Case Western Reserve nurse scientist leads $3.4 million project to help older African American patients access, advocate for better health care for their high blood pressure

A nurse scientist at the Frances Payne Bolton School of Nursing at Case Western Reserve University is launching a five-year, $3.4 million study to investigate ways to help older African American patients with high blood pressure get better health care through more effective digital technologies, such as educational websites and smart-phone apps.

Photo of Carolyn Harmon Still
Carolyn Harmon Still

High blood pressure, or hypertension, is a major risk factor for heart disease, stroke and other serious illnesses and is especially prevalent among African Americans—a health crisis requiring a heightened response among  health care leaders and institutions, according to the Centers for Disease Control.

“That’s why this is so important: The key to saving lives is to reduce cardiovascular risk  by controlling high blood pressure in hypertensive individuals, and one way to do that is to help these individuals adhere to their prescribed treatment regimen,” said Carolyn Harmon Still, a researcher and assistant professor at the nursing school leading the study. “We know that hypertension is a lifelong disease and there are sustainable solutions. Using technology can help achieve and sustain long term self-management, especially medications to lower blood pressure.”

Still’s project is funded by the National Institute of Nursing Research. She and her research team expect to later this year enroll more than 200 African American participants who are older than 50 and have a smart phone.

Still calls her project Optimizing Technology to Improve Medication Adherence and BP Control (OPTIMA-BP). She’ll test the effectiveness of various technology-based interventions to help patients remember to take as many as three different medicines often required to keep high blood pressure in check.

Those interventions include a smart-phone app to remind the patient when to take medications and a website to educate users about hypertension—its causes, dangers and treatments—as well as providing counsel from registered nurses.

“While that sounds pretty simple—and it is—it is also vital to them getting better care,” Still said.

Self-managing health care includes advocacy

Still said another potential benefit for participants is that they will be able to better advocate for their own health care needs.

“We want to ensure that they have the knowledge to speak on their own behalf, that they are empowered to be their own advocate,” she said.

She said previous research has shown that older, African American patients are often prescribed only one medication for lowering their blood pressure, when evidence suggests that two or three are needed to manager their condition.

“There are a variety of reasons for this, including social determinants of health—so we are not pointing the finger at the patient or the health provider,” she said. “Rather, we are providing resources to assist them with controlling their blood pressure to reduce disparities in hypertension, as well as empower the patient to communicate more effectively about their condition to the provider.”

This new work builds on a pilot study Still conducted in 2019, which examined whether older African Americans were using mobile technology to better control their blood pressure.

Still’s research team includes several co-investigators, including Jackson T. Wright, a hypertension expert at University Hospitals and professor emeritus of medicine at Case Western Reserve; and Carla Harwell, medical director of University Hospitals Otis Moss Jr. Health Center.

Others involved include: Ming-Chun Huang, an assistant professor of electrical engineering and computer science; Ronald Hickman, the Ruth Anderson Professor and associate dean for research at the nursing school; Cheryl Killion, associate professor at the nursing school; and Abdus Sattar, a researcher in Population and Quantitative Health Sciences at the Case Western Reserve School of Medicine.


For more information, contact Mike Scott at mike.scott@case.edu.

This article was originally published Sept. 1, 2021.