{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:46:20Z","timestamp":1792032380722,"version":"4.4.0"},"reference-count":56,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T00:00:00Z","timestamp":1607904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Having a stroke or transient ischaemic attack increases the risk of a subsequent one, especially with high blood pressure (BP). Home\u2010based BP management can be effective at maintaining optimal BP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the optimization of a digital intervention for stroke patients and the value of participant diversity, using the person\u2010based approach (PBA) and integral patient and public involvement (PPI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting and participants<\/jats:title><jats:p>Stroke patients recruited from primary care and community settings, and health\u2010care professionals in primary care, in England and Ireland.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Three linked qualitative studies conducted iteratively to develop an intervention using the PBA, with integral PPI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>The BP: Together intervention, adapted from existing BP self\u2010monitoring interventions, is delivered via mobile phone or web interface to support self\u2010monitoring of BP at home. It alerts patients and their clinicians when a change in antihypertensive medication is needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Feedback from a diverse range of participants identified potential barriers, which were addressed to improve the intervention accessibility, feasibility and persuasiveness. Easy\u2010to\u2010read materials were developed to improve usability for patients with aphasia and lower literacy. The importance of including family members who support patient care was also highlighted. Feedback messages regarding medication change were refined to ensure usefulness for patients and clinicians.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Input from PPI alongside qualitative research with a diverse study sample allowed the creation of a simple and equitable BP management intervention for stroke patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patient involvement<\/jats:title><jats:p>Two PPI co\u2010investigators contributed to design, conduct of study, data interpretation and manuscript preparation; community PPI sessions informed early planning. Study participants were stroke patients and family members.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hex.13173","type":"journal-article","created":{"date-parts":[[2020,12,15]],"date-time":"2020-12-15T06:57:20Z","timestamp":1608015440000},"page":"327-340","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Optimizing a digital intervention for managing blood pressure in stroke patients using a diverse sample: Integrating the person\u2010based approach and patient and public involvement"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5201-9780","authenticated-orcid":false,"given":"Tanvi","family":"Rai","sequence":"first","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6674-0314","authenticated-orcid":false,"given":"Kate","family":"Morton","sequence":"additional","affiliation":[{"name":"School of Psychology University of Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9164-8659","authenticated-orcid":false,"given":"Cristian","family":"Roman","sequence":"additional","affiliation":[{"name":"Department of Engineering Science University of Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4539-3982","authenticated-orcid":false,"given":"Roisin","family":"Doogue","sequence":"additional","affiliation":[{"name":"Graduate Entry Medical School University of Limerick Limerick Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5961-2413","authenticated-orcid":false,"given":"Cathy","family":"Rice","sequence":"additional","affiliation":[{"name":"Public and Patient Involvement (PPI) Contributor Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marney","family":"Williams","sequence":"additional","affiliation":[{"name":"Public and Patient Involvement (PPI) Contributor Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9408-3227","authenticated-orcid":false,"given":"Claire","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4836-3743","authenticated-orcid":false,"given":"Carmelo","family":"Velardo","sequence":"additional","affiliation":[{"name":"Department of Engineering Science University of Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0118-1646","authenticated-orcid":false,"given":"Lionel","family":"Tarassenko","sequence":"additional","affiliation":[{"name":"Department of Engineering Science University of Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3853-883X","authenticated-orcid":false,"given":"Lucy","family":"Yardley","sequence":"additional","affiliation":[{"name":"School of Psychology University of Southampton Southampton UK"},{"name":"Department of Experimental Psychology Institute of Biomedical Engineering University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3638-028X","authenticated-orcid":false,"given":"Richard J.","family":"McManus","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6082-3151","authenticated-orcid":false,"given":"Lisa","family":"Hinton","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford Oxford UK"},{"name":"The Healthcare Improvement Studies Institute University of Cambridge Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,14]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":". State of the nation: Stroke statistics February","author":"Stroke Association","year":"2018"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.002604"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00200-8"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-008-9262-2"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.116.08485"},{"key":"e_1_2_10_7_1","volume-title":"National Clinical Guideline for Stroke","author":"Intercollegiate Stroke Working Party","year":"2016"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60688-7"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b1665"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp16X685609"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-135-9-200111060-00012"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000011121"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.2.141"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a1655"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2016.12.005"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-029954"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.4055"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0196868"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7401.1244"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.002414"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/heart.89.3.327"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2018.11.002"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-14-177"},{"key":"e_1_2_10_24_1","volume-title":"Going The Extra Mile: Improving The Nation\u2019s Health And Wellbeing Through Public Involvement In Research","year":"2015"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25174"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40900-019-0169-8"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-012684"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f3030"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30309-X"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-017-0605-9"},{"issue":"1","key":"e_1_2_10_31_1","first-page":"58","article-title":"Evaluation of an Informational Web Site: Three Variants of the Think\u2010aloud Method Compared","volume":"54","author":"Haak MJ","year":"2007","journal-title":"Tech Commun"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.10057"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0084238"},{"key":"e_1_2_10_34_1","volume-title":"Qualitative Research","author":"Silverman D","year":"2016"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/561320"},{"key":"e_1_2_10_36_1","volume-title":"Enabling People With Aphasia To Participate In Research: Resources For Stroke Researcher","author":"Stroke NIFHRCRN","year":"2014"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000001738"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp13X668168"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp12X625201"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1332\/174426419X15552999451313"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.4999"},{"key":"e_1_2_10_42_1","volume-title":"Health Equity in England: The Marmot Review 10 Years On","author":"Marmot M","year":"2020"},{"key":"e_1_2_10_43_1","volume-title":"The Power Of Information: Giving People Control Of The Health And Care Information They Need","author":"Department of Health and Social Care","year":"2012"},{"key":"e_1_2_10_44_1","volume-title":"Personalised Health and Care 2020 Using Data and Technology to Transform Outcomes for Patients and Citizens A Framework for Action","author":"National Information Board","year":"2014"},{"key":"e_1_2_10_45_1","volume-title":"The Future Of Healthcare: Our Vision For Digital, Data And Technology In Health And Care","author":"Department of Health and Social Care","year":"2018"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9566.12980"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.1619"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0195447"},{"key":"e_1_2_10_49_1","volume-title":"Adults: Media Use And Attitudes Report","author":"Ofcom","year":"2019"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1057\/sth.2013.10"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1177\/2053951720918275"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9566.12590"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9566.12013"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1177\/0038026117717432"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40900-016-0023-1"},{"key":"e_1_2_10_56_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38061.593935.F7"},{"key":"e_1_2_10_57_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-016-0359-3"}],"container-title":["Health Expectations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hex.13173","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hex.13173","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hex.13173","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T20:05:05Z","timestamp":1693339505000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hex.13173"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,14]]},"references-count":56,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1111\/hex.13173"],"URL":"https:\/\/doi.org\/10.1111\/hex.13173","archive":["Portico"],"relation":{},"ISSN":["1369-6513","1369-7625"],"issn-type":[{"value":"1369-6513","type":"print"},{"value":"1369-7625","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,14]]},"assertion":[{"value":"2020-07-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}