Hypertension In East Indian Population In Fresno County, California

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According to CDC, 1 out of every 3 Americans have Hypertension, which is about 75 million American adults which contributed death more than 410,000 Americans in 2014. The purpose of this study is to evaluate participants knowledge regarding the risk factors and lifestyle modifications in regards to hypertension after providing information. It was hypothesized that education has a positive impact on participants knowledge regarding the risk factors and lifestyle modifications on hypertension. Education plays a key role in preventing and early diagnosis of the disease process.

Survey questionnaire was utilized in collection of data for the research. Questionnaire consisted of 6 questions, which were used as pre and post tests. Educational material was provided in Punjabi and English in written form. Results suggest that education has a positive impact in improving the knowledge of participants.


I would like to show my gratitude to the Fresno Pacific University for sharing their pearls of wisdom with us during the course of this research. I am also immensely grateful to my Family, who supported and encouraged me throughout this process. I would also like to thank the Gurdwara, who allowed me to conduct my study.


Centers for Disease Control and Prevention

According to Centers for Disease Control and Prevention (CDC), there are about 75 million people who have high blood pressure, which is 1 out of every 3 U.S adults. Only half of these individuals have their high blood pressure under control (Chan, 2013). Hypertension is a common risk factors for many cardiovascular diseases such as heart disease and stroke, which are the leading causes of death in United States (Chan, 2013). Majority of the population that have hypertension are not aware of the disease they have, as it has no warning signs and symptoms, which is why it’s also often referred to the as “silent killer”. It’s also one of the diseases that is very easily controlled and prevented through the right education tools such as diet and exercise (Chan, 2013).


Awareness plays a tremendous role in reducing prevalence of any disease. Rural communities are at increased risk for developing life-threatening diseases that could have been easily prevented with education and awareness. Several studies have been done in third world country, with different utilization on preventing a disease. Regardless of the several resources available to individuals, hypertension continues to be a challenging for public health to adequately prevent and control the disease (Kusuma, Gupta and Pandav 2009).

Hypertension itself can be very challenging, when there are lack of resources provided to a particular population East Indian population . This research is aimed at East Indian population in Fresno county, as there are lack of information. According to U.S Census Bureau, there is less than 13.6% which consist of East asian Indian, under Asian category. Studies have stated, the hypertension is the most important risk factor for Cardiovascular disease (CVD) in India (Gupta and Xavier, 2018). The aim if the study was to determine whether education affects the knowledge of individuals regarding hypertension. Hypothesis on this study is that, there will be an difference in the level of knowledge individual would have, after the education has been provided. It was hoped, this study would demonstrate a positive finding on educational programs having an affect the on risk factors of a disease.

Problem Statement

Several articles have been published regarding Hypertension risk factors, prevention and treatment. In addition, there are few studies which focuses on hypertension in the rural areas of India. However, there is very little information or studies available on the residences of California regarding hypertension. Moreover, there’s an additional need of research for population residing in Fresno, California. Barriers such as language and cultural norms contributes to the prevalence of hypertension due to lack of information in the given community. Community- specific information is an important way to communicate appropriate strategies for behavior changes. Although there are several preventive strategies such as dietary and lifestyle modifications available, it is the lack of access to this knowledge which contributes to the problem (Kusuma et al., 2009).

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Purpose of This Study

The purpose of this study is to determine if education has an positive impact on East Asian Indians regarding hypertension, in relation to preventative measures and healthy lifestyle choices.

Significant of This Study

Aim of this study is fill in the gaps of existing research in regards to hypertension in South East Asian population. Providing a population based approach will enhance the information to help providers address hypertension.


Some of terms used in the study are defined below:

Patient - Person who is under the health are. He or she may be waiting for this care or may be receiving it or could have already received it (MedicineNet, 2018).

Nurse Practitioner - “A registered nurse who has additional education and training in how to diagnose and treat disease. Nurse practitioners are licensed at the state level and certified by national nursing organizations” (National Cancer Institute, 2018).

Primary care - Strategy for organizing health care system; “strategy for organizing the healthcare system as a whole—such as community-oriented primary care, which gives priority to and allocates resources to community-based health care and places less emphasis on hospital-based, technology-intensive, acute-care medicine” (Donaldson, Yordy, Lohr and Vanselow, 1995).

Theoretical Framework

The Health Promotion Model (HPM), is a framework created by Nola, J. Pender, in 1996, which is primarily used for education, practice and research. The purpose of this model is to simply helps nurses understand the health behaviors of individuals in order to promote healthy lifestyle changes. It influences and promotes health professionals to provide resources to help achieve positive behavior changes and increase individual's level of well being. Major concept of this theory focuses on how personal experience of individuals affects their actions. The model looks at three different areas: (1) Individual characteristics and experiences (Age, gender, body mass index); (2) behavior specific cognitions and affect (social support from family and friends for activities); (3) lastly behavioral outcomes. Factors associated with HPM are mainly due to person’s lifestyle, outlook, psychological health, social and cultural trails and biological factors (Nursing theory, 2016). There are four assumptions of Health Promotion Model, which reflects both nursing and behavioral science. First it includes individuals to regulate their own behavior. Secondly, individuals interact with environment, slowing transforming environment and transformation over time. Thirdly, Nola J. Peter articulates that the health professionals contribute a part of interpersonal environment, which exerts influence of the individual throughout their life span. Lastly, it’s believed that self-initiating is an essential, for behavior change (Current nursing, 2011). Health promotion method is being utilized into this study, as this study focuses on enhancing and changing healthy behaviors of individuals with the assist of education.

HPM was utilized into this study by using the three areas discussed by Nola J. Peter. Individuals who were instructed regarding hypertension, had to understand the benefits of change, not just the change in health benefits. In addition, promoting individual’s behavioral control was a significant part of the study. In order for patients to feel they could change the diet or increase exercise is related to self-efficacy or behavioural control. Positive changes can be taken place after an individual believe in their own ability to accomplish something. In order for this to be achieved, there needs to be a focus on small goals instead of swapping individuals on larger things which require change (Current nursing, 2011).

In addition, theory talks about identifying barriers to help facilitate change. For example, patients with HTN in East Asian Indian (EAI) community, tends to eat a lot of fried foods. Identifying the some of the barriers to overcome, such as peer pressure from friends and cravings will aid in the process of improvement. Another example in HPM, is for individuals to recognize there is a wider environment. For example individuals with HTN, who want to work on exercise, may be discouraged from unfriendliness, unfamiliarity and embarrassment to an exercise in indoor environment. These patients require a friendly and safe environment. Under the Pender model, it is assumed the education provided to participants would give them the tools they need for healthy decisions.


The purpose of this study, was to educate individuals on risk factors and lifestyle modifications and enhance their health. Pender’s Health Method is an effective tool in assessing individuals by incorporating different variables and characteristics of EAI community. This thus, encourages individuals and motivates for a healthier lifestyle.

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