# Adherence to Clinical Practice Guidelines for Screening and Management of Pediatric High Blood Pressure within a Massachusetts Safety-Net Health Care System

> **NIH NIH F31** · UNIV OF MASSACHUSETTS MED SCH WORCESTER · 2022 · $33,958

## Abstract

PROJECT SUMMARY
Cardiovascular trajectories begin in early childhood and continue across the life course. Early recognition and
management of cardiovascular disease (CVD) risk factors in childhood stand to improve these trajectories and
prevent CVD risk factors in adulthood. One CVD risk factor which in conjunction with obesity has gained
prominence in childhood and which affects about 1 in every 25 children in the U.S is hypertension. Health
disparities which are intrinsically linked to social determinants of health (i.e., the circumstances that children
live in), persist in the prevalence of hypertension with consistently higher rates of this condition seen in those of
lower socioeconomic status and those of Black race and Latino ethnicity. The American Academy of Pediatrics
(AAP) 2017 Clinical Practice Guidelines recommend regular screening and follow-up for the detection and
management of hypertension. However, diagnosis of this condition is rare (~74% undiagnosed), and there are
racial disparities in the likelihood of diagnosis as white children are more likely to have this condition
diagnosed. Understanding the processes that lead to a diagnosis of hypertension (e.g., blood pressure
screening and follow-up), since the release of the updated AAP guidelines, is lacking. Therefore, the goal of
the present investigation is to describe the current state of pediatric blood pressure screening and follow-up
according to the 2017 AAP guidelines. Using retrospective electronic health record data for children aged 3-17
years from the UMass Memorial Health Care System, a safety-net system, and the largest non-for profit health
care system in Central Massachusetts, we will: (1) conduct a one year period prevalence study to quantify the
prevalence of guideline adherent blood pressure screening and examine disparities in lack of receipt of
guideline concordant care; (2) conduct a cohort study through which we will describe the cumulative incidence
of guideline adherent follow-up after the detection of high blood pressure and disparities in the lack of receipt of
guideline concordant care; and (3) conduct a qualitative study through which we will describe providers’
experiences with and perceptions of clinical practice guidelines for pediatric blood pressure screening and
follow-up. Through the present work it is hypothesized that inequities in care, heterogeneity in follow-up, and
challenges to guideline adherence will be identified to inform future efforts to improve clinical practice guideline
uptake and pediatric preventive care. Supported by a robust academic environment at the University of
Massachusetts Medical School, and a rigorous, tailored training plan, this F31 will position Ms. Goulding to
become an independent investigator addressing CVD health disparities among youth.

## Key facts

- **NIH application ID:** 10464844
- **Project number:** 1F31HL164126-01
- **Recipient organization:** UNIV OF MASSACHUSETTS MED SCH WORCESTER
- **Principal Investigator:** Melissa Goulding
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $33,958
- **Award type:** 1
- **Project period:** 2022-06-01 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10464844

## Citation

> US National Institutes of Health, RePORTER application 10464844, Adherence to Clinical Practice Guidelines for Screening and Management of Pediatric High Blood Pressure within a Massachusetts Safety-Net Health Care System (1F31HL164126-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10464844. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*