Evidence map›Paper›PMID 31487546›Full record

Trial reportJournal of the American College of Cardiology2019

Community Health Workers Improve Linkage to Hypertension Care in Western Kenya.

Rajesh Vedanthan, Jemima H Kamano, Allison K DeLong, Violet Naanyu, Cynthia A Binanay, Gerald S Bloomfield, Stavroula A Chrysanthopoulou, Eric A Finkelstein, Joseph W Hogan, Carol R Horowitz and 7 more

Registry-linked trialOpen access · greenAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American College of Cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01844596 (Optimizing Linkage and Retention to Hypertension Care in Rural Kenya), which is not on this map. Cited by 79 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
79citing papers in PubMed, 12 pooled it
6.9field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01844596 nacompletednot on this map

Optimizing Linkage and Retention to Hypertension Care in Rural Kenya

TypeinterventionalSponsorIcahn School of Medicine at Mount SinaiRan2014 to 2017Enrolled1,455ConditionsHypertension, High Blood PressureArmsbehavioral communication strategy, Behavioral communication strategy, plus smartphone-based tool
3 · Its place in the literature

Who cites it

79 citing papers in PubMed, 12 syntheses or guidelines pooled it, 117 citations in OpenAlex.

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19 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 9 institutions in 2 countries.

Rajesh VedanthanNew York University School of Medicine, New York, New York. Electronic address: rajesh.vedanthan@nyulangone.org.
Jemima H KamanoMoi University College of Health Sciences, Eldoret, Kenya.
Allison K DeLongSchool of Public Health, Brown University, Providence, Rhode Island.
Violet NaanyuMoi University College of Health Sciences, Eldoret, Kenya.
Cynthia A BinanayDuke University, Durham, North Carolina.
Gerald S BloomfieldDuke University, Durham, North Carolina.
Stavroula A ChrysanthopoulouSchool of Public Health, Brown University, Providence, Rhode Island.
Eric A FinkelsteinDuke University, Durham, North Carolina.
Joseph W HoganSchool of Public Health, Brown University, Providence, Rhode Island.
Carol R HorowitzIcahn School of Medicine at Mount Sinai, New York, New York.
Thomas S InuiIndiana University School of Medicine, Indianapolis, Indiana.
Diana MenyaMoi University College of Health Sciences, Eldoret, Kenya.
Vitalis OrangoAcademic Model Providing Access to Healthcare, Eldoret, Kenya.
Eric J VelazquezYale University, New Haven, Connecticut.
Martin C WereVanderbilt University, Nashville, Tennessee.
Sylvester KimaiyoMoi University College of Health Sciences, Eldoret, Kenya.
Valentin FusterIcahn School of Medicine at Mount Sinai, New York, New York.
Moi University · KEBrown University · USDuke University · USIcahn School of Medicine at Mount Sinai · USAMPATH · KEIndiana University School of MedicineNew York University · USVanderbilt University · USYale University · US

Funding

Translational ScienceP30AI042853 · NIAID · MIRIAM HOSPITAL · PI CURT G BECKWITH, DEBBIE M. CHENG · 1998 to 2026
$51.7M
Optimizing Linkage and Retention to Hypertension Care in Rural KenyaU01HL114200 · NHLBI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI FUSTER, VALENTIN · 2012 to 2016
$2.1M
NHLBI NIH HHS U01 HL114200NIAID NIH HHS P30 AI042853
6 · The paper itself

Abstract

backgroundElevated blood pressure (BP) is the leading global risk factor for mortality. Delay in seeking hypertension care is associated with increased mortality.

objectivesThis study investigated whether community health workers, equipped with behavioral communication strategies and smartphone technology, can increase linkage of individuals with elevated BP to a hypertension care program in western Kenya and significantly reduce BP.

methodsThe study was a cluster randomized trial with 3 arms: 1) usual care (standard training); 2) "paper-based" (tailored behavioral communication, using paper-based tools); and 3) "smartphone" (tailored behavioral communication, using smartphone technology). The co-primary outcomes were: 1) linkage to care; and 2) change in systolic BP (SBP). A covariate-adjusted mixed-effects model was used, adjusting for differential time to follow-up. Bootstrap and multiple imputation were used to handle missing data.

resultsA total of 1,460 individuals (58% women) were enrolled (491 usual care, 500 paper-based, 469 smartphone). Average baseline SBP was 159.4 mm Hg. Follow-up measures of linkage were available for 1,128 (77%) and BP for 1,106 (76%). Linkage to care was 49% overall, with significantly greater linkage in the usual care and smartphone arms of the trial. Average overall follow-up SBP was 149.9 mm Hg. Participants in the smartphone arm experienced a modestly greater reduction in SBP versus usual care (-13.1 mm Hg vs. -9.7 mm Hg), but this difference was not statistically significant. Mediation analysis revealed that linkage to care contributed to SBP change.

conclusionsA strategy combining tailored behavioral communication and mobile health (mHealth) for community health workers led to improved linkage to care, but not statistically significant improvement in SBP reduction. Further innovations to improve hypertension control are needed. (Optimizing Linkage and Retention to Hypertension Care in Rural Kenya [LARK]; NCT01844596).

Indexed as

Community Health WorkersHealth Services AccessibilityTelemedicineAdultAgedAntihypertensive AgentsBlood PressureBlood Pressure DeterminationCluster AnalysisCommunicationCommunity Health ServicesFemaleHealth BehaviorHealth PromotionHealth Services ResearchHumansAntihypertensive Agentscommunity health workershypertensionKenyalinkage to caresmartphone technologytailored behavioral communication

Identifiers

PMID31487546
PMCPMC6788970
OpenAlexW2971906840

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.