Comparing the Effectiveness of Lifestyle Counseling and Patient Navigation on Hypertension Control and Colorectal Cancer Screening in Black Men

Background: Black men in the US have the greatest burden of death from hypertension and colorectal cancer (CRC). Reasons for the disproportionate morbidity/mortality from these conditions in black men include low blood pressure (BP) control rates in part due to adverse lifestyle behaviors, and lower rates of timely colorectal cancer screening. Though approaches can lower BP through therapeutic lifestyle changes and increase CRC screening through patient navigation in clinic settings, few studies have tested these approaches among black men in non-clinical community-based settings.

Objective: To evaluate the impact of community-based lifestyle counseling, patient navigation, and the combination of both on BP and CRC screening among hypertensive black men.

Methods: In a randomized, three-parallel-arm controlled trial, 1440 black men aged >50 years with uncontrolled hypertension who have not had previous CRC screening will be recruited from barbershop/churches and randomized to a lifestyle intervention using motivational interviewing, a culturally-targeted patient navigation intervention or a combination of motivational interviewing and patient navigation. The primary outcomes are within-person change in BP and CRC screening rate at 6-months. Data collected will be used to model the potential impact of the interventions on life expectancy and quality-adjusted life-years.

Results: Recruitment is underway in barbershops and churches in NYC.

Implications: Our program is a non-traditional model of disseminating proven interventions for BP control and CRC prevention in Black men nationwide – a group often underrepresented in clinical practices. The potential for dissemination and scalability is high, given the ubiquity of churches and barbershops across the US.