Health Coaches Support Blood Pressure Management in Vermont

Submission Date: April 2023

State/Territory Submitted on the Behalf of: Vermont

States/Territories Involved: Vermont

Funding Source: CDC

CDC Funding:

Yes

CDC Funding (Specified):

Other CDC Funding

Grant Number:

DP18-1815: Strategies for Improving the Health of Americans Through Prevention and Management of Diabetes, Heart Disease, and Stroke

Other Federal Funding:

N/A

Other Funding:

Other

Domain Addressed:

Community-Clinical Linkages, Health Equity, Health Systems Strategies

Public Health Issue:

According to the 2017 Vermont Behavioral Risk Factor Surveillance System (BRFSS), about 1 in 4 adult Vermonters (26%) said they had been told they have hypertension. While Vermont’s hypertension statistics are generally better than the national average, more than half of Vermont residents have at least one of the key risk factors for CVD: high blood pressure, high cholesterol, or smoking.

National and state data show high blood pressure may be under-identified and not as well controlled as possible. The Vermont Blueprint for Health (Blueprint), a collaboration between the Vermont Department of Health and statewide partners, offers innovative programs and workshops focused on building healthy behaviors, including strategies to improve blood pressure management at home.

Project Objectives:

The Blueprint brings together healthcare providers, accountable care organizations, social services, and other organizations to help Vermonters receive the support needed to take control of their health. The My Healthy Vermont website provides easy access to various workshops and programs, including in-person and online High Blood Pressure Management Workshops. These workshops (also known as Health Coaches for Hypertension Control) are evidence-based programs developed to help participants ages 40 and older manage high blood pressure at home.

The goal of the workshop is to improve the health of the community by:
• increasing knowledge about hypertension self-management,
• increasing stage of readiness to make lifestyle changes required for successful self-management, and
• promoting behavior changes in nutrition, physical activity, stress management, tobacco use, and medication management.

Program Action:

All Vermont (VT) insurers, including Medicaid and Medicare, fund the Blueprint, and all programs and workshops offered through My Healthy VT are free of charge.

The High Blood Pressure Management Workshops are led by trained Health Coaches, many of whom have faced similar health challenges. Sessions are conducted using a scripted manual and visual aids and include experiential learning strategies appropriate for those with health literacy challenges. A support person, such as a spouse or friend, may also attend the workshop.

Session topics include:
• Basics of hypertension control
• Nutrition with an emphasis on the DASH diet
• Physical Activity
• Tobacco cessation
• Stress management
• Medication management
• Developing short- and long-term action plans

Data/Other Information Collected:

More than 100 Vermont residents have participated in the program since its introduction. Enrollment has continued to grow, likely related to an increase in the number of workshops being offered and building awareness and a strong referral network.

Blood pressure measurements are recorded and tracked throughout the program. Average blood pressure decreased from 132/77 to 127/74 for participants completing the workshop. If this drop in blood pressure is maintained, participants will move from stage 1 hypertension (130-139 systolic/80-89 diastolic) to elevated blood pressure (120-129 systolic/less than 80 diastolic).

Impact/Accomplishments:

Data on cost and cost savings are not yet available for the program. However, the Diabetes and Heart Disease Program within the Division of Health Promotion and Disease Prevention became the administrating agent in 2021, and the Vermont Department of Health will examine the economic impact of these programs going forward.

Challenges/Lessons Learned:

Establishing strong statewide partnerships has helped to sustain and expand this initiative. The ability to offer the program free of charge to all Vermont residents and utilizing experiential learning strategies have helped address economic and social barriers to participation.

Next Steps:

The Vermont Diabetes and Heart Disease Program within the Division of Health Promotion and Disease Prevention will continue to administer this program, assessing the economic impact and expansion needs.

Program Areas:

Health Equity and Cultural Competency, Heart Disease and Stroke

State Contact Information:

Vermont
Caitlin Moroney, MA
Vermont Department of Health
(802) 859-5913
Caitlin.Moroney@vermont.gov

Board President's Challenge:

No

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