PHN 652 When addressing an identified community health need, an intervention may already be in place for a similar population

PHN 652 When addressing an identified community health need, an intervention may already be in place for a similar population

PHN 652 When addressing an identified community health need, an intervention may already be in place for a similar population

Week 6: Implementation Strategies Summary

This week we identified barriers to and strategies to overcome barriers to implementing evidence‐based interventions. Chapter 25 in Public Health Nursing: Population-Centered Health Care in the Community guided in planning programs that can be evaluated for their effectiveness, including examining the elements of planning and evaluation, how cost studies are applied to program evaluation, and how programs may be funded. In many ways, we discover that the program management process is parallel to the nursing process. The process of program management consists of a rational decision-making system designed to help nurses know when to decide to develop a program (through the needs assessment and defining the problem), where they want to be at the end of the program (goal setting), how to decide what encompasses a successful program (planning), how to develop a plan to go forward so they will know where they want to be (implementing), how to know that they are getting there (formative evaluation), and what to measure to know that the program has successful outcomes (summative evaluation).

1 Peter 5:7-“Cast all your anxiety on him because he cares for you.”

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The e-cigarettes are the most popular tobacco products among the youth. There are more high school students that uses e-cigarettes than regular cigarettes. They also used flavored tobacco products with their e-cigarettes and hookahs which fruit flavor is the most common with current users (Gentzk et al., 2022). Nicotine products affects the development of brain which continue to develop up to age of 25 years old (Office of the U.S. Surgeon General, n.d.). E-cigarettes contains nicotine as well harmful chemical products that can damage the health of the students. The current intervention for this community health need is the new legislation “Tobacco 21”.

The first intervention I recommend is talk to student. Talking to student can influence their decision whether to use or continue using tobacco products. It is also important to be clear that tobacco products are unsafe, and it has negative effect to their bodies. The second intervention is to support Tobacco 21. Tobacco 21 is a new legislative raising the age limit for tobacco use from 18 years old to 21 years old (American Lung Association, n.d.). Lastly, promote programs to support intervention with youth engaged in using tobacco products Supporting programs and policies to help the youth quit smoking can also make an impact in promoting their health and prevent them from developing chronic diseases.

Reference

American Lung Association. (n.d.). Tobacco 21 laws. Retrieved from

 https://www.lung.org/policy-advocacy/tobacco/prevention/tobacco-21-laws

Gentzk, A.S., Wang, T.W., Cornelius, M., Park-Lee, E., Ren, C., Sawdey, M.D., Cullen, K.A.,

Loretan, C., Jamal, A., & Homa, D.M. (2022). Tobacco product use and associated factors among

middle school and high school students- National youth tobacco survey, United States, 2021.

MMWR Survell Summ 2022, 71(5), 1-29. DOI:

http://dx.doi.org/10.15585/mmwr.ss7105a1externalicon

Office of the U.S. Surgeon General. (n.d.). The facts on e-cigarette use among youth and young adults.

Retrieved from https://e-cigarettes.surgeongeneral.gove.default.htm

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Populations can face health issues despite the implementation of population-based interventions. Communities face social inequities (low income, poor education and cultural diversity) that limit access and optimal utilization of health promotion interventions (Desai et al., 2020). An example of a population health need is diabetes care. The populations with reduced physical activity and limited access to healthy diets and healthcare services have a high risk for diabetes (Kumah et al., 2021). An existing intervention to address diabetes care is the Diabetes self-management education and support (DSMES) program.

DSMES aims to improve self-management and encourage patients diagnosed with diabetes to participate in treating

PHN 652 When addressing an identified community health need, an intervention may already be in place for a similar population
PHN 652 When addressing an identified community health need, an intervention may already be in place for a similar population

and managing diabetes symptoms. DSMES intervention is implemented during patient diagnosis, when symptoms exacerbate (complications such as persistent and non-healing wounds or heart complications occur), annually, during the transition of care and when not meeting treatment targets (Powers et al., 2020). Caregivers focus on increasing referral and utilization of the DSMES program. However, there is a lack of improvement in achieving goals despite advanced treatment technologies such as blood glucose level monitors and insulin patch pumps (Powers et al., 2020). In addition, residents in diabetes belts in the United States (non-metropolitan states) have an 11.7% prevalence of diabetes (Rural Health Information Hub., 2021). The rationale is that patients in underserved regions face access and utilization barriers that result in poor patient outcomes.

Public health nurses can advocate for financial incentives to improve the utilization of diabetes prevention and management programs with lifestyle interventions (Desai et al., 2020). Financial incentives promote participation and outcomes in diabetes management. In addition, financial incentives improve the affordability of insurance covers, thus reducing the financial burden of healthcare costs and improving quality of life. Patients can access social education and coaching services to improve adherence to medication, physical activity, healthy diets and lifestyle habits. Desai et al.’s study (2020) in the BMC Public Health journal provides evidence of the efficiency of incentives in improving the utilization of diabetes management services. Therefore, this intervention can eliminate barriers to healthcare utilization and improve patient outcomes.

References

Desai, J. R., Vazquez-Benitez, G., Taylor, G., Johnson, S., Anderson, J., Garrett, J.           E., … & O’Connor, P. J. (2020). The effects of financial incentives on diabetes prevention program attendance and weight loss among low-income patients:  The We Can Prevent Diabetes cluster-randomized controlled trial. BMC            Public Health20(1), 1-11. https://doi.org/10.1186/s12889-020-09683-5

Kumah, E., Otchere, G., Ankomah, S. E., Fusheini, A., Kokuro, C., Aduo-Adjei, K.,        & A. Amankwah, J. (2021). Diabetes self-management education            interventions in the WHO African Region: A scoping review. PloS one16(8),         e0256123. https://doi.org/10.1371/journal.pone.0256123

Powers, M. A., Bardsley, J. K., Cypress, M., Funnell, M. M., Harms, D., Hess-Fischl,       A., … & Uelmen, S. (2020). Diabetes self-management education and support    in adults with type 2 diabetes: a consensus report of the American Diabetes      Association, the Association of Diabetes Care & Education Specialists, the            Academy of Nutrition and Dietetics, the American Academy of Family     Physicians, the American Academy of PAs, the American Association of        Nurse Practitioners, and the American Pharmacists Association. Diabetes Care43(7), 1636-1649.https://doi.org/10.2337/dci20-0023

Rural Health Information Hub. (2021, January 7). Telehealth Use in Rural            Healthcare. https://www.ruralhealthinfo.org/topics/telehealth#:~:text=Teleheal      th%20allows%20small%20rural%20hospitals,distances%20to%20access%20s       pecialty%20care

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A community needs assessment provides community leaders with a snapshot of local policy, systems, and environmental change strategies currently in place and helps to identify areas for improvement. With this data, communities canmap out a course for health improvement by creating strategies to make positive and sustainable changes in their communities (Community Needs Assessment, 2013). A need that has already been addressed by an intervention is maternal and neonatal care. A mother’s health and wellbeing during pregnancy and around the time of delivery, including access to appropriate care, are critical determinants of maternal mortality and neonatal and child health in the early years of life, and possibly for much longer. Preventive interventions before or during pregnancy including family planning, treatment of infections, such as syphilis and malaria, good nutrition, including micronutrients, good antenatal monitoring and care, and access to skilled care at time of delivery and postpartum (Smith, 2015).

The intervention I would implement for this community to enhance outcomes is to ensure constant reminders on prenatal and neonatal care through education. Provide pamphlets in different languages, and that are simple to read and understand, making it interesting for the mothers to read. Educate them on what to expect during and after pregnancy. This to ensure a safe and healthy pregnancy.

References

Community Needs Assessment. (2013). Centers for Disease Control and Prevention. https://www.cdc.gov/globalhealth/healthprotection/fetp/training_modules/15/community-needs_pw_final_9252013.pdf

Smith PG (2015). Field Trials of Health Interventions: A Tool Box. Types of intervention and their development (3rd ed) Oxford (UK).