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  6. Implementation of Target: BP Hypertension guidelines in a Patient Population Experiencing Homelessness

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Implementation of Target: BP Hypertension guidelines in a Patient Population Experiencing Homelessness

Background

Cardiovascular disease remains the leading cause of death among individuals experiencing homelessness, who face profound inequities in access to healthcare, chronic disease management, and preventive services. Hypertension鈥攐ften undiagnosed or poorly controlled鈥攁ccounts for a significant proportion of premature deaths in this population. The American Heart Association鈥檚 Target:BP鈩� program provides evidence-based tools to improve blood pressure control, yet has not been implemented in Health Care for the Homeless (HCH) settings. This study addresses that gap by adapting and testing the feasibility of Target:BP鈩� in partnership with Healthcare for the Homeless鈥揌ouston, a large federally qualified health center network.

Study Objectives

  1. Evaluate the feasibility of HCH clinics as regular sources of care for longitudinal blood pressure monitoring and management.

  2. Identify barriers and facilitators to implementation using evidence-based frameworks.

  3. Assess implementation outcomes and health impacts using the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation fidelity, Maintenance).

  4. Develop a tailored implementation toolkit to guide equitable adoption of Target:BP鈩� in safety-net clinical settings.

Project Timeline

  • Apr 2025-Mar 2028

Scholarly Works: 

  • Differences in Cardiovascular Disease Burden, Screening, Education, and Care by Clinic Type in the 2022 Health Center Patient Survey (HRSA).  
    Ben King, Ph.D., Olivia Jones, B.S., Edgard Castillo,* Sarina Attri, Dave Buck, M.D.
  • Housing and Social Service Engagement Prior to Death Among People Experiencing Homelessness in a Large Urban County.  
    Stratemann, C., Shaya Khorsandi, Shriya Swami, Lucas Lin, Ben King, Ph.D.  
  • Teaching Inclusion Health Principles: What Medical Students Must Learn to be prepared to work with Marginalized Populations.  
    Ben King, Ph.D. Carlos G. Fuentes, B.A., Mat Mendoza,* Geraldo Medrano,* Dave Buck, M.D.
  • Early Mortality and Medical Complexity Among Medicolegal Cardiovascular Disease Deaths: Comparing Housed and Unhoused Decedents. 
    Ben King, Ph.D., Shriya Swamy, Shaya Khorsandi