Linking community-based blood pressure measurement to clinical care: A randomized controlled trial of outreach and tracking by community health workers

Objectives. This study assessed the effectiveness of enhanced tracking and follow-up services provided by community health workers in promoting medical follow-up of persons whose elevated blood pressures were detected during blood pressure measurement at urban community sites. Methods. In a randomized controlled trial, 421 participants received either enhanced or usual referrals to care. Participants were 18 years or older; were either Black or White, and had blood pressure greater than or equal to 140/90 mm fig and income equal to or less than 200% of poverty. The primary outcome measure was completion of a medical follow-up visit within 90 days of referral. Results. The enhanced intervention increased follow-up by 39.4% (95% confidence interval [CI] = 14%, 71%; P = .001) relative to usual can. Follow-tap visits were completed by 65.1% of participants in the intervention group, compared with 46.7% of those in the usual-care group. The number needed to treat was 5 clients (95% CI = 3, 13) per additional follow-up visit realized. Conclusions. Enhanced tracking and outreach increased the proportion of persons with elevated blood pressure-detected during community measurement who followed up with medical care.