# mHealth to Enable Task Sharing for Hypertension Care in LMIC

> **NIH NIH R33** · UNIVERSITY OF WISCONSIN-MADISON · 2024 · $251,700

## Abstract

Although hypertension diagnosis is relatively simple and there are cheap and effective medications for lowering
blood pressure, less than 40% of patients with hypertension in low- and middle-income countries (LMIC) are
aware of their diagnosis and less than 10% have good control of their blood pressure. Community health
workers (CHWs) and mobile health (mHealth) technology are increasingly being used in LMIC to fill gaps in
hypertension care, but current approaches are too dependent on physician direction. The long-term goal is to
increase the number of patients living with hypertension in LMIC who are diagnosed and effectively treated
through task sharing with CHWs equipped with mHealth technology. The overall objectives in this application
are to 1) develop a mobile application to provide advanced clinical decision support (CDS) for CHWs in
Guatemala, a middle-income country; 2) determine the accuracy of CHWs using this application in diagnosing
hypertension; and 3) determine the effectiveness of these CHWs thus-equipped in managing hypertension
compared to care provided by a physician. The central hypothesis is that CHWs using an mHealth application
and remotely supervised can diagnose and manage hypertension with similar accuracy, efficacy, and safety to
a physician. The rationale for this project is that demonstration of the efficacy of CHWs using mobile health
technology for independent hypertension diagnosis and management would have broad implications for health
service delivery in LMIC and the application and care model developed for this proposal could be easily
adapted to other settings. The central hypothesis will be tested by pursuing three specific aims: 1) Test the
accuracy of CHWs equipped with a mobile application to diagnose hypertension; 2) Assess the feasibility of
CHW-led hypertension management enabled by a mobile application; and 3) Determine the efficacy of
CHW-led hypertension management aided by a mobile application compared to physician care. Under the first
aim, CHWs using the application developed for this proposal will screen patients for hypertension and their
diagnostic accuracy compared with that of a physician. For the second aim, CHWs using the application will
manage a small group of patients with hypertension to assess intervention feasibility and continue iterative
application development. For aim three, a randomized, controlled, non-inferiority trial will be conducted to
compare the safety and efficacy of hypertension management by CHWs equipped with the mobile application
to physician care. The proposed research is innovative because it represents a substantive departure from the
status quo by enabling CHWs to independently identify and treat hypertension with asynchronous physician
supervision using a sophisticated mHealth CDS application providing guidance on titration of multiple
medications and validated through a rigorous experimental design. This project is significant because it is
expected to result...

## Key facts

- **NIH application ID:** 10906252
- **Project number:** 5R33TW011891-04
- **Recipient organization:** UNIVERSITY OF WISCONSIN-MADISON
- **Principal Investigator:** Sean Michael Duffy
- **Activity code:** R33 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $251,700
- **Award type:** 5
- **Project period:** 2021-08-10 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10906252

## Citation

> US National Institutes of Health, RePORTER application 10906252, mHealth to Enable Task Sharing for Hypertension Care in LMIC (5R33TW011891-04). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10906252. Licensed CC0.

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