# A Randomized Pilot Trial of a Digital Health Platform To Control BP To Address Stroke Disparities

> **NIH NIH R21** · SUNY DOWNSTATE MEDICAL CENTER · 2022 · $323,000

## Abstract

Stroke is a leading cause of disability, cognitive impairment, and death. The COVID-19 pandemic has surfaced
longstanding and severe health disparities in a range of conditions, including stroke. Compared to other groups,
African American individuals have a higher prevalence of stroke risk factors, including hypertension, diabetes
mellitus, high cholesterol, and peripheral vascular disease. These factors are compounded by differences in
socioeconomic status, leading to higher stroke prevalence and mortality. However, there is growing evidence to
suggest that most strokes can be prevented by controlling modifiable risk factors. The guiding assumption in this
research is that interventions targeting blood pressure (BP) control in people of color can narrow racial and ethnic
disparities in stroke recurrence. Although there is limited research, it has been shown that telehealth can be
effectively used to reduce BP in populations of color. The proposed research leverages preliminary work by the
investigative team on stroke disparities to conduct a pilot randomized control trial (RCT) in an African American
and Afro-Caribbean population in Central Brooklyn. The proposed studies are informed by a TRANSCREATION
implementation science framework and an intervention model we developed called the Digital Equity for Stroke
Approach (DESA). DESA’s innovation lies in integrating four novel components: provision of broadband internet
(or equivalent) to address the digital divide, enhanced family caregiver support, flexible (telehealth, text, email)
remote two-way communication between patient and clinician, and real-time remote BP monitoring. The proposal
is constituted by three aims, corresponding to the following stages: pre-trial preparatory RCT and post-trial
phases that examine facilitators and barriers. We will employ a convergent mixed method design to guide data
collection and analysis. The first aim lays the foundation for the RCT by developing a digital equity plan,
assessing user experience, and conducting preliminary telehealth experiments to ensure usability, flow and
address implementation issues. In the pilot RCT, we will test whether the DESA group will lead to a net reduction
in BP control and improvement in medication adherence in the participant group compared to usual care. We
will randomize stroke patients into a 9-month pilot RCT (standard care, N=40 vs. DESA, N=40). Our primary
hypothesis is that patients randomized to DESA will have a greater reduction in systolic BP (SBP) at 9 months
than control patients. All patients will receive a BP Monitor that will capture, store and automatically transmit BP
readings in real-time to a secure server via an encrypted cellular connection. Participants randomized to DESA
will also receive a touch screen telehealth tablet with the necessary applications installed, and a cellular
connection enabled. The third aim/ post-trial phase will solicit feedback via a survey and key informant interviews.
The ulti...

## Key facts

- **NIH application ID:** 10442098
- **Project number:** 1R21MD017394-01
- **Recipient organization:** SUNY DOWNSTATE MEDICAL CENTER
- **Principal Investigator:** Aimee Afable
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $323,000
- **Award type:** 1
- **Project period:** 2022-05-18 → 2024-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10442098

## Citation

> US National Institutes of Health, RePORTER application 10442098, A Randomized Pilot Trial of a Digital Health Platform To Control BP To Address Stroke Disparities (1R21MD017394-01). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10442098. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*