NURS FPX 9020 Assessment 2 Literature Synthesis Organization
Student Name
Capella University
NURS-FPX 9020 Doctor of Nursing Practice 3
Professor Name
Submission Date
Literature Synthesis: Organization
Hypertension is a significant health disparity in Caribbean women, and poor rates of reported control result in higher rates of cardiovascular morbidity and mortality in each of the identified groups. Interventions that are culturally tailored and include patient education and lifestyle change have been shown to improve blood pressure outcomes as well as increase patient engagement among minority populations (Miezah & Hayman, 2024; Singh et al., 2023). Nurses who perform care using competency-based training offer a model of applying evidence-based intervention and make sure that the care is rendered in a competent and culturally appropriate way (Bulto et al., 2024; Bisbey et al., 2021). The PICOT question that will guide the project is: Compared to the current practice (C), implementation of a culturally specific lifestyle modification programme (I) in the primary care clinic among nurses and direct care delivery to Caribbean women with hypertension (P), the type of impact on the rates of blood pressure control (O) over one year (T)? It is hypothesized that the project will result in better management of blood pressure and enhanced cultural competence of nursing personnel, and eventually will decrease health disparities among the identified group of women at high risk of developing health problems.
Literature Search Strategy
One evident practice gap that is presented by the literature is that, despite the overwhelming evidence indicating the importance of nurse-led, culturally-specific lifestyle interventions to manage hypertension, many primary care environments continue to apply standard hypertension education, lack culturally specific dietary patterns, beliefs, or social determinants influencing Caribbean women. The findings of Bulto (2024) also suggested that nurse-led programs with a cultural focus yield a better effect on systolic blood pressure and lifestyle adherence, but cite that the specified strategies are not equally used in the context of a regular clinical setting, which means that a formal program that incorporates cultural competence into the process of hypertension treatment is required. The main search terms were: hypertension, blood pressure control, Caribbean women, culturally-sensitive interventions, lifestyle modifications, dietary counseling, and nursing education. Key search terms between them were combined with the help of Boolean operators (AND and OR) to make sure that the literature search is comprehensive and focused: such key search terms as hypertension, blood pressure control, Caribbean women, culturally tailored interventions, lifestyle modifications, and nursing education. Also, MeSH terms such as ‘hypertension,’ ‘culturally competent care,’ ‘lifestyle,’ and ‘health education’ were used. Filters such as publication date, language, and peer-reviewed journals were limited, and so were human subjects. Only the publications in English, peer-reviewed journals, 2022-2026, and human subjects were considered. PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycInfo were searched using electronic databases. Hand searches of reference lists from related systematic reviews and practice guidelines were also performed. Preliminary searches found more than 1,200 articles.
The studies included in the analysis that met the inclusion criteria were those that involved adult populations of Caribbean or a minority group, nurse-led interventions that were culturally sensitive to effect lifestyle changes, and presented quantifiable changes in blood pressure. The exclusion criteria were studies involving children, studies in non-English languages, and studies not containing hypertension outcomes. Following the screening of titles, abstracts, and full-texts, 27 articles were left, containing systematic reviews, clinical practice guidelines, randomized controlled trials, and narrative reviews. Sources that were used among the retained articles were selected based on relevance to the intervention design, outcome measure, and the use of culturally specific management of hypertension.
Analysis of Evidence
By conducting a literature synthesis, the evidence matrix establishes a framework to analyze the findings of the articles used in the research review to address the issue of nurse-led culturally-sensitive lifestyle interventions aimed at enhancing hypertension management among Caribbean women. The quality of methodology and clinical applicability of the studies included in the synthesis were determined by the use of the strength of recommendation taxonomy (SORT) framework. Recent systematic reviews and randomized controlled trials provide evidence that nurse-led, culturally-sensitive lifestyle interventions have a significant impact on the systolic and diastolic blood pressure control of Caribbean women, indicating both the methodological rigor and clinical applicability in the assessment based on the SORT framework (Bulto et al., 2024). The grading system enhances patient-focused results and encourages evidence-based clinical decision-making processes to provide culturally responsive treatment of hypertension.
The 20 studies reviewed found a good result in support of the culturally sensitive interventions led by nurses in blood pressure and lifestyle behavioral change management. Out of the 20 studies reviewed, eight studies were deemed to be of high methodological quality (Level A), and two were randomized controlled trials or systematic reviews (under the SORT framework). Nine studies were rated as moderate (Level B) in their methodological quality, and the study designs were quasi-experimental, cohort studies, and comparative effectiveness studies with limitations. The last set of three research papers was rated as Level C, and they consisted of narrative reviews, practice guidelines, or quality improvement projects (Bulto, 2024; Ocran, 2024; Brewer, 2023). The interventions were found to have varying effects. However, some evidence indicated that the interventions had an overall 4.5-7.6 mmHg systolic blood pressure reduction and positively impacted the response to dietary, physical activity, and stress management recommendations (Bulto, 2024; Ocran, 2024; Brewer, 2023). The fact that technology-enhanced interventions (including mHealth applications and telehealth counseling services) were used offered a possibility to enhance patient engagement and, at the same time, make the interventions culturally acceptable. There are gaps in the form of the optimal duration of intervention, the availability of the latter in the setting of a clinic, and the addition of social determinants such as food insecurity and community resources.
Organization of Literature According to the Main Themes
Four thematic areas have been used to arrange the literature, which provide a systematic means of synthesising evidence on nurse-led culturally-specific lifestyle interventions to manage hypertension in Caribbean women.
Theme 1: Hypertension Prevalence, Disparities, and Social Determinants
The role of social determinants of health and health disparities in the accessibility of healthcare is another important reason why hypertension disparities are prevalent in minority groups. Aggarwal et al. (2021) also discovered that the United States had a steady disparity in awareness, treatment, and management of hypertension based on race and ethnicity and identified systemic disparities in offering preventive care. On the same note, Oladele et al. (2025) determined a disproportionately high prevalence rate of hypertension among food-insecure communities in the Caribbean and how economic instability affected the disease burden. Mills et al. (2020), on the other hand, introduced a worldview and showed how the inequalities related to hypertension are distributed around low-resource settings and are mostly disproportionate and experienced by the ethnic minorities in all corners of the world. Equally, Schutte et al. (2022) emphasized the fact that inadequate access to healthcare, poverty, and structural issues are major impediments to blood pressure management among various groups. Bello et al. (2021) also reported that new ACC/AHA guidelines enhanced the detection of hypertension in women, thus exposing groups that were underdiagnosed previously. Altogether, the literature reveals that disparities in hypertension are multifactorial, and they are determined by socioeconomic, systemic, and policy-level factors. The synthesis highlights the importance of tackling upstream social determinants of hypertension in combination with clinical interventions to support equitable hypertension outcomes. To solve structural inequities, the public health strategies, following food security, healthcare access, and socioeconomic stability, have to be incorporated. Policy interventions and community-based outreach initiatives are still important to alleviate the burden of hypertension in Caribbean women. Prevention should be reinforced with a more equity-oriented approach, and enhance long-term blood pressure control outcomes.
Theme 2: Nurse-Led Interventions and Staff Competency Development
The nurse-led interventions and competency-based training are essential to enhance the outcomes of hypertension management and maintain the evidence-based practice. Bulto et al. (2024) have shown that the structured nurse-led interventions considerably decreased the systolic and diastolic blood pressure and encouraged positive lifestyle changes in patients. Equally, Bisbey et al. (2021) have pointed out that competency-based training promotes clinical performance and facilitates regular provision of evidence-based care. Conversely, Alsadaan and Ramadan (2025) emphasized that the success of nurse-led evidence-based practices is impossible without the involvement of the leadership in the organization and the allocation of organizational resources. In line with this observation, Joo and Liu (2021) discovered that culturally sensitive interventions through trained personnel enhanced care coordination and provider involvement in patient-centered care. Miezah and Hayman (2024) also indicated that culturally modified lifestyle programs by nurses led to significant improvement in the outcomes of hypertension in minority groups. In general, the literature shows that nurse-led models are effective, but the success will be determined by the organizational support, training of the workforce, and cultural competence. The identified theme demonstrates the significance of combining staff development strategies with clinical interventions in order to maximize the hypertension management outcomes. The maintenance of clinical improvement is based on the constant development of professionals and the solidification of evidence-based competencies in the nursing staff. Training infrastructure and leadership participation by organizations enhance adherence to implementation and clinical outcomes. Incorporation of cultural competence in nurse-led models will boost performance among a wide range of patients.
Theme 3: Patient-Centered, Culturally Tailored Education Interventions
Culturally adjusted and patient-based education interventions are fundamental when it comes to enhancing the outcomes of hypertension among different groups of people. Singh et al. (2023) confirmed that community-informed education programs tremendously improved blood pressure control by aligning health messages with cultural beliefs and practices. Equally, Hasan et al. (2021) have indicated that culturally competent education interventions that targeted groups of the Caribbean diaspora enhanced health literacy and patient engagement. Furthermore, Ocran et al. (2024) discovered that community-based programs with a multi-level approach saw clinically significant systolic blood pressure reductions of between 6 and 7.6 mmHg. Contrary to this, Brewer et al. (2023) emphasized that mHealth interventions with culturally-influenced support showed similar systolic blood pressure decreases, which means that the integration of technology and education could be effective. Equally, Jones et al. (2025) stressed the importance of culturally-sensitive, team-based care practices in enhancing outcomes in hypertension among underserved groups. Collectively, the literature suggests that culturally relevant education enhances patient adherence, engagement, and clinical outcomes. The synthesis supports the role of cultural-specificity in interventions in order to be effective and sustainable. Relevant communication strategies can enhance the understanding of patients and the sustainability of lifestyle change behaviors as they are culturally relevant. Towards the disarmament of the socially constructed and culturally relevant intervention, community involvement and incorporation of culturally significant practices can raise acceptance of the intervention and enhance the participation rates. To achieve success in the long run, the educational interventions, patient values, and local health beliefs have to be in harmony.
Theme 4: Technology-Enhanced Hypertension Management and Remote Monitoring
Interventions that are enhanced by the use of technology will offer unique ways of aiding with the management of hypertension and overcoming barriers associated with access. Pinto et al. (2024) have shown that physical activity programs based on technology and aligned with culture enhanced compliance to diverse populations. On the same note, the findings of Jackson et al. (2023) revealed that telehealth interventions were able to produce similar blood pressure reduction as the traditional in-person care, demonstrating their usefulness in remote care. Additionally, Teng et al. (2025) indicated that long-term blood pressure reductions were maintained in the home-based remote monitoring systems because of continuous tracking of the patients and prompt clinical intervention. Conversely, Blazel et al. (2024) found that there were long-standing and ongoing differences in neighborhoods, which required technology-based methods to address geographic and socioeconomic barriers to care. On the same note, Abdalla et al. (2023) showed that care models that were delivered via teams and were facilitated by digital health technologies increased compliance with hypertension guidelines and care coordination. In sum, the literature suggests that technology increases accessibility, continuity of care, and patient engagement. The theme underscores the importance of including digital health solutions with culturally sensitive and nurse-focused interventions in enhancing hypertension outcomes. The development of telehealth and remote monitoring enhances the accessibility of health care among underserved and geographically isolated communities. The implementation of digital tools within the clinical workflow improves real-time decision-making and follow-up of patients. The strategic adoption of technology-based models of care can help to sustainably manage hypertension and decrease the disparity in care delivery.
Conclusion
Community-based, patient-focused programs incorporate culturally sensitive interventions by nurses, in which the Caribbean women will experience a better success rate in hypertension management. Remote access to patients with the help of technology gives the opportunity to control blood pressure over a long period of time and enhance the number of patients adhering to lifestyle changes and education regarding health management. High-quality care that fulfills the clinical guidelines will be provided through staff development and training. The mentioned strategies could be implemented to improve health equity in the entire population and reduce inequities in cardiovascular risk factors.
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, regression models | Significant racial/ethnic disparities exist in awareness, treatment, and control; Black adults had 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 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, hypertension control | Descriptive statistics, regression analyses | Higher hypertension prevalence in food-insecure populations; food insecurity 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 higher in low-resource and ethnic minority groups; control 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 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 prevalence of hypertension in pregnant women using updated ACC/AHA guidelines | Not explicitly stated | Observational cohort | BP measurement, pregnancy outcome tracking | Pregnant women in U.S. healthcare system | Maternal BP, pregnancy outcomes | Descriptive statistics, logistic regression | Updated guidelines increased prevalence identification; early recognition 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 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 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 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 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 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, 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 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 Medicine. https://doi.org/10.1177/15598276241297675 | Peer-reviewed | To explore 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 targeted rationale for 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 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 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 Caribbean women 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 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 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 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 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 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 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
Below are references for NURS FPX 9020 Assessment 2 Literature Synthesis: Organization:
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. Hypertension, 78(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 Nursing, 24(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 American Medical Association Network Open, 7(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 Research, 7, 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 Nursing, 23(1), 21-32. https://doi.org/10.1093/eurjcn/zvad040
Chu, W., Wippold, G., & Becker, K. D. (2022). A systematic review of cultural competence trainings for mental health providers. Professional Psychology: Research and Practice, 53(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 Health, 18(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 Reports, 4(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. Circulation, 152, 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. Circulation, 134(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 Health, 5(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 Research, 119(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 Disparities, 10(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 Medicine, 23(1), 1–8. https://doi.org/10.1186/s12916-025-04278-6
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NURS FPX 9020 Assessment 2
Question 1: What is NURS FPX 9020 Assessment 2 about?
Answer 1: NURS FPX 9020 Assessment 2 involves literature synthesis and an evidence table for a hypertension intervention project.
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