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Improving Hypertension Medication Adherence in West Palm Beach: Health Promotion Program Evaluation

May 20, 2023 | 0 comments

May 20, 2023 | Essays | 0 comments

As explained by the community health assessment for West Palm Beach, hypertension was a major problem facing African American men. This problem was further exacerbated by the lack of adherence to medication due to a myriad of factors among them being cultural beliefs and barriers. As a result, a health promotion program specifically targeting this target group was undertaken in a bid to enhance adherence to hypertension medication. According to Uyehara et al. (2007), health promotion has evolved to become a vital tool for enhancing community health, but its effectiveness solely lies in its ability to meet its objectives. Therefore, the purpose of this paper is to explain and evaluate how the health promotion program was carried out.


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Summary of the Health Promotion Plan

After the completion of the community health assessment program through a windshield survey and subsequently identifying the major health problem and the aggregate, health promotion proceeded. The planning of the health promotion included the identification of resources available and the overall resources required to implement the health promotion. Subsequently, the probable barriers to the implementation of the program were highlighted, and solutions to these barriers were sought beforehand.

During this initial stage of planning, I was involved alongside community nurses and community leaders. The actual implementation of the health promotion included stakeholders such as the state authorities (public health), healthcare agencies, notably, non-profit organizations, the patients, media, and community leaders. Public health state authorities and the healthcare agencies are primarily involved in the promotion of the overall society health and as such, they had a role in the facilitation of the project through the provision of some resources, equipment, personnel, goodwill will. Additionally, non-profit organizations were equally involved in mobilizing resources and contributing to the project in terms of resources. Community leaders and the media were primarily involved in the dissemination of information and sensitizing the public to the importance and existence of the health promotion program. The participation of the patients, notably, from within the aggregate was essential to achieving the ultimate goal of the promotion.

Evaluation of the Initial Plan

Apparently, in a rating of 0-10, I would offer a value rating of seven points in the range of accomplishment of the goals and objectives of the study. This signals a significant and viable outcome for the project with several misses and omissions in the accomplishment that would indeed not be ignored and were expected. In this regard, it is agreeable that the omissions and misses that were identified will be used as the corner steins for reviewing the project and ultimately fulfilling the intended role to completion (Uyehara et al, 2007). The failures identified are attributable to the myriad of challenges that sprout during the implementation process from various components of the project. These are discussed below, and the possible solutions identified;

1) The lack of extrinsic incentives for adherence to the project plan by the target population

While the project was targeted to benefit the population identified as vulnerable and with the primary benefits heading in the direction of each individual and ultimately their society, there was a tendency for lack of adherence to the project especially in the last six months of the implementation (McCaffrey et al, 2010). This gradual decline in the number of participants for the project was attributed to the lack of extrinsic or material incentives to keep the participants involved. For a population that exhibits a knowledge gap and the seemingly long timeline for the completion of the project, it is apparent that participants lacked the initial enthusiasm for continued participation.

The need to incorporate extrinsic or material incentives for the project participants then arose as an unseen need. With limited resources, it was almost impossible to provide extrinsic incentives. Nevertheless, considering that this challenge occurred midway through the project, the project utilized the early learners in the project to act as peer educators for their colleagues who were losing the motivation to carry on with their specific roles (Harwood et al, 2010). This helped create a familial structure within the groups and ultimately see out the remaining timeline for the project. The peer educators played a key role in the last three months of the project and this was identified as an extra benefit for the project and more importantly the community since it was a perfect indication of a more informed society (McCaffrey et al, 2010).

2) The support decline from key stakeholders towards the last stages of the project

There was an apparent lack of enthusiasm and support from key stakeholders specifically the political wing and the community leaders and sponsors (McCaffrey et al, 2010). This was attributed to the general perception that there were no visible benefits for the intended community, which in all essence was a vague outlook or evaluation of the project. The lack informed this of a continued communication platform between the project owners and these key stakeholders which would have provided a gradual update and reminder of the project goals as had been agreed from the very beginning (Uyehara et al., 2007). To overcome this challenge, it was apparent to call out all the stakeholders once more and develop; a Risk Manager, Integrated Projected Team, the risk owners and other key stakeholders. Furthermore, there is an efficient communication platform, which would facilitate the continued common focus on the specific role and responsibility of each stakeholder until completion. Within the set agreement, all stakeholders were to provide emails that would be used as a funds to achieve their proposal ideas. The campaign has determined the communication platform with each stakeholder required to at least providing a brief review of the project on a biweekly basis. Up to ninety percent of the stakeholders were able to adhere to this agreement and at the very end; their feedback was regarded as critical to the achievement of the project goals.

Action Plan Implemented

Before launching the project and subsequently implementing it, the first step was to disseminate information to the public regarding the importance of the project, how it will be implemented, those who were involved, and the venue where the project was launched. The dissemination was done through the use of print media and electronic media. Print media such as posters and billboards played a significant role in passing this information. Electronic media such as television advertisements were used to communicate these aspects of the program. This communication plan was developed by a multidisciplinary team involving community nurses, community leaders, and representatives from the public health departments and the corporate organizations.

The project was started with a kick-off event that was held at the social public hall, attracting various members of the community including the community leaders, public health officials, healthcare agencies, community nurses, and the larger public.

The timeline for the health promotion was one year and as such, meetings were health monthly to showcase accomplishment, redefine milestones and subsequently make the necessary adjustments for the preceding phases of the implementation.

Evaluation of the Health Promotion Plan

Project’s Cost-Effectiveness

The project was economically viable, and the cost-benefit analysis shows that the project was entirely beneficial. The major areas of expenditure for the project were on transport, acquisition of stationery, miscellaneous costs, and the cost of extrinsic motivation for the participants. In the first phases of the project, we had managed to contain the costs but as demand for the project’s services towards the end, the overall costs of transport, miscellaneous, and extrinsic motivation increased. However, we were able to manage this issue by seeking alternatives and cutting on miscellaneous and transport costs. Optimization of resources was quite crucial as a way of reducing or slashing the unnecessary costs of the project. Overall, the project may be termed as cost-effective since its overall outcomes and benefits promise to reduce the overall cost of health care is a basic human right. She has previously led the fight for access to quality, affordable healthcare for this aggregate in the long-term.

Project’s Practical Use and Sustainability

The project was pretty practical and relevant to the target audience and the response from the public, and the stakeholders were incredible. The health promotion program helped in many ways including changing the mindset of the aggregate towards drug adherence and subsequently addressing the hypertension drugs adherence barriers that pre-existed. The overall awareness and knowledge about hypertension improved, and the participants’ ability to effectively manage the disease was improved. The project was sustainable since the information gained by the participant was of course going to impact the overall society. Believably, the participants were awarded a certificate of participation, and they would promisingly become ambassadors to the larger society on the need to adhere to hypertension drugs. Nonetheless, it is important to incorporate a follow-up plan and a post-promotion plan that would assess the long-term effectiveness of the project and subsequently act as a reminder to the aggregate on the need to adhere to drugs. This may be done through phone follow-up and face-to-face visits to enhance the exchange of information between nurses and residents in the post-project phase (McCaffrey et al, 2010).

Project’s Financial Implications

The project was designed to take up minimal costs of implementation and sustainability during the period it was set to take place. Except for the need to integrate an aspect of extrinsic rewards midway through the project, which was also resolved through alternate approaches, the project financial aspect from an overall, perspective feels within the set limits (Uyehara et al, 2007). There was no extra pressure towards the sponsors regarding demanding more funding. On the other hand, the owners took care of the learning materials, and with the entry of new sponsors who felt the need to support the project; there were no financial shortcomings whatsoever.

Over-All Summary and Expectations

While there were many challenges during the implementation process, the project ultimately met the most important goals and objectives. This specifically included the objective of increased adherence to medication from the target population and more importantly, filling the knowledge gap which was identified as the primary cause of the poor health status of this community (McCaffrey et al, 2010). The imminent challenges which have been identified helped create new platforms for approaching the project and ultimately these alternate solutions were regarded as the more viable ideas for the project for instance regarding the emergence of peer educators who eliminated the end for paid educators or part-time educators. These were among the extra benefits which the project achieved and which would prove more beneficial in the natural setting compared to the more theoretical frameworks, which seemingly missed this aspect (Harwood et al, 2010).


Nurses have a role to promote the overall health of the community through health promotion. The majority of lifestyle diseases such as obesity, hypertension, and diabetes believably continue to affect many people in Palm Beach County primarily due to lack of awareness and information regarding these diseases. This problem typically affects minority groups in the United States such as African Americans and it is the role of community health workers to work collaboratively in bridging knowledge gaps.

As demystified in the pre-project phase, failure to adhere to hypertension drugs among the members of the aggregate was due to cultural and social barriers, predominantly, belief and stereotypical barriers. As such, this health promotion was evidence-based and utilized evidence-based approaches to address the drug adherence problems among the aggregate. The beauty of this health promotion program is that the participants within the aggregate would definitely increase the overall knowledge of the community towards the importance of adherence to hypertension drugs through their ambassadorial role. This is a score for the project since it is self-sustaining through the ambassadorial role of the participants.


Harwood, L., Ridley, J., Wilson, B., & Laschinger, H. (2010). Workplace empowerment and burnout in Canadian nephrology nurses. CANNT Journal, 20(2), 12-17. Retrieved from CINAHL with Full-Text database.

McCaffrey, R., Hayes, R., Stuart, W., Cassell, A., Farrell, C., Miller-Reyes, C., et al. (2010). A program to improve communication and collaboration between nurses and medical residents. Journal of Continuing Education in Nursing, 41(4), 172-178. doi:10.3928/00220124-20100326-04.

Uyehara, J., Magnussen, L., Itano, J., & Zhang, S. (2007). Facilitating program and NCLEX-RN success in a generic BSN program. Nursing Forum, 42(1), 31-38. Retrieved from CINAHL with Full-Text database. Retrieved from https://ecampus.phoenix.edu/secure/aapd/cwe/citation_generator/gen.asp

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