Uncontrolled hypertension among young adults (18 to 39 year-olds) [1] is an enormous public health burden [2,3]. In the United States, over 10 million 18 to 39 year-olds (1 in 5 men; 1 in 6 women) have hypertension [4-7], increasing their risk of premature heart failure, stroke, and chronic kidney disease [4,8-11]. Young adults with hypertension have a high lifetime risk for cardiovascular disease due to the longer exposure to high blood pressures and ongoing risk of organ damage [11-17]. Hypertension control reduces morbidity, mortality, and future healthcare costs [18-22]. Yet, only 40% of young adults with hypertension in the United States have achieved blood pressure control (defined as a blood pressure less than 140/90 mmHg) [23-27]. Our prior research demonstrated that within 1 year of developing hypertension, almost half of young adults do not receive guideline recommended lifestyle counseling [28]. Young adults are also less likely to receive a hypertension diagnosis and, if necessary, medication initiation compared to middle-aged and older adults [29,30].

To further understand barriers to young adults achieving hypertension control, we engaged racially and ethnically diverse young adults in 6 focus groups and conducted one-on-one interviews with primary care providers [31,32]. Two focus groups were conducted at each site: 1 academic, 1 urban, and 1 rural healthcare system [31,32]. The young adult respondents identified hypertension education topics that were not commonly addressed in current educational materials [32]. Young adult respondents shared their preferred social media channels and requested Web-based education to provide flexible access to hypertension information “when they wanted it” [32]. Primary care providers shared similar views of lacking hypertension materials and/or the time for extended education for young adults [31]. Both groups also highlighted other common barriers (eg, transportation, work-life balance, financial limitations) to hypertension care delivery. The combined qualitative and quantitative data highlighted the need to provide a website tailored to young adults with hypertension.

Prior studies demonstrated that when patients with hypertension receive health education targeted to their needs, their self-management of hypertension improves (eg, behavior changes, home blood pressure monitoring) [33]. In addition, patient education should provide a sense of personal medical empowerment to promote, initiate, and maintain health behavior changes [32,34]. Finally, hypertension education can serve as a bridge between clinic visits. To address an unmet need in the delivery of hypertension care for young adults, we developed the My Hypertension Education and Reaching Target (MyHEART) program, a young adult hypertension education program.

The aims of MyHEART are to (1) decrease barriers to young adult hypertension care delivery; and (2) improve hypertension control in this hard to reach population. It is known that website education alone is insufficient for long-term health behavior change; however, it can be effective as an additional component to ongoing hypertension control initiatives [35]. Therefore, the goals of the MyHEART website [36] are to (1) be a portable resource for young adults’ questions and challenges with managing blood pressure; and (2) supplement the hypertension clinical care and education of healthcare teams and organizations. The aims of this proposal were to (1) develop the architectural structure of the MyHEART website through community engagement partnerships; and (2) launch and disseminate the MyHEART website to clinicians, healthcare systems, and community organizations committed to hypertension control.

Prior studies [31,32,37] that informed the MyHEART website development were approved by the University of Wisconsin-Madison Health Sciences Institutional Review Board (IRB) and informed consent was obtained from patient and clinician stakeholders. Neither IRB approval nor written consent were needed to design or implement this website because the data that informed MyHEART development was already described in the original IRB submission for the prior studies.

The Dissemination Planning Tool of the Agency for Healthcare Research and Quality (AHRQ) [42] was used to outline and navigate the dissemination plan that was started in February 2017. The website and toolkit were first disseminated through HIPxChange [43] in association with the University of Wisconsin HIP. In late 2012, HIP launched HIPxChange to disseminate evidence-based programs, tools, and other materials for free to the public [44]. The goal of HIPxChange is to accelerate the translation of new and existing knowledge into clinical practice to improve healthcare delivery and health outcomes.

Additional dissemination avenues included clinician notifications, academic and healthcare marketing teams, university/campus health centers, research communities, and public community announcement boards (eg, grocery stores, coffee shops, etc). Regional dissemination efforts include the Wisconsin Collaborative for Healthcare Quality (WCHQ). This is a voluntary consortium of 37 Wisconsin healthcare organizations (physician groups, hospitals, health plans) that has led the nation in measuring and improving healthcare quality for multiple chronic conditions [45,46]. Social media streams (eg, Facebook, Twitter, health blogs) have been activated.

The MyHEART website and corresponding toolkit were successfully developed with diverse young adult, community, and academic stakeholders. The website can provide young adults with evidence-based hypertension information to support their self-management goals. The corresponding toolkit can support clinicians’ efforts to share knowledge about hypertension with young adults and offer counseling about behavior change. The authors successfully engaged clinical staff and their patients across healthcare systems and are actively working to engage young adults in the community (with limited healthcare access). The MyHEART website’s accessibility on mobile platforms helps target the young adult population. However, the authors are learning how to increase the duration of engagement of young adults on the website. For example, an interactive functionality is in development with the goal of increasing the length of time young adults use the website and acquire hypertension information.

We recognize that the website and toolkit were created in English, limiting access to young adults and clinicians who are not fluent in English. However, our team plans to make these materials available in Spanish. The website also currently lacks interactivity, but we plan to add this in the near future. Finally, we did not conduct a comparative analysis with other technology or programs. We are continuing to expand our dissemination activities and will develop multidimensional interventions in the future.

In collaboration with young adults, health systems, and community stakeholders, the MyHEART young adult website is a portable resource to provide evidence-based information to a hard-to-reach population. The MyHEART website and toolkit provide resources for patients, clinicians, and healthcare organizations to improve hypertension control in young adults