Case Study Part I
Student’s name: Maria Diaz
Instructor: Moriane Joseph
Course: Integration Advanced Primary Care of Family
Date: May 16, 2024
High Blood Pressure in the Elderly Population of Miami, Florida
High blood pressure, or hypertension, is a significant health issue for the elderly in Miami, Florida. According to Oliveros et al. (2020), almost 70% of adults aged 65 years and older are hypertensive, making it a very prevalent health issue in this older age group. Now in Miami, with a heavy elderly population due to the city’s popularity as a retirement haven, hypertension causes huge risks such as heart disease, stroke, and kidney failure. This health promotion program aims to reduce risks by improving the elderly population’s ability in Miami to manage their high blood pressure through evidence-based, realistic, and measurable interventions on lifestyle modifications and regular monitoring to reduce the incidence and complications of hypertension.
Selected Condition and PICOT Question
Condition: High Blood Pressure (Hypertension) in the Elderly Population
PICOT Question: In elderly adults living in Miami, Florida (P), does the implementation of a self-management program (I) reduce blood pressure levels (O) compared to standard care (C) over six months (T)?
Vulnerable Population
In Miami, several factors predispose the elderly to the risk of hypertension. Age is the first predisposing factor; with increased age, blood vessels lose their elasticity and cause increased blood pressure. The elderly population is very common with a high-sodium diet, physical inactivity, and obesity. These then increase the risks for the elderly population. Socioeconomic factors also predispose the elderly in terms of possible low access to healthcare and their inability to buy healthy food since they might have fixed incomes. It follows that indeed, the evidence does support these risk factors, hence the call for tailored interventions. For instance, in one study, it was noted that “hypertension prevalence among older adults is significantly influenced by socioeconomic status and lifestyle choices.”
Review of Literature
Management of hypertension in older adults is very challenging and complex, as highlighted by Oliveros et al. (2020). The article emphasized that the intervention made for this group should be individualized, considering comorbidities, polypharmacy, and the potential for drug reactions. The strength of this review is an in-depth evaluation of current strategies and a focus on practical challenges, while the weakness of this review is its wide coverage. Such evidence supports the requirement for tailored hypertension management programs, as proposed through a focus on self-management and regular monitoring among the elderly in Miami.
Bryant et al. (2020) probe into the impacts of SMBP on long-term control of blood pressure among older populations. Therefore, it is concluded in this paper that SMBP significantly increases patient engagement and the level of adherence to laid-out treatment plans, which is evident in the management of hypertension. The main strength of this paper is that the methodology of this study was sound, and the length of the follow-up presented strong evidence for the effectiveness of SMBP. On the downside, the study depended heavily on self-reported data, which tends to bring in bias. However, the value of SMBP in the management of hypertension underscores its inclusion in the proposed health promotion program for the elderly in Miami.
Theoretical Framework
The most appropriate model that could best determine this health promotion plan for the elderly population in Miami is the “Health Belief Model (HBM)”. HBM is a psychological model that was founded in the 1950s, and it explains and predicts health behaviors based on people’s attitudes and beliefs. “The model is made up of perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy” (Suharmanto, 2021). All these components will have an important impact on shaping the motives of individuals for health-promoting behavior. Perceived severity is the belief of an individual about the seriousness of a health condition and its consequences. The education of severe complications that are associated with hypertension, like stroke, heart disease, and kidney failure, may then enhance the perception of the seriousness of the condition by the elderly. Perceived susceptibility is the perception of a person’s risk of developing a health problem. Increased education on the high prevalence of hypertension in the elderly may help them perceive their susceptibility to the condition. Perceived benefits are the belief in how effective the recommended action is in reducing the risk or seriousness of the health condition. If, in this case, the benefits are pointed out, such as lifestyle changes such as eating healthy, exercising, and routine blood pressure checks, it may encourage the elderly to adopt the behavior. Perceived barriers are the individual’s estimation of the obstacles to behavior change. Barriers such as the unavailability of exercise facilities, financial constraints, and access to health food should be addressed. Providing this may include community exercise programs, affordable health food options, and home blood pressure monitors, among others. In addition, the elderly may be empowered through the provision of skill-building activities for increased confidence. These include how to monitor blood pressure at home and how to prepare healthy meals, for example. Using the HBM, the planned program can effectively educate and motivate the elderly to manage their hypertension, specifically in Miami, for a healthier existence with improved outcomes and, hence, quality of life.
References
Bryant, K. B., Sheppard, J. P., Ruiz‐Negrón, N., Kronish, I. M., Fontil, V., King, J. B., … & Bellows, B. K. (2020). Impact of self‐monitoring of blood pressure on processes of hypertension care and long‐term blood pressure control. Journal of the American Heart Association, 9(15), e016174.
Oliveros, E., Patel, H., Kyung, S., Fugar, S., Goldberg, A., Madan, N., & Williams, K. A. (2020). Hypertension in older adults: Assessment, management, and challenges. Clinical cardiology, 43(2), 99-107.
Oliveros, E., Patel, H., Kyung, S., Fugar, S., Goldberg, A., Madan, N., & Williams, K. A. (2020). Hypertension in older adults: Assessment, management, and challenges. Clinical cardiology, 43(2), 99-107.
Suharmanto, S. (2021). Health Belief Model and Hypertension Prevention. Health Belief Model and Hypertension Prevention, 15(3), 2054-2059.
Based on PART 1 ATTACHED, COMPLETE PART 2 WITH THE REQUIREMENTS BELOW:
4-Do not forget to tell me about what program you are proposing. How will you do your project and tell what will you do at each time point over the 6 months.
5. Propose a health promotion program using an evidence-based intervention found in your literature search to address the problem in the selected population/setting. Include a thorough discussion of the specifics of this intervention which include resources necessary, those involved, and feasibility for a nurse in an advanced role. Be certain to include a timeline. (2 to 4 paragraph. You may use bullets if appropriate).
6. Thoroughly describe the intended outcomes. Describe the outcomes in detail concurrent with the SMART goal approach. (1 paragraph).
7. Provide a detailed plan for evaluation for each outcome. (1 paragraph).
8. Thoroughly describe possible barriers/challenges to implementing the proposed project as well as strategies to address these barriers/challenges. (1 paragraph).
9. Conclude the paper with a Conclusion paragraph. Don’t type the word “Conclusion”. Here you will share your insights about this strategy and your expectations regarding achieving your goals. (1 paragraph).
Requirements
Your assignment should be 3 pages (excluding title page, references, and appendices), following APA standards.
Remember, your Proposal must be a scholarly paper demonstrating graduate school level writing and critical analysis of existing nursing knowledge about health promotion.
DUE DATE JUNE 5, 2024
NO PLAGIO MORE THAN 10 % ACCEPTED
PLEASE CHECK GRAMMAR
3 PAGES
Part II: Health Promotion Program Proposal
Proposed Health Promotion Program
Program Overview: The proposed health promotion program aims to implement a self-management blood pressure (SMBP) program for elderly adults living in Miami, Florida. This program will focus on lifestyle modifications and regular blood pressure monitoring to reduce the incidence and complications of hypertension. The program will be structured over six months, incorporating education, practical skills training, and regular follow-up to ensure adherence and effectiveness.
Implementation Plan:
- Month 1: Baseline Assessment and Education
- Conduct baseline blood pressure measurements and health assessments for all participants.
- Provide educational sessions on hypertension, its risks, and the importance of blood pressure control.
- Distribute educational materials, including brochures and videos.
- Introduce participants to the Health Belief Model (HBM) to enhance understanding and motivation.
- Month 2: Skill-Building Workshops
- Conduct workshops on lifestyle modifications such as healthy eating, physical activity, and sodium reduction.
- Train participants on how to use home blood pressure monitors.
- Offer cooking demonstrations and exercise sessions tailored to the elderly.
- Month 3: Monitoring and Support
- Begin regular home blood pressure monitoring with weekly check-ins.
- Provide telephone and in-person support to address any challenges or questions.
- Establish peer support groups to encourage shared experiences and motivation.
- Month 4: Midpoint Evaluation and Adjustment
- Conduct a mid-program evaluation to assess progress and adherence.
- Adjust the program based on individual needs and feedback.
- Reinforce education and skills through refresher sessions and new workshops.
- Month 5: Continued Support and Engagement
- Continue regular monitoring and support.
- Introduce advanced topics such as stress management and medication adherence.
- Organize community events to promote social interaction and physical activity.
- Month 6: Final Evaluation and Sustainability Planning
- Conduct final blood pressure measurements and health assessments.
- Evaluate the overall effectiveness of the program.
- Provide resources and strategies for maintaining healthy behaviors post-program.
- Develop a plan for long-term support and follow-up.
Resources Necessary:
- Home blood pressure monitors for each participant.
- Educational materials and workshop supplies.
- Staff including nurses, dietitians, and fitness instructors.
- Facilities for workshops and community events.
- Funding for materials and staff time.
Involved Parties:
- Advanced practice nurses to oversee the program and provide direct care.
- Dietitians and fitness instructors for specialized workshops.
- Community health workers for support and follow-up.
- Local health organizations and senior centers for collaboration.
Feasibility: This program is feasible for a nurse in an advanced role due to the availability of community resources and the structured support system. The timeline is realistic, with activities spaced out to ensure manageable workloads and effective participant engagement.
Intended Outcomes: The intended outcomes align with the SMART goal approach:
- Specific: Improve blood pressure control in elderly adults in Miami.
- Measurable: Achieve a 10% reduction in average blood pressure levels.
- Achievable: Provide participants with the tools and knowledge for self-management.
- Relevant: Address the high prevalence of hypertension in the elderly population.
- Time-bound: Achieve these outcomes within six months.
Evaluation Plan:
- Baseline and Final Assessments: Measure blood pressure levels and health indicators at the start and end of the program.
- Monthly Monitoring: Track weekly blood pressure readings and adherence to lifestyle changes.
- Participant Feedback: Collect feedback through surveys and focus groups to assess satisfaction and identify areas for improvement.
- Outcome Analysis: Compare baseline and final data to evaluate the effectiveness of the intervention.
Barriers and Challenges:
- Financial Constraints: Address by seeking funding and providing low-cost resources.
- Participant Adherence: Enhance through continuous support and motivation strategies.
- Access to Healthy Food and Exercise Facilities: Collaborate with community organizations to provide these resources.
Conclusion: The proposed self-management program for managing hypertension in the elderly population of Miami, Florida, is a comprehensive and evidence-based approach. By focusing on education, skill-building, and regular monitoring, this program aims to reduce the incidence and complications of hypertension, ultimately improving the quality of life for participants. The structured timeline and inclusion of community resources ensure feasibility and sustainability, while continuous evaluation and feedback will drive ongoing improvements. This strategy is expected to yield significant health benefits and empower elderly individuals to take control of their blood pressure management.