Strengths and limitations
hypertensive
UNCONTROLLED HYPERTENSION, RECRUITMENT
A few aspects of this study need more explanation. First, the size of the ITT group hints at individual-level, intervention delivery, and implementation fidelity factors that affect our ability to conclusively determine the effectiveness of the PTSC intervention among study participants. Second, over half of the women in the PTSC-RCT sample had BP in the normotensive range at baseline. We did not exclude these women from the study at the request of the partnering FQHC, because they did not want to give women deemed eligible for participation an incentive to not take their BP medication on recruitment days so they could participate in our study. The inclusion of these women in the study may have reduced our ability to discern the true impact of the PTSC intervention on improved BP for women with uncontrolled hypertension. To address this concern, we estimated the model for women who were hypertensive at baseline. The results were similar, but we lost statistical power. Third, we did not use food diaries to measure changes in dietary habits or employ validated measures for physical activity and stress management techniques. Finally, the study enrollment of 339 was 70% of our target of 480 participants. This reduced our study’s expected statistical power and may be the primary source of our insignificant effect sizes. Our target enrollment was probably too ambitious given we were drawing from a relatively small population of 2216 potential participants which required enrolling one of every five eligible patients.