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Darby Township, PA
The study is devoted to the eastern part of Darby Township, PA; the green circle shows this community, which is not strictly limited by the Township’s borders and includes a certain part of the neighboring Southwest Philadelphia.
Population Group
The 2010 Census data for the community demonstrates that the African-American population of Darby constitutes almost 40% of its total population, and it is the group that is targeted by the current study.
The population has a tendency to be affected by particular health issues, including the susceptibility to heart disease and hypertension (as compared to the White population), which is exhibited by African American population in the U.S. in general (Go et al., 2013). Hypertension, on the other hand, increases the risk of heart diseases, which are very widespread throughout the Delaware County. Moreover, hypertension is one of the major preventable risks of heart diseases (Pennsylvania Department of Health, 2011). Heart disease, on the other hand, is a very difficult condition that disables, kills, and requires major spending. It is apparent, therefore, that the prevention of hypertension is a form of primary preventive measures with respect to heart disease (CDC, 2016).
Community Assessment
Statistics and my personal experience, as well as the interviews with the population and healthcare specialists, indicate that the community can be characterized by a low to medium income, which, according to governmental sources, can amount to $25.000-50.000 (Keefe et al., n.d.). Apart from that, the population shares the common issue of African Americans: it is still less likely to engage in preventive measures and receive healthcare services when compared to the White population. Also, there is a noticeable prevalence of smoking in the population, which is also of importance for heart issues (Go et al., 2013).
From the point of view of positive aspects, there exist several centers that can be used for preventive measures, including religious ones and the Good Neighbor Senior Center, which, however, targets only the senior population. According to the interviews, the selected population is quite religious, though, and using religious authority for health care purposes is a possibility. Also, the community and the population selected maintain high integrity, which opens the opportunity for communication and cooperation.
Primary Prevention and System Level of Care (CDC, 2016; NHLBI, 2011)
We have established that hypertension prevention offers the chance of heart disease prevention, and as a result, we will consider several hypertension prevention strategies in this program. NHLBI (2011) offers multiple strategies of hypertension prevention (while focusing on the primary prevention) and points out that system-level methods include those related to physical activity and diets, which both have proven to work and are evidence-based. Apart from that, CDC (2016) gives similar advice and also focuses on early detection of hypertension, for which the use of medical services is the best strategy.
Primary Prevention and System Level of Care: Application
The guidelines of CDC (2016) and NHLBI (2011) can be applied to Darby’s unique set of resources and needs, the need being the reduction of hypertension and heart disease.
All the sources insist on information spreading, which is typical for nursing interventions and which may be achieved in the community with the help of the mentioned centers and healthcare facilities. The development of a specifically Darby booklet would help; also, the Darby Township website can be used to this end. It is likely to promote the use of healthcare services as well.
The centers can be used for more purpose than one. The First African Baptist Church that is located in Darby Township is perfect for the spread of information and religious authority use, which can help to modify the dietary and other preferences of the targeted population, including the use of healthcare services. In particular, it appears to be an appropriate place for smoking cessation programs.
Finally, with respect to psychical activity, Darby Township is located next to John Heinz National Wildlife Refuge, which offers hiking opportunities. The establishment and promotion of hiking clubs at the centers can help to use this resource for the benefit of the targeted population and for the promotion of a healthy lifestyle, which includes the regular use of healthcare services.
As a result, the presented program addresses hypertension from more aspects than one and provides the means to ensure its early detection.
Evaluating Outcomes
From the point of view of outcome evaluation, multiple measures can be suggested, but for the short-term goal, I suggest a means of evaluating the extensiveness of the program and the effectiveness of resource use. As a result, the short-term goal consists of mobilizing all the resources available within the four months after the beginning of the project.
It is important that Delaware is one of the most heart-disease-prone Counties of Philadelphia with the mortality of 4394 between the year 2006-2008 (Pennsylvania Department of Health, 2011). As a result, I suggest setting the major long-term goal at reducing the heart disease mortality in the selected population by 25% within the following 10-15 years.
Also, other measures should also be developed for the program.
The Role of a Health Care Leader (Stanhope & Lancaster, 2016)
Finally, concerning the role of a healthcare leader, it can be said that it consists in the promotion of health initiative. In particular, a nursing leader contributes to the development and implementation of the program and promotes its use and implementation, implements it in personal practice, promotes related measures, including the use of preventive healthcare services, and generally leads the change, for instance, through personal example.
References
Albert, M., Ayanian, J., Silbaugh, T., Lovett, A., Resnic, F., Jacobs, A., & Normand, S. (2014). Early Results of Massachusetts Healthcare Reform on Racial, Ethnic, and Socioeconomic Disparities in Cardiovascular Care. Circulation, 129(24), 2528-2538. Web.
CDC. (2016). High blood pressure fact sheet. Web.
Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Borden, W. B.,… & Franco, S. (2013). Executive Summary: Heart Disease and Stroke Statistics—2013 Update. Circulation, 127(1), 143-152. Web.
Keefe, J., Ma, L., Amico, C., & Melendez, S. (n.d.). WNYC median income across the US: 2008-2012 American Community Survey 5-Year Estimates from the U.S. Census Bureau. Web.
NHLBI. (2011). Primary prevention of hypertension. Web.
Pennsylvania Department of Health. (2011). Chronic disease in Pennsylvania. Web.
Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in the community (9th ed.). St. Louis, MO: Elsevier.
U.S. Census Bureau. (n.d.). 2010 Census Interactive Map. Web.
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