Trial results for a study on a mobile health (mHealth) strategy for Hypertension among homeless persons were posted on ClinicalTrials.gov on 2025-09-09, with 123 participants enrolled.
Background
Hypertension, or high blood pressure, is a significant public health challenge, particularly among vulnerable populations such as homeless individuals. This group often faces numerous barriers to consistent healthcare access, medication adherence, and lifestyle management, leading to high rates of uncontrolled hypertension. Mobile health strategies, utilizing accessible technologies like text messaging, offer a potential avenue to support hypertension management by providing education and reminders, thereby addressing some of these barriers and improving health outcomes in underserved communities.
Trial design
This completed study, designated as Phase NA, enrolled 123 participants to investigate Hypertension among homeless persons with uncontrolled blood pressure in New York City. The trial utilized a randomized clinical trial design to assess the effect of implementing a mobile health strategy using text messaging for hypertension management. The intervention compared a 'Hypertension-Specific Education' group, receiving targeted text messages, with a 'General Health Education' group, receiving text messages for usual standard care/healthy lifestyle, over a 6-month follow-up period.
Key results
The trial reported several key measurements and analyses:
- Blood Pressure (Systolic) for the Hypertension-Specific Education group had a mean of 135.36 mmHG (Standard Deviation 18.31).
- Blood Pressure (Systolic) for the General Health Education group had a mean of 136.19 mmHG (Standard Deviation 15.68).
- Blood Pressure (Diastolic) for the Hypertension-Specific Education group had a mean of 89.67 mmHG (Standard Deviation 10.71).
- Blood Pressure (Diastolic) for the General Health Education group had a mean of 92.38 mmHG (Standard Deviation 82.22).
- Medication Adherence (Percentage of Adherent Participants) for the Hypertension-Specific Education group was a median of 83.3%.
- Medication Adherence (Percentage of Adherent Participants) for the General Health Education group was a median of 50%.
- Appointment Attendance (Percentage) for the Hypertension-Specific Education group had a mean of 46.08% (Standard Deviation 35.81).
- Appointment Attendance (Percentage) for the General Health Education group had a mean of 57.41% (Standard Deviation 33.51).
- The number of participants who completed interviews was 13 for the Hypertension-Specific Education group, 6 for the General Health Education group, and 10 for providers.
Key analyses revealed:
- A significant reduction in systolic blood pressure (SBP) from baseline to final measurements, with a Mean Difference of -7.16 (95.0% CI: -12.59 to -1.73) and a p-value of 0.006 (t-test, 1 sided).
- No significant reduction in diastolic blood pressure (DBP) from baseline to final measurements, with a Mean Difference of -2.15 (95.0% CI: -4.79 to 0.49) and a p-value of 0.056 (t-test, 1 sided).
- No significant difference in the change in SBP between the two study arms, with a Mean Difference of -0.67 (95.0% CI: -8.76 to 7.42) and a p-value of 0.87 (ANCOVA).
- No significant difference in the change in DBP between the two study arms, with a Mean Difference of 0.98 (95.0% CI: -3.02 to 4.98) and a p-value of 0.63 (ANCOVA).
- No significant difference in medicine adherence between the two groups, with an Odds Ratio, log of 0.89 (95.0% CI: -0.26 to 2.29) and a p-value of 0.14 (Logistic Regression).
- No significant difference in appointment adherence between the study arms, with an Odds Ratio, log of -0.19 (95.0% CI: -0.58 to 0.19) and a p-value of 0.32 (Logistic Regression).
What this means
The study indicates that a mobile health strategy for homeless individuals with uncontrolled hypertension resulted in an overall improvement in systolic blood pressure. However, the specific hypertension-focused educational messages delivered via text messaging did not demonstrate a statistically significant advantage over general health education in improving blood pressure, medication adherence, or appointment attendance. These findings suggest that while mHealth interventions can be beneficial for this vulnerable population, the content specificity of the educational messages might not be the primary factor driving differential outcomes in this context. Further research may be needed to optimize mHealth strategies for this group.
Source
The information regarding these trial results was obtained from ClinicalTrials.gov, a public database of clinical studies. The results for the study NCT05187013, titled "Uncontrolled Hypertension Among the Homeless", were posted on 2025-09-09 on clinicaltrials.gov.