JMIR Publications

ABSTRACT

Background:

Mass displacement is a grand public health challenge. Refugees experience a disparate hypertension (HTN) burden and disparities in self-management. Successful HTN self-management is key for improving outcomes, but research on its feasibility in refugee healthcare settings is limited.

Objective:

Our aim was to assess the perspectives of refugee health providers on telemonitoring home BP management using connected BP monitors.

Methods:

Primary care physicians (PCPs) and medical assistants (MAs) that care for refugees in San Diego were interviewed using human-centered semi-structured methods (n=18). Interviews were analyzed using an inductive approach. Usability testing for the BP software (Med Pro Care) was conducted with participants (n=15) to test the feasibility of real-time tracking of BP home readings. Providers rated their satisfaction on a System Usability Scale and the NASA Task Load Index which measures mental workload.

Results:

For refugee patients self-managing HTN, providers identified the following as facilitators: 1) family support, 2) language resources, and 3) trust. The following barriers were identified: 1) life stressors, 2) language barriers, 3) cultural differences, 4) socioeconomic status, 5) lack of awareness, and 6) unavailability of equipment. PCPs completed 90% and MAs completed 83% of the tasks successfully. The majority of providers found the software system for self-management of HTN to be easy to use with an average score for usability of 3.59 out of 5 (SD ± 0.76).

Conclusions:

Identified barriers and facilitators of self-management of HTN are crucial to designing effective interventions in real-world refugee healthcare settings. Telemonitoring interventions using software that transfers BP readings to providers in real time may be feasible from the perspective of healthcare providers and can address hypertension disparities in marginalized populations.