The Study of the Epidemiology of Pediatric Hypertension Registry (SUPERHERO): Rationale and Methods.

Despite increasing prevalence of hypertension in youth and high adult cardiovascular mortality rates, the long-term consequences of youth-onset hypertension remain unknown. This is due to limitations of prior research such as small sample sizes, reliance on manual record review, and limited analytic methods that did not address major biases. The Study of the Epidemiology of Pediatric Hypertension (SUPERHERO) is a multisite retrospective Registry of youth evaluated by subspecialists for hypertension disorders. Sites obtain harmonized electronic health record data using standardized biomedical informatics scripts validated with randomized manual record review. Inclusion criteria are index visit for International Classification of Diseases Diagnostic Codes, 10th Revision (ICD-10 code)-defined hypertension disorder ≥January 1, 2015 and age <19 years. We exclude patients with ICD-10 code-defined pregnancy, kidney failure on dialysis, or kidney transplantation. Data include demographics, anthropomorphics, U.S. Census Bureau tract, histories, blood pressure, ICD-10 codes, medications, laboratory and imaging results, and ambulatory blood pressure. SUPERHERO leverages expertise in epidemiology, statistics, clinical care, and biomedical informatics to create the largest and most diverse registry of youth with newly diagnosed hypertension disorders. SUPERHERO's goals are to (i) reduce CVD burden across the life course and (ii) establish gold-standard biomedical informatics methods for youth with hypertension disorders.

How parent stress and COVID-19 impact on the family are associated with parental pressure to eat during COVID-19.

This study aimed to assess how parent stress and COVID-19 impact on the family are associated with parental pressure to eat during the COVID-19 pandemic. Parents of healthy preschool-aged children completed measures including pressure to eat (Child Feeding Questionnaire), parent perception of their stress (Perceived Stress Scale), household food insecurity (Hunger Vital Sign) and effects of COVID-19 on families (COVID-19 Exposure and Family Impact). Children (N = 228) were racially, ethnically, and socioeconomically diverse (34 % Black, 15 % Hispanic, and 29 % with household income <$20,000). Bivariate analyses showed that parent stress at Year 1 (ß 0.02; 95 % CI 0.006, 0.04) was significantly associated with pressure to eat at Year 1 and that COVID-19 impact at Year 1 (ß 0.02; 95 % CI 0.001, 0.03) was also significantly associated with pressure to eat. Multivariable linear regression analyses showed that parent stress at Year 1 was significantly associated with pressure to eat at Year 1 (ß 0.39; 95 % CI 0.16, 0.61) while COVID-19 impact was not significantly associated with pressure to eat at Year 1. This study, consisting of racially and socioeconomically diverse children, found that while parent stress was significantly associated with increased parental utilization of pressure to eat feeding practice, COVID-19 impact was not significantly associated with pressure to eat in adjusted analyses. This suggests that overall perceived stress by parents could be an important factor in parent pressuring feeding practices.

Differences in maternal and paternal pressure to eat and perception of household responsibilities.

Controlling feeding practices, such as pressure to eat, are associated with a child's disinhibited eating and extremes in bodyweight. We aimed to explore which factors are associated with parent dyads' pressuring feeding practices, including how mothers and fathers perceive the sharing of household tasks such as mealtime and child feeding responsibilities. In this cross-sectional study, parent dyads (mother and father) of healthy preschool-aged children completed an identical questionnaire consisting of measures of picky eating (food fussiness subscale of Child Eating Behavior Questionnaire), parental concern for undereating, and pressure to eat (Child Feeding Questionnaire). We used separate multivariable linear regression models for mothers and fathers to assess correlates associated with pressure to eat subscale score, including slowness of eating and enjoyment of food, child BMI z-score and race/ethnicity, and household income. Separate unadjusted linear regression models for mothers and fathers were used to report the association of pressure to eat with household responsibilities. Parents (N = 88) had similar mean picky eating, concern for undereating, and pressure to eat scores; more fathers had high pressure to eat scores (36% vs 27%). Higher pressure to eat was significantly associated with lower income, non-Hispanic Black or Black race/ethnicity, slow eating, and lower enjoyment of food. Pressure was not associated with household responsibilities. While there were similar maternal and paternal perceptions of child eating behaviors, more fathers reported pressuring their child to eat. Identifying differences in parental feeding practices may assist in intervention development to improve feeding practices.