mHealth to Enable Task Sharing for Hypertension Care in LMIC

mHealth to Enable Task Sharing for Hypertension Care in LMIC is sponsored by Fogarty International Center at NIH. Funds projects that utilize mHealth technologies to empower community health workers in managing hypertension in LMICs.

mHealth to Enable Task Sharing for Hypertension Care in LMIC Project Number 5R33TW011891-04 Former Number 4R21TW011891-03 Contact PI/Project Leader DUFFY, SEAN MICHAEL Although hypertension diagnosis is relatively simple and there are cheap and effective medications for lowering blood pressure, less than 40% of patients with hypertension in low- and middle-income countries (LMIC) are aware of their diagnosis and less than 10% have good control of their blood pressure.

Community health workers (CHWs) and mobile health (mHealth) technology are increasingly being used in LMIC to fill gaps in hypertension care, but current approaches are too dependent on physician direction. The long-term goal is to increase the number of patients living with hypertension in LMIC who are diagnosed and effectively treated through task sharing with CHWs equipped with mHealth technology.

The overall objectives in this application are to 1) develop a mobile application to provide advanced clinical decision support (CDS) for CHWs in Guatemala, a middle-income country; 2) determine the accuracy of CHWs using this application in diagnosing hypertension; and 3) determine the effectiveness of these CHWs thus-equipped in managing hypertension compared to care provided by a physician.

The central hypothesis is that CHWs using an mHealth application and remotely supervised can diagnose and manage hypertension with similar accuracy, efficacy, and safety to a physician.

The rationale for this project is that demonstration of the efficacy of CHWs using mobile health technology for independent hypertension diagnosis and management would have broad implications for health service delivery in LMIC and the application and care model developed for this proposal could be easily adapted to other settings.

The central hypothesis will be tested by pursuing three specific aims: 1) Test the accuracy of CHWs equipped with a mobile application to diagnose hypertension; 2) Assess the feasibility of CHW-led hypertension management enabled by a mobile application; and 3) Determine the efficacy of CHW-led hypertension management aided by a mobile application compared to physician care.

Under the first aim, CHWs using the application developed for this proposal will screen patients for hypertension and their diagnostic accuracy compared with that of a physician. For the second aim, CHWs using the application will manage a small group of patients with hypertension to assess intervention feasibility and continue iterative application development.

For aim three, a randomized, controlled, non-inferiority trial will be conducted to compare the safety and efficacy of hypertension management by CHWs equipped with the mobile application to physician care.

The proposed research is innovative because it represents a substantive departure from the status quo by enabling CHWs to independently identify and treat hypertension with asynchronous physician supervision using a sophisticated mHealth CDS application providing guidance on titration of multiple medications and validated through a rigorous experimental design.

This project is significant because it is expected to result in a model of care that would be widely adaptable to low-resource settings around the world, leading to increased diagnosis and treatment of hypertension and reduced cardiovascular disease and death.

Public Health Relevance Statement The proposed research is relevant to public health because it advances an innovative model of hypertension care - community health workers empowered by mobile health technology to identify and manage hypertension - which overcomes the health care workforce limitations not addressed by current approaches in low- and middle-income countries.

This model would be widely adaptable to low-resource settings around the world, leading to increased identification and treatment of people with hypertension. Thus, the proposed research is relevant to the part of the Fogarty International Center’s vision that pertains to reducing the burden of disease, promoting health, and extending longevity for all people.

Cardiovascular Clinical Research Clinical Trials and Supportive Activities Health Disparities Research Health Disparities and Racial or Ethnic Minority Health Research Health Services Hypertension Networking and Information Technology R&D (NITRD) Prevention Primary Health Care Social Determinants of Health Telehealth Address Adult Adverse event Awareness Blood Pressure Cardiovascular Diseases Caring Cause of Death Cessation of life Chronic Chronic Disease Clinic Clinical Collaborations Communities Community Health Aides Community Healthcare Counseling Country Development Diabetes Mellitus Diagnosis Disease Disease Outcome Enrollment Event Experimental Designs Fogarty International Center Goals Government Guatemala Health Promotion Health Technology Health system Healthcare Hypertension Income Infrastructure Intervention Intervention Trial Life Style Longevity Medical Mission Mobile Health Application Modeling Morbidity - disease rate Nurses Patient Education Patient Participation Patients Persons Pharmaceutical Preparations Physicians Play Preclinical Testing Primary Care Process Protocols documentation Provider Public Health Randomized Recommendation Research Resource-limited setting Role Rural Safety Supervision Technology Testing Titrations Training Vision Work acute care blood pressure control burden of illness clinical decision support cost effective diabetes management diagnostic accuracy disability effectiveness evaluation efficacy evaluation empowerment health care delivery hypertension control hypertension treatment hypertensive improved innovation low and middle-income countries mHealth mobile application mortality neighborhood safety patient screening primary outcome programs rural area safety outcomes screening standard care UNIVERSITY OF WISCONSIN-MADISON INTERNAL MEDICINE/MEDICINE [Special Emphasis Panel[ZRG1-IMST-U(55)R]](https://public.

csr. nih. gov/StudySections/SmallBusinessAndTechnologyTransfer) Administering Institutes or Centers John E.

Fogarty International Center for Advanced Study in the Health Sciences Assistance Listing Number Project Funding Information for 2024 NIH Categorical SpendingClick here for more information on NIH Categorical Spending | FOGARTY INTERNATIONAL CENTER | $251,700 | Cardiovascular; Clinical Research; Clinical Trials and Supportive Activities; Health Services; Hypertension; Networking and Information Technology R&D (NITRD); Prevention; Social Determinants of Health; Telehealth; Health Disparities Research; Primary Health Care; Health Disparities and Racial or Ethnic Minority Health Research | No Sub Projects information available for 5R33TW011891-04 Publications are associated with projects, but cannot be identified with any particular year of the project or fiscal year of funding.

This is due to the continuous and cumulative nature of knowledge generation across the life of a project and the sometimes long and variable publishing timeline. Similarly, for multi-component projects, publications are associated with the parent core project and not with individual sub-projects.

No Publications available for 5R33TW011891-04 No Patents information available for 5R33TW011891-04 The Project Outcomes shown here are displayed verbatim as submitted by the Principal Investigator (PI) for this award. Any opinions, findings, and conclusions or recommendations expressed are those of the PI and do not necessarily reflect the views of the National Institutes of Health. NIH has not endorsed the content below.

No Outcomes available for 5R33TW011891-04 No Clinical Studies information available for 5R33TW011891-04 No news release information available for 5R33TW011891-04 No Historical information available for 5R33TW011891-04 No Similar Projects information available for 5R33TW011891-04 ## Select options for export: