Key2025

1 Develop shared data platforms and dashboards
2 Engage nonprofits early to build trust
3 Pull vital records and demographic data to identify hot spots and disparities of people with elevated blood pressure
4 CBOs evaluate data about resources and services that are most needed by clients
5 Target farm owners as well as farm workers with health and resource outreach to gain trust
6 Develop multi-pronged outreach strategies – farm associations, farm managers/middle people, etc
7 Strengthen team-based care models
8 Cross-sector collaboration to share nurses, interpreters, physicians
9 Larger systems donate staff time
10 Add dedicated hypertension clinic days
11 FQHCs health and dental clinics integration of blood pressure communication
12 Launch cultural tailored public education campaigns that target populations that are identified by health system stratified data
13 Promote SMBP and lifestyle changes in trusted spaces through community leaders and peer educators
14 Capture patients regarding elevated blood pressures during initial PCP visit
15 Clarify CHW roles and expand training – potential pilot project with SMBP and follow-up with clients about home BPs and whether they are taking their meds and have nurses and CHWs for ongoing support
16 Empower all providers to “own” blood pressure by creating simple referral pathways to primary care
17 Expand telehealth for hypertension care
18 Use validated SMBP tools and wearable tech
19 Monitor and adjust treatment remotely
20 Hire a bilingual lifestyle coach to pilot a program at the Wausau Free Clinic – there could be individual and/or group appointments
21 Train staff and bilingual/bicultural navigators in patient-centered care to improve cultural competency and communication tailoring healthy diet education materials