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Q&A

Health Equity/Community Health

Poster Session 1

(233) Is ethnicity associated with different rates of engagement with remote postpartum blood pressure monitoring?

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

    Primary & Presenting Author(s)

  • Adam K. Lewkowitz, MD, MPH

    Assistant Professor
    Warren Alpert Medical School of Brown University, Women & Infants Hospital Rhode Island
    Providence, RI, United States

    • Coauthor(s)

  • Nina K. Ayala, MD, ScM (she/her/hers)

    Assistant Professor
    Women & Infants Hospital of Rhode Island / Warren Alpert Medical School of Brown University
    Providence, RI, United States

  • LS

    Lauren Schlichting, PhD

    Hassenfeld Child Health and Innovation Institute of Brown University
    Providence, RI, United States

  • CW

    Crystal F. Ware, RN

    Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University
    Providence, RI, United States

  • JR

    Janet Rousseau, RN

    Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University
    Providence, RI, United States

  • AO

    Amanda O'Neill, RN

    Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University
    Providence, RI, United States

  • KM

    Katherine D. McCleary, MD

    Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University
    Providence, RI, United States

  • MR

    Megan L. Ranney, MD, MPH

    Yale School of Public Health
    New Haven, CT, United States

  • Methodius G. Tuuli, MBA, MD, MPH

    Chace-Joukowsky Professor and Chair
    Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University
    Providence, RI, United States

Objective: Remote postpartum blood pressure (ppBP) programs reduce racial disparities in ppBP assessment. Their effect on ethnic disparities in ppBP assessment is less clear. We examined whether ppBP assessment differed among participants in remote ppBP monitoring programs who self-reported being Hispanic versus non-Hispanic.

Study Design: This is a planned secondary analysis of a RCT including women in our tertiary care center’s postpartum unit who had chronic or pregnancy-related hypertension (HTN) and were enrolled into our remote ppBP program, in which they manually enter BPs into a patient portal for 6 weeks. In the parent trial, consenting patients were randomized to remain in this program or be enrolled in another remote ppBP program, in which a Bluetooth-enabled BP cuff synched to an app utilizing AI to respond to each BP/symptom and flag abnormalities for providers. For this study, women who self-reported their ethnicity were stratified into two ethnic groups—Hispanic and non-Hispanic—regardless of randomization group. The primary outcome was ≥1 BP assessment 3-7 days after discharge. Secondary outcomes are listed in the Table. Odds ratios (OR) were calculated for categorical and betas for continuous outcomes.

Results: Among 119 women in the parent study, 83 (70%) self-reported ethnicity, and the proportion of Hispanic people was similar in both groups. This study included 21 Hispanic (19% monolingual in Spanish) and 62 non-Hispanic women. Rates of BP assessment 3-7 days after discharge were similar (Hispanic 71% vs Non-Hispanic 79%; OR 0.7 (95% CI 0.2, 2.0). There were no differences in mean number of remote ppBP assessments and rates of remote BP medication initiation or titration and HTN-related ED visits or readmission. Patients rated their remote ppBP program highly favorably, with median Likert scale scores of 10 (out of 10) in both groups.

Conclusion: Hispanic and non-Hispanic women in remote ppBP monitoring had similar HTN-related outcomes and favorable patient perceptions. These findings suggest the impact of remote ppBP programs on perinatal equity may not be limited to race-based disparities.