Abstract P113: Pairing the Mobile Device: Does the Engagement of Student Health Coaches Help Patients Use Smart-phone Enabled Devices for Blood Pressure Monitoring?

Abstract

Research Question: Does pairing of health coaches with smartphone-enabled blood pressure cuffs improve hypertension control and self-monitoring in a medically underserved area (MUA)? Introduction/Context: This pilot study aims to assess whether infusing tech-savvy youths trained as health technology coaches would (1) be a feasible approach in an MUA and (2) improve the frequency of self-monitoring, patient satisfaction, and blood pressure control of Stockton residents. Methods: Patients with hypertension were randomly assigned to 1 of 3 intervention arms. The “Cuff Alone" (CA) group was provided a QardioArm cuff only, and was encouraged to use the cuff at their convenience. The “Student Alone" (SA) group was instructed to meet for 30 minutes once a week for 5 weeks with a student health coach who had completed a 3-day health coach training. The third group “Student Plus Cuff" (SPC) group received both a QardioArm cuff and student coach. Student coaches and patients were surveyed about their experience in the project. Results: Participants (n=27) were randomly assigned (9:9:9). All 15 students completed training and 6/15 students (40%) completed all 5 meetings with their assigned patient. Barriers to feasibility included transportation and patient response drop-off at the end of the study. There was a statistically significant difference in frequency of cuff use (SPC vs CA groups, 37v17, p<0.01). The initial blood pressures for SPC, SA and CA groups were 139/78, 142/84, and 149/85 mmHg, respectively. Final BP readings were 128/69, 150/85, and 145/85 mmHg, respectively. The SPC group was the only group that reached adequate BP control, though it was not statistically significant (p=0.89). 77% of the SPC group rated the project overall as excellent, compared to CA and SA (77% vs 55% vs 44%). 78% of SPC participants reported their blood pressure to be well controlled most days of the week, compared to CA (32%) and SA (22%). Conclusions: This pilot trial demonstrated feasibility of pairing technology with that young student coaches, though challenges existed. The SPC group used their cuff more than twice the frequency of the CA group. Patients were more engaged in the SPC group, resulting in better blood pressure control by both self-reported and objective measures.