Community-Based Evaluation of Hypertension Awareness and Knowledge Among Underserved Bateyes in the Dominican Republic

Abstract

Background: Globally, hypertension rates are rising, particularly in low-income nations where access to healthcare and education remains limited. In the Dominican Republic, marginalized Haitian migrant communities, known as Bateyes, face disproportionate burdens. However, limited information exists on their understanding of hypertension and related health risks. This program-based evaluation aimed to explore community knowledge as part of ongoing outreach efforts.

Methods: We conducted a descriptive analysis of responses from 379 adults across three Bateyes in the Puerto Plata region. Participants completed a 15-item hypertension knowledge questionnaire during a routine mobile medical screening program (December 2022-January 2023) coordinated by the Kerolle Initiative. Hierarchical clustering was used to identify knowledge patterns and explore associations with community differences and systolic blood pressure (SBP) levels.

Results: Average BP values were 133/84 mmHg for males and 125/84 mmHg for females, with 27% of respondents meeting the clinical threshold for hypertension. Knowledge levels varied with 44% of participants having insufficient knowledge, and only one participant demonstrating adequate knowledge. Knowledge was associated with education level and household income. Poor awareness of basic concepts emerged as a key driver of variation across Bateyes. Cluster analysis revealed three knowledge patterns: (1) awareness shaped by lived experience of hypertension; (2) gaps due to common misconceptions; and (3) protective behaviors likely influenced by broader public messaging.

Conclusion: Findings from our educational outreach program evaluation suggest variable hypertension awareness across Batey communities. These observations highlight key areas for tailoring future community-centered health education efforts to the local needs of Bateyes.

Keywords: Batey; Dominican republic; hypertension; knowledge; prevalence.

Figure 1.

Distribution of total score on hypertension knowledge questionnaire—red indicates insufficient knowledge (⩽ 8 points); yellow indicates average knowledge (9-12 points); and green indicates sufficient knowledge (13-15 points).

Figure 2.

Multiple correspondence analysis (MCA) of individual survey responses by Batey. The left panel shows the distribution of individual responses from participants in Batey A (purple), B (teal), and C (yellow) projected onto the first 2 MCA dimensions, which together explain 32.9% of the total variance. Each point represents an individual, and shaded ellipses represent 95% confidence intervals for the Batey groupings. The right panel displays the contribution of individual survey item responses (correct or incorrect) to the MCA dimensions. The placement reflects the response pattern relative to the Batey distributions.

Figure 3.

Hierarchical clustering of survey questions and knowledge patterns by cluster. The left panel displays a hierarchical clustering dendrogram of the 15 survey questions based on four variables: the correlation between correctness and systolic blood pressure (Corr_SBP), and the proportion of correct responses in Batey A, B, and C (Prop_A, Prop_B, Prop_C). Questions with similar patterns across these variables were grouped using Ward’s method on a scaled distance matrix. The resulting dendrogram identified three distinct clusters of questions with shared behavioral profiles. The right panel is a radar (spider) plot comparing the average knowledge pattern across the three question clusters. Each axis represents one of the input variables used for clustering—Cluster 1 (red), Cluster 2 (blue), and Cluster 3 (green).