Feasibility and Acceptance of Early Ambulatory Blood Pressure Monitoring (ABPM) for Enhanced Pediatric Hypertension Diagnosis within a High Deprivation Community

早期动态血压监测 (ABPM) 用于在高度贫困社区内增强小儿高血压诊断的可行性和接受度

• 批准号: 10771786
• 负责人: CARISSA BAKER-SMITH
• 金额: $ 17.65万
• 依托单位: UNIVERSITY OF DELAWARE
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-30 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10771786
• 关键词: 13 year old; 18 year old; Address; Adherence; Adolescent; Adult; Age; Algorithms; Ambulatory Blood Pressure Monitoring; Attenuated; Blood Pressure; Cardiology; Carissa; Cells; Centers of Research Excellence; Child; Childhood; Clinical; Communities; Consumption; Data; Data Analyses; Decision Making; Delaware; Development; Devices; Diagnosis; Diastolic blood pressure; Dissemination and Implementation; Family; Funding; Future; Goals; Guidelines; Heart failure; Home; Hour; Hypertension; Individual; Intervention; Interview; Investigation; Joints; Left Ventricular Hypertrophy; Manuals; Measurement; Measures; Methods; Office Visits; Organ; Outpatients; Parents; Patients; Perception; Prevalence; Preventive; Protocols documentation; Provider; Psychologist; Recommendation; Records; Reporting; Research; Research Design; Research Methodology; Research Personnel; Risk Factors; Schedule; Series; Structure; Telephone; Time; Training; Visit; Work; Youth; arm; cardiovascular health; clinical decision support; clinical practice; deprivation; diagnostic strategy; economic disparity; experience; follow-up; hypertensive; improved; indexing; innovation; monitoring device; novel strategies; patient oriented; pediatric cardiologist; pediatrician; response; responsible research conduct; social; support tools; tool; undergraduate student; white coat hypertension

PROJECT SUMMARY/ABSTRACT: This proposal investigates a novel approach to hypertension (HTN) diagnosis in youth. We investigate the feasibility of ambulatory blood pressure monitoring (ABPM) device placement at an initial outpatient pediatrician visit for expediated diagnosis of HTN in youth living within socially and economically deprived communities. We assess the feasibility of ABPM device placement and provider, parent, and patient acceptance of ABPM at this initial visit. We will use 20 INBRE already purchased ABPM devices. ABPM device placement will occur within a single pediatric practice. The pediatric practice is located within a high socially and economically deprived community in Wilmington, Delaware. The ABPM will be offered at an initial outpatient pediatric visit in youth 10 to 18 years of age, when initial manual BP measured is above threshold (e.g., systolic blood pressure > 130mmHg and/or diastolic blood pressure > 80mmHg). Currently, HTN diagnosis in youth is fraught with the challenges of underdiagnosis, compounded by time-consuming algorithms that require multiple visits. We address a significant clinical need encompassing timely diagnosis and prompt clinical intervention for adolescents with HTN. The supplement also employs a mixed-methods approach and applies qualitative interview to assess provider, patient and parent response to this modified diagnostic strategy. The proposal is a supplement to 1 actively funded INBRE proposal and 1 actively funded COBRE. In accordance with the goals of this supplement, an undergraduate student will be trained in research design, ABPM placement and reporting, guideline recommendations for HTN diagnosis in youth, responsible conduct of research, data entry, qualitative interview, data analysis and presentation of findings. The supplement is the joint effort of 2 experienced INBRE and COBRE funded investigators, Dr. Carissa Baker-Smith (pediatric cardiologist, director of Pediatric Preventive Cardiology) and Dr. Erica Sood (psychologist). This project will lay the groundwork for future dissemination and implementation of a clinical decision support tool combined with earlier placement of ABPM device to improve HTN diagnosis. Earlier introduction of hypertensive disease attenuating intervention strategies in youth is possible if diagnosis is made earlier.

项目摘要/摘要： 这项建议探讨了一种诊断青年高血压(HTN)的新方法。我们调查了 门诊儿科医生放置动态血压监测(ABPM)装置的可行性 访问，以便在生活在社会和经济贫困社区的青年中快速诊断HTN。我们 评估ABPM设备放置的可行性以及提供商、家长和患者对ABPM的接受度 初次访问。我们将使用20个INBRE已经购买的ABPM设备。ABPM设备放置将在 一家儿科诊所。儿科诊所位于一个高度的社会和经济贫困地区。 特拉华州威尔明顿的社区。ABPM将在10岁青年首次儿科门诊就诊时提供 至18岁，当初始手动测量的血压高于阈值时(例如，收缩压和GT； 130毫米汞柱和/或舒张压&80毫米汞柱)。目前，青少年HTN的诊断充满了 诊断不足的挑战，再加上需要多次访问的耗时的算法。我们 解决重大临床需求，包括及时诊断和及时临床干预 患有HTN的青少年。本附录还采用了混合方法，并应用了定性 面谈以评估提供者、患者和家长对这一改进的诊断策略的反应。该提案是一项 对1个积极资助的INBRE提案和1个积极资助的科布雷项目的补充。根据以下目标 作为补充，本科生将接受研究设计、ABPM布局和报告方面的培训， 青少年HTN诊断指南建议，负责任的研究，数据录入，定性 访谈、数据分析和调查结果的陈述。这份补充是两位经验丰富的INBRE共同努力的结果 Cobre资助的研究人员，Carissa Baker-Smith博士(儿科心脏病专家，儿科主任 预防心脏病学)和Erica Sood博士(心理学家)。该项目将为今后的工作奠定基础 传播和实施临床决策支持工具，并结合早期放置ABPM 提高HTN诊断水平的设备。早期引入高血压病减毒干预策略 如果及早诊断，青春期是有可能的。