Closing the Gap on Health Disparities in Hypertension Management (2025-2026)

Background

Hypertension affects over 119 million adults in the United States, with direct costs projected to exceed $220 billion by 2035. Over a third of Americans with hypertension are not aware they have it. Despite the existence of proven interventions, only 48% of patients who are diagnosed with hypertension have their condition controlled. 

Disparities are well documented in hypertension treatment, control and outcomes. The prevalence of hypertension among Black Americans is much higher than among non-Hispanic white Americans and deaths attributable to hypertension are twice as frequent.

In Durham County, the prevalence of hypertension is 42%, with a strong association with residential racial isolation. This data suggests opportunities to intervene at the neighborhood level to reduce hypertension disparities and improve overall population health.

Project Description

Building on the work of previous teams, this project will focus on evaluating the policy implications of changes affecting minoritized people with severe uncontrolled hypertension and poor access to care. The project aims to increase the proportion of adults using a digital health portal for tracking their blood pressure and improving hypertension control.  Additionally, the project seeks to boost enrollment in the Closing the Gap program, a healthcare initiative designed by the Agency for Healthcare Research and Quality in collaboration with the Centers for Medicare and Medicaid Services. The initiative aims to have participants achieve blood pressure control within 6 to 12 months of starting the program.

Team members will participate in a quality improvement intervention, a systematic method aimed at improving healthcare processes and outcomes, with a focus on adult Black patients with severe uncontrolled hypertension. The team will conduct one-to-one telephone outreach to engage patients in care and encourage participation in blood pressure reduction initiatives. Members will also analyze key elements of the intervention, including the demographics of the cohort and responders, completion rate, blood pressure improvement and barriers within software.

The team will also continue to build on existing local and national community partnerships to help develop and implement evidence-based tools and infographics to encourage the self-measuring of blood pressure at the patient, health system and community level. Team members will engage with committed partners in deployment and evaluation of strategies and use data infrastructure developed in the earlier phases of the project to provide ongoing feedback to individuals and organizations. The 2025-2026 team will particularly focus on digital health platform use and feedback reports to patients and clinics.

Anticipated Outputs

Data and recommendations to help improve Closing the Gap program; peer-peer education for hypertension and digital health platform use; publication and presentation of findings

Student Opportunities

Ideally, this project team will include 18 undergraduate students. Applicants may come from academic backgrounds based in clinical health, population health, health informatics and digital health disciplines, alongside health policy and the humanities.

Students will have the opportunity to contribute to publications and presentations at a number of national professional forums including the American Heart Association Scientific Sessions, the Academy of Nursing Health Policy Conference, the American Public Health Association Annual Meeting and the AcademyHealth Annual Research Meeting. Team members will meet on Tuesdays.

This project includes an optional summer component in 2025. Students will spend 8 weeks (June-July) helping refine the current research plan and obtain Institutional Review Board (IRB) approval. Additionally, students will conduct literature reviews on policy implementation strategies and hold group discussions with community partners to gather information on local implementation strategies in high-risk areas.

Timing

Summer 2025 – Summer 2026

• Summer 2025 (optional): Refine current research plan and obtain IRB approval; conduct literature reviews; hold group discussions with community partners
• Fall 2025: Collect data in the telehealth and patient portal (one-to-one intervention with patients); collect data for pitch to policymakers, health administrators and clinicians/provider groups
• Spring 2026: Clean and analyze data; prepare presentations and publications of 6-month outcomes
• Summer 2026 (optional): Continue manuscript development

Crediting

Academic credit available for fall and spring semesters; summer funding available

See earlier related team, Closing the Gap on Health Disparity and Outcomes in Hypertension (2024-2025)