Abstract 11231: Rethinking the Disconnect in Patient Outreach: Key Considerations in Addressing Racial Disparities in Hypertension

Background: Disparities in hypertension and cardiovascular outcomes among Black men in the US are influenced by social determinants of health (SDOH) and systemic inequity. Self-measured blood pressure (SMBP) monitoring programs may be an efficacious strategy to combat these disparities in the community setting. Leveraging the advantages of SMBP, however, requires improved understanding of barriers to engagement in this population. Methods: A total of 258 Black male patients of a Federally Qualified Health Center, with severe hypertension ( > 160mm Hg systolic or > 100mm Hg diastolic) were eligible. Patients were called using the phone number(s) in the electronic health record (EHR), and callers documented brief summaries of the call. At least 3 attempts were made to offer a free BP cuff, and provide longitudinal SMBP education and heart-healthy lifestyle counseling. NVivo was used for coding and content analysis, employing mixed inductive and deductive approaches to identify barriers to engagement. Coding structure included ‘communication’ and ‘engagement’, stratified by positive and negative attributes. Results: Analysis of initial outreach data (n=172) highlighted themes of unfavorable engagement to include excessive burden from competing health priorities and socioeconomic stress, and communication themes included unreliable phone numbers in the EHR hindering contact, and skepticism/mistrust of the caller by those patients reached. (Table). Conclusion: Optimizing engagement in SMBP programs to address hypertension disparities remains challenging, however improved SDOH screening and resource connection, system practices in EHR integrity, and understanding of patient mistrust of the health system may be key considerations. Ongoing thematic analyses on sustained SMBP skill-building and patient trust in care navigation may provide further insight on strategies to improve racial disparities in cardiovascular health outcomes.