Hypertension Clinical Trial
Official title:
Evaluation of a Community Health Worker Intervention on Adherence to Therapy for Non-Communicable Chronic Disease in Chiapas, Mexico
This study evaluates the effectiveness of community health workers when added to routine care for patients with diabetes and high blood pressure in rural clinics in Chiapas, Mexico. It does so by recording information on adherence to therapy, blood pressure and hemoglobin A1c while a non-governmental organization working in Mexico trains and introduces a community health worker program.
Compañeros en Salud (CES), an affiliate project of Partners in Health, has been working in
the rural Sierra of Chiapas, Mexico since February 2012. CES works in partnership with the
local Ministry of Health to rehabilitate and staff existing government primary care clinics.
Each community's clinic is staffed by one CES project physician year-round. CES activities
span the range of allopathic medicine, but the focus of the project is in the prevention,
detection, diagnosis and management of non-communicable diseases (NCDs) such as diabetes and
hypertension. CES currently operates in several rural communities with catchment areas of
approximately 1,500 - 2,500 people. Routine care for NCDs is based on national guidelines and
consists of monthly in-clinic visits by primary care physicians.
Over 9 months in 2014 and again over 6 months in 2016, CES will introduce a community health
worker program called "Acompañantes" to its project communities to augment care of patients
with NCDs. Acompañantes are lay health workers and members of the community who bridge the
gap between project clinics and patients, improving understanding of NCDs, their treatments,
and adherence to therapy. The introduction of Acompañantes to communities is planned in a
once-every-three-months fashion, the most rapid roll-out logistically feasible for CES. The
investigators' project will document their experience over this time, and for one year after
introduction of the Acompañantes program to all seven study communities, by documenting
adherence to therapy, hemoglobin a1c, and blood pressure at every-three month intervals over
this time frame.
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