PROJECT SUMMARY Non-communicable diseases (NCDs), including cancer, cardiovascular disease, diabetes, have become the greatest health threat for low and middle-income countries (LMIC). In Ghana, hypertension is recognized as a major public health challenge. The ubiquity of mobile phones in Ghana and the popularity of mobile communications make it possible to deliver mHealth interventions to our target population. However, there is crucial gap in knowledge of the effectiveness of mobile health technology-based interventions for hypertension management in SSA. The proposed AHOMKA mHealth platform is an evidence-based intervention to assist with management of hypertension in an urban and rural region of Ghana. AHOMKA is adapted from the Empower HealthTM system, a proprietary software application developed by Medtronic for direct patient-to- provider communication via a mobile application and text messaging for hypertension management. This US- Ghana collaborative R21/R33 research project will focus on adaptation of the Empower HealthTM system into the local context in an urban and rural region of Ghana by multi-level engagement with stakeholders. We have assembled a multi-national, multi-disciplinary team of researchers and medical device professionals with expertise in mobile technology development, hypertension, cardiology, population studies, and public health across multiple institutions in Ghana (University of Ghana, University of Health and Allied Sciences, Medtronic Labs Ghana) and the USA (Beth Israel Deaconess Medical Center, Tufts University). The proposed feasibility studies will be conducted at two large cardiovascular clinics in the Greater Accra region and the Volta region in Ghana. Phase One aims to (1) implement a user-centered, iterative design approach to adapt the mHealth platform based on feedback from stakeholders, and (2) conduct a 6-month usability and feasibility study with a cohort of patients. Phase Two aims to conduct a 12-month feasibility study to assess change in blood pressure among a cohort of patients in two regions of Ghana. In order to accelerate mobile health research in Ghana, we propose to form the AHOMKA Research and Education Network as part of the strategic capacity building plan.

PROJECT NARRATIVE The prevalence of mobile telephony in sub-Saharan Africa (SSA) creates an opportunity for the adoption of mobile technology for monitoring and control of hypertension, the most prevalent NCD risk factor. We propose to study the usability and feasibility of a Ghana-adapted, evidence-based mHealth platform to improve self-care and management of hypertension in an urban and rural region of Ghana. Capacity building initiatives include the formation of a research and education network to accelerate mHealth research in Ghana.