Implementation of a New Kiosk Technology for Blood Pressure Management in a Community-Based Primary Care Clinic

Background: Hypertension (HTN) is the most potent cardiovascular disease worldwide and a major public health concern in the U.S. Although Social Determinants of Health (SDoH) are associated with HTN, it is unclear whether these indicators are routinely captured in the primary care setting. We sought to examine the prevalence of any HTN and its association with captured SDoH for new patients (pts) presenting to an urban community primary care clinic for 2019 and 2020. Methods and Results: We identified a cohort-based, cross-sectional sample of 2,577 new pts ≥ 18 years of age in a community clinic in Atlanta, GA, between Jan 2019 and Dec 2020. Electronic health records were reviewed to determine the rate of selected SDoH indicators (financial strain, transportation, medical transportation, and food insecurity) captured at any time and the presenting blood pressure for all new patients. Blood pressure was classified as follows: normal, systolic BP/diastolic BP (SBP/DBP) ≤120/80 mmHg, elevated SBP 120-129mmHg and DBP<80mm, stage 1 SBP 130-139mmHg or DBP 80-90mmHg, and stage 2 SBP ≥ 140mmHg+ or DBP 90mmHg+. Likelihood-ratio Chi-square tests were analyzed to detect an association between SDOH and stages of HTN. Of the 2,577 pts seen, 93% were African American, 72% were female, 59% were single, 77% had BMI ≥ 25, and 85% were insured. Only 41% (n=1062) pts had information of at least one SDoH measure in the entire cohort. Of the SDoH domains evaluated, financial strain and food insecurity were more likely in new pts with stage 1 HTN or higher (χ2= 16.0, df=8, p=0.04; χ2= 27.7, df=12, p=0.006). Conclusion: Routine assessments of SDoH for African American pts presenting for new pt visits are suboptimal in the primary care setting. However, financial strain and food insecurity are significantly associated with stage 1 and 2 HTN in this population. Standardization of intake processes is essential to increase the collection of SDoH indicators and may ultimately guide secondary prevention strategies for HTN interventions.

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713 BLOOD PRESSURE CONTROL AND THE NUMBER OF ANTI-HYPERTENSIVE DRUGS NEEDED AT AN URBAN PRIMARY CARE CLINIC

Journal of Hypertension ◽

10.1097/01.hjh.0000420695.91122.bc ◽

2012 ◽

Vol 30 ◽

pp. e207

Author(s):

Yook-Chin Chia ◽

SiewMooi Ching

Keyword(s):

Blood Pressure ◽

Primary Care ◽

Blood Pressure Control ◽

Primary Care Clinic ◽

Pressure Control ◽

Care Clinic

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Pilot of Community-Based Diabetes Self-Management Support for Patients at an Urban Primary Care Clinic

Diabetes Spectrum ◽

10.2337/ds18-0040 ◽

2019 ◽

Vol 32 (2) ◽

pp. 157-163

Author(s):

Pamela Jo Johnson ◽

Mollie O’Brien ◽

Dimpho Orionzi ◽

Lovel Trahan ◽

Todd Rockwood

Keyword(s):

Primary Care ◽

Primary Care Clinic ◽

Self Management ◽

Management Support ◽

Community Based ◽

Care Clinic

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Cluster-Randomized Controlled Trial of Oscillometric vs. Manual Sphygmomanometer for Blood Pressure Management in Primary Care (CRAB)

American Journal of Hypertension ◽

10.1038/ajh.2009.55 ◽

2009 ◽

Vol 22 (6) ◽

pp. 598-603 ◽

Cited By ~ 15

Author(s):

M. R. Nelson ◽

S. Quinn ◽

L. Bowers-Ingram ◽

J. M. Nelson ◽

T. M. Winzenberg

Keyword(s):

Blood Pressure ◽

Primary Care ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Cluster Randomized Controlled Trial ◽

Pressure Management ◽

Randomized Controlled ◽

Blood Pressure Management ◽

Cluster Randomized

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Pregnant Hispanic Women: A Mental Health Study

Families in Society The Journal of Contemporary Social Services ◽

10.1177/104438949207300901 ◽

1992 ◽

Vol 73 (9) ◽

pp. 515-521 ◽

Cited By ~ 11

Author(s):

Luis H. Zayas ◽

Nancy A. Busch-Rossnagel

Keyword(s):

Mental Health ◽

Primary Care ◽

Low Income ◽

Mental Health Problems ◽

Hispanic Women ◽

Primary Care Clinic ◽

Health Study ◽

Community Based ◽

Care Clinic ◽

Mental Health Study

By most accounts, pregnant Hispanic women are a population at risk for perinatal health and mental health problems. In this article, the authors report on a pilot study of the mental health status of 86 low-income, pregnant Hispanics. Three cases drawn from a community-based, primary care clinic demonstrate how Hispanic women may appear in the clinical setting and how interventions can be designed.

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Reaching Out to Rural Caregivers and Veterans with Dementia Utilizing Clinical Video-Telehealth

10.20944/preprints201804.0229.v1 ◽

2018 ◽

Author(s):

James S. Powers ◽

Jennifer Buckner

Keyword(s):

Primary Care ◽

Rural Areas ◽

Primary Care Clinic ◽

Primary Care Providers ◽

Dementia Care ◽

Mental Health Provider ◽

Care Providers ◽

Community Based ◽

Term Care ◽

Care Clinic

Context: A clinical video telehealth (CVT) program was implemented improve access and quality of dementia care to patients and their caregivers in rural areas. The program was offered as part of an established dementia clinic/geriatric primary care clinic in collaboration with five community-based outpatient clinics (CBOC’s) affiliated with the Tennessee Valley Healthcare System (TVHS) in middle Tennessee. Telehealth support was provided by a physician – social worker team visit. Methods: Telehealth training and equipment were provided to clinic personnel, functioning part-time with other collateral clinical duties. Patients and caregivers were referred by primary care providers and had an average of 1 to 2 CVT encounters originating at their local CBOC lasting 20 to 30 minutes. Clinical characteristics and outcomes of patients and caregivers receiving CVT support were collected by retrospective electronic medical record (EMR) review. Results: Over a 3-year period 45 CVT encounters were performed on patient-caregiver pairs, followed for a mean of 15 (1-36) months. Some 80% patients had dementia confirmed and 89% of these had serious medical comorbidities, took an average of 8 medications, and resided at a distance of 103 (76-148) miles from the medical center. Dementia patients included 33% with late stage dementia, 25% received additional care from a mental health provider, 23% took antipsychotic medications, 19% transitioned to a higher level of care, and 19% expired an average of 10.2 months following consultation. Caregiver distress was present in 47% of family members. Consult recommendations included 64% community-based long-term care services and supports (LTSS), 36% medications, and 22% further diagnostic testing. Acceptance of the CVT encounter was 98%, with 8770 travel miles saved. Conclusion: CVT is well received and may be helpful in providing dementia care and supporting dementia caregivers to obtain LTSS for high-need older adults in rural areas.

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