|Institution:||University of Washington|
|Keywords:||Chronic disease management; Community-clinical linkages; Community health workers; Himmelman Collaboration Continuum; Hypertension management; Interorganizational partnerships; Public health; Health services|
|Full text PDF:||http://hdl.handle.net/1773/40915|
Introduction: Under the new guidelines for defining and diagnosing high blood pressure set forth by the American Heart Association and American College of Cardiology, 46% of adults in the United States are now living with hypertension. Hypertension management has traditionally been addressed in clinical settings. However, only 54% of adults with hypertension have their condition under control. Improved partnership among clinic staff, pharmacists, community organizations, and community health workers could bridge community-clinical silos to improve medication adherence and promote lifestyle changes necessary to manage hypertension. Our purpose was to explore partnerships for hypertension management in Washington State. Methods: We conducted 41 semi-structured interviews via telephone with clinics (n=10), community organizations (n=10), pharmacies (n=10), and community health workers (n=11) in Washington State. We asked participants about their partnerships for hypertension management, facilitators and barriers to developing partnerships for hypertension management, and strategies public health could apply to promote these partnerships. We coded interview transcripts in Atlas.ti using deductive and inductive thematic analysis that included a priori codes from the CDC-adapted Himmelman Collaboration Continuum. Results: Participants from the clinical sector, including clinic staff and pharmacists, engaged in partnerships with fewer sectors and at more extreme levels in comparison to participants from the community sector, including community organizations and community health workers. Facilitators to partnership included shared priorities and trust. Barriers to partnership included lack of awareness of community resources, competition (turf), lack of time, and exclusion from electronic health records. Conclusion: Facilitating partnerships among sectors would help patients who have traditionally only received health care within clinical settings access community resources to better manage their condition. Future efforts to promote partnerships for hypertension management should focus on reducing barriers by bringing potential partners together to discuss shared priorities, increasing technological support, and building awareness of community resources. Reducing barriers and leveraging facilitators is key for bridging across clinical and community silos for improved continuity of care and hypertension management at the population level.Advisors/Committee Members: Petrescu-Prahova, Miruna (advisor), Baldwin, Laura-Mae (advisor).