Abstract Body:
Introduction: The University of Pennsylvania Shelter Health Outreach Program (SHOP) is a student-led community health initiative where volunteers go weekly to various sites around Philadelphia and take blood pressure (BP) for unhoused guests at no cost. The objective of the study is to estimate the prevalence of high BP among the unhoused population in Philadelphia and its association with various factors relating to health access.

Methods: SHOP BP screening tables were set up at six food and housing sites once a week from September 2022 to December 2023. The study cohort included guests who voluntarily came to the tables for BP measurement. High BP was defined as having a single measurement systolic BP over 130 mmHg and/or having a diastolic blood pressure over 80 mmHg. BP results and responses to survey questions about health status and momentary social situation were stored in a secure cloud server. The data were analyzed using the R statistical software.

Results: We surveyed 2,138 guests across the 6 sites. Among the guests who were surveyed, 73.6% had high BP and of these 65% of guests had at least stage 2 hypertension as defined by the American Heart Association Guidelines. In addition, a higher proportion of high BP was observed among guests who were returning to a SHOP table for a repeat screening after one or more weeks. A higher proportion of high BP was also observed for guests who reported having had a physical exam in the past year. At least one-third of the guests reported as returning to the screening site after having received a prior BP screening from a SHOP table.

Conclusions: Our results show a high burden of hypertension, especially severe hypertension, in the unhoused population in Philadelphia. Although significant challenges exist to ascertain accurate BP readings at the community level, SHOP demonstrated relatively high retention. This model of BP screening represents a distinct opportunity to introduce community-based interventions to manage hypertension in such a highly disadvantaged population.