Counseling African Americans to Control Hypertension (CAATCH) Study- Data Dictionary Primary Contacts for CAATCH: Olugbenga Ogedegbe (Study PI) - Olugbenga.Ogedegbe@nyumc.org Ferdinand Zizi (CHBC Program Manager) - Ferdinand.Zizi@nyumc.org Mark Butler (Data Analyst) Mark.Butler@nyumc.org Study Abstract from Ogedegbe, et al. (2009) Despite strong evidence of effective interventions targeted at blood pressure (BP) control, there is little evidence on the translation of these approaches to routine clinical practice in care of hypertensive blacks. The goal of this study is to evaluate the effectiveness of a multilevel, multicomponent, evidencebased intervention compared with usual care in improving BP control among hypertensive blacks who receive care in community health centers. The primary outcomes are BP control rate at 12 months and maintenance of intervention 1 year after the trial. The secondary outcomes are within-patient change in BP from baseline to 12 months and cost-effectiveness of the intervention. Counseling African Americans to Control Hypertension (CAATCH) is a group randomized clinical trial with 2 conditions: intervention condition and usual care. Thirty community health centers were randomly assigned equally to the intervention condition group (n_15) or the usual care group (n_15). The intervention comprises 3 components targeted at patients (interactive computerized hypertension education, home BP monitoring, and monthly behavioral counseling on lifestyle modification) and 2 components targeted at physicians (monthly case rounds based on Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure guidelines, chart audit and provision of feedback on clinical performance and patients home BP readings). All outcomes are assessed at quarterly study visits for 1 year. Chart review is conducted at 24 months to evaluate maintenance of intervention effects and sustainability of the intervention. Poor BP control is one of the major reasons for the mortality gap between blacks and whites. Findings from this study, if successful, will provide salient information needed for translation and dissemination of evidence-based interventions targeted at BP control into clinical practice for this high-risk population.
Sample Descriptives Variable Mean Standard Deviation Range Age 56.94 12.252 24-94 Variable Value N Percent Sex Male 292 27.6% Female 739 71.7% Hispanic Status Not Hispanic 903 85.3% Hispanic 65 6.1% Race African American 746 70.4% Jamaican 76 7.2% Other West Indian/Non- 38 3.6% Latino Caribbean Trinidadian 22 2.1% Puerto Rican 20 1.9% Haitian 18 1.7% Other Central or South 21 2.0% American Multi 11 1.0% Dominican 6 0.6% Unknown 56 5.3% Study Intervention Control 510 48.2% Treatment 529 50.9% Marital Status Never Married 285 29.4% Married 250 25.8% Divorced 165 15.6% Separated 121 11.4% Widowed 147 13.9% Education Less than 8 th Grade 6 0.6% 8 th Grade 102 9.6% 9 th Grade 252 23.8% High School 318 30.0% Technical School 18 1.7% Some College 167 15.8% Associates Degree 29 2.7% Bachelor s Degree 54 5.1% Some Graduate School 23 2.2% Master s Degree or Higher 2 0.2%
Brief Summary of Demographic Measures in the CAATCH Database Measure Description Number of Items Age Participant s age at study start 1 Clinic 1 Intervention Was the participant part of the intervention or control 1 group? Sex Participant gender 1 Hispanic Status Is the participant Hispanic 1 Race The participant s race, especially differentiating between African Americans, Africans and Caribbean blacks. 1 US Birth or Years of Residence Language Religion Was the participant born in the United States? If not, where were they born and how long have they been living in the United States? Does the participant speak English or Spanish? If neither, what language do they speak? Is the participant Christian, Muslim or Other? If other, what religion do they practice? Also measured is whether they practice regularly, visit their place of worship monthly, or visit their place of worship on holidays alone. Marital Status Participant s current marital status 1 Education Participant education level 1 Income Participant income 1 Employment Insurance Life Experiences Smoking Status Drinking Status Items asking whether the participant is employed (fulltime or part-time) or unemployed (retired, disabled, etc.) Questions asking whether the participant is insured and what type of insurance they have. Questions asking about divorce, job loss, failure of business, violence, marital conflict, major illness, death of loved one, and other major stressors. Questions regarding current and lifetime smoking habits Questions about current and lifetime alcohol drinking habits 3 2 5 3 8 10 4 9
Brief Summary of Blood Pressure and Laboratory Measures in the CAATCH Database Measure Description Number of Items Blood Pressure Measurements Arm circumference Resistant Hypertension Status Number of Antihypertensive medications Diuretic Cholesterol Contains date of visit, mean of SBP/DBP, median of SBP/DBP, standard deviation of SBP/DBP and number of s for SBP/DBP Arm circumference in centimeters and date of A coding of resistant hypertension based on blood pressure and number of medications Cleaned and confirmed number of antihypertensive medications taken throughout study Was patient taking a diuretic during study Cholesterol values and dates of Measurement Timepoints 11 LDL LDL values and dates of HDL HDL values and dates of Glucose Creatinine Sodium Potassium Albumin Glucose values and dates of Creatinine values and dates of Sodium values and dates of Potassium values and dates of Albumin values and dates of 1 Overall (Baseline through 12 Months) 1 Overall (Baseline through 12 Months) 1 Overall (Baseline through 12 Months) BUN BUN values and dates of Weight Height Weight in pounds and date of Height in inches and date of
Brief Summary of Psychosocial Measures in the CAATCH Database Measure Description Number Measurement Timepoints of Items Cook Medley Hostility Scale A measure of overall hostility, cynicism, aggressive responding, hostile affect, 28 Time 1 Discrimination Questionnaire and hostile attributions A measure looking at 1 year frequency of discriminatory events, lifetime frequency of discriminatory events, and how distressing these events were 18 Time 1 Epworth Sleepiness A questionnaire examining sleeping 8 Baseline Scale habits EUROQOL An overall health measure which measures different aspects of health. 6 3 months (time 2) and 12 months (time 5) Hypertension A measure of an individual s knowledge 17 Baseline and Knowledge of hypertension facts MASES Medication Measure of self-efficacy as a relates to a patient s ability to consistently take 26 Baseline, 6 months (time 3), and Adherence Self- Efficacy Scale medication Morisky Medication Measure examining how adherent individuals are with their medication 5 Baseline, 6 months (time 3), and Adherence Scale MOS Social Support Survey Measure examining different kinds of social support (emotional, tangible, etc.) 19 Time 1, 6 months (time 3), and 12 Outcome Expectations Scale A measure examining expected outcomes of medical care 26 TIme 1, 6 months (time 3), and 12 Paffenbarger Physical Activity A measure looking at physical activity levels 8 Baseline, 6 months (time 3), and Perceived Stress Scale A measure of perceived stress levels with a cut-off score indicating when 14 Time 1, 6 months (time 3), and 12 levels of stress may be significant. PHQ9 A measure of depression 10 Time 1, 6 months (time 3), and 12 Physician Communication Style A measure examining how well patients felt their doctors communicated with them. 13 Baseline REALM REAP Reed Spiritual Perspectives Scale SF-12 Version 1 A list of vocabulary words where the number of words known corresponds to a reading level A diet measure which examines poor eating habits A measure examining different aspects of spirituality A health measure which has two main scales measuring overall physical health and overall mental health 66 Baseline 31 Baseline, 6 months (time 3), and 10 6 months (time 3) and 12 months (time 5) 12 Baseline, 6 months (time 3), and SPPI Measure of Hypertension Knowledge 15 Pre-test and post-test at Time 1 with administration of a hypertension education program between pre- and post-tests.
CAATCH Article List 1. Fernandez, S., Tobin, J.N., Cassells, A., Diaz-Gloster, M., Kalida, C., & Ogedegbe, G. (2011). The Counselling African Americans to Control Hypertension (CAATCH) Trial: Baseline Demographic, Clinical, Psychosocial and Behavioral Characteristics. Implementation Science, 6:100. 2. Forsyth, J., Schoenthaler, A., Chaplin, W.F., Ogedegbe, G., & Ravenell, J. (2014). Perceived Discrimination and Medication Adherence in Black Hypertensive Patients: The Role of Stress and Depression. Psychosomatic Medicine, 76, 229-236. 3. Forsyth, J.M., Schoenthaler, A., Ogedegbe, G., & Ravenell, J. (2014). Perceived Racial Discrimination and Adoption of Health Behaviors in Hypertensive Black Americans: The CAATCH Trial. Journal of Health Care for the Poor and Underserved, 25(1), 276-291. 4. Lewis, L.M., Schoenthaler, A.M., & Ogedegbe, G. (2012). Patient Factors, But Not Provider and Health Care System Factors, Predict Medication Adherence in Hypertensive Black Men. Journal of Clinical Hypertension, 14(4), 250-255. 5. Ogedegbe, G., Tobin, J.N., Fernandez, S., Gerin, W., Diaz-Gloster, M., Cassells, A., Khalida, C., Pickering, T., Schoenthaler, A., & Ravenell, J. (2009). Counseling African-Americans to Control Hypertension (CAATCH) Trial: A Multi-Level Intervention to Improve Blood Pressure Control in Hypertensive Blacks. Circulation: Cardiovascular Quality and Outcomes, 2, 249-256. 6. Ogedegbe, G., Tobin, J.N., Fernandez, S., Cassells, A., Diaz-Gloster, M., Khalida, C., Pickering, T., & Schwartz, J. (2014). Counseling African Americans to Control Hypertension (CAATCH): Cluster Randomized Clinical Trial Main Effects. Circulation, 129 (20), 2044-2051. 7. Schoenthaler, A., Chaplin, W.F., Allegrante, J.P., Fernandez, S., Diaz-Gloster, M., Tobin, J.N., Ogedegbe, G. (2009). Provider Communication Effects Medication Adherence in Hypertensive African Americans. Patient Education and Counseling, 75, 185-191. 8. Schoenthaler, A., Allegrante, J.P., Chaplin, W., & Ogedegbe, G. (2012). The Effect of Patient- Provider Communication on Medication Adherence in Hypertensive Black Patients: Does Race Concordance Matter? Annals of Behavioral Medicine, 43(3), 372-382. 9. Volpp, K.G. (2014). The CAATCH Study and Ways To Enhance the Next Wave of Behavioral Interventions. Circulation, 129(20), 2002-2004. 10. Williams, N., Abo Al Haija, O., Workneh, A., Sarpong, D., Keku, E., Ogedegbe, G., McFarlane, S.I., Jean-Louis, G. (2013).Excessive Daytime Sleepiness Among Hypertensive US-Born Blacks and Foreign-Born Blacks: Analysis of the CAATCH Data. International Journal of Hypertension, 2013, 852389. 11. Williams, N.J., Jean-Louis, G., Pandey, A., Ravenell, J., Boutin-Foster, C., & Ogedegbe, G. (2014). Excessive Daytime Sleepiness and Adherence to Antihypertensive Medications Among Blacks: Analysis of the Counseling African Americans to Control Hypertension (CAATCH) Trial. Patient Preference and Adherence, 8, 283-287.