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Context: Preterm birth (PTB) is among the leading causes of infant morbidity and mortality in the United States. PTB also presents risks to mothers. Women who deliver preterm are at twice the risk for future cardiovascular disease as women who have term deliveries. Improving women's health before conception may help reduce preterm births and improve maternal and infant outcomes. Preconception care has been highlighted in many national guidelines as crucial to the success of healthier maternal and infant outcomes. Objective: Identify gaps and opportunities in preconception care of females of reproductive age, with a focus on modifiable preconception indicators that are associated with PTBs. Methods: This is a retrospective case control study. The cases (n=221), PTBs at Lehigh Valley Health Network (LVHN), are compared to the controls (n=442), term births at LVHN. Eligible charts are those of women, 18 years and older, who delivered at one of the LVHN sites between 6/1/2018 to 5/31/2019, matched 1:2, based on age, parity and prior history of preterm delivery. Exclusion criteria is any delivery prior to 20 weeks of pregnancy or maternal age under 18 years, two years prior to pregnancy intake. Patient charts were reviewed for all primary care visits at LVHN in the 2 years prior to pregnancy intake for assessment of key indicators of preconception care. Data extracted from the Electronic Medical Records (EMR) was imported into a secure Excel database and transferred to REDCap Project. Preconception care indicators were manually reviewed and entered into the same REDCap Project. Pearson's Chi square test was used to evaluate for association between the eleven preconception indicators and PTB. All statistical tests were conducted using SPSS. Results: Three of the eleven preconception indicators, i.e., use of multivitamins 3 months before conception, diabetes control and blood pressure control in preconception have a statistically significant association with PTB (p, Presenters Ashwini Kamath Mulki, MD, MBBS, MPH, Elaine Banerjee, MD, MPH, Melanie Johnson, MPA, Katarzyna Jabbour, PharmD, BCPS, Beth Careyva, MD, FAAFP, Katie Nesbitt, PharmD, [...]

Aims: The aim of this study is to report on the development and evaluation of the co-designed website for delivering interactive self-directed cardiac rehabilitation (CR). Methods and results: Multi-method user experience design framework was used to co-design the web application and complete usability testing. Participants were recruited based on their eligibility for CR. Thematic analysis collected the participants' design specifications and lived experiences. The System Usability Scale (SUS) was administered at the completion of the website development and the usability testing workshops. This collected the participants' perceptions of the website's effectiveness, efficiency, and their satisfaction. Website development and usability testing workshops included 39 and 35 participants with a mean age of 66.5 (SD 11.7) and 68.6 (SD 11.2), respectively. Both genders were equally represented across both workshops with 19 (48.7%) and 16 (45.7%) women. Workshop themes guided the design process. The mean SUS scores increased from 66.7 (SD 16.8) to 73.6 (21), P = 0.26. Easiness of use (P = 0.03), integration of the website functions (P ≤ 0.001), and consistency (P = 0.038) significantly improved from website development to usability testing. The proportion of participants rating it as excellent increased from 20.5% to 42.9%, P = 0.11. Conclusion: The evolution of our CR website development was completed with an improvement in usability. Upcoming evaluation of this intervention will report on its effectiveness. Graphical Abstract [ABSTRACT FROM AUTHOR]

Aims: This review aimed to investigate the effectiveness of nurse-led interventions vs. usual care on hypertension management, lifestyle behaviour, and patients' knowledge of hypertension and associated risk factors. Methods: A systematic review with meta-analysis was conducted following Joanna Briggs Institute (JBI) guidelines. MEDLINE (Ovid), EmCare (Ovid), CINAHL (EBSCO), Cochrane library, and ProQuest (Ovid) were searched from inception to 15 February 2022. Randomized controlled trials (RCTs) examining the effect of nurse-led interventions on hypertension management were identified. Title and abstract, full text screening, assessment of methodological quality, and data extraction were conducted by two independent reviewers using JBI tools. A statistical meta-analysis was conducted using STATA version 17.0. Results: A total of 37 RCTs and 9731 participants were included. The overall pooled data demonstrated that nurse-led interventions may reduce systolic blood pressure (mean difference −4.66; 95% CI −6.69, −2.64; I2 = 83.32; 31 RCTs; low certainty evidence) and diastolic blood pressure (mean difference −1.91; 95% CI −3.06, −0.76; I2 = 79.35; 29 RCTs; low certainty evidence) compared with usual care. The duration of interventions contributed to the magnitude of blood pressure reduction. Nurse-led interventions had a positive impact on lifestyle behaviour and effectively modified diet and physical activity, but the effect on smoking and alcohol consumption was inconsistent. Conclusion: This review revealed the beneficial effects of nurse-led interventions in hypertension management compared with usual care. Integration of nurse-led interventions in routine hypertension treatment and prevention services could play an important role in alleviating the rising global burden of hypertension. Registration: PROSPERO: CRD42021274900 Graphical Abstract [ABSTRACT FROM AUTHOR]

Although available evidence demonstrates positive clinical outcomes for patients attending and completing cardiac rehabilitation, the effectiveness of interactive cardiac rehabilitation web applications on programme completion has not been systematically examined.This JBI systematic review of effects included studies measuring effectiveness of interactive cardiac rehabilitation web applications compared to telephone, and centre-based programmes. Outcome data were pooled under programme completion and clinical outcomes (body mass index, low-density lipoproteins, and blood pressure). Databases including MEDLINE (via Ovid), Cochrane Library, Scopus (via Elsevier) and CINAHL (via EBSCO) published in English were searched. Articles were screened and reviewed by two independent reviewers for inclusion, and the JBI critical appraisal tool and Grading of Recommendations Assessment, Development and Evaluation tool were applied to appraise and assess the certainty of the findings of the included studies. A meta-analysis of the primary and secondary outcomes used random effects models.In total, nine studies involving 1175 participants who participated in web-based cardiac rehabilitation to usual care were identified. The mean critical appraisal tool score was 76 (standard deviation: 9.7) with all (100%) studies scoring >69%, and the certainty of evidence low. Web-based programmes were 43% more likely to be completed than usual care (risk ratio: 1.43; 95% confidence interval: 0.96, 2.13) There was no difference between groups for clinical outcomes.Despite the relatively small number of studies, high heterogeneity and the limited outcome measures, the results appeared to favour web-based cardiac rehabilitation with regard to programme completion. [ABSTRACT FROM AUTHOR]