The Retail Outlet Health Kiosk Hypertension Trial (ROKHYT): Pilot Results.

Shea, Steven; Thompson, John L P; Schwartz, Joseph E; Chen, Yineng; de Ferrante, Morgan; Vanderbeek, Alyssa M; Buchsbaum, Richard; Celibell, Vargas; Siddiqui, Khan M; Moran, Andrew E; Stockwell, Melissa

BACKGROUND Blood pressure (BP) control was only 43.7% in the National Health and Nutrition Survey (NHANES) survey in 2017-2018. Scalable, non-clinic-based strategies to control BP are needed. We therefore conducted a pilot trial of a text-messaging intervention in a national network of retail outlet health kiosks with BP devices. All study procedures were conducted remotely. METHODS Eligible individuals (N=140), based on average BP >140/90 mmHg at kiosks during the prior year, were randomized to intervention vs. usual care. Intervention consisted of tailored text messages providing educational information with embedded links to educational videos on topics related to BP control. BP measurements were obtained at kiosks at 3, 6, and 12 months following randomization; control was defined as BP <140/90 mmHg. Follow-up at 12 months was curtailed due to SARS-CoV-2. We therefore combined 12-month (N=62) or carried forward 6-month (N=61) data as the primary endpoint. RESULTS Participants were 51.4% male, 70.7% white/Caucasian, had mean age of 52.1 years, and mean baseline BP 145.5/91.8 mmHg. At the endpoint, 37.7% intervention vs. 27.4% usual care subjects achieved BP control (difference, 10.3%, 95% CI -6.2%, 26.8%). In an intention-to-treat analysis with multiple imputation of missing data, 12-month BP control was 29.0% vs. 19.8% favoring intervention (difference, 9.2%. 95% CI -7.3%, 25.7%); intervention vs. control differences in adjusted mean BP levels were SBP: -5.4 mmHg (95% CI: -13.5, 2.7) and DBP: +0.6 mmHg (95% CI: -4.2, 5.4). CONCLUSIONS These pilot results support the potential for a highly scalable text-messaging intervention to improve BP.