Abstract P507: Adherence to Pediatric Screening Guidelines for Cardiovascular Risk Factors in a Diverse Cohort of Children in Chicago

Abstract

Background: Preventive screenings in children and adolescents encourage maintenance of optimal cardiovascular health (CVH) early in life, but there may be a gap between recommendations and clinical practice. We evaluated adherence to pediatric guidelines for universal age-based and risk-based screening for body mass index (BMI), blood pressure (BP), lipids, and blood glucose. Methods: We used 2010-2018 ambulatory visit data from children aged 2-12y within CAPriCORN, an electronic health record network from major healthcare systems in Chicago. For each child who attended a well-child visit and met age and/or risk-based criteria, receipt of BMI, BP, lipids, and/or HbA1c or fasting blood glucose measurements were assessed. For each metric, proportion adherence was calculated via generalized estimating equations with an exchangeable correlation structure and was stratified by age, sex, race/ethnicity, and insurance status. Results: This study included 87,549 children who attended 197,559 well-child encounters. Across all encounters, children were 51.5% male and mean (SD) age 6.4 (3.3) years. Universal age-based screening prevalence (95% CI) per 100 eligible children was 77.1 (76.8, 77.3) for BMI, 33.4 (33.1, 33.7) for BP, and 9.6 (9.3, 9.9) for lipids. Risk-based screening prevalence (95% CI) per 100 eligible children was 13.9 (12.2, 15.9) for BP, 6.9 (6.4, 7.5) for lipids, and 13.3 (12.6, 14.1) for blood glucose. Conclusions: Early screening of CVH risk factors could lead to earlier interventions, which could alter CVH trajectories across the lifetime. Low levels of adherence to universal age-based and risk-based CVH screening highlight the gap between recommendations and clinical practice, emphasizing the need to understand and address barriers to screening in pediatric populations.