Nurse-Led Development and Pilot Evaluation of a Hypertension Self-Management App in a Rural, Underserved Academic Medical Setting

Background/Objectives: Rural and underserved adults face barriers to hypertension (HTN) self-management, and in-person lifestyle education programs in academic medical settings may have limited reach This pilot study evaluated a publicly available HTN self-management app (iOS/Android) with respect to feasibility, perceived usefulness, user satisfaction, and user-entered metrics relevant to HTN and lifestyle management. Methods: We conducted an internet-based, single-arm pilot of a mobile app available in commercial app stores. Adults aged ≥19 years who downloaded the free app and reported HTN self-enrolled via in-app registration and electronic consent; no direct recruitment or compensation was provided. Outcomes included an in-app questionnaire (HTN history, perceived BP status, concern, and a key self-management behavior) and app engagement/health-entry data (registration counts; use of tracking features; distributions of user-entered metrics). Results: From June 2020–July 2025, 819 users completed the in-app questionnaire; five were excluded as spam (N=814). Responses clustered in 2021 (76.8%), and completion time was brief (median 91 s; IQR 65–131). Most respondents reported hypertension for >2 years (57.3%; 21.5% unsure). Perceived BP was “normal” (42.1%), “borderline” (24.8%), or “high” (15.2%), with 15.0% unsure. For a key self-management behavior, only 21.8% reported measuring their blood pressure “usually/always,” while 24.8% reported never measuring their blood pressure. More than half were at least somewhat concerned about their BP (56.6%). Conclusions: In a largely rural, southeastern context, this publicly available HTN app demonstrated feasible low-touch uptake and captured user-entered self-management data, though sustained tracking occurred in a subset of users. Findings support further pragmatic testing focused on engagement, equity, and integration into nurse-led care workflows.