Pilot Testing the Effectiveness of a Culturally Tailored Hypertension Education Program at a Community-Run Clinic

Introduction

Hypertension remains the leading preventable cause of cardiovascular morbidity and mortality worldwide and disproportionately affects underserved populations with limited access to linguistically and culturally appropriate care (World Health Organization, 2021). Barriers such as low health literacy, language discordance, and limited access to preventive education contribute to poor disease management and outcomes. Evidence demonstrates that targeted educational intervention such as individualized counseling sessions, multidisciplinary lifestyle modification programs, and culturally tailored education material can significantly improve patient knowledge, self-efficacy, and adherence to lifestyle modifications necessary for blood pressure control (Carey et al., 2021; Rakhshani et al., 2024; Upoyo et al., 2024). While effective, these interventions can be resource-intensive, requiring dedicated personnel, repeated patient engagement, and program infrastructure. Despite these advancements, there remains a critical need for simple, accessible, and culturally responsive interventions. This pilot study evaluated the effectiveness of a brief, low-resource, population-tailored educational intervention designed to improve patient knowledge and self-efficacy in lifestyle modifications for hypertension management.

Methods

A pre–post quasi-experimental design was used to assess the impact of the intervention among 30 adult participants with physician-diagnosed uncontrolled hypertension at Julia’s Center, a community-run clinic in North Texas serving uninsured and predominantly Spanish-speaking patients. Participants received culturally and linguistically tailored written educational materials (e.g., brochures, handouts, and visual guides) combined with individualized, 10–15-minute, one-on-one teaching sessions delivered by second year clinical PA student investigators during scheduled clinic visits. Educational sessions focused on sodium reduction, dietary modifications, fruit and vegetable intake, healthy substitutions, and lifestyle behaviors associated with blood pressure control.

Outcome measures included an adapted version of a seven-item survey that included the Self-Efficacy for Managing Chronic Disease Scale and related health education measures (Carey et al., 2021; Lorig et al., 2001). The adapted survey accommodated lower health literacy levels and Spanish language translation. The survey utilized a five-point Likert scale to evaluate patient confidence in understanding hypertension management and ability to implement lifestyle changes. The post-intervention survey was administered immediately following the educational session. All participants completed both the educational intervention and post-survey assessment.

Results

Results demonstrated a statistically significant improvement in overall patient confidence in managing hypertension following the intervention (mean score increase from 4.20 to 4.55, p < 0.001, Wilcoxon signed-rank test). Knowledge improved significantly across six of seven domains, with the greatest gains observed in sodium reduction (p < 0.01), fruit and vegetable intake (p < 0.01), and healthy dietary substitutions (p < 0.01). Participants also reported increased confidence in their ability to apply lifestyle changes, including dietary modifications and self-management behaviors.

Conclusion

This study highlights the feasibility and effectiveness of delivering culturally tailored, low-resource educational interventions to improve hypertension-related knowledge and self-efficacy among underserved populations. These findings reinforce that simple, brief, human-centered, and targeted educational approaches can significantly impact patient knowledge and self-efficacy, particularly in settings with limited time and resources. Limitations of this study include the small sample size, immediate post-intervention assessment, and reliance on self-reported data, which may limit generalizability and the ability to assess long-term outcomes.

Future research should explore the longitudinal impact of such interventions on objective health outcomes, including blood pressure control, medication adherence, and sustained behavioral change. Expanding these approaches across diverse clinical settings may support the integration of scalable, culturally responsive education into routine care and contribute to reducing health disparities.

Acknowledgement

The authors would like to that Dr. Barbara Devitt for providing access to the Julia’s Center site, the facilitation of data collection, and mentorship.