In November 2022, the City and Hackney Community Health Champion (CHC) programme launched a blood pressure awareness pilot project, commissioned by NHS North East London. The approach outlined below has had a huge impact on City and Hackney residents’ understanding of blood pressure and has also demonstrated sustainability where it has been able to continue beyond the pilot.
The aim: to access and raise awareness of the importance of regular blood pressure checks across under-represented populations, specifically those with an identified higher risk of developing hypertension (high blood pressure)/cardiovascular disease.
The idea: What if, rather than waiting for people to come into the GP to ask about their blood pressure, trusted members of the community carried out awareness/blood pressure check demonstrations in places where – and amongst people with whom – residents feel comfortable.
The results: More residents getting their blood pressure checked, understanding what their blood pressure numbers mean, and if necessary, what follow up steps to take to more proactively manage their own health. More residents understand the dangers of high blood pressure, that it may not present with symptoms, and which lifestyle changes (e.g. diet, movement, weight, reducing alcohol and smoking) may help keep blood pressure at a healthy level.
The process: The Community Health Champion core team developed a hyperlocal approach that leveraged the trust and proximity of Community Health Champions and their organisational settings. This approach was complemented by developing tailored messaging (both verbal and written) and easy to read and understand communications materials. The CHC team activated blood pressure demonstration events that met residents where they were and where they felt comfortable.
Step 1: The Community Health Champion programme initially collaborated with four Champion-hosting organisations (Shepherd Fold Ministry, Hawa Trust, City and Hackney Carers Centre and The Listening Place). These organisations were proactively approached to host blood pressure check demonstrations because they represent specific communities (e.g. Black African/Black Caribbean) identified as being at higher risk for hypertension. Later, additional organisations, including Hackney Cypriot Association, joined the programme.
Step 2: Provide Community Health Champions hosted by these organisations with training and support from specialist health professionals/the CHC team to:
- Demonstrate how to take blood pressure readings and explain to residents why it’s important to administer regular blood pressure checks.
- Know where to direct residents for next steps if they need more information or support.
- Share advice on behaviour/lifestyle management to reduce modifiable risks for hypertension (all approved by health specialists).
Step 3: Draft, review, edit and shape the materials for residents, making sure they are jargon-free, and easy to understand. The Community Health Champion programme packaged the materials into a Blood Pressure Communications Toolkit and made it available to all Champions across the network.
Step 4: Build the blood pressure demonstrations into already established events within the pilot organisations, with support from the CHC team, health care specialists, staff and volunteers. For example, Shepherd Fold Ministry offered the demonstrations alongside its warm space/food bank services; the Hackney Cypriot Association offered demonstrations during its weekly lunch club and seated exercise classes.
Key benefits reported by Community Health Champions:
- Seeing someone administering the checks, who speaks their language and shares similar cultural references, makes residents feel more comfortable, more understood and more willing to talk about healthy lifestyle behaviours to maintain blood pressure at a healthy level.
- Conducting the checks within community settings improves trust and openness, reduces anxiety in the process and the discussions around related health conditions. Community Health Champions also reported that this model prompts more conversations about other health and wellbeing topics with residents.
- Creates more awareness of the risk factors in developing high blood pressure and how it can relate to the development of other long term conditions e.g. type 2 diabetes, Vascular dementia, bowel cancer etc.
Following the pilot, other voluntary and statutory organisations across Hackney began to offer the demonstrations, using an easy-to-follow guide created by the CHC team.
For example, Beis Brucha, a mother and baby centre supporting the Orthodox Jewish community, requested hypertension awareness and BP monitoring training for their postnatal mothers and have incorporated it into the services they provide:
“I’m happy to report that the blood pressure monitor and resources are being used and have been incredibly valuable. Staff are using them around 3-4 times a week. To sum up, this has arguably been one of our most valuable resources, benefiting mothers on a daily basis. Thank you to everyone involved in providing this training and monitor to our staff.” – Beis Brucha
Blood pressure demonstrations are just one of several initiatives planned and delivered by the City and Hackney Community Health Champion Programme. The core team and Community Champions work to break down health inequalities and create a healthier City & Hackney by increasing health literacy within specific communities and empowering residents to work towards more positive health outcomes.
Anyone interested in learning more about the CHC programme, please contact [email protected].