Telehealth-Enhanced Assessment and Management

Eligibility Criteria

• * Diagnosis of ischemic stroke defined as acute brain, spinal cord, or retinal infarction based on objective evidence on imaging (such as a focal area of restricted diffusion on Magnetic Resonance Imaging \[MRI\]) in a defined vascular distribution or clinical evidence of focal ischemic injury based on symptoms persisting \> 24 hours; or spontaneous hemorrhagic stroke defined as a focal collection of blood within the brain parenchyma that is non-traumatic and identified by brain computed tomography (CT) or brain MRI
• * Age ≥18 years
• * Discharged directly home from acute care or inpatient rehabilitation
• * At least one of the following: documented history of hypertension; self-reported history of hypertension; use of
• * hypertension medications (either prescribed prior to stroke, administered during hospital stay, or prescribed at discharge)
• * Systolic Blood Pressure ≥ 130 mmHg
• * Able to read and understand English or Spanish,
• * Have access to a functioning smartphone or tablet with broadband access
• * Willing to install and use a study-compatible physical activity monitoring application on their smartphone or tablet or smartphone or tablet of a qualifying caregiver
• * Stated agreement to participate in either intervention to which they are assigned and attend all required study visits,
• * Consent to receiving Short Message Service (SMS) required as part of the study interventions
• * Consent to enrollment in Chronic Care Management required as part of the study interventions,
• * Provision of a signed and dated informed consent form
• * Subdural hematoma or subarachnoid hemorrhage
• * Current participation in another stroke clinical trial precluding dual enrollment
• * Presence of terminal illness, such as cancer, that limits life expectancy to \<1 year
• * Diagnosis of end-stage renal disease defined as permanent kidney dysfunction requiring the use of hemodialysis or peritoneal dialysis
• * Pregnancy, lactation or planning to become pregnant
• * Late-stage Alzheimer's disease or related dementia
• * Transitioned to a facility such as skilled nursing or long-term care prior to enrollment
• * Mid upper arm circumference \> 45 cm/17.7 inches or \< 22 cm / 8.66 inches
• * Missing values for Systolic Blood Pressure or Privileged Access Management (PAM) score at baseline
• * Any condition that in the opinion of the study investigator would preclude the participant from being able to safely participate in the trial