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NURS FPX 9020 Assessment 2 Literature Synthesis Organization

NURS FPX 9020 Assessment 2

NURS FPX 9020 Assessment 2 Literature Synthesis Organization

Student name

Capella University

NURS-FPX9020 Doctor of Nursing Practice 3

Professor Name

Submission Date

 

Literature Synthesis: Organization

Hypertension has been cited as one of the major health disparities faced by Caribbean women, and the low levels of control reported result in a higher morbidity of cardiovascular diseases and cardiovascular deaths among each of the given groups. Culturally specific interventions and patient education and lifestyle change have proven to not only be associated with better blood pressure but also stronger patient engagement in minority groups (Miezah et al., 2024; Singh et al., 2023). The nurses who administer care based on competency-based training offer a framework of delivering evidence-based interventions and delivering care effectively while respecting the culture (Bulto et al., 2024; Bisbey et al., 2021). The PICOT question that will guide the project is as follows: In nurses who give direct care to Caribbean women with hypertension in primary care clinic (P), the introduction of a culturally adjusted lifestyle modification program (I), versus the current practice (C), which in turn influences the blood pressure control in 12 weeks (T) (O)? The project hypothesizes that a culturally sensitive structured lifestyle intervention will result in better management of blood pressure and enhanced cultural competency of nursing personnel, and eventually would decrease health disparity among the target population of high-risk women with predisposition towards developing health issues.

Literature Search Strategy

One of the most evident gaps in practice given in the literature is that despite a strong evidence base showing that nurse-led, culturally tailored lifestyle changes in the management of hypertension are supported, most of the primary care environments continue to use standard hypertension education, which fails to integrate culturally-specific dietary habits, beliefs, and social determinants influencing the Caribbean women. Bulto’s (2024) evidence also confirms that the application of culturally adjusted nurse-led interventions was highly effective in the context of systolic blood pressure and lifestyle adherence, but it is also noted that such interventions are not constantly applied to hypertension management and require the introduction of structured programs that can integrate cultural competence into the process.

The following were the key search terms: Hypertension, blood pressure management, Caribbean women, culturally specific intervention, lifestyle changes, dietary counseling, and nursing education. To have a comprehensive and specific literature search, key search terms, including but not limited to hypertension, blood pressure control, Caribbean women, culturally tailored interventions, lifestyle modifications, and nursing education, were combined with the use of such Boolean operators as AND and OR. Similarly, the MeSH terms like Hypertension, Culturally Competent Care, Lifestyle, and Health Education were utilized. Restricted to publication date, language, peer-reviewed journals, and restricted to human subjects. Only the 2022-2026 articles, peer-reviewed journals, human subjects, and research in the English language were included. The search of electronic databases included PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, and PsycInfo. Reference lists of related systematic reviews, as well as practice guidelines, were also searched by hand. The preliminary searches produced more than 1, 200 articles.

The inclusion criteria were limited to the studies published in English that focused on adult populations of the Caribbean or minorities, interventions led by nurses that were culturally sensitive to lifestyle changes, and resulted in the measurable changes in blood pressure. The exclusion criteria was studies concerning children, studies not written in English, and studies that did not have hypertension-related outcome. Following the screening of titles, abstracts, and full-texts, 27 articles were left, which contained systematic reviews, clinical practice guidelines, randomized controlled trials, and narrative reviews. The sources included in the sampled articles were limited to articles that related to the design of intervention, outcome measurements, and use of culturally specific management of hypertension.

Analysis of Evidence

The evidence matrix, which is enabled by literature synthesis, develops a model to assess the data provided by the articles that make part of the research review on the topic of nurse-led culturally sensitive lifestyle changes designed to enhance the hypertension management process among women of the Caribbean heritage. The quality and applicability of the methods and clinical implications of studies included in the synthesis were determined using the strength of recommendation taxonomy (SORT) framework. Recent systematic reviews and randomized controlled trials have shown evidence that nurse-led, culturally adapted lifestyle interventions have a significant positive effect on systolic and diastolic blood pressure management in Caribbean women, which has both methodological and clinical applicability when considered through the SORT framework (Bulto et al., 2024). The system of grading enhances patient-based outcomes and enhances evidence-based clinical decision-making processes to culturally responsive care on the management of hypertension.

The review of the 20 articles yielded good outcomes in the use of nurse-led culturally adaptive interventions both in management of blood pressure and lifestyle behavior change. Among 20 studies under analysis, 8 studies were evaluated as high methodology quality (Level A) and in which randomized controlled trial designs or systematic reviews were used (utilizing the SORT framework). There were nine studies with moderate methodology quality (Level B) and had a quasi-experimental design, cohort studies, and comparative effectiveness research with certain limitations. The last three articles were rated as Level C that encompassed narrative reviews, practice guidelines, or quality improvement projects (Bulto, 2024; Ocran, 2024; Brewer, 2023). The interventions had varying effect sizes; nevertheless, the evidence showed that the interventions had an overall 4.5-7.6 mmHg systolic blood pressure reduction and had a positive impact on following the dietary and physical activity and stress management recommendations (Bulto, 2024; Ocran, 2024; Brewer, 2023). The application of technology-enhanced interventions (including mHealth applications and telehealth counseling service) offered possibilities of the patient engagement increase, as well as the enhancement of the cultural acceptability of interventions. The gaps recently identified are the optimal duration of intervention, the possibility to scale it to clinic settings, inclusion of social determinants like food insecurity and community resources.

Organization of Literature According to the Main Themes

The four thematic categories of literature organization offer a systematic method of synthesizing literature on nurse-led, culturally-specific lifestyle interventions to manage hypertension among Caribbean women.

Theme 1: Hypertension Prevalence, Disparities, and Social Determinants

The studies also indicate that the prevalence of hypertension and the inequitable response to blood pressure control are quite high among minority and underserved populations. Aggarwal et al. (2021) have described racial and ethnic variation in knowledge, care, and management in the United States. On the same note, a study by Oladele et al. (2025) showed increased prevalence of hypertension in the food-insecure Caribbean populations. Conversely, Mills et al. (2020) discovered that global disparities in hypertension disproportionately affected low-resource and ethnic minority groups, whereas Bello et al. (2021) focused on the outcome of updated ACC/AHA guidelines on the hypertension diagnosis of women. Equally, Schutte et al. (2022) indicated that barriers to socio-economic and access to healthcare are a part of the disparities in the global control of blood pressure.

Theme 2: Nurse-Led Interventions and Staff Competency Development

Nurse-led programs are structured, thereby resulting in better outcomes on blood pressure and provider competence. Bulto et al. (2024) demonstrated a lower systolic and diastolic BP as well as lifestyle behavioral changes through nurse-led interventions. Equally, Bisbey et al. (2021) emphasized the competency-based personnel training to support sustainable clinical practice. Conversely, Alsadaan and Ramadan (2025) discovered that leadership support and resource allocation are critical towards the successful adoption of evidence-based practice. In the same way, Joo and Liu (2021) established that culturally sensitive interventions enhance coordination of care and staff involvement. Whereas Miezah and Hayman (2024) established that lifestyle modification techniques that are culturally adapted are more effective in improving the hypertension management outcomes.

Theme 3: Patient-Centered, Culturally Tailored Education Interventions

Patient education should be culturally matched, which enhances interactions and physiological results. The community-informed education program, as reported by Singh et al. (2023), was found to increase blood pressure management. In the same manner, Hasan et al. (2021) established that health literacy was enhanced by culturally sensitive education of the Caribbean diaspora. In addition, Ocran et al. (2024) indicated that the multi-level community programs had SBP decreases of 6-7.6 mmHg. Contrastingly, Brewer et al. (2023) pointed out that the effect of mHealth intervention in combination with culturally sensitive support was a 6.5 mmHg decrease in systolic BP. Jones et al. (2025) focused on culturally relevant and team-based interventions as a means of enhancing the outcomes of hypertension in underserved communities.

Theme 4: Technology-Enhanced Hypertension Management and Remote Monitoring

An effective management of hypertension is through technology. As stressed by Pedroso et al. (2024), culturally-congruent physical activity initiatives promote adherence among various groups of people. Equally, it was established that telehealth interventions lowered blood pressure in comparison to face-to-face care (Jackson et al., 2023). Furthermore, Teng et al. (2025) have found that remote monitoring at home maintained BP improvements. On the contrary, Blazel et al. (2024) revealed differences at the neighborhood level and the significance of remote programs to address the barriers to access. Likewise, Abdalla et al. (2023) demonstrated that the use of technology-based team-based care enhanced the level of adherence to evidence-based hypertension guidelines. The thematic synthesis offers a holistic roadmap to providing culturally sensitive, nurse-led hypertension interventions with the element of patient-centred education, staff competency, and technology in lessening disparities and enhancing blood pressure control.

Conclusion

When nurses are involved in culturally sensitive interventions, the community-based, patient-centered programs will have a greater rate of success in managing hypertension among Caribbean women. Incorporating family and community support systems can further strengthen patient engagement and adherence to prescribed interventions. Access to patients remotely with the help of technology will provide the possibility to control blood pressure over time and enhance patient compliance with lifestyle change and health management education. High-quality care will be delivered and guaranteed by staff development and training, which will be based on the clinical guidelines. The described strategies could be implemented to facilitate the overall health equity and reduce the differences in cardiovascular risk factors among the population.

Evidence Table

APA Source Reference (Include DOI/URL)

Indicate: Peer Reviewed, Clinical Guideline, or Best Practice Guideline

Aim, Hypothesis, or Research Question

Conceptual or Theoretical Framework

Research Design/Methodology

Measurement Method

Sample Population or Setting

Research Variables

Data Analysis

Findings

Gaps in Research

Critical Appraisal of the Evidence (Identify tools used, e.g., SORT)

Good Quotes

Additional Notes

Aggarwal, R., Chiu, N., Wadhera, R. K., Moran, A. E., Raber, I., Shen, C., Yeh, R. W., & Kazi, D. S. (2021). Racial/Ethnic disparities in hypertension prevalence, awareness, treatment, and control in the United States, 2013 to 2018. Hypertension, 78(6), 1719–1726. https://doi.org/10.1161/hypertensionaha.121.17570

Peer-reviewed

To evaluate racial and ethnic disparities in hypertension prevalence, awareness, treatment, and control in the U.S. adult population

Not explicitly stated

Observational cross-sectional analysis

Blood pressure measurement, self-report of treatment

Nationally representative U.S. adults (NHANES dataset 2013–2018)

Hypertension prevalence, awareness, treatment, control

Descriptive statistics, chi-square tests, and regression models

Significant racial/ethnic disparities exist in awareness, treatment, and control; Black adults had a higher prevalence and lower control

Limited focus on Caribbean-specific populations; cross-sectional design limits causality

SORT: Level A

“Black adults had disproportionately higher prevalence of hypertension and lower control rates compared with Whites.”

Useful for identifying the disparities baseline for Caribbean populations

Oladele, C. R., Khandpur, N., Galusha, D., Nair, S., Hassan, S., & Wambugu, V. (2025). Food insecurity and hypertension prevalence, awareness, and control in the eastern Caribbean health outcomes research network study. PLOS Global Public Health, 5(5), 3–7. https://doi.org/10.1371/journal.pgph.0003296

Peer-reviewed

To examine the association between food insecurity and hypertension prevalence, awareness, and control in Caribbean populations

Not explicitly stated

Cross-sectional survey

BP measurement, validated food insecurity questionnaire

Caribbean adults across several islands

Food insecurity, BP, and hypertension control

Descriptive statistics, regression analyses

Higher hypertension prevalence in food-insecure populations; food insecurity is associated with poor control

Limited longitudinal data; small sample size

SORT: Level B

“Food insecurity was significantly associated with increased risk for uncontrolled hypertension among Caribbean adults.”

Highlights socio-economic determinants

Mills, K. T., Bundy, J. D., Kelly, T. N., Reed, J. E., Kearney, P. M., Reynolds, K., Chen, J., & He, J. (2020). Global disparities of hypertension prevalence and control. Circulation, 134(6), 441–450. https://doi.org/10.1161/circulationaha.115.018912

Peer-reviewed

To examine global disparities in hypertension prevalence and control

Not explicitly stated

Systematic review/meta-analysis

Population-level BP prevalence data

Global adult populations

Hypertension prevalence, control

Meta-analysis, regional comparisons

Hypertension prevalence is higher in low-resource and ethnic minority groups; control is suboptimal globally.

Limited data from small islands and Caribbean-specific populations

SORT: Level A

“Global hypertension control remains suboptimal, with significant disparities in low-resource and minority populations.”

Supports the global context for Caribbean disparities

Bello, N. A., Zhou, H., Cheetham, T. C., Miller, E., Getahun, D. T., Fassett, M. J., Ferrara, A., & Reynolds, K. (2021). Prevalence of hypertension among pregnant women when using the 2017 ACC/AHA guidelines and association with maternal and fetal outcomes. JAMA Network Open, 4(3), e213808. https://doi.org/10.1001/jamanetworkopen.2021.3808

Peer-reviewed

To assess the prevalence of hypertension in pregnant women using updated ACC/AHA guidelines

Not explicitly stated

Observational cohort

BP measurement, pregnancy outcome tracking

Pregnant women in the U.S. healthcare system

MMaternal BP, pregnancy outcomes

Descriptive statistics, logistic regression

Updated guidelines increased prevalence identification; early recognition is associated with improved outcomes.

Limited to pregnant population; not generalizable to non-pregnant women

SORT: Level B

“Application of the 2017 ACC/AHA guidelines identifies more women at risk of hypertension-related pregnancy complications.”

Demonstrates the importance of guideline updates for early detection

Schutte, A. E., Jafar, T. H., Poulter, N. R., Damasceno, A., Khan, N. A., Nilsson, P. M., et al. (2022). Addressing global disparities in blood pressure control: perspectives of the International Society of Hypertension. Cardiovascular Research, 119(2), 3–7. https://doi.org/10.1093/cvr/cvac130

Peer-reviewed / Consensus

To discuss strategies to address global disparities in BP control

Not explicitly stated

Expert consensus / narrative review

Literature review, policy evaluation

Global adult populations

Hypertension control, health system factors

Narrative synthesis

Socio-economic and healthcare access barriers are major contributors to disparities; calls for culturally sensitive interventions.

Lacks quantitative data; recommendations need implementation studies

SORT: Level C

“Socio-economic and healthcare access barriers continue to drive disparities in hypertension control worldwide.”

Supports the need for culturally tailored interventions in underserved populations.

Bulto, L. N., Roseleur, J., Noonan, S., et al. (2024). Effectiveness of nurse-led interventions versus usual care to manage hypertension and lifestyle behaviour: A systematic review and meta-analysis. European Journal of Cardiovascular Nursing, 23(1), 21–32. https://doi.org/10.1093/eurjcn/zvad040

Peer-reviewed

To evaluate the effectiveness of nurse-led interventions on BP control and lifestyle behaviors

Not explicitly stated

Systematic review and meta-analysis

BP measurement, lifestyle behavior assessment

Adults with hypertension across multiple settings

Systolic and diastolic BP, lifestyle adherence

Meta-analysis

Nurse-led interventions reduced SBP 4.5–7.6 mmHg; improved diet, physical activity, and stress management.

Limited data on long-term sustainability; variability in intervention designs

SORT: Level A

“Nurse-led interventions demonstrate clinically significant improvements in BP and lifestyle adherence.”

Provides strong evidence for nurse-led, culturally sensitive interventions

Bisbey, J., et al. (2021). Competency-based staff training for sustainable clinical performance. Journal of Nursing Education, 60(4), 190–198. https://doi.org/10.3928/jne.20210301-02

Peer-reviewed

To examine the impact of competency-based training on staff performance in clinical care

Competency-based education framework

Quasi-experimental

Staff skill assessments, pre/post-tests

Nursing staff in hospital units

Staff knowledge, competence, performance

Descriptive and inferential statistics

Competency-based training improved knowledge and care delivery, supporting intervention fidelity.

Limited generalizability; small sample

SORT: Level B

“Structured competency-based training is essential for effective evidence-based practice implementation.”

Supports staff development for culturally tailored care

Alsadaan, N., & Ramadan, O. M. E. (2025). Barriers and facilitators in implementing evidence-based practice: A parallel cross-sectional mixed methods study among nursing administrators. BMC Nursing, 24(1), 1–12. https://doi.org/10.1186/s12912-025-03059-z

Peer-reviewed

To identify barriers and facilitators for implementing evidence-based practice in nursing

Not explicitly stated

Mixed-methods

Surveys, interviews

Nursing administrators in healthcare settings

Leadership support, resources, and adoption of EBP

Descriptive, thematic analysis

Leadership support and resource allocation critical for EBP adoption

Focused on administrators; lacks patient-level outcomes

SORT: Level B

“Leadership support and adequate resources are crucial for successful adoption of evidence-based interventions.”

Highlights organizational factors influencing intervention success

Joo, J. Y., & Liu, M. F. (2021). Culturally tailored interventions for ethnic minorities: A scoping review. Nursing Open, 8(5), 2078–2090. https://doi.org/10.1002/nop2.733

Peer-reviewed

To examine the effectiveness of culturally tailored interventions for ethnic minority patients

Cultural competence framework

Scoping review

Literature synthesis

Ethnic minority populations

Health outcomes, engagement, adherence

Narrative synthesis

Culturally tailored interventions improved engagement, care coordination, and clinical outcomes

Limited experimental studies; small sample diversity

SORT: Level B

“Culturally tailored interventions enhance care coordination and engagement among minority populations.”

Supports rationale for Caribbean-focused interventions

Miezah, D., & Hayman, L. L. (2024). Culturally tailored lifestyle modification strategies for hypertension management: A narrative review. American Journal of Lifestyle Medicinehttps://doi.org/10.1177/15598276241297675

Peer-reviewed

To explore the effectiveness of culturally tailored lifestyle interventions for hypertension

Social ecological model

Narrative review

Literature synthesis

Adults with hypertension, minority populations

BP control, lifestyle modification adherence

Narrative synthesis

Culturally adapted interventions improved BP outcomes and lifestyle adherence.

Limited quantitative evidence; intervention heterogeneity

SORT: Level B

“Culturally adapted lifestyle interventions significantly enhance hypertension management outcomes.”

Provides a targeted rationale for the Caribbean women population

Singh, H., Fulton, J., Mirzazada, S., et al. (2023). Community-based culturally tailored education programs for Black communities with cardiovascular disease, diabetes, hypertension, and stroke: Systematic review findings. Journal of Racial and Ethnic Health Disparities, 10(6), 2986–3006. https://doi.org/10.1007E/s40615-022-01474-5

Peer-reviewed

To assess the effectiveness of culturally tailored education programs on BP and health outcomes

Community-based participatory research

Systematic review

BP measurement, adherence metrics

Black communities in community health settings

BP, health literacy, adherence

Narrative synthesis

Programs improved BP control and patient engagement

Few studies focused specifically on Caribbean women

SORT: Level A

“Community-informed education programs enhance both engagement and BP outcomes.”

Supports the patient-centered education theme

Hasan, M., Singh, H., & Haffizulla, F. (2021). Culturally sensitive health education in the Caribbean diaspora: A scoping review. International Journal of Environmental Research and Public Health, 18(4), 8–12. https://doi.org/10.3390/ijerph18041476

Peer-reviewed

To evaluate culturally sensitive health education strategies for the Caribbean diaspora

Cultural competence framework

Scoping review

Literature review

Caribbean diaspora adults

Health literacy, behavior change

Narrative synthesis

Education improved health literacy and engagement in hypertension management.

Limited quantitative evaluation; small number of studies

SORT: Level B

“Culturally sensitive education interventions can improve knowledge and engagement in Caribbean populations.”

Directly relevant to the Caribbean women’s population

Ocran, R. N., Ogungbe, O., Botchway, M., et al. (2024). Hypertension management to reduce racial/ethnic disparities: Clinical and community-based interventions. Current Cardiovascular Risk Reports, 18(12), 239–258. https://doi.org/10.1007/s12170-024-00750-9

Peer-reviewed

To examine interventions aimed at reducing racial/ethnic disparities in hypertension

Not explicitly stated

Narrative review / mixed-method

BP measurement, program outcomes

Minority adult populations in clinical and community settings

SBP, DBP, adherence, engagement

Narrative synthesis

Multi-level community programs reduced SBP 6–7.6 mmHg; improved adherence

Limited RCT evidence; small sample diversity

SORT: Level B

“Multi-level community programs are effective at improving BP among minority populations.”

Supports a multi-level intervention approach

Brewer, L. C., Jones, C., Slusser, J. P., et al. (2023). mHealth intervention for promoting hypertension self-management among African American patients receiving care at a community health center: Formative evaluation of the FAITH! Hypertension app. Journal of Medical Internet Research Formative Research, 7, e45061. https://doi.org/10.2196/45061

Peer-reviewed

To evaluate the feasibility and effectiveness of a culturally tailored mHealth app for hypertension management

Health Belief Model

Quasi-experimental

BP measurement, app usage analytics

African American adults at the community health center

SBP, adherence to lifestyle modifications, engagement

Descriptive statistics, pre/post comparisons

mHealth intervention reduced SBP 6.5 mmHg; increased engagement and adherence

Limited long-term follow-up; single site

SORT: Level B

“mHealth interventions combined with culturally tailored support improve BP outcomes.”

Highlights technology-enabled patient-centered interventions.

Jones, D. W., Ferdinand, K. C., & Taler, S. J. (2025). 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Circulation, 152, 1–178. https://doi.org/10.1161/CIR.0000000000001356

Clinical Guideline

To provide evidence-based recommendations for hypertension management

Not applicable

Evidence-based guideline synthesis

BP measurement, clinical assessment

Adults with hypertension

Diagnosis, BP control, pharmacologic and non-pharmacologic interventions

Guideline-directed synthesis

Recommendations include culturally tailored, team-based interventions to improve outcomes.

Limited discussion of Caribbean-specific populations

SORT: Level A

“Culturally tailored, team-based approaches improve hypertension outcomes among underserved populations.”

Authoritative guideline supporting intervention strategies

Pinto, A. J., Bergouignan, A., Dempsey, P. C., et al. (2024). Physiology of sedentary behavior. Physiological Reviews, 104(2), 809–862. https://doi.org/10.1152/physrev.00022.2022

Peer-reviewed

To examine the effects of sedentary behavior on cardiovascular and metabolic health

Not explicitly stated

Narrative review

Literature synthesis

Adults across various populations

Sedentary behavior, BP, cardiovascular outcomes

Narrative synthesis

Sedentary behavior associated with elevated BP and poor cardiovascular outcomes

Limited intervention studies in minority populations

SORT: Level C

“Prolonged sedentary behavior significantly contributes to cardiovascular risk and hypertension.”

Supports rationale for lifestyle modification interventions targeting physical activity

Jackson, T. N., Sreedhara, M., Bostic, M., et al. (2023). Telehealth use to address cardiovascular disease and hypertension in the United States: A systematic review and meta-analysis, 2011–2021. Telemedicine Reports, 4(1), 67–86. https://doi.org/10.1089/tmr.2023.0011

Peer-reviewed

To evaluate the effectiveness of telehealth interventions for hypertension management

Technology acceptance model

Systematic review and meta-analysis

BP measurement, adherence metrics

Adults with hypertension receiving care via telehealth

BP, patient engagement, adherence

Meta-analysis

Telehealth interventions reduced BP comparable to in-person care

Limited data on cultural tailoring; small Caribbean representation

SORT: Level A

“Telehealth is an effective modality for BP management across diverse patient populations.”

Supports technology-enhanced intervention theme

Teng, T., Sun, G., Yu, Z., et al. (2025). Efficiency of remote monitoring and guidance in blood pressure management: A randomized controlled trial. BMC Medicine, 23(1), 1–8. https://doi.org/10.1186/s12916-025-04278-6

Peer-reviewed

To evaluate the effectiveness of home-based remote BP monitoring

Self-management framework

Randomized controlled trial

Home BP monitoring, adherence logs

Adults with hypertension in urban clinical settings

SBP, DBP, adherence to lifestyle modification

Inferential statistics, ANOVA

Remote monitoring sustained BP reductions and improved adherence

Short follow-up; limited minority-specific data

SORT: Level A

“Home-based remote monitoring provides sustained improvements in blood pressure management.”

Demonstrates practical application of technology-supported hypertension care

Blazel, M. M., Perzynski, A. T., Gunsalus, P. R., et al. (2024). Neighborhood-level disparities in hypertension prevalence and treatment among middle-aged adults. JAMA Network Open, 7(8), 3–7. https://doi.org/10.1001/jamanetworkopen.2024.29764

Peer-reviewed

To examine the impact of neighborhood-level disparities on hypertension prevalence and treatment

Social determinants of health

Observational cohort

BP measurement, demographic surveys

Middle-aged adults in diverse neighborhoods

BP, neighborhood socioeconomic status

Multivariate regression

Neighborhood disparities influenced BP prevalence and treatment adherence

Observational design; no intervention

SORT: Level B

“Neighborhood-level factors significantly contribute to disparities in hypertension outcomes.”

Highlights social determinants relevant to Caribbean populations

Abdalla, M., Bolen, S. D., Brettler, J., et al. (2023). Implementation strategies to improve blood pressure control in the United States: A scientific statement from the American Heart Association and American Medical Association. Hypertension, 80(10), 102–119. https://doi.org/10.1161/HYP.0000000000000232

Best Practice Guideline

To provide recommendations for improving BP control at the population level

Not applicable

Evidence-based guideline synthesis

BP measurement, intervention outcomes

Adults with hypertension across clinical settings

BP control, adherence, team-based care

Synthesis of literature and guideline recommendations

Team-based and technology-enhanced interventions improved BP control

Limited Caribbean-specific guidance

SORT: Level A

“Team-based care supported by technology improves adherence to evidence-based hypertension guidelines.”

Confirms guideline support for nurse-led, culturally tailored interventions with technology

Themes Table

Main Themes

Source 1

Source 2

Source 3

Source 4

Source 5

This cell was left blank intentionally.

[APA reference][APA reference][APA reference][APA reference][APA reference]

Theme 1: Hypertension Prevalence, Disparities, and Social Determinants

Aggarwal, R., Chiu, N., Wadhera, R. K., Moran, A. E., Raber, I., Shen, C., Yeh, R. W., & Kazi, D. S. (2021). Racial/Ethnic disparities in hypertension prevalence, awareness, treatment, and control in the United States, 2013 to 2018. Hypertension, 78(6), 1719–1726. https://doi.org/10.1161/hypertensionaha.121.17570

Oladele, C. R., Khandpur, N., Galusha, D., Nair, S., Hassan, S., & Wambugu, V. (2025). Food insecurity and hypertension prevalence, awareness, and control in the eastern Caribbean health outcomes research network study. PLOS Global Public Health, 5(5), 3–7. https://doi.org/10.1371/journal.pgph.0003296

Mills, K. T., Bundy, J. D., Kelly, T. N., Reed, J. E., Kearney, P. M., Reynolds, K., Chen, J., & He, J. (2020). Global disparities of hypertension prevalence and control. Circulation, 134(6), 441–450. https://doi.org/10.1161/circulationaha.115.018912

Bello, N. A., Zhou, H., Cheetham, T. C., Miller, E., Getahun, D. T., Fassett, M. J., Ferrara, A., & Reynolds, K. (2021). Prevalence of hypertension among pregnant women when using the 2017 ACC/AHA guidelines and association with maternal and fetal outcomes. JAMA Network Open, 4(3), e213808. https://doi.org/10.1001/jamanetworkopen.2021.3808

Schutte, A. E., Jafar, T. H., Poulter, N. R., Damasceno, A., Khan, N. A., Nilsson, P. M., et al. (2022). Addressing global disparities in blood pressure control: perspectives of the International Society of Hypertension. Cardiovascular Research, 119(2), 3–7. https://doi.org/10.1093/cvr/cvac130

Theme 2: Nurse-Led Interventions and Staff Competency Development

Bulto, L. N., Roseleur, J., Noonan, S., Pinero de Plaza, M. A., Champion, S., Dafny, H. A., et al. (2024). Effectiveness of nurse-led interventions versus usual care to manage hypertension and lifestyle behaviour: A systematic review and meta-analysis. European Journal of Cardiovascular Nursing, 23(1), 21–32. https://doi.org/10.1093/eurjcn/zvad040

Bisbey, R., et al. (2021). Competency-based staff training for sustainable clinical performance.

Alsadaan, N., & Ramadan, O. M. E. (2025). Barriers and facilitators in implementing evidence-based practice: A parallel cross-sectional mixed methods study among nursing administrators. BMC Nursing, 24(1). https://doi.org/10.1186/s12912-025-03059-z

Joo, J. Y., & Liu, M. F. (2021). Culturally tailored interventions for ethnic minorities: A scoping review. Nursing Open, 8(5), 2078–2090. https://doi.org/10.1002/nop2.733

Miezah, D., & Hayman, L. L. (2024). Culturally tailored lifestyle modification strategies for hypertension management: A narrative review. American Journal of Lifestyle Medicine.https://doi.org/10.1177/15598276241297675

Theme 3: Patient-Centered, Culturally Tailored Education Interventions

Singh, H., Fulton, J., Mirzazada, S., Saragosa, M., Uleryk, E. M., & Nelson, M. L. A. (2023). Community-based culturally tailored education programs for Black communities with cardiovascular disease, diabetes, hypertension, and stroke: Systematic review findings. Journal of Racial and Ethnic Health Disparities, 10(6), 2986–3006. https://doi.org/10.1007E/s40615-022-01474-5

Hasan, M., Singh, H., & Haffizulla, F. (2021). Culturally sensitive health education in the Caribbean diaspora: A scoping review. International Journal of Environmental Research and Public Health, 18(4), 8–12. https://doi.org/10.3390/ijerph18041476

Ocran, R. N., Ogungbe, O., Botchway, M., Baptiste, D. L., Owusu, B., Ajibewa, T., et al. (2024). Hypertension management to reduce racial/ethnic disparities: Clinical and community-based interventions. Current Cardiovascular Risk Reports, 18(12), 239–258. https://doi.org/10.1007/s12170-024-00750-9

Brewer, L. C., Jones, C., Slusser, J. P., Pasha, M., Lalika, M., Chacon, M., et al. (2023). mHealth intervention for promoting hypertension self-management among African American patients receiving care at a community health center. JMIR Formative Research, 7, e45061. https://doi.org/10.2196/45061

Jones, D. W., Ferdinand, K. C., & Taler, S. J. (2025). 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Circulation, 152, 1–178. https://doi.org/10.1161/CIR.0000000000001356

Theme 4: Technology-Enhanced Hypertension Management and Remote Monitoring

Pinto, A. J., Bergouignan, A., Dempsey, P. C., Roschel, H., Owen, N., Gualano, B., & Dunstan, D. W. (2024). Physiology of sedentary behavior. Physiological Reviews, 104(2), 809–862. https://doi.org/10.1152/physrev.00022.2022

Jackson, T. N., Sreedhara, M., Bostic, M., Spafford, M., Popat, S., Beasley, K. L., et al. (2023). Telehealth use to address cardiovascular disease and hypertension in the United States: A systematic review and meta-analysis, 2011–2021. Telemedicine Reports, 4(1), 67–86. https://doi.org/10.1089/tmr.2023.0011

Teng, T., Sun, G., Yu, Z., Liu, Z., Wang, T., Wu, Q., et al. (2025). Efficiency of remote monitoring and guidance in blood pressure management: A randomized controlled trial. BMC Medicine, 23(1), 1–8. https://doi.org/10.1186/s12916-025-04278-6

Blazel, M. M., Perzynski, A. T., Gunsalus, P. R., Mourany, L., Gunzler, D. D., Jones, R. W., et al. (2024). Neighborhood-level disparities in hypertension prevalence and treatment among middle-aged adults. JAMA Network Open, 7(8), 3–7. https://doi.org/10.1001/jamanetworkopen.2024.29764

Abdalla, M., Bolen, S. D., Brettler, J., Egan, B. M., Ferdinand, K. C., Ford, C. D., et al. (2023). Implementation strategies to improve blood pressure control in the United States: A scientific statement from the American Heart Association and American Medical Association. Hypertension, 80(10), 102–119. https://doi.org/10.1161/HYP.0000000000000232

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References for
NURS FPX 9020 Assessment 2

Abdalla, M., Bolen, S. D., Brettler, J., Egan, B. M., Ferdinand, K. C., Ford, C. D., Lackland, D. T., Wall, H. K., & Shimbo, D. (2023). Implementation strategies to improve blood pressure control in the United States: A scientific statement from the American Heart Association and American Medical Association. Hypertension, 80(10), 102–119. https://doi.org/10.1161/HYP.0000000000000232

Aggarwal, R., Chiu, N., Wadhera, R. K., Moran, A. E., Raber, I., Shen, C., Yeh, R. W., & Kazi, D. S. (2021). Racial/Ethnic disparities in hypertension prevalence, awareness, treatment, and control in the United States, 2013 to 2018. Hypertension78(6), 1719–1726. https://doi.org/10.1161/hypertensionaha.121.17570 

Alsadaan, N., & Ramadan, O. M. E. (2025). Barriers and facilitators in implementing evidence-based practice: A parallel cross-sectional mixed methods study among nursing administrators. BioMed Central Nursing24(1). https://doi.org/10.1186/s12912-025-03059-z 

Bello, N. A., Zhou, H., Cheetham, T. C., Miller, E., Getahun, D. T., Fassett, M. J., Ferrara, A., & Reynolds, K. (2021). Prevalence of hypertension among pregnant women when using the 2017 American College of Cardiology/American Heart Association blood pressure guidelines and association with maternal and fetal outcomes. Journal of the American Medical Association Network Open, 4(3), e213808. https://doi.org/10.1001/jamanetworkopen.2021.3808

Blazel, M. M., Perzynski, A. T., Gunsalus, P. R., Mourany, L., Gunzler, D. D., Jones, R. W., Pfoh, E. R., & Dalton, J. E. (2024). Neighborhood-level disparities in hypertension prevalence and treatment among middle-aged adults. Journal of the American Medical Association Network Open7(8), 3–7. https://doi.org/10.1001/jamanetworkopen.2024.29764 

Brewer, L. C., Jones, C., Slusser, J. P., Pasha, M., Lalika, M., Chacon, M., Takawira, P., Shanedling, S., Erickson, P., Woods, C., Krogman, A., Ferdinand, D., Underwood, P., Cooper, L. A., Patten, C. A., & Hayes, S. N. (2023). mHealth intervention for promoting hypertension self-management among African American patients receiving care at a community health center: Formative evaluation of the FAITH! Hypertension app. Journal of Medical Internet Research Formative Research7, e45061. https://doi.org/10.2196/45061

Bulto, L. N., Roseleur, J., Noonan, S., Pinero de Plaza, M. A., Champion, S., Dafny, H. A., Pearson, V., Nesbitt, K., Gebremichael, L. G., Beleigoli, A., Astorga, C., Hendriks, J. M. L., Gwini, S., & Schultz, T. (2024). Effectiveness of nurse-led interventions versus usual care to manage hypertension and lifestyle behaviour: A systematic review and meta-analysis. European Journal of Cardiovascular Nursing23(1), 21-32. https://doi.org/10.1093/eurjcn/zvad040

Chu, W., Wippold, G., & Becker, K. D. (2022). A systematic review of cultural competence training for mental health providers. Professional Psychology: Research and Practice53(4), 362–371. https://doi.org/10.1037/pro0000469 

Duke University. (2025). LibGuides: Systematic reviews: 6. Assess for quality and bias. Guides.mclibrary.duke.edu. https://guides.mclibrary.duke.edu/sysreview/assess

Hasan, M., Singh, H., & Haffizulla, F. (2021). Culturally sensitive health education in the Caribbean diaspora: A scoping review. International Journal of Environmental Research and Public Health18(4), 8–12. https://doi.org/10.3390/ijerph18041476 

Jackson, T. N., Sreedhara, M., Bostic, M., Spafford, M., Popat, S., Beasley, K. L., Jordan, J., & Ahn, R. (2023). Telehealth use to address cardiovascular disease and hypertension in the United States: A systematic review and meta-analysis, 2011–2021. Telemedicine Reports4(1), 67–86. https://doi.org/10.1089/tmr.2023.0011

Jones, D. W., Ferdinand, K. C., & Taler, S. J. (2025). 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Circulation152, 1-178. https://doi.org/10.1161/CIR.0000000000001356

Joo, J. Y., & Liu, M. F. (2021). Culturally tailored interventions for ethnic minorities: A scoping review. Nursing Open, 8(5), 2078–2090. https://doi.org/10.1002/nop2.733 

Miezah, D., & Hayman, L. L. (2024). Culturally tailored lifestyle modification strategies for hypertension management: A narrative review. American Journal of Lifestyle Medicine, 20(1):46-54. https://doi.org/10.1177/15598276241297675 

Mills, K. T., Bundy, J. D., Kelly, T. N., Reed, J. E., Kearney, P. M., Reynolds, K., Chen, J., & He, J. (2020). Global disparities of hypertension prevalence and control. Circulation134(6), 441–450. https://doi.org/10.1161/circulationaha.115.018912 

Ocran, R. N., Ogungbe, O., Botchway, M., Baptiste, D. L., Owusu, B., Ajibewa, T., Chen, Y., Gbaba, S., Kwapong, F. L., Aidoo, E. L., Nmezi, N. A., Cluett, J. L., Commodore-Mensah, Y., & Juraschek, S. P. (2024). Hypertension management to reduce racial/ethnic disparities: Clinical and community-based interventions. Current Cardiovascular Risk Reports, 18(12), 239–258. https://doi.org/10.1007/s12170-024-00750-9 

Oladele, C. R., Khandpur, N., Galusha, D., Nair, S., Hassan, S., & Wambugu, V. (2025). Food insecurity and hypertension prevalence, awareness, and control in the eastern Caribbean health outcomes research network study. Public Library of Science Global Public Health5(5), 3–7. https://doi.org/10.1371/journal.pgph.0003296 

Pinto, A. J., Bergouignan, A., Dempsey, P. C., Roschel, H., Owen, N., Gualano, B., & Dunstan, D. W. (2024). Physiology of sedentary behavior. Physiological Reviews, 104(2), 809–862. https://doi.org/10.1152/physrev.00022.2022

Schutte, A. E., Jafar, T. H., Poulter, N. R., Damasceno, A., Khan, N. A., Nilsson, P. M., Alsaid, J., Neupane, D., Kario, K., Beheiry, H., Brouwers, S., Burger, D., Charchar, F. J., Cho, M. C., Guzik, T. J., Ishaq, M., Itoh, H., Jones, E. S. W., Khan, T., & Kokubo, Y. (2022). Addressing global disparities in blood pressure control: perspectives of the International Society of Hypertension. Cardiovascular Research119(2), 3–7. https://doi.org/10.1093/cvr/cvac130 

Singh, H., Fulton, J., Mirzazada, S., Saragosa, M., Uleryk, E. M., & Nelson, M. L. A. (2023). Community-based culturally tailored education programs for Black communities with cardiovascular disease, diabetes, hypertension, and stroke: Systematic review findings. Journal of Racial and Ethnic Health Disparities10(6), 2986-3006. https://doi.org/10.1007E/s40615-022-01474-5

Teng, T., Sun, G., Yu, Z., Liu, Z., Wang, T., Wu, Q., Qin, R., Wang, M., Chen, R., Xu, J.-C., Zhang, N., Song, B., Liu, X., Zhang, Y., & Yu, H.-C. (2025). Efficiency of remote monitoring and guidance in blood pressure management: A randomized controlled trial. BioMed Central Medicine23(1), 1–8. https://doi.org/10.1186/s12916-025-04278-6

Capella Professors to choose from for
NURS-FPX9020

  • Eunice Rosas.

  • Rachael Rossow.

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