One in five Canadians has high blood pressure, but the condition is often poorly controlled among First Nations people because of challenges in health care access. The Dream Global Study hopes to change that with personalized text messages.
Dr. Sheldon Tobe, a nephrologist at Sunnybrook and a professor of medicine at the University of Toronto and Northern Ontario School of Medicine, along with Nancy Perkins, a Sunnybrook clinical research manager, have been studying northern communities’ health-care systems and the impact of social determinants on their health.
“We meet with the members of the community to try and figure out what their needs and realities are and how our study can best meet these needs,” says Perkins. “Often, access to fresh fruit and vegetables can be seriously limited in remote areas, and energy-dense foods like potato chips are readily available at a much lower cost, making them an attractive alternative.”
Perkins and Dr. Tobe have developed culturally-relevant text messages based on clinical practice guidelines. The messages are sent out twice weekly to cell phones. Simple flip phones are provided for study participants who need them.
“The text messages are short, to the point and hopefully impactful,” says Dr. Tobe. “As an example, for those communities who rely on canned foods, it could be as simple as suggesting rinsing food before eating it to reduce the sodium content. Taken together, over time, even small behavioural shifts can dramatically impact one’s risk of obesity, diabetes and high blood pressure.”
When a participant’s blood pressure is too high, they get text messages directing them to their health-care provider, who also receives the measurement data. This helps to close the loop for health care, and it helps patients engage in their own care.
The research will be ongoing for some time. The goal is to show that new and innovative technologies can successfully lower the risk of high blood pressure and the complications of heart disease in First Nations communities.