Abstract: FR-OR42
Supporting Self-Management of Healthy Behaviors (SMART-HABITS) in CKD and Hypertension: A Pilot Trial
Session Information
- Interventions to Reduce CKD Progression
November 03, 2023 | Location: Room 119, Pennsylvania Convention Center
Abstract Time: 04:39 PM - 04:48 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Schrauben, Sarah J., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Purcell, Adriana, Yale School of Medicine, New Haven, Connecticut, United States
- Bilger, Andrea, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Amaral, Sandra, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Feldman, Harold I., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Dember, Laura M., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
Background
Home blood pressure monitoring (HBPM) and physical activity monitoring may have health benefits, but the feasibility and acceptability among individuals with chronic kidney disease (CKD) and hypertension (HTN) are not known.
Methods
In a 12-week study among individuals with stage 3-4 CKD and HTN, we evaluated the acceptance and feasibility of SMART-HABITS, a smartphone-based intervention to support physical activity and HBPM. Participants were asked to perform HBPM and share results at least 3x/wk and share step counts daily. For 6 weeks, two approaches to communicate HBPM were: 1) text message and 2) a smartphone application (app) connected to a Bluetooth-enabled BP machine, with the sequence determined via randomization. Step counts were monitored with a wearable device (Fitbit) and communicated via the Fitbit app for 12 weeks. Primary outcomes were 1) acceptance- assessed through surveys and interviews, and 2) feasibility- assessed with measures of adoption, adherence, and usability with the System Usability Survey (SUS). Secondary outcomes were maintenance (a HBPM or step count transmission ≥1x/wk), change in survey scores related to CKD knowledge, electronic health (eHealth) literacy, self-efficacy, self-management, QOL, BP, and daily step counts.
Results
Forty-seven participants were randomized. Mean age was 63 years, 49% women, and 48% were Black. For HBPM, 44 participants (94%) completed the text phase and 43 (92%) completed the Bluetooth phase. Adoption was reflected in a 92% retention rate, HBPM adherence was 81% in the text phase and 69% in the Bluetooth phase, and step count adherence was >83% over 12 weeks. Usability was adequate (SUS score ≥68), and participants rated SMART-HABITS as acceptable. CKD knowledge scores significantly increased (63 vs 66.7), but scores of self-management, self-efficacy, and QOL did not increase. eHealth literacy scores were inadequate at baseline (adequate score <32) and did not change. Forty-three (91.5%) participants communicated HBPM and/or step count data ≥1x/wk. Mean daily step counts significantly increased by 3414 steps, but BP did not change.
Conclusion
In this study of individuals with CKD and HTN, implementing a smartphone-based tool to support physical activity and HBPM is feasible and acceptable despite low eHealth literacy levels.
Funding
- NIDDK Support