CHSU Discovery

Abstract

Hypertension remains a significant health concern in California’s Central Valley, particularly in King County, which ranks among the highest for cardiovascular mortality. To improve hypertension management, Aria Health, a federally qualified clinic with locations in Fresno, Tulare, and King County, has implemented a Self-Measured Blood Pressure Program (SMBP). However, patient enrollment and retention often fall below the target. Previous studies suggest barriers such as limited technology access, inadequate hypertension knowledge, financial constraints, and distrust in monitoring devices may contribute to low participation. This study aimed to identify a minimum of two primary barriers to SMBP compliance at Aria Health by April 2025. A survey was developed using Likert-scale and open-ended questions. Eligible participants included Aria Health patients aged 18-85 with diagnosed hypertension (≥140/90 mmHg on at least two occasions) who were enrolled in SMBP but not actively submitting readings at their last three appointments. Surveys were administered via secure phone lines by student doctors. Survey results show that most participants are middle-aged to older adults (40–59), with a higher proportion of female and Hispanic individuals. Education levels are mostly high school or some college, and many are unemployed or retired. The majority have Medi-Cal or Medicare, indicating a low-income and/or elderly population. The survey findings highlight key barriers to adherence in Aria Health’s SMBP program, including forgetfulness, lack of education on BP interpretation, and inconsistent provider follow-up. While most participants feel confident using their BP monitors, some report difficulty with device operation, lack of training, and uncertainty about responding to abnormal readings. Addressing these gaps through enhanced patient education, reminders, and stronger provider engagement could improve adherence and effectiveness in home BP monitoring.