Project Summary/Abstract Candidate: Emma Lawrence MD MS is an Obstetrician Gynecologist with a global health research focus on obstetrics management and outcomes in Ghana. Dr. Lawrence’s long-term career goal is to become an independent global women’s health investigator, with methodologic expertise in randomized control trials and a research program focused on the management of hypertensive disorders of pregnancy in low-resource settings. Research Aims: The goal of this proposal is to implement and evaluate a home blood pressure (BP) monitoring intervention among women at risk of hypertensive disorders of pregnancy (HDP) in Ghana. The study’s specific aims are to: (1) Examine the barriers and facilitators of home BP monitoring among pregnant women at risk of HDP in Ghana; (2) Identify lower-performers of home BP monitoring, and elicit actionable factors that can be used to refine the intervention; and (3) Conduct an RCT to compare adherence with daily home BP monitoring between a group using paper logging and a group using cellphone-based electronic logging and daily reminders. Research Plan: Participants will complete pre-post surveys exploring the acceptability, feasibility, barriers, and motivators to home BP monitoring. After receiving training, participants will be instructed to check and log their BP daily and call a nurse triage line with pre-identified elevations in BP. Using data from participant logs, adherence with home BP monitoring and ability to take appropriate action when home BP values are elevated, will be assessed. The lower performing group will be identified, and key informants from this group will engage in semi-structured interviews to elicit actionable factors that can be used to refine the intervention. Using a 2- arm randomized controlled trial design, adherence to home BP monitoring will be compared between a group using paper logging and a group using cellphone-based electronic logging and daily reminders. Career Development Plan: Dr. Lawrence will develop expertise in: (1) Survey questionnaire design (2) Applied mixed methods 3) Advanced quantitative methods; and (4) Reproductive health in Sub-Saharan Africa. Her training will be enhanced by advanced coursework and participation in research and career development seminars. With the support of an expert mentorship team from Ghana and the University of Michigan, she is ideally poised to leverage a K award into a successful career as an independent global women’s health researcher. A subsequent planned R01 submission will evaluate the impact of home BP monitoring on clinical outcomes, including timing of HDP diagnosis, neonatal outcomes, and maternal morbidity and mortality.