{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:25:36Z","timestamp":1791246336616,"version":"4.1.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,5,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Hypertension management using home blood pressure monitoring\u2013guided pharmacotherapy is more effective than clinic\u2010based care, but the benefit is attenuated in underserved patients. We evaluated implementation determinants of a team\u2010based telehealth hypertension management program providing home blood pressure monitoring\u2013guided pharmacotherapy and self\u2010management and social support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We used Exploration, Preparation, Implementation and Sustainment, and Health Equity Implementation Frameworks for semistructured interviews and inductive\/deductive coding using thematic analysis of qualitative data and quantitative analysis to evaluate team\u2010based telehealth hypertension management program implementation facilitators, barriers, acceptability, appropriateness, and feasibility. We purposefully sampled 20 patients with hypertension and 16 clinic key players from 2 safety\u2010net clinics in North Carolina. Quantitative measures were Acceptability of Intervention Measure, Intervention Appropriateness Measure, Feasibility of Intervention Measure, Patient Assessment of Chronic Illness Care, Organizational Readiness for Implementing Change (all measures' score ranged 1\u20135; higher score is better). We used concurrent embedded mixed methods (qualitative + quantitative) for convergence and complementarity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Five qualitative themes emerged around (1) staffing barriers, coordinated teamwork, and friendly study tools; (2) the program's patient and provider centeredness; (3) ease of home blood pressure monitoring; (4) personalized, comprehensive self\u2010management calls; and (5) social support. Patients and clinic key players found the program acceptable (mean\u00b1SD, 4.42\u00b10.84 and 4.56\u00b10.59), appropriate (4.42\u00b10.86 and 4.61\u00b10.50), and feasible (4.40\u00b10.89 and 4.44\u00b10.53), respectively. Patient Assessment of Chronic Illness Care and Organizational Readiness for Implementing Change scores were 4.22\u00b11.01 and 4.11\u00b10.78, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Implementing a team\u2010based telehealth hypertension management program depends on its tailoring to patients and providers and having their endorsement; a user\u2010friendly and trust\u2010promoting model; and having a viable financial plan. Future studies should assess clinical and cost effectiveness of the program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>REGISTRATION: URL<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT05424744.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.047236","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T11:09:31Z","timestamp":1778756971000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Determinants of Successful Implementation: A Mixed\u2010Methods Evaluation of a Team\u2010Based Telehealth Hypertension Management Program for Underserved Patients"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4704-0272","authenticated-orcid":false,"given":"Sunit","family":"Chhetri","sequence":"first","affiliation":[{"name":"Wake Forest University School of Medicine","place":["Winston\u2010Salem, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8240-2254","authenticated-orcid":false,"given":"Srista","family":"Manandhar","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine","place":["Winston\u2010Salem, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7579-1777","authenticated-orcid":false,"given":"Austin L.","family":"Seals","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine","place":["Winston\u2010Salem, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3791-1548","authenticated-orcid":false,"given":"Justin","family":"Kramer","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine","place":["Winston\u2010Salem, USA"]},{"name":"Wake Forest University School of Medicine","place":["Winston\u2010Salem, USA"]},{"name":"Wake Forest University School of Medicine","place":["Winston\u2010Salem, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9338-2073","authenticated-orcid":false,"given":"Yashashwi","family":"Pokharel","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine","place":["Winston\u2010Salem, USA"]},{"name":"Wake Forest University School of Medicine","place":["Winston\u2010Salem, USA"]},{"name":"Wake Forest University School of Medicine","place":["Winston\u2010Salem, USA"]},{"name":"Wake Forest University School of Medicine","place":["Winston\u2010Salem, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","unstructured":"High Blood Pressure Facts. Centers for Disease Control and Prevention. Accessed April 17 2025. https:\/\/www.cdc.gov\/high\u2010blood\u2010pressure\/data\u2010research\/facts\u2010stats\/index.html."},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.111.174367"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1370\/afm.2491"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-154-12-201\u2009106\u2009210-00005"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.120.15873"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.109.149336"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYP.0000000000000065"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.123.22109"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1080\/14635240.2024.2403238"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.2147\/ppa.S46517"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2022.01.035"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1553-7250(10)36084-3"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.123.21354"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.122.20219"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40814-025-01656-y"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.12788\/jcom.0006"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-018-0842-6"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-021-00146-5"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.psych.52.1.1"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.6549"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315617444"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-013-0528-y"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000160375.47920.8c"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-9-7"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-017-0635-3"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/160940690600500107"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11577-017-0454-1"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.4135\/9781071802823"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.316"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-024-09314-4"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.4324\/9781032633749-15"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049732316654870"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.047236","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T06:36:28Z","timestamp":1789713388000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.047236"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,19]]},"references-count":32,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,5,19]]}},"alternative-id":["10.1161\/JAHA.125.047236"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.047236","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,19]]},"assertion":[{"value":"2025-10-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e047236"}}