Abstract 4147594: Improving Pregnancy Outcomes through Remote Monitoring and Rewards for Participation

Background: Mental health issues, preeclampsia, and eclampsia were among the leading causes of pregnancy-related deaths from 2018-2020 in Georgia. Studies from other countries have suggested that self-measured blood pressure (SMBP) among pregnant and postpartum women is a feasible method for reducing the risk for hypertension-related pregnancy complications (e.g., preeclampsia, eclampsia). Long-term risks of CV issues during pregnancy are known to increase the risk of stroke and heart attack later in life. Despite the benefits of SMBP, its impact is understudied among at-risk women during and after pregnancy. Therefore, we aimed to explore if incentives are associated with an increase in blood pressure (BP) reporting among pregnant and postpartum women utilizing the VidaRPM application. Methods: 91 women (67.5% HS or less, 58.8% Black, Mean Age = 27.01y) were randomized to the control (usual care, n=30), regular (SMBP through VidaRPM, n=30), or incentivized (SMBP with incentives, n=31). All women were between 13 and 34 weeks of pregnancy. All participants received a blood pressure monitor, and online education resources, and were asked to record BP three times a week and one mental health survey a week during pregnancy until the 12 th week postpartum. Regular SMBP participants received additional education, self-efficacy assessment, and ongoing support. Incentive participants received an additional $25 gift card for full engagement between 34 weeks of pregnancy and 6 weeks postpartum. Women who reported BP outside the normal range were instructed to follow up with their providers. Results: Moms in the Control Group had full engagement for 5 out of 304 weeks, regular SMBP arm for 56 out of 245 weeks, and Incentive arm, for 76 out of 254 weeks. The difference among all three groups is statistically significant (p-value = 9.7e-15) however the difference between the two treatment groups is not. Discussion: The incentive and regular SMBP groups demonstrated significantly increased adherence to reporting compared to control, and the incentive group more than regular group. This result supports incentivized SMBP during and after pregnancy, possibly reducing missed hypertensive issues and reducing the risk of unmonitored long-term cardiovascular outcomes. Improving women’s self-efficacy and knowledge of risk among at-risk populations will positively impact short and long-term CV health.