Veterans

Grand Rounds March 27, 2026: Text Messaging and Video Stories to Support Hypertension Self-Management in Black Veterans: A Randomized Clinical Trial (Sarah L. Cutrona, MD, MPH)

Posted on by Sophia Ramirez

Speaker

Sarah L. Cutrona, MD, MPH
Acting Director, Center for Health Optimization and Implementation Research (CHOIR)
VA Bedford Healthcare System
Professor, Division of Health Informatics and Implementation Science
Department of Population and Quantitative Health Sciences
UMass Chan Medical School

Keywords

Blood Pressure; Hypertension; Self-Management; Video; Texting; Black Americans; Veterans

Key Points

  • Black Americans experience disproportionate morbidity and mortality due to hypertension (HTN). Simultaneously, self-management is made more difficult by differential rates of diagnosis and treatment titration; decreased access to, trust in, and engagement with the healthcare system; and cost, access, and environmental barriers. This study sought to improve HTN control and self-management among about 600 Black Veterans by supplementing a preexisting video story intervention with longitudinal texting support.
  • Those in the intervention arm watched 5 video stories featuring other Black Veterans, chose their preferred storyteller, and received educational and interactive messages aligned with that storyteller. Those in the control arm received only interactive messages. The researchers hypothesized that peer stories would promote participants’ emotional engagement with the messages via a parasocial relationship with the storyteller, enhancing self-efficacy, influencing health behaviors and ultimately improving HTN control.
  • While participants in both arms saw marginal improvements in systolic and diastolic blood pressure (BP), there was no significant difference in the BP change between the arms. The intervention saw high treatment fidelity (92%) and sustained engagement, with over 55% of participants responding to texts through the end of the 6-month period. The researchers concluded that the interactive text messages, which were present in both arms, were an effective way to maintain engagement in a multi-month study and may serve as a useful strategy for future longitudinal interventions supporting Black Veterans.

Discussion Themes

The control group was intentionally kept active – i.e., received educational texts – to isolate the specific impact of storytelling rather than just the impact of receiving text messages.

The intervention was shaped by direct feedback from veteran consultants, who provided guidance on tone, word choice, and structure to ensure the messages felt authentic.

Attendees noted that negative studies are vital for informing future research and that the intervention provided valuable moments of outreach to a population facing socioeconomic vulnerabilities and isolation.

Grand Rounds February 20, 2026: Applying Mind-Body Skills for Pain Using a Whole Health Telehealth Intervention (RAMP): Early Progress and Lessons Learned (Diana Burgess, PhD; Roni Evans, DC, MS, PhD; Katie Hadlandsmyth, PhD)

Posted on by Sophia Ramirez

Speakers

Diana Burgess, PhD
Professor of Medicine,
University of Minnesota
Director, VA Advanced Fellowship Program in Health Systems Research, Center for Care Delivery and Outcomes Research (CCDOR),
Minneapolis Veterans Affairs Healthcare System
Director, QUERI Complementary and Integrative Health Evaluation Center (CIHEC),
Veterans Affairs Healthcare System

Roni Evans, DC, MS, PhD
Research Professor
Director, Integrative Health & Wellbeing Research Program
Earl E. Bakken Center for Spirituality & Healing,
University of Minnesota

Katie Hadlandsmyth, PhD
Associate Professor
College of Nursing
University of Iowa

Keywords

Chronic Pain; Whole-Health; Biopsychosocial; Veterans Administration (VA); Rural Populations

Key Points

  • Rural Veterans exist at the intersection of 2 populations that are disproportionately affected by chronic pain. Compared to urban Veterans, rural Veterans are less likely to receive comprehensive and specialty pain care; are more likely to be prescribed opioid medication; and utilize pain self-management strategies at lower rates. The Veterans Administration (VA) serves 2.7 million rural veterans.
  • Seeking to improve pain management and reduce opioid use among rural patients, VA researchers developed the Rural Veterans Applying Mind Body Skills for Pain (RAMP) intervention. RAMP addresses pain as a biopsychosocial condition, providing rural VA patients with the opportunities and resources to enhance their capabilities and motivations to engage in helpful pain self-management behaviors.
  • A pilot study found that the intervention met milestones for enrollment, satisfaction, and fidelity. The researchers concluded that a full-scale randomized trial of a complementary and integrative health telehealth program for rural VA patients with chronic pain is feasible and can meet pain self-management needs. Their intervention and study processes have been refined to increase engagement and data collection.
  • In March 2026, the team will begin enrollment for a Type II randomized hybrid-effectiveness implementation trial.

Discussion Themes

The team emphasized the need for “resilient interventions” that can withstand external disruptions, such as natural disasters and VA workforce restructuring.

Relationship-building with high-level and local stakeholders was essential for navigating the VA’s complex and dynamic organizational structure. The researchers detailed their strategy for managing stakeholder panels, which included roughly 21 core members (i.e., patients and community advisors) and 10 internal VA stakeholders.