Factors Associated With Potential Uptake Of An Alternative Hypertension Treatment In Black Americans
Bibliographic record
Abstract
Black Americans experience the greatest hypertension prevalence in comparison to other racial or ethnic groups in the United States (US). As such, there is an urgent need to translate effective blood pressure (BP)-lowering therapies into clinical practice for this population. At present, there is no existing work reporting the use of patient data to establish factors that may aid in predicting the uptake of alternative, non-pharmacological BP-lowering therapies for Black Americans with hypertension. PURPOSE: To identify factors that may indicate willingness to use isometric handgrip (IHG) training, an alternative therapy that has proven useful for BP-lowering, in Black Americans with hypertension and derive a preliminary prediction model. METHODS: Retrospective data were analyzed from a subsample of Black Americans with hypertension (N = 299) who presented to one of three Emergency Departments in Detroit, Michigan, US, and completed the IsoMetric-Associated Blood Pressure-Lowering Exercise (MAPLE) Questionnaire. A forward-stepwise binary logistic regression was performed to determine patients’ willingness to try an alternative BP-lowering treatment (e.g., IHG training) according to demographic, clinical, and psychosocial factors. RESULTS: Factors that predicted an individual’s willingness to try an alternative BP-lowering treatment included older age (odds ratio [OR] 1.03, p = 0.01), having a higher perceived life experience with racism (OR 1.05, p = 0.04), and having a previous medical history of hypertension (OR 2.20, p = 0.01). The area under the receiver operator characteristic (ROC) curve for a predictive model based on these factors was 0.67 (95% confidence interval [CI], 0.59 to 0.74). CONCLUSION: We identified several predictive factors that help identify Black Americans with hypertension willing to participate in IHG training. While a predictive model based on these factors showed poor discrimination, incorporation of an easy-to-use tool that can help clinicians identify patients who may be willing to use alternative hypertension therapies could help with implementation and improve individual BP control.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".