Assignment Prompt & Instructions
– ## HealthPromotionProposal2.docx
– ## HealthPromotionProposalPart11.docx
**## HealthPromotionProposal2.docx**
Health Promotion Proposal, Part 2
**Exercise Instructions**
**Health Promotion Proposal, Part 2**
**This is a continuation of the health promotion program proposal, part one**, which you submitted previously.
Please approach this assignment as an opportunity to integrate instructor feedback from part I and expand on ideas adhering to the components of the MAP-IT strategy. Include necessary levels of detail you feel appropriate to assure stakeholder buy-in.
**Directions**
You have already completed the steps 1-4.
**Do not resubmit part 1.** Make sure you incorporate any suggested revisions or improvements into your submission according to your instructor’s comments.
**To assist in maintaining harmony between Part I and 2 here you have a reminder of the previous paper outline:**
· 1. Describe the health problem. Using data and statistics support your claim that the issue you selected is a problem. What specifically will you address in your proposed health promotion program? Be sure your proposed outcome is realistic and measurable.
· 2. Describe the vulnerable population and setting. What are the risk factors that make this a vulnerable population? Use evidence to support the risk factors you have identified.
· 3. Provide a review of literature from scholarly journals on evidence-based interventions that address the problem. After completing a library search related to effective interventions for your chosen health promotion activity, you will write a review that evaluates the strengths and weaknesses of all the sources you have found. You might consult research texts for information on how to write a review of the literature found in your search.
· 4. Select an appropriate health promotion/disease prevention theoretical framework or conceptual model that would best serve as the framework guiding the proposal. Provide a rationale for your selection which includes a discussion of the concepts of the selected model
**For this assignment develop criteria 5-8 as detailed below:**
**You will submit just this section 5-8 as an essay. Please do not resubmit Part 1.**
Use a presentation page. Start the body of content with topic 5.
· 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 includes resources necessary, those involved, and feasibility for a nurse in an advanced role.
· Be certain to include a timeline. (3 to 4 paragraphs- you may use bullets if appropriate).
· 6. Thoroughly describe the intended outcomes. Describe the outcomes in detail concurrent with the SMART goal approach.
**The SMART goal statement should be no more than one sentence** (1 paragraph).
· 7. Provide a detailed plan for the evaluation of each outcome. (2-3 paragraphs).
· 8. Thoroughly describe possible barriers/challenges to implementing the proposed project as well as strategies to address these barriers/challenges. (2+ paragraphs).
· Finish the paper with a conclusion paragraph (2 paragraphs) without typing the word "conclusion" before the paragraph.
**Paper Requirements**
This assignment is to be submitted as an essay- with an introduction, questions developed at the graduate level, and a conclusion to summarize and synthesize key points. Remember, your Proposal must be a scholarly paper demonstrating graduate school-level writing and critical analysis of existing nursing knowledge about health promotion.
APA must be strictly followed.
Your final assignment should be minimally 5 pages (excluding title page and references).
Finish the essay with your reference page.
**Please review the Grading Rubric for this Assignment.**
s
**## HealthPromotionProposalPart11.docx**
2
**Health Promotion Proposal, Part 1**
Yitsy Serrano
Florida National University
Health Promotion & Role Development in Adv. Nursing Practice
Dr. Nora Hernandez-Pupo
May 28, 2025
**Health Promotion Proposal, Part 1**
**The Burden of Hypertension in Vulnerable Populations**
Hypertension is a quiet threat to the public that significantly raises the chances of heart disease, stroke, and kidney failure. More than 1.28 billion people worldwide between the ages of 30 and 79 are affected, and the burden is heaviest in low- and middle-income countries (Moloro et al., 2023). Approximately 122 million adults in the United States (over four out of ten) are diagnosed with hypertension (Centers for Disease Control and Prevention, 2025). Among non-Hispanic Black people, about 56% are impacted, tend to be younger, and experience more serious illness than in other groups (Ferdinand et al., 2021). This proposal focuses on the ongoing racial and socioeconomic differences in hypertension outcomes among African Americans living in underserved Chicago communities. The health promotion program is designed to increase awareness about hypertension, encourage healthier meals, and help people follow prescribed treatments through community activities that match cultural beliefs. The measurable outcomes will include increased blood pressure screenings, less uncontrolled hypertension among patients, and increased self-reported adherence to medication within 12 months of using the plan. With this plan, we can encourage equity and address what leads to hypertension differences in urban populations.
**Description of the Vulnerable Population**
The selected population are African Americans in Low-Income Chicago Communities
**Risk Factors that Make them Vulnerable**
**_Socioeconomic Disadvantage_**
One of the primary risk factors contributing to the vulnerability of African Americans in Chicago is socioeconomic disadvantage. Residents in many Black areas of Chicago’s South and West Sides are likely to experience extreme poverty, less access to learning, and fewer employment opportunities. All these social and financial difficulties are tied to chronic stress, lack of good food, and little access to healthcare, which result in high blood pressure. The reports from the Chicago Department of Public Health (CDPH) indicate that 58% of uncontrolled hypertension patients live below the poverty line. When faced with economic difficulties, many people must choose between buying medicine, getting to appointments, and covering everyday expenses—making it challenging to handle their chronic illnesses. The lack of funds to pay for nutritious foods and sports activities increases the risk of hypertension.
**_Healthcare Access Barriers_**
African Americans in these communities often rely on underfunded safety-net hospitals and community clinics for medical care, which limits continuity of care. Staff shortages, resource restrictions, and lengthy wait times discourage people from getting blood pressure testing or follow-ups. Insurance gaps exacerbate the issue—uninsured or underinsured individuals are significantly less likely to be diagnosed early or adhere to prescribed treatment. Influenced by prejudice and medical exploitation, Mistrust in the healthcare system also limits preventative service use. Language hurdles and a lack of culturally competent practitioners make appropriate treatment difficult.
**_Environmental and Dietary Challenges_**
Environmental determinants, such as food deserts, contribute substantially to hypertension disparities in Chicago's marginalized communities. Many individuals live in areas lacking fresh vegetables or healthful meals, depending on convenience shops and fast food. These dietary limitations increase salt intake and reduce consumption of potassium-rich fruits and vegetables, essential for blood pressure regulation. High crime rates and hazardous neighborhoods discourage outdoor exercise, decreasing cardiovascular health (Addas, 2025). These structural inequalities promote chronic illness and render these groups prone to hypertension-related death.
**Literature Review of Evidence-Based**
Cao et al. (2022) conducted a systematic review evaluating mHealth (mobile health) interventions for hypertension self-management, focusing on user engagement, interactivity, and content tailoring. The review analyzed 25 studies highlighting that personalized information and interactive elements, including real-time feedback, reminders, and progress monitoring, enhanced blood pressure management and prescription adherence. Success rates were higher for apps with user-specific objectives, health education modules, and healthcare provider communication. The research found that culturally appropriate customizing improved user engagement and long-term usage. Despite these advantages, Cao et al. found some drawbacks, including varying app quality, lack of engagement metrics standardization, and computer literacy issues, particularly among elderly and low-income people. Using culturally appropriate mHealth technologies and digital literacy to help control hypertension in impoverished African American communities like Chicago may be scalable and successful.
On the other hand, Miezah and Hayman (2024) examined how minority-specific lifestyle modification strategies helped African Americans control hypertension. The study found that culturally tailored interventions helped patients eat healthily, remain active, and take their prescriptions. The report indicated that using cultural customization helped programs keep participants involved for longer and made the program a greater success. Adapting the DASH diet to easy-to-recognize and accessible foods encouraged a greater number of people to try it. The review points out that including the community and its particular values and environment is very important. The authors report that the studies lasted for a short time and were measured with the same standards each time. Consequently, future projects should always use the same frameworks to regularly assess their program performance. The findings point toward the importance of emphasizing community and culture in lowering the high hypertension rates among African Americans in Chicago.
**Reviewing Evidence for Different Types of Literature and Intervention**
According to Cao et al. (2022) and Miezah and Hayman (2024), hypertension can be handled through technological means and lifestyle changes suitable for different groups. They have shown positive effects on lowering blood pressure and increasing self-care among African Americans and others in need. According to Cao et al., (2022, interactive and personalized technology allows patients and healthcare providers to communicate instantly and monitor issues live. Miezah and Hayman (2024) point out that making behavior changes last relies on both cultural fit and community involvement. These approaches highlight the importance of tailoring care to the community's daily lives, likes, and abilities.
Each intervention offers different benefits, so they are well suited for use in a health promotion program. The mHealth framework can be used for various applications and works outside the medical setting. This software gives patients personal reminders, feedback, and learning tools to support flexible healthcare. Despite its usefulness, the quality may decrease among low-income urban residents who often lack the required digital knowledge and the ability to get online. Conversely, programs adjusted to specific cultures give greater social support and help communities without much help from the healthcare system. They are most successful when carried out in churches, community groups, and families. Miezah and Hayman (2024) however pointed out that offering culturally specific interventions takes longer, funds and more human resource to deliver effectively. Scaling these programs may be difficult where strong community systems and teamwork are limited.
The best method for handling hypertension inequality in African American communities might be a hybrid system that brings together both prevention and management approaches. By integrating mHealth with community activities, you can help more people while keeping the services relevant. However, it is important for plans to focus on making outcome measurement consistent and providing lasting support for both funds and infrastructure. These results highlight the importance of complete, ongoing, and community-based strategies for managing hypertension for healthier populations.
**Theoretical Framework: The Social Ecological Model**
The Social Ecological Model (SEM) provides a multilayered framework for evaluating health behaviors and consequences (Caperon et al., 2022). It states that personal, social, organizational, community, and policy factors affect health. When it comes to hypertension among underprivileged African Americans, focusing on SEM is particularly useful since it stresses the role of social factors like income, level of education, and the surrounding environment. SEM therapies are more effective and persist longer since they touch many levels.
At the individual level, the SEM supports personalized interventions like education on healthy diets and medication adherence strategies. Workshops and mobile health technologies help promote health literacy. They may inspire individuals to set reasonable objectives and follow treatment procedures. Churches, schools, and clinics combine to offer screening and education. Community-level efforts may reduce food deserts and community safety by increasing access to healthy food and safe activity.
Finally, at the policy level, the SEM encourages advocacy for structural changes such as increased funding for safety-net clinics and mobile health programs and legislation to reduce food insecurity. The SEM allows our health promotion campaign to encompass community-based lifestyle interventions and digital health solutions at several levels. This concept encourages healthcare practitioners, community groups, and legislators to collaborate to incorporate the program into the targeted community's social fabric. The SEM's focus on interrelated layers of influence helps guide equitable, effective, and long-term treatments in vulnerable hypertension-disproportionate communities.
**References**
Addas, A. (2025). Impact of neighborhood safety on adolescent physical activity in Saudi Arabia: gender and socio-economic perspectives.
_Frontiers in Public Health_,
_13_. https://doi.org/10.3389/fpubh.2025.1520851
Cao, W., Milks, M. W., Liu, X., Gregory, M. E., Addison, D., Zhang, P., & Li, L. (2022). MHealth interventions for self-management of hypertension: Framework and systematic review on engagement, interactivity, and tailoring.
_JMIR MHealth and UHealth_,
_10_(3). https://doi.org/10.2196/29415
Caperon, L., Saville, F., & Ahern, S. (2022). Developing a socio-ecological model for community engagement in a health programme in an underserved urban area.
_PLOS ONE_,
_17_(9). https://doi.org/10.1371/journal.pone.0275092
CDC. (2025, January 28).
_High blood pressure facts_. High Blood Pressure. https://www.cdc.gov/high-blood-pressure/data-research/facts-stats/index.html
Ferdinand, K., Batieste, T., & Fleurestil, M. (2020). Contemporary and Future Concepts on Hypertension in African Americans: COVID-19 and Beyond.
_Journal of the National Medical Association_,
_112_(3), 315–323. https://doi.org/10.1016/j.jnma.2020.05.018
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
Moloro, A. H., Seid, A. A., & Jaleta, F. Y. (2023). A systematic review and meta-analysis protocol on hypertension prevalence and associated factors among bank workers in Africa.
_Sage Open Medicine_,
_11_, 205031212311720-205031212311720. https://doi.org/10.1177/20503121231172001
**## HealthPromotionProposalPart11.docx**
2
**Health Promotion Proposal, Part 1**
Yitsy Serrano
Florida National University
Health Promotion & Role Development in Adv. Nursing Practice
Dr. Nora Hernandez-Pupo
May 28, 2025
**Health Promotion Proposal, Part 1**
**The Burden of Hypertension in Vulnerable Populations**
Hypertension is a quiet threat to the public that significantly raises the chances of heart disease, stroke, and kidney failure. More than 1.28 billion people worldwide between the ages of 30 and 79 are affected, and the burden is heaviest in low- and middle-income countries (Moloro et al., 2023). Approximately 122 million adults in the United States (over four out of ten) are diagnosed with hypertension (Centers for Disease Control and Prevention, 2025). Among non-Hispanic Black people, about 56% are impacted, tend to be younger, and experience more serious illness than in other groups (Ferdinand et al., 2021). This proposal focuses on the ongoing racial and socioeconomic differences in hypertension outcomes among African Americans living in underserved Chicago communities. The health promotion program is designed to increase awareness about hypertension, encourage healthier meals, and help people follow prescribed treatments through community activities that match cultural beliefs. The measurable outcomes will include increased blood pressure screenings, less uncontrolled hypertension among patients, and increased self-reported adherence to medication within 12 months of using the plan. With this plan, we can encourage equity and address what leads to hypertension differences in urban populations.
**Description of the Vulnerable Population**
The selected population are African Americans in Low-Income Chicago Communities
**Risk Factors that Make them Vulnerable**
**_Socioeconomic Disadvantage_**
One of the primary risk factors contributing to the vulnerability of African Americans in Chicago is socioeconomic disadvantage. Residents in many Black areas of Chicago’s South and West Sides are likely to experience extreme poverty, less access to learning, and fewer employment opportunities. All these social and financial difficulties are tied to chronic stress, lack of good food, and little access to healthcare, which result in high blood pressure. The reports from the Chicago Department of Public Health (CDPH) indicate that 58% of uncontrolled hypertension patients live below the poverty line. When faced with economic difficulties, many people must choose between buying medicine, getting to appointments, and covering everyday expenses—making it challenging to handle their chronic illnesses. The lack of funds to pay for nutritious foods and sports activities increases the risk of hypertension.
**_Healthcare Access Barriers_**
African Americans in these communities often rely on underfunded safety-net hospitals and community clinics for medical care, which limits continuity of care. Staff shortages, resource restrictions, and lengthy wait times discourage people from getting blood pressure testing or follow-ups. Insurance gaps exacerbate the issue—uninsured or underinsured individuals are significantly less likely to be diagnosed early or adhere to prescribed treatment. Influenced by prejudice and medical exploitation, Mistrust in the healthcare system also limits preventative service use. Language hurdles and a lack of culturally competent practitioners make appropriate treatment difficult.
**_Environmental and Dietary Challenges_**
Environmental determinants, such as food deserts, contribute substantially to hypertension disparities in Chicago's marginalized communities. Many individuals live in areas lacking fresh vegetables or healthful meals, depending on convenience shops and fast food. These dietary limitations increase salt intake and reduce consumption of potassium-rich fruits and vegetables, essential for blood pressure regulation. High crime rates and hazardous neighborhoods discourage outdoor exercise, decreasing cardiovascular health (Addas, 2025). These structural inequalities promote chronic illness and render these groups prone to hypertension-related death.
**Literature Review of Evidence-Based**
Cao et al. (2022) conducted a systematic review evaluating mHealth (mobile health) interventions for hypertension self-management, focusing on user engagement, interactivity, and content tailoring. The review analyzed 25 studies highlighting that personalized information and interactive elements, including real-time feedback, reminders, and progress monitoring, enhanced blood pressure management and prescription adherence. Success rates were higher for apps with user-specific objectives, health education modules, and healthcare provider communication. The research found that culturally appropriate customizing improved user engagement and long-term usage. Despite these advantages, Cao et al. found some drawbacks, including varying app quality, lack of engagement metrics standardization, and computer literacy issues, particularly among elderly and low-income people. Using culturally appropriate mHealth technologies and digital literacy to help control hypertension in impoverished African American communities like Chicago may be scalable and successful.
On the other hand, Miezah and Hayman (2024) examined how minority-specific lifestyle modification strategies helped African Americans control hypertension. The study found that culturally tailored interventions helped patients eat healthily, remain active, and take their prescriptions. The report indicated that using cultural customization helped programs keep participants involved for longer and made the program a greater success. Adapting the DASH diet to easy-to-recognize and accessible foods encouraged a greater number of people to try it. The review points out that including the community and its particular values and environment is very important. The authors report that the studies lasted for a short time and were measured with the same standards each time. Consequently, future projects should always use the same frameworks to regularly assess their program performance. The findings point toward the importance of emphasizing community and culture in lowering the high hypertension rates among African Americans in Chicago.
**Reviewing Evidence for Different Types of Literature and Intervention**
According to Cao et al. (2022) and Miezah and Hayman (2024), hypertension can be handled through technological means and lifestyle changes suitable for different groups. They have shown positive effects on lowering blood pressure and increasing self-care among African Americans and others in need. According to Cao et al., (2022, interactive and personalized technology allows patients and healthcare providers to communicate instantly and monitor issues live. Miezah and Hayman (2024) point out that making behavior changes last relies on both cultural fit and community involvement. These approaches highlight the importance of tailoring care to the community's daily lives, likes, and abilities.
Each intervention offers different benefits, so they are well suited for use in a health promotion program. The mHealth framework can be used for various applications and works outside the medical setting. This software gives patients personal reminders, feedback, and learning tools to support flexible healthcare. Despite its usefulness, the quality may decrease among low-income urban residents who often lack the required digital knowledge and the ability to get online. Conversely, programs adjusted to specific cultures give greater social support and help communities without much help from the healthcare system. They are most successful when carried out in churches, community groups, and families. Miezah and Hayman (2024) however pointed out that offering culturally specific interventions takes longer, funds and more human resource to deliver effectively. Scaling these programs may be difficult where strong community systems and teamwork are limited.
The best method for handling hypertension inequality in African American communities might be a hybrid system that brings together both prevention and management approaches. By integrating mHealth with community activities, you can help more people while keeping the services relevant. However, it is important for plans to focus on making outcome measurement consistent and providing lasting support for both funds and infrastructure. These results highlight the importance of complete, ongoing, and community-based strategies for managing hypertension for healthier populations.
**Theoretical Framework: The Social Ecological Model**
The Social Ecological Model (SEM) provides a multilayered framework for evaluating health behaviors and consequences (Caperon et al., 2022). It states that personal, social, organizational, community, and policy factors affect health. When it comes to hypertension among underprivileged African Americans, focusing on SEM is particularly useful since it stresses the role of social factors like income, level of education, and the surrounding environment. SEM therapies are more effective and persist longer since they touch many levels.
At the individual level, the SEM supports personalized interventions like education on healthy diets and medication adherence strategies. Workshops and mobile health technologies help promote health literacy. They may inspire individuals to set reasonable objectives and follow treatment procedures. Churches, schools, and clinics combine to offer screening and education. Community-level efforts may reduce food deserts and community safety by increasing access to healthy food and safe activity.
Finally, at the policy level, the SEM encourages advocacy for structural changes such as increased funding for safety-net clinics and mobile health programs and legislation to reduce food insecurity. The SEM allows our health promotion campaign to encompass community-based lifestyle interventions and digital health solutions at several levels. This concept encourages healthcare practitioners, community groups, and legislators to collaborate to incorporate the program into the targeted community's social fabric. The SEM's focus on interrelated layers of influence helps guide equitable, effective, and long-term treatments in vulnerable hypertension-disproportionate communities.
**References**
Addas, A. (2025). Impact of neighborhood safety on adolescent physical activity in Saudi Arabia: gender and socio-economic perspectives.
_Frontiers in Public Health_,
_13_. https://doi.org/10.3389/fpubh.2025.1520851
Cao, W., Milks, M. W., Liu, X., Gregory, M. E., Addison, D., Zhang, P., & Li, L. (2022). MHealth interventions for self-management of hypertension: Framework and systematic review on engagement, interactivity, and tailoring.
_JMIR MHealth and UHealth_,
_10_(3). https://doi.org/10.2196/29415
Caperon, L., Saville, F., & Ahern, S. (2022). Developing a socio-ecological model for community engagement in a health programme in an underserved urban area.
_PLOS ONE_,
_17_(9). https://doi.org/10.1371/journal.pone.0275092
CDC. (2025, January 28).
_High blood pressure facts_. High Blood Pressure. https://www.cdc.gov/high-blood-pressure/data-research/facts-stats/index.html
Ferdinand, K., Batieste, T., & Fleurestil, M. (2020). Contemporary and Future Concepts on Hypertension in African Americans: COVID-19 and Beyond.
_Journal of the National Medical Association_,
_112_(3), 315–323. https://doi.org/10.1016/j.jnma.2020.05.018
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
Moloro, A. H., Seid, A. A., & Jaleta, F. Y. (2023). A systematic review and meta-analysis protocol on hypertension prevalence and associated factors among bank workers in Africa.
_Sage Open Medicine_,
_11_, 205031212311720-205031212311720. https://doi.org/10.1177/20503121231172001
**## HealthPromotionProposal2.docx**
Health Promotion Proposal, Part 2
**Exercise Instructions**
**Health Promotion Proposal, Part 2**
**This is a continuation of the health promotion program proposal, part one**, which you submitted previously.
Please approach this assignment as an opportunity to integrate instructor feedback from part I and expand on ideas adhering to the components of the MAP-IT strategy. Include necessary levels of detail you feel appropriate to assure stakeholder buy-in.
**Directions**
You have already completed the steps 1-4.
**Do not resubmit part 1.** Make sure you incorporate any suggested revisions or improvements into your submission according to your instructor’s comments.
**To assist in maintaining harmony between Part I and 2 here you have a reminder of the previous paper outline:**
· 1. Describe the health problem. Using data and statistics support your claim that the issue you selected is a problem. What specifically will you address in your proposed health promotion program? Be sure your proposed outcome is realistic and measurable.
· 2. Describe the vulnerable population and setting. What are the risk factors that make this a vulnerable population? Use evidence to support the risk factors you have identified.
· 3. Provide a review of literature from scholarly journals on evidence-based interventions that address the problem. After completing a library search related to effective interventions for your chosen health promotion activity, you will write a review that evaluates the strengths and weaknesses of all the sources you have found. You might consult research texts for information on how to write a review of the literature found in your search.
· 4. Select an appropriate health promotion/disease prevention theoretical framework or conceptual model that would best serve as the framework guiding the proposal. Provide a rationale for your selection which includes a discussion of the concepts of the selected model
**For this assignment develop criteria 5-8 as detailed below:**
**You will submit just this section 5-8 as an essay. Please do not resubmit Part 1.**
Use a presentation page. Start the body of content with topic 5.
· 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 includes resources necessary, those involved, and feasibility for a nurse in an advanced role.
· Be certain to include a timeline. (3 to 4 paragraphs- you may use bullets if appropriate).
· 6. Thoroughly describe the intended outcomes. Describe the outcomes in detail concurrent with the SMART goal approach.
**The SMART goal statement should be no more than one sentence** (1 paragraph).
· 7. Provide a detailed plan for the evaluation of each outcome. (2-3 paragraphs).
· 8. Thoroughly describe possible barriers/challenges to implementing the proposed project as well as strategies to address these barriers/challenges. (2+ paragraphs).
· Finish the paper with a conclusion paragraph (2 paragraphs) without typing the word "conclusion" before the paragraph.
**Paper Requirements**
This assignment is to be submitted as an essay- with an introduction, questions developed at the graduate level, and a conclusion to summarize and synthesize key points. Remember, your Proposal must be a scholarly paper demonstrating graduate school-level writing and critical analysis of existing nursing knowledge about health promotion.
APA must be strictly followed.
Your final assignment should be minimally 5 pages (excluding title page and references).
Finish the essay with your reference page.
**Please review the Grading Rubric for this Assignment.**
s
**## HealthPromotionProposalPart11.docx**
2
**Health Promotion Proposal, Part 1**
Yitsy Serrano
Florida National University
Health Promotion & Role Development in Adv. Nursing Practice
Dr. Nora Hernandez-Pupo
May 28, 2025
**Health Promotion Proposal, Part 1**
**The Burden of Hypertension in Vulnerable Populations**
Hypertension is a quiet threat to the public that significantly raises the chances of heart disease, stroke, and kidney failure. More than 1.28 billion people worldwide between the ages of 30 and 79 are affected, and the burden is heaviest in low- and middle-income countries (Moloro et al., 2023). Approximately 122 million adults in the United States (over four out of ten) are diagnosed with hypertension (Centers for Disease Control and Prevention, 2025). Among non-Hispanic Black people, about 56% are impacted, tend to be younger, and experience more serious illness than in other groups (Ferdinand et al., 2021). This proposal focuses on the ongoing racial and socioeconomic differences in hypertension outcomes among African Americans living in underserved Chicago communities. The health promotion program is designed to increase awareness about hypertension, encourage healthier meals, and help people follow prescribed treatments through community activities that match cultural beliefs. The measurable outcomes will include increased blood pressure screenings, less uncontrolled hypertension among patients, and increased self-reported adherence to medication within 12 months of using the plan. With this plan, we can encourage equity and address what leads to hypertension differences in urban populations.
**Description of the Vulnerable Population**
The selected population are African Americans in Low-Income Chicago Communities
**Risk Factors that Make them Vulnerable**
**_Socioeconomic Disadvantage_**
One of the primary risk factors contributing to the vulnerability of African Americans in Chicago is socioeconomic disadvantage. Residents in many Black areas of Chicago’s South and West Sides are likely to experience extreme poverty, less access to learning, and fewer employment opportunities. All these social and financial difficulties are tied to chronic stress, lack of good food, and little access to healthcare, which result in high blood pressure. The reports from the Chicago Department of Public Health (CDPH) indicate that 58% of uncontrolled hypertension patients live below the poverty line. When faced with economic difficulties, many people must choose between buying medicine, getting to appointments, and covering everyday expenses—making it challenging to handle their chronic illnesses. The lack of funds to pay for nutritious foods and sports activities increases the risk of hypertension.
**_Healthcare Access Barriers_**
African Americans in these communities often rely on underfunded safety-net hospitals and community clinics for medical care, which limits continuity of care. Staff shortages, resource restrictions, and lengthy wait times discourage people from getting blood pressure testing or follow-ups. Insurance gaps exacerbate the issue—uninsured or underinsured individuals are significantly less likely to be diagnosed early or adhere to prescribed treatment. Influenced by prejudice and medical exploitation, Mistrust in the healthcare system also limits preventative service use. Language hurdles and a lack of culturally competent practitioners make appropriate treatment difficult.
**_Environmental and Dietary Challenges_**
Environmental determinants, such as food deserts, contribute substantially to hypertension disparities in Chicago's marginalized communities. Many individuals live in areas lacking fresh vegetables or healthful meals, depending on convenience shops and fast food. These dietary limitations increase salt intake and reduce consumption of potassium-rich fruits and vegetables, essential for blood pressure regulation. High crime rates and hazardous neighborhoods discourage outdoor exercise, decreasing cardiovascular health (Addas, 2025). These structural inequalities promote chronic illness and render these groups prone to hypertension-related death.
**Literature Review of Evidence-Based**
Cao et al. (2022) conducted a systematic review evaluating mHealth (mobile health) interventions for hypertension self-management, focusing on user engagement, interactivity, and content tailoring. The review analyzed 25 studies highlighting that personalized information and interactive elements, including real-time feedback, reminders, and progress monitoring, enhanced blood pressure management and prescription adherence. Success rates were higher for apps with user-specific objectives, health education modules, and healthcare provider communication. The research found that culturally appropriate customizing improved user engagement and long-term usage. Despite these advantages, Cao et al. found some drawbacks, including varying app quality, lack of engagement metrics standardization, and computer literacy issues, particularly among elderly and low-income people. Using culturally appropriate mHealth technologies and digital literacy to help control hypertension in impoverished African American communities like Chicago may be scalable and successful.
On the other hand, Miezah and Hayman (2024) examined how minority-specific lifestyle modification strategies helped African Americans control hypertension. The study found that culturally tailored interventions helped patients eat healthily, remain active, and take their prescriptions. The report indicated that using cultural customization helped programs keep participants involved for longer and made the program a greater success. Adapting the DASH diet to easy-to-recognize and accessible foods encouraged a greater number of people to try it. The review points out that including the community and its particular values and environment is very important. The authors report that the studies lasted for a short time and were measured with the same standards each time. Consequently, future projects should always use the same frameworks to regularly assess their program performance. The findings point toward the importance of emphasizing community and culture in lowering the high hypertension rates among African Americans in Chicago.
**Reviewing Evidence for Different Types of Literature and Intervention**
According to Cao et al. (2022) and Miezah and Hayman (2024), hypertension can be handled through technological means and lifestyle changes suitable for different groups. They have shown positive effects on lowering blood pressure and increasing self-care among African Americans and others in need. According to Cao et al., (2022, interactive and personalized technology allows patients and healthcare providers to communicate instantly and monitor issues live. Miezah and Hayman (2024) point out that making behavior changes last relies on both cultural fit and community involvement. These approaches highlight the importance of tailoring care to the community's daily lives, likes, and abilities.
Each intervention offers different benefits, so they are well suited for use in a health promotion program. The mHealth framework can be used for various applications and works outside the medical setting. This software gives patients personal reminders, feedback, and learning tools to support flexible healthcare. Despite its usefulness, the quality may decrease among low-income urban residents who often lack the required digital knowledge and the ability to get online. Conversely, programs adjusted to specific cultures give greater social support and help communities without much help from the healthcare system. They are most successful when carried out in churches, community groups, and families. Miezah and Hayman (2024) however pointed out that offering culturally specific interventions takes longer, funds and more human resource to deliver effectively. Scaling these programs may be difficult where strong community systems and teamwork are limited.
The best method for handling hypertension inequality in African American communities might be a hybrid system that brings together both prevention and management approaches. By integrating mHealth with community activities, you can help more people while keeping the services relevant. However, it is important for plans to focus on making outcome measurement consistent and providing lasting support for both funds and infrastructure. These results highlight the importance of complete, ongoing, and community-based strategies for managing hypertension for healthier populations.
**Theoretical Framework: The Social Ecological Model**
The Social Ecological Model (SEM) provides a multilayered framework for evaluating health behaviors and consequences (Caperon et al., 2022). It states that personal, social, organizational, community, and policy factors affect health. When it comes to hypertension among underprivileged African Americans, focusing on SEM is particularly useful since it stresses the role of social factors like income, level of education, and the surrounding environment. SEM therapies are more effective and persist longer since they touch many levels.
At the individual level, the SEM supports personalized interventions like education on healthy diets and medication adherence strategies. Workshops and mobile health technologies help promote health literacy. They may inspire individuals to set reasonable objectives and follow treatment procedures. Churches, schools, and clinics combine to offer screening and education. Community-level efforts may reduce food deserts and community safety by increasing access to healthy food and safe activity.
Finally, at the policy level, the SEM encourages advocacy for structural changes such as increased funding for safety-net clinics and mobile health programs and legislation to reduce food insecurity. The SEM allows our health promotion campaign to encompass community-based lifestyle interventions and digital health solutions at several levels. This concept encourages healthcare practitioners, community groups, and legislators to collaborate to incorporate the program into the targeted community's social fabric. The SEM's focus on interrelated layers of influence helps guide equitable, effective, and long-term treatments in vulnerable hypertension-disproportionate communities.
**References**
Addas, A. (2025). Impact of neighborhood safety on adolescent physical activity in Saudi Arabia: gender and socio-economic perspectives.
_Frontiers in Public Health_,
_13_. https://doi.org/10.3389/fpubh.2025.1520851
Cao, W., Milks, M. W., Liu, X., Gregory, M. E., Addison, D., Zhang, P., & Li, L. (2022). MHealth interventions for self-management of hypertension: Framework and systematic review on engagement, interactivity, and tailoring.
_JMIR MHealth and UHealth_,
_10_(3). https://doi.org/10.2196/29415
Caperon, L., Saville, F., & Ahern, S. (2022). Developing a socio-ecological model for community engagement in a health programme in an underserved urban area.
_PLOS ONE_,
_17_(9). https://doi.org/10.1371/journal.pone.0275092
CDC. (2025, January 28).
_High blood pressure facts_. High Blood Pressure. https://www.cdc.gov/high-blood-pressure/data-research/facts-stats/index.html
Ferdinand, K., Batieste, T., & Fleurestil, M. (2020). Contemporary and Future Concepts on Hypertension in African Americans: COVID-19 and Beyond.
_Journal of the National Medical Association_,
_112_(3), 315–323. https://doi.org/10.1016/j.jnma.2020.05.018
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
Moloro, A. H., Seid, A. A., & Jaleta, F. Y. (2023). A systematic review and meta-analysis protocol on hypertension prevalence and associated factors among bank workers in Africa.
_Sage Open Medicine_,
_11_, 205031212311720-205031212311720. https://doi.org/10.1177/20503121231172001
**## HealthPromotionProposal2.docx**
Health Promotion Proposal, Part 2
**Exercise Instructions**
**Health Promotion Proposal, Part 2**
**This is a continuation of the health promotion program proposal, part one**, which you submitted previously.
Please approach this assignment as an opportunity to integrate instructor feedback from part I and expand on ideas adhering to the components of the MAP-IT strategy. Include necessary levels of detail you feel appropriate to assure stakeholder buy-in.
**Directions**
You have already completed the steps 1-4.
**Do not resubmit part 1.** Make sure you incorporate any suggested revisions or improvements into your submission according to your instructor’s comments.
**To assist in maintaining harmony between Part I and 2 here you have a reminder of the previous paper outline:**
· 1. Describe the health problem. Using data and statistics support your claim that the issue you selected is a problem. What specifically will you address in your proposed health promotion program? Be sure your proposed outcome is realistic and measurable.
· 2. Describe the vulnerable population and setting. What are the risk factors that make this a vulnerable population? Use evidence to support the risk factors you have identified.
· 3. Provide a review of literature from scholarly journals on evidence-based interventions that address the problem. After completing a library search related to effective interventions for your chosen health promotion activity, you will write a review that evaluates the strengths and weaknesses of all the sources you have found. You might consult research texts for information on how to write a review of the literature found in your search.
· 4. Select an appropriate health promotion/disease prevention theoretical framework or conceptual model that would best serve as the framework guiding the proposal. Provide a rationale for your selection which includes a discussion of the concepts of the selected model
**For this assignment develop criteria 5-8 as detailed below:**
**You will submit just this section 5-8 as an essay. Please do not resubmit Part 1.**
Use a presentation page. Start the body of content with topic 5.
· 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 includes resources necessary, those involved, and feasibility for a nurse in an advanced role.
· Be certain to include a timeline. (3 to 4 paragraphs- you may use bullets if appropriate).
· 6. Thoroughly describe the intended outcomes. Describe the outcomes in detail concurrent with the SMART goal approach.
**The SMART goal statement should be no more than one sentence** (1 paragraph).
· 7. Provide a detailed plan for the evaluation of each outcome. (2-3 paragraphs).
· 8. Thoroughly describe possible barriers/challenges to implementing the proposed project as well as strategies to address these barriers/challenges. (2+ paragraphs).
· Finish the paper with a conclusion paragraph (2 paragraphs) without typing the word "conclusion" before the paragraph.
**Paper Requirements**
This assignment is to be submitted as an essay- with an introduction, questions developed at the graduate level, and a conclusion to summarize and synthesize key points. Remember, your Proposal must be a scholarly paper demonstrating graduate school-level writing and critical analysis of existing nursing knowledge about health promotion.
APA must be strictly followed.
Your final assignment should be minimally 5 pages (excluding title page and references).
Finish the essay with your reference page.
**Please review the Grading Rubric for this Assignment.**
s
**## HealthPromotionProposalPart11.docx**
2
**Health Promotion Proposal, Part 1**
Yitsy Serrano
Florida National University
Health Promotion & Role Development in Adv. Nursing Practice
Dr. Nora Hernandez-Pupo
May 28, 2025
**Health Promotion Proposal, Part 1**
**The Burden of Hypertension in Vulnerable Populations**
Hypertension is a quiet threat to the public that significantly raises the chances of heart disease, stroke, and kidney failure. More than 1.28 billion people worldwide between the ages of 30 and 79 are affected, and the burden is heaviest in low- and middle-income countries (Moloro et al., 2023). Approximately 122 million adults in the United States (over four out of ten) are diagnosed with hypertension (Centers for Disease Control and Prevention, 2025). Among non-Hispanic Black people, about 56% are impacted, tend to be younger, and experience more serious illness than in other groups (Ferdinand et al., 2021). This proposal focuses on the ongoing racial and socioeconomic differences in hypertension outcomes among African Americans living in underserved Chicago communities. The health promotion program is designed to increase awareness about hypertension, encourage healthier meals, and help people follow prescribed treatments through community activities that match cultural beliefs. The measurable outcomes will include increased blood pressure screenings, less uncontrolled hypertension among patients, and increased self-reported adherence to medication within 12 months of using the plan. With this plan, we can encourage equity and address what leads to hypertension differences in urban populations.
**Description of the Vulnerable Population**
The selected population are African Americans in Low-Income Chicago Communities
**Risk Factors that Make them Vulnerable**
**_Socioeconomic Disadvantage_**
One of the primary risk factors contributing to the vulnerability of African Americans in Chicago is socioeconomic disadvantage. Residents in many Black areas of Chicago’s South and West Sides are likely to experience extreme poverty, less access to learning, and fewer employment opportunities. All these social and financial difficulties are tied to chronic stress, lack of good food, and little access to healthcare, which result in high blood pressure. The reports from the Chicago Department of Public Health (CDPH) indicate that 58% of uncontrolled hypertension patients live below the poverty line. When faced with economic difficulties, many people must choose between buying medicine, getting to appointments, and covering everyday expenses—making it challenging to handle their chronic illnesses. The lack of funds to pay for nutritious foods and sports activities increases the risk of hypertension.
**_Healthcare Access Barriers_**
African Americans in these communities often rely on underfunded safety-net hospitals and community clinics for medical care, which limits continuity of care. Staff shortages, resource restrictions, and lengthy wait times discourage people from getting blood pressure testing or follow-ups. Insurance gaps exacerbate the issue—uninsured or underinsured individuals are significantly less likely to be diagnosed early or adhere to prescribed treatment. Influenced by prejudice and medical exploitation, Mistrust in the healthcare system also limits preventative service use. Language hurdles and a lack of culturally competent practitioners make appropriate treatment difficult.
**_Environmental and Dietary Challenges_**
Environmental determinants, such as food deserts, contribute substantially to hypertension disparities in Chicago's marginalized communities. Many individuals live in areas lacking fresh vegetables or healthful meals, depending on convenience shops and fast food. These dietary limitations increase salt intake and reduce consumption of potassium-rich fruits and vegetables, essential for blood pressure regulation. High crime rates and hazardous neighborhoods discourage outdoor exercise, decreasing cardiovascular health (Addas, 2025). These structural inequalities promote chronic illness and render these groups prone to hypertension-related death.
**Literature Review of Evidence-Based**
Cao et al. (2022) conducted a systematic review evaluating mHealth (mobile health) interventions for hypertension self-management, focusing on user engagement, interactivity, and content tailoring. The review analyzed 25 studies highlighting that personalized information and interactive elements, including real-time feedback, reminders, and progress monitoring, enhanced blood pressure management and prescription adherence. Success rates were higher for apps with user-specific objectives, health education modules, and healthcare provider communication. The research found that culturally appropriate customizing improved user engagement and long-term usage. Despite these advantages, Cao et al. found some drawbacks, including varying app quality, lack of engagement metrics standardization, and computer literacy issues, particularly among elderly and low-income people. Using culturally appropriate mHealth technologies and digital literacy to help control hypertension in impoverished African American communities like Chicago may be scalable and successful.
On the other hand, Miezah and Hayman (2024) examined how minority-specific lifestyle modification strategies helped African Americans control hypertension. The study found that culturally tailored interventions helped patients eat healthily, remain active, and take their prescriptions. The report indicated that using cultural customization helped programs keep participants involved for longer and made the program a greater success. Adapting the DASH diet to easy-to-recognize and accessible foods encouraged a greater number of people to try it. The review points out that including the community and its particular values and environment is very important. The authors report that the studies lasted for a short time and were measured with the same standards each time. Consequently, future projects should always use the same frameworks to regularly assess their program performance. The findings point toward the importance of emphasizing community and culture in lowering the high hypertension rates among African Americans in Chicago.
**Reviewing Evidence for Different Types of Literature and Intervention**
According to Cao et al. (2022) and Miezah and Hayman (2024), hypertension can be handled through technological means and lifestyle changes suitable for different groups. They have shown positive effects on lowering blood pressure and increasing self-care among African Americans and others in need. According to Cao et al., (2022, interactive and personalized technology allows patients and healthcare providers to communicate instantly and monitor issues live. Miezah and Hayman (2024) point out that making behavior changes last relies on both cultural fit and community involvement. These approaches highlight the importance of tailoring care to the community's daily lives, likes, and abilities.
Each intervention offers different benefits, so they are well suited for use in a health promotion program. The mHealth framework can be used for various applications and works outside the medical setting. This software gives patients personal reminders, feedback, and learning tools to support flexible healthcare. Despite its usefulness, the quality may decrease among low-income urban residents who often lack the required digital knowledge and the ability to get online. Conversely, programs adjusted to specific cultures give greater social support and help communities without much help from the healthcare system. They are most successful when carried out in churches, community groups, and families. Miezah and Hayman (2024) however pointed out that offering culturally specific interventions takes longer, funds and more human resource to deliver effectively. Scaling these programs may be difficult where strong community systems and teamwork are limited.
The best method for handling hypertension inequality in African American communities might be a hybrid system that brings together both prevention and management approaches. By integrating mHealth with community activities, you can help more people while keeping the services relevant. However, it is important for plans to focus on making outcome measurement consistent and providing lasting support for both funds and infrastructure. These results highlight the importance of complete, ongoing, and community-based strategies for managing hypertension for healthier populations.
**Theoretical Framework: The Social Ecological Model**
The Social Ecological Model (SEM) provides a multilayered framework for evaluating health behaviors and consequences (Caperon et al., 2022). It states that personal, social, organizational, community, and policy factors affect health. When it comes to hypertension among underprivileged African Americans, focusing on SEM is particularly useful since it stresses the role of social factors like income, level of education, and the surrounding environment. SEM therapies are more effective and persist longer since they touch many levels.
At the individual level, the SEM supports personalized interventions like education on healthy diets and medication adherence strategies. Workshops and mobile health technologies help promote health literacy. They may inspire individuals to set reasonable objectives and follow treatment procedures. Churches, schools, and clinics combine to offer screening and education. Community-level efforts may reduce food deserts and community safety by increasing access to healthy food and safe activity.
Finally, at the policy level, the SEM encourages advocacy for structural changes such as increased funding for safety-net clinics and mobile health programs and legislation to reduce food insecurity. The SEM allows our health promotion campaign to encompass community-based lifestyle interventions and digital health solutions at several levels. This concept encourages healthcare practitioners, community groups, and legislators to collaborate to incorporate the program into the targeted community's social fabric. The SEM's focus on interrelated layers of influence helps guide equitable, effective, and long-term treatments in vulnerable hypertension-disproportionate communities.
**References**
Addas, A. (2025). Impact of neighborhood safety on adolescent physical activity in Saudi Arabia: gender and socio-economic perspectives.
_Frontiers in Public Health_,
_13_. https://doi.org/10.3389/fpubh.2025.1520851
Cao, W., Milks, M. W., Liu, X., Gregory, M. E., Addison, D., Zhang, P., & Li, L. (2022). MHealth interventions for self-management of hypertension: Framework and systematic review on engagement, interactivity, and tailoring.
_JMIR MHealth and UHealth_,
_10_(3). https://doi.org/10.2196/29415
Caperon, L., Saville, F., & Ahern, S. (2022). Developing a socio-ecological model for community engagement in a health programme in an underserved urban area.
_PLOS ONE_,
_17_(9). https://doi.org/10.1371/journal.pone.0275092
CDC. (2025, January 28).
_High blood pressure facts_. High Blood Pressure. https://www.cdc.gov/high-blood-pressure/data-research/facts-stats/index.html
Ferdinand, K., Batieste, T., & Fleurestil, M. (2020). Contemporary and Future Concepts on Hypertension in African Americans: COVID-19 and Beyond.
_Journal of the National Medical Association_,
_112_(3), 315–323. https://doi.org/10.1016/j.jnma.2020.05.018
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
Moloro, A. H., Seid, A. A., & Jaleta, F. Y. (2023). A systematic review and meta-analysis protocol on hypertension prevalence and associated factors among bank workers in Africa.
_Sage Open Medicine_,
_11_, 205031212311720-205031212311720. https://doi.org/10.1177/20503121231172001
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