PhD Sarah O'Leary, MPH, MA Nora Keenan, PhD Robert Merritt, MA Cathleen Gillespie, MS Kathryn Gallagher, MA Yuling Hong, MD, MSc, PhD, FAHA Michael Schooley, MPH Julie Will, PhD Darwin Labarthe, MD, MPH, PhD Sheree Marshall Williams, PhD Angela Soyemi, BA

Expert Panel

*Indicates primary project staff.

We extend many thanks to the project's expert panel for their guidance in the

development and content of this guide. Their contributions and participation

in the process were key in bringing together the document. The expert panel

consisted of the following:

Jean J.E. Bonhomme, MD, MPH Founding Member National Black Men's Health Network

Alan Richmond, MSW Director of Health Disparities North Carolina Institute of Minority

Jules Harrell, PhD

Economic Development

Professor, Department of Psychology Howard University

Herman A. Taylor, Jr, MD, MPH, FACC, FAHA

B. Waine Kong, PhD, JD Chief Executive Officer Association of Black Cardiologists

George Mensah, MD, FACP, FACC Director for Heart Health and

Professor of Medicine Shirley Professor for the Study of Health Disparities Principal Investigator, Jackson Heart Study University of Mississippi Medical Center

Global Health Policy

Corporate Research and Development Unit

PepsiCo., Inc.

a review to address blood pressure control in african american men 3

Special thanks to the key informants for providing us with the information necessary to produce this document. They are as follows: Shauntice Allen, MA University of Alabama at Birmingham Birmingham, AL Karen Boone Georgia Department of Human Resources' Division of Public Health Atlanta, GA Jeanne Charleston John Hopkins University Baltimore, MD Akilah Heggs, MA Association of Black Cardiologists, Inc. Atlanta, GA Devon Love Center for MultiCultural Health Seattle, WA James Plumb, MD, MPH Thomas Jefferson University Philadelphia, PA Sara Eve Sarliker, MPH Washington State Department of Health Olympia, WA Berenice Tow Chicago Department of Public Health Chicago, IL Ronald Victor, MD Cedars-Sinai Medical Center Los Angeles, CA

Top 10 Considerations for State Programs When

4 african american men and blood pressure control: a closer look

Top 10 Considerations for State Programs When Planning Systems-Level Interventions for African American Men to Control Blood Pressure

Because public health programs share the Division for Heart Disease and Stroke Prevention's mission of "...eliminating disparities in the burden of heart disease and stroke," this document provides a tool that can be used to develop or fund systemslevel interventions, particularly addressing African American men and high blood pres sure control. Below is a list of considerations as public health programs plan, develop, and implement systems-level interventions for this underserved population: 1. Review and become familiar with the national prevalence data on hypertension

in African American men, as well as factors related to awareness, treatment, and

control. Gather and analyze state and local data on this population; determine

priority groups or localities if appropriate.

2. Become familiar with the psychosocial factors (e.g., effects of racism, social support, access to care) related to high blood pressure control among African American men. 3. Identify and share data with stakeholders that public health programs might part ner with when developing interventions related to high blood pressure control in African American men. 4. Collaborate with non-traditional partners (e.g., faith-based organizations,

sororities and fraternities, barbershops) to develop and implement interventions

for this population.

5. Before implementing an intervention, examine the history and politics of the community. Be sure to include members of the community during the initial planning stages of an intervention or activity. Not only does this build trust, but it can also increase the chances that the intervention or activity will be successful. 6. Identify settings or mechanisms for possible intervention, which may include con ducting com-munity needs assessments or environmental scans of potential sites and how the priority group could best be reached. 7. Identify reviewed projects and interventions that have been evaluated for possible pilot programs; determine characteristics of programs that are most compatible with potential pilot program setting. 8. Consider reviewing information on similar interventions and programs dealing

with men's health concerns to discover promising or best practices regardless of

topic area, such as prostate cancer or diabetes.

9. Review the Lessons Learned from interviewed programs and Key Findings from

literature reviews to use as tools to develop interventions or similar activities for

your target population.

10. Develop evaluation plans for proposed interventions.

a review to address blood pressure control in african american men 5

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download