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Community-Based Organizations Help in Chronic Disease Prevention

Victoria Bailey

Patient Engagement HIT

Community-based organizations have the potential to aid in chronic disease prevention, especially among traditionally marginalized groups in which patient trust is often low, according to researchers from Beth Israel Deaconess Medical Center (BIDMC).

A paper published in the journal Circulation showed how barbershops can have a potentially positive impact on individuals with high blood pressure.

High blood pressure is the biggest cause of health-related deaths in America. Black Americans are especially affected by the condition due to racial care disparities, social determinants of health, and structural barriers in accessing care.

The paper followed the results of a 2018 trial, the Los Angeles Barbershop Blood Pressure Study (LABBPS). During the trial, barbers were trained to notice signs of high blood pressure in their Black male customers. The barbers would then refer the customers to a pharmacist who came to the barbershop and provided medication for hypertension.

Receiving care in a trusted environment where these individuals felt comfortable and safe produced positive health outcomes. The study participants saw a 20-point drop in systolic blood pressure that remained steady after the trial was finished.

The BIDMC researchers presented a model that used similar tactics as the LABBPS to prevent hypertension in Black men. The model showed that the program could potentially reach one in three Black men who have uncontrolled blood pressure. It could also prevent 40 percent of cardiovascular emergencies in men who participate, such as heart attacks and strokes

“Barbershop-based, pharmacist-led blood pressure control programs represent a novel and effective way to deliver hypertension care to Black men, who represent an underserved population that is disproportionately affected by the complications of uncontrolled hypertension,” said Dhruv S. Kazi, MD, MS, lead author of the paper and associate director of the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology at BIDMC.

“Our findings provide a blueprint to guide nationwide implementation of a program that has the potential to save lives and improve health outcomes at a reasonable cost per participant.”

If the program could be offered at the cost of $1,500 per participant each year, it would be cost-effective and have the potential to lower healthcare spending, the researchers said.

This community-based care program could prevent 8,600 major cardiovascular events each year relative to usual care, including 1,800 heart attacks and 5,500 strokes, according to the researchers’ projected results. The projected results were based on Black men between the ages of 35 and 79 who had a systolic blood pressure of 140 or higher. Researchers used the 20-point reduction from the LABBPS to determine these results.

The projected health outcomes could lower healthcare costs by over $200 million a year, the press release stated.

“There is no reason for us to accept the status quo – there are plenty of effective and affordable medications for blood pressure control if we can address the structural barriers to getting them to people,” Kazi explained.

“The barbershop-based blood pressure control program, pioneered by the late Ronald G. Victor, MD, challenges the dogma that high-quality blood pressure control can only happen in healthcare settings. By changing the locus of care to a trusted community setting and allowing trained pharmacists to prescribe antihypertensives and escalate doses of medications, Dr. Victor’s program achieved really impressive declines in blood pressure in an underserved population.”

Partnering with local businesses where citizens feel safe, like barbershops, can help payers and providers save money and improve health outcomes for patients, especially when it comes to underserved individuals who may not have easy access to care or have limited trust in healthcare.

Back in March, the community-based organization Health People pushed for funding from the New York state and federal government to support community-based chronic disease prevention. Their community-based organizations have had a major effect on reducing the impacts of diabetes.

Patient engagement in the form of behavioral counseling has also proved to be helpful in chronic disease prevention. Prioritizing the mental health and wellbeing of individuals can ultimately lead to positive physical health outcomes as well.