Document Type
Article
Publication Date
9-1-2025
Abstract
Pediatric hypertension (HTN) affects 3%-5% of children in the United States, yet only 25% are diagnosed and 60% lack recommended follow-up care. Skepticism about elevated blood pressure (BP) readings and reluctance to use antihypertensive medications by parents and clinicians highlight the need for stakeholder-informed strategies to address these challenges. This study examined parents' perceived needs, their recommended strategies to improve HTN detection, and contextual health system challenges. Parents and clinicians from 10 pediatric primary care clinics participated in semi-structured qualitative interviews. Only parents of children with documented stage 2 BP readings and a HTN diagnosis, but with gaps in care of 1 year or longer, were included. Participants were recruited from clinics in diverse communities. Thematic analysis identified major themes and recommendations guided by the Consolidated Framework for Implementation Research (CFIR). A total of 38 stakeholders participated, including 13 parents and 25 healthcare clinicians. Parents reported limited discussions in the clinic around pediatric HTN, logistical barriers related to social determinants of health, including financial burdens and insurance issues, and scheduling conflicts. Clinicians cited systemic constraints such as time limitations, staffing shortages, and insufficient resources to address social determinants of health-related needs. Parents recommended strategies, including enhanced education on pediatric HTN, flexible scheduling, telehealth, remote BP monitoring, and improved care coordination, to overcome barriers and align with systemic improvements. Parent-recommended strategies can address pediatric HTN detection challenges. However, aligning these strategies with systemic constraints is essential for effective, stakeholder-informed improvements in HTN detection.
Recommended Citation
Zaidi, Abbas H.; Sood, Erica D.; De Ferranti, Sarah; Gidding, Samuel; Zadokar, Varsha; Miller, Jonathan M.; and Kazak, Anne E, "Parent Needs, Recommendations, and Systemic Challenges Affecting Pediatric Hypertension Detection" (2025). Department of Pediatrics Faculty Papers. Paper 185.
https://jdc.jefferson.edu/pedsfp/185
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
PubMed ID
40991242
Language
English
Included in
Cardiovascular Diseases Commons, Demography, Population, and Ecology Commons, Diagnosis Commons, Pediatrics Commons
Comments
This article is the author’s final published version in Journal of Clinical Hypertension, Volume 27, Issue 9, 2025, Article number e70152.
The published version is available at https://doi.org/10.1111/jch.70152. Copyright © 2025 The Author(s).