JMIR Publications

ABSTRACT

Background:

Hypertension is a leading contributor to stroke and cardiovascular disease in underserved populations. This study aims to evaluate a community-based hypertension screening intervention in French Guiana’s precarious urban neighborhoods.

Objective:

This trial will assess whether a structured community health mediator-led intervention reduces stroke incidence among adults residing in socioeconomically precarious areas of the Communauté d’Agglomération du Centre Littoral (CACL).

Methods:

This is a 27-month, monocentric, quasi-experimental study conducted in the CACL (French Guiana), targeting neighborhoods classified as precarious. Adults aged ≥18 years will be included unless legally protected or opposed. Trained mediators will deliver blood pressure screening and health education through mobile units and home visits over 24 months. Participants with elevated readings will receive referrals and structured follow-up. Primary outcome is the change in stroke incidence pre- and post-intervention using PMSI hospitalization data. Secondary outcomes include changes in other cardiovascular and renal event rates and antihypertensive treatment adherence. Comparisons will use Interrupted Time Series, Chi-squared tests, and regression models. Missing data will be evaluated, and multiple imputation applied as needed.

Results:

This study was registered on ClinicalTrials.gov in April 2023 (NCT05814068). Patient enrolment started in September 2023, with 23289 participants having benefited from the intervention (including 10901 enrolled as of September 04, 2025). Corresponding to the end date of field interventions. Follow-up is currently underway.

Conclusions:

This study will determine whether scalable, community-mediated hypertension screening reduces stroke incidence in underserved populations. Clinical Trial: NCT05814068.