Skip to main content

Table 4 Multi-level disparities tailoring in Project ReD CHiP’s interventions

From: A multi-level system quality improvement intervention to reduce racial disparities in hypertension care and control: study protocol

   Blood pressure measurement Care management Provider education
  Disparities Specific Rationale • Clinical uncertainty is believed to be a major contributor to healthcare disparities [23] • Racial disparities in blood pressure control are due, in part, to poorer adherence to medications [24], limited access to healthful foods [25] and poor quality diets [26] • PCPs use less patient-centered communication in visits with African American patients [27, 28]; patients with low health literacy ask their physicians fewer questions about medical care issues [29]
   • Standardization of healthcare processes may reduce clinical uncertainty and variations in care [30] • 2Motivational interviewing is effective at promoting health behavior change [31, 32], medication adherence [33] and health outcomes [3133] in African Americans • The combination of cultural competency training and race-stratified performance reports increases clinician awareness of racial disparities in care [34]
    • Delivery of culturally and linguistically-tailored health information increases acceptability of interventions in minority populations [35] • PCP communication skills training improves patient-reported outcomes and blood pressure control in ethnic minorities and poor persons [36]
Disparities Tailoring Patient • Poster messages and images reduce patient anxiety and promote trust • Educational materials culturally and linguistically tailored • Patient scenarios include individual and environmental determinants of disparities and demonstrate methods to address them
   • Motivational interviewing enhances patient engagement and addresses individual determinants of disparities  
   • Community resource guide addresses environmental determinants of disparities  
Provider and Staff • Re-training videos use local staff as role models • Care managers enhance providers’ ability to address patients’ complex psychosocial needs by providing additional counseling and support • Dashboard increases provider awareness of disparities
    • Communication skills training enhances provider participatory skills leading to increased patient trust and engagement
Clinic • Patient posters provide culturally and linguistically tailored communication • Availability of phone contacts and flexible appointment times enhances access • Financial incentives reward providers for reviewing disparities data
    • Financial incentives encourage providers to make referrals