Rationale and design for Healthy Hearts in Manufacturing (HHM): A pragmatic single-arm hybrid effectiveness-implementation study for hypertension management and tobacco cessation
Background: Heart disease is the leading cause of mortality in the United States and contributes more than $320 billion annually in health care costs and lost productivity. Manufacturing employment is associated with higher rates of hypertension and smoking. Many large manufacturers provide health s...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-04-01
|
| Series: | Contemporary Clinical Trials Communications |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451865425000183 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823864391246807040 |
|---|---|
| author | Hanzi Jiang Yao Tian Jennifer Bannon Amy E. Krefman Lawrence C. An Dustin D. French Claude R. Maechling Jane Holl Richard Chagnon Theresa L. Walunas Christopher Burch Anthony Musci Darce Latsis Dawn Carey Megan McHugh |
| author_facet | Hanzi Jiang Yao Tian Jennifer Bannon Amy E. Krefman Lawrence C. An Dustin D. French Claude R. Maechling Jane Holl Richard Chagnon Theresa L. Walunas Christopher Burch Anthony Musci Darce Latsis Dawn Carey Megan McHugh |
| author_sort | Hanzi Jiang |
| collection | DOAJ |
| description | Background: Heart disease is the leading cause of mortality in the United States and contributes more than $320 billion annually in health care costs and lost productivity. Manufacturing employment is associated with higher rates of hypertension and smoking. Many large manufacturers provide health services to employees and their family members through worksite health centers (WHCs). Several quality improvement interventions for hypertension and tobacco cessation have shown to be effective in community-based primary care sites. The Healthy Hearts in Manufacturing (HHM) study aims to implement and test these interventions in WHCs. Methods: Two organizations that operate WHCs at manufacturing sites volunteered to participate in the 58-month HHM research study. The HHM intervention involves monthly coaching to assist WHCs with implementing evidence-based strategies for hypertension management and tobacco cessation advocated by the Million Hearts initiative and the U.S. Preventive Services Task Force. A pragmatic, Type II hybrid effectiveness-implementation study design is used to evaluate HHM. The approach is inspired by the stepped-wedge cluster-randomized trial to assess intervention effectiveness. We will conduct interviews to identify facilitators and barriers to implementation and budget impact analysis to estimate the financial impact of the HMM interventions and the potential healthcare savings to companies and Medicare. Results: Twelve WHCs were randomly selected to enroll in HHM. The WHCs are in nine states and provide primary care services for employees and family members of four manufacturing companies. Baseline patient smoking rates ranged from 13 % to 59 % across WHCs. The percentage of patients with blood pressure of 140/90 or greater ranged from 7 % to 56 % across WHCs. Conclusion: This exploratory five-year research study will identify facilitators and barriers to implementing the HHM interventions in WHCs, evaluate the effectiveness of hypertension management and use of tobacco screening and cessation, and provide evidence of HHM's potential cost-effectiveness for employers and Medicare. |
| format | Article |
| id | doaj-art-40ca0c686d6942018190429a5deef8f3 |
| institution | Kabale University |
| issn | 2451-8654 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Contemporary Clinical Trials Communications |
| spelling | doaj-art-40ca0c686d6942018190429a5deef8f32025-02-09T05:00:43ZengElsevierContemporary Clinical Trials Communications2451-86542025-04-0144101444Rationale and design for Healthy Hearts in Manufacturing (HHM): A pragmatic single-arm hybrid effectiveness-implementation study for hypertension management and tobacco cessationHanzi Jiang0Yao Tian1Jennifer Bannon2Amy E. Krefman3Lawrence C. An4Dustin D. French5Claude R. Maechling6Jane Holl7Richard Chagnon8Theresa L. Walunas9Christopher Burch10Anthony Musci11Darce Latsis12Dawn Carey13Megan McHugh14Institute for Public Health and Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA; Corresponding author. Institute for Public Health and Medicine, Northwestern University, Feinberg School of Medicine, 633 N. St Clair; 20th Floor, Chicago, IL, 60611, USA.Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USAInstitute for Public Health and Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USADepartment of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USADepartment of Internal Medicine, University of Michigan, Ann Arbor, MI, USADepartments of Ophthalmology and Medical Social Sciences, Feinberg School of Medicine, Chicago, IL, USA; Department of Veterans Affairs Health System Research Service, Hines, IL, USABranstad Family Foundation, Chicago, IL, USADepartment of Neurology, Biological Sciences Division and Center for Healthcare Delivery Science and Innovation, University of Chicago, Chicago, IL, USAInstitute for Public Health and Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USAInstitute for Public Health and Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USAOnSite Care, a CareATC Affiliate, Salt Lake City, UT, USAOnSite Care, a CareATC Affiliate, Salt Lake City, UT, USAOnSite Care, a CareATC Affiliate, Salt Lake City, UT, USAPerdue Farms, Salisbury, MD, USAInstitute for Public Health and Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USABackground: Heart disease is the leading cause of mortality in the United States and contributes more than $320 billion annually in health care costs and lost productivity. Manufacturing employment is associated with higher rates of hypertension and smoking. Many large manufacturers provide health services to employees and their family members through worksite health centers (WHCs). Several quality improvement interventions for hypertension and tobacco cessation have shown to be effective in community-based primary care sites. The Healthy Hearts in Manufacturing (HHM) study aims to implement and test these interventions in WHCs. Methods: Two organizations that operate WHCs at manufacturing sites volunteered to participate in the 58-month HHM research study. The HHM intervention involves monthly coaching to assist WHCs with implementing evidence-based strategies for hypertension management and tobacco cessation advocated by the Million Hearts initiative and the U.S. Preventive Services Task Force. A pragmatic, Type II hybrid effectiveness-implementation study design is used to evaluate HHM. The approach is inspired by the stepped-wedge cluster-randomized trial to assess intervention effectiveness. We will conduct interviews to identify facilitators and barriers to implementation and budget impact analysis to estimate the financial impact of the HMM interventions and the potential healthcare savings to companies and Medicare. Results: Twelve WHCs were randomly selected to enroll in HHM. The WHCs are in nine states and provide primary care services for employees and family members of four manufacturing companies. Baseline patient smoking rates ranged from 13 % to 59 % across WHCs. The percentage of patients with blood pressure of 140/90 or greater ranged from 7 % to 56 % across WHCs. Conclusion: This exploratory five-year research study will identify facilitators and barriers to implementing the HHM interventions in WHCs, evaluate the effectiveness of hypertension management and use of tobacco screening and cessation, and provide evidence of HHM's potential cost-effectiveness for employers and Medicare.http://www.sciencedirect.com/science/article/pii/S2451865425000183Quality improvementTobacco cessationHypertensionWorksite health centers |
| spellingShingle | Hanzi Jiang Yao Tian Jennifer Bannon Amy E. Krefman Lawrence C. An Dustin D. French Claude R. Maechling Jane Holl Richard Chagnon Theresa L. Walunas Christopher Burch Anthony Musci Darce Latsis Dawn Carey Megan McHugh Rationale and design for Healthy Hearts in Manufacturing (HHM): A pragmatic single-arm hybrid effectiveness-implementation study for hypertension management and tobacco cessation Contemporary Clinical Trials Communications Quality improvement Tobacco cessation Hypertension Worksite health centers |
| title | Rationale and design for Healthy Hearts in Manufacturing (HHM): A pragmatic single-arm hybrid effectiveness-implementation study for hypertension management and tobacco cessation |
| title_full | Rationale and design for Healthy Hearts in Manufacturing (HHM): A pragmatic single-arm hybrid effectiveness-implementation study for hypertension management and tobacco cessation |
| title_fullStr | Rationale and design for Healthy Hearts in Manufacturing (HHM): A pragmatic single-arm hybrid effectiveness-implementation study for hypertension management and tobacco cessation |
| title_full_unstemmed | Rationale and design for Healthy Hearts in Manufacturing (HHM): A pragmatic single-arm hybrid effectiveness-implementation study for hypertension management and tobacco cessation |
| title_short | Rationale and design for Healthy Hearts in Manufacturing (HHM): A pragmatic single-arm hybrid effectiveness-implementation study for hypertension management and tobacco cessation |
| title_sort | rationale and design for healthy hearts in manufacturing hhm a pragmatic single arm hybrid effectiveness implementation study for hypertension management and tobacco cessation |
| topic | Quality improvement Tobacco cessation Hypertension Worksite health centers |
| url | http://www.sciencedirect.com/science/article/pii/S2451865425000183 |
| work_keys_str_mv | AT hanzijiang rationaleanddesignforhealthyheartsinmanufacturinghhmapragmaticsinglearmhybrideffectivenessimplementationstudyforhypertensionmanagementandtobaccocessation AT yaotian rationaleanddesignforhealthyheartsinmanufacturinghhmapragmaticsinglearmhybrideffectivenessimplementationstudyforhypertensionmanagementandtobaccocessation AT jenniferbannon rationaleanddesignforhealthyheartsinmanufacturinghhmapragmaticsinglearmhybrideffectivenessimplementationstudyforhypertensionmanagementandtobaccocessation AT amyekrefman rationaleanddesignforhealthyheartsinmanufacturinghhmapragmaticsinglearmhybrideffectivenessimplementationstudyforhypertensionmanagementandtobaccocessation AT lawrencecan rationaleanddesignforhealthyheartsinmanufacturinghhmapragmaticsinglearmhybrideffectivenessimplementationstudyforhypertensionmanagementandtobaccocessation AT dustindfrench rationaleanddesignforhealthyheartsinmanufacturinghhmapragmaticsinglearmhybrideffectivenessimplementationstudyforhypertensionmanagementandtobaccocessation AT claudermaechling rationaleanddesignforhealthyheartsinmanufacturinghhmapragmaticsinglearmhybrideffectivenessimplementationstudyforhypertensionmanagementandtobaccocessation AT janeholl rationaleanddesignforhealthyheartsinmanufacturinghhmapragmaticsinglearmhybrideffectivenessimplementationstudyforhypertensionmanagementandtobaccocessation AT richardchagnon rationaleanddesignforhealthyheartsinmanufacturinghhmapragmaticsinglearmhybrideffectivenessimplementationstudyforhypertensionmanagementandtobaccocessation AT theresalwalunas rationaleanddesignforhealthyheartsinmanufacturinghhmapragmaticsinglearmhybrideffectivenessimplementationstudyforhypertensionmanagementandtobaccocessation AT christopherburch rationaleanddesignforhealthyheartsinmanufacturinghhmapragmaticsinglearmhybrideffectivenessimplementationstudyforhypertensionmanagementandtobaccocessation AT anthonymusci rationaleanddesignforhealthyheartsinmanufacturinghhmapragmaticsinglearmhybrideffectivenessimplementationstudyforhypertensionmanagementandtobaccocessation AT darcelatsis rationaleanddesignforhealthyheartsinmanufacturinghhmapragmaticsinglearmhybrideffectivenessimplementationstudyforhypertensionmanagementandtobaccocessation AT dawncarey rationaleanddesignforhealthyheartsinmanufacturinghhmapragmaticsinglearmhybrideffectivenessimplementationstudyforhypertensionmanagementandtobaccocessation AT meganmchugh rationaleanddesignforhealthyheartsinmanufacturinghhmapragmaticsinglearmhybrideffectivenessimplementationstudyforhypertensionmanagementandtobaccocessation |