A Randomized Community-based Intervention Trial Comparing Faith Community Nurse Referrals to Telephone-Assisted Physician Appointments for Health Fair Participants with Elevated Blood Pressure

To measure the effect of faith community nurse referrals versus telephone-assisted physician appointments on blood pressure control among persons with elevated blood pressure at health fairs. Randomized community-based intervention trial conducted from October 2006 to October 2007 of 100 adults who had an average blood pressure reading equal to or above a systolic of 140 mm Hg or a diastolic of 90 mm Hg obtained at a faith community nurse-led church health event. Participants were randomized to either referral to a faith community nurse or to a telephone-assisted physician appointment. The average enrollment systolic blood pressure (SBP) was 149 ± 14 mm Hg, diastolic blood pressure (DBP) was 87 ± 11 mm Hg, 57% were uninsured and 25% were undiagnosed at the time of enrollment. The follow-up rate was 85% at 4 months. Patients in the faith community nurse referral arm had a 7 ± 15 mm Hg drop in SBP versus a 14 ± 15 mm Hg drop in the telephone-assisted physician appointment arm (p = 0.04). Twenty-seven percent of the patients in the faith community nurse referral arm had medication intensification compared to 32% in the telephone-assisted physician appointment arm (p = 0.98). Church health fairs conducted in low-income, multiethnic communities can identify many people with elevated blood pressure. Facilitating physician appointments for people with elevated blood pressure identified at health fairs confers a greater decrease in SBP than referral to a faith community nurse at four months

Services Delivered by Faith-Community Nurses to Individuals With Elevated Blood Pressure

OBJECTIVE: Our study describes the services faith-community nurses provide to a community-dwelling sample of patients with elevated blood pressure. DESIGN AND SAMPLE: The faith-community nurses completed a survey describing services provided to study participants at each patient encounter. We describe the type of contact and the frequency and types of services provided to these patients. From October 2006 to October 2007, we conducted a partnered study with a faith-community nursing program and enrolled 100 adults with elevated blood pressure from church health fairs. MEASURES: Patient demographics and faith-community nurse services provided. RESULTS: Data from 63 of 108 (58%) visits to faith-community nurses made by 33 participants were collected from surveys completed by the nurses. The majority of the participants were female (64%), Latino (61%), with an average age of 59 (SD = 11) years and incomes below US$30,000 (83%). The most frequent services patients received from faith-community nurses were blood pressure measurement (73%), hypertension-specific education on dietary changes (67%), and supportive counseling (56%). CONCLUSIONS: Faith-community nurses represent a new method of supportive self-management for low-income individuals with a chronic condition who may otherwise have limited access to health services. Further research is needed to understand the effect of faith-community nurse interventions on improving chronic disease health outcomes in these communities