{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T12:07:32Z","timestamp":1784290052741,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K01 TW012166"],"award-info":[{"award-number":["K01 TW012166"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pregnancy"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Hypertensive disorders of pregnancy (HDP) remain a leading cause of maternal morbidity and mortality globally, with a disproportionate burden in low\u2010 and middle\u2010income countries (LMICs) such as Ghana. In high\u2010income settings, home blood pressure (BP) monitoring has emerged as an effective tool for early detection of HDP; however, limited data exist regarding its feasibility and acceptability in LMICs. This qualitative study sought to explore the experiences of women in Ghana who demonstrated low adherence to a home BP monitoring intervention during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was conducted at Korle Bu Teaching Hospital (KBTH), a tertiary care hospital in Accra, Ghana. Participants were 16 postpartum women, purposively sampled from an overarching cohort study of home BP monitoring based on low adherence, defined as recording BP values \u2264 4 days per week on average. Semi\u2010structured interviews were conducted in English or Twi. Interview guide questions focused on participants\u2019 experiences recording their BPs, specifically eliciting challenges and perceived benefits. Interviews were audio\u2010recorded, translated, transcribed, coded in Dedoose using an iteratively developed codebook, and thematically analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants had a mean age 30.4 years, 87% were married, and 69% had previously given birth. There were 29 codes grouped into four comprehensive themes: (1) disconnect between understanding and action, (2) barriers to adherence, (3) facilitators, and (4) suggestions for improvement. While many women understood the importance of BP monitoring in pregnancy and acknowledged its benefits, for some, there was dissonance between their understanding and behavior. Barriers included competing health priorities and familial responsibilities. Women emphasized familial support as a key facilitator to monitoring their BPs and suggested inclusion of their spouses and family members in further training. Finally, several women noted that frequent reminders, along with a machine with automatic data capturing, would facilitate adherence to at\u2010home monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Though participants recognized that home blood pressure monitoring was important, several barriers, including familial responsibilities and physical health, prevented them from adhering to daily checks. Incorporating culturally relevant digital reminders, simplified logging methods, and support from family may strengthen adherence. Future work will adapt and evaluate a smartphone\u2010based reminder and data\u2010capture platform informed by stakeholder input.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmf2.70294","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T13:55:32Z","timestamp":1776088532000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Strategies for improving home blood pressure monitoring among pregnant women with low adherence in Ghana"],"prefix":"10.1002","volume":"2","author":[{"given":"Akosua Y.","family":"Oppong","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxanne F.","family":"Harfmann","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betty A.","family":"Nartey","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Korle Bu Teaching Hospital  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Buxton","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Korle Bu Teaching Hospital  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl A.","family":"Moyer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Learning Health Sciences University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jody","family":"Lori","sequence":"additional","affiliation":[{"name":"University of Michigan School of Nursing  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8387-4667","authenticated-orcid":false,"given":"Samuel A.","family":"Oppong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Korle Bu Teaching Hospital  Accra Ghana"},{"name":"Department of Obstetrics and Gynaecology University of Ghana Medical School  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma R.","family":"Lawrence","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2018.01.012"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/4194443"},{"issue":"1","key":"e_1_2_10_4_1","first-page":"8","article-title":"Prevalence of Hypertensive Disorders in Pregnancy at Korle\u2010Bu Teaching Hospital in Ghana","volume":"3","author":"Adu\u2010Bonsaffoh K.","year":"2017","journal-title":"Journal of Gynecology & Neonatal Biology"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12919-024-00295-0"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7117a1"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2024.100864"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2015.08.026"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2019.12.001"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38121.684410.AE"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20200099"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2011.0271"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-024-06421-2"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jnu.12094"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2022.10.007"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xagr.2025.100471"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MBP.0000000000000315"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-023-05363-5"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/146879410100100307"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/1559827617745479"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16545"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2020.07.006"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2019.07.012"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2018.02.015"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.118.10971"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2012.125"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.2196\/55617"}],"container-title":["Pregnancy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmf2.70294","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pmf2.70294","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmf2.70294","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:51:05Z","timestamp":1784289065000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/pmf2.70294"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,13]]},"references-count":26,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/pmf2.70294"],"URL":"https:\/\/doi.org\/10.1002\/pmf2.70294","archive":["Portico"],"relation":{},"ISSN":["2997-9684","2997-9684"],"issn-type":[{"value":"2997-9684","type":"print"},{"value":"2997-9684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,13]]},"assertion":[{"value":"2025-12-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70294"}}