title: MyHEART: A Non Randomized Feasibility Study of a Young Adult Hypertension Intervention.
abstract: BACKGROUND
  In the United States, young adults (18-39 year-olds) have the lowest hypertension control rates (35%) compared to middle-aged (58%) and older (54%) adults. Ambulatory care for hypertension management often focuses on medication with little time for self-management and behavioral counseling. This study was designed to evaluate the feasibility of MyHEART, a telephone-based health coach self-management intervention for young adults. The goals were to determine the intervention's ability to: 1) recruit young adults with uncontrolled hypertension, 2) maintain ongoing communication between the coach and participants, 3) increase participants' engagement in self-management, 4) document coach-patient communication in the electronic health record, and 5) assess patient acceptability.
  
  
  METHODS
  Eligible participants were identified through the electronic health record. Inclusion criteria included 18-39 year-olds, with ICD-9 hypertension diagnoses and uncontrolled hypertension (≥ 140/90 mmHg), receiving regular primary care at a large multispecialty group practice. The intervention consisted of 6 telephone self-management sessions by a health coach targeting lifestyle modifications. Patients completed an open-ended acceptability survey.
  
  
  RESULTS
  Study uptake was 47% (9 enrolled/19 eligible). Mean (SD) age was 35.8 (2.6) years, 78% male, and 33% Black. Over 85% of enrolled young adults maintained communication with their health coach. At baseline, 11% reported checking their blood pressure outside of clinic; 44% reported blood pressure monitoring after the study. All coach-patient encounters were successfully documented in the electronic health record for primary care provider review. Open-ended responses from all surveys indicated that participants had a positive experience with the MyHEART intervention.
  
  
  CONCLUSIONS
  This study demonstrated that MyHEART was feasible and acceptable to young adults with uncontrolled hypertension. Health coaches can effectively maintain ongoing communication with young adults, document communication in the electronic health record, and increase engagement with home blood pressure monitoring. The results of this study will inform a multi-center young adult randomized controlled trial of MyHEART.
authors.affiliation: Department of Medicine, University of Wisconsin School of Medicine and Public Health, USA; Health Innovation Program, University of Wisconsin School of Medicine and Public Health, USA.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Johnson
authors.affiliation: Department of Medicine, University of Wisconsin School of Medicine and Public Health, USA; Health Innovation Program, University of Wisconsin School of Medicine and Public Health, USA.
authors.forename: Jamie N
authors.initials: JN
authors.lastname: LaMantia
authors.affiliation: Department of Counselor Education and Counseling Psychology, Marquette University, USA.
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Warner
authors.affiliation: Health Innovation Program, University of Wisconsin School of Medicine and Public Health, USA; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Pandhi
authors.affiliation: Department of Medicine, University of Wisconsin School of Medicine and Public Health, USA; Health Innovation Program, University of Wisconsin School of Medicine and Public Health, USA.
authors.forename: Christie M
authors.initials: CM
authors.lastname: Bartels
authors.affiliation: Health Innovation Program, University of Wisconsin School of Medicine and Public Health, USA; Department of Surgery, University of Wisconsin School of Medicine and Public Health, USA; Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, USA; Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, USA.
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Smith
authors.affiliation: University of Wisconsin-Madison School of Nursing, USA.
authors.forename: Diane R
authors.initials: DR
authors.lastname: Lauver
keywords: Feasibility; Health coach; Hypertension; Primary care; Self-determination theory; Self-management; Young adult