ArticleJournal of general internal medicine2026
Heart Healthy Ohio Initiative: A Statewide Cooperative to Improve Cardiovascular Risk.
Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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Who cites it
1 citing paper in PubMed.
- Factors Influencing Quality Improvement Success in Primary Care: A Comparative Case Study of High- and Low-Performing Sites in Patient Hypertension Outcomes.Journal of the American Heart Association · 2026Article
Corrections and comments
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Authors and funding
17 authors.
Funding
Abstract
backgroundOhio ranks among the highest US states for cardiovascular disease (CVD) morbidity and mortality. Although interventions exist for managing CVD risk factors, adoption in primary care is often limited. The Agency for Healthcare Research and Quality funded four states to develop scalable, statewide models for implementing evidence-based practices to address these gaps.
objectiveTo evaluate the effectiveness of the Heart Healthy Ohio Initiative (HHOI), a statewide quality improvement (QI) initiative focused primarily on improving blood pressure (BP) control
designPre-post, repeated cross-sectional QI study using electronic health record (EHR) data to compare patient outcomes 6 months pre- and post-intervention
participantsA total of 293,638 adult patients (aged ≥ 18 years) from 48 primary care clinics across 21 counties, of whom 107,216 (37%) had hypertension.
interventionsPractices received structured QI support to implement evidence-based strategies for hypertension management, including BP measurement, timely follow-up, treatment protocols, and outreach. Monthly QI coaching, peer learning, and data feedback supported implementation. Smoking cessation strategies were also encouraged. MAIN MEASURES: The primary outcome was BP control, defined as < 140/90 mmHg. Process measures included repeat BP measurement, timely follow-up, and medication intensification. Regression analyses evaluated the impact of process measures on BP control improvement. Secondary measures on smoking cessation included screening, quit advice, resource referrals, and medications prescribed. KEY
resultsBP control improved from 67.7% to 70.7% post-intervention. Greater improvements were observed among rural and uninsured patients (> 6%) compared to smaller gains among Medicaid enrollees, younger patients, and women (~ 2%). All three process measures were significantly associated with better BP control in multivariable models. Smoking cessation measures were maintained or declined by ~ 2%, although only five sites actively addressed smoking cessation.
conclusionsHHOI demonstrates the feasibility and early success of a statewide, cooperative QI infrastructure to improve BP control. This model may be replicable in other states and offers insights for addressing hypertension control through targeted, scalable strategies.
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Registered trials
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