# Multilevel mobile health program to improve rural hypertension

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2022 · $725,781

## Abstract

Hypertension (HTN) is the leading modifiable cause of cardiovascular disease. The Surgeon General’s 2020
Call to Action to Control Hypertension articulated the critical relevance of multilevel strategies to address the
social determinants and access to care that affect HTN control. Rural individuals experience the additional
challenges of the rural health divide: geographic distance from providers, social isolation, limited social
resources, and high rates of low health literacy. We have developed and validated a smartphone-based
program for home-based blood pressure monitoring (HBPM), termed MyBP, and have demonstrated the
success of MyBP to promote adherence to HBPM, improve blood pressure (BP) control, and enhance patient
engagement. We now adapt MyBP as a virtual agent, termed MyBP Coach, and leverage our experience
with such agents to provide longitudinal health education, empathic guidance, monitoring, and adaptable
patient-centered coaching to rural individuals with cardiovascular disease. Here, guided by a patient advisory
committee, we provide MyBP Coach to rural individuals as a personalized curriculum to promote and support
HBPM; HTN education; medication adherence; non-pharmacologic strategies for HTN management;
preparation for the clinical encounter; and enhanced problem-solving and engagement. We will evaluate the 6-
month MyBP Coach intervention in a single-center, parallel group clinical trial, randomizing 334 patients with
poorly controlled HTN (systolic BP 150-199 or diastolic BP 95-119 mm Hg at 2 ambulatory visits) to (1) HBPM
with MyBP Coach; or (2) the control, consisting of HBPM and a smartphone with a general health application
(WebMD). For both intervention and control, we provide HBPM summaries to clinicians to improve HTN
management for rural patients. We will follow treatment intensification and adjustment of hypertensive
medications over the 12-month trial; and track (a) adherence to antihypertensive medication with 6- and 12-
month proportion of days covered and (b) 6-month adherence to HBPM. Our aims are: (1) Examine the effect
of the MyBP Coach intervention on BP at 6 months and assess the sustainability of its effects at 12 months; (2)
Evaluate the effect of the intervention on adherence to BP medications and HBPM; and (3) Determine the
effect of the intervention on patient-reported outcomes including quality of life, engagement, and social
isolation. Our trial leverages our health system’s infrastructure across rural PA, a common electronic health
record of our large health care system, and established rural clinical partnerships. We incorporate methods
previously applied by us to recruit geographically isolated rural individuals with limited health and digital
literacy, conduct remote assessments, and provide similar smartphone-based resources and instruction.
Expected Results: In this project we will evaluate a scalable and patient-centered intervention to improve BP
control, medication and HBPM adherence, and ...

## Key facts

- **NIH application ID:** 10338415
- **Project number:** 1R01HL160749-01
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** MATTHEW F MULDOON
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $725,781
- **Award type:** 1
- **Project period:** 2022-07-01 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10338415

## Citation

> US National Institutes of Health, RePORTER application 10338415, Multilevel mobile health program to improve rural hypertension (1R01HL160749-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10338415. Licensed CC0.

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