Abstract / Description: 

BACKGROUND: Uncontrolled hypertension contributes to disparities in cardiovascular outcomes. Patient intervention strategies informed by behavioral economics and social psychology could improve blood pressure (BP) control in disadvantaged minority populations. OBJECTIVE: To assess the impact on BP control of an intervention combining short-term financial incentives with promotion of intrinsic motivation among highly disadvantaged patients. DESIGN: Randomized controlled trial. PARTICIPANTS: Two hundred seven adults (98% African American or Latino) aged 18 or older with uncontrolled hypertension attending Federally Qualified Health Centers. INTERVENTION: Six-month intervention, combining financial incentives for measuring home BP, recording medication use, BP improvement, and achieving target BP values with counseling linking hypertension control efforts to participants' personal reasons to stay healthy. MAIN MEASURES: Primary outcomes: percentage achieving systolic BP (SBP)

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Martin F. Shapiro MD, CM, PhD, Suzanne B. Shu PhD, Noah J. Goldstein PhD, Ronald G. Victor MD, Craig R. Fox PhD, Chi-Hong Tseng PhD, Sitaram Vangala MA, Braden K. Mogler MD, Stewart B. Reed MD, Estivali Villa BA & José J. Escarce MD, PhD