Development of a Mobile Health Intervention for Blood Pressure Management in Pregnancy - PROJECT SUMMARY / ABSTRACT Hypertension in pregnancy is highly prevalent and increasing in the United States, and 40% of maternal deaths involve women with hypertension. In adults from racial/ethnic minority groups, hypertension is two-fold more prevalent and leads to higher rates of preeclampsia and stroke, thus resulting in devastating health consequences in the infant and mother alike. The time required for frequent in-person visits, inadequate counseling, and the asymptomatic nature of hypertension are major barriers to effective blood pressure (BP) control in pregnant women. These issues can be addressed through home BP monitoring (HBPM), which holds the potential to reduce preventable and devastating clinical events while also proven to reduce racial inequities in pregnant women. Obstetric societies recommend HBPM for all pregnant women with hypertension, but our pilot work suggests that rates of HBPM counseling and uptake are low. With the increasing use of mobile health apps in pregnancy, there is an opportunity for digital health approaches with culturally appropriate storytelling to improve HBPM and allow pregnant women with hypertension to learn from others with similar lived experiences. This K23 Award proposes to develop Moms@Home, a digital health approach to support HBPM in pregnant women with hypertension. Moms@Home will integrate storytelling videos with a Social Cognitive Theory-based proven approach to support behavior change and address the cultural and literacy needs of a diverse population of pregnant women. Incorporating storytelling with a successful digital health approach may increase the adoption of HBPM. Guided by Patient and Clinician Advisory Groups, Aim 1 will adapt the existing mobile health app MyDataHelpsTM to create Moms@Home for pregnant women with hypertension by incorporating stories from women with similar lived experiences. Aim 2 will refine the Moms@Home components with obstetric caregiver and patient interviews. Aim 3 will pilot test the Moms@Home approach in pregnant women with hypertension, enriched in those from racial/ethnic minority groups, to assess HBPM adherence, feasibility, and acceptability. Beyond the research plan, the K23 will provide Dr. Kovell with advanced research training, protected time, and mentoring to become an independent physician-scientist focused on improving outcomes for pregnant women with hypertension. Dr. Kovell will be guided by experienced mentors with expertise in digital health and study design (Dr. McManus), behavior change (Dr. Lemon), peripartum/women’s health (Dr. Moore Simas), storytelling and health equity (Dr. Allison), and biostatistics (Dr. Person). Her advisory team are experts in hypertension, clinical trials, and informatics. In addition, her comprehensive career development plan will lead to a Master of Science in Clinical Investigation degree and expertise in digital health, behavior change, and clinical trials. This K23 award will set the stage for Dr. Kovell’s future R01 application examining digital behavioral health interventions on BP control for pregnant women with hypertension. This innovative and scalable proposal has tremendous potential to positively impact and support women with hypertension through healthy pregnancies.
