Cargando…

Improving Blood Pressure Among African Americans With Hypertension Using a Mobile Health Approach (the MI-BP App): Protocol for a Randomized Controlled Trial

BACKGROUND: African Americans shoulder significant disparities related to hypertension (HTN), which is a serious public health problem in the city of Detroit, Michigan, where more than 80% of the population is African American. Connectivity through smartphones, use of home blood pressure (BP) monito...

Descripción completa

Detalles Bibliográficos
Autores principales: Buis, Lorraine R, Dawood, Katee, Kadri, Reema, Dawood, Rachelle, Richardson, Caroline R, Djuric, Zora, Sen, Ananda, Plegue, Melissa, Hutton, David, Brody, Aaron, McNaughton, Candace D, Brook, Robert D, Levy, Phillip
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367671/
https://www.ncbi.nlm.nih.gov/pubmed/30681965
http://dx.doi.org/10.2196/12601
_version_ 1783393851025653760
author Buis, Lorraine R
Dawood, Katee
Kadri, Reema
Dawood, Rachelle
Richardson, Caroline R
Djuric, Zora
Sen, Ananda
Plegue, Melissa
Hutton, David
Brody, Aaron
McNaughton, Candace D
Brook, Robert D
Levy, Phillip
author_facet Buis, Lorraine R
Dawood, Katee
Kadri, Reema
Dawood, Rachelle
Richardson, Caroline R
Djuric, Zora
Sen, Ananda
Plegue, Melissa
Hutton, David
Brody, Aaron
McNaughton, Candace D
Brook, Robert D
Levy, Phillip
author_sort Buis, Lorraine R
collection PubMed
description BACKGROUND: African Americans shoulder significant disparities related to hypertension (HTN), which is a serious public health problem in the city of Detroit, Michigan, where more than 80% of the population is African American. Connectivity through smartphones, use of home blood pressure (BP) monitoring, and newly developed mobile health (mHealth) interventions can facilitate behavioral changes and may improve long-term self-care for chronic conditions, but implementation of a combined approach utilizing these methods has not been tested among African American patients with uncontrolled HTN. Since African Americans are more likely than other racial or ethnic subgroups to utilize the emergency department (ED) for ambulatory care, this presents an opportunity to intervene on a population that is otherwise difficult to reach. OBJECTIVE: The MI-BP app aims to reduce health disparities related to HTN in the community by employing a user-centered intervention focused on self-BP monitoring, physical activity, reduced sodium intake, and medication adherence. We seek to test the efficacy of MI-BP, an mHealth app for HTN self-management, on BP control (primary aim), physical activity, sodium intake, and medication adherence (secondary aim) in African Americans with HTN. This study also seeks to evaluate the cost-effectiveness of MI-BP when compared with usual care methods. METHODS: This is a 1-year randomized controlled trial that will recruit individuals who have uncontrolled HTN from 2 EDs in the city of Detroit, with a planned sample size of 396 randomized participants. To be eligible for inclusion, potential participants must be African American, 25 to 70 years old, previously diagnosed with HTN, have a smartphone compatible with MI-BP, and have uncontrolled BP at triage and on repeat measurement at least 1-hour post triage vitals. Once a participant is deemed eligible, all study procedures and subsequent follow-up visits (8 in total) are conducted at the Wayne State University Clinical Research Service Center. We seek to determine the effect of MI-BP on BP for 1 year (using BP control and mean systolic BP as coprimary outcomes and physical activity, sodium intake, and medication adherence as secondary outcomes) compared with usual care controls. RESULTS: Recruitment for this study began in January 2018. The study will continue through 2021. CONCLUSIONS: As the first of its kind conducted in an ED setting, MI-BP was designed to document the efficacy and acceptability of a multicomponent mHealth approach to help African Americans with uncontrolled BP modify their lifestyle to better manage their HTN. We expect to lay the foundation to sustainably reduce HTN-related health disparities through better integration of multiple behavior self-monitoring and improve outcomes for those who traditionally rely on the ED for chronic disease care. TRIAL REGISTRATION: ClinicalTrials.gov NCT02360293; http://clinicaltrials.gov/ct2/show/NCT02360293 INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/12601
format Online
Article
Text
id pubmed-6367671
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher JMIR Publications
record_format MEDLINE/PubMed
spelling pubmed-63676712019-02-27 Improving Blood Pressure Among African Americans With Hypertension Using a Mobile Health Approach (the MI-BP App): Protocol for a Randomized Controlled Trial Buis, Lorraine R Dawood, Katee Kadri, Reema Dawood, Rachelle Richardson, Caroline R Djuric, Zora Sen, Ananda Plegue, Melissa Hutton, David Brody, Aaron McNaughton, Candace D Brook, Robert D Levy, Phillip JMIR Res Protoc Protocol BACKGROUND: African Americans shoulder significant disparities related to hypertension (HTN), which is a serious public health problem in the city of Detroit, Michigan, where more than 80% of the population is African American. Connectivity through smartphones, use of home blood pressure (BP) monitoring, and newly developed mobile health (mHealth) interventions can facilitate behavioral changes and may improve long-term self-care for chronic conditions, but implementation of a combined approach utilizing these methods has not been tested among African American patients with uncontrolled HTN. Since African Americans are more likely than other racial or ethnic subgroups to utilize the emergency department (ED) for ambulatory care, this presents an opportunity to intervene on a population that is otherwise difficult to reach. OBJECTIVE: The MI-BP app aims to reduce health disparities related to HTN in the community by employing a user-centered intervention focused on self-BP monitoring, physical activity, reduced sodium intake, and medication adherence. We seek to test the efficacy of MI-BP, an mHealth app for HTN self-management, on BP control (primary aim), physical activity, sodium intake, and medication adherence (secondary aim) in African Americans with HTN. This study also seeks to evaluate the cost-effectiveness of MI-BP when compared with usual care methods. METHODS: This is a 1-year randomized controlled trial that will recruit individuals who have uncontrolled HTN from 2 EDs in the city of Detroit, with a planned sample size of 396 randomized participants. To be eligible for inclusion, potential participants must be African American, 25 to 70 years old, previously diagnosed with HTN, have a smartphone compatible with MI-BP, and have uncontrolled BP at triage and on repeat measurement at least 1-hour post triage vitals. Once a participant is deemed eligible, all study procedures and subsequent follow-up visits (8 in total) are conducted at the Wayne State University Clinical Research Service Center. We seek to determine the effect of MI-BP on BP for 1 year (using BP control and mean systolic BP as coprimary outcomes and physical activity, sodium intake, and medication adherence as secondary outcomes) compared with usual care controls. RESULTS: Recruitment for this study began in January 2018. The study will continue through 2021. CONCLUSIONS: As the first of its kind conducted in an ED setting, MI-BP was designed to document the efficacy and acceptability of a multicomponent mHealth approach to help African Americans with uncontrolled BP modify their lifestyle to better manage their HTN. We expect to lay the foundation to sustainably reduce HTN-related health disparities through better integration of multiple behavior self-monitoring and improve outcomes for those who traditionally rely on the ED for chronic disease care. TRIAL REGISTRATION: ClinicalTrials.gov NCT02360293; http://clinicaltrials.gov/ct2/show/NCT02360293 INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/12601 JMIR Publications 2019-01-25 /pmc/articles/PMC6367671/ /pubmed/30681965 http://dx.doi.org/10.2196/12601 Text en ©Lorraine R Buis, Katee Dawood, Reema Kadri, Rachelle Dawood, Caroline R Richardson, Zora Djuric, Ananda Sen, Melissa Plegue, David Hutton, Aaron Brody, Candace D McNaughton, Robert D Brook, Phillip Levy. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 25.01.2019. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.
spellingShingle Protocol
Buis, Lorraine R
Dawood, Katee
Kadri, Reema
Dawood, Rachelle
Richardson, Caroline R
Djuric, Zora
Sen, Ananda
Plegue, Melissa
Hutton, David
Brody, Aaron
McNaughton, Candace D
Brook, Robert D
Levy, Phillip
Improving Blood Pressure Among African Americans With Hypertension Using a Mobile Health Approach (the MI-BP App): Protocol for a Randomized Controlled Trial
title Improving Blood Pressure Among African Americans With Hypertension Using a Mobile Health Approach (the MI-BP App): Protocol for a Randomized Controlled Trial
title_full Improving Blood Pressure Among African Americans With Hypertension Using a Mobile Health Approach (the MI-BP App): Protocol for a Randomized Controlled Trial
title_fullStr Improving Blood Pressure Among African Americans With Hypertension Using a Mobile Health Approach (the MI-BP App): Protocol for a Randomized Controlled Trial
title_full_unstemmed Improving Blood Pressure Among African Americans With Hypertension Using a Mobile Health Approach (the MI-BP App): Protocol for a Randomized Controlled Trial
title_short Improving Blood Pressure Among African Americans With Hypertension Using a Mobile Health Approach (the MI-BP App): Protocol for a Randomized Controlled Trial
title_sort improving blood pressure among african americans with hypertension using a mobile health approach (the mi-bp app): protocol for a randomized controlled trial
topic Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367671/
https://www.ncbi.nlm.nih.gov/pubmed/30681965
http://dx.doi.org/10.2196/12601
work_keys_str_mv AT buislorrainer improvingbloodpressureamongafricanamericanswithhypertensionusingamobilehealthapproachthemibpappprotocolforarandomizedcontrolledtrial
AT dawoodkatee improvingbloodpressureamongafricanamericanswithhypertensionusingamobilehealthapproachthemibpappprotocolforarandomizedcontrolledtrial
AT kadrireema improvingbloodpressureamongafricanamericanswithhypertensionusingamobilehealthapproachthemibpappprotocolforarandomizedcontrolledtrial
AT dawoodrachelle improvingbloodpressureamongafricanamericanswithhypertensionusingamobilehealthapproachthemibpappprotocolforarandomizedcontrolledtrial
AT richardsoncaroliner improvingbloodpressureamongafricanamericanswithhypertensionusingamobilehealthapproachthemibpappprotocolforarandomizedcontrolledtrial
AT djuriczora improvingbloodpressureamongafricanamericanswithhypertensionusingamobilehealthapproachthemibpappprotocolforarandomizedcontrolledtrial
AT senananda improvingbloodpressureamongafricanamericanswithhypertensionusingamobilehealthapproachthemibpappprotocolforarandomizedcontrolledtrial
AT pleguemelissa improvingbloodpressureamongafricanamericanswithhypertensionusingamobilehealthapproachthemibpappprotocolforarandomizedcontrolledtrial
AT huttondavid improvingbloodpressureamongafricanamericanswithhypertensionusingamobilehealthapproachthemibpappprotocolforarandomizedcontrolledtrial
AT brodyaaron improvingbloodpressureamongafricanamericanswithhypertensionusingamobilehealthapproachthemibpappprotocolforarandomizedcontrolledtrial
AT mcnaughtoncandaced improvingbloodpressureamongafricanamericanswithhypertensionusingamobilehealthapproachthemibpappprotocolforarandomizedcontrolledtrial
AT brookrobertd improvingbloodpressureamongafricanamericanswithhypertensionusingamobilehealthapproachthemibpappprotocolforarandomizedcontrolledtrial
AT levyphillip improvingbloodpressureamongafricanamericanswithhypertensionusingamobilehealthapproachthemibpappprotocolforarandomizedcontrolledtrial