Levine 2003.
Methods |
Study design: controlled before‐after study Sampling frame: clinic patients with hypertension Sampling method: random assignment Collection method: review of records Description of the community coalition: Sandtown‐Winchester High Blood Pressure Control Program. Johns Hopkins University and Hospital led a coalition composed of city health department, city schools, district mayor’s office, recreation, social welfare sectors, and community churches in East Baltimore, MD, USA. A needs assessment was conducted using Maryland Department of Health data, hospital discharge data, community household survey, and interviews of community leaders to establish goals and objectives |
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Participants |
Communities: urban, low income, 82% African American with a median age of 30, East Baltimore, MD Country: USA Ages included in assessment: adults Reason provided for selection of intervention community: high risk, African American population Intervention community (population size): 120,000 Comparison community (population size): 120,000 |
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Interventions |
Name of intervention: Sandtown‐Winchester High Blood Pressure Control Program Theory: Precede‐Proceed Model Aim: to control hypertension Description of costs and resources: unknown Components of the intervention: (1) information provided to the patient to clarify and reinforce components of treatment (15 min); (2) family and peer education to enhance social support (2 hours); and (3) a small group approach to enhance motivation and commitment (three 2‐hour sessions) Start date: unknown Duration: 48 months |
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Outcomes |
Outcomes and measures: review of health records, % with high blood pressure under control (BP < 140/90) Time points: baseline and 60 months |
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Notes | Source of funding: government | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Study authors state that patients were randomly assigned to treatment and control groups but do not explain the method of randomization |
Allocation concealment (selection bias) | High risk | Allocation not concealed |
Baseline outcome measurement similar | Low risk | At baseline, % in control of high blood pressure was similar for treatment and control groups (38% vs 41%) |
Baseline characteristics similar | Unclear risk | Study authors do not report characteristics separately for the 2 groups |
Blinding of outcome assessment (detection bias) All outcomes | High risk | No blinding reported |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Treatment group attrition 16% and control group attrition 30% |
Blinding of participants and personnel (performance bias) All outcomes | High risk | No blinding reported |
Protection against contamination | Unclear risk | None reported |
Selective reporting (reporting bias) | Low risk | Relevant outcomes reported |