PDF(Pubmed)
Abstract：
BACKGROUND: Self-monitoring blood pressure (SMBP) programs are an evidence-based hypertension management intervention facilitated through telehealth. SMBP programs can provide a continuum of care beyond a clinical setting by facilitating hypertension management at home; however, equitable access to SMBP is a concern.
OBJECTIVE: To evaluate the implementation of telehealth SMBP programs using an equity lens in 5 federally qualified health centers (FQHCs) in Massachusetts (MA).
METHODS: A prospective case series study.
METHODS: Five FQHCs.
METHODS: The MA Department of Public Health (MDPH) selected 5 FQHCs to implement SMBP programs using telehealth. FQHCs were selected if their patient population experiences inequities due to social determinants of health and has higher rates of cardiovascular disease. Each of the 5 FQHCs reported data on patients enrolled in their SMBP programs totaling 241 patients examined in this study.
METHODS: SMBP programs implemented through telehealth.
METHODS: Systolic blood pressure and diastolic blood pressure.
RESULTS: Approximately 53.5% of SMBP participants experienced a decrease in blood pressure. The average blood pressure decreased from 146/87 to 136/81 mm Hg. Among all patients across the 5 FQHCs, the average blood pressure decreased by 10.06/5.34 mm Hg (P < .001). Blood pressure improved in all racial, ethnic, and language subgroups.
CONCLUSIONS: Five MA FQHCs successfully implemented equitable telehealth SMBP programs. SMBP participants enrolled in the programs demonstrated notable improvements in their blood pressure at the conclusion of the program. A flexible, pragmatic study design that was adjusted to meet unique patient needs; engaging nonphysician team members, particularly community health workers; adapting health information technology; and partnerships with community-based organizations were critical facilitators to program success.
OBJECTIVE: To evaluate the implementation of telehealth SMBP programs using an equity lens in 5 federally qualified health centers (FQHCs) in Massachusetts (MA).
METHODS: A prospective case series study.
METHODS: Five FQHCs.
METHODS: The MA Department of Public Health (MDPH) selected 5 FQHCs to implement SMBP programs using telehealth. FQHCs were selected if their patient population experiences inequities due to social determinants of health and has higher rates of cardiovascular disease. Each of the 5 FQHCs reported data on patients enrolled in their SMBP programs totaling 241 patients examined in this study.
METHODS: SMBP programs implemented through telehealth.
METHODS: Systolic blood pressure and diastolic blood pressure.
RESULTS: Approximately 53.5% of SMBP participants experienced a decrease in blood pressure. The average blood pressure decreased from 146/87 to 136/81 mm Hg. Among all patients across the 5 FQHCs, the average blood pressure decreased by 10.06/5.34 mm Hg (P < .001). Blood pressure improved in all racial, ethnic, and language subgroups.
CONCLUSIONS: Five MA FQHCs successfully implemented equitable telehealth SMBP programs. SMBP participants enrolled in the programs demonstrated notable improvements in their blood pressure at the conclusion of the program. A flexible, pragmatic study design that was adjusted to meet unique patient needs; engaging nonphysician team members, particularly community health workers; adapting health information technology; and partnerships with community-based organizations were critical facilitators to program success.
摘要：
背景：自我监测血压（SMBP）计划是通过远程健康促进的基于证据的高血压管理干预措施。SMBP计划可以通过在家中促进高血压管理来提供超出临床环境的连续护理;然而，公平获得SMBP是一个令人担忧的问题。
目的：在马萨诸塞州（MA）的5个联邦合格的健康中心（FQHC）中，使用公平视角评估远程医疗SMBP计划的实施情况。
方法：前瞻性病例系列研究。
方法：五个FQHC。
方法：MA公共卫生部（MDPH）选择了5个FQHC来使用远程医疗实施SMBP计划。如果患者群体由于健康的社会决定因素而经历不平等并且具有较高的心血管疾病发病率，则选择FQHC。5个FQHC中的每一个都报告了参与其SMBP计划的患者的数据，该研究共检查了241名患者。
方法：通过远程医疗实施的SMBP程序。
方法：收缩压和舒张压。
结果：大约53.5%的SMBP参与者经历了血压下降。平均血压从146/87降至136/81mmHg。在5个FQHCs的所有患者中，平均血压下降10.06/5.34mmHg(P<.001)。所有种族的血压都有所改善，民族,和语言子组。
结论：五个MAFQHC成功实施了公平的远程医疗SMBP计划。参加该计划的SMBP参与者在计划结束时表现出血压的显着改善。一个灵活的，经过调整以满足独特患者需求的务实研究设计；聘请非医师团队成员，特别是社区卫生工作者；适应卫生信息技术；与社区组织的伙伴关系是计划成功的关键促进因素。
目的：在马萨诸塞州（MA）的5个联邦合格的健康中心（FQHC）中，使用公平视角评估远程医疗SMBP计划的实施情况。
方法：前瞻性病例系列研究。
方法：五个FQHC。
方法：MA公共卫生部（MDPH）选择了5个FQHC来使用远程医疗实施SMBP计划。如果患者群体由于健康的社会决定因素而经历不平等并且具有较高的心血管疾病发病率，则选择FQHC。5个FQHC中的每一个都报告了参与其SMBP计划的患者的数据，该研究共检查了241名患者。
方法：通过远程医疗实施的SMBP程序。
方法：收缩压和舒张压。
结果：大约53.5%的SMBP参与者经历了血压下降。平均血压从146/87降至136/81mmHg。在5个FQHCs的所有患者中，平均血压下降10.06/5.34mmHg(P<.001)。所有种族的血压都有所改善，民族,和语言子组。
结论：五个MAFQHC成功实施了公平的远程医疗SMBP计划。参加该计划的SMBP参与者在计划结束时表现出血压的显着改善。一个灵活的，经过调整以满足独特患者需求的务实研究设计；聘请非医师团队成员，特别是社区卫生工作者；适应卫生信息技术；与社区组织的伙伴关系是计划成功的关键促进因素。
