Mobile health strategies for blood pressure self-management in urban populations with digital barriers: systematic review and meta-analyses

Abstract Mobile health (mHealth) technologies improve hypertension outcomes, but it is unknown if this benefit applies to all populations. This review aimed to describe the impact of mHealth interventions on blood pressure outcomes in populations with disparities in digital health use. We conducted...

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Autores principales:	Elaine C. Khoong, Kristan Olazo, Natalie A. Rivadeneira, Sneha Thatipelli, Jill Barr-Walker, Valy Fontil, Courtney R. Lyles, Urmimala Sarkar
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Computer applications to medicine. Medical informatics R858-859.7
Acceso en línea:	https://doaj.org/article/1e25028e05a9497d8fc3adb8cee24867
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spelling	oai:doaj.org-article:1e25028e05a9497d8fc3adb8cee248672021-12-02T17:03:47ZMobile health strategies for blood pressure self-management in urban populations with digital barriers: systematic review and meta-analyses10.1038/s41746-021-00486-52398-6352https://doaj.org/article/1e25028e05a9497d8fc3adb8cee248672021-07-01T00:00:00Zhttps://doi.org/10.1038/s41746-021-00486-5https://doaj.org/toc/2398-6352Abstract Mobile health (mHealth) technologies improve hypertension outcomes, but it is unknown if this benefit applies to all populations. This review aimed to describe the impact of mHealth interventions on blood pressure outcomes in populations with disparities in digital health use. We conducted a systematic search to identify studies with systolic blood pressure (SBP) outcomes located in urban settings in high-income countries that included a digital health disparity population, defined as mean age ≥65 years; lower educational attainment (≥60% ≤high school education); and/or racial/ethnic minority (<50% non-Hispanic White for US studies). Interventions were categorized using an established self-management taxonomy. We conducted a narrative synthesis; among randomized clinical trials (RCTs) with a six-month SBP outcome, we conducted random-effects meta-analyses. Twenty-nine articles (representing 25 studies) were included, of which 15 were RCTs. Fifteen studies used text messaging; twelve used mobile applications. Studies were included based on race/ethnicity (14), education (10), and/or age (6). Common intervention components were: lifestyle advice (20); provision of self-monitoring equipment (17); and training on digital device use (15). In the meta-analyses of seven RCTs, SBP reduction at 6-months in the intervention group (mean SBP difference = −4.10, 95% CI: [−6.38, −1.83]) was significant, but there was no significant difference in SBP change between the intervention and control groups (p = 0.48). The use of mHealth tools has shown promise for chronic disease management but few studies have included older, limited educational attainment, or minority populations. Additional robust studies with these populations are needed to determine what interventions work best for diverse hypertensive patients.Elaine C. KhoongKristan OlazoNatalie A. RivadeneiraSneha ThatipelliJill Barr-WalkerValy FontilCourtney R. LylesUrmimala SarkarNature PortfolioarticleComputer applications to medicine. Medical informaticsR858-859.7ENnpj Digital Medicine, Vol 4, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Computer applications to medicine. Medical informatics R858-859.7
spellingShingle	Computer applications to medicine. Medical informatics R858-859.7 Elaine C. Khoong Kristan Olazo Natalie A. Rivadeneira Sneha Thatipelli Jill Barr-Walker Valy Fontil Courtney R. Lyles Urmimala Sarkar Mobile health strategies for blood pressure self-management in urban populations with digital barriers: systematic review and meta-analyses
description	Abstract Mobile health (mHealth) technologies improve hypertension outcomes, but it is unknown if this benefit applies to all populations. This review aimed to describe the impact of mHealth interventions on blood pressure outcomes in populations with disparities in digital health use. We conducted a systematic search to identify studies with systolic blood pressure (SBP) outcomes located in urban settings in high-income countries that included a digital health disparity population, defined as mean age ≥65 years; lower educational attainment (≥60% ≤high school education); and/or racial/ethnic minority (<50% non-Hispanic White for US studies). Interventions were categorized using an established self-management taxonomy. We conducted a narrative synthesis; among randomized clinical trials (RCTs) with a six-month SBP outcome, we conducted random-effects meta-analyses. Twenty-nine articles (representing 25 studies) were included, of which 15 were RCTs. Fifteen studies used text messaging; twelve used mobile applications. Studies were included based on race/ethnicity (14), education (10), and/or age (6). Common intervention components were: lifestyle advice (20); provision of self-monitoring equipment (17); and training on digital device use (15). In the meta-analyses of seven RCTs, SBP reduction at 6-months in the intervention group (mean SBP difference = −4.10, 95% CI: [−6.38, −1.83]) was significant, but there was no significant difference in SBP change between the intervention and control groups (p = 0.48). The use of mHealth tools has shown promise for chronic disease management but few studies have included older, limited educational attainment, or minority populations. Additional robust studies with these populations are needed to determine what interventions work best for diverse hypertensive patients.
format	article
author	Elaine C. Khoong Kristan Olazo Natalie A. Rivadeneira Sneha Thatipelli Jill Barr-Walker Valy Fontil Courtney R. Lyles Urmimala Sarkar
author_facet	Elaine C. Khoong Kristan Olazo Natalie A. Rivadeneira Sneha Thatipelli Jill Barr-Walker Valy Fontil Courtney R. Lyles Urmimala Sarkar
author_sort	Elaine C. Khoong
title	Mobile health strategies for blood pressure self-management in urban populations with digital barriers: systematic review and meta-analyses
title_short	Mobile health strategies for blood pressure self-management in urban populations with digital barriers: systematic review and meta-analyses
title_full	Mobile health strategies for blood pressure self-management in urban populations with digital barriers: systematic review and meta-analyses
title_fullStr	Mobile health strategies for blood pressure self-management in urban populations with digital barriers: systematic review and meta-analyses
title_full_unstemmed	Mobile health strategies for blood pressure self-management in urban populations with digital barriers: systematic review and meta-analyses
title_sort	mobile health strategies for blood pressure self-management in urban populations with digital barriers: systematic review and meta-analyses
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/1e25028e05a9497d8fc3adb8cee24867
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Mobile health strategies for blood pressure self-management in urban populations with digital barriers: systematic review and meta-analyses

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