Background: African American (AA) women have the highest prevalence of hypertension (HTN) in the United States. Community health screenings targeting cardiovascular disease risk and awareness are effective in re-patterning knowledge, attitudes, and motivation concerning healthcare issues; however, limited data exists on the prevalence of essential health follow-up (FU) post community health screenings in participants with an elevated systolic blood pressure (SBP).
Objective: To examine and identify sociodemographic and clinical factors associated with health provider FU among African American women with a systolic blood pressure greater than 140.
Methods: Participants were AA women (n=401) with and without a prior history of HTN; mean age 51 ± 14 years, mean SBP 133±19, DBP 83±13, BMI 32 ± 9.2 with 52 % >30, 87.9% insured status, 58% college educated, and 36% with prior diagnosis of HTN. The Behavioral Model of Health Service Use guided variable selection for predictors of health provider FU. Baseline (BL) variables and measures: age, education, insurance, income, BMI, SBP, diastolic BP (DBP), HTN history, and recommended health FU. Analysis included descriptive, correlational, and logistic regression statistics.
Results: A total of 37 (9.2%) were referred for provider FU. Only 32.4% of those referred (n=12) sought FU compared to 68% (n=25) of those that did not. Sociodemographic and clinical variables were entered into the logistic regression model. For each 1-unit increase in BMI, the odds of provider FU in women were 1.03 times higher than those that did not FU post screening (OR 1.03, 95% CI:1.01-1.06, p=.01).
Discussion: Elevated BMI was the only predictor of health provider follow-up among AA women. Obesity is a significant risk factor for cardiovascular disease morbidity and mortality and may trigger greater self-perceived risk and FU. FU was low and of concern was the lack significance of HTN history in the model. Greater research is needed to identify strategies to promote effective FU after HTN risk identification.