{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T23:38:52Z","timestamp":1774568332338,"version":"3.50.1"},"reference-count":43,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T00:00:00Z","timestamp":1715126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"A. James and Alice B. Clark Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Cardiovascular disease is the leading cause of maternal death among Black women in the United States. A large, urban hospital adopted remote patient blood pressure monitoring (RBPM) to increase blood pressure monitoring and improve the management of hypertensive disorders of pregnancy (HDP) by reducing the time to diagnosis of HDP. The digital platform integrates with the electronic health record (EHR), automatically inputting RBPM readings to the patients\u2019 chart; communicating elevated blood pressure values to the healthcare team; and offers a partial offset of the cost through insurance plans. It also allows for customization of the blood pressure values that prompt follow-up to the patient\u2019s risk category. This paper describes a protocol for evaluating its impact. Objective 1 is to measure the effect of the digitally supported RBPM on the time to diagnosis of HDP. Objective 2 is to test the effect of cultural tailoring to Black participants. The ability to tailor digital content provides the opportunity to test the added value of promoting social identification with the intervention, which may help achieve equity in severe maternal morbidity events related to HDP. Evaluation of this intervention will contribute to the growing literature on digital health interventions to improve maternity care in the United States.<\/jats:p>","DOI":"10.3390\/ijerph21050603","type":"journal-article","created":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T13:20:24Z","timestamp":1715174424000},"page":"603","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Protocol for Evaluating Remote Patient Blood Pressure Monitoring Adapted to Black Women and Birthing Persons"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8152-5658","authenticated-orcid":false,"given":"Loral","family":"Patchen","sequence":"first","affiliation":[{"name":"MedStar Health Research Institute, Hyattsville, MD 20782, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asli","family":"McCullers","sequence":"additional","affiliation":[{"name":"MedStar Health Research Institute, Hyattsville, MD 20782, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6621-3947","authenticated-orcid":false,"given":"Serenity","family":"Budd","sequence":"additional","affiliation":[{"name":"MedStar Health Research Institute, Hyattsville, MD 20782, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Blumenthal","sequence":"additional","affiliation":[{"name":"MedStar Health Research Institute, Hyattsville, MD 20782, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7559-1592","authenticated-orcid":false,"given":"W.","family":"Evans","sequence":"additional","affiliation":[{"name":"Milken Institute School of Public Health, George Washington University, Washington, DC 20037, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Hoyert, D. (2023, March 16). Maternal Mortality Rates in the United States, 2021. Centers for Disease Control and Prevention, Available online: https:\/\/www.cdc.gov\/nchs\/data\/hestat\/maternal-mortality\/2021\/maternal-mortality-rates-2021.htm.","DOI":"10.15620\/cdc:124678"},{"key":"ref_2","unstructured":"Centers for Disease Control and Prevention (2024, April 28). Leading Causes of Death-Females-All Races\/Origins. Centers for Disease Control and Prevention, Available online: https:\/\/www.cdc.gov\/women\/lcod\/2017\/all-races-origins\/index.htm."},{"key":"ref_3","unstructured":"Heron, M. (2024, April 28). Deaths: Leading Causes for 2014, National Vital Statistics Reports, Available online: https:\/\/www.cdc.gov\/nchs\/data\/nvsr\/nvsr65\/nvsr65_05.pdf."},{"key":"ref_4","unstructured":"Tikkanen, R., Gunja, M., Fitzgerald, M., and Zephyrin, L. (2024, April 28). Maternal Mortality and Maternity Care in the United States Compared to 10 Other Developed Countries. The Commonwealth Fund. Available online: https:\/\/www.commonwealthfund.org\/publications\/issue-briefs\/2020\/nov\/maternal-mortality-maternity-care-us-compared-10-countries."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1542\/neo.20-10-e561","article-title":"Maternal Mortality in the United States: Updates on Trends, Causes, and Solutions","volume":"20","author":"Collier","year":"2019","journal-title":"NeoReviews"},{"key":"ref_6","unstructured":"Centers for Disease Control and Prevention (2024, April 28). Working Together to Reduce Black Maternal Mortality, Available online: https:\/\/www.cdc.gov\/healthequity\/features\/maternal-mortality\/index.html."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1111\/jmwh.12572","article-title":"The Impact of Racism and Midwifery\u2019s Lack of Racial Diversity: A Literature Review","volume":"61","author":"Donnelly","year":"2016","journal-title":"J. Midwifery Women\u2019s Health"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1007\/s40615-023-01579-5","article-title":"Healthcare Experiences of Black Patients during and after Pregnancy: A Needs Assessment for Provider Training to Improve Quality of Care","volume":"11","author":"Berk","year":"2023","journal-title":"J. Racial Ethn. Health Disparities"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1089\/jwh.2017.6807","article-title":"Unpacking Racial\/Ethnic Disparities in Prenatal Care Use: The Role of Individual-, Household-, and Area-Level Characteristics","volume":"27","author":"Green","year":"2018","journal-title":"J. Women\u2019s Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1053\/j.semperi.2017.04.008","article-title":"Exploring the Social Determinants of Racial\/Ethnic Disparities in Prenatal Care Utilization and Maternal Outcome","volume":"41","author":"Gadson","year":"2017","journal-title":"Semin. Perinatol."},{"key":"ref_11","unstructured":"Salam, M. (2024, April 28). For Serena Williams, Childbirth Was a Harrowing Ordeal. She\u2019s Not Alone. The New York Times, Available online: https:\/\/www.nytimes.com\/2018\/01\/11\/sports\/tennis\/serena-williams-baby-vogue.html."},{"key":"ref_12","unstructured":"Chappell, B. (2023). Tori Bowie, an Elite Olympic Athlete, Died of Complications from Childbirth, NPR. Available online: https:\/\/www.npr.org\/2023\/06\/13\/1181971448\/tori-bowie-an-elite-olympic-athlete-died-of-complications-from-childbirth."},{"key":"ref_13","unstructured":"(2024, April 28). Heart Disease and Stroke in Black Women. Available online: https:\/\/www.goredforwomen.org\/en\/about-heart-disease-in-women\/facts\/heart-disease-in-african-american-women#:~:text=Among%20Black%20women%20ages%2020."},{"key":"ref_14","first-page":"283","article-title":"Racial\/Ethnic Differences in Pregnancy-Related Hypertensive Disease in Nulliparous Women","volume":"24","author":"Ghosh","year":"2014","journal-title":"Ethn. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1161\/HYPERTENSIONAHA.121.17661","article-title":"Historical and Recent Changes in Maternal Mortality due to Hypertensive Disorders in the United States, 1979 to 2018","volume":"78","author":"Ananth","year":"2021","journal-title":"Hypertension"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/S0140-6736(20)32032-8","article-title":"Reckoning with Histories of Medical Racism and Violence in the USA","volume":"396","author":"Nuriddin","year":"2020","journal-title":"Lancet"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1089\/heq.2021.0015","article-title":"Obstetrics and Gynecology and Reparations: The Debt We Owe (and Continue to Accumulate)","volume":"5","author":"Swanson","year":"2021","journal-title":"Health Equity"},{"key":"ref_18","unstructured":"Johnson, J.U.S. (2024, April 28). Internet Reach by Age Group 2019|Statista. Statista. Available online: https:\/\/www.statista.com\/statistics\/266587\/percentage-of-internet-users-by-age-groups-in-the-us\/."},{"key":"ref_19","unstructured":"Laricchia, F. (2024, April 28). Smartphone Ownership in the US by Age 2021. Statista. Available online: https:\/\/www.statista.com\/statistics\/489255\/percentage-of-us-smartphone-owners-by-age-group\/#:~:text=Smartphone%20ownership%20in%20the%20United."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e18255","DOI":"10.2196\/18255","article-title":"Exclusively Digital Health Interventions Targeting Diet, Physical Activity and Weight Gain in Pregnant Women: Systematic Review and Meta-Analysis","volume":"8","author":"Rhodes","year":"2020","journal-title":"JMIR mHealth uHealth"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e17845","DOI":"10.2196\/17845","article-title":"Evaluating Engagement in a Digital and Dietetic Intervention Promoting Healthy Weight Gain in Pregnancy: Mixed Methods Study","volume":"22","author":"Willcox","year":"2020","journal-title":"J. Med. Internet Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e26091","DOI":"10.2196\/26091","article-title":"Effectiveness of a Smartphone App to Promote Healthy Weight Gain, Diet, and Physical Activity during Pregnancy (HealthyMoms): Randomized Controlled Trial","volume":"9","author":"Sandborg","year":"2021","journal-title":"JMIR mHealth uHealth"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s11883-020-00889-x","article-title":"Digital Health Innovations to Improve Cardiovascular Disease Care","volume":"22","author":"Santo","year":"2020","journal-title":"Curr. Atheroscler. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2148","DOI":"10.1161\/HYPERTENSIONAHA.122.19414","article-title":"Digital Therapeutics in Hypertension: Evidence and Perspectives","volume":"79","author":"Kario","year":"2022","journal-title":"Hypertension"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1161\/CIRCRESAHA.121.319876","article-title":"Cardiovascular Disease Screening in Women: Leveraging Artificial Intelligence and Digital Tools","volume":"130","author":"Adedinsewo","year":"2022","journal-title":"Circ. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1016\/j.hlc.2016.04.009","article-title":"MHealth in Cardiovascular Health Care","volume":"25","author":"Chow","year":"2016","journal-title":"Heart Lung Circ."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1097\/MLR.0000000000001869","article-title":"Bridging the Digital Health Divide","volume":"61","author":"Ahmed","year":"2023","journal-title":"Med. Care"},{"key":"ref_28","unstructured":"(2024, March 24). Safe Babies Mom\u2019s Program|Washington, DC|MedStar Health. Available online: https:\/\/www.medstarhealth.org\/services\/dc-safe-babies-safe-moms."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1007\/s10995-013-1346-2","article-title":"Lifecourse Health Development: Past, Present and Future","volume":"18","author":"Halfon","year":"2013","journal-title":"Matern. Child Health J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.ajog.2019.05.011","article-title":"Text Message Remote Monitoring Reduced Racial Disparities in Postpartum Blood Pressure Ascertainment","volume":"221","author":"Hirshberg","year":"2019","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1136\/bmjqs-2018-007837","article-title":"Comparing Standard Office-Based Follow-up with Text-Based Remote Monitoring in the Management of Postpartum Hypertension: A Randomised Clinical Trial","volume":"27","author":"Hirshberg","year":"2018","journal-title":"BMJ Qual. Saf."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1186\/s13063-020-04394-z","article-title":"Implementing Self-Management: A Mixed Methods Study of Women\u2019s Experiences of a Postpartum Hypertension Intervention (SNAP-HT)","volume":"21","author":"Cairns","year":"2020","journal-title":"Trials"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1891\/1541-6577.24.3.172","article-title":"Theory of Planned Behavior, Self-Care Motivation, and Blood Pressure Self-Care","volume":"24","author":"Peters","year":"2010","journal-title":"Res. Theory Nurs. Pract."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1464-0597.2008.00379.x","article-title":"Social Identity, Health and Well-Being: An Emerging Agenda for Applied Psychology","volume":"58","author":"Haslam","year":"2009","journal-title":"Appl. Psychol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1007\/s13142-014-0272-1","article-title":"Systematic Review of Health Branding: Growth of a Promising Practice","volume":"5","author":"Evans","year":"2014","journal-title":"Transl. Behav. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"100460","DOI":"10.1016\/j.conctc.2019.100460","article-title":"Design of a Novel Digital Intervention to Promote Healthy Weight Management among Postpartum African American Women","volume":"16","author":"Evans","year":"2019","journal-title":"Contemp. Clin. Trials Commun."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Napolitano, M.A., Harrington, C.B., Patchen, L., Ellis, L.P., Ma, T., Chang, K., Gaminian, A., Bailey, C.P., and Evans, W.D. (2021). Feasibility of a Digital Intervention to Promote Healthy Weight Management among Postpartum African American\/Black Women. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18042178"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Elrod, J.K., and Fortenberry, J.L. (2018). Driving Brand Equity in Health Services Organizations: The Need for an Expanded View of Branding. BMC Health Serv. Res., 18.","DOI":"10.1186\/s12913-018-3679-4"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Heaman, M.I., Sword, W.A., Akhtar-Danesh, N., Bradford, A., Tough, S., Janssen, P.A., Young, D.C., Kingston, D.A., Hutton, E.K., and Helewa, M.E. (2014). Quality of Prenatal Care Questionnaire: Instrument Development and Testing. BMC Pregnancy Childbirth, 14.","DOI":"10.1186\/1471-2393-14-188"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"209","DOI":"10.4103\/ijph.IJPH_29_18","article-title":"Development of Perceived Prenatal Maternal Stress Scale","volume":"63","author":"Jena","year":"2019","journal-title":"Indian J. Public Health"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Rath, J., Tulsiani, S., Evans, W.D., Liu, S., Vallone, D., and Hair, E.C. (2021). Effects of Branded Health Messages on E-Cigarette Attitudes, Intentions, and Behaviors: A Longitudinal Study among Youth and Young Adults. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-11092-1"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1192\/bjp.150.6.782","article-title":"Detection of Postnatal Depression: Development of the 10-Item Edinburgh Postnatal Depression Scale","volume":"150","author":"Cox","year":"1987","journal-title":"Br. J. Psychiatry"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"585","DOI":"10.15585\/mmwr.mm7117a1","article-title":"Hypertensive Disorders in Pregnancy and Mortality at Delivery Hospitalization\u2014United States, 2017\u20132019","volume":"71","author":"Ford","year":"2022","journal-title":"MMWR. Morb. Mortal. Wkly. Rep."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/5\/603\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:42:18Z","timestamp":1760107338000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/5\/603"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,8]]},"references-count":43,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["ijerph21050603"],"URL":"https:\/\/doi.org\/10.3390\/ijerph21050603","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,8]]}}}