Evidence to Support Universal Blood Pressure Screening in School‐Based Clinical Settings
ABSTRACT BACKGROUND Most pediatric elevated blood pressure (BP) remains undiagnosed. The American Academy of Pediatrics states “there is limited evidence to support school‐based measurement of children's BP.” We explored the utility school‐based BP screening. METHODS A cross‐sectional sample of...
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| Veröffentlicht in: | The Journal of school health 2020-06, Vol.90 (6), p.474-481 |
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| creator | Silberstein, Juliet Gwynn, Lisa Mathew, M. Sunil Arheart, Kristopher L. Messiah, Sarah E. |
| description | ABSTRACT
BACKGROUND
Most pediatric elevated blood pressure (BP) remains undiagnosed. The American Academy of Pediatrics states “there is limited evidence to support school‐based measurement of children's BP.” We explored the utility school‐based BP screening.
METHODS
A cross‐sectional sample of 4096 students ages 6 to 17 from Title 1 Miami‐Dade Public Schools (50% female, 71% non‐Hispanic black, 26% Hispanic) had their systolic/diastolic BP (SBP/DBP) and body mass index (BMI) collected over the 2016 to 2017 or 2017 to 2018 school years. Relative risks (RRs) ratios were calculated to estimate normal/elevated SBP/DBP by BMI percentile, ethnicity, and
sex.
RESULTS
Overall, 26.4% had at least one elevated BP measurement, of which 59% were not obese. RR for obese status was significant for all categories of elevated BP (RRs > 1.88, p |
| doi_str_mv | 10.1111/josh.12893 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2385709380</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ericid>EJ1252305</ericid><sourcerecordid>2398333554</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3793-e57d7d02e6634b5f7d0f6d4e281146fe83f16e09b781327b3565dbd6ae987c853</originalsourceid><addsrcrecordid>eNp9kE1P3DAQhq2qqCxLL723isQFVcpie-KPHMtq-RISlRYuXKIknhSvsvHWTkDc-hP6G_kleBvgwKFzmRnNM--MXkK-MDpjMY5WLtzNGNc5fCATpjKZMiHZRzKhlPM0g5ztkr0QVjSGAvWJ7ALnIHMpJ-R2cW8NdjUmvUuWw2bjfJ_cdPYefSjb5Lh1ziQ_PYYweEyWtUfsbPcrsV1s7pxrn_78PS4DmmTe2s7WcWeJfR-RsE92mrIN-PklT8nNyeJ6fpZeXp2ez39cpjWoHFIUyihDOUoJWSWaWDfSZMg1Y5lsUEPDJNK8UpoBVxUIKUxlZIm5VrUWMCWHo-7Gu98Dhr5Y21Bj25YduiEUHLRQNAdNI3rwDl25wXfxu0jlGgCEyCL1faRq70Lw2BQbb9elfywYLbaOF1vHi3-OR_jbi-RQrdG8oa8WR-DrCKC39dt4ccG44EC377Nx_mBbfPzPqeLiank2Hn0GBHaU1Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2398333554</pqid></control><display><type>article</type><title>Evidence to Support Universal Blood Pressure Screening in School‐Based Clinical Settings</title><source>Access via Wiley Online Library</source><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><creator>Silberstein, Juliet ; Gwynn, Lisa ; Mathew, M. Sunil ; Arheart, Kristopher L. ; Messiah, Sarah E.</creator><creatorcontrib>Silberstein, Juliet ; Gwynn, Lisa ; Mathew, M. Sunil ; Arheart, Kristopher L. ; Messiah, Sarah E.</creatorcontrib><description>ABSTRACT
BACKGROUND
Most pediatric elevated blood pressure (BP) remains undiagnosed. The American Academy of Pediatrics states “there is limited evidence to support school‐based measurement of children's BP.” We explored the utility school‐based BP screening.
METHODS
A cross‐sectional sample of 4096 students ages 6 to 17 from Title 1 Miami‐Dade Public Schools (50% female, 71% non‐Hispanic black, 26% Hispanic) had their systolic/diastolic BP (SBP/DBP) and body mass index (BMI) collected over the 2016 to 2017 or 2017 to 2018 school years. Relative risks (RRs) ratios were calculated to estimate normal/elevated SBP/DBP by BMI percentile, ethnicity, and
sex.
RESULTS
Overall, 26.4% had at least one elevated BP measurement, of which 59% were not obese. RR for obese status was significant for all categories of elevated BP (RRs > 1.88, p < .0001). Being either female (RR = 1.34, p = .009) or Hispanic (RR = 1.31, p = .014) was significantly associated with elevated DBP. BMI accounted for <10% of the variation in BP (SBP: F(1, 4095) = 367.6, adjusted R2 = .08, p < .0001; DBP: F(1, 4095) = 93.3, adjusted R2 = .02, p < .0001).
CONCLUSION
These findings support providing BP screenings in school settings. Low‐income and minority students often have limited access to health care, higher obesity rates, and unhealthy behaviors. Our findings support universal school‐based BP screening regardless of weight status, particularly among ethnically diverse populations.</description><identifier>ISSN: 0022-4391</identifier><identifier>EISSN: 1746-1561</identifier><identifier>DOI: 10.1111/josh.12893</identifier><identifier>PMID: 32236966</identifier><language>eng</language><publisher>Malden, USA: Wiley Periodicals, Inc</publisher><subject>Access to Health Care ; At Risk Persons ; Blood pressure ; Body Composition ; Body Height ; Body mass index ; Body Weight ; child and adolescent health ; Elementary School Students ; Ethnicity ; Gender Differences ; Health care access ; Hispanic Americans ; Hypertension ; Low Income Students ; Measurement ; Medical screening ; Minority Group Students ; Minority Groups ; Nursing ; Obesity ; pediatric hypertension ; Pediatrics ; Physical Health ; Physiology ; Public schools ; Racial Differences ; Risk factors ; school health policy ; School Health Services ; school‐based clinics ; Scientific Concepts ; Screening Tests ; Secondary School Students ; Teenagers ; Undiagnosed</subject><ispartof>The Journal of school health, 2020-06, Vol.90 (6), p.474-481</ispartof><rights>2020, American School Health Association</rights><rights>2020, American School Health Association.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3793-e57d7d02e6634b5f7d0f6d4e281146fe83f16e09b781327b3565dbd6ae987c853</citedby><cites>FETCH-LOGICAL-c3793-e57d7d02e6634b5f7d0f6d4e281146fe83f16e09b781327b3565dbd6ae987c853</cites><orcidid>0000-0002-8506-2520</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjosh.12893$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjosh.12893$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,30999,45574,45575</link.rule.ids><backlink>$$Uhttp://eric.ed.gov/ERICWebPortal/detail?accno=EJ1252305$$DView record in ERIC$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32236966$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Silberstein, Juliet</creatorcontrib><creatorcontrib>Gwynn, Lisa</creatorcontrib><creatorcontrib>Mathew, M. Sunil</creatorcontrib><creatorcontrib>Arheart, Kristopher L.</creatorcontrib><creatorcontrib>Messiah, Sarah E.</creatorcontrib><title>Evidence to Support Universal Blood Pressure Screening in School‐Based Clinical Settings</title><title>The Journal of school health</title><addtitle>J Sch Health</addtitle><description>ABSTRACT
BACKGROUND
Most pediatric elevated blood pressure (BP) remains undiagnosed. The American Academy of Pediatrics states “there is limited evidence to support school‐based measurement of children's BP.” We explored the utility school‐based BP screening.
METHODS
A cross‐sectional sample of 4096 students ages 6 to 17 from Title 1 Miami‐Dade Public Schools (50% female, 71% non‐Hispanic black, 26% Hispanic) had their systolic/diastolic BP (SBP/DBP) and body mass index (BMI) collected over the 2016 to 2017 or 2017 to 2018 school years. Relative risks (RRs) ratios were calculated to estimate normal/elevated SBP/DBP by BMI percentile, ethnicity, and
sex.
RESULTS
Overall, 26.4% had at least one elevated BP measurement, of which 59% were not obese. RR for obese status was significant for all categories of elevated BP (RRs > 1.88, p < .0001). Being either female (RR = 1.34, p = .009) or Hispanic (RR = 1.31, p = .014) was significantly associated with elevated DBP. BMI accounted for <10% of the variation in BP (SBP: F(1, 4095) = 367.6, adjusted R2 = .08, p < .0001; DBP: F(1, 4095) = 93.3, adjusted R2 = .02, p < .0001).
CONCLUSION
These findings support providing BP screenings in school settings. Low‐income and minority students often have limited access to health care, higher obesity rates, and unhealthy behaviors. Our findings support universal school‐based BP screening regardless of weight status, particularly among ethnically diverse populations.</description><subject>Access to Health Care</subject><subject>At Risk Persons</subject><subject>Blood pressure</subject><subject>Body Composition</subject><subject>Body Height</subject><subject>Body mass index</subject><subject>Body Weight</subject><subject>child and adolescent health</subject><subject>Elementary School Students</subject><subject>Ethnicity</subject><subject>Gender Differences</subject><subject>Health care access</subject><subject>Hispanic Americans</subject><subject>Hypertension</subject><subject>Low Income Students</subject><subject>Measurement</subject><subject>Medical screening</subject><subject>Minority Group Students</subject><subject>Minority Groups</subject><subject>Nursing</subject><subject>Obesity</subject><subject>pediatric hypertension</subject><subject>Pediatrics</subject><subject>Physical Health</subject><subject>Physiology</subject><subject>Public schools</subject><subject>Racial Differences</subject><subject>Risk factors</subject><subject>school health policy</subject><subject>School Health Services</subject><subject>school‐based clinics</subject><subject>Scientific Concepts</subject><subject>Screening Tests</subject><subject>Secondary School Students</subject><subject>Teenagers</subject><subject>Undiagnosed</subject><issn>0022-4391</issn><issn>1746-1561</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNp9kE1P3DAQhq2qqCxLL723isQFVcpie-KPHMtq-RISlRYuXKIknhSvsvHWTkDc-hP6G_kleBvgwKFzmRnNM--MXkK-MDpjMY5WLtzNGNc5fCATpjKZMiHZRzKhlPM0g5ztkr0QVjSGAvWJ7ALnIHMpJ-R2cW8NdjUmvUuWw2bjfJ_cdPYefSjb5Lh1ziQ_PYYweEyWtUfsbPcrsV1s7pxrn_78PS4DmmTe2s7WcWeJfR-RsE92mrIN-PklT8nNyeJ6fpZeXp2ez39cpjWoHFIUyihDOUoJWSWaWDfSZMg1Y5lsUEPDJNK8UpoBVxUIKUxlZIm5VrUWMCWHo-7Gu98Dhr5Y21Bj25YduiEUHLRQNAdNI3rwDl25wXfxu0jlGgCEyCL1faRq70Lw2BQbb9elfywYLbaOF1vHi3-OR_jbi-RQrdG8oa8WR-DrCKC39dt4ccG44EC377Nx_mBbfPzPqeLiank2Hn0GBHaU1Q</recordid><startdate>202006</startdate><enddate>202006</enddate><creator>Silberstein, Juliet</creator><creator>Gwynn, Lisa</creator><creator>Mathew, M. Sunil</creator><creator>Arheart, Kristopher L.</creator><creator>Messiah, Sarah E.</creator><general>Wiley Periodicals, Inc</general><general>Wiley-Blackwell</general><general>Blackwell Publishing Ltd</general><scope>7SW</scope><scope>BJH</scope><scope>BNH</scope><scope>BNI</scope><scope>BNJ</scope><scope>BNO</scope><scope>ERI</scope><scope>PET</scope><scope>REK</scope><scope>WWN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8506-2520</orcidid></search><sort><creationdate>202006</creationdate><title>Evidence to Support Universal Blood Pressure Screening in School‐Based Clinical Settings</title><author>Silberstein, Juliet ; Gwynn, Lisa ; Mathew, M. Sunil ; Arheart, Kristopher L. ; Messiah, Sarah E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3793-e57d7d02e6634b5f7d0f6d4e281146fe83f16e09b781327b3565dbd6ae987c853</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Access to Health Care</topic><topic>At Risk Persons</topic><topic>Blood pressure</topic><topic>Body Composition</topic><topic>Body Height</topic><topic>Body mass index</topic><topic>Body Weight</topic><topic>child and adolescent health</topic><topic>Elementary School Students</topic><topic>Ethnicity</topic><topic>Gender Differences</topic><topic>Health care access</topic><topic>Hispanic Americans</topic><topic>Hypertension</topic><topic>Low Income Students</topic><topic>Measurement</topic><topic>Medical screening</topic><topic>Minority Group Students</topic><topic>Minority Groups</topic><topic>Nursing</topic><topic>Obesity</topic><topic>pediatric hypertension</topic><topic>Pediatrics</topic><topic>Physical Health</topic><topic>Physiology</topic><topic>Public schools</topic><topic>Racial Differences</topic><topic>Risk factors</topic><topic>school health policy</topic><topic>School Health Services</topic><topic>school‐based clinics</topic><topic>Scientific Concepts</topic><topic>Screening Tests</topic><topic>Secondary School Students</topic><topic>Teenagers</topic><topic>Undiagnosed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Silberstein, Juliet</creatorcontrib><creatorcontrib>Gwynn, Lisa</creatorcontrib><creatorcontrib>Mathew, M. Sunil</creatorcontrib><creatorcontrib>Arheart, Kristopher L.</creatorcontrib><creatorcontrib>Messiah, Sarah E.</creatorcontrib><collection>ERIC</collection><collection>ERIC (Ovid)</collection><collection>ERIC</collection><collection>ERIC</collection><collection>ERIC (Legacy Platform)</collection><collection>ERIC( SilverPlatter )</collection><collection>ERIC</collection><collection>ERIC PlusText (Legacy Platform)</collection><collection>Education Resources Information Center (ERIC)</collection><collection>ERIC</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of school health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Silberstein, Juliet</au><au>Gwynn, Lisa</au><au>Mathew, M. Sunil</au><au>Arheart, Kristopher L.</au><au>Messiah, Sarah E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><ericid>EJ1252305</ericid><atitle>Evidence to Support Universal Blood Pressure Screening in School‐Based Clinical Settings</atitle><jtitle>The Journal of school health</jtitle><addtitle>J Sch Health</addtitle><date>2020-06</date><risdate>2020</risdate><volume>90</volume><issue>6</issue><spage>474</spage><epage>481</epage><pages>474-481</pages><issn>0022-4391</issn><eissn>1746-1561</eissn><abstract>ABSTRACT
BACKGROUND
Most pediatric elevated blood pressure (BP) remains undiagnosed. The American Academy of Pediatrics states “there is limited evidence to support school‐based measurement of children's BP.” We explored the utility school‐based BP screening.
METHODS
A cross‐sectional sample of 4096 students ages 6 to 17 from Title 1 Miami‐Dade Public Schools (50% female, 71% non‐Hispanic black, 26% Hispanic) had their systolic/diastolic BP (SBP/DBP) and body mass index (BMI) collected over the 2016 to 2017 or 2017 to 2018 school years. Relative risks (RRs) ratios were calculated to estimate normal/elevated SBP/DBP by BMI percentile, ethnicity, and
sex.
RESULTS
Overall, 26.4% had at least one elevated BP measurement, of which 59% were not obese. RR for obese status was significant for all categories of elevated BP (RRs > 1.88, p < .0001). Being either female (RR = 1.34, p = .009) or Hispanic (RR = 1.31, p = .014) was significantly associated with elevated DBP. BMI accounted for <10% of the variation in BP (SBP: F(1, 4095) = 367.6, adjusted R2 = .08, p < .0001; DBP: F(1, 4095) = 93.3, adjusted R2 = .02, p < .0001).
CONCLUSION
These findings support providing BP screenings in school settings. Low‐income and minority students often have limited access to health care, higher obesity rates, and unhealthy behaviors. Our findings support universal school‐based BP screening regardless of weight status, particularly among ethnically diverse populations.</abstract><cop>Malden, USA</cop><pub>Wiley Periodicals, Inc</pub><pmid>32236966</pmid><doi>10.1111/josh.12893</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-8506-2520</orcidid></addata></record> |
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| subjects | Access to Health Care At Risk Persons Blood pressure Body Composition Body Height Body mass index Body Weight child and adolescent health Elementary School Students Ethnicity Gender Differences Health care access Hispanic Americans Hypertension Low Income Students Measurement Medical screening Minority Group Students Minority Groups Nursing Obesity pediatric hypertension Pediatrics Physical Health Physiology Public schools Racial Differences Risk factors school health policy School Health Services school‐based clinics Scientific Concepts Screening Tests Secondary School Students Teenagers Undiagnosed |
| title | Evidence to Support Universal Blood Pressure Screening in School‐Based Clinical Settings |
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