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

加纳有妊娠高血压疾病风险的妇女的家庭血压监测

• 批准号: 10706337
• 负责人: Emma Rachel Lawrence
• 金额: $ 18.58万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-21 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10706337
• 关键词: 2 arm randomized control trial; Address; Adherence; Adult; Africa South of the Sahara; Blood Pressure; Blood Pressure Monitors; Caring; Cellular Phone; Chronic; Clinic Visits; Clinical; Country; Data; Development Plans; Diagnosis; Discipline of obstetrics; Early Diagnosis; Eclampsia; Education; Effectiveness; Electronics; Face; Frequencies; Ghana; Goals; Gynecologist; Healthcare Systems; Home; Home Blood Pressure Monitoring; Hypertension; Income; Intervention; Interview; K-Series Research Career Programs; Knowledge; Maternal Mortality; Measures; Mentorship; Methodology; Methods; Michigan; Morbidity - disease rate; Neonatal; Nurses; Outcome; Paper; Participant; Patients; Population; Pre-Eclampsia; Pregnancy; Pregnancy Outcome; Pregnant Women; Process; Questionnaire Designs; Randomized, Controlled Trials; Recommendation; Reporting; Reproductive Health; Research; Research Personnel; Research Project Grants; Resource-limited setting; Risk; Schedule; Seizures; Stroke; Structure; Surveys; Technology; Telephone; Time; Training; Triage; Universities; Visit; Woman; Women' s Health; arm; blood pressure elevation; career; career development; effectiveness testing; evidence base; global health; improved; informant; innovation; intervention refinement; low and middle-income countries; low health literacy; maternal morbidity; mathematical ability; mortality; neonatal outcome; pregnancy disorder; pregnant; prenatal; prevent; preventable death; primary outcome; programs; recruit; research and development; secondary outcome; skills; trial comparing; trial design

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.

项目摘要/摘要 候选人：艾玛·劳伦斯（Emma Lawrence）MD MS是一名妇产科医生，全球健康研究的重点 劳伦斯博士的长期职业目标是成为一个 独立的全球妇女健康调查员，具有随机对照试验的方法论专业知识， 研究计划的重点是管理低资源怀孕的过度疾病 设置。 研究目的：该提案的目的是实施和评估家庭血压（BP） 监测加纳高血压疾病（HDP）的风险 研究的具体目的是：（1）检查首映中家庭BP监测的障碍和促进者 加纳有HDP风险的妇女； 可用于完善相互作用的因素；（3）将RCT与每天进行比较。 使用纸记录和使用基于手机的电子的组之间的家庭BP监视 伐木和日常提醒。 研究计划：参与者将完成前调查，以探讨可接受性，可行性，障碍以及 在接受培训后的BP监控的动机，将指示参与者检查并记录 BP每天使用BP中的Pre-Prevations致电护士分类线。 遵守家庭BP监控和采用适当动作车轮BP值的能力升高， 将评估较低的表现小组，该小组的主要线人将参与 在半结构化的访谈中，以引发可用于完善干预措施的参与者因素。 手臂随机对照试验设计，对家庭BP监控的遵守，将在一组之间进行比较 使用纸记录和使用基于手机的电子记录和每日提醒的组。 职业发展计划：劳伦斯博士将在：（1）调查问卷设计（2）中发展专业知识 应用的混合方法3）撒哈拉以南非洲的高级定量方法； 高级课程和参与研究和职业发展将增强她的培训 在加纳和密歇根大学的专家指导团队的支持下 理想地准备利用K奖 研究人员。 结果，包括HDP诊断的时机，新生儿结局以及孕产妇的病情和死亡率。

项目成果

Ability and accuracy of patient-performed blood pressure monitoring among pregnant women in urban Ghana.

• DOI: 10.1016/j.xagr.2023.100243
• 发表时间: 2023-08
• 期刊: AJOG global reports
• 作者: Lawrence, Emma R;Beyuo, Titus K;Newman, Noah;Klutse, Makafui Aku;Asempa, Joshua Kafui;Pangori, Andrea;Moyer, Cheryl A;Lori, Jody R;Oppong, Samuel A
• 通讯作者: Oppong, Samuel A