Innovative Tools to Expand Music-Inspired Strategies for Blood Pressure and Stroke Prevention (I-TEST BP/Stroke)

Expanding evidence-based blood pressure/stroke prevention interventions for youth and their older adult caregivers (parents, grandparents, etc.) is critical to achieving the World Health Organization (WHO) and Nigerian goals for reducing the hypertension and stroke burden. Innovative strategies that engage local communities, link younger and older generations, and decrease health disparities are urgently needed. Music is a positive social determinant of health that is inclusive and can allow people to achieve healthy outcomes. It is also a non-invasive, safe, inexpensive, evidence-based implementation strategy, that can be used to engage youth in intervention design and evaluation tailored to their specific needs and those of their older adult caregivers. The effectiveness of music as an implementation strategy has been documented in various randomized control trials, including blood pressure and stroke prevention interventions. Nigeria also has a rich music culture that can be leveraged to increase uptake of evidence-based BP/stroke interventions. We propose “Innovative Tools to Expand Music-Inspired Strategies for Blood Pressure and Stroke Prevention (I- TEST BP/Stroke)” to accelerate behavioral BP/stroke campaigns in Nigeria inspired by music. I-TEST- BP/stroke will use participatory crowdsourcing methods to drive BP/stroke prevention among youth/caregiver dyads in Nigeria. Crowdsourcing open calls will allow us to identify locally relevant music-inspired campaigns to increase uptake of BP/stroke prevention. Then, apprenticeships with music and public-health professionals will build capacity for implementing these campaigns using common music elements (i.e., rhythms, beats, lyrics) known to impact cardiovascular health. Our preliminary data from Nigeria demonstrate that youth can develop effective public health interventions using these participatory methods. Our partnership with the Nigerian Institute of Medical Research provides extensive experience in implementation research, participatory methods, and pragmatic trials. Building on this strong foundation, our multi-disciplinary research team proposes a hybrid type II implementation trial with these specific aims: (1) to develop a new, combined, music- inspired BP/stroke campaigns for youth/caregiver dyads using crowdsourcing open calls and apprenticeships; (2) to determine whether the final music-inspired campaign increases uptake of BP/stroke prevention interventions among youth and their caregivers using a stepped-wedge, pragmatic randomized controlled trial (RCT) in 30 geographic areas; (3) to use mixed-methods approach to explore multi-level factors that influence the uptake of the music-inspired strategy. Our primary outcomes will be the uptake of strategy and BP/stroke preventive measures defined here as maintenance of normal BP rates for youth, systolic blood pressure reduction for caregivers, and increase in stroke preparedness knowledge. Secondary outcomes are reach, fidelity, acceptability, and sustainment. Our study is responsive to the strategic priorities of the United States National Institutes of Health, Sound Health, the WHO, the Nigerian Ministry of Health and PAR-22-132.