University of Arkansas for Medical Sciences Arkansas Prevention Research Center

Community-Clinical Links to Control Hypertension (CCLiCH)


Though hypertension is a relatively easy condition to control, it remains a major risk factor for a number of leading causes of disease and death. Hypertension, also known as high blood pressure, is the most common diagnoses made by U.S. primary doctors, affecting 76 million U.S. adults. While treatment is effective, current clinic-based approaches for hypertension care are not as effective as they might be, with more than half of the 76 million affected being uncontrolled. Uncontrolled hypertension is especially common in Arkansas. The percentage of U.S. adults with uncontrolled hypertension is higher in Arkansas than in the nation (29% vs. 16%) and even higher among African Americans in the state than whites (34% vs. 28%). The University of Arkansas Prevention Research Center plans to decrease rates of uncontrolled hypertension in a rural, under-served, predominately minority community, and identify cost-effective ways to better control hypertension.

Researchers are recruiting and training community health workers to deliver a stepped-care, community case management intervention. This program is designed to reduce uncontrolled hypertension in a rural, predominately African American community in Arkansas and minimize cost. The community health worker will provide lay education about blood pressure, help identify barriers to controlling it, and link participants to needed community services, such as insurance enrollment, medical services, and/or prescription assistance. The program includes three steps of support to help participants get their blood pressure under control. Each step is designed to be more intense than the previous step. Participants who still have uncontrolled hypertension after step 1, for instance, will be moved into step 2 and so forth. To test its effectiveness, researchers will randomly assign participants to the intervention group and a non-intervention group (usual care) and compare the outcomes.

A cost-effectiveness analysis will be conducted by comparing public health system costs and outcomes for participants in both the intervention and non-intervention groups. To inform this analysis, researchers plan to collect data from participants regarding doctor visits for hypertension management and hypertension medication, frequency of refills, and adherence. Costs associated with the resources used in the intervention to improve health outcomes will be calculated for each participant.

If proven effective in lowering uncontrolled hypertension rates and treatment costs, stepped-care, community case management intervention may be a hypertension control public health model to be replicated, not only across Arkansas, but the nation.

Project Identifier Stepped-Care, Community Case Management Intervention (SCCCMI)

Funding Source PRC Program

Project Status Active

Host Institution University of Arkansas

Health Topics Cardiovascular health

Research setting No specific focus

Race or ethnicity African American or Black

Gender No specific focus

Age group No specific focus

Contact Information Center
Arkansas Prevention Research Center for Cardiovascular Risk Reduction
UAMS Fay W. Boozman College of Public Health
4301 West Markham, #820
Little Rock, AR 72205

Principal Investigator
James Raczynski 

PRC Deputy Director
Martha Phillips, PhD, MPH, MBA
Phone: (501) 526-6413