Table 2.

Outcome, mediator, and intervention-based measures.

Measure					Description
Outcomes (exams 1 through 3 unless otherwise noted)
	Primary outcomes
		Blood pressure measurements
			Sitting blood pressure	We will use an automatic sphygmomanometer to evaluate sitting BP. This measurement device has been validated across multiple cohort studies including MESA, NHANES, and HCHS/SOL [44,45]. The 3 systolic and diastolic blood pressure readings will be taken with participants in the seated position; mean values will be obtained by averaging the last 2 readings
			24-hour ambulatory blood pressure	An ambulatory BP monitoring (ABPM) method will be used to capture 24-hour daytime and nighttime BP readings in the natural environment (CONTECTM Automatic Blood Pressure Monitor [ABPM50]); this device has shown adequate reliability and accuracy [46]. We will consider 24-hour mean systolic and diastolic readings. Weighing 1.87 lbs, the ABPM monitors will be fitted and pretested before 24-hour use [47]
	Secondary outcomes
		Psychological well-being
			Depressive symptoms	The 20-item Center for Epidemiologic Studies Depression Scale (CES-D) will be used to measure depressive symptomatology [48]. The CES-D uses a 4-point Likert scale to probe the extent to which an individual has been troubled by depressive symptoms in the last 7 days; scores range from 0 to 60
			Perceived stress scale (PSS)	The PSS includes 10-items to assess self-perceived levels of stress over the previous month using a Likert scale ranging from never to always [49]. Previously validated in the HCHS/SOL cohort [50], overall scores range from 0 to 40 for the full scale and includes items such as, “How often have you felt confident about your ability to handle your personal problems?”
			Positive and negative affect	Participants will be asked to recall emotions experienced in the past week using a modified version of the Differential Emotions Scale [51]. A list of 26 different emotions will be provided (eg, grateful, happy, guilty, relieved, ashamed, or humiliated) and participants will be asked to identify how often they have experienced each on a scale ranging from 1—Not at all to 9—All the time
			Dispositional optimism	The revised Life Orientation Test (LOT-R) will be used to assess dispositional optimism. The LOT-R is a validated 6-item self-administered questionnaire with possible scores ranging from 0 (least optimistic) to 24 (most optimistic) [52,53]. The scale includes 3 positively worded items and 3 negatively worded items that are rated on a 5-point Likert scale
			Emotional vitality	Emotional vitality is characterized as a sense of overall well-being through active engagement in day-to-day activities and effectual regulation of emotions. Borrowing items from the General Well-being Schedule, this construct will be captured using a 6-item measure previously used in published studies with available evidence of adequate psychometric properties [54,55]. Respondents are asked to think about the previous 30 days, and using an ordinal scale are instructed to rate statements such as, “Has your daily life been full of things that were interesting to you?” and “Have you been feeling emotionally stable and sure of yourself?”
			Life engagement and meaning (LET)	The LET is a 6-item instrument that probes the extent to which an individual engages in activities which they personally value and find meaningful [56], for example, To me, the things that I do are all worthwhile. Scores range from 6 to 30 with respondents rating items on a 5-point scale. Higher scores characterize an individual that experiences greater life engagement and purpose
			Happiness-inducing behavior	This 38-item survey inquires of the extent to which participant engage in behavior or prescribed strategies known to induce happiness, for example, relaying gratitude, engaging in mediation and religious practices, focusing on positive life events, among others [57]
			Self-perceived social support	The Medical Outcomes Study Social Support Survey will be used to quantify social support as provided by family, friends, and acquaintances [58]. This 20-item instrument first directs participants to quantify the total number of close friends and relatives they possess, that is, defined as the people they feel at ease with and can talk about what is on their mind. Remaining items ask participants to rate statements using a 5-point Likert scale that inquire of the perceived availability of support from family, friends, or others, if or when needed. Sample statements include “someone you can count on to listen to you when you need to talk” and “someone to help with daily chores if you were sick”
		Healthy behaviors
			Physical activity and dietary intake	Items of the Summary of Diabetes Self-Care Activities Measure will be used to assess engagement in physical activity and self-reported dietary intake. Items ask participants to report engagement across activities over a 7-day period and include queries such as, “On how many of the last SEVEN DAYS did you participate in at least 30 minutes of physical activity?” and “How many of the last SEVEN DAYS have you followed a healthful eating plan?”
			Sodium intake	The Scored Sodium Questionnaire will be used to measure dietary intake specifically targeting quantification of sodium consumption [59]. Participants will be asked to report dietary patterns over the last 7 days across multiple food groups (eg, breads, processed meats, tinned or packet soups) with response options indicating daily consumption to rare or never eaten items. Dietary intake will also include items of the Summary of Diabetes Self-Care Activities questionnaire [60]
			Smoking status	Participants will identify whether they are current smokers, former smokers, or if they have never smoked before. Current smokers will report the average number of cigarettes they smoke per day
			Self-reported sleep quality and duration	Two self-report items were used to capture subjective rating of sleep. The first inquired about the number of hours per night of sleep (ie, during the main sleep period) that participants were getting on weekdays or workdays. The second asked participants to rate their typical night’s sleep during the past 4 weeks, with a Likert response option ranging from very sound or restful to very restless
			Medication use and adherence	Participants will be asked if they were prescribed oral medication for their high blood pressure. Those indicating use of antihypertensive medication will be asked to identify the start date when they first initiated said use. We will also document whether participants had taken their blood pressure medication on the date of their clinical visit, and if so, the approximate time of day. Finally, medication adherence specific to antihypertensive drugs will be assessed using the Morisky Medication Adherence Scale [61]. At each scheduled assessment, participants will be instructed to bring all medications currently taken. Research staff will document details across medication (eg, dosage) and they will save a digital picture of associated pill bottles
		Markers of cardiovascular disease
			Serum blood spots	Serum blood spots will be collected from each participant at baseline and immediately postintervention (8 weeks). A trained research staff will prick the participant’s middle or ring finger using sterile procedures. After wiping away the first spot of blood, 5 subsequent drops will be collected using Whatman #903 filter paper. The blood spots will be stored for future analysis in a −20° freezer at the Institute for Minority Health Research at the University of Illinois at Chicago
	Covariates
		Antecedent or confounding variables
			Demographic factors	We will gather basic demographic information from all participants including: age, sex, income, educational attainment, marital status, health insurance status, employment type, nativity status and number of years in the United States, and country of origin
			Anthropometric measurements	Research staff will ascertain measures of height (to the nearest centimeter) and weight (to the nearest 0.1 kg) and will calculate BMI using these values. The waist-to-hip ratio will be derived from abdominal and hip girth obtained using a Gulick II 150- and 250-cm anthropometric tape measure with participants wearing light clothing
			Acculturation/cultural factors	The Short Acculturation Scale for Hispanics will be used to capture the construct of acculturation in Hispanic/Latino adults [62]. The 10-item scale inquires of language use (Spanish vs English) across settings (home vs social life), language in which entertainment is consumed, and race/ethnicity of individuals across varied social circles. Derived from the Duke University Religion Index [63], religiosity will be assessed using a 5-items scale that includes questions such as, “My religious beliefs are what really lie behind my whole approach to life.” It also assesses frequency of attendance to church services and engagement in religious practices
			Current health status and medical comorbidities	Self-reported physical and mental health will be measured using the 12-item Short Form Health Survey [64]. Participants will also self-report previous or current existence of any of the following medical conditions: heart attack; congestive heart failure; stroke; diabetes; arthritis; moderate or severe renal disease; fracture of the hip, wrist, arm, or shin; asthma; cirrhosis of the liver or liver disease; cancer; bypass of arteries in the leg; Parkinson’s disease; Alzheimer’s disease or dementia; HIV or AIDS; depression; or anxiety disorder
			Overall website use	We will also analyze data describing overall use of the website by trial participants, including the number of website logins per participant, average length of screen time per site visit, and extent to which enrollees completed and recorded practicing of at-home exercises