Participant Reported Barriers and Facilitators During Home Blood Pressure Monitoring

Barriers Facilitators 

1. Not at home/traveling (monitor not with them). 1. Visual--monitor is kept where participant

2. Forgot to take BP readings. can see it.

3. Distracted/busy with various activities (e.g., appointment, 2. Routine--home BP reading is part of their

work, housework, caregiving). daily routine; it is usually paired with

4. Technical problem with BP monitor/cuff (e.g., unpairing, another activity the participant does daily

full memory, batteries dying, cuff too tight, error (e.g., using bathroom, taking medication,

messages). eating breakfast).

5. Concern about BP readings (e.g., too high, too low, or 3. Reminders—different sources of

incorrect). reminders included ACL DASH staff,

6. Challenges/difficulties with study specific procedure (e.g., family, calendar, alarm, and phone.

2x/day readings, Tru-Read (triplicates), how to take BP 4. Caring about health (e.g., blood pressure).

reading). 5. Caring about research.

7. General emotional barriers (e.g., being sad, depressed, 6. Obligation—sense of duty being in study.

upset, anxious, worried, stressed, overwhelmed). 7. Familiarity—prior experience with self8. Sickness/pain due to health issues, illness, or surgery. home BP monitoring; they previously

9. Falls asleep before taking BP; not getting enough sleep, or owned a BP monitor.

other sleep issue. 8. Curiosity about BP readings.

10. Issues with specific time periods (e.g., difficult to do AM 9. Having assistance when taking readings.

readings, PM readings, or weekends).

11. Disruptions/lack of routine.

12. COVID-19—concern over pandemic, sickness, or

caregiving.

13. Thought the study ended (due to COVID-19).

14. Concern over home-delivered meals.

15. Using another BP monitor (own or someone else’s).

16. BP monitor is heavy, takes up space, or not portable.

17. Not having hypertension (being told by doctor or believing

this to be the case).

Comments about the Omron 10 home BP implementation

The home blood pressure device we chose, the Omron 10 Bluetooth monitor, is the most recent version of 

a consumer focused device optimized for patients to download and manage their own blood pressure files 

and forward files to their providers (or research team staff) via email. For digitally savvy patients or

participants who are able to manage their own account registration, device synchronization, and

downloads, this device is very convenient and could work in replication of a research project with home 

blood pressure monitoring, 

In our study, since a significant fraction of the participants had limited experience with digital devices, the 

study team set up individual accounts for each participant, synchronized their devices to their online 

accounts at download visits, paired them to tablets for downloading, and when the downloads 

malfunctioned, manually recorded the data or collected photographs of the device screens. With 100

devices, accounts, and pairings to manage at every update, the data collection involved a large amount of
effort and logistics, ongoing. When the pandemic imposed social distancing, managing the devices and 

downloads remotely via telephone conversations with seniors proved even more challenging. 

For participants who are not smartphone and internet savvy and cannot manage the remote data transfer 

on their own, we would not recommend replicating our implementation. We would recommend exploring 

other platforms with direct transfer of data, home-bp -monitoring buddies.