Exploring Opportunities to Implement a Virtual Blood Pressure Self-Monitoring Program (BPSM) to Reach Rural Communities in South Carolina

Posted on June 24, 2024 by Brittney Grant

This entry is part 6 of 7 in the series CVD Prevention 1

This blog post and supporting article summarizes findings and lessons learned from the virtual expansion of the YMCA’s BPSM program to reach rural communities in South Carolina.

Read the Article in JPHMP

Cardiovascular disease is a leading cause of death in South Carolina. Significant contributors to cardiovascular disease include high blood pressure and high blood cholesterol, of which need to be properly managed to prevent adverse cardiac events. Blood pressure self-monitoring (BPSM), where individuals measure their own blood pressure outside of the clinical environment, coupled with additional support, is an evidence-based, cost-effective strategy that is underutilized at large. Additionally, because rural communities face a disproportionate burden of cardiovascular disease, solutions are needed to support rural patients with self-management of their condition. In our paper, “Virtual expansion of the YMCA’s Blood Pressure Self-Monitoring (BPSM) Program: Using telehealth to adapt an evidence-based program to reach rural communities in South Carolina,” we present findings that highlight the value and challenges of expanding an evidence-based blood pressure program virtually to bridge the gap between clinical and community services to support underserved communities.

Intervention

The YMCA has positioned itself as one of the leading community-based organizations improving the nation’s health. One of its eight chronic disease prevention and management programs, the YMCA’s BPSM program has been shown to decrease both systolic and diastolic blood pressure among residents of low-income communities. Historically, YMCA evidence-based programs have been delivered solely in-person, however, with an increasing emphasis on telehealth and a need to reach rural communities, the SC Alliance of YMCAs adapted the traditional BPSM program to allow for virtual participant encounters via the Zoom teleconferencing platform. During the two-year implementation of this virtual pilot, ten partnerships with rural health centers, federally qualified health centers, mobile clinics, and free medical clinics were established to support clinical referrals to this community program. The YMCA created customized referral protocols with each referral partner and held promotional events at various clinics to educate patients about proper blood pressure screening techniques and recruit participants for the program. In total, 126 participants were enrolled into the virtual program, and among those, 52 participants completed the full four-month program and saw blood pressure improvements. The virtual program reached 59 zip codes across the state of South Carolina.

Key Implications

Improvements in blood pressure observed among the program completers and the program’s reach across the state showcases merit in maintaining a virtual option for this program. Lessons learned from implementing the program included the importance of ensuring participants’ readiness to engage in a four-month program, assessing participants’ digital literacy, and considering limitations to broadband access in rural areas of the state. Given this, further expansion of virtual program models must consider the structural and contextual factors impacting individuals that are referred to these programs. Lastly, sustainability of this program and other community-based programs is often a challenge without sustained funding sources or reimbursement opportunities. Funding opportunities should be explored to support the infrastructure needed (eg, program staff support, supplies, healthcare provider buy-in) to implement chronic disease prevention and management programs.

Final Thoughts

Readers of the “Virtual expansion of the YMCA’s Blood Pressure Self-Monitoring (BPSM) Program: Using telehealth to adapt an evidence-based program to reach rural communities in South Carolina,” will take away practical applications to support a virtual blood pressure self-monitoring program and examples of implementing creative solutions to barriers that inevitably arise. Additionally, readers will gain insight to how developmental evaluation can be used as a framework to assist planning, implementing, and adapting their approach. It is our hope that public health practitioners will be able to use our insights and lessons learned to continue supporting underserved communities through community-based programs aimed at improving health outcomes.

If you would like to learn more about the YMCA’s Blood Pressure Self-Monitoring Program or find a YMCA near you, visit: Blood Pressure Self-Monitoring – YMCA of the USA.

Acknowledgements

I would like to acknowledge my co-authors and colleagues for their work on implementing this project and their contributions made to this article: Kristian Myers, Halie Patterson, Ishan Suthar, Kaylin Garst, Michele James, and Chet Tucker.

About the Author

Brittney Grant: Brittney Grant, MPH, is a program evaluator at the SC Department of Health and Environmental Control. Her recent work has focused on evaluating community-based programs, health communication campaigns, and learning collaboratives. She holds a B.S. degree from the University of South Florida and an MPH from the University of South Carolina.