JMIR Publications

ABSTRACT

Background:

Hypertension (HTN) affects one-third of adults in the U.S and is the leading risk factor for death. For adults, a lack of HTN knowledge is a common barrier to HTN control, while social support is a strong facilitator. Youth increase confidence when given the responsibility to provide health education and care navigation to others. As such, we planned a randomized controlled trial (RCT) of the effectiveness of a digital youth-led HTN education intervention.

Objective:

In preparation for a RCT, we conducted a formative study to determine acceptable and easily understood ways to present HTN information to adults with HTN and optimal ways to engage youth to support adults on how to achieve better HTN control.

Methods:

After creating an intervention prototype with six weekly self-guided HTN online modules, we recruited 12 youth (adolescents 15-18 years old) for 3 focus groups and 10 adult emergency department (ED) patients with HTN for individual interviews on Zoom to garner feedback on the prototype.

Results:

Participants showed great interest in the intervention prototype and thought their peers would find it acceptable. Youth with family members with HTN reported that their family members needed more support, especially if there was language discordance with the doctor. Youth suggestions included adding more nutrition education activities. Adults discussed the need for the HTN support intervention for themselves and expected benefits to youth. They mentioned the overwhelming amount of HTN information available and appreciated the intervention’s concise content presentation. They suggested adding more mental health and smoking cessation resources, information about specific HTN medications, and adding active links for health center information.

Conclusions:

A youth-led digital HTN intervention is an acceptable strategy to engage both adults with HTN and youth. Incorporating participant suggestions into the intervention may improve the clarity, engagement, and impact of its content. We anticipate that implementing suggested changes will enhance effectiveness and engagement with the intervention when used in a subsequent RCT.