Hypertension
Conditions
Keywords
Hypertension, mHealth
Brief summary
This study seeks to evaluate a multicomponent mobile intervention to change multiple hypertension-related health behaviors in minorities and the underserved with uncontrolled hypertension. Half of the participants will receive a mobile intervention designed to improve physical activity, sodium intake, and medication adherence. The other half will receive usual care.
Interventions
MI-BP includes the following components: 1) Home blood pressure monitoring 2) Physical activity monitoring 3) Sodium intake self-monitoring 4) Physical activity and sodium intake goal setting 5) Educational messaging via push notification and in-app messaging 6) motivational messaging 7) tailored messaging relevant to individual participants and 8) medication reminders.
Sponsors
Study design
Eligibility
Inclusion criteria
* Detroit-area residents * Hypertensive * Owning a compatible smartphone * Presenting to the Detroit Medical Center Detroit Receiving, Sinai-Grace Hospital, or selected Community Health Screening Events with, but not necessarily for, uncontrolled blood pressure (systolic blood pressure ≥ 135 mm Hg at triage and on repeat measurement using the BpTRU device).
Exclusion criteria
* No self-reported prior history of hypertension * No hypertension diagnosis documented in their medical record * Non-English speaking * Presenting with an acute illness necessitating immediate medical intervention * Presenting with an admission to the hospital for critical reasons (as determined by the attending physician) * Pregnant (as determined by a dip test at screening), or self-report during trial. * Having the following serious comorbidities or confounders due to the fact that they may make blood pressure control difficult or necessitate frequent Emergency Department use or hospitalization: * Previous diagnosis of resistant hypertension (or current use of 3 or more maximally dosed antihypertensive agents without achievement of blood pressure control) * Steroid dependent asthma or emphysema * Cirrhosis or hepatic failure * Chronic heart failure (any stage) * Previous diagnosis of acute myocardial infarction, angina (stable or unstable), or known coronary artery disease * Previous diagnosis of cerebrovascular disease (including transient ischemic attack or stroke) * Known valvular heart disease * Stage IV or V chronic kidney disease * Cancer (terminal or undergoing active chemotherapeutic or radiation therapy) * Patients with other serious medical conditions that may affect their ability to self-monitor blood pressure (such a dementia) * Having a history of alcohol or drug abuse as determined by the CAGE-AID questionnaire (excluded if 2 or more) * Week 2 measurement of systolic blood pressure \< 130 mm Hg using the BpTRU device or study-issued BP cuff.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in mean systolic blood pressure | from baseline to 1 year |
Secondary
| Measure | Time frame |
|---|---|
| Change in physical activity as measured by the International Physical Activity Questionnaire (IPAQ-SF) | from baseline to 1 year |
| Change in sodium intake as measured by the Block Sodium Screener | from baseline to 1 year |
| Change in medication adherence as measured by Adherence to Refills and Medications Scale (ARMS) | from baseline to 1 year |
| Change in blood pressure control | from baseline to 1 year |
Other
| Measure | Time frame |
|---|---|
| Cost-effectiveness of MI-BP compared to usual care | within-trial |
Countries
United States