Haitians and hypertension (Project taking place at a primary care office in Miami Florida (USA)) – Graded Evidence Table also needed

Literature Review

This section should start seamless from the previous section. The overall goal of this section is to present to your audience the existing knowledge or evidence that is in existence about your identified topic. Be sure to summarize your literature. Synthesize your findings here and identify relationships between any evidence that you have reviewed. Your evidence tables should be helpful as your begin to write this section.

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As you begin to write this section, keep in mind you want your reader to have a full understanding of the topic when they finish reading this section. Read this section aloud, record yourself and listen to yourself. Make necessary adjustments to ensure you transition smoothly and seamlessly from one piece of evidence to the next. When you listen to yourself read this section, does it make sense? If it doesn’t, it will not make sense to your readers.
Direct quotes should be rarely used, however if absolutely necessary then use them sparingly. Do not include your personal interpretation or opinions. The literature review should contain all objective information.

You should include a minimum of 10-15 articles here (all of these articles should be appraised through the use of your evidence table). These articles must be from peer-reviewed articles and published in the last 3-5 years. If you found an article that is pivotal to the topic of your project that is more than 5 years old, discuss this with your mentor as this may still be okay because of the significance of the findings.
Conclude this section with a summary of your findings. Make a statement regarding the rationale for performing this project (as evidenced by your literature review).

Theoretical Framework

In this section, identify the theoretical framework (preferably a nursing theory) that supports your DNP Final Project. It is helpful to have a diagram of the framework here with its connection to your project. Be sure to explain how this framework relates to your project.

Translational Framework

In this section, identify the translational framework you used during your project planning, implementation and evaluation. Be sure to explain how this framework was used for your DNP Final Project.

Sample Answer

Introduction

Non-communicable diseases (NCDs) such as hypertension are the major cause of mortality and impairment in low- and middle-income countries (LMICs), accounting for three-quarters of all NCD fatalities. The World Health Organization (WHO) aims to reduce CVD mortality and hypertension by 25% globally by 2025 (Tymejczyk et al. 2019). However, attainment of these targets may be hindered in many LMICs due to a lack of data on the burden of NCDs and associated risk factors, such as hypertension. Hypertension is becoming more frequent in Haiti, the Western Hemisphere’s poorest country, where 74 percent of the urban population lives in slums.

Adult high blood pressure has been reported to be as high as 47 percent in Port-au-Prince, and hypertensive cardiovascular diseases is one of the nation’s fastest rising causes of mortality. Haiti has one of the greatest stroke fatality rates in Latin America/the Caribbean, more than double that of the neighboring Dominican Republic. Hypertension is prevalent among Haitian young women (largely due to peripartum cardiomyopathy). There are no slum-specific estimates of hypertension prevalence in Haiti, but research from other nations’ slums has shown a broad range of estimates, frequently minimal knowledge of having hypertension, and poor hypertension control, but most available data were constrained by convenience sampling. This chapter introduces the literature review regarding hypertension in Haiti. The researcher describes the understanding of the condition among the Haitian people and reflects on the existing literature about the matter. The researcher also describes critique of the existing literature, research gap and summarizes the literature in graded evidence table

 

 

Sampling Strategy

The search for literature regarding hypertension among the Haiti population was conducted from PubMed, Google Scholar and EBSCOhost. The researcher used the following words to search for existing literature; ‘hypertension’, ‘Haiti’, ‘people living in Haiti’  ‘adults’, and ‘Haitian population’. For more specific search outcomes, the researcher used Boolean search operators “and” and “or.” The search was guided by the statement ‘hypertension among the Haiti’ and was limited to peer-reviewed articles. Only studies published between the years 2016-2021 were included in the evidence table to provide an increasing focus of the literature on hypertension people living in Haiti. The researcher selected 15, which were relevant to the focus of study. The evidence provided by the existing literature will guide in the project taking place at a primary care office in Miami, Florida on hypertension.

LITERATURE REVIEW FINDINGS

General Findings

Baptiste et al. (2018) describe hypertension as a worldwide healthcare issue with approximately 972 million people globally living with the condition. Hypertension, defined by sustained blood pressure above 140/90mmHg, mostly affects people of African decency. Jones et al. (2017) highlight that factors associated with access to quality healthcare for controlling hypertension, cultural beliefs and race are significant in causing the high prevalence in people of African decency.

Hypertension in Haiti

Evidence from studies show that hypertension is a major health issue in Haiti. According to Baptiste et al. (2018), hypertension affects 45% of women and 39% of men living Haiti. The authors add that there is also a significant prevalence among young Haitian population, with the obese having higher rate than those of normal weight. A similar study by DeGennaro et al. (2018) reveals that 15.6% of people living in rural and urban settings suffer from hypertension. The studies reveal that hypertension is economic and healthcare burden in Haiti. Besides, there is need for effective measures to control the condition in Haiti and reduce morbidities and mortalities caused by the disease.

Risk Factors As a Result of Hypertension in Haiti

More studies evaluated the significance of risk factors that increase the prevalence of hypertension in the area. Among the Haitian people, the major risk factors are obesity, customary intake of high amount of dietary salt, genetic predisposition, smoking and sedentary lifestyle in urban areas. A study conducted by Pierre et al. (2019) revealed that 74% of the study participants had at least one risk factor, including 8% for diabetes, 10% obesity, 8% active smoking, and 43% had hypercholesterolemia.

Challenges as a Result of Hypertension

People with hypertension face challenges, which impede proper control of the condition. Study findings by Baptiste et al. (2018) reveal that major causes of ineffective management of the condition were lack of follow-up. Failure of the healthcare system to institute clear mechanisms to control hypertension has increased the morbidities associated with hypertension. Hypertension is related to kidney injury, aneurysms, and cardiovascular accidents such as stroke and transient ischemic attack (Jones et al., 2017). The researchers explain that unstable supply of drugs to health facilities in remote areas and lack of ongoing patient health education programs necessitate effective measures to promote proper hypertension control among the patients. Below is a graded evidence table with the studies and critiques of existing literature.

 

DISCUSSION

This literature review highlight the prevalence and effects of hypertension in Haiti. Most of the adult population in Haiti have hypertension or at a risk of getting the disease. The literature showed that adults in Haiti have exceptionally high rates of hypertension (high blood pressure), which contributes to a high incidence of fatalities from stroke, renal failure, and heart failure. The problem is not limited to elderly individuals; we sometimes encounter young Haitians suffering from hypertension. Although hypertension is easily treated, it is frequently misdiagnosed until a severe event such as a stroke happens. Worse, many Haitians do not have access to basic preventative health care.

Limitations

            One of the major limitations of this literature review is that some articles relied on primary data. While this is could be an advantage, their population sample does not represent the full picture of the prevalence of hypertension in Haiti. Hence, their research is based on a small group of people and not the whole of Haiti. However, these studies reveal the effects of the condition that affects the given population.

Conclusion

This literature review sought to highlight the prevalence of hypertension in Haiti. The effects of hypertension is not only felt by the patient but also their families and healthcare providers. While the condition is preventable, many of the adults in Haiti fall victims of the same. This condition is not only caused by poor lifestyle choices but also the living conditions and the level of stress among the people. These numbers can be reduced by educating the masses on the importance of healthier life choices and providing them with better medical services.

 

Graded Evidence Table

Article (APA Citation) Level of Evidence of Article (1-6) Purpose of Study or Review Design and Methods (Sampling Method Population, Sample Size Intervention Instruments Used, Outcomes Measured, etc.) Major Findings Relevant to the Project Critique of Study (What Makes it Strong or Weak Evidence to Use)
1.Tymejczyk, O., McNairy, M. L., Petion, J. S., Rivera, V. R., Dorélien, A., Peck, M., … & Nash, D. (2019). Hypertension prevalence and risk factors among residents of four slum communities: population-representative findings from Port-au-Prince, Haiti. Journal of hypertension37(4), 685.

https://www.ncbi.

nlm.nih.gov/pmc/articles/

PMC7680636/

LOE V-A

 

This study aimed to estimate the prevalence of hypertension and its risk factors among people living in Port-au-Prince, Haiti. The survey involved participants chosen via random cluster sampling. Sex-stratified logistic regression was used to correlate the results. The study reported 20.3% of hypertension in adults, with men leading by about 3%. 49.5% of the 3% population on treatment reported having hypertension under control. The study also found out that obesity is the leading risk factor for hypertension. Among the leading risk factors are age and genetics. The study findings were relevant to the topic at hand. The article provides substantial evidence on the some of the hypertension’s risk factors that Haitians should significant work on to evade this chronic cardiovascular disorder.
2. Newman, P. M., Franke, M. F., Arrieta, J., Carrasco, H., Elliott, P., Flores, H., … & Palazuelos, D. (2018). Community health workers improve disease control and medication adherence among patients with diabetes and/or hypertension in Chiapas, Mexico: an observational stepped-wedge study. BMJ global health3(1), e000566.

https://gh.bmj.com/

content/bmjgh/3/1/

e000566.full.pdf

LOE III – A

The study focused on the impact of Community Health Worker (CHW)-led interventions on medication adherence and disease control among diabetic and/or hypertensive patients in Chiapas. A prospective observational study involving 108 patients with hypertension or/and diabetes in a stepped-wedge rollout context through a CHW-led intervention. The CHW-led intervention was significantly linked with an approximately twofold improvement in the disease control odds. Moreover, it was also associated with a positive self-adherence behavior. The study is relevant to the study, hence denoting that CHWs have a pivotal role to play in supplementing the primary health care providers’ efforts in helping patients with non-communicable diseases, notably in low- and middle-income countries.
3. McNairy, M. L., Tymejczyk, O., Rivera, V., Seo, G., Dorélien, A., Peck, M., … & Fitzgerald, D. W. (2019). High burden of non-communicable diseases among a young slum population in Haiti. Journal of Urban Health96(6), 797-812.

https://link.springer.com/

article/10.1007/s

11524-019-00368-y

LOE V – A

This study focused on characterizing the demographics health of the population in four slums of Port-au-Prince, Haiti. The study’s main objective was to identify the community’s population density and the burden the communicable and non-communicable diseases had taken on the communities. The study utilized a population-representative design to survey the slums, while the sampling process utilized a multistage cluster area random sampling process to select the households and individuals within the household to participate in the study. Two samples were selected from each household by random sampling. The study collected data from 894 individuals from 525 Haitian households. The study’s findings indicated that the leading and most common illnesses in the slum community were psychological distress and hypertension, with 24% and 20% respectively. 10% of the sample population suffered from obesity, while 7% were currently smoking. The study reported that about one-third of the sampled population could not afford healthcare services due to financial constraints, especially on youth and females in the slum. The study is substantially not relevant in to this topic, hence its major weakness to be regarded as a reliable source of evidence.
4. Jones, L. M., Rosemberg, M. A. S., & Wright, K. D. (2017). Opportunities for the advanced practice nurse to enhance hypertension knowledge and self-management among African American women. Clinical nurse specialist CNS31(6), 311.

https://www.ncbi.

nlm.nih.gov/pmc/

articles/PMC5679274/

LOE IV – B

The study’s main purpose was to explore the African-American women’s knowledge of hypertension and blood pressure. The study utilized a descriptive cross-sectional design to collect the data from African American women who participated in the study. Women attending church conferences filled out questionnaires on their knowledge of high blood pressure. The study had a sample of 151. At least 62% of the sample population had a positive diagnosis of hypertension, while many, including the negative for hypertension, had elevated blood pressure. The respondents had difficulty identifying the causes of the condition or the associated symptoms. This article relevant to this topic since it provides substantial evidence on the appropriate interventions, which health professionals would implement. Such interventions would enhance Haitians’ health outcomes regarding hypertension.
5. Bridwell, M., Handzel, E., Hynes, M., Jean-Louis, R., Fitter, D., Hogue, C., … & Pearce, B. (2019). Hypertensive disorders in pregnancy and maternal and neonatal outcomes in Haiti: the importance of surveillance and data collection. BMC pregnancy and childbirth, 19(1), 1-11. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2361-0

LOE V – A

This study aimed to estimate the prevalence of hypertension and its effects on maternal and neonatal health in Haiti. The survey was retrospective and involved 8822 singleton deliveries in four hospitals across Haiti. The study reported that 5.8% of the deliveries were complicated by hypertension (20.8%), preeclampsia (55.9%), and eclampsia (23.3%).  . The study findings were relevant to the topic at hand. The article provides substantial evidence on the need to evaluate control strategies for hypertension in pregnancy as practiced in Haiti.
6. Baptiste, D. L., Hamilton, J. B., Foronda, C., Sloand, E., Fahlberg, B., Pfaff, T., … & Davidson, P. M. (2018). Hypertension among adults living in Haiti: An integrative review. Journal of clinical nursing27(13-14), 2536-2545.

https://onlinelibrary.

wiley.com/doi/full/

10.1111/jocn.14320

Level of evidence I – B

The purpose of this study was to determine the knowledge of hypertension among adults living in Haiti. The study explored the existing studies about hypertension among the Haitian population. This study was integrative and involved the search for relevant peer- reviewed articles about hypertension among in Haiti. The authors searched from the following site: Embase, CINAHL database, and BIREME (the regional virtual health library). The key terms used to search peer-reviewed articles were “Haiti” and “Hypertension.” The guiding statement was “knowledge about hypertension among adults living in Haiti. The authors selected 8 legible publications for qualitative analysis. The synthesis of literature revealed that knowledge of hypertension among the people living in Haiti was low at 47% in urban and 80% among adults living in rurals. Low knowledge was attributable to low literacy level, lack of perceiving hypertension and low awareness about the disease.  The study revealed high evidence of hypertension among people living in rural and urban environments of Haiti. One of the studies showed that among the adults in rural parts of Haiti, 45% of women and 39% of men were living with hypertension. Another theme identified in this study was barriers to effective control of hypertension. Major causes of ineffective management of the condition were lack of follow-up, unstable supply of drugs to health facilities in remote areas and lack of ongoing health education programs. The study provided a basis to inform care providers’ interventions to assist Haitian population. However, the studies reviewed had low to middle strengths of research hence reducing its quality.
7. Boggan, J. C., McCarthy, S. H., Pritchard, J. E., O’Brien, G., & Walmer, D. K. (2019). Prevalence of hypertension and peripheral arterial disease in adults in Léogâne, Haiti. Journal of Global Health Reports. https://www.researchgate.net/profile/Joel-Boggan/publication/332796953_Prevalence_of_hypertension_and_peripheral_arterial_disease_in_adults_in_Leogane_Haiti/links/5cccd066458515712e902eca/Prevalence-of-hypertension-and-peripheral-arterial-disease-in-adults-inLeogane-Haiti.pdf

LOE – V – A

The study aimed at determining the prevalence of HTN and peripheral arterial disease in adults in Haiti under different treatment modalities Descriptive statistics was utilized to determine the prevalence of HTN and peripheral artery diseases. The results demonstrated high HTN d.98.9% of participants showed some awareness of hypertension. The study showed a positive correlation between HTN and peripheral arterial disorders hence being of significance to the health care workers.

 

 

8. Walsh, K. F., Lee, M. H., Martelly, S., Pierre, M. M., Joseph, J., Gustin, M., … & McNairy, M. (2018). Integrating hypertension services at an HIV clinic in Port‐au‐Prince, Haiti: A report from the field. The Journal of Clinical Hypertension, 20(10), 1485-1492. https://www.ncbi.

nlm.nih.gov/pmc/

articles/PMC6186190/

LOE IV – B

The purpose of the study was to show the integration of HIV and hypertension services at an HIV clinic in Haiti Port au Prince. The study was a feasibility study design involving HIV positive patients who were older than 18 years and had recorded high blood pressure after two consecutive measurements The result demonstrated that management of hypertension could be integrated into HIV routine care successfully. For instance, 82% of patient portrayed a decreased blood pressure after a period of six months. The study is of significance to use as it provides evidence-based results relating the successful management of hypertension in HIV positive patients attending clinics.
9. Fath, A. R., Aglan, A., Platt, J., Yaron, J. R., Varkoly, K. S., Beladi, R. N., … & Lucas, A. R. (2020). Chronological Impact of Earthquakes on Blood Pressure: A Literature Review and Retrospective Study of Hypertension in Haiti Before and After the 2010 Earthquake. Frontiers in Public Health, 8. https://www.ncbi.

nlm.nih.gov/pmc/

articles/PMC7844318/

LOE V- B

The purpose of study was to review prior studies of hypertension incidences after an earthquake in Haiti and present a retrospective analysis A retrospective cohort study was performed in 11 patients with linear follow up. A retrospective chart review for diagnosis of HTN in 4308 patient charts were performed over a 7-year period in 5 clinics The results indicated that blood pressure changes and HTN incidence post-earth quake reported in multiple studies varies from acute, subacute and chronic effects Though the study is relevance to the study, the sample was not large enough to help determine the risk of significance rise in BP both early and late after disaster occurrence.
10. Feurer, A. E. (2020). The Perception of Hypertension among Haitian Adults: A Focused Ethnography (Doctoral dissertation, Rutgers the State University of New Jersey, Graduate School-Newark). https://rucore.libraries.

rutgers.edu/rutgers-lib

/64164/PDF/1/

LOE III- B

The study focused on examining the perceptions of high blood pressure among the adult Haitians. Focused ethnographic methodology was utilized in this study, owing to the advantage of flexibility that allows the participants’ lived experiences to evolve in their natural environments. Additionally, this design can be conducted in almost any location. 18 participants took part in the study. The findings of the study indicated that Haitians perceive hypertensions as a body feeling following impact of situational factors on their lives. The Haitians further demonstrated interest in initiating early treatment for this feeling to curb consequential fall-out. The study is substantially relevant to this study, which addresses perceptions of hypertension in the target population. The article has thus demonstrated the need for implementing appropriate interventions to boost the Haitians knowledge and perceptions regarding hypertension.
11. Rashid, A., Park, T., Macneal, K., Iannotti, L., & Ross, W. (2018). Maternal Diet and Morbidity Factors Associated with Low Birth Weight in Haiti: A Case–Control Study. Health equity, 2(1), 139-144. https://www.liebertpub.

com/doi/pdf/10.1089/

heq.2017.0063

LOE II-A

The purpose of this study was to examine the linkage between maternal factors and development of low birth weight (LBW), including socioeconomic factors, comorbidities, and dietary intake among women in Cap Haitian. Identification of mothers who delivered LBW babies denoted, as < 2.5 kg were located through review of medical records, and compared to the normal birth weight babies. The study involved 34 controls and 32 cases for parity, age, and delivery month. The study’s findings indicated that women who take eggs were significantly less likely to deliver LBW infants. Approximately 78% of the study participants with substantial protein consumption were linked with delivery of normal weight infants. The hypertension prevalence among women was as little as 27%, with significant other women diagnosed with hypertension were not previously aware of having this condition. The article is of relevance to this study. It implies that much of the Haitian women were unaware of the underlying hypertensive disease during pregnancy, with others being diagnosed with the health condition. The article is thus strong evidence that the Haitians need various interventions to boost their knowledge and preventive practices regarding hypertension.
12. Batavia, A. S., Severe, P., Myung Hee, L. E. E., Apollon, A., Yuan Shan, Z. H. U., Dupnik, K. M., … & Fitzgerald, D. W. (2018). Blood pressure and mortality in a prospective cohort of HIV-infected adults in Port-au-Prince, Haiti. Journal of hypertension, 36(7), 1533. https://www.ncbi.

nlm.nih.gov/pmc/

articles/PMC5976542/

LOE III – B

The study focused on determining how incident hypertension and baseline blood pressure are related to mortality, HIV-related inflammation, and antiretroviral therapy initiation among HIV-infected adults residing in low-income settings. A long-term follow-up and tracing of HIV-infected individuals who had initially undertaken a trial of delayed vs. early initiation of ART in Haiti. Randomization of study participants was done The Joint National Committee (JNC-7) guidelines provided the baseline for hypertension diagnosis. The study findings indicated a hypertensive incidence rate of 3.41 in every 100 study participants. The independent factors increasing the incident of hypertension were plasma interleukin (IL)-6 levels, higher BMI, and advanced age. Incident and prevalent hypertension were significantly attributed with mortality. The article is relevant to this study, notably among Haitians living with HIV. It would impart knowledge on the risk factors that would significantly aggravate incident and prevalent hypertension. As such, they would significantly evade HIV and hypertension-related mortalities.
13. Pierre, S., Seo, G., Rivera, V. R., Walsh, K. F., Victor, J. J., Charles, B., & McNairy, M. L. (2019). Prevalence of hypertension and cardiovascular risk factors among long‐term AIDS survivors: A report from the field. The Journal of Clinical Hypertension, 21(10), 1558-1566. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6896990/

LOE III – B

The study aimed at determining the prevalence of cardiovascular and hypertension risk factors among individuals with long-term AIDS survival, especially in resource-limited settings. The study involved a retrospective study for over 10 years, for a cohort of HIV-infected patients in Port-au Prince. 397 participants remained in care for more than 10 years and received subsequent essential screening. The study findings indicated that 74% of the study participants had at least one risk factor, including 8% for diabetes, 10% obesity, 8% active smoking, 43% hypercholesterolemia, and 58% hypertension. The study further indicated that long-term AIDs survivors have increase prevalence for cardiovascular risk factors. The study was carried out in resource-limited settings, corresponding to most of Haitians’ residences. Additionally, it focused on AIDs and cardiovascular risks including hypertension, hence significantly relevant to the study.
14. Tymejczyk, O. (2019). Hypertension and HIV in an Urban Slum Setting, Port-au-Prince, Haiti. https://academicworks.cuny.edu/sph_etds/38/

LOE V – B

 

 

The study’s purpose was to examine the patterns and burden of hypertension, besides the associated healthcare needs among individuals living with HIV, residing in slums, and receiving clinical care services in Port-au-Prince, Haiti. The study utilized a cross-sectional primary data along with longitudinal secondary data obtained from the electronic medical health records from an adjacent HIV clinic. The study finding indicated 20% of the study participants were positive for hypertension, with obesity and overweight being the primary risk factors, as well as low prevalence of smoking across both genders. The study is of relevance to the topic of hypertension prevention among Haitians for it was conducted among the target population, and the findings significantly indicate a gap in knowledge among this population.
15. DeGennaro Jr, V., Malcolm, S., Crompton, L., Vaddiparti, K., Mramba, L. K., Striley, C., … & Leverence, R. (2018). Community-based diagnosis of non-communicable diseases and their risk factors in rural and urban Haiti: a cross-sectional prevalence study. BMJ open, 8(4), e020317. https://bmjopen.bmj.com/content/8/4/e020317

LOE V – A

This study estimated the prevalence of non-communicable diseases – hypertension, DM and chronic kidney disease among people living in Haiti. The diagnosis involved 2648 households selected through cluster random sampling.  . The prevalence of hypertension in rural and urban areas was 15.6%, DM 19.7% and that of CKD was 12.3%. The study is of relevance to this study’s topic by explaining on the burden of hypertension and other non-communicable diseases in Haiti.

 

 

 

 

 

 

 

 

 

 

References

Baptiste, D. L., Hamilton, J. B., Foronda, C., Sloand, E., Fahlberg, B., Pfaff, T., … & Davidson, P. M. (2018). Hypertension among adults living in Haiti: An integrative review. Journal of clinical nursing27(13-14), 2536-2545. https://onlinelibrary.wiley.com/doi/full/10.1111/jocn.14320

Batavia, A. S., Severe, P., Myung Hee, L. E. E., Apollon, A., Yuan Shan, Z. H. U., Dupnik, K. M., … & Fitzgerald, D. W. (2018). Blood pressure and mortality in a prospective cohort of HIV-infected adults in Port-au-Prince, Haiti. Journal of hypertension, 36(7), 1533. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5976542/

Boggan, J. C., McCarthy, S. H., Pritchard, J. E., O’Brien, G., & Walmer, D. K. (2019). Prevalence of hypertension and peripheral arterial disease in adults in Léogâne, Haiti. Journal of Global Health Reports. https://www.researchgate.net/profile/Joel-Boggan/publication/332796953_Prevalence_of_hypertension_and_peripheral_arterial_disease_in_adults_in_Leogane_Haiti/links/5cccd066458515712e902eca/Prevalence-of-hypertension-and-peripheral-arterial-disease-in-adults-in-

Bridwell, M., Handzel, E., Hynes, M., Jean-Louis, R., Fitter, D., Hogue, C., … & Pearce, B. (2019). Hypertensive disorders in pregnancy and maternal and neonatal outcomes in Haiti: the importance of surveillance and data collection. BMC pregnancy and childbirth, 19(1), 1-11. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2361-0

DeGennaro Jr, V., Malcolm, S., Crompton, L., Vaddiparti, K., Mramba, L. K., Striley, C., … & Leverence, R. (2018). Community-based diagnosis of non-communicable diseases and their risk factors in rural and urban Haiti: a cross-sectional prevalence study. BMJ open, 8(4), e020317. https://bmjopen.bmj.com/content/8/4/e020317

Fath, A. R., Aglan, A., Platt, J., Yaron, J. R., Varkoly, K. S., Beladi, R. N., … & Lucas, A. R. (2020). Chronological Impact of Earthquakes on Blood Pressure: A Literature Review and Retrospective Study of Hypertension in Haiti Before and After the 2010 Earthquake. Frontiers in Public Health, 8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7844318/

Feurer, A. E. (2020). The Perception of Hypertension among Haitian Adults: A Focused Ethnography (Doctoral dissertation, Rutgers The State University of New Jersey, Graduate School-Newark). https://rucore.libraries.rutgers.edu/rutgers-lib/64164/PDF/1/

Jones, L. M., Rosemberg, M. A. S., & Wright, K. (2017). Opportunities for the advanced practice nurse to enhance hypertension knowledge and self-management among African American women. Clinical nurse specialist CNS31(6), 311. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5679274/

McNairy, M. L., Tymejczyk, O., Rivera, V., Seo, G., Dorélien, A., Peck, M., … & Fitzgerald, D. W. (2019). High burden of non-communicable diseases among a young slum population in Haiti. Journal of Urban Health96(6), 797-812. https://link.springer.com/article/10.1007/s11524-019-00368-y

Newman, P. M., Franke, M. F., Arrieta, J., Carrasco, H., Elliott, P., Flores, H., … & Palazuelos, D. (2018). Community health workers improve disease control and medication adherence among patients with diabetes and/or hypertension in Chiapas, Mexico: an observational stepped-wedge study. BMJ global health3(1), e000566. https://gh.bmj.com/content/bmjgh/3/1/e000566.full.pdf

Pierre, S., Seo, G., Rivera, V. R., Walsh, K. F., Victor, J. J., Charles, B., … & McNairy, M. L. (2019). Prevalence of hypertension and cardiovascular risk factors among long‐term AIDS survivors: A report from the field. The Journal of Clinical Hypertension, 21(10), 1558-1566. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6896990

Rashid, A., Park, T., Macneal, K., Iannotti, L., & Ross, W. (2018). Maternal Diet and Morbidity Factors Associated with Low Birth Weight in Haiti: A Case–Control Study. Health equity, 2(1), 139-144. https://www.liebertpub.com/doi/pdf/10.1089/heq.2017.0063

Tymejczyk, O. (2019). Hypertension and HIV in an Urban Slum Setting, Port-au-Prince, Haiti. https://academicworks.cuny.edu/sph_etds/38/

Tymejczyk, O., McNairy, M. L., Petion, J. S., Rivera, V. R., Dorélien, A., Peck, M., … & Nash, D. (2019). Hypertension prevalence and risk factors among residents of four slum communities: population-representative findings from Port-au-Prince, Haiti. Journal of hypertension37(4), 685.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7680636/

Tymejczyk, O., McNairy, M. L., Petion, J. S., Rivera, V. R., Dorélien, A., Peck, M., Seo, G., Walsh, K. F., Fitzgerald, D. W., Peck, R. N., Joshi, A., Pape, J. W., & Nash, D. (2019). Hypertension prevalence and risk factors among residents of four slum communities: population-representative findings from Port-au-Prince, Haiti. Journal of hypertension37(4), 685–695. https://doi.org/10.1097/HJH.0000000000001966

Walsh, K. F., Lee, M. H., Martelly, S., Pierre, M. M., Joseph, J., Gustin, M., … & McNairy, M. (2018). Integrating hypertension services at an HIV clinic in Port‐au‐Prince, Haiti: A report from the field. The Journal of Clinical Hypertension, 20(10), 1485-1492. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6186190/

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We use several writing tools checks to ensure that all documents you receive are free from plagiarism. Our editors carefully review all quotations in the text. We also promise maximum confidentiality in all of our services.

Customer Support 24/7

Our support agents are available 24 hours a day 7 days a week and committed to providing you with the best customer experience. Get in touch whenever you need any assistance.

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Essays

Essay Writing Services

No matter what kind of academic paper you need and how urgent you need it, you are welcome to choose your academic level and the type of your paper at an affordable price. We take care of all your paper needs and give a 24/7 customer care support system.

Admissions

Admission and Business Papers

An admission essay is an essay or other written statement by a candidate, often a potential student enrolling in a college, university, or graduate school. You can be rest assurred that through our service we will write the best admission essay for you.

Editing

Editing and Proofreading

Our academic writers and editors make the necessary changes to your paper so that it is polished. We also format your document by correctly quoting the sources and creating reference lists in the formats APA, Harvard, MLA, Chicago / Turabian.

Coursework

Revision Support

If you think your paper could be improved, you can request a review. In this case, your paper will be checked by the writer or assigned to an editor. You can use this option as many times as you see fit. This is free because we want you to be completely satisfied with the service offered.