250156 Evaluation of Fiscally Sustainable Community Hypertension Treatment Group in Rural Honduras

Wednesday, November 2, 2011: 9:42 AM

Sheridan Reiger, MD/MPHc , School of Medicine, University of Washington, Seattle, WA
Sarah Zelek, MPHc , School of Public Health, Department of Epidemiology, University of Washington, Seattle, WA
Robin Bigelow, BSc , College of Agricultural and Life Sciences, Cornell University, Ithaca, NY
James Logerfo, MD MPH FACP , Department of Health Services, Department of Global Health, University of Washington, Seattle, WA
Hector Lopez-Oqueli, MD , Clinica Municipal de Morazan, Yoro, Ministry of Health of Yoro, Honduras, Morazan, Honduras
M. Jane Mohler, RN, MPH, PhD , Arizona Center on Aging, College of Medicine, University of Arizona, Tucson, AZ
Jeffrey R. Harris, MD MPH MBA , Health Promotion Research Center, University of Washington, Seattle, WA
In March 2010, the NGO Salud Juntos (SJ) co-developed a fiscally self-sustaining hypertension group (HTN-G) in Punta Ocote, Honduras which provides medications, clinical care, education, and treatment protocols to 75 members for a monthly cost of $2.60 USD per member. Evaluation of HTN-G's effectiveness is necessary to identify appropriate changes and to gauge its potential. At monthly meetings, community health workers record blood pressures (BPs), compliance (prescribed medications taken on HTN-G meeting day), current medications, and demographic and behavioral measures using a modified WHO STEPS Survey. Data from March-November 2010 was obtained and analyzed retrospectively for HTN-G members enrolled for minimum of one month and having most recent visits in October or November (n=45). HTN-G members analyzed were enrolled from 2-9 months (mean/median:7.4667/9), and missed from 0-6 monthly visits during enrollment (mean/median:1/1). From March to November mean BP improved significantly (156.8/88.3 to 144/81.0, t-values systolic/diastolic = 0.0003/0.0034) as did compliance (50% to 96.8% of group, χ2 =9.6x10-7). Core Members, those in HTN-G for 7+ months and missing 0-2 meetings, showed significant improvements from first to most recent visit for BP (156.3/88.3 to 144.3/82.4, t-values = 0.0020/0.0132), compliance (45.2% to 93.8%, χ2=2.0x10-8), and control (BP £140/90 25% to 43.8%, χ2=0.014). These statistical improvements display the promise of the HTN-G model. At current date, the HTN-G has met for eleven months continuously, testament itself to its structure and potential. Ongoing evaluation of the HTN-G as it expands will enable further investigation of scalability and proper role in broader health environments.

Learning Areas:
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Program planning
Provision of health care to the public
Public health administration or related administration

Learning Objectives:
Demonstrate the impact of the participation in a systematic, community health worker based, community-led hypertension management group on the blood pressure, hypertension control, and treatment compliance of its membership in rural Honduras.

Keywords: Chronic Diseases, Community Health Programs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am the Executive Director of Salud Juntos and therefore in charge of Salud Juntos' participation in all program development in Honduras - including the hypertension management group of Punta Ocote, Honduras.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.