Assignment 3: Developing an Intervention and Determining the Impact SOLUTION

Assignment 3: Developing an Intervention and Determining the Impact SOLUTION

NURS 8310 Assignment 3: Developing an Intervention and Determining the Impact

Section 3: The Intervention

  • An outline of an intervention you would implement to address the population health problem with your selected population based on the results of the study in Section 2 (Note: If you selected a descriptive study design, you are still required to outline an intervention that might be developed based on future research.)
  • A review of the literature that supports this intervention

Section 4: The Impact

  • An explanation of the health outcome you would be seeking and the social impact of solving this issue

The Effect of Self-Monitoring on the Reduction of Hypertension Amongst Health Workers

For years, patient quality care and safety have been the major focus of nursing, meaning that efforts are put explored for ensuring that high standards are maintained. Nurses and other stakeholders employ various strategies such as evidence-based practice and quality improvement initiatives to ensure that patients receive the best nature of care possible. The implication is that nurses usually engage in the research processes, which may entail identifying health care problems and coming up with potential solutions which are then fine-tuned before implementation to ensure that the interventions achieve the intended purpose (Aiken et al., 2021). In the previ

Assignment 3 Developing an Intervention and Determining the Impact SOLUTION

Assignment 3 Developing an Intervention and Determining the Impact SOLUTION

ous weeks, various attempts have been made to use the epidemiological approach in a critical analysis of a population health problem. Therefore, the health problem identified in the previous weeks is hypertension among healthcare workers. The purpose of this assignment is to discuss an intervention that will be implemented to address the health problem a literature review that supports the intervention. Besides, this write-up explores the potential social impact of the solution.

The Intervention

As discussed in the previous sections, this project seeks to address hypertension among healthcare workers. Therefore, the following PICOT statement was chosen: Among Healthcare Personnel On a Medical Unit Aged 21 To 51 Years Having Psychological Stress, Does Blood Pressure Self-Monitoring with A Comprehensive Education in The Healthcare Facility as Compared to No Intervention Contribute to The Deterrence of Development of Hypertension Over 6 Months? From the above, the population encompasses the health workers of the medical unit aged 20 years to 50 years. Therefore, the chosen intervention to help address the problem of developing hypertension due to psychological stress is blood pressure self-monitoring with comprehensive education.

A Review of Literature

Hypertension has various adverse impacts, and therefore, over the years, there have been efforts to address the condition and come up with better ways of managing it. One of such interventions that have been used in Literature is the use of blood pressure self-monitoring and comprehensive education on how to keep the pressure normal. Therefore, this section presents some of the studies in the past that have addressed hypertension using this intervention.

In one of such studies, Persell et al. (2020) conducted research to investigate the impact of using a coaching application among patients to enhance various aspects such as blood pressure monitoring. The applied design was a randomized controlled study design. Upon the use of the intervention, the researchers observed various results. The mean systolic blood pressure was found to be better in the intervention group as compared to the control group. Besides, the participants in the study group showed more self-confidence in controlling blood pressure. One notable result is also that the blood pressure was similar among patients using a smartphone coaching app integrated with home monitoring and those who performed home monitoring integrated with a blood pressure monitoring app (Persell et al., 2020). Therefore, this study shows that blood pressure monitoring leads to better outcomes in reference to hypertension.

Khorsandi et al.( 2017), also conducted a study to evaluate the impact of education built on the health belief model on the adoption of behaviors that help control hypertension among the elderly. This research used a quasi-experimental study design involving a total of one hundred elderly patients living with hypertension. While part of the study participants was placed in the intervention group, the other part was in the control group. The researchers analyzed the results through repeated measures analysis of variance. From the analysis, the study revealed a substantial difference in the scores of the intervention and the control group’s constructs (Khorsandi et al., 2017).

The data were collected at baseline, immediately after the intervention, and three months after the educational intervention. Therefore, the use of the education initiative led to better use of strategies for controlling hypertension among elderly patients. From the study, it was evident that there is a close connection between patients’ health beliefs and their health behaviors (Khorsandi et al., 2017). The implication is that deliberate efforts should be made to design education initiatives that can influence such beliefs and promote health for better patient outcomes. This was reflected in the increased mean score of the patient’s health beliefs when the education initiative was used.

In another study, Gamage et al. (2020) focused on evaluating the impact of using a community health worker-led group-based education coupled with monitoring in improving patients’ blood pressure control. The researchers undertook a baseline community-based survey that was then integrated with a randomized controlled trial of individuals with hypertension. As the intervention, the trained community health workers offered a group-based education to individuals with hypertension, with the intervention offered every two weeks for three months. The researchers integrated health lifestyle change support, education about hypertension, and monitoring of blood pressure (Gamage et al., 2020).

Upon analysis of the data using mixed-effects regression, the researchers unveiled some important results. For example, while blood pressure was similar at baseline between the groups, it was observed that the blood pressure control significantly improved between the baseline time and follow-up time more in the intervention group as compared to the control group (Gamage et al., 2020). In addition, the researchers also noted a more significant reduction in the systolic and diastolic blood pressure in the experimental group in comparison to the control group.

Khanal et al. (2021) recently conducted another study involving the use of education among patients with hypertension. The research focused on assessing the effectiveness of health education sessions integrated with support programs in lowering blood pressure among patients living with hypertension. Using a cluster randomized controlled trial, the researchers randomly assigned wards into control and intervention groups. They went ahead and offered four health education sessions, and home care was done frequently for six months in the intervention group. The control group was offered the usual care.

The analysis of the collected data revealed significant differences between the control and the intervention groups. For example, they noted that the participants in the intervention group had had a better controlled systolic blood pressure as compared to the individuals in the control group (Khanal et al., 2021). Besides, it was also evident that the improvement in the knowledge scores significantly improved among the participants in the intervention group in comparison to those recruited in the control group. Therefore, this study also addresses the importance of using education as an intervention for patients with hypertension.

Recently, Mini et al. (2022) explored research involving nurse-initiated/led education programs among teachers. The research focused on examining the impact of nurse-led educational intervention on hypertension rate control among teachers. Using a cluster randomized controlled trial, the researchers recruited a total of four hundred and two teachers living with hypertension. While both the control and the intervention groups were offered leaflets with hypertension education such as medication adherence and healthy lifestyle, the intervention group received a further nurse-led education initiative which was conducted for three months on hypertension control.

Using a mixed-effect logistic regression model, the researchers noted a significant difference in the outcomes regarding the two groups. After the third month, most of the individuals recruited in the intervention group achieved hypertension control in comparison to usual care. In addition, the individuals in the intervention groups were almost two times more likely to practice medication adherence in comparison to the control group. Another significant result is that the reduction in systolic blood pressure was substantially bigger in the intervention group than in the control group.

Yatim et al. (2018) also conducted research that focused on evaluating the effect of group-based education on psychosocial and clinical outcomes among patients living with hypertension. The researchers employed a pretest-posttest quasi-experimental study design involving a total of forty-five study subjects. The group-based education was offered for a period of two months where, at the end of the sessions, the participants were found to have a substantial improvement in various aspects related to hypertension such as physical activity, cholesterol, and high-density lipoprotein. In addition, the researchers also note a substantial improvement in the patient’s self-care behavior.

The Impact

As earlier indicated, hypertension is a condition impacting patients negatively, and so there is always a need to seek better solutions or improved interventions. Indeed, hypertension has been shown to be a major risk factor for chronic kidney disease, stroke, and heart disease (Lee et al., 2018). Therefore, addressing hypertension using the already described intervention is expected to have various impacts. Since part of the intervention is the use of an educational initiative to teach the patients on the importance of blood pressure self-monitoring and leading a healthy lifestyle, among the expected impacts are improved acceptance of the use of blood pressure self-monitoring and health activities or lifestyles that support high blood pressure care and control. Since the study also focuses on patients experiencing psychological stress, it is also expected that the educational sessions will lead to reduced levels of psychological stress hence lower chances of patients getting hypertension.

The patients are also expected to have improved knowledge on the relationship between psychological stress and the development of hypertension among patients. Such knowledge will be key in ensuring that the patients follow appropriate steps and stick to treatment and management plans to ensure that they have better outcomes. The intervention can only be impactful if the educational sessions are designed to optimize content delivery and ensure that the patients understand the intervention’s aspects.


Hypertension is a global health concern whose prevalence can be reduced by lifestyle modifications. While various factors can cause it, it is possible for individuals to adopt lifestyle modifications to either prevent it or have better health outcomes while living with it. The importance of exploring interventions emanates from the fact that hypertension has been shown to be a major risk factor for chronic kidney disease, stroke, and heart disease. Therefore, this project has proposed a possible invention to help patients experiencing psychological stress from developing hypertension. The use of blood pressure self-monitoring coupled with educational initiatives has been shown to lead to better health outcomes. As such, a literature review has also been conducted to explore various publications in Literature that support the intervention.






Aiken, L. H., Sloane, D. M., Ball, J., Bruyneel, L., Rafferty, A. M., & Griffiths, P. (2021). Patient satisfaction with hospital care and nurses in England: an observational study. BMJ open8(1), e019189.

Gamage, D. G., Riddell, M. A., Joshi, R., Thankappan, K. R., Chow, C. K., Oldenburg, B., … & Thrift, A. G. (2020). Effectiveness of a scalable group-based education and monitoring program, delivered by health workers, to improve control of hypertension in rural India: A cluster randomized controlled trial. PLoS medicine17(1), e1002997.

Khanal, M. K., Bhandari, P., Dhungana, R. R., Bhandari, P., Rawal, L. B., Gurung, Y., … & Courten, B. D. (2021). Effectiveness of community-based health education and home support program to reduce blood pressure among patients with uncontrolled hypertension in Nepal: A cluster-randomized trial. PloS one16(10), e0258406.

Khorsandi, M., Fekrizadeh, Z., & Roozbahani, N. (2017). Investigation of the effect of education based on the health belief model on the adoption of hypertension-controlling behaviors in the elderly. Clinical interventions in aging12, 233.

Lee, M. R., Lim, Y. H., & Hong, Y. C. (2018). Causal association of body mass index with hypertension using a Mendelian randomization design. Medicine97(30).

Mini, G. K., Sathish, T., Sarma, P. S., & Thankappan, K. R. (2022). Effectiveness of a School‐Based Educational Intervention to Improve Hypertension Control Among Schoolteachers: A Cluster‐Randomized Controlled Trial. Journal of the American Heart Association, e023145.

Persell, S. D., Peprah, Y. A., Lipiszko, D., Lee, J. Y., Li, J. J., Ciolino, J. D., … & Sato, H. (2020). Effect of home blood pressure monitoring via a smartphone hypertension coaching application or tracking application on adults with uncontrolled hypertension: a randomized clinical trial. JAMA network open3(3), e200255-e200255. Doi: 10.1001/jamanetworkopen.2020.0255.

Yatim, H. M., Wong, Y. Y., Lim, S. H., Hassali, M. A., Hong, Y. H., Dali, A. F., & Neoh, C. F. (2018). Evaluation of a group-based hypertension self-management education programme among hypertensive community dwellers. European Journal of Integrative Medicine24, 79-84.