A Community and Technology-Based Approach for Hypertension Self-Management (COACHMAN) to Improve Blood Pressure Control in African Americans: Results from a Pilot Study

Carolyn H Still, Seunghee Margevicius, Carla Harwell, Ming-Chun Huang, LaTonya Martin, Phuong B Dang, Jackson T Wright Jnr, Carolyn H Still, Seunghee Margevicius, Carla Harwell, Ming-Chun Huang, LaTonya Martin, Phuong B Dang, Jackson T Wright Jnr

Abstract

Purpose: Adoption of technology has increased to support self-managing chronic diseases. However, behavioral interventions evaluating such technology have been understudied in African Americans with hypertension. The aim of this study was to explore a community and technology-based intervention for hypertension self-management (COACHMAN) intervention on blood pressure (BP) control and health-related quality of life (HRQoL) in African Americans with hypertension.

Methods: Sixty African Americans (mean age 60; 75% females) who were prescribed antihypertensive medications and owning a smartphone were randomized to the COACHMAN (n = 30) or enhanced usual care (n = 30) group for 12 weeks. COACHMAN is comprised of four components: web-based education, home BP monitoring, medication management application, and nurse counseling. Hypertension knowledge, self-efficacy, technology adoption/use, medication adherence, BP, and HRQoL scores were assessed.

Results: Mean systolic and diastolic BP at baseline was 150.49 (SD = 13.89) and 86.80 (SD = 13.39), respectively. After completing the 3-month intervention to improve hypertension self-management, the groups did not significantly differ in BP control and HRQoL. Clinically relevant BP reduction was observed in the intervention group. Paired t-test showed that mean medication-taking adherence scores significantly improved in the intervention group (P = 0.023) compared to the control group (P = 0.075).

Conclusion: Using technology may have a positive impact on supporting hypertension self-management, particularly in medication-taking adherence. Further research is warranted in a larger sample and should include standardization of medication management to isolate the effects of behavioral interventions on changes in BP.

Clinicaltrialsgov identifier: NCT03722667.

Keywords: African Americans; hypertension; minority health; self-management; technology.

Conflict of interest statement

The authors have no conflicts of interest, including no relevant financial or non-financial in the subject or materials discussed in this paper. The preliminary findings of this study were presented at the 2019 Gerontological Society of America’s 71st Annual Scientific conference as part of a symposium. The presentation’s abstract was published in Innovative Aging. https://doi.org/10.1093/geroni/igz038.269

© 2020 Still et al.

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