Health Promotion Problem
Cardiovascular disease (CVD) is an overall term used in the description of a condition that attacks the heart and blood vessel. CVDs happen as a result of either thrombosis or atherosclerosis. There are four primary forms of CVD, namely coronary heart disease, peripheral arterial disease, stroke, and aortic disease. There are numerous risk factors associated with CVD. Some of them include family background, ethnicity, and age. Others include exposure to tobacco and alcohol, hypertension, obesity, diabetes, unhealthy diet, and physical inactivity. Of particular interest in the U.S is that many individuals from low-income neighborhoods grapple with CVD prevalence. Placed into consideration is their nutrition, weight, the amount of alcohol they consume, exercising, and tobacco abuse.
Target Population
In nursing, the term vulnerability represents the vulnerability towards a particular problem for a particular disease. This essay considers African Americans as a vulnerable and target population to CVDs. According to a Statistical Fact Sheet from the American Heart Association (2013), CVD is common in 44.4 percent African-American men and 48.9 percent women over 20 years old. Further data from 2009 suggested that 48,070 black females and 46,334 black males died due to CVD (Heart.org, 2016). Integration of theory of vulnerability in a target population of African Americans will facilitate the understanding of the core reason for their vulnerability to CVD as well as help in identifying their healthcare needs so that enhanced protection can be assured.
One can categorize this vulnerability into three mutually dependent dimensions namely, individual, programmatic and social. Based on Nichiata et al. (2008), individual vulnerability links to the individual preventive measures connected with personal characteristics. These traits include elements such as age, gender, emotional development, sexuality, self-perception and attitudes about the risks, obtained knowledge about the problem, and faith. Programmatic vulnerability will consider the public policies of managing CVDs, the projected goals and measures of preventive programs, and allocation and organization of the resources for anticipation and control. Finally, social vulnerability considers the socio-economic configuration, community policies targeting health and education, cultural values and ideologies that determine the individual and programmatic vulnerabilities (Nichiata et al., 2008).
Applicability of CVD to Student Role
The global personal and societal costs associated with CVD are enormous. Current efforts concentrate on developing new ways that would help implement interventional strategies that are effective yet cost efficient. It is the role of student nurse to help advance this effort for the attainment of the overall national objectives of Healthy People 2020. As a student, I specialize in an area that is part of a larger team of experts comprising of nurses, nutritionists, and behavioral analytics among others. These individuals collaborate for a superior success level in preventive cures, especially among individuals that belong to high-risk and vulnerable populations.
Theoretical Framework
This proposal’s rich theoretical foundation seeks to underpin the community’s approach to CVD prevention. It borrows heavily from Huotari and Hirvonen (2013)’s framework that addresses three public health information practices. These practices include the search, usage, and sharing of information. Huotari and Hirvonen (2013) examine these practices based on the effects of individual and contextual factors on health information seeking behavior. Evidently, people seek information from their perceived environment, including the sources and channels of subscription. Information source horizons describe the sources that individual select as credible enough to make changes. Their seeking practices will include active seeking, active scanning, proxy sourcing, and non-supervised monitoring. Finally, information sharing happens when individuals offer or receive information from others. Thus, these three concepts interact to detail how individuals use information to change their knowledge and behavioral patterns (Huotari & Hirvonen, 2013).
Literature Review on Various Interventions
Lee, et al. (2012) explored the various interventions that remain effective in improving the outcomes for populations at risk for CVD. The study employs a systematic review of articles to help identify an appropriate intervention. The authors find self-directed learning, self-care, information organization, private provider interactions as some of the methods that have proved effective. Further, health practitioners have used plain language and color code emphasis as adequate behavioral change methods. They conclude that these individuals can use customized interventions at the community level to help offer better health care (Lee, Lee, Kim, & Kang, 2012).
Fletcher et al. (2011) conducted a similar study to explore the appropriate method that health practitioners could use to improve the wellbeing as well as prevent cardiovascular incidences among populations. According to these authors, current methods include cardiac rehabilitation, improved quality of life, improved symptom management, hospitalization, and accelerated recovery. However, their results revealed that these intervention strategies would only be helpful and effective if they are accessible to all societal members. They conclude that education as an intervention would offer a unique opportunity for individuals to learn about behavioral modification. Some of the modifications include nutritional therapy, exercising, and stress reduction therapy (Fletcher et al., 2011).
It would also be vital to understand health vulnerability theory through a series of studies. According to Val and Nichiata (2014), vulnerability consists of a group of multiple milieus linked to each other providing higher exposure to the problem with weak protection. In this exploratory study, they investigated the present approach related to its programmatic facet in fighting against HIV infections (Val & Nichiata, 2014).
Mussi et al. (2012) conducted another study to assess the vulnerability of nursing professionals to TB due to patients’ care schedules and transmission risks. It concluded that it would be appropriate for healthcare institutions to pursue preventive strategies and management policies for these vulnerable risks. Moreover, the successful execution of this plan exists through the learning processes and acquiring knowledge by nurses (Mussi et al., 2012).
De Chesnay, (2005) divided vulnerability into two aspects, namely individual focus and aggregate focus or vulnerable populations. In his book, Chesnay discussed other ideas and concept regarding vulnerability. One of the concepts says that access to required resources will help in decreasing the vulnerability that indicates the requirement of proper and rich resources will reduce the risks in vulnerable populations, such as pregnant mothers’ group, mentally-disabled groups, economic weaker sections, minorities, and immigrants or refugees. These people are highly sensitive due to the low programmatic and social support (De Chesnay, 2005).
The need for an appropriate intervention plan must include, a fair and non-biased delivery of care, non-discriminated and universal access to quality care and resources to all and legislative, consistent and concrete policies addressing the vulnerable populations. According to De Chesnay (2005), African Americans are at high risks of developing cardiovascular problems that may be due to multiple factors. Their low socioeconomic status, behavioral problems, living as a minority and low educational backgrounds, all these factors may collectively increase the risks to CVDs in this population. Nowadays, various government and non-government agencies came forward and identified the health care vulnerabilities in this population (De Chesnay, 2005). Finally, Murray (2015) explored the healthcare experiences of African Americans. The author concluded that to address the needs of a population trust is an essential step towards a healthy relationship between professionals and African American patients (Murray, 2015).
Plan
The plan is to find an appropriate intervention to promote the population’s health against CVD. This section sees it best to use community-based facilitators as a way of promoting positive health seeking behavior. These individuals will use education as a tool to train the community on the importance of various health behaviors in tackling the CVD problem. They work as part of a major campaign that promotes instances such as proper dieting, constant physical exercises, and reductions in tobacco and alcohol intake.
This plan comprises of three areas of interest in its description of dieting and exercise. These areas include intensity, frequency and duration. Duration would refer the time facilitators take to train target groups on various tasks and their importance in health promotion. Frequency means the number of times these facilitators make participants perform an activity of interest. Finally, intensity describes the extent to which mediators present an activity as a way of solving CVD as a health promotion problem (Allen, et al., 2011).
Intervention
According to Allen et al. (2011), proper dieting and exercise exist as important parts of everyone’s lifestyle. Nonetheless, it is the level of mental and physical exertion that is different among individuals. For this target population, it would be appropriate to introduce educational plans as the primary intervention in health seeking behavior to reduce chances of CVDs. This program includes sessions that train individuals on the importance of leading healthy lifestyles through exercising and proper dieting.
Numerous studies show that there is a positive correlation between appropriate diet, exercise, and good health. For instance, Allen et al. (2011) show a significant relationship between physical activity and life changing behavior concerning cardiovascular diseases. That is, increased physical activities eliminates the chance of developing CVD and vice versa. Furthermore, decreased cholesterol intake as well constant clinical evaluations show positive results in the campaign to mitigate the risk of CVD among a population (Allen, et al., 2011).
Approaches to Evaluation
The researcher proposes the use of questionnaires and pretest and posttest surveys as ways of measuring the success of the program. As stated above, the program encompasses the use of community-based facilitators to guide the community through various health activities around CVD. Questionnaires as data collection tools are vital in collecting information on the perceptions of individuals in the intervention. The tool will target both members of the community and the health experts. The pre-and post-test sample collection will focus on changes in essential body measurements before and after the intervention. Both tools are useful for tracking changes in behavior before and after intervention (Allen, et al., 2011).
Evaluation Plan
The tools of evaluation include questionnaires and pretest and post-test data. The surveys will be useful in the collection of information from both the community health facilitators and program participants on their pre and post intervention perceptions of healthy living. The researcher hopes that this tool is adequate for tracking changes in behavior along trend. Pre- and posttest data collected would touch on the main body indices such as weight and BP. The facilitator will collect periodic information on such indicators to track their effects on CVD cases (Craig, 2012).
The data analysis segment would require a correlational quantitative measurement to evaluate chances of a significant difference between pre- and post-test results. Data would include collecting BP profiles as well as cases of disease occurrence before and after the intervention. The analysis is vital in providing insight into possible consequences of exercise and proper dieting. The comparison acts an indication of the existence of statistical significance between two data sets (Craig, 2012).
References
Allen, J., Dennison, C., Szanton, S., Bone, L., Hill, M., Levine, D., . . . Anderson, K. (2011). Community Outreach and Cardiovascular Health (COACH) Trial: A Randomized, Controlled Trial of Nurse Practitioner/Community Health Worker Cardiovascular Disease Risk Reduction in Urban Community Health Centers. Circulation: Cardiovascular Quality and Outcomes, 4, 595-602.
Craig, P. (2012). Using natural experiments to evaluate population health interventions: new MRC guidance. Journal of Epidemiology & Community Health, 66 (12), 1182–1186.
De Chesnay, M. (2005). Caring for the vulnerable: Perspectives in nursing theory, practice, and research. Burlington, MA: Jones & Bartlett Learning.
Fletcher, B. (2011). Global Cardiovascular Disease Prevention: A Call to Action for Nursing Community-Based and Public Health Prevention Initiatives. Journal of Cardiovascular Nursing, 26 (45), 35-45.
Heart.ORG. (2016). African Americans and Cardiovascular Diseases. Retrieved from Heart.ORG: https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_319568.pdf
Huotari, N., & Hirvonen, M. (2013). Understanding information practices in an e-health intervention. The case of preventing cardiovascular diseases in northern Finland. International Journal of Health Information Management Research, 1 (1), 15-25.
Lee, T., Lee, S., Kim, H., & Kang, J. (2012). Effective Intervention Strategies to Improve Health Outcomes for Cardiovascular Disease Patients with Low Health Literacy Skills: A Systematic Review. Korean Society of Nursing Science, 6 (4), 128–136.
Murray, T. M. (2015). Trust in African Americans’ Healthcare Experiences. Nursing Forum, 50 (4), 285-292.
Mussi, T. V., Traldi, M. C., & Talarico, J. N. (2012). Knowledge as a factor in vulnerability to tuberculosis among nursing students and professionals. Revista da Escola de Enfermagem da USP, 46(3), 696-703.
Nichiata, L., Bertolozzi, M., Takahashi, R., & Fracolli, L. (2008). The Use of the Vulnerability Concept in the Nursing Area. Revista Latino Americana de Enfermagem, 16 (5), 923-928.
Val, L. F., & Nichiata, L. Y. (2014). Comprehensiveness and programmatic vulnerability to STDs/HIV/AIDS in primary care. Revista da Escola de Enfermagem da USP, 48(SPE), , 145-151.
