Researchers tested whether watching videos of Black veterans sharing their health stories, combined with text messages, could help other Black veterans better manage high blood pressure. Over 600 Black veterans participated in the study, with some receiving the video and text message program and others receiving only text messages. After 6 months, both groups improved their blood pressure slightly, but the group with videos didn’t do better than the group with just text messages. However, most participants found the text messages motivating and helpful for staying on track with their health goals.

The Quick Take

  • What they studied: Whether watching inspiring videos from other Black veterans combined with text messages could help Black veterans control their high blood pressure better than just getting text messages alone.
  • Who participated: 600 Black veterans (mostly men, average age 64) who were taking at least one blood pressure medication. The study took place at two Veterans Affairs hospitals in Chicago and Philadelphia from 2021 to 2023.
  • Key finding: Both groups improved their blood pressure slightly over 6 months, but the group that watched videos and got text messages didn’t improve more than the group that only got text messages. However, 79.5% of all participants said text messages were helpful for staying motivated about their health.
  • What it means for you: If you’re a Black veteran with high blood pressure, text message reminders may help keep you motivated to manage your health. The videos didn’t add extra blood pressure benefits, but they did help people feel more connected and understood. Talk to your doctor about what support tools might work best for you.

The Research Details

This was a randomized clinical trial, which is considered one of the strongest types of research studies. Researchers randomly divided 600 Black veterans into two groups. One group (the intervention group) watched five short videos (5-7 minutes each) featuring Black veterans sharing real stories about their struggles and successes managing high blood pressure. These participants then selected their favorite storyteller and received text messages for 6 months that included quotes from that person, educational tips, and two-way conversations. The other group (control group) received only the two-way text messages without the videos.

The study measured blood pressure at the beginning and after 6 months. Researchers also asked participants about their medication use, diet, and exercise habits. The study was conducted at two Veterans Affairs medical centers and followed participants for about 2 years total, with the main intervention lasting 6 months.

This research design is important because it allows researchers to see whether the videos actually made a difference beyond just getting text messages. By randomly assigning people to different groups, researchers can be more confident that any differences are due to the intervention itself, not other factors. The study also measured real health outcomes (blood pressure) rather than just asking people if they felt better.

This study has several strengths: it was published in a highly respected medical journal (JAMA Network Open), it included a large number of participants (600), it had a good follow-up rate (86% completed the study), and it focused on an important health disparity affecting Black veterans. The study was not blinded, meaning participants knew which group they were in, which could have influenced their behavior. The study was also conducted at only two locations, so results may not apply to all Black veterans everywhere.

What the Results Show

The main finding was that both groups improved their blood pressure over the 6-month period, but the improvement was similar in both groups. The group that received videos plus text messages did not have better blood pressure control than the group that received only text messages. The entire group of 600 veterans showed a small but meaningful decrease in systolic blood pressure (the top number) of about 2.1 points and diastolic blood pressure (the bottom number) of about 1.8 points.

Interestingly, the videos were very well-received by participants. About 92.5% of people in the intervention group said they could identify with the veterans in the videos, suggesting the stories were relatable and meaningful. This shows that even though the videos didn’t improve blood pressure more than text messages alone, they did help people feel understood and connected.

The study also looked at whether participants improved their medication adherence (taking pills as prescribed), diet, and physical activity. There were no significant differences between the two groups in these areas either. However, text messages proved to be a powerful motivational tool overall. About 79.5% of all participants (410 out of 516 who completed the study) described text messages as helpful motivators for improving their health. The response rate to text messages was 57.5%, meaning people actively engaged with the messages by responding to them.

Previous research has shown that text message interventions can help people manage chronic diseases like high blood pressure. This study confirms that text messages are helpful for engagement and motivation in Black veterans specifically. However, this study suggests that adding video stories to text messages may not provide additional blood pressure benefits beyond the text messages alone. This is a valuable finding because it helps researchers understand what components of health interventions are most effective.

The study had several limitations to consider. First, it was not blinded, meaning participants knew which group they were in, which could have affected their behavior or how they reported their results. Second, the study only included Black veterans at two locations, so the results may not apply to all Black veterans or to other populations. Third, the study lasted only 6 months, so we don’t know if benefits would continue or change over longer periods. Fourth, blood pressure can naturally go up and down, and the improvements seen in both groups were relatively small. Finally, the study relied partly on self-reported information about medication use and lifestyle changes, which may not always be completely accurate.

The Bottom Line

If you’re a Black veteran managing high blood pressure, consider using text message reminders and support as part of your health plan. Text messages appear to help with motivation and engagement (moderate confidence). The addition of video stories from other veterans is nice for feeling understood and connected, but may not provide extra blood pressure benefits beyond text messages alone (moderate confidence). Continue taking your blood pressure medications as prescribed and follow your doctor’s recommendations about diet and exercise.

This research is most relevant to Black veterans with high blood pressure who are looking for additional support tools. It may also interest healthcare providers working with Black veterans and researchers studying health disparities. People of other races or non-veterans with high blood pressure should talk to their doctor about whether these findings apply to them, as this study focused specifically on Black veterans.

In this study, participants saw small improvements in blood pressure within 6 months. However, these improvements were modest (about 2 points on systolic blood pressure). Most people should expect to see changes in motivation and engagement with text messages much faster—within the first few weeks. Significant blood pressure improvements typically take several months of consistent effort with medication, diet, and exercise changes.

Want to Apply This Research?

  • Track your systolic and diastolic blood pressure readings weekly at the same time of day. Record the date, time, and reading in your app. Also track whether you took your blood pressure medication each day (yes/no). This creates a clear picture of your progress over weeks and months.
  • Set up daily text message reminders to take your blood pressure medication at the same time each day. Use the app to log when you receive motivational messages and rate how helpful they were (1-10 scale). This helps you stay engaged and shows which types of messages work best for you personally.
  • Review your blood pressure trends monthly in the app to see if readings are staying stable or improving. Share these trends with your doctor at regular appointments. Also track your engagement with text messages—if your response rate drops below 50%, consider adjusting the frequency or type of messages you receive. Set a monthly goal to maintain at least 50% engagement with health-related text messages.

This research suggests that text messages may help with motivation for managing high blood pressure in Black veterans, but the study did not show that video stories added extra blood pressure benefits. These findings should not replace medical advice from your doctor. Always take your blood pressure medications as prescribed and follow your healthcare provider’s recommendations. If you have questions about whether this intervention is right for you, discuss it with your doctor or healthcare team. This study was conducted over 6 months, so long-term effects are unknown. Results may vary for different individuals.