Title X Hypertension Learning Collaborative

  • Current Introduction
  • Grantee Information
  • Application Questions
  • Complete

Introduction

Almost half of U.S. adults, and approximately four in 10 adult women, have hypertension—a major contributing risk factor for heart disease, stroke, and kidney disease. Hypertension prevention and control can improve health outcomes, including those related to reproductive and maternal health.1

The RHNTC is convening a six-month Title X Hypertension Learning Collaborative from January to June 2022 to support Title X grantees in developing a systematic, comprehensive method to improve hypertension prevention and control within their networks. This learning collaborative will guide Title X grantees and service sites through five steps to implementing hypertension prevention and control best practices in a reproductive health care setting:

  1. Assess your program’s hypertension prevention and control efforts
  2. Train and prepare staff for hypertension prevention and control improvements
  3. Integrate hypertension prevention and screening into all client visits
  4. Strengthen support for clients with or at risk for hypertension
  5. Integrate hypertension into community participation and program promotion activities

In applying these steps, grantees will utilize tools and resources presented in the RHNTC’s Hypertension Prevention and Control Improvement Toolkit.

By the end of the learning collaborative, participants will be able to: 

  • Describe the impact of addressing hypertension prevention and control in a reproductive health care setting
  • Apply quality improvement (QI) principles to measure performance and improve hypertension prevention and control
  • Implement a plan for improving hypertension prevention and control in their networks
  • Demonstrate improvements on performance measures related to hypertension prevention and control

Participants

The RHNTC will support up to 10 teams, consisting of a Title X agency in partnership  with a service site, to participate. Ideal participants will be highly motivated and engaged, and have the time and human resources to commit to the learning collaborative. While the time commitment will vary by team and role, each participant should expect to spend at least 5 to 10 hours per month on learning collaborative-related activities.

It is important to have participation from both the grantee (policy/decision making) as well as one identified service site (where practice change happens). Participation of a grantee representative enables capacity building at the grantee level, with the goal of replicating best practices across the network. Each team will consist of:

  • Grantee (and, when applicable, subrecipient) representative(s) who hold decision-making roles; develop clinical policies and protocols; and will be in a position to implement changes across the network after the learning collaborative ends 
  • Service site representative(s), including frontline staff (e.g. front desk, nurses, family planning counselors), as well as those primarily responsible for clinic management and oversight of clinical care (e.g., clinic manager, clinical services provider, medical director). Their primary role will be to lead/oversee hypertension prevention and control activities at the site. 

Structure

Between January to June 2022, participants will engage in monthly 90 minute virtual learning sessions and individual coaching calls facilitated by the RHNTC. 

The RHNTC will use the Breakthrough Series model. In this model, participants engage in the QI process through alternating learning sessions and action periods.

Learning sessions: The RHNTC will facilitate six monthly 90-minute learning sessions  which will outline a comprehensive method to improve hypertension prevention and control service delivery based on five recommended steps. Learning sessions will include presentations and facilitated discussions on common barriers, challenges, and implementation strategies. Participants will also receive access to online resources, including those presented in the RHNTC’s Hypertension Prevention and Control Improvement Toolkit

Action periods: Between learning sessions, teams will be expected to apply the content delivered during the sessions to work toward implementation of their improvement plan. Teams should plan to meet as a QI team, implement improvement plans, conduct Plan-Do-Study-Act (PDSA) cycles, and track evaluation measures. PDSA cycles will start as small pilot activities and, over time, be scaled up at the site or grantee level. The RHNTC will support grantees with a coaching call and resources. The estimated time commitment includes:

  • QI team meetings: 1 to 2 hours per month
  • Implementing QI plan activities and PDSA: 2 to 4 hours per month
  • Data collection and reporting: 1 to 2 hours per month

Coaching call: Over the course of the learning collaborative, each team will have the opportunity for a 60-minute, individualized virtual meeting with an RHNTC coach to discuss challenges and brainstorm strategies related to their improvement plan. 

Data Collection

Participating teams will be asked to complete a site assessment for their selected sites at three time points: baseline, endpoint, and three months after the learning collaborative concludes. In addition, teams will report each month on one or more of the following hypertension-related performance measures:

  • Percentage of Title X users with blood pressure screening
  • Percentage of Title X encounters with high blood pressure detected and blood pressure management provided
  • Percentage of clients whose blood pressure was adequately controlled

Application Process

Grantees should apply by December 17. Applications must be submitted by a Title X grantee in partnership with one representative from an identified service site. The RHNTC will evaluate applications based on need, motivation, and interest. Please review the application questions prior to completing the form. The RHNTC expects to notify all applicants of the outcome of their application by December 23

Schedule

All sessions will take place from 1:00 pm - 2:30 pm EST unless otherwise noted. The table below provides information about each learning session.

Date Session Topic Objectives
January 11, 2022
1–2 pm ET
 
 Orientation By the end of the session, participants will be able to: 
  • Describe the learning collaborative structure and objectives
  • Describe the learning collaborative expectations, including session attendance, data collection, and pre-work
January 25, 2022

 
 Assess your program’s hypertension prevention and control efforts  By the end of the session, participants will be able to: 
  • Identify foundational guidelines related to hypertension prevention and control in the family planning setting 
  • Identify gaps between current and recommended practices within their programs  
  • Discuss strategies for including hypertension prevention and control best practices into policies and procedures
  • Apply metrics to create a plan to improve hypertension prevention and control in their programs 
February 22, 2022

 
Train and prepare staff for hypertension prevention and control improvements By the end of the session, participants will be able to: 
  • Discuss foundational topics to include in staff training to improve hypertension prevention and control services
  • Identify opportunities for improvement in staff knowledge and skills related to hypertension prevention and control
  • Identify resources that they can share with staff as part of a hypertension prevention and control training plan
March 22, 2022

 
Integrate hypertension prevention and screening into all client visits  By the end of the session, participants will be able to: 
  • Discuss the importance of accurate blood pressure measurement and identify resources for supporting staff to measure blood pressure accurately
  • Identify approaches to integrate healthy living recommendations into every family planning visit 
  • Describe at least one strategy that can be used to integrate blood pressure screening into preconception health services
  • Identify tools that can be used to offer culturally competent healthy living and risk reduction resources and/or referrals
April 26, 2022
 
Strengthen support for clients with or at risk for hypertension  By the end of the session, participants will be able to: 
  • Understand the process for diagnosing and managing hypertension in a family planning setting 
  • Implement hypertension management approaches appropriate to their settings
  • Describe at least two strategies and resources to support clients in monitoring and managing their blood pressure 
May 24, 2022

 
Integrate hypertension into community participation and program promotion activities  By the end of the session, participants will be able to: 
  • Describe strategies to identify local programs that address social determinants of health 
  • Identify strategies and resources for strengthening partnerships to address hypertension prevention and control at the community level 
  • Describe an approach for incorporating effective hypertension messaging, education, and resources into outreach and project promotion activities
June 28, 2022

 
Team Presentations  By the end of the session, participants will be able to: 
  • Describe their progress toward improving hypertension prevention and control services within the Title X network
  • Discuss at least one lesson learned through the process of using data to strengthen hypertension prevention and control services 
  • Identify at least one strategy to address challenges related to strengthening hypertension prevention and control services that they could use within their networks 

Reference

  1. U.S. Department of Health and Human Services. (2020). The Surgeon General’s Call to Action to Improve Maternal Health. https://www.hhs.gov/sites/default/files/call-to-action-maternal-health.pdf