Shop-to-Stop Hypertension: a cluster randomised controlled trial of retail kiosk screening and text message follow-up to improve hypertension care pathways

Background Millions of people with hypertension are unaware of their status. Health kiosks are increasingly recommended for self-measurement of blood pressure (BP) in public spaces. However, new strategies are needed to better engage men – who are less likely to use kiosks in pharmacies and supermarkets – and to improve follow-up with a general practitioner (GP). Purpose The Shop-to-Stop Hypertension trial evaluated whether, among adults with raised BP detected at health kiosks in hardware stores, text message nudges increased repeat BP checks or GP attendance compared with usual care. Methods Shop-to-Stop Hypertension (December 2023–July 2025) was a multicentre, parallel-group, cluster-randomised trial across 30 hardware stores in New South Wales, Australia. Stores were randomised 1:1 to intervention or control. Consenting adults (≥18 years) with kiosk BP ≥140/90 mmHg and consenting to use their mobile number, were eligible. The intervention arm received automated text message nudges at 1, 2 and 12 weeks encouraging repeat kiosk BP checks, GP review, and self-care behaviours. The primary outcome was repeat kiosk BP check. Secondary outcomes were net differences in BP, target BP achievement, weight, BMI and body fat percentage. Exploratory secondary outcomes included self-reported GP attendance. Results Among 2,281 randomised adults (66% men), repeat kiosk BP checks occurred in 12.0% (140/1,173) in the intervention group and 9.8% (109/1,108) in usual care (adjusted RR 1.19, 95% CI 0.90–1.56; p=0.21). A significant interaction by sex was observed (p_interaction=0.016), with benefit in men (RR 1.45, 95% CI 1.05–2.00). Greater effect was also seen in participants from higher socioeconomic areas (RR 1.70, 95% CI 1.14–2.53; p=0.037) (Figure). No significant differences were observed for change in SBP or DBP, target BP achievement, weight, BMI, or body fat percentage. Self-reported GP attendance was higher in the intervention group (88% vs 79%; RR 1.10, 95% CI 1.01–1.21; p=0.034). Conclusions Text message nudges did not significantly increase repeat BP checks overall but were effective in men and higher socioeconomic groups, and were associated with greater GP attendance. Hardware store kiosk screening combined with targeted digital nudging may improve follow-up among men who are less likely to engage with traditional community-based models.