Evaluation of a mass hypertension screening program

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 Hg 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 care. Follow-up 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.

Prevalence and unawareness of hypertension in the petrochemical industrial population in China

This article reports the prevalence and unawareness of hypertension in a petrochemical industrial population. Data were obtained from the First Shanghai Petrochemical Complex Hypertension Survey, which was part of the first round of the Health Examination Survey Program (n = 29,391) from May 1979 through June 1982. In this study, 27,256 workers and staff were screened for hypertension (screening rate = 92.74%) in 19 plants of the Shanghai Petrochemical Complex. The overall prevalence rate was 3.05% (standard prevalence rate = 3.33%). Under age 60 years, the rates of hypertension were similar in both sexes except for the age group 30-39 (P less than 0.01). Of 830 hypertensives detected, 245 (29.5%) were unaware of their hypertension at the time of screening, with men ages 30-39 having the highest level of unawareness (45.2%, P less than 0.005). The importance of periodic, organized health examination surveys is stressed, and it is emphasized that they are imperative for the early detection and control of hypertension, as indicated by the fact that so many of the hypertensives detected by this screening were completely unaware of their elevated blood pressures. It is also concluded that special care should be directed toward men under age 30.

Bibliographies on Health Promotion Programs for Business and Industry

Health promotion programs have been developing at a rapid pace throughout the United States. Business and industry have been major targets for and supporters of these new ventures. This intense interest in health promotion programs has produced a need for a systematic review of past experience. The Center for Health Services Administration at Arizona State University prepared two comprehensive bibliographies of references on occupational health promotion programs. The annotated bibliography includes ninety references that were deemed most relevant to the subject at the time the searches were made in Spring of 1982. The second bibliography, which is not annotated, is supplemental and provides eighty-eight additional related references.