Background: Mobile technologies provide the possibility to interact with stroke survivors in supporting risk factor self-management with much greater frequency, in real-time, and over the long-term, in their home environment where daily management of health takes place. The objective was to test the feasibility of a mobile intervention to support risk factor management.
Methods: mHealth for brainHealth was developed with a user-centered approach, undertaken in 3 sequential phases: 1) focus groups with stroke survivors to understand their perception on risk factor management; 2) survey about blood pressure (BP) control and use of technology; and 3) a pilot study to examine feasibility of a mobile intervention that combines home BP monitoring (HBPM), a mobile application (app) to transfer and display BP readings, and text-messaging support around BP and other risk factors, reported here. Stroke survivors were provided with Bluetooth-enabled HBPM and a Smartphone with the BP app, along with training on BP measurement and the intervention. They were instructed to measure their BP daily, which was then transferred to a server, triggering automated messages and alerts related to BP. Participants also selected two other areas of risk and were sent regular educational text messages. Participants provided feedback at study end.
Results: Fifteen stroke survivors with hypertension, 48 to 81 years of age, 70% male, 73% Hispanic, on average 4 months poststroke, tested the intervention for 6 weeks. All reported the system was important for their health and mostly fit into their daily schedule. Some reported difficulty with the technology, which prompted changes to the training program. Participants were 80% adherent to the BP measurement schedule. They reported the BP messages were very informative and improved understanding of their BP readings. While educational messages were important, participants felt messages should be more motivating. Participants reported improved knowledge about risk factor control.
Conclusions: Results of this pilot study demonstrate feasibility of the mobile intervention and also show areas for improvement. Participant feedback is being incorporated into the redesign, to be tested in a randomized controlled trial.