Date of Award

Winter 12-14-2013

Document Type


Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

MacMillian,Deborah, PhD

Second Advisor

Dorman, Genie, PhD

Third Advisor

Sewell, Jeanne, MSN


Abstract Title: Efficacy of Motivational Interviewing and Centering to Increase Physical Activity and Dietary Adherence in African Americans with Pre-hypertension and Hypertension.

Objectives: The purpose of this study was to evaluate the knowledge and self-care behaviors of African Americans necessary to prevent the development of hypertension or to improve the control of all ready existing hypertension. Motivational interviewing was used to identify and address barriers to lifestyle modifications. The feasibility of using a Centering Care Model to deliver interactive educational sessions to empower individuals to take an active role in their health care was evaluated.

Significance of the Problem: African Americans have a higher prevalence and severity of hypertension than any other racial group in the United States. The prevalence rate of hypertension in African American males is 43.0% and 45.7% in females compared to 33.9 % in male Caucasians and 31.3% in Caucasian females.

Design: Quasi-experimental study

Setting: A primary care setting in Southeastern United States

Participants: Twenty-nine (n = 29) African American individuals with the diagnosis of pre-hypertension or hypertension.

Methodology: This study compared self-reported motivation, health beliefs and barriers to lifestyle changes associated with hypertension before and after a 4 week Centering Care Educational intervention. The Theory of Planned Behavior was used to guide this study.

Result: Participants reported a statistically significant increase in how often they exercised prior to (M = 3.48, SD = 1.50) and after completing the educational sessions (M = 4.59, SD 1.26), t (28) = 4.70, p

Additionally, the participants reported eating fast food significantly less from baseline (M = 3.07, SD = 1.73) to the final measure (M = 2.62, SD = 1.32), t (28) = 2.28, p

Motivation to exercise and make dietary changes showed significant improvement following the educational sessions. The participants reported statistical significant scores for motivation to exercise at initial time measure (M = 3.07, SD = 2.21) and at final measure (M = 2.10, SD 1.92, t (28) = 3.29, p

Furthermore, result showed statistical significant decrease in body mass index (BMI) from initial time measure (M = 29.60, SD = 4.62) to final measure after the 4-week educational sessions (M = 29.0, SD = 4.39, t (28) = 6.13, p

Conclusion: Results from the pilot study indicated that motivational interviewing and Centering Care educational sessions are effective in helping African Americans with pre-hypertension and hypertension make effective lifestyle changes that improved their blood pressure.

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