Hypertension
Conditions
Keywords
Medication adherence, Self-monitoring of blood pressure, Clinical encounters, Health equity, Precision nudging, Digital health intervention, Behavioral reinforcement learning
Brief summary
The purpose of the proposed observational study is to explore the relations between data-driven personalization and equitable health outcomes in a digital health intervention (DHI) for hypertension management. In the current intervention, behavioral reinforcement learning is applied to personalize intervention content to maximize the behavioral outcomes of three target behaviors critical for effective hypertension management: clinical encounters, medication adherence, and self-monitoring of blood pressure (SMBP).
Interventions
BEHAVIORALPrecision Nudging for Hypertension Management
The hypertension digital health intervention under study combines behavioral science theory with a type of machine learning called reinforcement learning to enable precision nudging: the selection, assembly, and delivery of behavioral science-based messages created to address barriers to, and promote, management of hypertension. The behavioral design process used for the hypertension DHI intentionally includes research on traditionally underserved populations, such as racial and ethnic minorities and people with lower incomes or educational attainment. By including the right ingredients to meet a diverse set of needs and by effectively personalizing the content each individual sees based on their own reactions, the intervention aims to improve health equity by matching each individual to the right behavioral approach.
Sponsors
Lirio
Cone Health
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient of Cone Health. * Hypertension condition considered "uncontrolled" (signaled by an eligibility indicator). * Most recent blood pressure reading is at or higher than 160/90 (lowered to 140/90 in April 2025 in accordance with approved protocol)
Exclusion criteria
* Non-English speaking. * Globally unsubscribed. * Locally unsubscribed. * Deceased.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Clinical encounter behavioral outcome | 0-18 months | Adherence with recommended clinical encounters given eligibility based on blood pressure readings and medication |
| Blood pressure reading clinical outcome | 0-18 months | Blood pressure reading |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Engagement | 0-18 months | Digital engagement (opens, clicks, responses, etc.) |
| Medication adherence behavioral outcome | 0-18 months | Self-reported medication adherence |
| Self-monitoring of blood pressure behavioral outcome | 0-18 months | Self-reported self-monitoring of blood pressure |
Countries
United States
Outcome results
None listed