RICH LIFE Project (2015-2020)
The RICH LIFE (Reducing Inequities in Care of Hypertension: Lifestyle Improvement for Everyone) Project will help to lower blood pressure and heart disease risk among ethnic minority, low income, and rural populations, by comparing standard clinical performance feedback and education for providers and staff to a more comprehensive approach that includes workshops for health system leaders, a structured team approach to care, and access to subspecialists or community health worker support as needed for patients with hypertension.
The RICH LIFE (Reducing Inequities in Care of Hypertension: Lifestyle Improvement for Everyone) Project is a pragmatic cluster randomized trial that incorporates collaborative care management, community health workers, standardized blood pressure monitoring, and audit feedback to reduce disparities in blood pressure control and improve patient activation among patients with hypertension. The study uses patient and broad stakeholder engagement and applies principles of community-based participatory research to refine and adapt intervention protocols and materials to the needs of participating organizations, clinic sites, and populations.
Thirty primary care clinics across Maryland and Pennsylvania, including federally qualified health centers, have partnered with the Center in designing and conducting the RICH LIFE Project. We are recruiting an average of 63 patients from each practice site (total = 1,890 patients) for participation in the study. Eligible patients are 21 years of age or older; are non-Hispanic black, non-Hispanic white, or Hispanic; receive care at participating clinics; and have uncontrolled hypertension and another condition such as diabetes, heart disease, or depression. Participants are enrolled in the study for 2 years.
Finding effective approaches for patients to achieve better heart health helps patients and doctors to make critical decisions on real-world care for high risk patients, and our study combines tested approaches with new ideas in an innovative program that treats patients as whole people, rather than as a disease. Carefully tested interventions that show promise in improving health outcomes will give doctors, insurers, and law makers the confidence to support the widespread use of similar programs in a variety of medical settings and among other at-risk populations.
The RICH LIFE Project is funded by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the Patient-Centered Outcomes Research Institute (PCORI). Lisa A. Cooper, MD, MPH, and Jill A. Marsteller, PhD, MPP, are co-principal investigators of the RICH LIFE Project. We are grateful to our partnering health systems, Berks Community Health Centers, Choptank Community Health System, Johns Hopkins Community Physicians, Park West Health System, and Total Health Care, Inc., and our health insurer partner Johns Hopkins Healthcare, for their commitment to reducing disparities in hypertension, improving patient outcomes, and their on-going support of the RICH LIFE Project!