{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T05:31:37Z","timestamp":1783229497635,"version":"3.54.6"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Pediatric hypertension (HTN) affects 3%\u20135% of children in the United States, yet only 25% are diagnosed and 60% lack recommended follow\u2010up care. Skepticism about elevated blood pressure (BP) readings and reluctance to use antihypertensive medications by parents and clinicians highlight the need for stakeholder\u2010informed strategies to address these challenges. This study examined parents\u2019 perceived needs, their recommended strategies to improve HTN detection, and contextual health system challenges. Parents and clinicians from 10 pediatric primary care clinics participated in semi\u2010structured qualitative interviews. Only parents of children with documented stage 2 BP readings and a HTN diagnosis, but with gaps in care of 1 year or longer, were included. Participants were recruited from clinics in diverse communities. Thematic analysis identified major themes and recommendations guided by the Consolidated Framework for Implementation Research (CFIR). A total of 38 stakeholders participated, including 13 parents and 25 healthcare clinicians. Parents reported limited discussions in the clinic around pediatric HTN, logistical barriers related to social determinants of health, including financial burdens and insurance issues, and scheduling conflicts. Clinicians cited systemic constraints such as time limitations, staffing shortages, and insufficient resources to address social determinants of health\u2010related needs. Parents recommended strategies, including enhanced education on pediatric HTN, flexible scheduling, telehealth, remote BP monitoring, and improved care coordination, to overcome barriers and align with systemic improvements. Parent\u2010recommended strategies can address pediatric HTN detection challenges. However, aligning these strategies with systemic constraints is essential for effective, stakeholder\u2010informed improvements in HTN detection.<\/jats:p>","DOI":"10.1111\/jch.70152","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T15:14:42Z","timestamp":1758726882000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Parent Needs, Recommendations, and Systemic Challenges Affecting Pediatric Hypertension Detection"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3521-8942","authenticated-orcid":false,"given":"Abbas H.","family":"Zaidi","sequence":"first","affiliation":[{"name":"Nemours Children's Health Cardiac Center  Wilmington Delaware USA"},{"name":"Department of Pediatrics Sidney Kimmel Medical College Thomas Jefferson University  Philadelphia Pennsylvania 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