By Anne Harding
NEW YORK (Reuters Health) - Church health fairs are an effective way of identifying people with high blood pressure and making sure they get treatment, new research shows.
These fairs are a venue to get people from low-income immigrant communities into medical care, Dr. Arshiya A. Baig of the University of Chicago told Reuters Health.
Baig and her team worked with a faith community nurse program in Los Angeles that runs clinics and provides community outreach. Registered nurses also partner with churches, holding office hours there and providing services.
Baig and her team visited 26 health fairs in Los Angeles County from October 2006 to June 2007, testing blood pressure in 886 people aged 18 and older. They randomly assigned 100 people with high blood pressure to a referral to the nurse at the church holding the health fair, or to get help making an appointment with a doctor by telephone.
People in the first group were introduced to the nurse at the health fair, and instructed to make an appointment with the nurse within the next two weeks. The nurse would provide counseling and help them set up an appointment with a physician. People in the doctor referral group didn't meet with a nurse. If they didn't already have a primary care physician, Baig and her colleagues would find a clinic nearby and make an appointment with them.
Four months later, the researchers were able to follow up with 41 people in the nurse group and 44 in the physician referral group. They found that 68 percent of the nurse group had seen a physician during that time, compared to 80 percent of the doctor referral group. This difference was not statistically significant, meaning it could have been due to chance.
The average systolic blood pressure drop (the top number) in the community nurse group was 7 mm Hg, compared to 14 mm Hg in the physician referral group. Twenty-seven percent of the patients in the nurse group had their medications changed during follow up, while 32 of the telephone referral group did.
The telephone referral group may have fared better because they saw a doctor earlier, Baig noted; she also pointed out, however, that patients in the nurse group were more likely to get counseling on lifestyle changes to help lower their blood pressure, which probably wouldn't have had an effect within four months.
The findings shouldn't be interpreted as meaning that telephone referrals to a physician are more effective than faith community nurse referrals, Baig added. "I think at four months you can't say one is better than the other."
The important thing, she added, is that both nurses and telephone-assisted appointments were an effective way to get people in to see a doctor. And without faith community nurses, Baig said, "There wouldn't be health fairs, we wouldn't be finding people who have undiagnosed or poorly controlled (high blood pressure)."
SOURCE: Journal of General Internal Medicine, online March 27, 2010.