lthy Behaviors was observed to be readily usable because of high levels of adherence and usability scores. Background Support programs for self-management are underutilized among people with CKD. We examined the feasibility of a smartphone-based intervention to support physical activity and BP monitoring, Supporting Self-Management of Healthy Behaviors (SMART-HABITS), for individuals with CKD and hypertension. Methods SMART-HABITS was piloted in a 12-week randomized cross-over trial among people with CKD and hypertension. Participants were asked to monitor BP ≥3-times/wk and step counts ≥5-times/wk. Participants were randomized to BP communication approach–self-report through text message for 6 weeks versus automatic reporting with a smartphone application (app) paired to a Bluetooth enabled BP machine for the alternate 6 weeks. The approach to monitoring and reporting steps was the same during both phases. Primary outcomes were adoption (retention and use of SMART-HABITS dashboard), adherence (% of transmitted BP and step counts), and acceptability as assessed with surveys and interviews. Secondary outcomes were reach, maintenance, CKD knowledge, digital health literacy, self-management, self-efficacy, quality of life, step counts, and BP values. Interviews were conducted at study end. Results Of the 47 randomized participants, 44 (94%) completed the text phase and 43 (92%) completed the app phase. The median age was 63 years, 49% were female, and 45% were Black. Retention was 91%. BP adherence was 87% in the text phase and 74% in the app phase, and step count adherence was 97%. Acceptability scores were high, and interviews largely conveyed acceptance. CKD knowledge increased but remaining survey scores did not change. Mean step counts increased from the prestudy period similarly in both phases. BP did not change over time. Conclusions Implementing a smartphone support tool for self-management was feasible among people with CKD and hypertension. The approach can supplement clinic-based care and potentially lead to less cardiovascular disease and CKD progression. Clinical Trial registry name and registration number: NCT04858295....

中文翻译：

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支持慢性肾病和高血压患者的健康行为自我管理：支持健康行为自我管理试点随机试验


由于高水平的依从性和可用性分数，lthy 行为被观察到很容易使用。背景 慢性肾病患者的自我管理支持计划并未得到充分利用。我们研究了基于智能手机的干预措施的可行性，以支持 CKD 和高血压患者的体力活动和血压监测、支持健康行为的自我管理 (SMART-HABITS)。方法 SMART-HABITS 在 CKD 和高血压患者中进行了一项为期 12 周的随机交叉试验。参与者被要求监测血压≥3次/周，步数≥5次/周。参与者被随机分配接受 BP 沟通方法——在 6 周内通过短信进行自我报告，并在接下来的 6 周内通过与蓝牙血压计配对的智能手机应用程序 (app) 自动报告。两个阶段的监测和报告步骤方法是相同的。主要结果是采用（SMART-HABITS 仪表板的保留和使用）、依从性（传输血压和步数的百分比）以及通过调查和访谈评估的可接受性。次要结果是覆盖范围、维持情况、CKD 知识、数字健康素养、自我管理、自我效能、生活质量、步数和血压值。在研究结束时进行访谈。结果 在 47 名随机参与者中，44 名 (94%) 完成了文本阶段，43 名 (92%) 完成了应用程序阶段。中位年龄为 63 岁，49% 为女性，45% 为黑人。保留率为 91%。文本阶段的 BP 遵守率为 87%，应用程序阶段的 BP 遵守率为 74%，步数遵守率为 97%。可接受性分数很高，面试很大程度上传达了接受度。 CKD 知识有所增加，但其余调查分数没有变化。 平均步数从研究前阶段开始在两个阶段都有类似的增加。血压不随时间变化。结论 在 CKD 和高血压患者中实施智能手机支持工具进行自我管理是可行的。该方法可以补充临床护理，并有可能减少心血管疾病和 CKD 进展。临床试验注册名称和注册号：NCT04858295....