Impact of a mobile hypertension program in four rural Dominican bateyes
[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] Hypertension contributes significantly to cardiovascular risk and overall mortality worldwide. Among Haitians, uncontrolled hypertension is a leading contributing cause of death. The Dominican Republic is home to a large population of Haitian migrant workers who are living in poverty in sugar cane villages called bateyes. Like other rural impoverished communities, batey residents often lack access to basic health and education services which can result in poor cardiovascular health outcomes. This dissertation examined the impact of the first 12 months of an ongoing mobile hypertension program. The program, developed via an academic-community partnership, was delivered by a local Dominican non-governmental organization (NGO) in four rural bateyes. A ‘promotora’ (lay health promoter) who is a resident of each batey works closely with the team to enhance community participation in the program. Descriptive statistics were used to describe the study sample (n=70). A within-group, repeated-measures, pre-/post design examined the impact of the program on the main outcome measure of blood pressure control. Other outcome measures of interest were body mass index (BMI) and self-reported salt, alcohol, and smoking behaviors, and medication adherence (measured by self-report and pill counts). Results from analyses of 5 visits over a 12-month period showed a decrease in mean systolic and diastolic blood pressure over time (p <.005). Of note, 68% of the participants were >80% adherent to their antihypertensive medications. A Pearson’s correlation showed that individuals with increased medication adherence also had clinically and statistically significant reductions in SBP and DBP. Findings from this analysis of the first 12 months of the program indicate that the mobile hypertension screening and treatment program has a positive impact on blood pressure control. Evaluation of the program is ongoing and could serve as a model that has widespread implication in other isolated communities worldwide.
Access to files is limited to the University of Missouri--Columbia.