January 25, 2010

Goal: Improve cardio health in Baltimore substance abusers

Johns Hopkins School of Nursing researcher Benita Walton-Moss is partnering with Baltimore’s community leaders in reaching out to substance abusers with hypertension, with the goal of improving cardiovascular health.

The associate professor is launching a two-and-a-half-year study in a Baltimore neighborhood with the aim of decreasing the high rate of hypertension among African-Americans, particularly those who are substance abusers. “Those who abuse alcohol—and, to a lesser extent, cocaine—are more likely to have high blood pressure,” said Walton-Moss. “But substance abusers tend to be excluded from health studies in which substance abuse is not the focus of the study.”

In advance of the study, which begins in June, Walton-Moss is forming a neighborhood-based advisory group of pastors, owners of barbershops and other small stores, and residents of transitional housing units. They, Walton-Moss and community health care workers selected by the advisory group will develop a program to reach and educate area residents about high blood pressure.

The program will be presented over a period of six weeks. In each week’s two-hour session, participants will be instructed on proper diet, nutrition and exercise; how best to communicate with medical professionals; and how to monitor their blood pressure. Participants will transmit their blood pressure readings by telephone so that the intervention’s effectiveness can be measured over time. Key to the study, Walton-Moss said, is testing whether strengthening participants’ health literacy results in habits that lead to better health.

The study is facilitated by a $90,000 grant that is part of a larger National Institute of Nursing Research grant to the School of Nursing’s Center for Excellence for Cardiovascular Health in Vulnerable Populations. In reaching out to African-Americans, Walton-Moss plans to adapt some of the materials developed under the NINR grant by the research center’s director, Miyong Kim, in a project to reduce hypertension among Baltimore-area Korean-American immigrants.

African-Americans have the world’s highest prevalence of hypertension, a major risk factor for cardiovascular disease. One in three African-Americans is affected by high blood pressure, but approximately 30 percent of them are unaware that they have this condition. Substance abuse, particularly of alcohol, is a frequent contributor to high blood pressure, she said.

“Ideally, the program would be sustainable after this research is over,” Walton-Moss said. “Even after we leave, community health workers can share information with others. Hopefully, the education can be ongoing.”