Check it, change it: A community-based, multifaceted intervention to improve blood pressure control

Kevin L. Thomas, Bimal R. Shah, Sharon Elliot-Bynum, Kristin D. Thomas, Katrina Damon, Nancy M.Allen LaPointe, Sarah Calhoun, Laine Thomas, Khadijah Breathett, Robin Mathews, Monique Anderson, Robert M. Califf, Eric D. Peterson

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Background-Although home blood pressure (BP) monitoring interventions have shown potential in selected populations, it is unclear whether such strategies can be generalized. We sought to determine whether a multifaceted BP control program that uses a web-based health portal (Heart360), community health coaches, and physician assistant guidance could improve hypertension control in a diverse community setting. Methods and Results-Between September 12, 2010, and November 11, 2011 Check It, Change It, a community-based hypertension quality improvement program, enrolled 1756 patients with hypertension from 8 clinics in Durham County, NC. The Check It, Change It community intervention was evaluated using a prepost study design without a concurrent control. Participants were stratified into 3 tiers according to their initial BP: tier 0 (BP <140/90 mm Hg)=51% of population, tier 1 (BP=140/90-159/99 mm Hg)=30% of total, and tier 2 (BP ≥159/99 mm Hg)=19% of total. Overall, median age was 59 years (interquartile range, 49-69), 67% were female, and 76% black. After 6 months, the mean overall systolic BP declined 4.7 mm Hg. Rates of achieving target BP control (<140/90) increased overall from 51% at baseline to 63% by 6 months, and 69% had either reached their BP target or had reduced their baseline systolic BP by 10 mm Hg or more. Conclusions-A multicomponent-tiered hypertension program was associated with improved BP control in a diverse community-based population.

Original languageEnglish (US)
Pages (from-to)828-834
Number of pages7
JournalCirculation: Cardiovascular Quality and Outcomes
Issue number6
StatePublished - Nov 1 2014
Externally publishedYes


  • Blood pressure
  • Hypertension
  • Quality improvement
  • Self blood pressure monitoring
  • residence characteristics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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