Providing health care services in an easily accessible, community environment doubled the success rate of African-American patients achieving blood pressure and cholesterol goals, compared to those who received care at a traditional clinic, according to a report in a special disparities themed issue of Circulation: Journal of the American Heart Association.
"Attending to unique social and cultural needs of the African-American community means making a major change in the way you deliver care. But in exchange, you can markedly reduce risk," said lead author Diane Becker, Sc.D., a health researcher in the division of general internal medicine at Johns Hopkins Medical Institutions in Baltimore.
"A mainstream model of medical care may not be the answer for eliminating disparities in this population," she said.
The study included 364 people who had brothers or sisters with a history of premature coronary disease (before age 60), placing the study group at high risk for heart disease themselves. Participants, on average, were 49 years old with a high school education. None had a personal history of heart disease when they enrolled in the study.
Those who had risk factors for heart disease (for example, high blood pressure, high cholesterol, current smoking history) were randomly assigned to two groups.
One group of 196 people received care in a community-based setting developed from recommendations by an advisory board that included members of the local African-American community. The other 168 people received care at a traditional health care clinic. About two-thirds of both groups were women and 80 percent of both groups had health insurance.