Abstract Body: Introduction: Shared decision-making (SDM) facilitates active participation of patients and healthcare professionals in the decision-making process. This collaborative approach has the potential to improve hypertension management and cardiovascular health (CVH), allowing patients to pursue health decisions that adequately address health factors and encompass personal preferences. Engagement in health behaviors, such as a healthy diet, is a fundamental practice for improving CVH, yet the relationship between SDM and these behaviors remains understudied.

Objective: To examine the association between SDM and health behaviors in a Cardiometabolic Health Program LINKED with Community Health WorkErs and Mobile HeAlth TelemonitoRing To reduce Health DisparitieS, the “LINKED-HEARTS” Program.

Methods: A cross-sectional analysis was conducted using baseline data from the LINKED-HEARTS Program, an ongoing cluster randomized clinical trial of adults with hypertension and diabetes or chronic kidney disease (CKD). The exposure of interest was SDM, measured using the CollaboRATE scale (high SDM: 27 points and low SDM: 0-26 points). The outcome of interest was engagement in ≥2 optimal health behaviors, including a healthy diet (Mediterranean eating pattern), moderate or vigorous physical activity (≥150 minutes/week), non-smoking, and healthy sleep habits (7–9 hours/night). We conducted a multivariable logistic regression model to examine the association between SDM (high SDM vs. low SDM) and engagement in at least 2 optimal health behaviors, adjusting for covariates (Table 1).

Results: The study included 333 adults with hypertension and comorbid conditions, with a mean age of 62.8 years (±SD 12.3), of whom 63.1% were female and 64.0% were non-Hispanic Black adults. Of them, 27.6% of the participants reported engaging in ≥2 optimal health behaviors. Participants who reported high SDM were 2.77 times more likely to engage in ≥2 optimal health behaviors compared with those who reported low SDM (adjusted odds ratio 2.77, 95% CI: 1.17-6.58, P = 0.021) (Table 1).

Conclusion: High SDM was significantly associated with greater engagement in optimal health behaviors among adults with hypertension and diabetes or CKD. Future research should investigate whether increased implementation of SDM can improve hypertension control and CVH by facilitating health behavior change.