Evaluating the effectiveness of a culturally appropriate Spanish language pilot case management and health education program for hypertensive Latino patients residing in southern San Diego County

Effectively managing hypertension to reduce risk of future health complications such as transient ischemic attacks, cerebral vascular attacks and myocardial infarctions is a challenge for low-income, low-education, and low-acculturated Latinos residing in southern San Diego, California. To address this issue, San Ysidro Health Center (SYHC) in collaboration with the National Alliance for Hispanic Health (the Alliance) implemented a culturally tailored pilot case management and health education intervention to improve adherence to recommended hypertension treatment and improve overall health status for 53 diagnosed hypertensive SYHC patients, aged 40 years and older. Participants were recruited via physician referrals, onsite patient recruitment, and direct mailing using the health center's electronic disease management system. Intervention components included: 1) Four health education sessions; 2) distribution of Spanish education materials provided by the Alliance; and 3) in-person/phone-based case management. Pre and post intervention data consisted of: Anthropometric measurements (height, weight, waist and hip circumference); blood pressure; fasting blood analyses (lipid panel and complete blood count); and a 75-item questionnaire assessing stress, social support, language usage, eating habits, physical activity, smoking habits, depression, hypertension management and support, medication adherence, and health barriers. Results demonstrate participants who took part in this four-month educational and case management intervention showed significant improvements in health status (total, HDL, and LDL cholesterol, and triglycerides), and in self-reported antihypertension medication adherence and health behaviors. Further research is needed on effective approaches that support adherence to hypertension treatment for underserved Latinos. The study was funded by the Alliance with support from Novartis, Inc.