Department of Family Medicine and Community Health; Division of Cardiovascular Medicine, Department of Medicine; Department of Population and Quantitative Health Sciences; Center for Integrated Primary Care
Alternative and Complementary Medicine | Behavioral Medicine | Cardiovascular Diseases | Health Information Technology | Health Psychology | Health Services Research | Integrative Medicine | Mental and Social Health | Movement and Mind-Body Therapies | Primary Care | Psychiatry and Psychology
BACKGROUND: Hypertension (HTN) affects millions of Americans. Our Whole Lives: an eHealth toolkit for Hypertension and Cardiac Risk Factors (OWL-H) is an eHealth platform that teaches evidence-based lifestyle strategies, such mindfulness and cooking skills, to improve self-management of HTN.
OBJECTIVE: The primary goal of this pilot study was to evaluate the feasibility of OWL-H combined with teaching kitchen medical group visits (TKMGVs) in a low-income population of participants with HTN.
METHODS: We conducted a pre-post 8-week study to assess the feasibility of a hybrid program (a web-based 9-module self-management program, which includes mindfulness and Mediterranean and Dietary Approaches to Stop Hypertension diet) accompanied by 3 in-person TKMGVs among patients with HTN. Data including demographics, platform use, and satisfaction after using OWL-H were examined. Outcome data collected at baseline and 8 weeks included the Mediterranean Diet Questionnaire, Hypertension Self-Care Profile Self-Efficacy Instrument, Blood Pressure Knowledge Questionnaire, and the number of self-reported blood pressure readings. For the statistical analysis, we used descriptive statistics, paired sample t tests (1-tailed), and qualitative methods.
RESULTS: Of the 25 enrolled participants, 22 (88%) participants completed the study. Participants' average age was 57 (SD 12.1) years, and 46% (11/24) of them reported a household income < US $30,000 per year. Among the 22 participants who logged in to OWL-H, the average number of mindfulness practices completed was 7 and the average number of module sessions accessed was 4. In all, 73% (16/22) of participants reported that they were "very satisfied" with using OWL-H to help manage their HTN. Participants' blood pressure knowledge significantly increased from baseline (mean 5.58, SD 1.44) to follow-up (mean 6.13, SD 1.23; P=.03). Participants significantly increased their adherence to a Mediterranean diet from baseline (mean 7.65, SD 2.19) to follow-up (mean 9, SD 1.68; P=.004). Participants' self-efficacy in applying heart-healthy habits, as measured by the Hypertension Self-Care Profile Self-Efficacy Instrument, increased from baseline (mean 63.67, SD 9.06) to follow-up (mean 65.54, SD 7.56; P=.14). At the 8-week follow-up, 82% (18/22) of the participants had self-reported their blood pressure on the OWL-H platform at least once during the 8 weeks.
CONCLUSIONS: The eHealth platform for HTN self-management, OWL-H, and accompanying in-person TKMGVs have the potential to effectively improve lifestyle management of HTN.
TRIAL REGISTRATION: ClinicalTrials.gov NCT03974334; https://clinicaltrials.gov/ct2/show/NCT03974334.
health disparities, hypertension, low income, medical group visits, mindfulness, mobile phone, teaching kitchen, technology
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Copyright ©Paula Gardiner, Lisa McGonigal, Ariel Villa, Lara C Kovell, Pallavi Rohela, Andrew Cauley, Diana Rinker, Barbara Olendzki. Originally published in JMIR Formative Research (https://formative.jmir.org), 16.05.2022. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included.
DOI of Published Version
Gardiner P, McGonigal L, Villa A, Kovell LC, Rohela P, Cauley A, Rinker D, Olendzki B. Our Whole Lives for Hypertension and Cardiac Risk Factors-Combining a Teaching Kitchen Group Visit With a Web-Based Platform: Feasibility Trial. JMIR Form Res. 2022 May 16;6(5):e29227. doi: 10.2196/29227. PMID: 35576575; PMCID: PMC9152723. Link to article on publisher's site
JMIR formative research
Gardiner P, McGonigal L, Villa A, Kovell LC, Rohela P, Cauley A, Rinker D, Olendzki BC. (2022). Our Whole Lives for Hypertension and Cardiac Risk Factors-Combining a Teaching Kitchen Group Visit With a Web-Based Platform: Feasibility Trial. Center for Integrated Primary Care Publications. https://doi.org/10.2196/29227. Retrieved from https://escholarship.umassmed.edu/cipc/115
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This work is licensed under a Creative Commons Attribution 4.0 License.
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