Counseling Adults to Choose a Heart Healthy Diet to Appropriately Manage Hypertension in a Local Ambulatory Clinic in Tucons, Arizona

Abstract

Background: Hypertension continues to plague United States (U.S.) adult population, and at southwest local city of Tucson, Arizona. A brief educational intervention along with a dietary intervention prescription template were used to implement a quality improvement (QI) project to improve patient care and bring awareness of this issue in a Tucson, Arizona local primary care clinic. Purpose: The purpose of this QI project was to (1) improve provider knowledge on the affects of diet on patients’ blood pressures, and to use the DASH Diet prescription for patient counseling, (2) increase providers’ intent to prescribe the dietary prescription, and (3) evaluate satisfaction with the content and delivery of this educational intervention. Methods: A single group, quasi-experimental pre-test/post-test comparison study was used at the local primary care clinic of Carondelet Medical Group-Central. All of the primary care providers (n=15) in this clinic were invited to become participants in this QI project. Intervention: The project’s intervention consisted of a 15-minute brief educational intervention that used the Power Point platform, and covered the current hypertension guidelines and best evidence on the DASH Diet being the most effective dietary intervention in controlling adult blood pressures, along with the presentation of the dietary intervention prescription template based on the DASH Diet recommendations. The participants completed the pre-test survey before the intervention and the post-test survey after. The surveys’ responses were used in the data analysis of the QI project, and used descriptive statistics mean, median, and mode to determine the central tendency of all the participants. Results: There were 12 participants who attended the entire educational brief, 12 pre-tests were completed, and 11 post-tests were returned. Medical doctors (n=6), advanced practice nurses (n=4), and physician assistants (n=2) consisted the sample population, and they all had a variety of years of experience (>=8 years, n=9; <1 year, n=2; 1-3 years, n=1). Knowledge based on the DASH Diet, knowledge on DASH Diet guidelines, prescribing habits of dietary interventions, and the perception of dietary intervention were the main outcome measures. The pre-test and post-test comparison yielded all positive change in percentage for all the outcome measures. The results were Knowledge mean 43%+, median 43%+, mode 57%+; Dash Diet guideline mean 19%+, median 33%+, mode 57%+; Prescribing of dietary intervention habits 44%+, 67%+, 67%+; and Perception of dietary intervention mean 16%+, median 25%+, mode 50%+. Conclusion: At this local primary care clinic, a brief educational presentation and the dietary interventional prescription were deemed effective and satisfactory in improving provider knowledge on the effects of diet on patients’ blood pressures, and to use the DASH Diet prescription for patient counseling in their future practice habits, and it increased providers’ intention to prescribe the dietary prescription.