TY  - JOUR
AU  - Heinert, Sara W
AU  - Guzman-Baez, Kelvin
AU  - Aamir, Affan
AU  - Penugonda, Ananya
AU  - Crabtree, Benjamin F
AU  - Greene, Kathryn
AU  - Heckman, Carolyn J
AU  - Levy, Phillip
AU  - Strickland, Pamela Ohman
AU  - Hudson, Shawna V
PY  - 2024
DA  - 2024/9/6
TI  - Developing a Youth-Led Digital Hypertension Education Intervention for Adults With Hypertension: Qualitative Study on Refinement and Acceptability
JO  - JMIR Form Res
SP  - e54909
VL  - 8
KW  - hypertension
KW  - adolescents
KW  - adults
KW  - emergency department
KW  - digital health intervention
KW  - dyad intervention
KW  - intervention development
KW  - qualitative research
KW  - youth
KW  - adolescent
KW  - teen
KW  - teens
KW  - teenager
KW  - teenagers
KW  - adult
KW  - youth-led
KW  - digital health
KW  - health education
KW  - refinement
KW  - acceptability
KW  - USA
KW  - United States
KW  - care navigation
KW  - effectiveness
KW  - formative study
KW  - prototype
KW  - self-guided
KW  - online module
KW  - online modules
KW  - engagement
KW  - blood pressure
KW  - health knowledge
KW  - health promotion
KW  - nutrition education
KW  - support intervention
KW  - support
KW  - supports
AB  - Background: Hypertension affects one-third of adults in the United States and is the leading risk factor for death. Underserved populations are seen disproportionately in the emergency department (ED) and tend to have worse blood pressure (BP) control. For adults, a lack of hypertension knowledge is a common barrier to hypertension control, while social support is a strong facilitator, and providing information that is culturally sensitive and relevant is especially important in this context. The youth experience increased confidence when given the responsibility to provide health education and care navigation to others. As such, we planned a randomized controlled trial (RCT) for the effectiveness of a digital youth-led hypertension education intervention for adult patients in the ED with hypertension, focusing on change in BP and hypertension knowledge. Objective: In preparation for an RCT, we conducted a formative study to determine acceptable and easily comprehensible ways to present hypertension information to adults with hypertension and optimal ways to engage youth to support adults on how to achieve better hypertension control. Methods: After creating an intervention prototype with 6 weekly self-guided hypertension online modules, we recruited 12 youth (adolescents, aged 15-18 years) for 3 focus groups and 10 adult ED patients with hypertension for individual online interviews to garner feedback on the prototype. After completing a brief questionnaire, participants were asked about experiences with hypertension, preferences for a hypertension education intervention, and acceptability, feasibility, obstacles, and solutions for intervention implementation with youth and adults. The moderator described and showed participants the prototyped intervention process and materials and asked for feedback. Questionnaire data were descriptively summarized, and qualitative data were analyzed using the template organizing style of analysis by 3 study team members. Results: Participants showed great interest in the intervention prototype, thought their peers would find it acceptable, and appreciated its involvement of youth. Youth with family members with hypertension reported that their family members need more support for their hypertension. Youth suggested adding more nutrition education activities to the intervention, such as a sodium tracker and examples of high-sodium foods. Adults discussed the need for a hypertension support intervention for themselves and the expected benefits to youth. They mentioned the overwhelming amount of hypertension information available and appreciated the intervention’s concise content presentation. They suggested adding more mental health and smoking cessation resources, information about specific hypertension medications, and adding active links for health care information. Conclusions: Based on focus groups and interviews with participants, a youth-led digital hypertension intervention is an acceptable strategy to engage both adults with hypertension and youth. Incorporating participant suggestions into the intervention may improve its clarity, engagement, and impact when used in a subsequent RCT. 
SN  - 2561-326X
UR  - https://formative.jmir.org/2024/1/e54909
UR  - https://doi.org/10.2196/54909
UR  - http://www.ncbi.nlm.nih.gov/pubmed/39240662
DO  - 10.2196/54909
ID  - info:doi/10.2196/54909
ER  -