Blood Pressure Disparities Reduction, Equity, and Access among safety net patients with Cardiovascular Health risk (BP REACH)
BP control is critical for reducing risk of recurrent CV events and improving outcomes after myocardial infarction (MI) or stroke, yet control rates in these patients remain suboptimal, particularly for socially disadvantaged racial/ethnic minority populations served by safety net health systems. In this project, Drs. Towfighi and Casillas leverage their decades of collaboration with safety-net populations and health system stakeholders across the LA County Department of Health Services (LAC DHS) to implement a multilevel, culturally and linguistically tailored, complex intervention. The community-tailored intervention provides pharmacist-led medication management, remote BP self-monitoring, and CHW navigation in chronic disease education/outreach based on SDOH. The study aims to reduce BP in multi-ethnic patients with prior stroke or MI; the team includes LAC DHS leaders and staff, and patient/community partners.
Skills-based Educational strategies to Reduce Vascular Events in Orange County (SERVE OC)
Primordial prevention of HTN is critical in reducing health disparities. Achievement of ideal cardiovascular health (CVH), defined by the American Heart Association (AHA) based on 7 modifiable risk factors, referred to as Life's Simple 7 (LS7), is associated with lower risk of heart disease, stroke, and chronic kidney disease compared to suboptimal ranges.112 The LS7 factors are all modifiable, appropriate for children and adults. Achieving optimal LS7 levels are cost saving, and can be improve through lifestyle changes; however, they are also associated with profound disparities across the age spectrum. With the goal of addressing primordial prevention of HTN using community-based participatory research (CBPR), this 36-month RCT intervention examines efficacy of SERVE OC in achieving ideal CVH in households using LS7 scores and examining efficacy in reduction of SBP among non-hypertensive adults versus enhanced usual care (EUC). SERVE OC utilizes a skills-focused web-portal engaging in strategies to: 1) Enhance provider-family communication, 2) Identify challenges to CVH, and, 3) Optimize risk perception. CHWs will engage families in building an iterative list of barriers/solutions to be shared with community stakeholders. SERVE OC includes Latino and Vietnamese families working to improve CVH and achieve.