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.
CLINICALTRIAL
NCT03422718