AU researchers use library check outs to check in on cardiovascular health

High blood pressure affects nearly half of adults in the United States and kills more than half a million Americans every year, according to the Centers for Disease Control and Prevention. The problem is more severely concentrated in the South, known as the Stroke Belt.

“There are significant chronic disease risk factors in this so-called Stroke Belt. We’ve got high obesity rates. We have family history. We have high rates of diabetes and kidney disease and they all kind of feed into each other to really create this cardiovascular health need in our communities. And women, in general, are just at a higher risk for this,” said Marlo Vernon, PhD, associate professor in the Department of Health Management, Economics, and Policy in Augusta University’s School of Public Health.

Vernon is the community education coordinator for AU’s Rural Obese At-Risk initiative led by Jennifer Sullivan, PhD, dean of The Graduate School. The team has been working to raise awareness about high blood pressure – its risks, prevention methods and the control and treatment of hypertension. One of the main problems people in rural areas face is access to care, as well as access to preventative measures like healthy food, primary care providers and medicine.

Brianna McIndoe, community outreach coordinator for the School of Public Health, spent months visiting close to 20 rural counties in the state, meeting women where they are – grocery stores, farmers’ markets, shopping centers, gyms and more – to ask them research questions and gather data for this project.

Some of the stories McIndoe and Vernon have encountered through their research are troublesome, including women walking a mile or more – often in the heat of a Georgia summer – to use a blood pressure monitor in public. It’s a problem because it’s not an ideal way to get an accurate reading. And then there are women facing the choice of paying for food for their children or taking care of their own health with medicine or a blood pressure monitor.

“There was one woman who, after she gave birth to her daughter, her blood pressure spiked to 210/120, and the doctor told her to go home and take a bubble bath,” McIndoe recalled in disbelief. “She ended up having to rush to the emergency room the next day, and a rural county emergency room was something like an hour and a half away.”

What they learned motivated Vernon and McIndoe to provide public blood pressure monitors in areas of need in the state, so they started at the Sparta-Hancock County Library in the Azalea Regional Library System last spring. They supply five blood pressure cuffs per library, making them available for anyone to check out.

The researchers have noted two main motivations for people to check out a blood pressure monitor: they’re interested in what their blood pressure is and want to start logging it, or their physicians have told them they need to regularly chart their blood pressure for health reasons.

If they don’t have a home monitor, this initiative can potentially eliminate the burden of having to repeatedly go to a Walmart, CVS or other public place in order to produce a log to provide to their doctors. The blood pressure cuffs available at the participating libraries make logging blood pressure and creating long term data for their physicians a viable option. Patients can improve accuracy by measuring their blood pressure at the same time each day, after a period of rest, before drinking coffee, all from the comfort of their home.

In the last few months, McIndoe has delivered more blood pressure cuffs to other library systems in Jefferson County and northeast Georgia. Vernon and McIndoe have divided the state into five sections based around the satellite campuses of the Medical College of Georgia at Augusta University. As their research continues, they’ll check back in with libraries to get demographic information on who is checking the BP monitors out and how often.

Through this project, Vernon is deeply committed to finding out what people in more rural areas know about cardiovascular health and whether they’re able to access care in a timely manner. If they are not, she’s particularly interested in what barriers need to be removed.

“We try to talk about it in terms of opportunities. Where are our opportunities for growth, improvement or change? I’ve done similar research before talking to women about real care, because my specialty area is maternal-child health, and I do a lot of work with maternal mortality prevention,” Vernon explained. “I knew from that work that access to the internet is very limited and so far, broadband internet is not ubiquitous across the state. A lot of people just don’t have access to the internet.”

Assessing access to technology plays an important role in the plans for moving the project forward. Internet access makes a big difference in what kinds of tools the researchers put together for the women to be able to use.

“That really helps us to identify what kinds of interventions we can create. If you have internet access, we can do online learning projects. We can create some really cool materials for distribution. So, we are thinking through, what are some ways we can take these amazing resources we have at MCG and AU and put it to the community in a way that they can really access it,” Vernon said.

Another common barrier women in previous studies have mentioned is uncertainty about who and what to trust when finding health information online or in other publications.

“There’s so much information out there, but then being able to use some health literacy skills to really distill what’s legitimate and what’s not legitimate and whether or not they feel confident talking to their doctor about it. Or they’re listening to someone they found on TikTok or Instagram, they just wanted a source they knew they could trust. We included questions about that as well in our research,” Vernon said.

Education is one way to move this project forward. A future component of the blood pressure monitor check-out boxes will be including a guide on how to interpret blood pressure.

Vernon and her team hope clarity is an outcome of this outreach project.

“People tell us all the time, ‘I go to the doctor and they tell me my blood pressure’s fine. I go another time and they tell me it’s good. I don’t know the difference between good and fine,'” Vernon recalled. “So we have a card from the American Heart Association that helps detail that – that’s one component. Another component is how to properly take their blood pressure. Reminders about all the different steps like sitting still, not drinking a cup of coffee before you sit down, things like that.”

More education and training projects are planned for 2026, and McIndoe, whose passion is public health, is thrilled to be on a team making a difference in people’s lives.

“I’ve really loved working on this project, and it’s been so exciting to see it get underway. I love being able to hear all these different stories and talk to all these different women, but actually seeing we’re able to do something in the community and seeing something that’s actually tangible, I’m super excited about that. I’m so glad to be a part of it,” she said.