Details:

• Alternative Title:
  J Public Health Manag Pract
• Personal Author:
  Zook, Heather G ; Cruz, Rachel S ; Capesius, Traci R ; Haynes, Melissa Chapman

  Zook, Heather G ; Cruz, Rachel S ; Capesius, Traci R ; Haynes, Melissa Chapman Less -
• Description:
  Context:
  
  Self-measured blood pressure monitoring (SMBP) with clinical support is effective at reducing blood pressure for people with hypertension. While strengths and challenges around SMBP are well documented, few studies describe the complexities of real-world implementation of SMBP with clinical support in the Federally Qualified Health Center (FQHC) setting.
  
  Program:
  
  Between 2019 and 2023, the Ohio Department of Health funded the Ohio Association of Community Health Centers to manage a multi-year quality improvement (QI) project with 21 FQHCs. The project aimed to improve the identification and management of patients with hypertension, diabetes, and prediabetes. This study focuses on the activities implemented to provide SMBP support to patients with hypertension.
  
  Implementation:
  
  FQHCs implemented clinical SMBP support using multiple roles, approaches, and resources. FQHCs established a process to identify patients eligible for SMBP support, provide blood pressure monitors, train patients on SMBP, track blood pressure readings, follow up with patients, and connect patients to resources.
  
  Evaluation:
  
  External evaluators interviewed 13 staff within seven FQHCs from the QI project. Interviewed FQHCs were located across Ohio and represented urban, rural, suburban, and Appalachian areas. Clinical activities to support SMBP, facilitators, and barriers were identified with thematic analysis. The National Association of Community Health Centers SMBP Implementation Toolkit was used as a framework to assess SMBP activities. Facilitators included team-based care, health information technology capacity, funding for blood pressure monitors and staff time, leadership and staff support, and external support. Barriers included technology challenges, staffing shortages, low patient engagement, sustainability, and the COVID-19 pandemic.
  
  Discussion:
  
  This study demonstrates how FQHCs can use a variety of staff, processes, and resources to implement clinical SMBP support across a range of geographic regions. To facilitate this, FQHCs and patients may need more comprehensive insurance coverage of blood pressure monitors, reimbursement for staff time, and technology support.
  
  
• Subjects:
  [+]

  Blood Pressure Determination Humans Hypertension Ohio Qualitative Research Quality Improvement Self Care
• Keywords:
  [+]

  Blood Pressure Federally Qualified Health Center Hypertension Self-measured Blood Pressure Monitoring
• Source:
  J Public Health Manag Pract. 30:S107-S115
• Pubmed ID:
  39041744
• Pubmed Central ID:
  PMC11268788
• Document Type:
  Journal Article
• Funding:
  NU58DP006544/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  30
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  [+]

  urn:sha-512:d8c2b8dc2fee5d5de82ae126402f05ef3c56efa7008bd63cd3880c841b0b61be7c157f7135f472888e761e4110ab496d672780043e0bd815d4343ee8acb8ee18
• File Type:

• Supporting Files:
  No Additional Files