The study was based on the ‘train the trainer’ approach and the community health worker
(CHW) model.19 Each patient recruited to the intervention group (MVP) was asked to reach
out and extend an invitation to two relatives or friends eligible to participate to enroll in the
program. Subsequently, these two patients each recruited two patients of their own. This
created a cluster of 7 patients in total, who were followed up as a team. These patients were
referred to or were enrolled from the primary care practices at the University of Maryland
(Figure 1). Patients presented to the research center with hypertension as indicated by
current drug treatment for hypertension or a history of hypertension, or severe risk factors
for uncontrolled hypertension, e.g., gastroenteritis, muscle spasm, allergy, backache, hernia,
and otitis media. The control group was a retrospective cohort consisting of a random
sample of a pool of patients who had previously enrolled in the control arm of a closely
related randomized clinical trial from 2008 (BPTEACH) examining the effect of education
to physicians and patients on improving blood pressure control in a mostly African
American population in Baltimore, MD 20. Subjects in the BPTEACH trial had enrolled
individually and had been followed up as such.