Self-management program and Black women with hypertension: Randomized controlled trial substudy.

Only participants who completed the 6-week self-management program were randomized, so the study cannot compare the program with no program. The randomized comparison tested added text coaching versus no coaching after everyone had already received the same education, so any blood pressure fall cannot be credited to coaching alone. The sample was small: 90 were enrolled, 83 were randomized, and 69 completed the study. Participants were recruited from one region of North Carolina, were mostly highly educated, and many had incomes of $55,000 or more, so results may not apply to less advantaged Black women with hypertension. All participants needed a smartphone with Wi-Fi, which excludes people without that access. Self-care, self-efficacy, communication, and medication adherence were self-reported and may be affected by response bias. The primary outcome was blood pressure, and the between-group result was null; the positive self-care findings were secondary outcomes. The study did not assess motivation or readiness to change before the intervention, and it did not collect qualitative data about barriers to self-care.

The authors declare no conflict of interest. The work was funded by the National Heart, Lung, and Blood Institute.

Do not read the blood pressure fall in both groups as proof that text coaching works. The randomized comparison was coaching added to a completed self-management program versus no coaching, and it found no significant between-group difference in blood pressure.