Continuing the Conversation: Using Narrative Communication to Support Hypertension Self-management in African American Veterans

NCT03970590 | Completed Results DMC

• 1 other identifier: IIR 17-185
• Study Type: interventional
• Target: 600
• Locations: 1 country
• Sites: 3

Brief Summary

In this study the investigators will conduct a randomized controlled trial aimed at improving hypertension self-management and lowering blood pressure (BP) in African-American Veterans. In this study, the investigators 'begin the conversation' by showing previously created videos to Veteran participants, inviting them to select the peer narrative that is most compelling. The investigators then 'continue the conversation', offering longitudinal support via 6 months of narrative-aligned text messages. Texts will cover key subject areas, providing education, reminders and periodic assessments, and include quotations derived from and aligned with transcripts from the chosen narrative. The investigators will measure the intervention's impact on BP, self-efficacy and self-management behaviors, and conduct a cost analysis.

Conditions

Hypertension

Keywords

hypertension; Minority Health; health behavior; text messaging

Outcome Measures

Primary Outcomes (1)

• BP Measurement Change at Follow-up

  Blood Pressure (H1), will be calculated / performed to detect a difference in the change in both Diastolic and Systolic BP, comparing intervention and control.

  From enrollment to the time of follow-up, up to 8 months

Study Arms (2)

CTC

EXPERIMENTAL

An integrated peer narrative-based intervention (VIEW \> SELECT \> GET), beginning with VIEW In-person viewing of VA Stories narratives, followed by SELECT a favorite Veteran Storyteller, and then GET favorite Storyteller "narrative-aligned" text messages over 6 months

Behavioral: CTC Intervention

Control

ACTIVE COMPARATOR

6-month HTN management assessment text messages without narrative component

Behavioral: Control

Interventions

CTC Intervention BEHAVIORAL

An integrated peer narrative-based intervention (VIEW \> SELECT \> GET), beginning with VIEW In-person viewing of VA Stories narratives, followed by SELECT a favorite Veteran\] Storyteller, and then GET favorite Storyteller "narrative-aligned" text messages over 6 months

Also known as: CTC

CTC

Control BEHAVIORAL

6-month HTN management assessment text messages without narrative component

Also known as: Active Comparator

Control

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Veterans who have been receiving care at the recruiting VA site for 1 year prior to recruitment
• With 2 or more visits documented over the past year
• Veterans who have documented HTN (ICD10 diagnosis codes: I10-essential HTN) during this 1-year period
• Patients who self-identify as African American or Black
• Participants must be on at least one medication for BP
• Need to have access to their own or a family member's cell phone or smart phone for participation
• Must be willing to use this phone for receipt of text messages over a 6-month period

You may not qualify if:

• Veterans who participated in our previous VA Stories study
• Veteran who fail the memory and concentration questions asked in the screening survey
• Pregnant Veterans (verified by self-report)

Sponsors & Collaborators

• VA Office of Research and Development: lead

Study Sites (3)

Jesse Brown VA Medical Center, Chicago, IL

Chicago, Illinois, 60612, United States

Location

VA Bedford HealthCare System, Bedford, MA

Bedford, Massachusetts, 01730-1114, United States

Location

Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA

Philadelphia, Pennsylvania, 19104-4551, United States

Location

Related Publications (2)

• DeLaughter KL, Fix GM, McDannold SE, Pope C, Bokhour BG, Shimada SL, Calloway R, Gordon HS, Long JA, Miano DA, Cutrona SL. Incorporating African American Veterans' Success Stories for Hypertension Management: Developing a Behavioral Support Texting Protocol. JMIR Res Protoc. 2021 Dec 1;10(12):e29423. doi: 10.2196/29423.

  PMID: 34855617 RESULT

• Cutrona SL, McDannold SE, DeLaughter KL, Fix GM, Shimada SL, Bokhour BG, Gordon HS, Pope C, Smith BM, Ndiwane N, Gardner J, DeFelice DC, Bal ES, Long JA. Text Messaging and Video Stories to Support Hypertension Self-Management in Black Veterans: A Randomized Clinical Trial. JAMA Netw Open. 2025 Nov 3;8(11):e2541342. doi: 10.1001/jamanetworkopen.2025.41342.

  PMID: 41191358 DERIVED

MeSH Terms

Conditions

Hypertension; Health Behavior

Condition Hierarchy (Ancestors)

Vascular Diseases; Cardiovascular Diseases; Behavior

Results Point of Contact

• Title: Sarah Cutrona, MD
• Organization: VA Bedford Healthcare System Center for Health Organization and Implementation Research

sarah.cutrona@va.gov

781-687-2861

Study Officials

• Sarah L Cutrona, MD

  VA Bedford HealthCare System, Bedford, MA

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: FED
• Responsible Party: SPONSOR

Model Details: The investigators will conduct an RCT testing the CTC intervention (video viewing, selection of preferred narrative, narrative-aligned text messages) compared to assessment text messages alone.

Study Record Dates

• First Submitted: May 30, 2019
• First Posted: May 31, 2019
• Study Start: January 30, 2021
• Primary Completion: May 4, 2023
• Study Completion: May 4, 2023
• Last Updated: April 3, 2025
• Results First Posted: April 3, 2025

Record last verified: 2025-03

Data Sharing

• IPD Sharing: Will share

Locations

US (3)