Background and Significance
Hypertension also referred to as high blood pressure is among the more severe cardiovascular-related conditions. It occurs when the blood pumping through the heart's main arteries has a lot of force and pressure. According to the WHO, more than 7.5 million deaths are caused by high blood pressure which accounts for about 12.8% of the total deaths (Ahmad et al., 2016). In 2008, the pervasiveness of high blood pressure in adults aged 25 years and above was 40% while the number of people who have unrestrained hypertension rose from 600 million to more than 1 billion from 1980 to 2008 (Ahmad et al., 2016). In the USA, the African Americans have the highest prevalence rates when it comes to hypertension not only in the country but the world (Ferdinand and Armani, 2007).They tend to develop the condition at an early age as compared to the whites whereby they have a 1.3 times grander degree of non-fatal stroke, 1.8 times grander percentage of fatal stroke and 50% greater rate of developing heart failure (Ferdinand and Armani, 2007).The exact cause of hypertension is not known, but several factors that lead to the development of the disease are attributed to poor lifestyle habits. So as to bring down the prevalence rates of hypertension, there is a need to educate people on the importance of living a healthy lifestyle.
Needs Assessment
In Los Angeles, the prevalence rates in young adults' aged18-35 have been on the rise over the years. A study carried out in Los Angeles was able to reveal that about 39% of the women were suffering from this condition (Jose, 2013). Only 2 out of the three women were undertaking treatment which was below than the national rate (Jose, 2013). Another 1 in 5 women in the city had uncontrolled blood pressure (Jose, 2013). Among the males, 35%were suffering from the condition with same rates of treatment as the women (Jose, 2013). In the South Central parts of Loss Angeles, the hypertension rates are much worse whereby the conditions accounts for about 1 in every five patient diagnoses (Jose, 2013). From the entire statistics carried out in the city, more than half of the black women and men were suffering from hypertension whereas the other remaining was shared amongst the remaining groups such as the Hispanics, Whites, Asians and other minority groups in Los Angeles.
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The people also have poor eating habits for they do not have access to good education that can help them modify what they are eating (Jose, 2013). They are involved in minimal physical exercise activities, and this can be seen from the 31% overweight and obese African-Americans in the Los Angeles (Babey et al., 2012).By ensuring that the African-American population in South Central Los Angeles involves itself in some form of daily physical activity, reducing the rates of alcohol consumption, reduction in stress levels and eating a balanced diet, it will indeed bring down the obesity and overweight rates to zero.
Program Intervention
The prevalence of hypertension among young and adult African-American aged 18-35 years should be of uttermost importance. It is because this group of young adults forms the backbone upon which the country's future lies upon. As such, it is significant to ensure that their health is always at its optimum levels if this dream is to become successful.
Eating habits
Most of the individuals from this demographic group have poor eating habits which lead to the development of obese and overweight. These two conditions have been linked to increased cases of hypertension (Campbell et al., 2012). The poor eating habits are due to the increased consumption of foods that have a high content of fats and salts referred to as "junk foods." These foods are readily available and cheap from the local stores and supermarkets. There is a need to turn to a more balanced dietary pattern. It will involve the consumption of foods that are rich in vitamins, proteins, carbohydrates and minerals. Such foods are found in small quantities in the local shops and supermarkets. However, an increase in the foods from these selling points will indicate that they are being consumed by a large number of people.
To ensure that people change their eating habits, there is a need to bring to play people who have the knowledge in regards to the human anatomy. It will include doctors, nurses, nutritionist and other people who have relevant knowledge on dietary patterns. The doctor and nurse will offer the community tests to determine what their blood pressure levels. It is the duty of the nutritionist and three speakers to inform the community members on the importance of observing a healthy eating diet. They will also bring forward the connection between an unhealthy eating pattern and hypertension. The sessions by the doctor and nurse will be carried out from various selected schools and churches in the areas. The nutritionist and other speakers will pass their information to the community from community centers including churches. The doctor will work for 30 days with each daily session lasting for 2 hours. For the nutritionist, they will pass on their information in 30 minutes sessions for 120 days. The speakers will have 30 minutes session which will run for only six days while the nurse will have a one-hour daily session for 120 days.
Physical Inactivity
Lack of physical activity has been linked to increased obesity and overweight cases that lead to hypertension in the long run (Kunes and Zicha, 2009). Physical activity does not have to be a vigorous activity such as lifting weights or running for kilometers.it is just mere simple activities such as walking to work, riding a bicycle or jogging. In the South Central Los Angeles, there are community centers that offer simple gym activities including some open parks that can allow for simple activities such as jogging. A large number of people signing up in the gyms will indicate that people have started taking physical exercises. An observation of the different parks and streets of people walking to work and engaging in some form of physical exercise is also a measurable factor.
Physical trainers will be involved in the program so that they can offer the people the best training techniques and the time required for each exercise.3speakerswith relevant backgrounds on physical fitness experience will also be made available. The physical trainers will have a one-hour session for 120 days while the guest speaker will have 30 minutes daily sessions for only six days.
Alcohol Intake
The intake of alcohol has been around for thousands of years. Today, the consumption of alcoholic in the world has become a regular norm in most societies. However, alcohol abuse has turned out to become a major problem throughout the world. In the USA, more than 20 million people are affected by alcohol abuse leading to more than 100000 lives being lost annually (Husain et al., 2014). Alcohol has an ethanol compound of which, its high consumption is known to lead to blood pressure elevation. Studies have been able to show that an intake of more than three alcoholic drinks per day (30g of ethanol) increases the chances for one developing hypertension (Husain et al., 2014).
In South Central Los Angeles, various rehabilitation centers offer services top people who suffer from alcohol addiction. An increased number of people in the centers mainly due to alcohol-related problems will indicate people are starting to become the ice. A nutritionist will be part of the program so that they can offer the person answers on the relationship between high alcohol intakes hypertension. The nutritionist will have 30 minutes session for the next 120 days with the people.
Chronic Stress
Chronic stress has been theorized to be a causing factor for hypertension (Spruill, 2010). In most of the neighborhood in South Central Los Angeles, the people come from low social, economic classes. As such, most of the people are subjected to stress on how they will manage their families. Stress is seen as an environmental perception whereby the demand expected from them is exceeded by the resources that they have in place (Spruill, 2010). The duration that an individual is exposed to stress and the intensity is what brings about high blood pressure. Racially related discrimination can also lead to chronic stress (Spruill, 2010).
Stress management practices are offered in the different psychological hospitals South Central Los Angeles. A high number of people signing up will indicate that they are managing their stress levels. Physical exercise is also known to help as a stress management strategy. High numbers of people in the gym will also indicate some are managing their high-stress levels.
Research Methods and Statistical Analysis Plan
In carrying out a study revolving around a health issue, the sample size should be one that will ensure there are minimal errors; it respects the ethical standards and one that will improve its success rates when evaluated by a funding body. As such, in the study, it will involve 60 participants due to the nature of the calculated budget. An excessive sample will mean that it will need a lot of resources and it might also affect the overall findings of the study. During the first one month of the study participants will be recruited through standard media whereby related pamphlets will be availed on various community center noticeboards including churches. Snowballing will also be used to recruit more participants from the community. The period will take a whole month so that the study can have the right participants who can bring about conclusive findings. The Principal Investigator will manage the recruitment process with the assistance of the Project Manager and Research Manager. The participants will each be one week so that they can give a chance to go through the consent form and in the case of any question, they can get clarification. The signing of the consent forms will take place for two days that will make sure their confidentiality is observed. The participants will be involved in the study for four months whereby they will be observed and outcomes made about the program procedures. In the final week of the fifth month, the participants will be awarded vouchers and certificates of participation. During the sixth month of the study, the Principal Investigator, Project Manager, and the Research Assistant will compile all their findings into one report and come up with an overall conclusion.
A t-Test will be used as the study design in the research. The T-Test allows the researcher to determine whether two groups are statistically different from each other. The formula used in the T-test is usually a ratio whereby the ratio’s top part indicates the difference between the averages of groups being studied. The bottom part of the ratio indicates the dispersion between the groups. The internal validity determines whether there is enough evidence that can support any claim by the researcher. This type of study design benefits the internal validity through allowing the computing of the statistics using two ts. One t is used in the pre-post variance of the control group and the other the experimental group. In case the t-test results produced by the experimental group are statistically substantial as different by the control group, the evidence by the researcher is said to be correct.
Budget
So as to ensure that this study is successful, it will involve the following individuals, a Principal Investigator, research assistant and project manager who will be available throughout the entire six months the research is bound to take. Other individuals in the study will include the doctor, nurse, nutritionist, physical trainers, guest speakers and unlicensed personnel. The Principal Investigator will have the responsibility of ensuring the research is compliant with the rules and regulations related to carrying out researches. He/she will also have the duty to oversee the informed consent process of the participants. They will also delegate the task to different members of the research team. The principal investigator salary will be $10,800 and an additional $1404 concerning benefits. The project manager will have the duty of ensuring the research is being executed by leading the team involved to complete the study within the allocated budget and time.
The project manager's salary is expected to be $9300 with an additional $1209 regarding benefits. The research assistant will ensure all articles; reports and presentations regarding the study are prepared. The expected salary is $5100 and an additional $663 for benefits. The doctors and nurse role will be to test the individual and determine those who are suffering from hypertension. The doctor will work for 1 hour daily at $100/hr. For one month while the nurse will work for 1 hour daily at $50/hr. for 120 days. The nutritionist will provide the participants with the best dietary pattern that will help them, lead a healthy eating habit.
The working period will be 1 hour day at $42/hr. for 120 days. The physical trainers will be two, and they will work for1 hour day at $30/hr. for 120 days. Their duties will be to provide the participant with the best training techniques and assist them during the training sessions. The additional speakers will be 6 in number, and they will assist the nutritionist and physical trainers in offering advice to the participants. They will be made up of people who have recovered from hypertension, and they will have 30-minute sessions at $20/hr. for six days. The EVS will assist in collecting information during the project and they will workfor2 hrs. Daily at $12/hr. for 120 days. Necessary equipment needed for the effective carrying of the study will include; the training materials, BP machine and weight machine and other supplies such as pencils, notebooks, pamphlets, pencils, and files will cost $1983.Hiring the city hall for six months will require about$600 at $100/monthly. In total, the entire research will require $100,000 for it to be successfully carried out. In the long-run, the lives of thousands of African-American citizens will be saved.
References
Ahmad J. Z. K., Nadimi, A. E., Nejadghaderi, M., Saeidi, A., & Porkarami, A. (2016). Prevalence of smoking and high blood pressure, two major risk factors for non-communicable diseases: the SuRF NCD (surveillance of risk factors of non-communicable disease) report 2012. Journal of Cardiovascular and Thoracic Research, 8 (4), 183.
Babey, S. H., Wolstein, J., Diamant, A. L., Bloom, A., & Goldstein, H. (2012). Overweight and obesity among children by California cities–2010. UCLA Center for Health Policy Research and California Center for Public Health Advocacy.
Campbell, T., Bacon, S. L., Dimsdale, J. E., & Carroll, D. (2012). Hypertension: A Behavioral Medicine Perspective. International journal of hypertension .
Ferdinand, K. C., & Armani, A. M. (2007). The management of hypertension in African Americans. Critical pathways in cardiology, 6 (2), 67-71.
Husain, K., Ansari, R. A., & Ferder, L. (2014). Alcohol-induced hypertension: Mechanism and prevention. World journal of cardiology , 6 (5), 245.
Jose. M. (2013). Report: In LA County, 39 percent of women, 35 percent of men have high blood pressure. Retrieved on 3 May 2017, from http://www.scpr.org/blogs/southla/2013/04/08/13208/in-la-county-39-percent-of-women-35-percent-of-men/.
Kunes, J., & Zicha, J. (2009). The interaction of genetic and environmental factors in the etiology of hypertension. Physiological research, 58 , S33.
