Abstract
Background In Western countries, hypertension and hypertension-related complication are more common in ethnic minority groups of African descent than in indigenous populations. Addressing ethnic minority patients’ perceptions of hypertension and its treatment through the use of cultural appropriate hypertension education (CAHE) increases adherence to medication and lifestyle recommendations. Given these effects, it seems warranted to develop a training program on how to deliver this type of patient education for Primary Care Nurse Practitioners (PCNPs). Objective Development and evaluation of a training program for PCNPs aimed at providing culturally appropriate hypertension patient education. Design Prospective cohort study evaluating attitude and intended behavioral changes. Participants Both experienced PCNPs and PCNPs in training participated in this study. Main measures The effects of the CAHE-training were measured by 3 different questionnaires on 1) the satisfaction with the training program, 2) the attitude towards culturally appropriate care, and 3) the commitment to change. PLOS ONE | June 8, 2017 1 / 13 OPEN ACCESS Citation: Meinema JG, Haafkens JA, Jaarsma DADC, van Weert HCPM, van Dijk N (2017) Development and evaluation of a culturally appropriate hypertension education (CAHE) training program for health care providers. PLoS ONE 12(6): e0178468. journal.pone.0178468 Editor: Christophe Leroyer, Universite de Bretagne Occidentale, FRANCE Received: January 9, 2017 Accepted: May 13, 2017 Published: June 8, 2017 Copyright: © 2017 Meinema et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper. Funding: This work was supported by ZonMw (http://dx.doi.org/10.13039/501100001826) NOW grant 201X 12010095425 (Dr. Joke A. Haafkens). Competing interests: The authors have declared that no competing interests exist. Abbreviations: CAHE-care, delivery of culturally adapted hypertension education to patients in Results The CAHE-training program consists of 10 different components divided over two 4-hour sessions and was taught to 87 participating PCNPs. The program utilizes constructivistlearning principles and educational evidence on adult learning. The content of the program is based on the knowledge obtained from our previous studies on culturally appropriate care. The mean satisfaction-score was 7.5 (1–10 scale), with the role-play exercise with patient-actors scoring highest (8.2). We observed non-significant but positive changes in attitude. PCNPs who reported on the implementation of their intended behavior change showed significant attitude changes after