NURS FPX 9020 Assessment 2 Literature Synthesis Organization
Student Name
Capella University
NURS-FPX 9020 Doctor of Nursing Practice 3
Professor Name
Submission Date
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Literature Synthesis: Organization
There is a high level of hypertension among Caribbean women with low levels of reported control, and this increases rates of cardiovascular morbidity and mortality in each of the mentioned groups. Culturally sensitive interventions with patient education and lifestyle change aspects have been indicated to enhance blood pressure outcomes and heighten patient engagement among minorities (Miezah & Hayman, 2024; Singh et al., 2023). With competency-based training, nurses who deliver care can offer a model to implement evidence-based interventions and help provide care in an effective and culturally respectful way (Bulto et al., 2024; Bisbey et al., 2021). The question to be used in the project is as follows: To understand how the introduction of a culturally specific lifestyle change program (I),, compared with the existing practice (C), would change the level of blood pressure control (O) in 12 weeks (T) in the nurses who directly treat the Caribbean women with hypertension in a primary care clinic (P)? The project hypothesizes that an intervention based on a structured lifestyle intervention program, culturally designed, will result in better blood pressure management and enhanced cultural competency of nursing personnel, and eventually will decrease the health inequalities within the group of women who are at high risk of getting health-related issues.
Literature Search Strategy
The evident practice gap found in literature is that although there is overwhelming evidence about professionally conducted, culturally-differentiated lifestyle hypertension management plans, most of the primary care environments continue to use the conventional hypertension education model, which cannot integrate culturally specific dietary practices, beliefs, or even social factors that influence Caribbean women in this case. The findings of Bulto (2024) also suggest that culturally-specific nurse-led interventions have been shown to help reduce systolic blood pressure and lifestyle adherence, but the results also point to the fact that the interventions are not systematically applied in clinical practice, which is why the introduction of the structured programs, where the idea of cultural competence is implemented into the framework of dealing with hypertension, is welcome. Other major keywords were: hypertension, blood pressure management, Caribbean women, culturally-sensitive interventions, lifestyle change, diet education, and nursing education. Key search terms like hypertension, blood pressure control, Caribbean women, culturally-specific interventions, lifestyle modifications, and nursing education were combined using Boolean operators (AND and OR) to make sure that a thorough and purposeful literature search was obtained. MeSH terms like Hypertension, Culturally Competent Care, Lifestyle, and Health Education were also employed. A filter was used to limit the publication date, language, peer-reviewed journals, and human subjects. Published 2022-2026, peer-reviewed journals, human subjects, and research in the English language were included. PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, and PsycInfo were searched as electronic databases. Reference lists of systematic reviews and practice guidelines related to the subject matter were searched by hand as well. The first searches have provided more than 1,200 articles.
Articles included in the criteria of the study were written in English, aimed at adult populations in the Caribbean or minority groups, interventions in which a nurse was a member of the program, and culturally-tailored initiatives aimed at making changes in blood pressure. Exclusion criteria were limited to studies that involved children, studies published in a non-English language, and studies that had no hypertension-related outcomes. Following the process of screening titles, abstracts, and full-texts, 27 articles were left that contained systematic reviews, clinical practice guidelines, randomized controlled trials, and narrative reviews. The sources identified within the articles that were retained were informative on the design of the intervention, outcome measurement, and the use of culturally specific management of hypertension.
Analysis of Evidence
The evidence matrix, developed by synthesis of the literature, will establish a framework to compare the findings of the articles included in the research review in terms of nurse-led culturally tailored lifestyle interventions aimed at enhancing hypertension management among Caribbean women. The quality and applicability of the clinical relevance of studies in the synthesis were determined based on the strength of recommendation taxonomy (SORT) framework. Evidence (as indicated by recent systematic reviews and randomized controlled trials) in favor of the applicability of culturally adapted lifestyle interventions by nurses illustrates the enhancement of systolic and diastolic blood pressure control (Caribbean women) based on the application of only one methodological rigor, but the clinical applicability of these studies can be judged using the SORT framework (Bulto et al., 2024). The grading system enhances patient-centered results and encourages evidence-based clinical decision-making steps towards culturally responsive management of hypertension.
The review of the 20 articles came up with powerful findings that advocate the use of nurse-led culturally specific interventions in the management of blood pressure, as well as lifestyle behavior modification. Eight studies (Level A) were rated as high-quality methodological studies, with randomized controlled trial designs or systematic reviews using the SORT framework, of the 20 studies that were analyzed. Nine articles were rated as moderate methodological quality (Level B), utilized quasi-experimental types of study, cohort studies, and comparative effectiveness studies with some limitations. All three works were rated at Level C and comprised any of the following types: narrative reviews, practice guidelines, or quality improvement projects (Bulto, 2024; Ocran, 2024; Brewer, 2023). The interventions were found to have a range of effect sizes, but there was evidence that they did lead to an overall reduction in systolic blood pressure by 4.5-7.6 mmHg and that they positively impacted adherence to dietary, physical activity, and stress management advice (Bulto, 2024; Ocran, 2024; Brewer, 2023). Economies of patient engagement (i.e., using technology-based interventions (mHealth apps and telehealth provision of counseling services, etc.)) and enhancing cultural acceptability of interventions were given a chance. The identified gaps are: best intervention duration, ability to scale up across clinic settings, and incorporation of social issues like food insecurity and community resources.
Structuring texts of literature by the Main Themes
Systematic review of the literature into four theme categories offers a well-organized method of integrating evidence on nurse-led, culturally-sensitive lifestyle interventions to hypertension management among Caribbean women.
Theme 1: Hypertension Prevalence, Disparities, and Social Determinants
Studies show that the level of hypertension and unequal treatment in blood pressure control is very prevalent and prominent among minority and underserved groups. Agarwal et al. (2021) have presented the United States ‘ awareness, treatment, and control disparities, which are based on racial and ethnic factors. On the same note, Oladele et al. (2025) revealed that the level of prevalence of hypertension among food-insecure populations in the Caribbean was high. However, Mills et al. (2020) identified low-resource and ethnic minority groups disproportionately affected by the global disparities in hypertension, and Bello et al. (2021) highlighted the effect of the new ACC/AHA guidelines on hypertension diagnosis in women. In the same vein, Schutte et al. found that socio-economic and healthcare access issues are a reason why the world has disparities in blood pressure control (2022).
Theme 2: Nurse-Led Interventions and Staff Competency Development
Nurse-led programs with structure have been shown to have a positive effect on BP outcomes and competence of providers. Bulto et al. (2024) found that nurse-led interventions led to a decrease in systolic and diastolic BP and a better lifestyle. Likewise, Bisbey et al. (2021) emphasized competency-based employee training in order to achieve long-term clinical performance. On the contrary, Alsadaan and Ramadan (2025) identified support by leaders and the allocation of their resources as a decisive factor in the successful adoption of the evidence-based practice. Likewise, Joo and Liu (2021) showed that the use of culturally-specific interventions enhances the coordination of care and staff involvement. Although Miezah and Hayman (2024) found that culturally-modified lifestyle modification measures lead to better hypertension outcomes.
Theme 3: Patient-Centered, Culturally Tailored Education Interventions
Patient education should be culturally adjusted to enhance the aspects of engagement and physiological results. Community-based education programs based on community knowledge were effective in improving BPs (Singh et al., 2023). Likewise, Hasan et al. (2021) showed that Caribbean Diaspora education that was culturally sensitive enhanced health literacy. Furthermore, as reported by Ocran et al. (2024), community-based interventions on a multi-level yielded an SBP effect with an average of 6-7.6 mmHg. Brewer et al. (2023), on the other hand, noted that mHealth interventions plus culturally adapted support led to a decrease in systolic BP of 6.5 mmHg. Jones et al. (2025) are keen to point out the importance of culturally-based, team-based interventions to enhance the hypertension outcomes of underserved populations.
Theme 4: Technology-Enhanced Hypertension Management and Remote Monitoring
The use of technology can be used to manage high blood pressure, accessibly and effectively. Pinto et al. (2024) highlighted the importance of culturally appropriate physical activity programs to make physical activities more adherent to among different populations. On the same note, Jackson et al. (2023) also showed that in telehealth, blood pressure was lowered and was not any different than face-to-face interventions. Further, Teng et al. (2025) found that remote monitoring, which was performed at home, maintained BP reductions. On the contrary, Blazel et al. (2024) discovered disparities at the neighborhood level and the relevance of program access via remote programs. On the same note, Abdalla et al. (2023) demonstrated that evidence-based hypertension guidelines were better adhered to in a team-based care with technology support.The thematic synthesis can offer a detailed model of how to approach the implementation of culturally specific, nurse-delivered hypertension interventions, incorporating patient-centered education, staff competency, and technology to decrease disparities and enhance blood pressure control.
Conclusion
When hypertension management or management programs are culturally relevant, and nurses lead these programs, the success rate of the women in the Caribbean countries will increase. Remote patient access through the use of technology enables long-term management of blood pressure and enhances compliance of patients towards lifestyle change and health management education. In-service staff development and training will be used to provide high-quality care that can meet the clinical guidelines. The identified strategies should be implemented to facilitate the overall health equity, as well as reduce the risk of disparity in the cardiovascular risk factors in 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, 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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NURS FPX 9020 Assessment 2
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References For
NURS FPX 9020 Assessment 2
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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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Best Capella Professors To Choose From For NURS-FPX9020 Class
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- Lisa Kreeger, PHD, RN
- Buddy Wiltcher, EdD, MSN, APRN, FNP-C
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NURS FPX 9020 Assessment 2
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Question 1: What is NURS FPX 9020 Assessment 2 about?
Answer 1: DNP literature synthesis organizing evidence on culturally tailored, nurse-led hypertension interventions for Caribbean women.
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