Medicine and Health Sciences Commons^™

Strengthening Medication Adherence In African Americans Diagnosed With Hypertension, Daphne James

Doctor of Nursing Practice Projects

Background: African Americans have a high rate of hypertension, which varies by region. Additionally, African Americans struggle to understand the risks of uncontrolled high blood pressure and the necessity of medication adherence in lowering strokes, heart attacks, and quality of life.

Purpose: The project aims to implement a patient education program to improve medication adherence and blood pressure control for African American patients in a primary care setting.

Methods: Twenty African Americans ages 18–65 with hypertension (130/80 mm Hg or above) and six months of nonadherence participated in this project. The pre-, mid-, and post-questionnaires assessed medication adherence and blood …

Addressing Air Quality Mitigation As A Key Factor In Asthma Management And Prevention, Julia Buckles, Jewel Radford

Doctor of Nursing Practice Projects

Asthma is the most prevalent disease in childhood and disproportionately affects African American (AA) populations in terms of prevalence and frequency of exacerbations. Air quality and environmental factors are strongly associated with the diagnosis and management of asthma and AA children are more likely to live in areas with poor air quality. An air quality flag program was implemented in a daycare located in a county with a predominantly AA population with a high prevalence of asthma diagnoses. The goal of the intervention was to increase staff awareness of air quality and the impact it can have on asthma diagnosis …

Exploring The Nexus: The Influence Of Acculturation And Stress On Infant Outcomes Among Hispanic And Black/African American Adolescents, Mia I. Moreno

2024 Spring Honors Capstone Projects

Numerous studies on acculturation and acculturative stress exist; however, findings are inconsistent and overlook an exploration of differences between Hispanic and Black/African American (B/AA) adolescents’ acculturation, stress, and birth outcomes. Despite societal and cultural challenges for both minorities, Hispanic women typically have positive birth outcomes comparable to White women, but B/AA women show an increased risk for negative birth outcomes. Further, minority and adolescent childbearing women frequently receive fewer prenatal care (PNC) visits than recommended which may impact birth outcomes. Therefore, my study sought to compare Hispanic and B/AA women’s birth outcomes assessing acculturation and stress and examine the relationship …

African American Women’S Perceptions Of A Group Based, Diabetic Medical Nutritional Therapy Intervention: A Qualitative Study, Megan Mcmahon, Laura Gray

DNP Scholarly Projects

Background: African American women exhibit lower rates of attaining recommended diabetes management goals such as optimal blood sugar, cholesterol, and blood pressure numbers compared to other racial and gender groups. As a result, they bear a disproportionate burden of the adverse outcomes associated with poorly managed type 2 diabetes, including increased complications and mortality rates compared to other demographic groups. Despite favorable qualitative findings regarding group-based interventions for African American women with other chronic diseases, a notable gap in the literature exists regarding the women’s perceptions of a group-based medical nutritional therapy tailored to type 2 diabetes. Purpose: This scholarly …

Diabetic Coaching Program To Improve African American Patients Glycemic Control, Shonda Moore

Student Scholarly Projects

Practice Problem: The purpose of the practice problem was to find out if, among African Americans with type II diabetes who are over 18, adopting a diabetic coaching program that emphasizes diet management can result in better glycemic control over 10 weeks than for those who do not receive coaching.

PICOT: In African Americans with type II diabetes over 18 years of age (P), does a diabetic coaching program on diet management (I), compared to no coaching program (C), improve glycemic control (O) over 10 weeks (T)?

Evidence: The evidence used to guide this project came from databases, including PubMed, …

Improving Heart Health In African Americans Using A Cardiovascular Disease Bundle, Loretta N. Bennam

Doctor of Nursing Practice (DNP) Scholarly Projects

Cardiovascular disease (CVD) is a significant cause of mortality in the United States of America. Risk factors include abnormal low-density lipoprotein (LDL) cholesterol, physical inactivity, and unhealthy diets. African American (AA) adults have higher mortality rates from CVD than other demographics. In Houston, Texas, age-adjusted death rates for CVD per 100,000 population by race in AAs were 111, 85.0 in Whites, 62.9 in Hispanics, and 49.5 in Asians. This project evaluated the impact of using a CVD bundle over an eight-week period on cholesterol medication adherence, physical activity, and heart disease knowledge and was titled Improving Heart Health in African …

Reducing Mortality Among African American Mothers Related To Postpartum Hemorrhage By Implementing Early Education And Risk Assessments, Don'ya Truesdale

Theses and Dissertations

African American women are at the highest risk for hemorrhaging during childbirth (Okunlola, 2022). A hemorrhage can occur among postpartum mothers for many reasons, with the main causes being uterine atony, tissue trauma, and clotting issues. However, risks for Black mothers differ. The comorbid and social factors within the Black community greatly influence the likelihood of Black mothers experiencing postpartum hemorrhage. Additionally, the lack of assessment and attention catered towards those risk factors lead to an increased mortality among African American (AA) mothers compared to Caucasian mothers and all other ethnicities. Nonetheless, as maternal risk assessments and education increase, mortality …

Unlocking Population-Specific Treatments To Render Equitable Approaches And Management In Cardiovascular Disease (Upstream Cvd): African American Emerging Adults, Shannon Bright Smith

Theses and Dissertations

Cardiovascular disease (CVD) is the leading cause of death in America. African American people have disparate CVD outcomes, and African American emerging adults (AAEAs) aged 18-25 have CVD risk factors. This study aimed to examine the state of CVD risk factors in AAEAs, assess upstream and population factors in AAEAs attending a southeastern historically black college/university (HBCU), compare their perceived and objective CVD risk, explore their level of CVD knowledge, and examine responses when they learn their objective CVD risk.

Chapter 1 presents background literature on CVD in AAEAs and the research plan. Chapter 2 presents a newly synthesized situation-specific …

Church-Based Hypertension Education: An Alternative Solution To Hypertension Management In The African American Community, Nicole Tofi Rice

Doctor of Nursing Practice Final Manuscripts

Purpose: The objective of this evidence-based project is to explore a church-based hypertension education program as an alternative solution to providing hypertension education to the African American community. The desired goals of this project are: (a) to assess the current levels of adherence to antihypertensive therapy among members of a local African American church, using the Hill-Bone Compliance to High Blood Pressure Therapy Scale, and (b) to conduct a literature review exploring policy options encouraging the implementation of a church-based hypertension education program.

Background: Despite medical advances aimed towards prevention and effective treatment, the African American community remains disproportionately affected …

A Rapid Review Of The Literature: Cardiovascular Disease Preventive Practices And Rural Black Women, Modjadji M. Choshi, Maria Devalpine

Virginia Journal of Public Health

Cardiovascular disease (CVD) is the leading cause of death among Black/African American women. Rural Black women have the highest CVD prevalence and are more likely to have modifiable risk factors such as high blood pressure, diabetes, and obesity than any other race. Accessible evidence-based culture-appropriate self-care programs for risk reduction and CVD prevention can address these disparities. This rapid review aims to provide a comprehensive collection of such programs. Methods. Searches were performed in PubMed, CINAHL, Web of Science, Psychinfo-Embase, and Scopus for studies reporting CVD prevention programs for rural Black women. Three articles met the inclusion criteria, with …

Impact Of Culturally Tailored Shared Medical Appointments On Diabetes Self-Care Ability And Knowledge In African Americans, Adrienne L. Reddick, Deborah C. Gray

Nursing Faculty Publications

Background: Type 2 diabetes mellitus (T2DM) continues to disproportionately affect African Americans, significantly impacting morbidity and mortality. Research suggests that addressing barriers that stem from socioeconomic circumstances, systemic inequalities, biological factors, and cultural factors may positively influence biometric indicators of health and diabetes control. Objective: The aim of this study was to evaluate a diabetes shared medical appointment (SMA) model program that has been culturally tailored to address the unique social determinants of health barriers faced by an inner city African American population in Norfolk, Virginia. Methods: A pilot study using a within-group pretest–posttest design was conducted. Information was collected …

Management Of Stage I And Stage Ii Labor Arrest Disorder To Reduce Primary Cesarean Section Birth Rate For African American Women, Ariam Yitbarek Mha, Bsn, Rn, Nea-Bc

Doctor of Nursing Practice Projects

Background: Cesarean section delivery rate in the United States has reached an alarming rate of over 30%. African American women experience a higher cesarean birth rate compared to Caucasian Women. The repeat c-section rate for all patients is greater than 80%. These findings underscore the need for intervention to reduce primary cesarean section deliveries in African American Women.

Objective: This quality improvement project aimed to implement caregiver education on the ACOG/SMFM definition of the first and second-stage labor arrest disorder to reduce primary cesarean section birth for African American women.

Method: This pre-and post-intervention quality improvement project was conducted on …

Substance Use Disorder Treatment Among African American Men Living In The Rural South Of The United States, Serge Raoul Wandji

Theses and Dissertations

Substance use disorders (SUD) affect more than 40 million Americans. African American (AA) men are disproportionally affected by the negative health and social consequences of SUD, and men in rural areas may be particularly at risk due to disadvantaged socioeconomic conditions and persistent race-related stressors such as perceived discrimination. The overall purpose of this study is to advance the understanding of factors associated with SUD treatment acceptance and relapse potential among Southern rural AA men.

This purpose was achieved by determining differences in treatment acceptance and relapse potential by race and gender among rural residents admitted in a SUD treatment …

Clinical Vaccination Education Guideline For The African American Community, Margaret Chinedum Nwoji

Walden Dissertations and Doctoral Studies

AbstractVaccination hesitancy is high among African Americans and other people of color. The practice gap addressed in this project was the lack of a culturally sensitive clinical guideline for vaccination education relevant to the African American community. The practice-focused question was answered by developing an evidence-based Clinical Vaccination Education Guideline for the African American Community (CVEGAAC) that was validated by a group of four content experts using the Appraisal of Guidelines, Research, and Evaluation tool. The content experts scored each of the domains above 90%, implying that the CVEGAAC is of high quality and ready for implementation. The end users …

Addressing Disparity: A Waiting Room Intervention For Preeclampsia Prevention In African Americans, Morgan Semana

Nursing | Student Research Posters

No abstract provided.

Empowering Nurses To Recognize Post-Stroke Depression In The African American Community, Deidra Frisbie, Robin Simon

Doctor of Nursing Practice Projects

African Americans (AA) have the highest prevalence of stroke and death compared to other racial groups in the United States. Post-stroke depression (PSD) affects approximately 1/3 of all stroke patients and is underdiagnosed in the African American community.

Aim: By using a mHealth mobile app and a Psychiatry provider list at discharge, PSD can be identified, and interventions initiated, thus decreasing the sequela of PSD in AA.

Methods: Nurses were provided education on PSD, expressions of depression in African-Americans, cultural humility, implicit bias, and the importance of the nurse's role in developing a therapeutic relationship.

Results: Quantitative analysis revealed the …

Addressing Culturally Congruent Care Amongst African Americans In Skilled Nursing Facility: A Systematic Review, Adekemi T. Adedipe

DNP Qualifying Manuscripts

Introduction: Healthcare disparities and mistrust of the healthcare system discourage African Americans from seeking mental health services. Healthcare providers face challenges delivering culturally appropriate care. Examining current cultural practices can inform the education needed for healthcare providers to understand cultural care and awareness. This review aimed to identify evidence available to understand the impact of a cultural training on healthcare providers in skilled nursing facilities.

Methods: APA PsycINFO, CINAHL, and PubMed, were searched for English-language studies published between January 2016 and January 2022. Healthcare cultural competency training

in any aspect of cultural care was considered. Outcomes of interest included changes …

Exploring Cultural Values, Beliefs, And Perceptions Of Human Papillomavirus Vaccine Acceptance In African American Men, Rashida Henderson

Electronic Theses and Dissertations

Introduction: African American (AA) /Black men have a higher rate of anal and rectal HPV-associated cancer, which the HPV vaccine can prevent. Purpose: This study aimed to understand the cultural values, perceptions, and beliefs of the HPV vaccine in African American/Black Men. Method: Through a focused ethnography, a semi-structured guide was utilized to interview 24 AA men. Inclusion criteria included identifying as AA/Black, aged 18-30 years, born and living in the United States, identify and born as male, and able to understand, read, and write English. Results: Through Leininger’s Four Phases of Analysis, three themes emerged: 1) lack of knowledge …

Exploring Feasibility Of Mhealth To Manage Hypertension In Rural Black Older Adults: A Convergent Parallel Mixed Method Study, Danice B. Greer, Willie M. Abel

Nursing Faculty Publications and Presentations

Objective: The purpose of this study was to explore perceived ease of use, usability, and the feasibility of using mobile health applications to manage hypertension self-care in rural Black older adults with hypertension.

Methods: A convergent parallel mixed method design was used to study a purposeful sample of 30 Black older adults (29 females, 1 male) from rural East Texas. Quantitative data included demographic characteristics and measured blood pressure, height, and weight, along with questionnaires: the Hill-Bone Compliance to High Blood Pressure Therapy Scale, the Krousel-Wood Medication Adherence Scale-4, and the Technology Acceptance Model Questionnaire (adapted). Qualitative data …

Midwifery Care's Potential To Improve Birth Outcomes And Experiences For Black Women And Infants, Neville Wintergerst-Burch

Undergraduate Theses

Black women and infants experience higher morbidity and mortality rates compared to white women and infants in the United States. Forces of systemic racism and poverty often lead to inadequate access to prenatal care for Black women, and care received is often compromised by implicit bias or barriers related to insurance coverage, impersonal provider-patient relationships, and poor healthcare literacy. Despite the rich history of Black Granny midwives in the United States, most Black women began using physicians for obstetric care in the 20th and 21st centuries. This integrative review explores how improving access to midwifery care for Black women could …

Examining Secondary Victimization Within The Nurse-Patient Relationship, Ashley Ruiz

Theses and Dissertations

Sexual assault (SA) is a public health and human rights problem disproportionately affecting women globally (WHO, 2013). A report conducted by the World Health Organization (2013) indicated that one out of three women globally experience sexual or physical violence. Although sexual assault is widespread, many survivors of SA encounter further traumatic experiences after disclosing experiences of SA and seeking care (Campbell, Wasco, Ahrens, Sefl, & Barns, 2001; Campbell & Raja, 2005; Jackson, Valentine, Woodward, & Pantalone, 2017; Patterson, Pennefather, & Donoghue, 2017). Referred to as secondary victimization (SV), SV has yet to be explored in women’s interactions with nurses across …

Leadership Relationships And Advancement Opportunities Among African American Female Nurses, Kendra Pitts

Walden Dissertations and Doctoral Studies

A healthy work environment for nurses is critical to staff recruitment, retention, patient safety, and the financial sustainability and viability of a healthcare organization. The specific research problem under study was whether a lack of advancement opportunity or a lack of good leadership has an impact on African American female nurses leaving the nursing profession. Researchers have investigated the impact of leadership and advancement opportunity on the general population, but there is a dearth of research specific to African American female nurses and their reason for leaving the profession. Secondary quantitative data analysis was performed using survey data from the …

Improving Medication Adherence For African American Patients With Hypertension, Kimberly Fitzgerald

Walden Dissertations and Doctoral Studies

Adherence to antihypertensive medications is essential for positive outcomes in treating hypertension (HTN). But the rate of nonadherence to antihypertensive medications among African Americans (AA) is low. The purpose of this DNP project was to develop a clinical practice guideline (CPG) that would assist in improving hypertensive medication adherence in the AA patient population as well as assess whether the CPG would be recommended by a team of content experts for use in their practice. The Hypertension Medication Adherence CPG incorporated the medication adherence model and the transtheoretical model to generate evidence-based interventions. Grading of Recommendations Assessment, Development, and Evaluation …

Family History Of Substance Problems Among African Americans: Associations With Drug Use, Drug Use Disorder, And Prescription Drug Misuse, Rebecca Mahrs-Gould

Theses and Dissertations

Background: Understanding individual risk for substance use and substance use disorders is important in the efforts of reducing risk and prevention of these problems. A family history of alcohol and/or drug problems often increases the risk for these problems, however the majority of research in this area is conducted in samples that are predominantly White. African Americans face disparate outcomes from substance use and substance use disorders, and the risks for substance problems may not be the same as for Whites. A systematic review of the literature identified nine studies that examined a family history of either substance problems or …

Exploring The Relationship Between Chronic Stressors And Protective Factors And Preterm Risk In An African American Pregnant Population, Megan Mileski

All ETDs from UAB

BACKGROUND: In the United States, infant mortality is a serious public health issue, particularly for the African American (AA) population. Despite ample research investigating explanations for the significantly higher infant mortality rate (IMR) for AA infants in the United States, the reason for the racial disparity remains unknown. Reports suggest that chronic, life-course stressors may increase risk of preterm birth (PTB), the leading contributor to the high IMR for AA infants. Adverse childhood experiences and perceived racial discrimination, experienced over the life course, have the potential to increase a stress response in AA women, leading to PTB. Psychosocial resources may …

The Psychosocial Experiences Of African American Sexual And Gender Minority Caregivers Of People With Dementia, Lakeva Harris

Doctoral Dissertations

Over 50 million people in the United States provide unpaid care to a family member or friend. One-third of these caregivers (16 million) provide care to someone with Alzheimer’s disease and related dementias (ADRD). Of these caregivers, more than 20% state caregiving has led to a decline in their health. African American caregivers are less likely to report being in very good or better health than their white caregiving peers. Similarly, lesbian, gay, bisexual, transgender, and/or queer (LGBTQ) caregivers are more likely to report fair or poor health than their heterosexual, cisgender peers. The overlap of these minoritized identities may …

Detection Of Breast Cancer In African American Women Using Walk-In Mammography, Munachi Nwosu

Dissertations

Abstract

Problem: Breast cancer is a life-threatening condition, in which the prognosis could potentially worsen with a delay in the detection and commencement of treatment. Scheduling patients for mammograms continues to allow for long wait times that exist in screening mammography. Lower rates of participation in scheduled screening mammograms contributes to the increased rate of advanced breast cancer diagnosis that exit in African American women and threatens their health outcomes. The purpose of this project was to implement walk-in mammography to increase participation for early breast cancer detection.

Methods: An observational descriptive design with a retrospective chart review. A PDSA …

Innovations In U.S. Health Care Delivery To Reduce Disparities In Maternal Mortality Among African American And American Indian/Alaskan Native Women, Swapna Reddy, Nina Patel, Mary Saxon, Nina Amin, Rizwana Biviji

Journal of Patient-Centered Research and Reviews

Despite spending more on health care than any other country, the United States has the worst maternal mortality rate among all developed nations. African American and American Indian/Alaskan Native women have the worst outcomes by race, representing a stark health disparity within the country. Contributing factors disproportionately experienced by these minority populations include challenges of access to consistent and high-quality prenatal care, prevalence of underlying conditions, toxic stress due to systemic racism, and unconscious bias in health care. While many of these factors lie upstream in the lives of women, and seemingly beyond the scope of the clinical walls, the …

A Faith-Based Approach To Promote African American Healthy Heart Behaviors, Gwendolyn Gaston

Electronic Theses and Dissertations

More than 100 million American people have some form of cardiovascular disease. African American life expectancy is 3.4 years shorter than that of Caucasians, with an estimated 32% difference in cardiovascular disease mortality between Caucasian and African American men and a 43% difference between Caucasian and African American women. The purpose of this project was to utilize a faith-based approach in developing a heart-healthy program for addressing health disparities in an African American Baptist Church. The program focused on improving cardiovascular health literacy and addressing modifiable risk factors. The results of this project revealed that African Americans need interventions to …

Developing A Lifestyle Modification Tool To Prevent And Manage Elevated Blood Pressure Among African Americans, Magdalene Oziwo

Walden Dissertations and Doctoral Studies

Hypertension is a national medical problem that has been predominantly seen amongst African Americans. Within this community, hypertension has been associated with obesity, a sedentary lifestyle, and poor nutrition. It is for this reason that lifestyle modifications can be used as applied tools in the field of nursing in the prevention and management of hypertension among African American patients. This doctoral project was conducted to address the gap in nursing practice that currently exists for the African American population with regards to hypertension. The project focused on a nursing staff education program with 10 participants to promote the implementation of …