Médecine communautaire et éducation à la santé

Abstrait

Weight Management and Hypertension Services in a Rural Public Health Clinic

Charles D Sands IV, Charles D Sands III and Robert W Hensarling

Objective: To improve chronic disease health outcomes through a culturally competent, preventive care intervention for the underserved, economically disadvantaged, underinsured, and other people of a rural Alabama county.

Design: One-group pre-test/post-test design.

Setting: Public health department in a rural county in the Southeastern part of the United States.

Methods: A free, weekly clinic was held at the county health department. The clinic was staffed by Samford University pharmacy and exercise science faculty, a public health pharmacy practice resident, senior pharmacy students, and undergraduate exercise science majors. During weekly visits patients had baseline measures assessed and they were interviewed on medication therapy, dietary practice, and exercise regimen. Weekly follow-up to previous sessions provided opportunities for health coaching and monitoring of goal-setting.

Results: The intervention clinic averaged 10 patients per week. Adult participants (n=357) had a mean age of 53.6±17.3. Comparison of year 1 (201.3±51.5) and year 2 (187.1±67.6) weight was statistically significant (p=0.004). Year 1 systolic blood pressure was 141.6±18.4 mmHg and diastolic blood pressure was 79.2±10.6. Where follow-up measures were available (n=81), the year 2 systolic blood pressure was 139.2±20.4 mmHg while the year 2 diastolic blood pressure was 77.1±11.8 mmHg. Year 1 BMI was 32.1±12.7 and year 2 BMI was 31.5±14.9 (n=23).

Conclusion: Preventive services provided by pharmacists and health educators had a statistically significant effect on weight loss. While not statistically significant, clinical significance is noted on other key measures as blood pressure and BMI were trending in a positive direction. Further efforts towards weight loss will likely result in statistically significant changes to blood pressure and BMI.