Abstract 200: Outcomes of the American Heart Association’s Check. Change. Control Program: A Multi-Community Hypertension Intervention

Objectives: Previous trials have demonstrated that individual, multi-faceted and intensive community-based BP intervention programs can improve BP control. It is unknown whether such programs can be effective using a more simplified format and generalized to multiple community settings. Methods: The AHA Check.Change.Control. program was implemented over a 7-month period in 18 US cities with high minority populations and burden of cardiovascular disease. AHA staff partnered with local community organizations/businesses and trained volunteer health mentors (VHM) to develop and implement a program centered on the use of Heart360™ health information technology, health education and events, and support to participants to monitor and reduce BP. We evaluated programs based upon their performance on three outcomes of interest: participant enrollment, participant engagement (8 BPs uploaded over 4 months), and blood pressure (BP) change. BP change was defined continuously comparing first and last recorded BP. We then examined program factors associated with program success. Results: From 1/1/2013 to 7/31/2013, n=4069 participants were enrolled in the program across 18 geographically-distinct communities. Most programs were implemented in churches, work-site wellness programs, and healthcare institutions. The mean number of patients enrolled by each site was 226 (SD=106) over 3 months. Programs with the highest enrollment were more likely to recruit from senior residential institutions and service organizations, hold hypertension management classes, hold more frequent kick-off events, and utilize a combination of established and new community partners. Participant engagement ranged from 0% to 52.8%. Programs with the highest engagement were more likely to hold hypertension education classes and follow-up with participants via call or face-to-face contact. Among all participants, systolic BP decreased by a mean of -7.5 mmHg (SD 20.1 mmHg, p<0.0001) and diastolic BP by -3.3 mmHg (SD 11.2 mmHg, p<0.0001). There was significant program level variation in systolic (+7.2 to -29.3 mmHg) and diastolic (+1.84 to -9.89 mmHg) BP change. Top programs for BP change were more likely to distribute blood pressure cuffs as incentives, check BPs at engagement activities, and use volunteer leads to oversee program activities. Increasing number of BP uploads was associated with larger declines in systolic (r=-0.27, p<0.0001) and diastolic (r=-0.17, p<0.0001) BP. Conclusions: Check.Change.Control. is a novel community-based initiative that demonstrated significant reduction in BP among 18 communities. We have identified several programmatic factors associated with improved program implementation and success that may guide future implementation in other communities.