# ACHIEVE P1 - HTN

> **NIH NIH P50** · WAYNE STATE UNIVERSITY · 2021 · $537,803

## Abstract

PROJECT SUMMARY
Hypertension is the leading risk factor for global morbidity and mortality. Even mild elevations in blood pressure
(BP) are harmful whereby individuals with stage 1 hypertension are at double cardiovascular risk. Black adults
suffer from a higher prevalence, worse control rates, and more frequent adverse health effects from high BP.
They are also at heightened risk for an earlier accelerated progression from mild to more severe hypertension.
Little progress has been made in mitigating health inequities related to high BP. Predominantly Black cities
such as Detroit disproportionately suffer from nearly twice the national average mortality rate due to heart
disease. Mounting evidence shows that pervasive negative social determinants of heath (SDoH) are major
drivers of these inequities and represent a critical barrier to achieving BP control in Black hypertensives. Core
issues include poor access to healthcare and a burdensome system for care linkage especially in under-
resourced settings, low health education and literacy, and structural inadequacies in care delivery including a
failure to address the spectrum of life circumstances that elevate BP and hinder the adoption of salutary
lifestyle changes. In PROJECT 1 of the ACHIEVE GREATER research center, we propose an innovative
approach to identify and control hypertension at its earliest stages in undiagnosed Black adults, potentially
yielding an enormous benefit towards lifetime health equity. Using a hybrid type I effectiveness-implementation
and quasi-experimental design, we will leverage our novel mobile health unite (MHU) platform to implement a
program that links low risk Black adults with stage 1 hypertension to collaborative care delivered by non-
physicians, community health workers (CHWs) and pharmacists, consisting of a personalized, adaptable
approach to lifestyle and life circumstance (PAL2) intervention for 12-months. Core features of PAL2 include the
ability to choose from a menu of readily available interventions that address individual negative SDoH,
culturally sensitive health and lifestyle education, and adaptability over time according to its acceptance,
effectiveness (home BP), and evolving patient needs. If BP remains ≥130/80 mm Hg after 6 months, a
pharmacist-directed medical treatment algorithm will be added to achieve timely BP control. Program benefits
including BP-lowering will be assessed during the implementation (12-months) and maintenance phases (year
2) after linkage to medical care. We aim to show the effectiveness of project 1 to lower home BP after 12
months in 500 Black patients with mild stage 1 hypertension living in disadvantaged communities in Detroit and
to reach the target population. We also aim to evaluate the fidelity and outcomes of project 1 and examine its
cost effectiveness. Improving care access by strategic MHU outreach, coupled with enhanced collaborative
care, can effectively remove barriers, mitigate negative SDoH and improve ...

## Key facts

- **NIH application ID:** 10437396
- **Project number:** 1P50MD017351-01
- **Recipient organization:** WAYNE STATE UNIVERSITY
- **Principal Investigator:** Robert Daniel Brook
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $537,803
- **Award type:** 1
- **Project period:** 2021-09-24 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10437396

## Citation

> US National Institutes of Health, RePORTER application 10437396, ACHIEVE P1 - HTN (1P50MD017351-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10437396. Licensed CC0.

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