A School-based Program to Improve Hypertension Awareness and Blood Pressure Control in the Community: Rationale, Design, and Planned Pilot Testing

Context: Despite the existence of national guidelines and over 70 antihypertensive medications, 42% of hypertensives are not being treated, and up to 75% of those treated are not at goal blood pressure. Over 30% of adults are not even aware that they have hypertension. Innovative strategies aimed at the community level might lead to improved hypertension awareness and control. Objectives: (1) To describe the rationale behind a school-based intervention designed to raise children's awareness of the health risks of high blood pressure as well as strategies that can help reduce those health risks and to serve as an innovative means of deploying home blood pressure monitors in an effort to raise community awareness of high blood pressure. (2) To describe planned pilot testing of the program. Design: Pilot, crossover trial. Setting: Public school in a suburban community. Participants: Fifth grade students and their parents/guardians. Intervention: (1) Classroom didactic about hypertension followed by an in-class laboratory consisting of measurement of blood pressure using automatic oscillometric devices. (2) Automatic blood pressure devices taken home by students for measurement of parent/guardian blood pressures with a form of immediate feedback. Main and Secondary Outcomes: (1) Child and parent/guardian knowledge about high blood pressure, (2) Parent/guardian intent to have blood pressure checked by health professional, (3) Parent/guardian reported control of blood pressure. Results/Conclusions: The pilot study (n=60 students) is currently ongoing. Results will not be available until June/July 2006-05. Importantly, as a pilot study, the goal is not to demonstrate effectiveness but to assess feasibility in preparation for a larger trial.