Jerilyn K. Allen|Cheryl Dennison Himmelfarb|Sarah L. Szanton|Lee Bone|Martha N. Hill|David M. Levine
COACH trial: A randomized controlled trial of nurse practitioner/community health worker cardiovascular disease risk reduction in urban community health centers: Rationale and design
Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins University|Johns Hopkins University|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins Medicine
despite wellpublicized guidelines appropriate management cardiovascular disease cvd type 2 diabetes implementation riskreducing practices remains poor paper describes rationale design randomized controlled clinical trial evaluating effectiveness comprehensive program cvd risk reduction delivered nurse practitioner npcommunity health worker chw teams versus enhanced usual care improving proportion patients urban community health centers achieve goal levels recommended national guidelines lipids blood pressure hba1c prescription appropriate medications coach community outreach cardiovascular health trial randomized controlled trial patients federallyqualified community health centers randomly assigned one two groups comprehensive intensive management cvd risk factors one year npchw team enhanced usual care control group total 3899 patients assessed eligibility 525 randomized groups comparable baseline sociodemographic clinical characteristics exception statistically significant differences total cholesterol hemoglobin a1c study novel amalgam multilevel interdisciplinary strategies translate highly efficacious therapies lowincome federallyfunded health centers care patients carry disproportionate burden cvd type 2 diabetes uncontrolled cvd risk factors impact community clinicbased intervention potentially enormous