Assessing Daily Antihypertensive Medication Compliance Among Black Adults Using Smartphone-Based Ecological Momentary Assessment

Lower compliance to antihypertensive medication among the Black population, the gold standard for hypertension management, increases their risk of uncontrolled hypertension and serious health complications. One effective strategy for improving compliance with hypertension self-management involves real-time assessment of behavior using ecological momentary assessment in a person's natural environment. This allows for the determination of self-management behavioral patterns such as medication compliance, as well as overcoming the limitations of recall bias common in retrospective cross-sectional data. In the few ecological momentary assessment studies focused on hypertension self-management, individuals of Black descent are significantly underrepresented. We aimed to assess the feasibility and acceptability of smartphone-based ecological momentary assessment among Black adults with hypertension (n = 34), in the context of compliance to antihypertensives. Of the 952 assessment prompts delivered to participants' smartphones, participants responded to 918 (96.4%). Daily medication compliance was high among participants-25 days out of 28 (M = 24.71, SD = 6.79). Participants indicated they had a good experience with the assessment method and their intention to participate in future studies of this method. Our study demonstrated that a digitized smartphone-based ecological momentary assessment is a promising, feasible, and acceptable approach for assessing hypertension self-management behavior among Black adults.