Michael Tran, Joel Rhee, Oliver Smith
Improving feedback literacy in a primary care rotation
Medical teacher
hypertension leading cause cardiovascular kidney disease united states yet blood pressure bp control population level poor worsening systematic home bp monitoring hbpm programs lower bp programs supporting hbpm routinely used mybp program deploys automated bidirectional text messaging hbpm disease selfmanagement support aim produce qualitative analysis input providers staff regarding implementation innovative hbpm program primary care practices semistructured interviews average length 31 minutes conducted physicians n11 nurses medical assistants n6 primary care settings interview assessed multiple constructs consolidated framework implementation research domains intervention characteristics outer setting inner setting characteristics individuals interviews transcribed verbatim analyzed using inductive coding organize meaningful excerpts identify salient themes followed mapping updated consolidated framework implementation research constructs health care providers reported mybp good ease use likely engage patients managing high bp also felt would directly support systematic bp monitoring habit formation convenience patients home could increase health literacy generate concrete feedback raise daytoday salience bp control providers expressed concern cost bp devices remains encumbrance patients felt overriding social emotional barriers lack needed technical skills interact program use good measurement technique input readings accurately respect effects medical practice providers felt mybp would improve accuracy frequency hbpm data thereby improve diagnosis treatment management program may positively affect patientprovider relationship increasing rapport bidirectional accountability providers appreciated receiving aggregated hbpm data increase efficiency also expressed concern timely routing incoming hbpm reports lack true integration electronic health record need dedicated trained staff member qualitative analysis health care providers perceived strong relative advantages using mybp support patients identified barriers suggest need corrective implementation strategies support providers adopting program routine primary care practice integration workflow provider education clinicaltrialsgov nct03650166 httpstinyurlcombduwn6r4