Date of Submission

Spring 5-7-2023

Document Type


Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Dr. Trinette Radasa

Second Advisor

Dr. Jo Loomis



Background: Rural population accounts for 15% of the population in the United States of America. Rural residents have a higher risk of health disparities than urban populations. The significant health inequities in the underprivileged population include a higher incidence of chronic diseases, lack of access to healthy foods, unhealthy eating habits, lack of access to health care, poor socioeconomic status, lack of health insurance, cultural and language barriers, and lack of health literacy. Local Problem: The population in Fresno and Tulare Counties in Central Valley, California is underprivileged, lacks access to proper health care and has higher rates of health disparities. The Save the Children organization’s Community Health Workers (CHWs) work in these counties. Methods: An integrated literature review was conducted searching the databases, resulting in eleven studies of various levels and strengths. Interventions: Motivational Interviewing (MI) is an evidence-based communication skill which helps alleviate ambivalence associated with behavior change and enhance healthy lifestyle modifications such as smoking cessation, reduce substance abuse and unhealthy eating habits. Literature suggests that the use of MI skills has been proven effective in changing high risk behaviors in the community. Educating the CHWs in MI would aid in improving healthy behaviors. Results: This integrated literature review reveals with strong and compelling evidence that CHWs trained in MI promote healthy behaviors in the community. Conclusions: It is evident from the literature that the rural populations, especially Latinx, have poor health outcomes and face several health inequalities compared to the urban population. Improving healthy behaviors in rural areas is proven effective with the MI help. Therefore, using competent CHWs trained in the use of MI would be beneficial in impacting community behavior change, resulting in improved health outcomes in rural areas.

Included in

Nursing Commons