Implementing Million Hearts for Provider and Community Transformation
Project IMPACT, a core research project of the New York University School of Medicine – City University of New York Prevention Research Center (NYU-CUNY PRC), is a Centers for Disease Control and Prevention-funded initiative launched in 2014 to improve blood pressure control and cardiovascular health among South Asian patients receiving care in primary care clinics across New York City. Building on the strategies of the Million Hearts® initiative, the goal of this study is to test the efficacy, adoption, and impact of the integration of physician-directed training and technical assistance to optimize use of electronic health record-based tools (EHRs) combined with patient-directed community health worker coaching and culturally tailored health education to improve hypertension control.
Project IMPACT is being implemented in 15 small primary care practices serving large proportions of South Asian patients across the city in collaboration with Healthfirst, an insurance organization serving more than 35,000 South Asian members in New York City, as well as Improving Healthcare for the Common Good (IPRO), a quality improvement organization for New York State.
South Asians have disproportionately high rates of cardiovascular disease (CVD), with a relatively unique profile of associated risk factors, including high rates of hypertension and diabetes and a different distribution of obesity across CVD risk factor groups. South Asians face numerous cultural, linguistic, and social barriers to accessing healthcare, which may impede clinical and self-management of hypertension. Physicians may also lack evidence-based tools to identify and manage South Asian hypertensive patients or refer them to culturally appropriate resources that support hypertension and diabetes control. Project IMPACT aims to identify best practices for adaptation and meaningful translation of evidence-based strategies to improve hypertension management in South Asians.