Mi Propio Camino
(My Own Path)
Personalized approaches to improve blood pressure control
Latinx adults with hypertension in the U.S are much more likely to have uncontrolled blood pressure than others, but are much less likely to be taking guideline medications.
Research shows that many patients from low-income and ethnic minority backgrounds have unfavorable beliefs about medications (such as concerns about safety or effectiveness) and are less likely to adhere to their medication treatment or start a new medication as a result. In addition, few patients discuss these beliefs with their providers which may result in reluctance to take their medication.
We hypothesize that patients who see for themselves what strategies work best and feel best for them, and who discuss their experiences with their peers and their doctors, will be more successful addressing concerns and engendering mutual trust than those we simply educate about hypertension risks and recommendations. Through this approach, we hope to see more patients find their own way to incorporate evidence-based medications alongside lifestyle change to control blood pressure.
Specifically, Mi Propio Camino (MPC) invites patients to participate in group medical visits where we introduce an array of different integrative and lifestyle regimens to complement, but not replace medication, and then to track their own blood pressure changes at home to reflect on what works best for them. Through this approach, we hope to see more patients find “my own path” to control their blood pressure.
Study Aim 1: To investigate perceptions patients may have about controlling blood pressure, concerns patients may have about taking medications, and experiences discussing concerns about medications with health providers.
Study Aim 2: To evaluate the effectiveness of a culturally appropriate intervention in a randomized controlled trial comparing two sets of group education sessions that differ in the focus on addressing negative beliefs about medications and through emplying mHealth.
Cross Sectional Study
Randomized Controlled Trial (RCT)
Timeline
Cross sectional observational study approach examining topics including concerns patients have about taking medications, perceptions about controlling blood pressure, and experiences discussing concerns about medications with health providers. Completed through conducting a 30-45 min questionnaire.
Randomized controlled trial evaluating a culturally appropriate intervention to improve adherence to anti hypertensive medications.
Participants will be enrolled in one of two versions of in-person, group health education classes, offered in Spanish and English, to compare their impact on blood pressure management
Collecting outcomes data on medication adherence and blood pressure control at 1 month and 6 month follow up
Four year randomized controlled trial (RCT)
Collecting questionnaire and health record data on up to 1000 Latinx patients with uncontrolled hypertension
500 of these participants will be enrolled in the RCT
Ongoing Patient Advisory Group meetings to guide study implementation, interpretation and dissemination
MPC students have the opportunity to learn and conduct community based participatory research first hand through:
One-on-one patient interaction through patient recruitment at the UCI Family Health Center in Santa Ana.
Entails approaching and administering questionnaires to patients centered around blood pressure (BP), beliefs about medication and social determinants of health all within the clinic flow.
Supporting with study intervention sessions composed of group education on high blood pressure.
Opportunity to guide groups of patients in healthy lifestyle habits, home monitoring, participate in interactive activities, learn more about blood pressure, food demonstrations and more
Learn about the clinic setting, work flow and get to work among healthcare professionals
Presenting what we learn from study components through the Undergraduate Research Opportunities Program (UROP) and national conferences.
Material Need Insecurity and Its Concurrent Barriers to Diabetes Management Among Low-Income Latino Adults Receiving Medical Care
Mullin B, Cervantes BS, Billimek J
Economic Instability and Readiness for Behavior Change Among Latinx Hypertensive Patients
Chaulagain, Abhiruchi UCI
School of Medicine, Health Policy Research Institute John Billimek, PhD
Excellence in Research 2020
Increased Hesitancy to Take Medications During Periods of Food Insecurity among Latinx Patients with Hypertension: Findings from the Mi Propio Camino study
Karina Fing, Brett Cervantes, Adriana Orellana, Sergio Gago-Masague PhD, Dara Sorkin PhD, David Kilgore MD, John Billimek PhD
Poster presented at the Latino Medical Student Association (LMSA) Annual National Conference, March 2021
Disparities in the Timing of Diabetes Treatment Intensification in Response to Poor Glycemic Control
Yang S, Billimek J
Poster presented at the AcademyHealth Annual Research Meeting, Washington DC. June 2019
Relationship between Economic Instability and Readiness for Behavior Change Among Latinx Hypertensive Patients
Chaulagain, A., Fing-Castro, K., Salazar, A., Cervantes, B., Gago-Masague, S., Sorkin, D., Kilgore, D., Billimek, J
Poster presented virtually at the Society for Behavioral Medicine Annual Meeting, San Francisco CA. April 2020.
Examining the impact of medication beliefs on medication adherence among hypertensive patients
Ordonez E, Cha J, Xu M, Billimek J
Podium presentation at 44th Annual West Coast Biological Sciences Undergraduate Research Conference, San Diego CA. April 2019.
Project PI - John Billimek, PhD
Co-Investigator - David Kilgore, MD
Co-Investigator - Dara Sorkin, PhD
Co-Investigator - Sergio Gago-Masague, PhD
Co-Investigator and Biostatistician - Tuyen Hoang, PhD
Project Director - Tanya Honey
Assistant Project Coordinator - Jocelyn Pineda
Field Coordinator - Adriana Orellana-Barrientos
This project is supported by the NIH National Heart, Lung and Blood Institute (NHLBI), grant number R01HL142964 February 1st, 2020 - January 31st, 2024