From 2012 to 2015, Jo-Ann Eastwood, associate professor at UCLA School of Nursing, partnered with several local African American churches to conduct an American Heart Association–funded clinical trial that tested the effectiveness of using smartphone apps to help black women ages 25–45 reduce their risk for heart disease. Most of the study participants had multiple risk factors, such as obesity, hypertension, high cholesterol, high stress levels, and a family history of cardiovascular disease.

First, Eastwood and her team taught four weekly education sessions to increase the young women’s awareness of their risks and provide tips for making risk-lowering lifestyle changes. For many participants, the classes—which covered topics such as knowing your family history, heart-healthy eating, getting more exercise, and techniques for coping with stress—were an eye-opening experience.

After the last class, everyone in the intervention group was given a smartphone uploaded with apps Eastwood had developed in collaboration with UCLA’s Wireless Health Institute. “We used the apps to stay connected with the women,” she says. “They couldn’t call out on the phones, but we could call them and send them text messages.”

The apps were programmed to send a rotating series of daily reminders, such as “How many servings of vegetables did you eat today?” and “Did you try to reduce your stress today?” The women entered their answers into the phone, which streamed the data to the researchers through a server at the university.

In addition, the phones automatically tracked the women’s physical activity throughout the day and took their blood pressure once a week. “We gave them wireless talking blood pressure machines,” Eastwood explains. “The women would push a button on the phone, their blood pressure would be taken, and the phone would tell them what their numbers were. Then they would push a button that would stream it to our server.”

Although Eastwood is still analyzing the study’s results, her initial findings are impressive. After six months, compared with a control group, the women who received the smartphone intervention had lowered their blood pressure and total cholesterol, increased their HDL (“good”) cholesterol, reduced their waist circumference, and decreased their stress. “They were changing their diets, they were becoming more physically active, and they made notable and significant lifestyle changes over time,” Eastwood reports.

Even more encouraging, these changes empowered the women to improve not just their own cardiovascular health but their families’ as well. One woman, for instance, had been serving her husband and children meals that were high in sodium, fat, and cholesterol. As a result, her husband’s blood pressure was 210/120—dangerously out of control. But when she switched to more heart-healthy cooking habits, his hypertension began to drop dramatically. And at the end of the study, says Eastwood, “he came in and thanked us for saving his life, because his blood pressure was now 120/80 for the first time since sixth grade.”

Pam Chwedyk

Pam Chwedyk is a freelance health care writer based in Chicago. She is a former editor of Minority Nurse.
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