TY - JOUR
T1 - Evidence to Support Universal Blood Pressure Screening in School-Based Clinical Settings
AU - Silberstein, Juliet
AU - Gwynn, Lisa
AU - Mathew, M. Sunil
AU - Arheart, Kristopher
AU - Messiah, Sarah E.
N1 - Funding Information:
Four elementary (K‐5), two middle (6‐8), and three high schools (9‐12) were included. School‐based health services at all schools were overseen by the Dr. John T. MacDonald Foundation in partnership with the University of Miami. The University of Miami was also under contract with the Children's Trust, a grant‐making organization with a dedicated revenue stream from county tax funds, to support their program. The Florida State Health Department has authorized the Children's Trust to implement school health services for Miami‐Dade County. Schools were located in the neighborhoods of North Miami, North Miami Beach, and Overtown, predominantly comprised families of non‐Hispanic black race from a variety of ethnic backgrounds (eg, Haitian, West Indian/Caribbean Island nations, African, etc.). The Florida Department of Education reported the minority rate at the study schools to be >96% (range 95.9‐99.1%) and the percent of students qualifying for free‐and‐reduced lunch to be >89% (range 88.8‐97.3%). Parents of students with abnormal BMI or BP measurements were notified and follow‐up appointments were scheduled with clinic staff.
Funding Information:
for the Miami Dade County Public School Health Clinics is provided by the Dr. John T. Macdonald Foundation and the Children's Trust. No author has financial relationships relevant to this article to disclose. No author has conflicts of interest to disclose.
Publisher Copyright:
© 2020, American School Health Association
PY - 2020/6/1
Y1 - 2020/6/1
N2 - 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.
AB - 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.
KW - blood pressure
KW - child and adolescent health
KW - obesity
KW - pediatric hypertension
KW - school health policy
KW - school-based clinics
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U2 - 10.1111/josh.12893
DO - 10.1111/josh.12893
M3 - Article
C2 - 32236966
AN - SCOPUS:85083109490
VL - 90
SP - 474
EP - 481
JO - Journal of School Health
JF - Journal of School Health
SN - 0022-4391
IS - 6
ER -