Johnson Heather M, Warner Ryan C, LaMantia Jamie N, Bowers Barbara J
Department of Medicine, School of Medicine and Public Health, University of Wisconsin, H4/512 CSC, MC 3248, 600 Highland Avenue, Madison, WI, 53792, USA.
Health Innovation Program, University of Wisconsin School of Medicine and Public Health, 800 University Bay Drive, Suite 210, Box 9445, Madison, WI, 53705, USA.
BMC Fam Pract. 2016 Mar 11;17:31. doi: 10.1186/s12875-016-0428-9.
In the U.S., young adults (18-39 year-olds) have the lowest hypertension control rates among hypertensive adults. Understanding young adults' unique perceptions about hypertension and perceived barriers to hypertension control is critical to develop effective interventions for this population. This multi-center study explored young adults': 1) emotions and reactions after a hypertension diagnosis, 2) attitudes about managing hypertension (lifestyle changes, follow-up visits, antihypertensive medication use), 3) opinions about their healthcare system's hypertension education materials, and 4) opinions about using social media to manage hypertension.
Young adults (18-39 year-olds) with a diagnosis of hypertension and regular primary care access were recruited by the Wisconsin Research and Education Network (WREN). Two focus groups (one per age range: 18-29 years, 30-39 years) were conducted in three Midwestern Family Medicine Clinics (academic, rural, and urban). Conventional content analysis was performed.
Thirty-eight young adults (mean: 26.7 [9.6] years old, 34% male, 45% Black, 42% with ≥1 year of college) identified barriers to managing hypertension. Emergent themes overlapped across age groups and geographic regions. Most respondents were surprised and angry about a hypertension diagnosis; they expected to develop hypertension, but at a much older age. A hypertension diagnosis negatively altered their "young" self-identity; suggested behavior changes and antihypertensive medications made them feel "older" than their peers. Young adults missed blood pressure follow-up visits due to co-payments, transportation barriers, and longer than desired wait times for brief visits. Contrary to our hypothesis, most young adults disliked social media or text messaging to support self-management; they were most concerned that their peers would see the hypertension communication. Current hypertension education materials were described as not addressing young adults' health questions and are often discarded before leaving the clinic.
Targeting interventions to young adults' unique needs is necessary to improve hypertension control and cardiovascular preventive healthcare delivery.
在美国，年轻成年人（18 - 39岁）在高血压成年人中的高血压控制率最低。了解年轻成年人对高血压的独特认知以及高血压控制的感知障碍对于为该人群制定有效的干预措施至关重要。这项多中心研究探讨了年轻成年人的：1）高血压诊断后的情绪和反应；2）对高血压管理的态度（生活方式改变、随访就诊、使用降压药物）；3）对其医疗系统高血压教育材料的看法；4）对使用社交媒体管理高血压的看法。
威斯康星研究与教育网络（WREN）招募了诊断为高血压且有定期初级保健服务的年轻成年人（18 - 39岁）。在三个中西部家庭医学诊所（学术型、农村型和城市型）进行了两个焦点小组讨论（每个年龄范围一组：18 - 29岁，30 - 39岁）。进行了常规内容分析。
38名年轻成年人（平均年龄：26.7 [9.6]岁，34%为男性，45%为黑人，42%拥有≥1年大学学历）确定了高血压管理的障碍。不同年龄组和地理区域出现了重叠的主题。大多数受访者对高血压诊断感到惊讶和愤怒；他们预计会患高血压，但年龄要大得多。高血压诊断负面地改变了他们“年轻”的自我认同；建议的行为改变和降压药物让他们感觉比同龄人“更老”。年轻成年人因自付费用、交通障碍以及简短就诊的等待时间比预期长而错过血压随访就诊。与我们的假设相反，大多数年轻成年人不喜欢使用社交媒体或短信来支持自我管理；他们最担心同龄人会看到高血压相关信息。当前的高血压教育材料被描述为没有解决年轻成年人的健康问题，并且在离开诊所前常常被丢弃。
针对年轻成年人的独特需求进行干预对于改善高血压控制和心血管疾病预防保健服务是必要的。
