Article

Innovating Hypertension Management Amongst Refugees in San Diego

4 min read

Refugees are a subset of the population that suffer displacement and other stressors, and once they reach their new home country, medical conditions including hypertension can go undetected and untreated. However, research into this very topic began in February 2021. The study entitled “Perceptions, Knowledge, and Attitudes Towards Hypertension Management among Refugees in San Diego” is being carried out by Dr. Tala Al-Rousan, a founding faculty member at the Herbert Wertheim School of Public Health at the University of California San Diego, in partnership with Dr. Job Godino who leads the Laura Rodriguez Research Institute at the Family Health Care Centers of San Diego.

Throughout the program, participants are using Withings BPM Connect, a smart blood pressure monitor, as well as the Withings Data Hub, a cellular gateway used to collect measurements. The study is funded by The National Heart, Lung, and Blood Institute of the US National Institutes of Health. It aims to contribute to a relatively small body of literature surrounding the unaddressed global challenge of uncontrolled blood pressure in displaced populations including refugees and asylum seekers. The problem of hypertension among displaced peoples is even more prevalent as the numbers of refugees continue to increase due to higher rates of violence, natural disasters, and health inequities.

A specific goal of the project is to examine the feasibility of self-administered blood pressure monitoring through supportive healthcare infrastructure. The study hopes to show preliminary data that refugee patients can and prefer to take leadership over their hypertension management from where they are residing in combination with receiving guidance on medication titration plans from their healthcare providers.

In combination with BPM Connect, Drs. Al-Rousan and Godino’s teams collect patient data using Withings remote patient monitoring (RPM) solution. Both device and RPM help solve several pain points that participants may face such as interrupted healthcare access, economic hardship, language barriers, and varying levels of health literacy and numeracy. Regarding interrupted access, going to the doctor can be difficult for participants as some may have employment that does not allow for brief leave from work; since the device can be used at home, less time needs to be budgeted. BPM Connect also uses one button to take measurements which reduces potential language and use factors. Finally, any question of whether participants can access the internet has been assuaged using Withings Data Hub, a cellular gateway that requires no installation from users and securely connects retrieved data to the Withings RPM solution without requiring a smartphone or Wi-Fi.

The study includes 80 Aramaic and Arabic-speaking refugees with diagnosed uncontrolled blood pressure. Participants were recruited in consultation with ethnic community-based organizations in San Diego that serve refugees including Al Majdal Center and others. Multicultural and multilingual investigators with expertise in refugee health, digital health, epidemiology, and chronic disease prevention are involved in the team.

The study asks participants to measure their blood pressure three times a day every other day for four weeks. Qualitative interviews are being conducted before and after the intervention period to understand the levels of acceptability of remote monitoring and whether participants feel more in control, empowered, aware, and engaged in better quality healthcare. Questions on the role of social networks in health education and medication adherence are also asked about in this study.

“This project is revolutionary in that it is the first of its kind to be addressing the unmet need of uncontrolled blood pressure, a silent killer to millions all over the world, in one of the most understudied and underserved populations which is the refugee population.” — Dr. Al-Rousan

An observation the team has noted in the program are the results of two randomized groups — one that receives in-person education about how to use BPM Connect and the other that receives the same education virtually. The virtual education group has not only received the intervention smoothly but actually preferred it over in-person instruction which may be explained by fears of contracting COVID, or simply convenience and saving on transportation and other costs. Additionally, the use of the BPM Connect has extended beyond the intended four-week intervention period.

The ongoing pandemic has highlighted health disparities that vulnerable populations face. Drs. Al-Rousan and Godino hope that this study will show how innovative digital health solutions fit within patients’ feelings of acceptance while displaying that taking healthcare to marginalized people’s homes enables these populations to relate to their health providers, engage in healthier behaviors, and better manage chronic diseases.

The study is now in the end phase and results will soon be published. For questions, please contact Dr. Tala Al-RousanTo find out more about how institutions are using BPM Connect and other connected health devices with the Withings Data Hub, you can visit Withings.com.

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Introduction

Wearable ECG technology is increasingly used to support ambulatory cardiac rhythm monitoring, but questions remain about how these tools fit into patients’ daily lives.

 

A recent qualitative study conducted in the Netherlands explored this issue by comparing patient experiences using a smartwatch with single-lead ECG (1L-ECG) capability and a traditional Holter monitor over the course of one week.

 

The findings offer useful insights into the practical benefits and limitations of smartwatch-based ECG monitoring and what matters most to patients when rhythm monitoring moves beyond the clinic.

Study Overview

The study included 18 adults referred for ambulatory rhythm monitoring at a diagnostic center in the Netherlands, specifically through referrals from primary care to the cardiology outpatient clinic of the Dijklander Hospital in Hoorn. Participants were aged 32–85, with a median age of 66.

 

Each participant wore both:

  • A smartwatch with 1L-ECG capability (Withings ScanWatch), and
  • A conventional chest-worn Holter monitor

for seven days. Afterward, researchers conducted semi-structured interviews to understand their experiences with usability, comfort, confidence, and perceived clinical value.

 

Rather than focusing on diagnostic accuracy, the study centred on how patients experienced the monitoring process itself, an increasingly important consideration as wearable technologies become more common in routine care.

What Patients Reported

 

Comfort and Ease of Use

Participants consistently described the smartwatch as easier to wear and less intrusive than the Holter monitor. Wearing the watch felt familiar and fit naturally into daily routines, including sleep and regular activities. In contrast, the Holter monitor’s electrodes and wiring were more noticeable and, for some, uncomfortable over time.

 

Several participants noted skin irritation or inconvenience associated with adhesive electrodes, whereas the smartwatch was generally described as something they could wear without significant disruption to daily life.

 

“It’s a bit heavier than my own smartwatch. That takes a minute to get used to, but after that you don’t even notice it anymore. It’s waterproof, so you barely notice you’re wearing it — not even at night, since I always sleep with a watch on. I don’t feel the difference anymore. Other than that, it does what it’s supposed to do: tell the time. Which is pretty handy, too.”
P16, male patient, 48 years

 

Capturing Symptoms in Real Life

One of the key differences between the two approaches is how data are captured. The Holter monitor records continuously, while the smartwatch requires users to actively initiate an ECG recording.

 

Participants appreciated having control over recordings but also expressed uncertainty about when to trigger them, particularly when symptoms were brief, unexpected, or occurred during sleep or activities like driving. This highlights a trade-off between passive continuous monitoring and more user-driven approaches.

 

Automated ECG Results: Reassurance and Uncertainty

Some participants found algorithm-based ECG feedback reassuring, especially when results were reported as normal. Others described moments of uncertainty or anxiety when the smartwatch flagged potential abnormalities without immediate clinical context.

 

This finding underscores the importance of clear patient education and pathways for clinical follow-up when wearable ECG data are shared directly with users.

 

Integration With Clinical Care

Across interviews, participants emphasized that wearable ECG data felt most valuable when it could be reviewed by a healthcare professional. Many expressed a desire for smoother integration between smartwatch ECG recordings and clinical systems, as well as clearer guidance on how and when clinicians would review their data.

 

Patients generally viewed the smartwatch as a helpful complement to traditional monitoring, particularly when combined with clinician oversight, rather than a complete replacement.

Implications for Wearable ECG Monitoring

 

Overall, the study suggests that smartwatch-based 1L-ECG monitoring is acceptable to patients and may reduce some of the burden associated with traditional Holter monitoring, particularly in terms of comfort and day-to-day wearability.

 

At the same time, the findings point to areas where wearable ECG programs can improve:

  • Providing clearer guidance on when and how to record symptoms
  • Reducing uncertainty around automated ECG interpretations
  • Ensuring timely clinician review and communication

As devices like the Withings ScanWatch continue to be used in real-world clinical settings, patient experience will remain a critical factor alongside clinical validation.

Looking Forward

This study adds to a growing body of evidence showing that wearable ECG devices can support ambulatory rhythm monitoring in ways that align more closely with everyday life. Designing these tools and the care pathways around them with patient experience in mind will be key to realizing their full potential in clinical practice.

 

For more research-driven insights on connected health and remote monitoring, explore the latest updates on the Withings blog.

Interested in partnering with us?

Contact Us [post_title] => Patient Experiences With Smartwatch ECG Monitoring Compared to Traditional Holter Devices [post_excerpt] => A recent qualitative study conducted in the Netherlands compares patient experiences using a smartwatch with single-lead ECG (1L-ECG) capability and a traditional Holter monitor over the course of one week. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => patient-experiences-with-smartwatch-ecg-monitoring-compared-to-traditional-holter-devices [to_ping] => [pinged] => [post_modified] => 2026-01-06 15:51:03 [post_modified_gmt] => 2026-01-06 15:51:03 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=2100 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [1] => WP_Post Object ( [ID] => 2088 [post_author] => 11 [post_date] => 2025-12-15 15:48:18 [post_date_gmt] => 2025-12-15 15:48:18 [post_content] =>

The World Health Organization recently released its first global guideline on the use of GLP-1–based therapies for obesity, a milestone that signals a major shift in how health systems worldwide should approach long-term obesity care.

 

For obesity programs, digital-health organizations, and chronic-care providers, the message is clear: GLP-1s can be valuable tools, but only when embedded within a structured framework of behavioral support, lifestyle intervention, and ongoing monitoring.

Here’s a guide to what programs need to understand and how to prepare.

 

1. WHO Defines Obesity as a Chronic, Relapsing Disease, Not a Short-Term Problem or Fix

The guideline reinforces a position many clinicians already share: obesity requires ongoing management similar to other chronic diseases. This means obesity programs must prioritize continuity, long-term engagement, and structured monitoring, not episodic care. Many times patients see weight loss as a goal that they reach and that concludes their obesity care journey. The WHO emphasizes the ongoing nature of obesity as a disease, and obesity care as a necessity.

 

2. GLP-1s Are Recommended Conditionally and Only as Part of Comprehensive Care

WHO does not recommend medication alone. The guideline emphasizes:
GLP-1 therapies should be considered as one component of a broader care plan.

Treatment decisions should reflect patient context, preferences, and access. Programs must integrate behavioral interventions and lifestyle support alongside medication. For organizations delivering obesity care, this signals a need to strengthen or formalize their behavioral-support models, including: coaching, education, medical nutrition therapy (MNT), activity support, and digital engagement.

 

3. Behavioral Support Is Essential-Not Optional

The guideline places intensive behavioral therapy (IBT) at the center of obesity care. Programs should ensure they can offer:

  • Structured lifestyle guidance
  • Goal setting and personalized plans
  • Coaching or counseling pathways
  • Tools for sustained behavior change
  • Ongoing check-ins and accountability
  • Medical nutrition therapy (MNT) when needed

This isn’t merely additive, it is foundational to responsible GLP-1 prescribing and to long-term patient outcomes.

 

4. Monitoring Frameworks Must Become Core Infrastructure

One of the most operationally important implications for obesity programs is WHO’s emphasis on continuous monitoring and follow-up. Because obesity is chronic and GLP-1 outcomes evolve over time, programs need systems that can:

  • Track weight, body composition, and metabolic markers
  • Detect early signs of weight regain or treatment non-response
  • Support long-term engagement after dose changes or discontinuation
  • Ensure care teams can intervene proactively and remain the decision makers

This is where digital health infrastructure becomes essential. Connected devices, remote monitoring, and automated data flows make it possible to support thousands of patients consistently without adding extensive labor burden to clinical teams.

 

5. What Obesity Programs Should Do Next

To align with WHO’s guidance and strengthen patient outcomes, programs can begin by:

  • Evaluating their behavioral-support offering - ensuring it is structured, consistent, and accessible.
  • Implementing device-based monitoring- enabling ongoing, objective tracking of patient progress without the barriers of in-office care.
  • Ensuring continuity models beyond initial weight loss - including maintenance and relapse-prevention.
  • Building customizable data workflows that let care teams intervene early, efficiently, and at scale, while keeping the decision-making in the hands of the clinician.
  • Partnering with technology providers already equipped to deliver these components reliably.

The Bottom Line for Obesity Programs

The new WHO guideline is not simply a statement on medications. It is a blueprint for comprehensive, long-term obesity care. Programs that combine medication, behavioral support, and robust monitoring will be best positioned to deliver durable outcomes, meet patient expectations, reduce clinical burden, and scale responsibly.


Withings Health Solutions stands ready to support that evolution with the technology, partnerships, and evidence-aligned frameworks that make multimodal obesity care possible.

Interested in partnering with us?

Contact Us [post_title] => What Obesity Care Programs Need to Know About WHO’s New GLP-1 Guidelines [post_excerpt] => Learn what obesity care programs need to know about the new World Health Organization GLP-1 guidelines for obesity care. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => what-obesity-care-programs-need-to-know-about-whos-new-obesity-treatment-guidelines [to_ping] => [pinged] => [post_modified] => 2026-01-06 14:26:20 [post_modified_gmt] => 2026-01-06 14:26:20 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=2088 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [2] => WP_Post Object ( [ID] => 2083 [post_author] => 11 [post_date] => 2025-12-02 20:22:02 [post_date_gmt] => 2025-12-02 20:22:02 [post_content] =>

Chronic Kidney Disease stage 5 on dialysis (CKD5D) presents one of the most complex and high-risk scenarios in modern medicine. Among the many challenges faced by these patients, cardiovascular disease (CVD) stands out as the leading cause of mortality—a stark reminder of the systemic stress that accompanies kidney failure and dialysis.

 

But what if technology could help bridge the gap between dialysis sessions, offering clinicians a window into the patient's health in real-time? An article in Frontiers in Nephrology explores exactly that, highlighting the transformative potential of digital health technologies to monitor and manage CKD5D patients beyond the clinic.

The Hidden Risks Between Dialysis Sessions

For CKD5D patients, the risks of CVD are amplified by both traditional and disease-specific factors:

  • Traditional risks like hypertension, diabetes, and obesity.
  • CKD-specific risks such as inflammation, fluid overload, protein-energy wasting and vascular calcification.
  • The dialysis process itself, which induces rapid fluid shifts, blood pressure fluctuations, and metabolic imbalances.

Current clinical care models often focus on in-center dialysis data, leaving a crucial blind spot during the interdialytic period—a time when many adverse events begin to develop unnoticed.

A New Monitoring Paradigm: The Withings Toolkit

The article introduces a compelling case for home-based, connected health technologies—specifically, the Withings toolkit. This suite of medical-grade, consumer-friendly devices allows CKD patients to monitor key health indicators in the comfort of their homes:

  • Weight, body composition and ECG monitoring with the BodyScan smart scale.
  • Blood pressure, heart rate and survey responses for added context via BPM Pro 2.
  • Sleep quality and breathing event metrics using the Sleep Rx.

All data is seamlessly uploaded to the Withings Remote Patient Monitoring platform, providing healthcare providers and researchers with real-time, longitudinal insights into a patient’s well-being.

Why This Matters: Real-World Clinical Benefits

 

1. Early Detection of Complications
Weight gain could signal fluid retention, but muscle loss could indicate protein-energy wasting. A sudden spike in blood pressure or irregular heartbeat might indicate arrhythmias or volume overload. Poor sleep patterns could reflect apnea or restless leg syndrome—conditions with known ties to CKD.

 

2. Personalized, Data-Driven Care
These devices enable a dynamic view of health trends, allowing clinicians to tailor treatments proactively rather than reactively. Medication adjustments, fluid restrictions, or further diagnostics can be made with greater confidence.

 

3. Patient Empowerment

When patients can see and understand their own data, they become more engaged in their care. This promotes better self-management, increased treatment adherence, and a stronger sense of control over their condition.

 

4. Systemic Healthcare Advantages
Remote monitoring can reduce emergency visits and hospitalizations, easing the burden on overtaxed healthcare systems and offering a cost-effective alternative to frequent in-person evaluations.

The Future: Digital Tools as Standard of Care?

While still in its early stages, this integration of digital health into CKD care reflects a broader movement toward remote, preventative, and personalized medicine. The Withings case study serves as a promising example of how everyday technology can be adapted to serve complex clinical needs.

 

However, as the authors note, more clinical trials are needed to validate these tools in nephrology settings, establish protocols for data use, and ensure equitable access across diverse patient populations.

Final Thoughts

As we face growing rates of kidney disease and limited nephrology resources, connected health technologies offer a lifeline—not just to patients, but to an entire care infrastructure in need of modernization.


The Withings toolkit is more than a gadget suite; it's a glimpse into the future of chronic disease management, where data flows continuously, care is adaptive, and patients are active participants in their own health journey.

Reference:
Article: Frontiers in Nephrology, 2023 - DOI: 10.3389/fneph.2023.1148565

Interested in partnering with us?

Contact Us [post_title] => Revolutionizing Chronic Kidney Disease Management with Digital Health Tools: The Withings Case Study [post_excerpt] => Researchers from Imperial College London explored how continuous, contactless sleep monitoring using the Withings Sleep Analyzer can be used to detect acute conditions, focusing particularly on urinary tract infections (UTIs) before patients even recognize symptoms. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => revolutionizing-chronic-kidney-disease-management-with-digital-health-tools-the-withings-case-study [to_ping] => [pinged] => [post_modified] => 2025-12-02 20:22:24 [post_modified_gmt] => 2025-12-02 20:22:24 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=2083 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) ) [post_count] => 3 [current_post] => -1 [before_loop] => 1 [in_the_loop] => [post] => WP_Post Object ( [ID] => 2100 [post_author] => 11 [post_date] => 2026-01-06 15:23:33 [post_date_gmt] => 2026-01-06 15:23:33 [post_content] =>

Introduction

Wearable ECG technology is increasingly used to support ambulatory cardiac rhythm monitoring, but questions remain about how these tools fit into patients’ daily lives.

 

A recent qualitative study conducted in the Netherlands explored this issue by comparing patient experiences using a smartwatch with single-lead ECG (1L-ECG) capability and a traditional Holter monitor over the course of one week.

 

The findings offer useful insights into the practical benefits and limitations of smartwatch-based ECG monitoring and what matters most to patients when rhythm monitoring moves beyond the clinic.

Study Overview

The study included 18 adults referred for ambulatory rhythm monitoring at a diagnostic center in the Netherlands, specifically through referrals from primary care to the cardiology outpatient clinic of the Dijklander Hospital in Hoorn. Participants were aged 32–85, with a median age of 66.

 

Each participant wore both:

  • A smartwatch with 1L-ECG capability (Withings ScanWatch), and
  • A conventional chest-worn Holter monitor

for seven days. Afterward, researchers conducted semi-structured interviews to understand their experiences with usability, comfort, confidence, and perceived clinical value.

 

Rather than focusing on diagnostic accuracy, the study centred on how patients experienced the monitoring process itself, an increasingly important consideration as wearable technologies become more common in routine care.

What Patients Reported

 

Comfort and Ease of Use

Participants consistently described the smartwatch as easier to wear and less intrusive than the Holter monitor. Wearing the watch felt familiar and fit naturally into daily routines, including sleep and regular activities. In contrast, the Holter monitor’s electrodes and wiring were more noticeable and, for some, uncomfortable over time.

 

Several participants noted skin irritation or inconvenience associated with adhesive electrodes, whereas the smartwatch was generally described as something they could wear without significant disruption to daily life.

 

“It’s a bit heavier than my own smartwatch. That takes a minute to get used to, but after that you don’t even notice it anymore. It’s waterproof, so you barely notice you’re wearing it — not even at night, since I always sleep with a watch on. I don’t feel the difference anymore. Other than that, it does what it’s supposed to do: tell the time. Which is pretty handy, too.”
P16, male patient, 48 years

 

Capturing Symptoms in Real Life

One of the key differences between the two approaches is how data are captured. The Holter monitor records continuously, while the smartwatch requires users to actively initiate an ECG recording.

 

Participants appreciated having control over recordings but also expressed uncertainty about when to trigger them, particularly when symptoms were brief, unexpected, or occurred during sleep or activities like driving. This highlights a trade-off between passive continuous monitoring and more user-driven approaches.

 

Automated ECG Results: Reassurance and Uncertainty

Some participants found algorithm-based ECG feedback reassuring, especially when results were reported as normal. Others described moments of uncertainty or anxiety when the smartwatch flagged potential abnormalities without immediate clinical context.

 

This finding underscores the importance of clear patient education and pathways for clinical follow-up when wearable ECG data are shared directly with users.

 

Integration With Clinical Care

Across interviews, participants emphasized that wearable ECG data felt most valuable when it could be reviewed by a healthcare professional. Many expressed a desire for smoother integration between smartwatch ECG recordings and clinical systems, as well as clearer guidance on how and when clinicians would review their data.

 

Patients generally viewed the smartwatch as a helpful complement to traditional monitoring, particularly when combined with clinician oversight, rather than a complete replacement.

Implications for Wearable ECG Monitoring

 

Overall, the study suggests that smartwatch-based 1L-ECG monitoring is acceptable to patients and may reduce some of the burden associated with traditional Holter monitoring, particularly in terms of comfort and day-to-day wearability.

 

At the same time, the findings point to areas where wearable ECG programs can improve:

  • Providing clearer guidance on when and how to record symptoms
  • Reducing uncertainty around automated ECG interpretations
  • Ensuring timely clinician review and communication

As devices like the Withings ScanWatch continue to be used in real-world clinical settings, patient experience will remain a critical factor alongside clinical validation.

Looking Forward

This study adds to a growing body of evidence showing that wearable ECG devices can support ambulatory rhythm monitoring in ways that align more closely with everyday life. Designing these tools and the care pathways around them with patient experience in mind will be key to realizing their full potential in clinical practice.

 

For more research-driven insights on connected health and remote monitoring, explore the latest updates on the Withings blog.

Interested in partnering with us?

Contact Us [post_title] => Patient Experiences With Smartwatch ECG Monitoring Compared to Traditional Holter Devices [post_excerpt] => A recent qualitative study conducted in the Netherlands compares patient experiences using a smartwatch with single-lead ECG (1L-ECG) capability and a traditional Holter monitor over the course of one week. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => patient-experiences-with-smartwatch-ecg-monitoring-compared-to-traditional-holter-devices [to_ping] => [pinged] => [post_modified] => 2026-01-06 15:51:03 [post_modified_gmt] => 2026-01-06 15:51:03 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=2100 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [comment_count] => 0 [current_comment] => -1 [found_posts] => 54 [max_num_pages] => 18 [max_num_comment_pages] => 0 [is_single] => [is_preview] => [is_page] => [is_archive] => 1 [is_date] => [is_year] => [is_month] => [is_day] => [is_time] => [is_author] => [is_category] => 1 [is_tag] => [is_tax] => [is_search] => [is_feed] => [is_comment_feed] => [is_trackback] => [is_home] => [is_privacy_policy] => [is_404] => [is_embed] => [is_paged] => [is_admin] => [is_attachment] => [is_singular] => [is_robots] => [is_favicon] => [is_posts_page] => [is_post_type_archive] => [query_vars_hash:WP_Query:private] => 4c4cccd009c84d2156f7c3abc8b35a49 [query_vars_changed:WP_Query:private] => [thumbnails_cached] => [allow_query_attachment_by_filename:protected] => [stopwords:WP_Query:private] => [compat_fields:WP_Query:private] => Array ( [0] => query_vars_hash [1] => query_vars_changed ) [compat_methods:WP_Query:private] => Array ( [0] => init_query_flags [1] => parse_tax_query ) [query_cache_key:WP_Query:private] => wp_query:3d63db898e9a07f0f3625bed34dcd3ac )
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