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May 2 -- The Office of the Secretary (OS), Department of Health and Human Services (HHS), invites comment to OMB by June 10, 2022 regarding the proposed Evaluation of the National Hypertension Control Initiative (NHCI). [Note: OMB received HHS submission May 11.]

As part of the federal response to COVID-19, the U.S. Department of Health and Human Services (HHS) has funded a new initiative involving two cooperative agreements with the American Heart Association (AHA) to improve COVID-19-related health outcomes by addressing hypertension (high blood pressure) among racial and ethnic minority populations. The $32 million project from the HHS Office of Minority Health (OMH) and the Health Resources and Services Administration (HRSA) Bureau of Primary Health Care will support the implementation of the National Hypertension Control Initiative (NHCI), a national initiative to improve blood pressure control among the most at-risk populations, including racial and ethnic minorities.

The NHCI will support 350 participating HRSA-funded health centers by providing patient and provider education and training for effective hypertension control as well as integration of remote blood pressure monitoring technology into the treatment of hypertension for patients served by participating health centers. The project will also utilize the American Heart Association's targeted media campaigns and existing partnerships with community-based organizations (CBOs) to help reach Black, Latino, and other impacted communities with (i) culturally and linguistically appropriate messages, (ii) access to blood pressure screenings, and (iii) connection to health centers to encourage proper treatment and management of hypertension of screened individuals. This initiative serves to increase the number of adult patients with controlled hypertension and reduce the potential risk of COVID-related health outcomes.

AHA aims to conduct an evaluation to assess the feasibility of the implementation of each of the three NHCI strategies. The findings of this evaluation will inform the improvement and tailoring of AHA's communication approaches about the importance of and techniques for improving blood pressure control, including the benefits of accurately measuring, rapidly acting, and having a patient-focused approach to blood pressure control.

The evaluation of the NHCI project will use a mixed methods design, integrating both quantitative and qualitative data collection and analyses. Three main goals of data collection will be to: (1) Track and monitor systems change implementation process information from Community Health Centers (CHCs) on a quarterly basis, (2) assess the capacity of NHCI partners to implement the NHCI project, their needs, the strengths and weaknesses of the systems change approach, and the feasibility of the implementation of the NHCI in their organizations and communities, and (3) assess the reach and success of NHCI project strategies implemented by partners.

Specifically, the AHA will engage in:

1. Primary Data Collection
a. Qualtrics Survey. Collecting participation and outcome data from CHCs and CBOs using an online survey administered using Qualtrics. This will be used during the first two quarterly data collection periods.

b. DREaM. Collecting participation and outcome data from CHCs and CBOs using an online Data Reporting, Evaluation, and Monitoring (DREaM) dashboard. This is the evolution of the Qualtrics survey and will be used after the first two quarterly data collection periods.

c. Feasibility Assessments. Engaging in qualitative and quantitative data collection using focus groups, interviews and questionnaires from CHCs and CBOs to assess the feasibility of various data collection and program implementation approaches.

d. EmPOWERED to Serve. Administering health lessons to community members via Community-based Organizations and assessing awareness, education, and referral outcomes.

2. Secondary Data Collection
a. Social Needs Platforms. CBOs and CHCs will be asked to use one of two publicly available social needs platforms (Find Help or Unite Us) and CHCs will be asked to use the Unite Us social needs platform to connect individuals receiving services at the CBOs to Community Health Centers (CHCs), and vice versa, to receive additional blood pressure-related services.

b. Remote Patient Monitoring. AHA will be partnering with Canary Telehealth to collect aggregate metrics from a subset of Community Health Centers (CHCs).

c. Blood Pressure Control Metrics via Electronic Health Records. AHA will be partnering with external research partners to obtain reports of aggregated blood pressure control metrics from NHCI CHCs to inform clinical decision making, clinical quality improvement, and clinical outcomes.
 
National Hypertension Control Initiative: Addressing Disparities among Racial and Ethnic Minority Populations (HTN Initiative) https://www.minorityhealth.hhs.gov/omh/Content.aspx?ID=18513&lvl=2&lvlid=12
National Hypertension Control Initiative AHA https://www.heart.org/en/national-hypertension-control-initiative
NCHI Evaluation submission to OMB: https://www.reginfo.gov/public/do/PRAViewICR?ref_nbr=202204-0990-005 Click IC List for data collection instrument, View Supporting Statement for technical documentation.  
FRN: https://www.federalregister.gov/d/2022-09318    
 
For AEA members wishing to submit comments, "A Primer on How to Respond to Calls for Comment on Federal Data Collections" is available at https://www.aeaweb.org/content/file?id=5806

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