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

项目总结/摘要 候选人：艾玛劳伦斯医学博士MS是一个妇产科医生与全球健康研究的重点是 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 独立的全球女性健康调查员，具有随机对照试验的方法学专长， 研究计划集中在管理妊娠高血压疾病在低资源 设置. 研究目的：本提案的目标是实施和评估家庭血压（BP） 监测加纳有妊娠期高血压疾病风险的妇女的干预措施。的 本研究的具体目的是：（1）探讨孕妇家庭血压监测的障碍和促进因素， 加纳有HDP风险的妇女;（2）确定家庭BP监测的低绩效者， 可用于改进干预的因素;（3）进行RCT，比较每日 在使用纸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 日志和每日提醒。 研究计划：参与者将完成前后调查，探索可接受性，可行性，障碍， 家庭血压监测的动机。在接受培训后，将指示参与者检查并记录他们的 每天测量血压，并在预先确定血压升高的情况下拨打护士分诊热线。使用参与者日志中的数据， 坚持家庭血压监测，并能够在家庭血压值升高时采取适当措施， 将被评估。将确定表现较低的组，并从该组的关键线人将从事 在半结构化访谈中，引出可用于完善干预措施的可操作因素。使用2- 随机对照试验设计，将家庭血压监测的依从性进行组间比较 使用纸质记录，一组使用基于手机的电子记录和每日提醒。 职业发展计划：Lawrence博士将在以下方面发展专业知识：（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和参与研究和职业发展来加强 研讨会等在来自加纳和密歇根大学的专家导师团队的支持下，她 作为一个独立的全球妇女健康组织， 研究员后续计划的R 01提交将评价家庭BP监测对临床 结果，包括HDP诊断的时间，新生儿结果和孕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.