Medical providers’ perceptions of and response to adolescent hypertension : the role of social determinants of health in messaging

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Coleman Murray Hale (Creator)
Institution
The University of North Carolina at Greensboro (UNCG )
Web Site: http://library.uncg.edu/
Advisor
Lauren Haldeman

Abstract: The objective of this study was to identify medical providers’ perceptions of and response to adolescent hypertension (HTN) and to identify if and how social determinants of health (SDOH) play a role in the medical providers’ messaging to these adolescents. In addition, barriers experienced by medical providers were assessed regarding the management of HTN and the collection and use of SDOH data. A mixed-methods study was conducted using an online survey (n=110) and semi-structured phone interviews (n=12) of medical providers who treat adolescents ages 13 to 18 years old in North Carolina. Most providers expressed limited comfort with the treatment of HTN (67%). When looking at providing lifestyle recommendations, 44% of providers were completely comfortable with providing nutrition recommendations and 49% were completely comfortable with providing physical activity recommendations to adolescents with HTN. In addition, most medical providers reported rarely having knowledge of their patients’ SDOH factors like access to healthy food (64%) or caregiver’s educational status (81%). Main themes identified in the interviews included (1) monitoring of BP in adolescents, (2) level of comfort associated with HTN diagnosis and management, (3) approaches to weight and diet related chronic disease discussions, (4) SDOH data collection and influence on provider messaging, and (5) resources desired. Providers had variable approaches to managing HTN with greater comfort in recommending lifestyle changes than prescribing medications. Collection methods varied related to a patient’s SDOH, and these factors were used differently among providers. Most providers considered access to food and a safe space to exercise in their messaging to adolescents and families. The management of adolescent HTN is challenging because medical providers must consider clinical symptoms as well as unmet social needs when making recommendations to their patients. Altering messages to meet adolescents and families where they are and providing referrals to appropriate community resources supports patients in their efforts to make changes for the better. Providers identified barriers and opportunities for improvement which should be further investigated to improve overall care of patients.

Additional Information

Publication
Dissertation
Language: English
Date: 2021
Keywords
Adolescent, Adolescent hypertension, Blood pressure, Hypertension, Medial provider, Social determinants of health
Subjects
Pediatricians $x Attitudes
Hypertension in adolescence
Health $x Social aspects
Physician and patient

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