Accepted for/Published in: JMIR Formative Research
Date Submitted: Oct 31, 2023
Date Accepted: Apr 8, 2024
Exploring Acceptability and Feasibility of Remote Measurement of Blood Pressure and Cognition among Participants Recruited from a Safety-Net ED: Reach Out Cognition
ABSTRACT
Background:
Hypertension is a prevalent cardiovascular risk factor disproportionately affecting Black Americans, who also experience a higher incidence of Alzheimer's disease and Alzheimer's disease-related dementias. Monitoring blood pressure and cognition may be important strategies in reducing these disparities.
Objective:
The objective of Reach Out cognition explored was to explore the feasibility, acceptability, and satisfaction of remote cognitive and blood pressure monitoring in a predominantly Black, low-income population.
Methods:
Reach Out was a randomized, controlled, mHealth clinical trial to reduce blood pressure (BP) among hypertensive safety-net ED patients. Upon conclusion of Reach Out, participants were given the option of continuing into an extension phase, Reach Out cognition, that included Bluetooth-enabled BP monitoring and digital cognitive assessments for 6 months. Digital cognitive assessments were text message linked online surveys of the Self-Administered Gerocognitive Exam (SAGE) and Quality of Life in Neurological Disorders (Neuro-QoL- Cognition). BP assessments were measured with Bluetooth enabled BP cuffs paired with an app with data manually sent to research team. Outcomes were feasibility (i.e enrollment and 3-and 6-month completion of digital cognitive and BP assessment) and acceptability of assessments using 4 item validated survey (1-5 completely acceptable).
Results:
Of 211 Reach Out participants, 107 (51%) consented and 71 (34%) completed enrollment. Participants had a mean age of 49.9 years, 70.4% were female and 57.8% identified as Black. Cognitive assessments were completed by 51 (72%) participants at 3-months and 34 (48%) participants at 6-months. Remote BP assessment were completed by 37 (52%) participants at 3-months and 20 (28%) participants at 6-months. Participants were neutral on the acceptability of the digital cognitive assessments (mean=3.7) and Bluetooth SMBP (Self Measured Blood Pressure) monitoring (mean=3.9)
Conclusions:
Overall, enrollment and outcome measure completion were low and acceptability was moderate. Further research is warranted to optimize participant engagement and overcome technological challenges. Clinical Trial: NCT03422718
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.