Home blood pressure monitoring among women at risk of hypertensive disorders of pregnancy in Ghana

项目摘要/摘要 候选人：艾玛·劳伦斯，医学硕士，产科妇科医生，专注于全球健康研究 加纳的产科管理和结果。劳伦斯博士的长期职业目标是成为一名 独立的全球妇女健康调查员，在随机对照试验和 研究计划集中在低资源地区妊娠高血压疾病的管理 设置。 研究目的：本提案的目标是实施和评估家庭血压(BP) 监测加纳妊娠高血压疾病(HDP)高危妇女的干预措施。这个 这项研究的具体目的是：(1)检查孕妇家庭血压监测的障碍和促进者 加纳有患高血压风险的妇女；(2)识别家庭血压监测中表现较差的人，并引发可操作的 可用于改进干预的因素；以及(3)进行RCT以比较遵守情况与日常情况 使用纸质记录的组和使用基于手机的电子记录的组之间的家庭BP监测 日志记录和日常提醒。 研究计划：参与者将完成岗前调查，探索可接受性、可行性、障碍和 推动BP监测的因素。在接受培训后，参与者将被指示检查并记录他们的 BP每天，并拨打护士分诊热线，事先确定BP的海拔高度。使用来自参与者日志的数据， 坚持家庭血压监测，并有能力在家庭血压升高时采取适当行动， 将会被评估。将确定表现较差的小组，并将与来自该小组的主要信息提供人接洽 在半结构化访谈中，以引出可用于改进干预措施的可操作因素。使用2- ARM随机对照试验设计，依从性家居血压监测将组间比较 使用纸质记录，并使用基于手机的电子记录和日常提醒的小组。 职业发展计划：劳伦斯博士将在以下方面发展专长：(1)调查问卷设计(2) 应用混合方法：3)先进的定量方法；和(4)撒哈拉以南非洲的生殖健康。 她的培训将通过高级课程以及参与研究和职业发展而得到加强 研讨会。在来自加纳和密歇根大学的专家指导团队的支持下，她 作为一家独立的全球妇女健康机构，理想的准备是利用K奖进入成功的职业生涯 研究员。随后计划的R01提交将评估家庭BP监测对临床的影响 结果，包括HDP诊断的时间、新生儿结果以及产妇发病率和死亡率。

Project Summary/Abstract Candidate: Emma Lawrence MD MS is an Obstetrician Gynecologist with a global health research focus on obstetrics management and outcomes in Ghana. Dr. Lawrence’s long-term career goal is to become an independent global women’s health investigator, with methodologic expertise in randomized control trials and a research program focused on the management of hypertensive disorders of pregnancy in low-resource settings. Research Aims: The goal of this proposal is to implement and evaluate a home blood pressure (BP) monitoring intervention among women at risk of hypertensive disorders of pregnancy (HDP) in Ghana. The study’s specific aims are to: (1) Examine the barriers and facilitators of home BP monitoring among pregnant women at risk of HDP in Ghana; (2) Identify lower-performers of home BP monitoring, and elicit actionable factors that can be used to refine the intervention; and (3) Conduct an RCT to compare adherence with daily home BP monitoring between a group using paper logging and a group using cellphone-based electronic logging and daily reminders. Research Plan: Participants will complete pre-post surveys exploring the acceptability, feasibility, barriers, and motivators to home BP monitoring. After receiving training, participants will be instructed to check and log their BP daily and call a nurse triage line with pre-identified elevations in BP. Using data from participant logs, adherence with home BP monitoring and ability to take appropriate action when home BP values are elevated, will be assessed. The lower performing group will be identified, and key informants from this group will engage in semi-structured interviews to elicit actionable factors that can be used to refine the intervention. Using a 2- arm randomized controlled trial design, adherence to home BP monitoring will be compared between a group using paper logging and a group using cellphone-based electronic logging and daily reminders. Career Development Plan: Dr. Lawrence will develop expertise in: (1) Survey questionnaire design (2) Applied mixed methods 3) Advanced quantitative methods; and (4) Reproductive health in Sub-Saharan Africa. Her training will be enhanced by advanced coursework and participation in research and career development seminars. With the support of an expert mentorship team from Ghana and the University of Michigan, she is ideally poised to leverage a K award into a successful career as an independent global women’s health researcher. A subsequent planned R01 submission will evaluate the impact of home BP monitoring on clinical outcomes, including timing of HDP diagnosis, neonatal outcomes, and maternal morbidity and mortality.