University of Michigan School of Information associate professor Lorraine Buis has published new work examining the impact of using a self-monitoring intervention on Black individuals with hypertension. 

Her paper, “The Effect of an mHealth Self-Monitoring Intervention (MI-BP) on Blood Pressure Among Black Individuals With Uncontrolled Hypertension: Randomized Controlled Trial” was published with JMIR mHealth and uHealth. The paper contributes to a growing body of research on the efficacy of self-monitoring interventions to help patients improve health outcomes. 

Buis, who is also an associate professor at the U-M Medical School, conducts research on technology, clinical care and chronic disease self management. She has been teaching at UMSI since 2013 and exploring opportunities for cell phones and mobile applications to help people prevent and manage health conditions like high blood pressure, Type 2 diabetes and cancer. 

Her current research is focused on Black residents in Detroit where the burden of hypertension is particularly high. Her research team developed MI-BP, a culturally tailored multi-behavior mobile health intervention that targeted behaviors of blood pressure self-monitoring, physical activity, sodium intake and medication adherence.

“Behavior is difficult to change, and even when we find short term success, long term success is a different beast,” she says. “And communities where inequities are abundant face more challenges in addressing those behaviors and are less likely to engage in behavior change. It’s a critical problem to address in the city of Detroit.” 

Buis’ paper asks whether a mobile tool that tracks blood pressure and encourages residents to make lifestyle changes to improve physical activity, diet and medication adherence would help them better manage their health and lead to lower blood pressure, compared to self-monitoring blood pressure alone. The study found that average blood pressures in both the mobile app and the control conditions significantly improved over one year, but no differences between the groups were found.  

Further research is needed, Buis said. 

“Something we don’t know well about mobile interventions is how to get people to engage,” she says. “As a whole, we see people begin using digital health interventions in the beginning, but then rates plummet. Think about how many apps you have on your phone that you opened once or twice and then never returned to.” 

As the Editor-in-Chief of JMIR mHealth and uHealth, Buis is hoping to push more research into this area and further study engagement within mobile health studies, including better defining what is meant by “engagement”, as well as understanding what individual characteristics or design factors lead to better engagement with these types of interventions. 

“When you have a negative trial, is it because the intervention didn’t work, or is it because the intervention wasn’t used?” she asks. “And I think that's a really important question that we don't have the answers for yet.” 

“The Effect of an mHealth Self-Monitoring Intervention (MI-BP) on Blood Pressure Among Black Individuals With Uncontrolled Hypertension: Randomized Controlled Trial” is authored by Lorraine Buis, Junham Kim, Ananda Sen (Department of Family Medicine, Department of Biostatistics), Dongru Chen  (Department of Family Medicine), Katee Dawood (Wayne State University), Reema Kadri (Department of Family Medicine), Rachelle Muladore (Wayne State University), Melissa Plegue (Department of Pediatrics), Caroline Richardson (Department of Family Medicine, U-M, Brown University), Zora Djuric (Department of Family Medicine), Candace McNaughton (University of Toronto), David Hutton (School of Public Health), Lionel Robert, Sun Young Park and Phillip Levy (Wayne State University). 

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Learn more about Lorraine Buis by visiting her UMSI faculty profile. 

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— Noor Hindi, UMSI public relations specialist