Transl Behav Med. 2026 Jan 7;16(1):ibaf094. doi: 10.1093/tbm/ibaf094.
ABSTRACT
BACKGROUND: Self-measured blood pressure (SMBP) monitoring is an evidence-based practice effective for improving the diagnosis and control of hypertension. Healthcare settings face challenges integrating it into clinical care.
PURPOSE: This study applied behavior change theory to design a clinic-based intervention to integrate SMBP within safety net primary care settings.
METHODS: We conducted multi-phase, mixed methods research to adapt a clinic-level intervention across 25 safety net primary care clinics within three California public healthcare systems as part of the Championing Hypertension Remote Monitoring for Equity and Dissemination (CHARMED) Study. From February to August 2024, clinic champions participated in surveys and focus groups to assess: (i) current practices in hypertension management, (ii) implementation barriers, and (iii) strategies for optimizing the use of SMBP within clinics. Using the Behavior Change Wheel, we designed and tailored the intervention to improve clinical practices for SMBP.
RESULTS: Over 50 clinicians/staff participated. Surveys revealed varying SMBP use due to knowledge gaps, lack of standardized processes, and insufficient financial and human resources. Focus groups highlighted the importance of increasing SMBP knowledge among patients and care teams (capability); promoting structured workflows/templates for documenting and acting on SMBP data (opportunity); and building care team buy-in for SMBP (motivation). These insights guided the final intervention activities.
CONCLUSIONS: Using behavior change theory and stakeholder-engaged methods, we developed a multi-component clinic-focused intervention to promote tailored SMBP implementation within safety net primary care clinics. This evidence-based, adaptable approach may inform future efforts to implement SMBP at multiple levels of care.
CLINICAL TRIAL INFORMATION: The Clinical Trials Registration #NCT06113458.
PMID:41723583 | DOI:10.1093/tbm/ibaf094