Abstract P211: Use Of Coaching And Technology To Improve Blood Pressure Control In Black Women With Hypertension

Abstract

Introduction: Hypertension (HTN) is the main cause of cardiovascular disease, especially in women. Black females (58%) are disproportionately affected by higher rates of HTN than White (41%), Hispanic (41%), and Asian (42%) females, contributing to higher death rates from myocardial infarction, heart failure, stroke, and renal failure. Active involvement in self-care is key to preventing and controlling HTN. Aim: To test the effects of Interactive Technology Enhanced Coaching (ITEC) on achieving blood pressure (BP) control, adherence to antihypertensive medication, and adherence to lifestyle modifications (physical activity, healthy diet, and weight management) at 3-, 6-, and 9-months post Chronic Disease Self-Management Program (CDSMP) compared with Interactive Technology (IT) alone. Methods: Black women in this RCT pilot study were prescribed antihypertensive medication and had BPs ≥ 130/80. All participants completed a 6-week CDSMP and afterwards were randomly assigned to the ITEC or IT group. Participants were trained to use equipment and apps that were synced to smartphones to daily monitor (over a 9-month period) BP, weight, physical activity (steps), diet (caloric intake), and medication adherence in real-time, though the Fitbit Plus Platform. Results: A total of 90 women were recruited. Data were analyzed from 77 participants aged 24 to 70 years. A hierarchical, mixed-effects repeated measures design was used to measure changes over time. The main effect of group means indicated no significant difference between the treatment and control groups on all study variables. The main effect of time indicated significant differences between repeated measures for SBP ( p < .0001 and steps ( p = .012). An interaction effect was significant for all measures except DBP and calories. SBP decreased to <130 following CDSMP and remained stable thereafter for both groups. Conclusions: Participant engagement declined as coaching decreased in the treatment group. Enhancing motivation and making self-care a priority in this population warrants further exploration.