Abstract P088: Comparison Of Lay Advisor Interventions For Hypertension Across Racial Groups In The United States

Background: Lay advisor interventions for hypertension are frequently tailored to a single racial group. We conducted a systematic review comparing components of lay advisor interventions for hypertension across racial groups in the US. Methods: Multiple databases were searched from 1980 to 2020 using relevant search terms. Results: Of 5986 articles, 14 studies were eligible for inclusion: 5 with predominantly white participants, 4 with Black participants, 3 with Hispanic participants and 2 with Asian participants. All studies but two were RCTs. One study with white participants and one with Hispanic participants were clinic-based; all other studies were community-based. Lay advisors were matched to participants’ social groups in 13 studies and 1 study used health coaches with a bachelor's degree. Home visits were included in 44% (4/9) of studies with minority participants and in no studies with predominantly white participants. Most (4/5) studies with white participants included group education and one study had individual education. All studies with Black participants included only individual education. Two studies with Hispanic participants included group education while one study used health coach phone calls and home BP monitoring. Both studies with Asian participants included group education with follow-up individual education. For BP outcomes: 3 studies with predominantly white participants, 3 with Black participants, 1 with Hispanic participants, and 2 with Asian participants showed statistically significant improvement. One health coach study with Hispanic participants showed a systolic BP reduction of 19.3 mm Hg; all other studies showed mean systolic BP improvements between 6 to 8.3 mm Hg across races. Three studies examined hypertension control outcomes, of which 2 studies with Asian participants showed improved hypertension control. Individualized low-intensity interventions were as effective as high-intensity interventions. Conclusion: Lay advisor interventions were effective and mainly community-based across racial groups. Individualized education by lay advisors belonging to patients’ social groups may be a feasible and effective approach for health systems that care for diverse populations.