The Effect of Community/Public Health Nurses in Hypertension Prevention and Control

Background: Maryland participated in the Association of State and Territorial Health Official’s Million Hearts State Learning Collaborative in 2014 and 2015. Washington County, Maryland formed a collaboration between the County Health Department, Meritus Health System and the Meritus Health Parish Nurse Network to address undiagnosed and uncontrolled hypertension in the county. Objectives: Data from the Meritus Health Parish Nurse Network’s Million Hearts Program was analyzed to determine the effect of a community nursing intervention of teaching blood pressure self-monitoring and providing coaching on blood pressure and lifestyle changes in the at-risk and hypertensive population and to create a plan for program dissemination. Methods: Within this network of 52 faith communities, 39 faith community nurses provided a three month blood pressure self-monitoring and coaching for lifestyle changes program in 2014 and 2015 to 119 community participants. A secondary data analysis using a repeated measure ANOVA to assess differences in systolic and diastolic blood pressure readings collected before, during and after the intervention and a paired t-test to compare pre- and post-lifestyle scores was completed. Results: A total of 109 participants completed the program and were included in the analysis showing that blood pressure decreased and that lifestyle satisfaction in six out of seven areas improved across the three-month period. Conclusion: Coaching provided to participants by nurses in the community can create an environment of sustained support to promote improved lifestyle and blood pressure changes over time. This program can be replicated in a variety of community settings to build the evidence-base and support systems-level change in community/public health nursing practice