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Mi Propio Camino (My Own Way): Addressing negative beliefs about medication to improve adherence among Hispanic adults with hypertension

Award Number: R01HL142964
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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PROJECT SUMMARY/ABSTRACT In the past decade, the prevalence of uncontrolled hypertension has remained substantially higher in Latino Americans compared to other groups, even as access to health insurance has increased. This rise can be explained in part by high rates of medication nonadherence in this population. Many existing approaches to improve medication adherence, such as cell phone reminders, mail order refills and cost-lowering programs, can be effective in patients who are motivated to take a prescribed medication. However, these approaches will not help the over 40% of Latino patients who engage in “intentional nonadherence”—choosing not to take medications because of serious concerns that the drugs are not needed, or will cause side effects. Culturally- bound, negative beliefs about medications, and a preference to replace medications with natural remedies, are common in disadvantaged Latino communities, but are rarely discussed with health providers due to language barriers, low health literacy and cultural distance. Interventions supporting direct and vicarious experiences with a medication may dispel myths about medications and promote more positive beliefs and motivation to adhere. The proposed study is a RCT testing a culturally appropriate and novel intervention to improve adherence to antihypertensive medications in low-income Latino Americans with uncontrolled hypertension. The intervention aims to address negative beliefs over four group medical visit (GMV) sessions by incorporating culturally-bound perspectives on lifestyle and natural remedies alongside medications in discussions of blood pressure lowering strategies, and engaging patients in three brief periods of home monitoring with mHealth devices to support discussion of patients’ actual individual experiences with a regimen. The investigators have many years of experience researching contributors to nonadherence in low- income Latino communities, developing mHealth applications and delivering health interventions in safety net clinics. The aims of the study are (1) to evaluate the efficacy of a theory-based intervention to modify negative medication beliefs and promote medication adherence through direct and vicarious experiences with a medication, and (2) to test a theoretical model by which beliefs about medication at baseline predict subsequent use of behavioral strategies to improve adherence. If successful, the intervention may serve as a model approach to reduce intentional nonadherence due to negative beliefs about medications, and address an important contributor to health disparities.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2023 ( Subtotal = $582,706 )
2023	2023	UNIVERSITY OF CALIFORNIA, IRVINE	160 ALDRICH HALL	IRVINE	CA	92697	ORANGE	USA	Cardiovascular Diseases Research	001	4	5/11/2023	NON-COMPETING CONTINUATION	$58,271
2023	2023	UNIVERSITY OF CALIFORNIA, IRVINE	160 ALDRICH HALL	IRVINE	CA	92697	ORANGE	USA	Cardiovascular Diseases Research	000	4	1/22/2023	NON-COMPETING CONTINUATION	$524,435
														Subtotal = $582,706

Issue Date FY: 2022 ( Subtotal = $624,011 )
2022	2022	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Cardiovascular Diseases Research	001	3	5/24/2022	NON-COMPETING CONTINUATION	$62,402
2022	2022	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Cardiovascular Diseases Research	000	3	1/23/2022	NON-COMPETING CONTINUATION	$561,609
														Subtotal = $624,011

Issue Date FY: 2021 ( Subtotal = $626,066 )
2021	2021	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Cardiovascular Diseases Research	001	2	2/13/2021	NON-COMPETING CONTINUATION	$624,011
2021	2020	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Cardiovascular Diseases Research	000	1	1/21/2021	NEW	$2,055
														Subtotal = $626,066

Issue Date FY: 2020 ( Subtotal = $645,286 )
2020	2020	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Cardiovascular Diseases Research	002	1	5/1/2020	NEW	-$645,286
2020	2020	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Cardiovascular Diseases Research	000	1	1/22/2020	NEW	$645,286
2020	2020	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Cardiovascular Diseases Research	001	1	1/27/2020	NEW	$0
2020	2020	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Cardiovascular Diseases Research	003	1	5/11/2020	NEW	$645,286
														Subtotal = $645,286

Grand Total All Awards = $2,478,069

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Mi Propio Camino (My Own Way): Addressing negative beliefs about medication to improve adherence among Hispanic adults with hypertension

Award Number: R01HL142964

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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