A clinic and community-based approach to hypertension control for an underserved minority population: Design and methods

This paper describes the design and methodology of the Community Hypertensi on Intervention Project (CHIP). CHIP is investigating the environmental and psychosocial factors related to treatment adherence and examining the effe cts of combining usual hypertension care with the effects of three interven tions designed to improve patient compliance with treatment for high blood pressure in a high-risk, underserved minority population. Thirteen hundred and sixty-seven inner-city hypertension patients (75% black and 25% Hispani c) have agreed to participate in the 4-year longitudinal study. These parti cipants were randomized to usual care or one of three intervention groups: individualized counseling sessions; home visits/discussion groups; or compu terized appointment-tracking system. Participants are representative of the surrounding, predominantly low-income minority community and are treated i n a hospital-based clinic and in a private clinic in the community. About 6 5% have blood pressure levels considered to be out of control. It was concl uded that structural changes at the clinic site, along with the targeted in terventions, would improve patient satisfaction, increase treatment adheren ce, and improve blood pressure control. (C) 2000 American Journal of Hypert ension, Ltd.