266385 Comparative effectiveness of interventions to address hypertension control and colorectal cancer screening in Black men: Baseline findings and lessons learned

Monday, October 29, 2012 : 2:30 PM - 2:50 PM

Joseph Ravenell, MD, MS , Department of Population Health, New York University School of Medicine, New York, NY
R. Scott Braithwaite, MD , Department of Medicine, New York University School of Medicine, New York, NY
Chau Trinh-Shevrin, DrPH , Institute of Community Health and Research, NYU Center for Study of Asian American Health, New York, NY
Mariano Rey, MD , Center for the Study of Asian American Health, NYU Institute of Community Health and Research, New York University School of Medicine, New York, NY
Background: Black men in the US have the greatest burden of death from hypertension and colorectal cancer (CRC), in part due to adverse lifestyle behaviors, and lower rates of timely CRC screening. While lifestyle interventions can lower BP and patient navigation (PN) can increase CRC screening in clinic settings, few studies have examined the comparative effectiveness of these approaches among black men in community-based settings.

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

Methods: Black men aged >50 years with uncontrolled hypertension without previous CRC screening were recruited from barbershop/churches and randomized to a lifestyle intervention using motivational interviewing (MI), a culturally-targeted PN intervention or a combination of MI/PN. Outcomes include within-person change in BP, CRC screening rate at 6-months, and the impact of the interventions on life expectancy and quality-adjusted life-years.

Results: In a 16-month period, we screened 4035 black men aged 50+ at 79 barbershops and 39 churches; 1106 were eligible; 794 were randomized and initiated one of the three interventions. Among enrolled men, 67% of non-retired men were unemployed, and 40% reported not having a primary care doctor. Six-month follow up is ongoing, and mathematical models of the potential population-wide impact of the interventions are being developed.

Implications: Our comparative effectiveness program provides valuable insight into how best to address important public health challenges among Black men, and informs the process of implementing public health comparative effectiveness research in real-world settings.

Learning Areas:
Public health or related research

Learning Objectives:
1. Discuss the problem of hypertension and colon cancer disparities among Black men. 2. Compare community-based interventions to address hypertension control and colon cancer prevention in high-risk populations. 3. Discuss unique challenges associated with comparative effectiveness research in community-based settings.

Keywords: Community-Based Public Health, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal of multiple federally funded grants focusing on community-based interventions to improve hypertension control and colorectal cancer prevention in Black men.
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.