Community Health Worker Coaching and Remote Blood Pressure Monitoring to Reduce Heart Disease Risk in Women After High Blood Pressure During Pregnancy

What this Trial Is About

Researchers are evaluating whether an enhanced program combining remote blood pressure monitoring RBPM with a lifestyle coaching program led by a community health worker CHW is more effective than RBPM alone for women who experienced high blood pressure during pregnancy. The study focuses on women with current or past hypertensive disorders of pregnancy or chronic hypertension and aims to see if the enhanced program better controls blood pressure, improves heart health risk factors, supports mental well-being, and reduces emergency visits and hospital readmissions by six months after delivery. Participants are assigned to one of two groups the RBPM alone group or the enhanced care group. Both groups receive an automatic blood pressure cuff to wear and measure blood pressure frequently for six weeks after childbirth, with readings sent to the medical record and nurse support provided. The enhanced care group continues blood pressure monitoring beyond six weeks if needed and also receives a 10-week program of weekly health coaching calls focused on heart-healthy lifestyle changes, stress management, and social support. After six weeks, the RBPM group stops monitoring but receives weekly messages with heart health and infant care tips. Women will be involved from 28 weeks of pregnancy through six months postpartum. During the study, participants will measure their blood pressure regularly, receive coaching calls if in the enhanced group, and complete assessments of blood pressure control, weight, diet, physical activity, self-efficacy, and healthcare use. Nurses will provide reminders and referrals as needed. The main outcomes measured include blood pressure control rates and changes in blood pressure at six months, along with secondary outcomes such as weight, diet, physical activity, mental well-being, and hospital visits.

Community Health Worker Coaching to Reduce Cardiovascular Risk Among Women After a Hypertensive Disorder of Pregnancy