PUBH6006: Hypertension Health Promotion and Community Assessment

This essay delves into the critical topic of hypertension and its prevention through community-based health promotion strategies. The paper is divided into three key sections. The first part examines the application of Laverack’s ladder, outlining strategies such as community readiness, participation, and engagement to implement effective programs. The second part describes the core domains of capacity building, including learning opportunities, leadership, participatory decision-making, and communication, to empower communities. The third section explores various health promotion models like the health belief model and behavioral change approach, along with their advantages and disadvantages, to educate and motivate communities. The assignment emphasizes the importance of addressing hypertension through a multifaceted approach that includes community involvement, capacity building, and evidence-based health promotion models.

Running head: HYPERTENSION HEALTH PROMOTION
Community assessment and prevention of hypertension
Name of the Student:
Name of the University:
Author Note:

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Health issue: Hypertension
Introduction
Hypertension is a chronic medical condition wherein the blood pressure against the walls of
the arteries remains elevated resulting in high blood pressure. It presents long-term risk
factors for strokes, heart diseases, coronary artery disease, atrial fibrillation and other clinical
conditions. It is a result of lifestyle and genetic factors. It is a leading health issue with
widespread prevalence in the community (Pancha Mbouemboue et al., 2016). This paper is
divided into three sections. Part one discusses three key strategies using Laverack’s ladder to
implement a program in the community addressing hypertension. Part two describes the
application of the core domains of building capacity to empower communities and prevent
the prevalence of hypertension. Part three sets out methods to promote health and educate the
community about hypertension, and identifies the advantages and disadvantages of the
methods.
Strategies for community-based interactions
Hypertension is an increasing health concern with increasing trends in the community. It is
associated with the continued high blood pressures of the individuals. The various risk factors
include smoking, obesity, excessive salts in the food, insufficient potassium in the diet and
family history (Iyer et al., 2014). Laverack’s ladder serves as an essential tool for the
assessment of community health and provides strategies to implement health promotion
programs in the community. The growing prevalence of hypertension can be prevented by
implementing suitable health promotion programs and framing these programs by using
appropriate strategies. Three chief strategies to implement a successful health promotion

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program for hypertension include policy-making, leadership building and community
development program. This ladder outlines a step-wise framework beginning from
community readiness to community participation, engagement, organization, development,
capacity, action, and finally, community empowerment (Laverack, 2007).
Three of these strategies and their implementations have been describes as follows:
1. Community readiness: The first strategy to implement a suitable health promotion
program addressing hypertension in the community is community readiness. It
involves the preparedness of the community to collaborate with an external agent or
partner towards preventing hypertension by an appropriate program. It implies a
willingness to interact with the people of the community (Kostadinov et al., 2015).
This strategy focuses on working in partnership between the members of the
community and external agents to collaboratively implement suitable programs for the
prevention of hypertension and reduce its symptoms with primary foundations of
mutual respect, transparency in work, effective communication, compatible
experience, and deep trust.
2. Community participation: The second key strategy includes community participation
which involves developing adequate interaction with the people of the community to
target the widespread issues of hypertension faces by the people and take into account
the right ideas and opinions of the experts accordingly. This method is a step to spread
awareness of hypertension to the people of the community and involve them in
activities relevant to their health and influencing their lives. It also builds the
capacities and competencies of the community to help the members make better
lifestyle choices and educate people with a genetic risk factor of hypertension to be
extremely careful. This strategy helps to implement health promotion and educating

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people on hypertension-related issues by organizing meetings and forums for these
discussions and communicate information on hypertension.
3. Community engagement: The third key strategy in implementing a health promotion
program for hypertension is community engagement. This strategy aims to involve the
people of the respective community facing the issue of hypertension and consider
their views and suggestions to establish a program that adequately addresses all the
issues and identify any underlying concerns as well. This strategy of community
engagement includes various steps starting with listening and communicating.
Community engagement is the process that begins with informing the members
belonging to the community about the rising trend and ill-effects of hypertension,
followed by explaining the significance to adopt appropriate measures to mitigate the
associated issues of hypertension at an individual’s level. An insufficient
understanding of the strategies to prevent hypertension can be resolved by targeting
knowledge particularly on those factors. For instance, many people lack adequate
knowledge of lifestyle habits such as dietary constituents like salt consumption as
preventable causes of hypertension. A targeted knowledge on the role of modifiable
factors leading to hypertension and suitable action plans to avoid it may be helpful. At
this level of the Laverack’s ladder, the communities are actively involved in the role
of identifying the risk factors of hypertension and engaging themselves in taking
appropriate actions towards decreasing the symptoms and are not just passive
participants in the promotion program.
Capacity-building domains
Liberto et al. (2011) identify nine core domains of capacity for empowerment and ownership
of the community. These domains consist of learning opportunities and development of skills,

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mobilization of resources, leadership, linkage/ networking/partnership, assets based method,
participatory decision-making, sense of community, development pathway, and
communication. Three of these domains are discussed as follows:
1. Learning opportunities and skills development: The first domain may be used in the
prevention of hypertension by building the capabilities of the people of the
community required for hypertension program related skills, such as measuring blood
pressure. Health education on hypertension improves the theoretical knowledge and
necessary practical skills of the people regarding hypertension and change their
outlook towards health behaviors. Some of the topics of health education that can be
addressed in the health promotion program include checking blood pressure and non-
pharmacological interventions such as healthy diets, physical activity, quit smoking,
stress-relieving activities and maintaining moderate consumption of alcohol. This
promotion plan can be implemented by setting up teams under suitable leaders, each
dealing with a particular aspect of hypertension, as discussed above. For instance, if
team A is responsible for measuring blood pressure, another team B can be assigned
to counsel the participants about their lifestyle habits. Another effective way to
increase the competencies of the affected people includes training them on patient-
centered approach and to empower them in encountering healthcare providers to
acquire specific knowledge and potential complications for individual cases to find
out ways to manage the complication.
2. Leadership: The next domain is an essential element in motivating the people of the
community to participate in the health promotion program actively and make efforts
to successfully reducing the trends of hypertension by practicing the strategies
suggested. This domain is primarily about engaging and remodeling bold actions.
Leaders are responsible for welcoming the scrutiny of the members. The fundamental

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role of this domain of leadership is to provide mental support to the people of the
community and increase their participation in the activities of health promotion. For
instance, significant figures and influencers of a community can encourage people to
adopt healthy food habits lacking excessive salts to reduce the risk of hypertension
(Raine et al., 2014).
3. Participatory decision making: This is another chief domains identified by Liberto et
al. (2011) and is complementary to the previous domain of leadership. This domain
involves the inclusion of the opinions of the community members in identifying
potential causes of hypertension and the ways suggested by them to overcome the
barriers. For instance, taking the public opinion in the treatment options, including
pharmacological and non-pharmacological interventions, suggested by the healthcare
providers for hypertension can identify any underlying errors (Geller et al., 2014).
Furthermore, questioning the patients on any side-effects noted or willing to be
suppressed can provide means to target specific issues in the program.
4. Communication: The last domain is communication and involves exchanging and
spreading the causes, risk factors, and preventive measures within the community and
outside to the other communities an organizations as well. This information is more
targeted and designed according to the usual lifestyle and daily practices of the
community to apply required modifications in underlying causes. For instance, after
carefully analyzing the current knowledge of the people of the community on the
epidemiology, sociology and entomology of hypertension within the community, if
the community exhibits trends of obesity, information targeted to modify lifestyle
habits involving higher physical activities and maintaining diets is preferred (Hall et
al., 2014).

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Models and approaches to health promotion
The different models and approaches to health promotion are useful in motivating and
educating the members of the community about the issue of hypertension. The models of
health promotion include the health belief model, health action model and theory of planned
behavior.
The health belief model
The health belief model is among the earliest models focusing on social cognition. This is a
model based on perceptions rather than reactions to the events. This model consists of four
fundamental aspects which include severity, susceptibility, health motive and benefits minus
costs. These aspects collectively develop the behavior, cognition, perception, thinking and
beliefs of an individual which form the basis of this model.
The advantages of this model are described as follows:
1. The health belief model demonstrates the significance of personal beliefs and finds
relations between the effect of change in perception of the behavior.
2. This model helps in estimating if an individual is willing to take suitable prevention
actions.
3. This model is useful to evaluate the expenses and advantages of any action or step
taken by the individual.
The disadvantages of this model are discussed as follows:
1. The health belief model does not take into account that health decisions might not
always be taken rationally.
2. It also fails to consider the broader determining factors of health.

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3. This model has another drawback as it assumes that families, social life, political
factors, and cultural surrounding do not influence the procedure of decision-
making (Gottwald & Goodman-Brown, 2012).
Behavioral change approach
In contrast, some of the approaches to health promotion include the medical approach,
behavioral change approach, and educational approach. The behavioral change approach to
health promotion depends on changing the attitude and behavior of the individual to
encourage them to incorporate healthy habits in lifestyle.
The advantages of the behavioral change approach are discussed as follows:
1. It allows individuals to genuine improvement in their health habits by modifying their
lifestyle (Eldredge et al., 2016).
2. Besides, it implies a pestering of power that cannot be ignored easily.
The disadvantage of the behavioral change approach is described as follows:
1. It solely depends on the willingness of the person to bring about the necessary change.
2. Also, this approach frequently makes people feel dictated or preached at and
consequently develop resistance among them to the campaigns and promotion
programs (Baum & Fisher, 2014).
Capacity building approach
Another empowering approach is the capacity-building approach. It consists of top-down
organizational theory, bottom-up organizational theory, community organizing and
partnerships. The top-down organizational theory involves the development of policies,
judicious allocation of resources, organizational implementation and helps in sanctioning
incentives. The bottom-up organizational approach includes professional development, staff

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skills, understanding, participation and commitment. Next, the community organizing
involves chief leaders of the community, the disadvantaged groups and the community
ownership as well. Lastly, the partnerships include collaborations, community activation,
network density and reorientation of services and programs. These aspects of community
building are essential to strengthen all the segments of the community required for the
effective implementation of the strategies proposed in the following section.
Implementation of the health belief model and behavioral change approach
Despite the disadvantages of the health belief model and behavioral change approach, they
can be used together to plan individual interventions by emphasizing the specific areas of
consideration for the individual. In the case of hypertension, this collaboration of the ideas of
the health belief model and behavioral change approach can be suitably applied in the
promotion program (Kamran et al., 2014). It can be applied to the program by making the
members of the community believe that their lifestyle habits are potential risk factors in
developing hypertension and that they are susceptible to the disorder. Next, this is applied to
make the people believe that changes in lifestyle such as dietary habits in case of increased
obesity are essential to prevent the disease (Teixeira et al., 2015). It can further be applied by
educating the people about the barriers they might face in the initial days of implementing the
practices in their daily routines. For instance, the community members need to be ready to
have difficulty in consuming food with less salt in it or manage time for significant physical
activities in their schedule to prevent hypertension. Lastly, the most critical element in
applying this is developing the confidence of the people of the community that they hold the
required capacity to make the change (Khalil & Tartour, 2017).

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Conclusion
In conclusion, hypertension is a leading health concern of many communities and is chiefly
caused by lifestyle habits along with genetic factors. Therefore, it is a crucial issue to be
addressed by planning appropriate health promotion programs and suitable strategies. These
strategies focus on community assessment and public health management to effectively treat
the disease. The application of the health belief model and behavioral change approach in
planning the promotion program ensures its effective implementation. Overall, it helps in
preventing the spread and prevalence of hypertension in the community.

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