Appropriateness of Web-Based Resources for Home Blood Pressure Measurement and Their Alignment With Guideline Recommendations, Readability, and End User Involvement: Environmental Scan of Web-Based Resources.

Abstract

Background: High blood pressure (≥140/90 mm Hg) is the most prominent mortality risk factor worldwide. Home blood pressure measurement (HBPM) is recommended for blood pressure (BP) management. HBPM is most effective to improve BP management when delivered with patient education. It is unknown whether web-based resources are appropriate for patient education for HBPM. Patient education should provide accurate, evidence-based information, communicate at an eighth grade reading level, and involve end users in development to meet the needs of adults of all health literacy levels. Using these criteria, this study aimed to determine the appropriateness of web-based HBPM resources.

Objective: This study aimed to determine whether web-based resources are appropriate for HBPM education based on three research questions: (1) Do web-based resources provide evidence-based information that aligns with guideline recommendations? (2) Do they communicate at an appropriate reading level? (3) Do they involve end users in their development?

Methods: An environmental scan of web-based resources for HBPM was conducted on Google (October 2022) using search terms developed with consumers (n=6). Resources were included if they were identified on the first page of the search findings, not paywalled, and in English. Resource appropriateness was appraised based on three criteria: (1) alignment of resource content to 23 recommendations for HBPM from 6 international guidelines, (2) being at an appropriate grade reading level as determined by a health literacy assessment software, and (3) having evidence of end user involvement in resource development.

Results: None of the identified resources (n=24) aligned with all 23 of the guideline recommendations. All resources aligned with the recommendation to measure BP when seated, while few aligned with the recommendation to use a validated BP device (n=9, 38%). All resources exceeded the recommended eighth grade reading level (mean 11.8, range 8.8-17.0) and none reported evidence of patient end user involvement in development.

Conclusions: None of the web-based resources met the criteria for appropriate education to support adults to measure BP at home. Resources should be developed with end users using health literacy tools and multimodal communication methods to ensure they are appropriate to meet the needs of patients.