Intervention for Proposed Clinical Change Project

Proposed Solutions and Interventions

Based on a literature review, the proposed intervention is a collaborative community-based hypertension management program. This program will involve a partnership between advanced practice registered nurses (APRNs) from the Kisii Teaching and Referral Hospital and local community health volunteers (CHVs). The intervention has two primary components:

Enhanced Community-Based Education: The APRNs will train CHVs to deliver culturally-tailored, simplified health education on hypertension management, focusing on diet, exercise, and medication adherence.

Home-Based Monitoring and Telehealth Support: CHVs will provide patients with blood pressure monitors and train them on their use. They will collect weekly blood pressure readings and transmit this data to a centralized telehealth hub managed by the APRNs. The APRNs will then provide real-time feedback and clinical guidance to both the CHVs and the patients, flagging any concerning trends for immediate follow-up.

This intervention has a clear connection to the research problem because it directly addresses the identified barriers to hypertension control: low health literacy, lack of consistent monitoring, and inadequate support. By empowering CHVs and leveraging technology, the project creates a sustainable model for care that reaches patients where they are.

Comparison with Other Views

Other approaches to this problem typically focus on facility-based interventions, such as increasing clinic hours or creating specialized hypertension clinics. While these methods are valuable, they often fail to address the root causes of non-adherence, such as geographic distance, transportation costs, and patients' limited understanding of their condition. Another view focuses on a top-down, policy-driven solution, such as mass public health campaigns. While these raise awareness, they often lack the personalized, long-term follow-up necessary for chronic disease management. Our proposed solution is a hybrid model that combines the clinical expertise of APRNs with the community reach of CHVs, offering a more personalized and sustainable solution that overcomes the limitations of other, more fragmented approaches.

Sample Answer

Clarifying the Issue Under Study

The issue under study is the disproportionately high rate of uncontrolled hypertension among adults aged 45 and older in underserved communities of Kisii County, Kenya. Despite the availability of public health services, many individuals in this demographic are not achieving or maintaining their blood pressure goals. This leads to increased rates of cardiovascular events, such as strokes and heart attacks, placing a significant burden on individuals, families, and the local healthcare system. This problem is exacerbated by low health literacy, a lack of consistent monitoring, and poor adherence to treatment plans due to socioeconomic barriers.