Research Critique and PICOT Statement Final Draft Essay

Research Critique and PICOT Statement Final Draft Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below. PICOT Question  Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor. The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study). Research Critiques In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions. The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question. Refer to ”Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper. Proposed Evidence-Based Practice Change Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes. General Requirements Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the  for assistance.
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Summary of Clinical Issue:

Hypertension is one of the highest health problems globally because it contributes to increased rates of mortality and morbidity. It is estimated that approximately 56% of coronary artery diseases and 48% of stroke incidences result from hypertension (Chiu et al. 2014). In the US, hypertension affects 29% of the population leading to risks of cardiovascular diseases and stroke.  Factors such as poor dietary practices, sedentary lifestyles, and physical inactivity are the primary contributors to hypertension. According to Osté (2010), physical inactivity augments the risk of hypertension 8-9 times. Lifestyle modifications, including exercise and diet changes are the central management and preventive measures against cardiovascular diseases and hypertension (Apovianet al. 2014).  Besides, lifestyle modifications increase the efficacy of antihypertensive drug and control of blood pressure. Therefore it is critical to maintaining levels of blood pressure through exercises and dietary changes to prevent damage of vital body organs.

The PICOT question aims to determine whether the DASH and WTW improve blood pressure control among urban African Americans within five months of initiation of the intervention. According to Apovian et al. (2018), enhancing adherence to exercises and the DASH diet is essential to reducing an individual’s blood pressure. However, WTW is an intervention looking to reduce physical inactivity among individuals to help manage cardiovascular diseases and stroke. EBP intervention can be implemented and applied to determine whether they enhance or impede high-quality nursing care. This help to evaluate the outcome of the WTW and DASH on improving the level of patient’s high blood pressure.

PICOT Question:

Does the Dietary Approaches to Stop Hypertension (DASH) (I) in urban African-Americans with hypertension (P) improve blood pressure control (O) within 5 months of initiation of the intervention (T)?

Criteria Article 1 Article 2 Article 3
APA-Formatted Article Citation with Permalink Akita, S., Sacks, F. M., Svetkey, L. P., Conlin, P. R., & Kimura, G. (2003). Effects of the Dietary Approaches to Stop Hypertension (DASH) diet on the pressure-natriuresis relationship. Hypertension42(1), 8-13. Chiu, S., Bergeron, N., Williams, P. T., Bray, G. A., Sutherland, B., & Krauss, R. M. (2015). Comparison of the DASH (Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins: A randomized controlled trial–3. The American journal of clinical nutrition103(2), 341-347. Kwon, I., Choi, S., Mittman, B., Bharmal, N., Liu, H., Vickrey, B., Song, S., Araiza, D., McCreath, H., Seeman, T., Oh, S. M., Trejo, L., … Sarkisian, C. (2015). Study protocol of “Worth the Walk”: A randomized controlled trial of a stroke risk reduction walking intervention among racial/ethnic minority older adults with hypertension in senior community centers. BMC Neurology15, 91.
How does the Article Relate to the PICOT Question?   The article proves whether the (DASH) the diet hasa significant blood pressure (BP)-lowering action   The article analyzes whether the DASH Dietary Approaches to Stop Hypertension is a critical dietary modification for reducing cardiovascular disease and blood pressure (BP) risk. The article reflects how physical activity through the Worth the Walk” (WTW) can help prevent stroke by reducing blood pressure.
Quantitative, Qualitative(How do you know?) The article is quantitative because it is based on the collection and analysis of numerical data. The article is quantitative because it is based on the collection and analysis of numerical data. The article is quantitative because it is based on the collection and analysis of numerical data.
Purpose Statement The effect of the DASH diet on the pressure-natriuresis relationship to find out the mechanisms of its BP-lowering action. The effects of substituting full-fat for low-fat dairy foods in the DASH diet, with a corresponding increase in fat and a reduction in sugar intake, on blood pressure and plasma lipids and lipoproteins The relationship between the Worth the Walk” (WTW) intervention and biological markers of health including blood pressure, non-HDL cholesterol, and body-mass index,
Research Question Does Dietary Approaches to Stop Hypertension (DASH) diet, rich in fruits, vegetables, and low-fat dairy foods, have substantial blood pressure (BP)-lowering action? Does substituting full-fat for low-fat dairy foods in the DASH diet, with a corresponding increase in fat and a reduction in sugar intake affects blood pressure and plasma lipids and lipoproteins Does the WTW increase physical activity and improve self-efficacy for being physically active and reducing the risk of stroke.
Outcome The study outcome is to find out whether the DASH diet can lower high blood pressure among patients with hypertension. The DASH significantly reduces blood pressure,high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol in the body. The WTW intervention will increase physical activity and reduce the risk of stroke
Setting (Where did the study take place?) The study was carried out in a hospital setting that is not mentioned n the study.   The study was carried out at a clinical research center in Berkeley, California. The study was carried out at four ethnic-specific clusters at senior centers in Los Angeles.
Sample The study sample 412 participants were expected, but a sample size of n=375 was used in the study. The study sample involvesthirty-six participants who finished all the experimental diets and took part in the study. The study sample involves a total of 240 participants (60 participants from each of the four targeted ethnic groups).
Method The study employed a parallel-group design. The study employed a 3-period randomized crossover trial design. The study employed a single-blind randomized wait-list controlled trial design.
Key Findings of the Study The study showed that the DASH diet reduced BP effectively in groups with high sodium sensitivity.Besides, the DASH diet did not imply blood pressure at low intakes of sodium. The HF-DASH diet significantly reduced lipoprotein (VLDL) and triglycerides concentrations and significantly increased LDL compared with the DASH diet. The DASH dietsignificantly reduced BP, LDL cholesterol, and HDL cholesterol. The results showed that the physical activity was improved through the WTW intervention and this, in turn, reduces the risks of stroke. Therefore, WTW intervention reduces hypertension and stroke.
Recommendations of the Researcher It is recommended that the DASH diet is a critical non-pharmacological measure for controlling BP. It is recommended that the modified HF-DASH diet can be used as an effective alternative to the DASH diet. It is recommended that the Worth the Walk should function as the primary stroke prevention model stroke patients.
Criteria Article 4 Article 5 Article 6
APA-Formatted Article Citation with Permalink   Apovian, C. M., Murphy, M. C., Cullum-Dugan, D., Lin, P. H., Gilbert, K. M., Coffman, G., … & Moore, T. J. (2010). Validation of a web-based dietary questionnaire designed for the DASH (dietary approaches to stop hypertension) diet: the DASH online questionnaire. Public health nutrition13(5), 615-622.   Osté, M. C., Gomes‐Neto, A. W., Corpeleijn, E., Gans, R. O., de Borst, M. H., van den Berg, E., … & Bakker, S. J. (2018). Dietary Approach to Stop Hypertension (DASH) diet and the risk of renal function decline and all‐cause mortality in renal transplant recipients. American journal of transplantation18(10), 2523-2533. Staffiliano, A. B., Tangney, C, C., Fogg, L. (2018). Favorable Outcomes Using an eHealth Approach to Promote Physical Activity and Nutrition Among Young African American Women. The Journal of Cardiovascular Nursing. 33, 62–71.  
How Does the Article Relate to the PICOT Question?   The article looks at the DASH diet its correlation to lowering blood pressure and reduces the risk of heart disease, stroke, and osteoporosis. The article addresses the Dietary Approach to Stop Hypertension (DASH) diet.   The article analyzes improving healthy nutrition behaviors by including a DASH diet can reduce the risk of hypertension.
Quantitative, Qualitative(How do you know?) The study is qualitative research because itmarked by use of online questionnaires, to collect verbal information,perceptions,and understandings of the topic. The study is qualitative research because itmarked by use of online questionnaires, to collect verbal information, perceptions, and understandings of the topic. The study is qualitative research because itmarked by use of Web-based questions that are accessible via the Internet and mobile devices, to collect verbal information, perceptions, and understandings of the topic.
Purpose Statement Assess the validity of a new, short, online dietary questionnaire created to capture DASH food intake. Dietary Approach to Stop Hypertension (DASH) diet and the risk of renal function decline and all‐cause mortality in renal transplant recipients. Favorable Outcomes Using an eHealth Approach to encourage Physical Activity and Nutrition Among Young African American Women
Research Question Does the validity of a new, short, online dietary questionnaire capture DASH food intake. Does the DASH diet lead to a lower risk of renal function? Does eHealth approach promote physical activity and nutrition among young African American women?
Outcome The DASH OLQ is a critical assessment tool for measuring DASH diet adherence. The Dietary Approach to Stop Hypertension (DASH) diet reduces the risk of renal transplant among patients. To improve healthy nutrition behaviors to decrease health risk behaviors, and decrease the risk of hypertension based on the DASH diet.
Setting (Where did the study take place?) The study was carried out atBoston University Medical Center, Boston, Massachusetts. The study was carried out in a large single‐center prospective cohort of RTR at the University Medical Center Groningen. The study was carried out at the University Medical Center
Sample The study sample includes faculty and staff aged 20–70 years at Boston University Medical Center The study sample includes the 817 invited patients;however, 632 participants were eligible for analyses. The study sample of 142 participants was expected, but a sample size of 124 was used in the study.
Method The study employed a cross-sectional validation of the DASH OLQ method. The study employed the observational prospective cohort study, and data were collected through a validated 177‐item food frequency questionnaire. A randomized, pre-post design Web-based design was used in the study.
Key Findings of the Study The DASH OLQ is a critical assessment tool for measuring DASH diet adherence.The DASH diet lowers blood pressure, cholesterol and the risk of stroke, osteoporosis, and heart disease.   The study showed that adherence to a DASH‐style diet is linked with a lower risk of renal function. The DASH participants showed that eHealth approach could be used for changing health behaviors patients with hypertension.
Recommendations of the Researcher It is recommended that the DASH OLQ is important in assessing the DASH diet adherence in clinical practice. It is recommended that a randomized clinical trial should be carried out to show whether adherence to the DASH diet risk of renal function. It is recommended that the eHealth approach is a critical program that can be used for changing health behaviors for other populations at risk.

The Link between the PICOT Question and Research Articles

DASH and WTW can help improve blood pressure control among urban African Americans within five months of initiation of the intervention. Hypertension is one of the highest health problems globally because it contributes to increased rates of mortality and morbidity. Physical inactivity and lifestyle modifications including exercise and diet changes are the main management and preventive measures against cardiovascular diseases and hypertension. Individuals can take control of the levels of their blood pressure through taking medication and adhering to lifestyle changes such as exercise, nutrition and weight management, and low sodium intake.

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