CBT-based Lifestyle Modification Education to Improve Hypertension Management for Spanish Speaking Patients at One Community Health Center

Abstract

Hypertension affects Hispanic populations in the U.S., requiring culturally tailored interventions. This quality improvement (QI) project evaluated the effect of Cognitive Behavioral Therapy (CBT)-based lifestyle modification education and individualized hemodynamic monitoring program for Spanish-speaking patients at a community health center. The four-week intervention incorporated CBT principles, including SMART goal-setting to improve diet, physical activity, smoking cessation, and sleep hygiene. Seven participants enrolled, with five completing the program. Self-care outcomes were measured using the Self-Care of Hypertension Inventory (SCHI) and Self-Care Self-Efficacy (SCSE) surveys. Hemodynamic parameters were assessed using the NICaS Hemodynamic Navigator, a non-invasive bioimpedance device. Results showed a mean reduction in systolic blood pressure from 172 mmHg to 133 mmHg and total body water percentage from 64.8% to 51.1%, indicating improved cardiovascular function. The SCHI exhibited strong adherence to recommended self-care management behaviors across three domains: self-care maintenance (M = 80.00, SD = 9.50), self-care monitoring (M = 78.57, SD = 22.45), and self-care management (M = 75.00, SD = 13.18). The SCSE score (mean=86.00, SD = 13.76) suggested high confidence in managing hypertension. Participants feedback demonstrated they valued Spanish-language instruction and culturally relevant education, reporting reduced sodium intake, increased physical activity, and attempts at smoking cessation. While sleep improvement remained a challenge, CBT-based strategies supported behavioral change. Findings suggest integrating CBT-based education with SMART goal-setting and hemodynamic monitoring can enhance hypertension management. Future research should explore long-term adherence and clinical outcomes to validate this approach.Doctor of Nursing Practice, Psychiatric Mental Health Nurse Practitioner (PMHNP