University of California, San Francisco
This clinical trial aims to assess the impact of patient-focused and clinical-focused implementation strategies on blood pressure control. The investigators will assess the costs of these strategies and how effective they were at safely and equitably increasing home blood pressure monitoring.
This study will focus on assessing implementation strategies to increase adoption of self-monitored blood pressure (SMBP) monitoring among low-income, culturally and linguistically diverse patients with hypertension in an urban safety net. The investigators propose a hybrid type 1 effectiveness-implementation trial of implementation strategies to increase use of SMBP monitoring with clinical support in an urban safety net system. 330 patients will be randomized to a low-intensity vs high-intensity implementation strategy for SMBP monitoring. The low-intensity strategy will replicate frequently…
Inclusion Criteria: * 18 years old/order * Any sex or gender * Any race or ethnicity * Must be receiving primary care at any of the six enrolled clinics * Have uncontrolled hypertension (two clinic BP readings ≥140/90 mmHg within the previous 18 months) * Can read and write English, Spanish, or Cantonese * Be able to provide consent * Must own a cell phone that receives SMS or text messages Exclusion Criteria: * Those with conditions that might complicate remote BP monitoring: * Pregnancy (and 12 months postpartum) * Acute myocardial infarction or stroke in the last 12 months * End-s…
Patients will be taught how to use a BP monitor, along with the accompanying mobile app to view their readings.
Patients will receive training on how to use an online patient portal. If they are not yet enrolled in an online patient portal and would like to be, they will also be enrolled into one.
Patients will receive reminders via SMS to take their blood pressure.
One-time training with action planning, access to website with language concordant patient education, and educational text messages
Educational text messages about behavioral changes that explicitly encourage seeking support from a support person
Patients will be asked to involve a caregiver or support person for all activities above, including patient portal proxy access.
Patients will be asked to attend in-person or online group education classes on hypertension management
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