Category: Population

Introduction

South Africa is one of the strongest and fastest developing countries in Africa. A country that was heavily affected by racial segregation during the apartheid rule that ended in 1994, South Africa has experienced massive growth in its economy over the past two decades. This may be attributed to its rich mineral reserves, especially gold. It has the strongest economy in Africa.

Analysis of the Country

Historical Issues

South Africa is one of the countries that gained independence several years after other African states, and other states around the world had gained independence. The country was ruled by the Boers after the departure of British colonizers in 1910. Nelson Mandela, Walter Susuli among other leaders is lauded to have fought for the independence of this country. It is one of the African states with the best government structures.

Economic Issues

The economy of South Africa is one of the fastest developing economies in the world. This is due to good governance and rich oil reserves. The country has the best infrastructure in Africa, especially after hosting the 2010 FIFA World Cup. However, most of the South Africans, especially those living in the rural set-ups and in slums, live in object poverty.

Social Issues

For a long time, South Africa had experienced racial segregation where the whites and blacks had different status in the country. The blacks were considered subordinate to the whites. This came to an end when Mandela finally came to power. Other than the xenophobic movement that was slightly experienced in 2009, South Africans have come to appreciate cultural diversity.

Technological Issues

South Africa is not one of the giants in the field of technology. However, this country has come to embrace the importance of technology in running various sectors. The government has supported various initiatives meant to enhance technological developments. Institutions such as schools, hospitals, and business units among others have embraced the emerging technology.

Geographical and Climate Issues of South Africa

This African country generally has two seasons in a year. The country has winter and summer. During summer, the country experiences hot and wet climate, while in winter, the temperatures are rather cold. The country borders the Indian Ocean, making its beaches one of the most attractive beaches in the world.

Health Status and Healthcare System in South Africa

South African government has made concerted effort to ensure that its healthcare system reflects the needs of its populace. The population of South Africans has been on the rise over the past one decade, but the government has not been in a position to upgrade its health system to reflect this. According to Padayachee (118), although the government has made an effort to improve health facilities in major cities, people living in rural set-ups and slums lack proper medical facilities.

Relationship between South Africa and the World

Abstract

South Africa has had a very cordial relationship with its neighbors and the world. Following the end of apartheid rule in 1994, this country has been able to develop a cordial relationship with other states in Africa and the world at large.

South Africa and its Neighbors

South Africa has been a friendly nation to its neighbors. It has been a very resourceful neighbor to Swaziland and Lesotho which are landlocked countries within its borders. Its neighboring countries such as Namibia, Lesotho, Swaziland, Botswana, Zimbabwe, and Mozambique have registered satisfaction with the relationship they have had with this country.

South Africa and the World

South Africa has also had a positive relationship with other African states and the world in general. Being the only African country which is a member of the G-20, this country has been seen to champion the interests of African nations in the world forum. Its first president, Nelson Mandela, is known to have been a champion of peace around the world.

Demographic Data

Ethnic Composition

About 92 percent of those who live in South Africa are the black Africans who are the natives. The highest percentage out of this population lives in object poverty. About 2 percent of this population is the Dutch who never left the country after the curtain fell on their leadership. There are other ethnic groups like the Arabs, Chinese, and other ethnic groups from all over the world.

Religious Groupings

The main religion in South Africa is Christianity. This religion was spread during the colonization of this country. However, there are various other religions in this country. After Christianity, African religious groups are dominant, especially in the interiors of the country. Islam, Hinduism, and Buddhism are also practiced, especially among the non-natives.

Cultural Characteristics

South Africa is one of the countries with rich cultural heritage. Most of the native Africans have maintained their cultural practiced such as male circumcision. The culture that allows men to marry more than one wife is also cherished in various societies. In various national ceremonies, traditional dancers and artists would be called upon to perform before dignitaries.

Education Levels

Most of the young South Africans, especially those who were born after independence, have had the opportunity to go to school. However, a good number of the middle aged and the aging population also have basic education. This is because they were either too busy fighting for the liberation of this country from the Boers, or they could not withstand racial segregation witnessed in schools during their era.

Health Statistics

Health statistics of this country shows that South Africa is one of the countries at risk of experiencing massive health problem. According to Padayachee (56), South Africa is one of the countries with the highest percentage of its population living with HIV/AIDs in the world. A number of South Africans have also perished from cardiovascular diseases. The table below shows the percentage of those suffering from cardiovascular disease over the last three years.

Source: (Rao 78)

Population Affected

Majority of those affected with cardiovascular disease in this country are the middle class who have put their focus on gaining financial security. This category of people does less strenuous work because they work in large offices in major cities in this country. They have limited time to spare for physical activities hence putting them at risk.

Problem Identification

Major Health Concern

As stated above, cardiovascular disease is a major killer disease in this country. Many South Africans have died due to this health complication. The main reason why these people perish is because of lack of proper healthcare facilities in the country to deal with this complication.

Economic and Social Impact of Cardiovascular Disease

Cardiovascular disease has had serious impact on the economic and social status of those affected. Most of those who suffer from this disease are the middle class trying to find financial security. Once affected by this disease, they would spend most of their savings, and would at times run into debts trying to meet the costs of treating the disease. This affects their social standings a great deal as they find themselves in lower social class that they thought they had passed.

Scope of the Problem

According to Jamison (92), although the problem has not reached an alarming level, the rate at which individuals are being diagnosed with this problem is alarming. The problem, once thought to be a preserve for the rich, is now affecting the middle class which is actually the driving force of this country. Although the government has tried to deal with it, it still remains a big issue in the society.

Historical Development of Cardiovascular Disease

Historical development of cardiovascular disease can be analyzed on an individual level basis. History of this disease on one patient may not be the same as that of another patient. According to Rao (67), this health issue is associated with lack of proper physical exercise and intake of a lot of calories. When the body fails to burn these calories, their accumulation may lead to this health concern.

World Wide Disparity of the Problem

Cardiovascular disease was previously considered a disease of the west. This was so because of the technological advancements in the west that meant that people would only perform light tasks that does not need heavy physical activity. However, as this technology spread, the disease became common even among Africans. Currently, cardiovascular disease is considered as a major global issue in the society.

Effects of Globalization and Technology on Cardiovascular Disease

Globalization and technology has had positive effect on the efforts to counter this disease. Given the fact that this is not a communicable disease that can be spread by being in contact with a victim, the ability to move enhances the possibility of finding its solution. A patient from South Africa can be flown to the United States where there are adequate medical facilities to deal with the problem. Advancements in technology has helped in coming up with sophisticated machines that help in detection and treatment of this complication.

Effects of Cardiovascular Disease if Left Unchecked

If left unchecked, cardiovascular disease can have serious negative impact in the society. The government needs to equip public hospitals with the machines that can help deal with the problem. If this is not done, the country will continue losing its citizens, and this would lead to decreased labor force in the economy. Children will be left orphaned, and this will increase the levels of poverty in this country.

International Healthcare Organization Involved in the Delivery of Healthcare in South Africa

The main international healthcare organization that has come out to help country this problem in the country is World Health Organization. Working with the local hospitals and community health workers, W.H.O. has made an effort to increase awareness of this disease. It has been working closely with donors and government to find permanent solution.

Summary and Conclusion

Cardiovascular disease is a health concern that has been on the rise in this country. The government of South Africa has not been able to come up with a lasting solution for this problem because of the costs associated with its treatment. However, partnering with international agencies such as W.H.O., the government has increased its effort in managing this disease.

Works Cited

Jamison, Dean. Disease and Mortality in Sub-Saharan Africa. Washington: World bank, 2006. Print.

Padayachee, Vishnu. The Development Decade? Economic and Social Change in South Africa, 1994  2004. Cape Town: HSRC Press, 2006. Print.

Rao, Gudu. Coronary Artery Disease: Risk Promoters, Pathophysiology, and Prevention. New Delhi: Jaypee Brothers Medical Publishers, 2012. Print.

Introduction

The population of aging Americans has been on the rise consistently over the past several decades. Improved healthcare, increasing levels of income, and other human development index (HDI) factors have improved life expectancy in most developed economies such as the United States. In a study by Poo (2015), the increasing population of elderly people in the United States is an indication that more focus needs to be placed on their wellness. Seniors, especially those who are over 75 years of age, need close attention from family members and medical practitioners. Physical therapy assistants (PTAs) are critical in the care of these individuals, especially those who are already in homes for the elderly. Rubin (2015) argues that the best way to improve the health of the elderly is to ensure that they remain physically active. In this study, the researcher will use quantitative research methods to analyze population trends in the United States and the impact of an aging population on American society.

Discussion

The United States of America has one of the highest life expectancies in the world for both men and women. The improved healthcare sector and the high living standards are some of the factors that have led to an improved life expectancy in the country. Emerging technologies in the field of medicine have also helped with eradicating or managing some of the dangerous diseases that claimed many lives in the past. It is important to look at American population trends and the principal consequences they have on society, especially in the health sector.

Rate of Increase of the Elderly Population in America

According to a report by Samuel (2017), the number of the elderly in the United States has been on the rise since the country gained independence. There was a sharp increase in the countrys general population after the Second World War. Although the country participated in the war and emerged as one of the two world superpowers, the battlefields were in Europe. This means that the economy of the country was not adversely affected by the war. The economic boom after the war made the United States the most highly desired destination for economic immigrants from Europe, the Asia-Pacific region, and Africa. Soon after the war, many people immigrated to the United States because of socio-political reasons. The country is still the most sought-after destination for migrants from all over the world. According to Moody and Sasser (2015), most of those who move to the United States, especially from developing countries, rarely go back to their country of birth. This means that they end up aging in the United States. Figure 1 below shows the changing population of the elderly from 1900 to 2018. It also shows a projected trend that will be witnessed from 2019 to 2060.

As shown in the figure above, the population of the elderly in the United States almost tripled (from 3.1 million to 9 million) between 1900 and 1940. From 1940 to the year 2000, it rose from 9 million to 35 million, which is almost a 300% increase. The statistics show that the population of the elderly will be about twice its current number. It is important to analyze the demographic factors of the elderly population in the country. Figure 2 below shows the population of elderly people based on their marital status.

The statistics above show that married couples are the majority among the elderly population. 70% of women who are over 65 years are in a marriage, and so are 45% of men in that age bracket. The widowed form another significant population, followed by the divorced, the separated, or those with absent spouses. Those who have never been married form the smallest fraction of seniors above 65 years in age. According to Wong (2014), the earnings of a family also determine peoples longevity. Members of well off families are likely to have longer lives than those from impoverished families. Figure 3 below shows the classification based on family income.

The statistics in the figure above show that poverty is inversely proportional to life span. The rich in American society tend to live longer than the poor. The cost of healthcare services remains high despite the effort put in place by the current and previous administrations to make them more affordable. The rich can afford expensive heath insurance coverage that enables them to visit hospitals regularly for check-ups. It makes it easy to detect diseases early enough so that they can be managed in the countrys top hospitals. On the other hand, the poor lack the privilege of receiving the best healthcare services the country has to offer. Their limited financial capacity forces them to visit hospitals only when it is necessary. This means that in most of the cases, the diseases that affect them are diagnosed at very late stages, making the treatment process complex and costly. A significant number of them do not survive after such late diagnosis. That is why they form the smallest percentage of the elderly.

Impact of the Aging Population

The increasing population of aging citizens has had a significant impact on the socio-economic environment in the United States. According to Wong (2014), not all of the aging people in the country have families who can support them during the late stages of their lives. As such, some of them are forced to go to homes for the elderly where they can get the support they need. Others opt to look for gainful employment as a way of remaining physically active and meeting their socio-economic needs. The figure below shows a declining rate of unemployment among adults aged over 65 years.

It is clear from the above statistics that more senior Americans are considering formal employment as an option even after they retire. There was a sharp decrease in the rate of unemployment among Americans aged over 65 years. Although some of these adults cite the need to remain physically active as one of the reasons why they prefer working even after their formal retirement, Rubin (2015) observes that many do so as a way of gaining economic freedom. Improved medical services allow them to be physically active and as such, they prefer continuing to work to meet their basic expenses. The social benefit of remaining at work is another major determinant of why these seniors prefer regular employment. Unlike staying at home, where they are left in solitude when their children are at work, going to work allows them to interact with other people. They end up remaining physically and mentally strong.

How to Manage the Changes

It is evident that that the number of aging Americans is increasing consistently because of various socio-economic and technological factors. Other than the socio-economic factors discussed above, the increasing elderly population will have significant implications for the healthcare sector. These individuals are more likely to fall sick that younger people. According to Wong (2014), it is important to find a way of managing the change in a way that will be beneficial to the elderly. The following are some of the factors that should be considered:

Promote physical exercise among the elderly

According to Moody and Sasser (2015), one of the main issues that often lead to poor health among the elderly is limited physical exercise. Most of the elderly spend most of their time indoors watching television or reading newspapers if they do not have gainful employment. Many do not travel a lot (Poo, 2015). Reduced physical activity speeds up the aging process. It makes them prone to numerous opportunistic diseases. Those who are obese may face more serious challenges if they remain inactive. Samuel (2017) advises that they should always find ways of remaining active. Having a regular walk and visiting the gym are some of the best options for staying physically fit. One hour at the gym three or four times a week and a daily stroll, either in the morning or evening, have numerous health benefits. These senior citizens will remain healthy and the need to provide them with constant medical services will be reduced. This strategy helps in reducing the demand for healthcare services in the country. Doctors, nurses, and clinicians will have more time to attend to other urgent needs within their workplaces.

Improve facilities in the nursing homes

Some of the senior citizens who are over 80 years old may not find it possible to continue going to work. Some of them may have physical complications that limit their ability to engage in physical exercise regularly or vigorously. In such cases, they may need the close attention of nurses to help in improving their wellness at this delicate stage of life. It may be necessary to equip nursing homes with state-of-the-art facilities that will improve their experience while in the hospital. The facilities should help in early detection and management of health problems that these clients may have. The facilities should also help them maintain some form of physical activity even when they feel weak. It is also important to protect them from injuries that may be caused by a fall or dangerous objects within the facility. Whenever necessary, these individuals should be enabled to communicate easily with nurses and other stakeholders as a way of improving their experience.

Increase the number of PTAs in nursing homes

Physical therapy assistants play a critical role in nursing homes and in other areas where they have to care for the elderly. Rubin (2015) laments that some Americans abandond their aging parents in nursing homes and do not bother to visit them regularly to ensure that they remain comfortable. The role of caring for them falls on the shoulders of the nurses. They have to ensure that the attention that they give to these patients is as personal as possible. Samuel (2017) states that nurses should strive to create a personal relationship with their clients. Their unique needs, likes and dislikes, and any other relevant issue that may improve their experience when they are in the nursing home should be understood.

Some of them may be terminally ill and need constant assistance with almost everything. The demand for the attention of the nurses can become even greater when handling patients who have been abandoned or those who do not have family members who visit them regularly. It is sometimes necessary to increase the number of PTAs in the nursing home to ensure that they can give personalized quality care to the patients. According to Poo (2015), a nurse to patient ratio of 1:5 is recommended. A nurse who handles more than 5 patients in a day may not deliver quality care. Nursing homes should be adequately staffed to ensure that these individuals are offered the best services available. With the right facilities and adequate staff, the senior citizens in nursing home will feel comfortable away from their homes.

Conclusion

The population of elderly citizens is consistently rising in the United States. Factors such as improved healthcare services, improved standards of living, awareness about avoidance or management of major diseases, and advanced technologies have contributed to a life expectancy that is longer than it was in the past. The study shows that the growing number of senior citizens may exert pressure on healthcare facilities. Promoting healthy lifestyles such as regular exercise and good diet may reduce the need for them to visit hospitals regularly. The study also suggests that nursing homes for the elderly should be properly equipped and staffed to meet the demand.

References

Department of Health & Human Services. (2016). A profile of older Americans: 2016. Web.

Moody, H., & Sasser, J. (2015). Aging: Concepts and controversies. New York, NY: Sage Publications.

Poo, A. (2015). The age of dignity: Preparing for the elder boom in a changing America. New York, NY: The New Press.

Rubin, L. (2015). 60 on up: The truth about aging in America. New York, NY: Beacon Press.

Samuel, R. (2017). Aging in America: A cultural history. Philadelphia, PA: Philadelphia University of Pennsylvania Press.

Wong, D. (2014). Counseling individuals through the lifespan. Thousand Oaks, CA: SAGE Publications.

Introduction

This paper focuses on health status identification and health promotion in Spartanburg, SC. Taking into account that nurses play an integral part in improving the health status of the community, it is essential to explore the mentioned topic in detail.

Community Evaluation

The status of the public health of Spartanburg County is determined by a range of factors. According to Spartanburg (SP) Health Rankings (2016), the key health factors include obesity, smoking, physical inactivity, sexually-transmitted diseases, food environment index, and alcohol abuse  all these factors are behavioral. In turn, environmental ones involve air pollution, housing issues, and drinking water quality. Also, among social and economic factors, one might note unemployment, low income, and crime.

At that, considerable efforts to address the mentioned issues are conducted by Partners for Active Living (PAL), the Childhood Obesity Task Force (COTF), and the Mary Black Foundation. The City of Spartanburg has an elaborate network of public, private, and non-profit organizations that are open to communicating with each other and the public. In particular, the Road to Better Health (RTBH) coalition is one of the most prominent of them.

Specific Ways to Improve the Health Status of the Community

In this regard, it is essential to suggest appropriate preventive measures to improve health outcomes in Spartanburg County. According to Five Public Health Priority Areas & Goals for 2018 identified by RTBH, the community is in need to enhance access to care. Namely, it is expected to achieve a 30% reduction in the number of emergency room discharges for ambulatory care sensitive conditions and 30% reduction in the number of hospital readmissions within 30 days (Public Health, 2016, para. 2).

Another specific way to improve the current health status is to reduce tobacco use among the population that can be reached by the facilitation of at least 150 SC Tobacco Quitline fax referrals from Access Health Spartanburg and changes through one new smoke-free ordinance (Public Health, 2016, para. 2). It is also crucial to point out that other initiatives might be considered as well. For example, the reduction of childhood obesity, the improvement of birth outcomes, and the increase in health behaviors should be taken into account within the framework of a comprehensive approach.

Patients with Congestive Heart Failure

SC Office of Research and Statistics reports that Spartanburg County residents were registered as 129 patients and 219 visitors with congestive heart failure at South Carolina Emergency Departments in 2012 (Public Health, 2016). The data provided shows the necessity to improve this area.

Considering that congestive heart failure is sometimes a result of the obesity factor that was identified above, Harkness and DeMarco (2012) offer to implement the Weight Watchers program. Based on encouragement, the program also requires the active involvement of nurses in teaching and continuous surveillance of patient care. However, it is significant to provide primary (aimed at preventive measures before the disease appearance), secondary (used to reduce the impact of the existing disease), and tertiary prevention (used to soften the influence of the congestive heart failure).

Spartanburg Regional Healthcare agency provides education and special medical attention to patients with chronic heart failure. Striving to meet the expectations of every client, nurse practitioners can also assist with emergency visits and medical goals along with care plans as well as offer various medication assistance programs (Heart Failure Center: Helping You Take Control, 2016).

Spartanburg Regional Heart Center is another agency that is a hospital specializing in training, treatment, and rehabilitation of patients with congestive heart failure. The cost of the services at both health agencies is affordable and supplemented by discounts, cheer cards, and other bonuses. Medicaid services allow residents of South Carolina who are suffering from heart problems to receive services at both centers.

References

Harkness, G. A., & DeMarco, R. (2012). Community and public health nursing: Evidence for practice. Philadelphia, PA: Lippincott Williams & Wilkins.

Heart Failure Center: Helping You Take Control. (2016). Web.

Public Health. (2016). Web.

Spartanburg (SP) Health Rankings. (2016). Web.

Introduction

Due to the divergences between various ethnic groups, some groups of people tend to be more exposed to some diseases than others. One of the most vulnerable populations out of those living in the US is the Afro-American group. These people have a higher risk of acquiring asthma, heart failure, kidney disease, lung cancer, diabetes, stroke, or unintentional injuries (Johnson, 2015). Not only do these people have worse access to health care but they also frequently are unaware of the dangers that their health conditions may cause. To improve the state of health among African Americans, it is necessary to develop education plans that will include all the necessary information to enhance the at-risk populations chances of maintaining their health at a high level.

Identifying the Specific At-Risk Population

Afro-Americans have a much higher disposition towards developing diabetes than White Americans due to several reasons. First of all, the representatives of this population group are more prone to obesity which is one of the major causes of diabetes. Secondly, African Americans usually have high blood pressure which is another common cause of diabetes. Thirdly, these peoples level of education and life prevents them from finding out the information about early symptoms of diabetes, as well as its dangers. Thus, this population group faces a 77% higher danger of the disease in comparison with White Americans (Chow, Foster, Gonzalez, & McIver, 2012). Such a combination of social and environmental factors puts African American population at high risk of diabetes.

Evidence-Based Strategies to Improve Health Outcomes for the At-Risk Population Group

Many efforts have been and still are dedicated to the elimination of negative diabetes outcomes for African American population. Several evidence-based strategies have been suggested by the specialists with the aim of increasing the quality of health outcomes for the identified at-risk group.

The first strategy is arranging a patient-centered approach (American Diabetes Association, 2016). Evidence-based practice recommendations are aimed at instructing a general approach to care for diabetes patients. Healthcare workers have to combine their medical experience and science when giving recommendations to patients belonging to a risk group. Not only is the disease itself dangerous but its probable complications bring challenges as well. Thus, patient-centeredness allows clinicians to come up with individual plans of eliminating the risks for each patient.

The second evidence-based strategy in diabetes across the life span (American Diabetes Association, 2016). This approach is concerned with the fact that diabetes is a disease that develops into old age, which means that patients conditions should be analyzed at different life periods to obtain the best health outcomes and ways of managing the disease. Due to demographic-associated issues, there is a need to enhance the regulation between clinical approaches while patients move through the phases of their life span.

The third suggested strategy is arranging advocacy campaigns for diabetes patients. People with high risk for disease, such as African Americans, require additional assistance and participation in advocacy projects that are developed to enhance their chances to cope with diabetes (American Diabetes Association, 2016). Such social factors as low physical activity, smoking, and exposure to obesity should be addressed to make the representatives of the at-risk group less likely to meet the most severe challenges of diabetes.

Healthcare Resources that Serve the Vulnerable Population

One of the most effective ways of helping the vulnerable population group is organizing programs for easier access to healthcare services. Such resources may involve state and local financial support for underserved populations. With the help of such measures, the at-risk population group will acquire better access to health care, which will help eliminate the development of diabetes and its negative side effects.

Nursing Interventions that Will Provide Quality Care for At-Risk Population

Taking into consideration the demographic and social characteristics of the vulnerable population, the interventions should be simple and accessible. The easiest to implement is the one that presupposes the use of mobile phone applications (Nundy, Dick, Solomon, & Peek, 2013). One of the most accessible interventions is with the help of text messaging (Nundy et al., 2013). Research has shown that patients who receive text messages helping to monitor diabetes are better at managing their health condition than the ones who do not receive such messages. Another helpful feature is using smartphone applications. Since one of the most frequent causes of diabetes is obesity, an application Fooducate Weight Loss Coach is aimed at relieving this symptom and thus eliminating the possibility of the development of diabetes (Fooducate weight loss coach, 2017). With the help of this application, patients can develop healthy eating habits and decrease the risk of obesity. Fooducate Weight Loss Coach suggests information about the nutritional value of food and drink products. Also, with the help of the app, users can analyze the list of ingredients and evaluate the usefulness of the food they consume.

Another kind of interventions is based on the risk groups religious beliefs. Williams et al. (2013) suggest a faith-based adaptation campaign Fit Body and Soul. The major goal of the program is eliminating obesity. Secondary objectives incorporate leveling blood pressure and raising the quality of life (Williams et al., 2013). The asset of this program is that it presupposes the cooperation of health professionals and church activists, which increases the opportunity of enrolling many representatives of the risk population group.

The third type of interventions addressing the problem of diabetes in African Americans is represented by culturally competent programs (Zeh, Sandhu, Cannaby, & Sturt 2012). Scholars suggest that such interventions are cost-effective and enable a high-quality assessment.

Strategies to Support Plan Implementation

To organize a better implementation of the suggested interventions, the following strategies may be employed:

1. evaluating the education plan: this measure will help to check whether all elements of interventions are possible to be met;
2. creating a vision for carrying out the plan: thinking of the steps that will lead to achieving the objectives of the intervention;
3. arranging a team of specialists that will be responsible for the implementation of the plan;
4. scheduling meetings at which the plans success will be discussed.

Conclusion

African American population is vulnerable due to various social and demographic reasons. Due to its vulnerability, this population group has a high disposition towards some dangerous diseases, one of which is diabetes. African Americans have worse access to health care, and they do not have enough knowledge of the diseases side effects. In order to decrease the negative impact of diabetes of this at-risk population group, several types of interventions are suggested. These programs, if successfully implemented, will eliminate the risks faced by the vulnerable population group and will enable African Americans to lead a normal lifestyle.

References

American Diabetes Association. (2016). Strategies for improving care. Diabetes Care, 39(Suppl. 1), S6-S12.

Chow, E. A., Foster, H., Gonzalez, V., & McIver, L. (2012). The disparate impact of diabetes on racial/ethnic minority populations. Clinical Diabetes, 30(3), 130-133.

Fooducate weight loss coach. (2017). Web.

Johnson, K. (2015). Health is wealth: Five deadly health issues for African Americans.Black Enterprise. Web.

Nundy, S., Dick, J. J., Solomon, M. C., & Peek, M. E. (2013). Developing a behavioral model for mobile phone-based diabetes intervention. Patient Education and Counseling, 90(1), 125-132.

Williams, L. B., Sattin, R. W., Dias, J., Garvin, J. T., Marion, L., Joshua, T., & Narayan, K. M. V. (2013). Design of a cluster-randomized controlled trial of a diabetes prevention program within African-American churches: The fit body and soul study. Contemporary Clinical Trials, 34(2), 336-347.

Zeh, P., Sandhu, H. K., Cannaby, A. M., & Sturt, J. A. (2012). The impact of culturally competent diabetes-related outcomes in ethnic minority groups: A systematic review. Diabetic Medicine, 29(10), 1237-1252.

Assessment data was gathered by interviewing a nurse practitioner working at Hope House. The data already gathered is enough to support our work throughout the semester, though it may be important to analyze documented data from the local and state health departments to develop an adequate understanding of the health issues affecting vulnerable populations such as the homeless and women who live in shelters.

Findings from our population-focused assessment indicated that residents of the shelter home suffer from several health issues such as smoking, wounds, COPD, Hepatitis C, diabetes, STDs, HIV/AIDs, and eye problems. Mental health problems and substance abuse were also cited as major health concerns for the residents, who totaled 90 in number (45 men and 45 women with children). Other health issues that arose from the assessment include lack of health insurance, low health literacy levels due to lack of health resources, lack of primary care providers, and lack of nutritional food. Furthermore, the assessment revealed that around 70% of women in the shelter do not know much about the health of their children and lack adequate parenting skills. Yeast and skin infections, toy safety, lack of baby diapers, and lack of a balanced diet formed major health concerns for the children in the shelter. Lastly, several needs of the population residing in the shelter (e.g., toiletries, clothes, backpacks and school supplies) were not being adequately met.

Population-Focused Nursing Diagnosis

The priority nursing diagnoses developed from the assessment findings include (1) knowledge deficit related to little access to women and infant health information and (2) inadequate parenting skills noted in most of the mothers residing in Hope House.

Planning and Evaluating a Population-Focused Intervention

Intervention Plan

• Community Focus Area: Maternal and child health literacy for women residing in the shelter
• Collaborating Organization(s) Group(s): Local health centers, local NGOs, church, public health department, schools, Hope House, child health experts, and nutrition officials

Overall Objective

Increasing the knowledge on maternal and child health in the shelter with the view to assisting women to make superior health choices and take better care of their children

Action Steps

Evaluation of Action Plan

Design a plan for how the intervention/project would be evaluated

Infertility is one of the most common problems these days, and it means that a person does not have a chance to get pregnant for several health issues. Many couples in the United States may face this problem, and the causes can vary from congenital diseases to acquired physical or psychological trauma. This body condition does not always affect only females but also males can suffer from this issue. Genetics has a strong influence on infertility, and it may be connected to people of all ages and nationalities. Around 18% of women in the United States between the age of 21 and 52 stated that they had faced infertility in their lives (Mancuso et al., 2020). I believe that environment plays a significant role in this issue. People should be more cautious about their health to predict health problems that may cause the inability to become pregnant or impregnate a partner.

The causes of infertility are diverse and might not be seen by non-professionals. For instance, age plays a significant role as the older males and females are, the more chances of receiving infertility. Moreover, hormones play an important role in pregnancy, and when any type of disbalance appears in the human body, problems with pregnancy might arise. Obesity or anorexia can also indicate infertility as the human body spends crucial resources on other areas to support life without giving a chance for women to become pregnant. Some physiological problems like anomalies of the uterus or ovaries may also become the main cause of the issue.

The percentage of male infertility is not high compared to the opposite gender. Nevertheless, 7% of men suffer from this problem, and the causes of these cases are different (Krausz et al., 2022). Around 20% of those males who cannot impregnate their couples are suffering from genetic factors that were transferred throughout generations. When males check their health conditions and diagnose infertility at early stages, they have a chance to overcome this problem and protect the ability to procreate. Low sperm production may also happen due to psychological factors like depression or any type of disorder.

The percentage of females suffering from infertility is higher, and it is usually related to diseases that cannot be treated. When women become diagnosed with several health issues which do not allow them from becoming pregnant, doctors rarely have a chance to restore the ability to procreate (Barbieri, 2019). Nevertheless, a females mentality is under a lot of pressure due to sentimentality, which is specific to this gender, and this factor may cause psychological problems which cause infertility. Abortion might also become the reason for the inability to become pregnant. While the procedure is at the late stages of pregnancy, doctors might not restore the functions that allow women to become pregnant again.

Infertility remains the main problem that is not under full control. In some cases, it may become impossible to give a person a chance to continue becoming pregnant or impregnate their partner. However, sometimes it is possible to solve the problem by using medicines, surgical procedures, and In vitro fertilization (Repping, 2019). Moreover, a psychotherapist can help deal with psychological problems that are barriers to conceiving a child. Every case is unique, and only doctors can decide if any treatment would be useful or not.

References

Barbieri, R. L. (2019). Female infertility. Physiology, Pathophysiology, and Clinical Management, 556-581. Web.

Krausz, C., Rosta, V., and Swerdloff, R. S. (2022). Genetics of male infertility. Perinatal and Reproductive Genetics, 121-147. Web.

Mancuso, A. C., Summers, K. M., and Mengeling, M. A. (2020). Infertility and health-related quality of life in United States women veterans. Journal of Womens Health, 29(3). Web.

Repping, S. (2019). Evidence-based medicine and infertility treatment. The Lancet, 393(10170), 380-283. Web.

Problem Statement

Individuals at risk of poor health and healthcare disparities are normally regarded as being vulnerable. For homeless persons and other socially marginalized populations, an effective healthcare system is always not within their reach. Moreover, other social determinants of health, such as income, housing, and social support are often not present. No clear approach to healthcare delivery for homeless persons and other vulnerable people has been defined. Vulnerability, which is likelihood to harm, emanates from an interaction among various factors, including an individual, society, and prevailing life challenges encountered.

Notably, vulnerable people experience extremely high rates of acute and chronic behavioral health disorders and physical conditions and injuries than the general population. Usually, these conditions remain unmet medical needs. Further, competing interests, such as housing and food, implies that vulnerable people may not always prioritize health needs. Most of them are uninsured and often seek care in emergency departments (EDs) when unmanaged symptoms lead to hospitalization.

Project Description and Overall Goal(s)

The practicum, Improving the Overall Health of Hope House Residents in Middletown, Ohio, seeks to improve health of homeless individuals. The program will target 40 homeless residents aged between 18 and 75. The overall objective of the project will be to ensure that those who reside in the shelter are encouraged to take care of their own health through access to the necessary knowledge.

This project will be implemented in Hope House Mission, a faith-based shelter for the homeless. Its mission is to provide a wide of range of programs and services designed to achieve long-term, sustainable life transformation for homeless children, men, and women. Homeless persons usually have perceived unmet health needs, and they use high-levels of healthcare, usually in costly emergency departments or acute care settings (OToole, Johnson, Aiello, Kane, & Pape, 2016). Thus, the practicum, which is a holistic in approach to public health, will ensure that Hope House Mission and homeless persons have enhanced capacity to address healthcare needs they experience.

Rationale

The practicum is expected to run for about 24 weeks (six months), and will be performed via PowerPoint presentation and following with discussion. Since the facility lacks the equipment to accommodate for the laptops or projectors, I plan on giving each individual a print out of the desired topic being addressed. Having identified the health needs that continue to affect the residents of Hope House, the project leader developed several topics that will be used to improve the overall health of people at the facility.

These topics will aim not only to empower the residents with the knowledge on how to deal with common health issues, but also to underscore the importance of self-worth and self-esteem in managing challenging conditions. Some of the topics that will be addressed in this project are medication management, diabetes and hepatitis C management, self-neglect, oral health management, and vision management. Classes and group discussions will be held on a weekly basis with the residents of the Hope House, who will be encouraged to attend to ensure they gain useful knowledge on how they can deal with common health issues.

Objectives

The objectives of this practicum address multiple areas of public health improvement among homeless persons in Hope House. The objectives include:

1. Increase awareness in homeless people about the significance of overall health and well-being
2. Increase acceptance and usability of effective preventive interventions and treatments in homeless persons at Hope House
3. Promote educational interventions to lessen healthcare problems in homeless shelters
4. Enhance the capacity of homeless shelter programs to offer preventive health services to homeless persons at homeless shelters

These objectives are designed in line with the overall goal of the practicum. Thus, at the end of the practicum, noticeable changes in knowledge, awareness, and practices would be expected in homeless persons at Hope House.

Review

Homeless persons are considered vulnerable, and vulnerability, as previously noted, emanates from multiple sources (Grabovschi, Loignon, & Fortin, 2013; Culo, 2011). For homeless persons, the rate of healthcare challenges are higher compared to the general population (Lin, Bharel, Zhang, OConnell, & Clark, 2015). For medication management, it is shown that vulnerable people are at greater risks because of limited abilities to manage a complicated medication regimen based on multiple conditions they may experience. Non-adherence to medication, therefore, is a primary contributing factor for poor healthcare outcomes in vulnerable people. As such, interventions, such as education, that help such individuals to manage their medication could assist in avoiding needless, costly emergency department visits, admission, and hospitalization, as well as help in improving quality of life (Knowlton, Nguyen, Robinson, Harrell, & Mitchell, 2015).

Diabetes and hepatitis C virus are two health problems considered as chronic. Studies have demonstrated a significant relationship between diabetes and hepatitis C virus (Ba-Essa, Mobarak, & Al-Daghri, 2016). Notably, patients who share personal items, occupational exposure to blood or its related products, tattooing items, increased transaminases and risk practices were most likely to have both conditions leading to frequencies of hospital admission (Ba-Essa et al., 2016). These results underscore the need for educational intervention for vulnerable persons.

From a broader perspective, self-neglect is a growing condition that is poorly understood social and medical challenge. Self-neglect is a multifactorial behavioral issue that accounts for an individuals inability or a rejection to attend to own health, personal hygiene, and personal and environmental needs (Culo, 2011).

Self-neglect is the chief reason for referral to adult protection services (Culo, 2011, p. 421). In this case, unsafe behaviors expose individuals to self-endangerment, which is an isolated risk factor for death and institutionalization. Vulnerable persons, especially older adults, who demonstrate self-neglect tendencies, usually live in situations of greater isolation, squalor, and foulness. Such individuals may refuse any help because they do not see anything amiss in their conditions.

However, they present safety hazard and health risks to self and others. It is imperative to understand that such cases are controversial and, thus, care providers often argue whether the condition is social or medical, especially when mental conditions are absent (Culo, 2011). In the end, the issue of self-neglect comes to semantics. Nevertheless, individuals who neglect themselves are incapable and sick, and care providers should not ignore them (Culo, 2011). This explains why the practicum will adopt a holistic approach to address overall health and well-being of homeless persons.

Not much is known about the ocular condition of homeless persons (Noel et al., 2015). Visual acuity is significantly associated with reduced overall well-being. Thus, it is a critical educational program for homeless shelters, which host majorities with such complications. The training program will explore factors related to visual impairment and demonstrate the relevance of constant visual screening programs and treatment for homeless persons, especially where free eye clinics are found to help address this unmet health need.

Poor oral health based on all measurement indicators, such as decayed teeth, missing teeth, and oral pain, have been found among homeless persons (Costa et al., 2012). The educational program will cover causes, symptoms, diets, and offer a list of physicians who accept Medicaid and Medicare.

Competencies

This project lies squarely on the public health domain as it aims to protect the safety and improve health of the homeless members of the Hope House community through education. Rather than seeking to provide diagnostic interventions for the health problems affecting the homeless, the project aims to create awareness and empower the homeless on how to manage these issues through education. Additionally, this project is in the public health realm because the feedback received from the intervention could be employed to develop policies and processes in order to ensure the safety and health improvement of the homeless members of the community. Overall, the projects focus on improving the overall health of Hope House residents makes it a public health issue as the main goal of public health interventions is to safeguard improve health of different community members through education, policy making, and research on disease and injury prevention.

Methods

A holistic approach to public health was used to ensure that the project helps develop all aspects of peoples lives that are critical to improving the overall health of the targeted population. The approach was based on the realization that most residents of Hope House face different health challenges and, thus, a holistic perspective was needed to ensure that the project would have an impact on physical, emotional, mental, and spiritual needs of the residents. The justification for using this perspective was due to difficulties to improve the overall health and well-being of the targeted population without adopting such a perspective. The integrated educational package ensured a holistic approach to improve health and well-being of homeless persons while addressing care and underlying health challenges leading to emergency department use (OToole et al., 2016).

This practicum containing educational programs prepared by the presenter was presented to homeless persons through face-to-face using oral PowerPoint presentation and brochures. I printed out the copies for each individual participants. The educational interventions happened in a private room, which had a sitting arrangement for about 50 people. These learning materials were kept in a binder to be used as toolkits and references to ensure the continuity of the project even in the absence of the main implementer and for educating new residents. The toolkits contained information and resources to assist the homeless people residing in the shelter in improving their overall health on different levels  physical, emotional, mental, and spiritual.

The project targeted between 35 and 45 homeless individuals at Hope House (note that it was not difficult to find all homeless people at the shelter on a specific day). One general approach to assess learning in the educational package was to administer a pre-test and a post-test examination (Boston University, 2013). The pre-test was administered at the start of the instruction to assess pre-existing knowledge of the content program, including medication management, diabetes and hepatitis C management, self-neglect, oral health management, and vision management. Dr. Jaana Gold (my advisor) and Mrs. Lisa Field (my preceptor) approved the questionnaire before I gave to the residents. Later on at the end of every instruction program involving oral presentations and group discussions, a post-test assessment was administered in an effort to show measurable achievements in homeless persons knowledge. The entire practicum lasted 24 weeks (see the table below).

Impact evaluation was used at the end of the interventional educational program to determine the degree to which the practicum met its main goal of knowledge acquisition in homeless persons at Hope House. It was an important instrument to improve the quality of program and improve the outcomes. In this case, pre-test and post-test assignments was used for the practicum evaluation.

Collected data were analyzed using frequencies and percentage to determine changes in knowledge following implementation of the project for homeless persons. Changes in percentage prior to and following the practicum determined potential new knowledge acquired.

Sufficient resources, such as time, funds, instructional materials, and others, were provided to facilitate the implementation of this practicum. The overall interventional educational practicum addressed the following topics: medication management, diabetes and hepatitis C management, self-neglect, oral health management, and vision management within 24 weeks. The topics were divided into different weeks to facilitate the implementation of the practicum through oral PowerPoint presentation, group discussions, pre-tests, post-tests, and brochures to reinforce learning.

Data Analysis

Data analysis involved determining the difference between pre-test scores and post-test scores of homeless men who took part in the integrated educational program to improve their oval health. Analysis was done by examining the change in scores of individual participants to determine if there were any indications of a gain because of education provided. For each participant who took part in both pre-test and post-test, a variation in score (the value of post-test score less the value of pre-test score) for the entire topics covered during the program. This is generally the appropriate way to interpret the impacts of a training program in a given pre-test post-test test, since it allows the researcher to determine the extent of the difference in scores. Scores are displayed in graphic formats and tables for clarity.

Individual improvements of a given point show enhanced thinking (diminished weakness to basic thinking mistakes) and improvements of many points are great confirmation that learners actually benefited incredibly from the training program. These increases in the whole score demonstrate significant changes in learners. The variation in percentile score depends on where the learners score is found in the curve. It is imperative to recognize that scores of an individual may drop if the individual is not sure or lacks consistency when they select the best responses for the tasks. However, a drop in scores of many points is normally a characteristic of poor effort at post-test without some other influencing factors, for example, cognitive damage, exhaustion, or testing conditions. Data were analyzed using Excel.

Results

It is important to recognize that the number of participants in who participated in this program in different educational topics were not the same because of homelessness status of participants. For each educational topic, the participants ranged between 35 and 45 (hence, n = 35  45). The program was delivered over the course of five months. Only homeless men sheltered at Hope House Residents in Middletown, Ohio and aged between 18 years old and 75 years old took part in this educational program.

For educational program on scabies, the number of participants was 45. Pre-test was administered before the start of the educational program and post-test was also administered at the end of the educational program. The mean score percentage for pre-test was 56.84, and the mean score percentage for post-test was 80.27. Tests administered in the pre-test assessment were the same tests used in the post-test assessment. The mean score percentage difference between pre-test and post-test was 23.43, indicating an improvement of many points, which was a great confirmation that learners actually benefited incredibly from the educational program.

Participants were also tested on diabetes mellitus after the educational program. There were 42 learners who took both pre-test and post-test tests. Pre-test was administered before the start of the educational program and post-test was administered at the end of the educational program. The mean score percentage for pre-test was 66.67 and the mean score percentage for post-test was 84.52. Tests administered in the pre-test assessment were the same tests used in the post-test assessment. The mean score percentage difference between pre-test and post-test was 17.85, indicating an improvement of many points, which was a great confirmation that learners actually benefited incredibly from the educational program.

Learners change in knowledge was also tested following educational program on hepatitis C. This class had 35 participants who took both pre-test and post-test tests. Pre-test was administered before the start of the educational program and post-test was administered at the end of the educational program. The mean score percentage for pre-test was 47.8 and the mean score percentage for post-test was 79.06. Tests administered in the pre-test assessment were the same tests used in the post-test assessment. The mean score percentage difference between pre-test and post-test was 31.26, demonstrating an improvement of many points, which was a great confirmation that learners actually benefited incredibly from the educational program.

Learners change in knowledge was also tested following educational program on depression. This class had 40 participants who took both pre-test and post-test tests. Pre-test was administered before the start of the educational program and post-test was administered at the end of the educational program. The mean score percentage for pre-test was 56.85 and the mean score percentage for post-test was 78.65. Tests administered in the pre-test assessment were the same tests used in the post-test assessment. The mean score percentage difference between pre-test and post-test was 21.8, demonstrating an improvement of many points, which was a great confirmation that learners actually benefited incredibly from the educational program.

Participants change in knowledge was also tested following educational program on anxiety disorder. This class had 45 participants who took both pre-test and post-test tests. Pre-test was administered before the start of the educational program and post-test was administered at the end of the educational program. The mean score percentage for pre-test was 51 and the mean score percentage for post-test was 78. Tests administered in the pre-test assessment were the same tests used in the post-test assessment. The mean score percentage difference between pre-test and post-test was 26, demonstrating an improvement of many points, which was a great confirmation that learners actually benefited incredibly from the educational program.

Participants change in knowledge was also tested following educational program on lice. This class had 45 participants who took both pre-test and post-test tests. Pre-test was administered before the start of the educational program and post-test was administered at the end of the educational program. The mean score percentage for pre-test was 60.91 and the mean score percentage for post-test was 93.64 Tests administered in the pre-test assessment were the same tests used in the post-test assessment. The mean score percentage difference between pre-test and post-test was 32.73, demonstrating an improvement of many points, which was a great confirmation that learners actually benefited incredibly from the educational program.

For educational program on nutrition, the number of participants was 45. Pre-test was administered before the start of the educational program and post-test was also administered at the end of the educational program. The mean score percentage for pre-test was 48.04 and the mean score percentage for post-test was 77.02. Tests administered in the pre-test assessment were the same tests used in the post-test assessment. The mean score percentage difference between pre-test and post-test was 28.98, indicating an improvement of many points, which was a great confirmation that learners actually benefited incredibly from the educational program.

Summary of the Results

The above findings demonstrated that participants who took part in the educational program to improve overall health of homeless male at Hope House Residents in Middletown, Ohio did exceptionally well. For educational program on scabies, the mean score percentage for pre-test was 56.84, and the mean score percentage for post-test was 80.27, indicating a percentage gain of 23.43. Test scores for diabetes mellitus showed the mean score percentage for pre-test as 66.67 and the mean score percentage for post-test as 84.52, showing a percentage gain of 17.85. Additionally, for educational program on hepatitis C, the mean score percentage for pre-test was 47.8 and the mean score percentage for post-test was 79.06, which showed a percentage gain of 31.26.

Assessment results for showed that the mean score percentage for pre-test was 56.85 and the mean score percentage for post-test was 78.65, reflecting a knowledge gain of 21.8%. For anxiety disorder, the mean score percentage for pre-test was 51 and the mean score percentage for post-test was 78, depicting an increment in knowledge by 26 percent. The results of the assessment for lice showed that the mean score percentage for pre-test was 60.91 and the mean score percentage for post-test was 93.64, reflecting a change of 32.73 percent. Finally, The mean score percentage for pre-test was 48.04 and the mean score percentage for post-test was 77.02, showing a gain of 28.98 percent in the case of nutrition.

The participants who received this educational program gave overwhelming responses and enjoyed the educational materials left for references and future programs. They were delighted to have these classes and looked forward for more.

Discussion

This project focused on improving the overall health of Hope House Residents in Middletown, Ohio. Its mission was to provide wide-ranging programs and services designed to achieve long-term, sustainable life transformation for homeless men aged between 18 years old and 75 years old. The overall objective of the project was to ensure that men who reside in the shelter were encouraged to take care of their own health through access to the necessary knowledge. A holistic approach to public health was adopted for this educational program.

It should be clear that limited literature is available to provide empirical evidence for health educational programs for homeless individuals. In fact, a more comprehensive work was done in 1994 by May and Evans, and they too observed little report in research specifically for health education targeting homeless persons. Instead, current literature tends to focus on health promotion, which is a wide scope approach for interventions for health education for homeless populations. Nonetheless, the past research determined that healthcare educational programs for the homeless persons in shelters were often delivered by volunteer instructors, such as nurses, who offered lessons on health promotion, disease prevention, and self-care (May & Evans, 1994).

In light of the review of assessment results for a year and a half, it was found that 50 volunteer educators, the greater part of whom were nurses, provided 49 healthcare topics in 176 classes (May & Evans, 1994). Learners showed that the classes were useful, and they expressed their desires for future studies. This research conducted in 2017 still reflects findings established more than two decades ago by May and Evans. It confirms that health educational programs are hardly available to homeless individuals in their shelters, although they always express their desire to have search services.

Homeless is a complex, far-reaching issue in the United States (Coles, Themessl-Huber, & Freeman, 2012). Current health promotion underscores the ideas of lifestyle change, risks, and preventive health behavior, as well as the more extensive societal issues of the environment, public policy, and cultural influences. Therefore, the focus has shifted to a more planned way to deal with health promotion for individuals who are socially excluded, stressing behavioral change by focused interventions at the level of community settings, including homeless shelters.

Research concentrated on homelessness and related health challenges (Costa et al., 2012; Grabovschi, Loignon, & Fortin, 2013; Knowlton et al., 2015), and findings demonstrate the need for urgent action, yet little consideration has been given to the health promotion needs of homeless persons, and there is no clear proof of evidence-based outcomes following interventions. One issue for health promotion is to create and deliver suitable educational activities to a heterogeneous populace that is not generally simple to classify but rather has an extensive variety of health needs. As such, this study settled on a holistic approach to address multiple health concerns of homeless men.

For instance, the healthcare needs of a young fellow without a shelter vary widely from those of an old homeless man with other conditions related to advance age. To be destitute goes beyond a lack of a shelter alone, and it includes other health-related issues among other challenges. Homelessness has as much to do with social exclusion as with housing, and requires a wide range of health promotion methodologies.

Due to lack of earlier interventions and exclusion (Campbell, ONeill, Gibson, & Thurston, 2015), homeless persons are more probable than other populations to present with a severe illness and regularly utilize accident and emergency units for their healthcare needs. As a result, they are frequently missed by essential care health promotion initiatives.

Usually, healthcare services focused on homeless persons incorporate visiting care providers, community workers, health advocates, and occasional specialists, for example, general practitioners and community nurses, who have given intervention in homeless facilities and day centers (Jego et al., 2016). This study supports a more sustained implementation of educational programs for homeless persons as constituents of health promotion programs. Given these results, health promotion ought to be created with regard to how homeless persons look for care services. As such, this may include significant adjustment of, or specifically a move away from, conventional cases of care delivery, for example, in primary care setting situated in main hospitals.

Many intervention programs aimed for homeless persons have concentrated on illness prevention and are to a great extent not published (Jahan, 2012). These interventions incorporate immunization programs, mobile screening facilities, and the dissemination of condoms, but educational programs are not generally common because of resources (Ba-Essa et al., 2016; Knowlton et al., 2015). Intervention programs also tend to focus on youthful homeless living in the streets, in hostels, or other forms of accommodation facilities. Groups, for example, elderly individuals and families living in temporary settlement have largely been disregarded.

Even in this study, the focus was only on male, leaving out female homeless persons irrespective of their needs. Homeless care services are frequently engaged in emergency services provision and, thus, the long-term care of homeless persons is not generally a priority. Undoubtedly, health may not be a need for homeless persons themselves. Rather, basic survival needs, for example, food, water, and shelter may occupy their thoughts more than the likelihood of diseases. Hence, one valuable intervention may just be to inform such an individual where the closest shelter offering food and drink is. Thus, health promotion ought to likewise give useful help, for example, food, drink, and clothing. In the meantime, information can also be given about how to avoid some health risks and improve general hygiene.

The main objective of the homeless health educational program is usually to offer health information to homeless people and families in an unmistakable, precise, socially acceptable way to advance understanding, involvement, motivation, empowerment, and constructive health behavior change. This aim is successfully realized by applying different techniques drawn from the areas of health education and social or community work.

Engaging homeless persons is extremely important to service delivery because offering specific health information and supportive solution can only take place when individuals have expressed their concerns openly to care providers. Once educational programs have been provided, it is imperative to explore the recommendations and implement them. For instance, shelter providers should now strive to improve the provision of health information by organizing many formal educational and interventional classes and individually focused sessions on health subjects or topics important to needs of specific groups.

Health instructors give training and support around a wide scope of themes, for example, hypertension, nutrition, asthma, diabetes, hepatitis, HIV/AIDS, condom use, pregnancy, tuberculosis, physical activity, cancer, tumor, smoking, alcohol abuse and other substance abuse, oral health, and stress management, to give some examples. This demand for health educational programs demonstrates a complex system that requires a holistic approach.

This study was based on the formal needs of homeless persons at Hope House Residents in Middletown, Ohio. Irrespective of the lack of published findings, there are cases of specific issues that healthcare promoters consider great practice. These strategies account for national campaigns designed to meet local health needs, health fairs and other group based health promotion events, and outreach programs specifically designed for homeless persons. Strategies relying on peer interventions, concentrating on counselling and rapport building have also been effective. Many experts have now established services to cater for health needs of homeless individuals.

Training materials, especially those concentrating on chronic disease, such as HIV and AIDS information tend to target young homeless people while other health information on diabetes, heart conditions, obesity and others are have been targeted for older homeless persons (Culo, 2011; OToole et al., 2016). This demonstrates attempts to reach specific segments of homeless individuals. Health promoters have additionally focused on the significance of practical solutions.

As such, instructing homeless individuals about dental care might be inconsequential simply because they a toothbrush and toothpaste, and care for personal hygiene may not generally be practical for individuals sleeping in the streets. Thus, straightforward, practical help may occasionally be the most suitable type of health promotion. Health promotion efforts, therefore, should be accompanied by some quick and practical solutions. For instance, homeless alcohol and drug abusers might be more amiable to general health promotion activities once they are some forms therapies.

It is also important to recognize that health promotion efforts targeting homeless individuals may not record the best success rates (Jahan, 2012). This implies that multiple barriers are faced before homeless individuals can receive the intended health promotion initiatives. These barriers have been linked to multiple issues. First, health educational initiatives or educators are often isolated. As such, little collaboration or coordination is noted between stakeholders. In fact, it is recommended that any interventions targeting homeless individuals should be an integrated, multidisciplinary approach (Maness & Khan, 2014).

Second, public health departments have largely ignored health promotion and education for homeless persons. Third, some health promotion materials are written in technical languages, which usually need high levels of literacy or specialized knowledge. Hence, homeless persons feel excluded by such materials. Finally, while homeless persons may eagerly seek care, low self-esteem and diminished expectations often inhibit them from involving health promotion initiatives.

Some challenges are more complex. Numerous organizations do not have the capacity to implement health promotion without support. An essential factor is to gather the right resources and workforce, and design a framework for health promotion (Jahan, 2012). Health promotion also faces vested interests of various stakeholders. Powerful entities, such as businesses, are most likely to influence health promotional outcomes, for instance.

There is an increasing acknowledgment of part of ethics and, thus, stakeholders are expected to emphasize the practical reasons and benefits for health promotion. Educational programs are the best interventions engage homeless persons to determine what they value and how they can embrace practical approaches to reduce health risks and management existing conditions. To accomplish this goal, particular interventions to local circumstances are required as opposed to treating all groups similarly. Another issue is to develop a long-term rapport with marginalized individuals, such as homeless persons.

As poverty and inequality escalate in society, homeless persons and other disadvantaged groups may fail to appreciate any messages associated with health promotion. It will require some efforts, time to stakeholders offering related services, and find the right homeless persons. More importantly, this study revealed that homeless persons in different setting require different approaches. As such, the study strives to enhance access to health care for marginalized, underserved persons in society, and this should be a matter of public health policy. There are difficulties identified with research in the field of health promotion, specifically for health education for homeless persons (Jahan, 2012).

There is absence of implementation evidence in health promotion practice and absence of use of evidence while developing promotional strategies. There are specialized challenges in assessment of health promotional strategies. For performing assessment of health promotion outcomes, it is essential to characterize and gauge the results of the intervention, as was done in this case. Suitable approaches for assessment of intervention outcomes should be developed and embraced. To enhance the quality of studies in the health educational programs, researchers and other stakeholders should enhance the quality and number of published works, specifically for homeless persons and other marginalized groups.

Despite these drawbacks, health promotions have positively influenced health care outcomes in both private settings and public health initiatives (Jahan, 2012). Various public health accomplishments are credited to health promotion. Some of the most incredible health promotion accomplishments of include immunization; more secure work environments; infectious disease control; diminished mortality rates associated with chronic conditions; safer and more beneficial diets; family arranging and enhanced maternal and child health; fluoridation of drinking water and fortification of some foodstuff; and acknowledgment of health risks associated with tobacco use.

None of these accomplishments would have been conceivable without health promotion (Jahan, 2012). In these examples, clearly, specific achievements associated with homelessness are not defined. Nonetheless, health promotion is a necessary intervention strategy, and empowers individuals to adopt practical solutions to their health needs. Health promotion should be implemented in a team with individuals and requires their committed involvement. It assists communities in enhancing their capacities and their skills to take activities, which promote healthy living. They act in groups to bringing about change and improve outcomes.

While challenges exist for health promotion initiatives, opportunities have also been identified for the same (Jahan, 2012). Various agencies, organizations, and individuals around the globe are focused on health promotion for their communities. World organizations, such as the World Health Organization (WHO) and others, continuously highlight the plight of homeless individuals as among the most vulnerable in society. As such, they respond by developing strategies, projects, and activities designed for health promotion. Any health care related visits for different reasons for existing are open doors for wellbeing advancement exercises.

It is particularly critical for homeless individuals who may face difficulties gaining access to care facilities. As such, when they are visited at their shelters, the visits should be used to advance health among the most vulnerable population. Visits for any purpose are an opportunity for health promotion to enhance health outcomes of the target groups. Although immense opportunities for promoting health can be found the existence of current advanced technology and electronic modes of communication, these tools are largely not accessible to homeless persons. Nonetheless, health educators can exploit them to deliver their topics.

As previously noted, it is important that any health promotion initiative ought to be implemented following an evaluation of health needs of the target group. This strategy will not just help distinguish needs but will help with planning and creating interventions as indicated by the needs of the target group and different settings.

The difference of specific groups of homeless persons is clear. In comparison with general health promotion efforts, directed interventions can concentrate on the specific needs of homeless groups, for example, persons without shelter, single parents, adolescent, women, or seniors. It is imperative to conduct further research to determine the key health promotion needs of various homeless groups. Identification of informal communities, networks and the engagement of homeless persons in developmental assessments will identify the places and best methods for delivering health promotion. In this study, the researcher had to identify the best venue to reach homeless persons with health educational promotional program.

That is, it is extremely difficult to offer any interventions for homeless persons without prior planning. Social networks and peer educators, and sources of food and drinks can significantly contribute in health promotion for homeless persons. It all requires any creative strategies, which require careful implementation and assessment. Education appears to be the best initial strategy for homeless persons, who lack basic knowledge on self-care.

The numerous needs of homeless individuals force them into contact with many different support organizations. However, the response of a given organization is frequently narrowly focused and determined by emerging cases, rather than long-term approaches. Yet, the different qualities of these multiagency facilities introduce a genuine chance for collaborative health promotion. For instance, health educators can work with shelter home operators to deliver educational programs to homeless individuals, for instance. These organizations can ensure long-term health promotion for homeless persons by coordinating with relevant stakeholders. Novel primary care stakeholders may offer a perfect discussion to establish procedures, supported by sufficient resources to improve interventions. Shelter services may well take part in health promotion to ensure that many homeless persons are reached during their stay.

Recommendations

Results from this study showed that participants who received this educational program gave overwhelming responses and enjoyed the educational materials left for references and future programs. They were delighted to have these classes and looked forward for more. However, from the discussion, it was established that limited literature is available on health education for homeless persons. Much literature tends to concentrate on multiple health issues homeless persons face, but do not look at educational interventions. As such, researchers should focus on impacts of health education programs targeted at homeless persons as a constituent of health promotion to enhance general health.

Research ought to show that health education programs are important for improving health among homeless persons. It is also shown that delivery and promotion for homeless persons require coordination. Hence, researchers should also work together. There is additionally a need to promote collaboration among all stakeholders.

The health promotion initiatives ought to be research based and target specific groups, for instance, vulnerable men. It is important to appreciate the role of evidence in health care settings. Hence, failure to publish findings on health promotion programs is a major drawback to stakeholders who rely findings to make recommendations on policies. In fact, only one old source, in this case, was directly linked to the subject under homeless health education.

The study shows that health care professionals play a major role in health care promotion among underserved populations. Hence, adaptation to clinical practice ensures that health care professionals play a critical part regarding treatment and education of patients and in promoting enhanced health care outcomes within vulnerable groups. Findings provide a practical basis for implementing policies that support physician engagement for the medically marginalized, underserved homeless persons. Improving the health outcomes of homeless individuals is an important initiative to reduce cases of morbidity and mortality in society. General practitioners, family physicians, and nurses are preferably appropriate to offer care, all-inclusive, and sustained care for homeless patients and to guide multidisciplinary teams.

Strengths and Limitations

Given the limited research on health education programs for homeless persons, this research was extremely useful. The learning was conducted in a normal setting (shelter for homeless persons) and, thus, the results were reliable and not prone to any external influences. It might not be possible to generalize the findings of this study to other homeless facilities because only descriptive statistics was used. It was not always easier to find all participants and, thus, their number kept on fluctuating for every topic across the four months of the study.

Conclusion

The aim of this health educational program was to improve overall health of homeless male at Hope House Residents in Middletown, Ohio. The educational program was implemented for four months using a holistic approach. The results showed an exceptional performance in knowledge gain among participants. The participants who received this educational program gave overwhelming responses and enjoyed the educational materials left for references and future programs. They were delighted to have these classes and looked forward for more. Across the seven areas evaluated, results were excellent demonstrated the desire among homeless persons to learn. As such, these results will enable the development of a new model of primary care for health education programs to improve access to healthcare for underserved homeless individuals.

Health care professionals and researchers could effectively advance to the improvement of health care and outcomes for homeless persons, if homeless shelters and other stakeholders can coordinate their efforts. It is necessary to establish a group of multidisciplinary to support vulnerable people in society.

While outcomes were positive and participants were delighted, limited works exist on outcomes of education programs targeting homeless persons. As such, it was difficult to find current empirical data to support the findings of this study. This study therefore recommended further studies in health care educational programs specifically targeting homeless persons.

References

Ba-Essa, E. M., Mobarak, E. I., & Al-Daghri, N. M. (2016). Hepatitis C virus infection among patients with diabetes mellitus in Dammam, Saudi Arabia. BMC Health Services Research, 16, 313. Web.

Boston University. (2013). Choosing the right assessment method: Pre-test/post-test evaluation. Web.

Campbell, D. J., ONeill, B. G., Gibson, K., & Thurston, W. E. (2015). Primary healthcare needs and barriers to care among Calgarys homeless populations. BMC Family Practice, 16, 139. Web.

Coles, E., Themessl-Huber, M., & Freeman, R. (2012). Investigating community-based health and health promotion for homeless people: A mixed methods review. Health Education Research, 27(4), 624-644. Web.

Costa, S. M., Martins, C. C., de Lourdes, C. B., Zina, L. G., Paiva, S. M., Pordeus, I. A., & Abreu, M. H. (2012). A systematic review of socioeconomic indicators and dental caries in adults. International Journal of Environmental Research and Public Health, 9(10), 35403574. Web.

Culo, S. (2011). Risk assessment and intervention for vulnerable older adults. British Columbia Medical Journal, 53(8), 421-425.

Grabovschi, C., Loignon, C., & Fortin, M. (2013). Mapping the concept of vulnerability related to health care disparities: A scoping review. BMC Health Services Research, 13, 94. Web.

Jahan, S. (2012). Health promotion: Opportunities and challenges. Journal of Health Education Research & Development, 1, e105. Web.

Jego, M., Grassineau, D., Balique, H., Loundou, A., Sambuc, R., Daguzan, A.,& Gentile, S. (2016). Improving access and continuity of care for homeless people: How could general practitioners effectively contribute? Results from a mixed study. BMJ Open, 6(11), e013610. Web.

Knowlton, A. R., Nguyen, T. Q., Robinson, A. C., Harrell, P. T., & Mitchell, M. M. (2015). Pain symptoms associated with opioid use among vulnerable persons with HIV: An exploratory study with implications for palliative care and opioid abuse prevention. Journal of Palliative Care, 31(4), 228233.

Lin, W.-C., Bharel, M., Zhang, J., OConnell, E., & Clark, R. E. (2015). Frequent emergency department visits and hospitalizations among homeless people with Medicaid: Implications for Medicaid expansion. American Journal of Public Health, 105(S5), S716-S722. Web.

Maness, D. L., & Khan, M. (2014). Care of the homeless: An overview. American Family Physician, 89(8), 634-640.

May, K. M., & Evans, G. G. (1994). Health education for homeless populations. Journal of Community Health Nursing, 11(4), 229-37. Web.

Noel, C. W., Fung, H., Srivastava, R., Lebovic, G., Hwang, S. W., Berger, A., & Lichter, M. (2015). Visual impairment and unmet eye care needs among homeless adults in a Canadian City. JAMA Ophthalmology, 133(4), 455-460. Web.

OToole, T. P., Johnson, E. E., Aiello, R., Kane, V., & Pape, L. (2016). Tailoring care to vulnerable populations by incorporating social determinants of health: The Veterans health administrations homeless patient aligned care team program. Preventing Chronic Disease, 13, E44. Web.

Introduction

Human health is a priority to individuals, communities, non-governmental groups, governments, and international associations. An effective planning process addresses the current and future needs of the people. Human health is an essential requirement, and individuals should invest in their well-being while the government lays necessary measures to provide health services primarily to vulnerable groups. The vulnerable population living at high health risks includes children, the poor, the aged, and people living with disabilities (Trusted Choice Team, 2020). The individuals in these categories have greater chances of being affected by chronic and other adverse infections due to their weak body immunity. Therefore, they should be protected constantly bypassing health bills that simplify their access to medical care. This studys scope will be limited to a health policy relating to the geriatric population using Milios approach.

The geriatric population is composed of the least productive members of society. Although they pay taxes during their years of employment, they no longer participate actively in the economic building at their advanced age. The World Health Organization (WHO) states the right to health as a claim to a set of structures that ensure everyone enjoys the rights (Baer et al., 2016). Governments should initiate healthcare measures that provide the aged access to health care services at a reasonable cost. Some of the steps may include providing health insurance plans for the aged and other health determinants such as proper housing, a clean environment, and sanitization. The provision of preventive measures for chronic diseases, pain-relieving medicines, and enough public healthcare institutions with quality services also favors health care for the geriatric population.

Milios Policy Process

Milio wrote resourceful materials discussing the health sectors improvements and other industries that can promote healthy living. She states that the physical environment and behavior patterns significantly impact either promoting or hindering healthy living (Super et al., 2020). Some of the tools discussed by Milio as health-enhancing policies in other sectors include the development of social epidemiology, improved health education and health economics, and information technology (Super et al., 2020). She also discussed the role of love and power in promoting healthy living. Milios approach is applied in this study to examine the role of the environment in health-enhancing among the elderly societal members.

The Environmental Policy

Knowing an individuals physical environment is crucial in preventing and controlling some diseases and infections common during old age. Prevention of some illnesses would be a better measure compared to managing the condition or even treatment. The geriatric population is very vulnerable to multiple functional impairments. Healthy living can be attained by maintaining a clean physical environment, a well-balanced diet, and access to social, and moral support. The geriatric population should be settled in places free from pollutants such as air pollutants, noise, harmful chemicals, unclean water, and residential areas, free from toxic metal contents such as mercury and aluminum (Fachbibliothek Umwelt, 2017). Therefore, policies relating to reliable, effective, and efficient health care of the elderly in their physical environment should be formulated.

Some human-triggered and naturally-caused changes in the environment are causes of some health problems. Environmental changes such as high air pollution and high ozone levels are harmful to the human breathing system (Fachbibliothek Umwelt, 2017). Less concern about health care is directed to the environment, while much effort and funds are invested in the other measures to maintain a healthy environment. The geriatric population is very vulnerable and should not be exposed to a harsh climate. Therefore, health policies concerning maintaining a healthy environment should be formulated.

In addition to the living conditions, the environmental factor should be considered compared to the accessibility of medical care. The geriatric population is affected by many health problems which require close medical check-ups and regular clinics. The check-ups may involve visiting a health care facility or the physician visiting the patient at their homes. The American Geriatrics Society (2020) supports implementing a policy on assisting the geriatric population in fighting Covid-19 through the establishment of Assisted Living Facilities (ALF). The policy would ensure that the elderly have close access to medical care and treatment by relocating to a residential where they can be taken care of in a better way.

This study supports the Assisted Living Facilities (ALF) policy to be implemented fully considering the health factor instead of Covid-19 infection. The policy would be sustained by the Medicare program and some individual costs to pay for the rental residence. The family members of the person under medication would take care of them during the treatment period, providing meals and other basic needs. Care and time from family members ensure both moral and physical support, which Milio was advocating for.

Inconsistence of the Policy

The main challenge facing the implementation of environmental policies on geriatric population health is inconsistency in service delivery. Poor planning has delayed the implementation of government policies on maintaining a pollution-free environment and Assisted Living Facilities (ALF) may not be fully implemented. Moreover, they are not entirely acts of mercy but mainly compensation for peoples health insurance plans. The policy demonstrates discrimination and unfairness since it is implemented effectively to the affluent members who have heavy insurance covers while delayed or denied to the poor who are even more vulnerable.

Conclusion

Therefore, the geriatric population can have better lives if the necessary measures for preventing and controlling infections are put in place. A healthy environment should be free from hazards and pollutants, access to medical care, and enough physical, material, and moral support from family members. Therefore, governments should formulate and fully implement policies relating to the environment of the geriatric population.

References

American Geriatrics Society. (2020). American Geriatrics Society (AGS) policy brief: COVID 19 and assisted living facilities. Journal of the American Geriatrics Society, 68(6), 1131-1135. Web.

Baer, B., Bhushan, A., Taleb, H. A., Vasquez, J., & Thomas, R. (2016). The right to health of older people. The Gerontologist, 56(Suppl 2), S206-S217. Web.

Trusted Choice Team. (2020). Senior health insurance. TrustedChoice. Web.

Fachbibliothek Umwelt (2017). Environmental pollution and diseases of the elderly. Umweltbundesamt. Web.

Super, S., Klerkx, L. W. A., Hermens, N., & Koelen, M. A. (2020). A multilevel transition perspective on embedding intersectoral action in local health policies. Health Promotion International, 1-12. Web.

Many people suffer from chronic diseases, which is a common phenomenon nowadays. Chronic illnesses can vary from diabetes to asthma and significantly impact a persons everyday life. Regularly individuals are unaware of having any kind of chronic disease, and they spend a decent time of their lives without knowing about it. However, some population groups are affected more than others to the particular health problems. The race or ethnicity minorities of the population may be at the higher explosion to the different chronic diseases due to numerous factors such as genetics or discrimination. Therefore, this paper aims to evaluate the black population of New York state affected by hypertension and analyze the reasons behind it and the interventions to improve the health outcomes.

One of the high-risk groups most affected by chronic high blood pressure is African Americans. Hypertension was initially a widespread issue all over the United States, but the black population has the highest rates of dealing with the illness. They can get hypertension at a young age, especially those children who also suffer from obesity. However, specific risk factors exist that influence the appearance and the development of hypertension and might cause complications of the physical state. Regarding sex, men are the ones who tend to get hypertension more often than women. At the elderly age, both female and male individuals tend to be at a higher risk, especially if they smoke, lead an inactive lifestyle, and overuse alcohol (Mills et al., 2020). In addition, more narrow-focused factors such as pregnancy, family history disease, or second type o diabetes may result in high blood pressure.

Besides all the fundamental characteristics, the black population experience additional causes of hypertension, which make them a high-risk segment. Its reasons may consist of the genetic features and their socioeconomics position in society. Considering their biological background, black people tend to be overweight and have sensory blood vessels (High blood pressure and African Americans, 2022). Nevertheless, socioeconomic reasons are the most influential in this case and intensify already existing conditions. Black population compared to the white live in the greater stress resulting from the difficulties of getting a well-paid job, existing in poverty, and having a household in the dangerous criminal districts (Clark et al., 2019). Therefore, African Americans have fewer opportunities to get a quality education, lead a healthy lifestyle, and access medical care and information (Howard et al., 2018). Moreover, because of all the factors, many black people are unaware of having the disease or its danger to their health, and as a result, they do not take any measures.

In the different regions of the United States, indicators of hypertension prevalence vary significantly. New York states counties illustrate the distinction between the counties. Many African Americans live in the Monroe and Westchester counties, and Monroe county portrays a greater level of hypertension prevalence among the black population than Westchester, resulting in the indicator differences. The crucial social determinants such as quality of life, income, and unemployment determine the outcome of the prevalence in the two compared areas. Monroe county has higher adult smoking and obesity indexes than Westchester (New York, 2022). It also shows a higher percentage of excessive drinking and fewer possibilities for physical activity, resulting in a poor physiological state (New York, 2022). In addition, Westchester demonstrates noticeably lower statics regarding the socioeconomic factors, and its unemployment rate is less than Monroes (New York, 2022). Children who live in a poor household in Westchester represent 10% of the population which is almost two times lower than Monroe county (New York, 2022). Thus, some social determinants lead to disparities in the health conditions of the black communities.

In order to improve the situation with the healthcare and decrease the negative outcomes for the group at high risk, several decisions were implemented. Firstly, the initial cause of this is racial discrimination, limited access to medical resources, and crisis in public health. Consequently, the primary focus should be on the social and cultural factors in the first place. One of the efficient approaches is to spread awareness among the community and educate black people about the issue.

Several electronic and online services help people get information on health issues, particularly hypertension. For instance, websites such as the website Medicare.gov allow individuals to easily find healthcare institutions near their homes and choose from those who provide more affordable services and consultations (Find and Compare Nursing Homes, Hospitals and Other Providers Near You, 2022). Nurses are also the ones who contribute to the spread of health literacy by informing the patients about the diagnosis, causes, and treatment (Loan et al., 2018). Those who work in schools can promote knowledge among the children and teenagers, which positively affect their lives and prevent them from negative outcomes. Another way that helps to improve the medical care regarding hypertension is the cooperation with the community partners, particularly those involved in the healthcare (Ferdinand et al., 2020). Their investment and work regarding technologies and health promotion among community cities such as supermarkets or barbershops reduce the risk factor.

Overall, the black population is more affected by hypertension than the white due to some biological but mainly social factors such as poverty, lack of education, and unemployment. Racial discrimination is a huge factor that puts African Americans at high risk and exposes them to chronic disease. However, with the help of informational electronic sources and the cooperation inside of the community by providing access and the knowledge about the high blood pressure helps to lower the number of risk factors.

References

Clark, D., Colantonio, L. D., Min, Y. I., Hall, M. E., Zhao, H., Mentz, R. J.,& & Muntner, P. (2019). Population-attributable risk for cardiovascular disease associated with hypertension in black adults. JAMA cardiology, 4(12), 1194-1202.

Ferdinand, D. P., Nedunchezhian, S., & Ferdinand, K. C. (2020). Hypertension in African Americans: advances in community outreach and public health approaches.Progress in cardiovascular diseases, 63(1), 40-45. Web.

Find and Compare Nursing Homes, Hospitals and Other Providers Near You. Medicare.gov. Web.

High blood pressure and African Americans. Stanford Childrens Health. Web.

Howard, G., Cushman, M., Moy, C. S., Oparil, S., Muntner, P., Lackland, D. T.,& & Howard, V. J. (2018). Association of clinical and social factors with excess hypertension risk in black compared with white US adults. Jama, 320(13), 1338-1348.

Loan, L. A., Parnell, T. A., Stichler, J. F., Boyle, D. K., Allen, P., VanFosson, C. A., & Barton, A. J. (2018). Call for action: Nurses must play a critical role to enhance health literacy. Nursing Outlook, 66(1), 97-100.

Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Nature Reviews Nephrology, 16(4), 223-237.

New York. County Health Rankings & Roadmaps. Web.

Planning in an organization is very critical as it gives direction on what should be done and procedures to be followed. The CDC evaluation model is used in the obtaining of the program policies in healthcare and sickness arresting. The model possesses six steps which are based on feasibility, utility, accuracy, and propriety (CDC, 2021). These steps are involving stakeholders, outlining the program, concentrating on the evaluation perspective, collecting dependable confirmation, supporting conclusions, guaranteeing use, and sharing lessons (CDC, 2021). The Palm Island Indigenous population is the subject study in which the report shows the need for evaluation to help society and its strategy. Additionally, another objective is to raise the number of people who have received the barge of COVID-19 vaccines.

The CDC evaluation design utilizes the six steps to come up with better implementation and revision of the program strategy. The engagement of stakeholders is the first step where the Australian Government Department of Health and the Queensland Government are mainly involved. The framework gives a comprehensive tool in the vaccination and immunization program. The objectives and goals of the program are discussed in conjunction with its target groups and strategies.

The different stakeholders play unique roles to make the plan a success. The evaluator is responsible for overseeing the future and present outcomes. The evaluation includes the target population involving individuals receiving the vaccine to determine its efficiency. They should maintain their lifestyle and provide relevant feedback and report any issues related to COVID-19. The Queens Health department supports the vaccination and provides a disease-free community. Australia Immunization offers vaccination delivery services, the register monitors coverage, digital health maintains the record and the pharmacovigilance monitors adverse effects after the immunization process.

The description of the program indicates the challenges faced by the target population during the alarming pandemic. The group was underestimated in receiving medical attention during the corona period hence facing high health risks. The aged and people with pre-existing conditions like diabetes, pressure, and obesity were the most affected. A lifestyle that is diverse between the indigenous people and Australians posed a difference in the risk factors faced. False beliefs, lack of knowledge, and unhealthy lifestyles were the most contributing factors.

Links to Current Policies and Framework

The Queensland Government and the Australian Government Department of Health have a framework for the vaccination of COVID-19 for the indigenous population in Queensland.it caters to the population with varying ages as from 12,18, and 60 with the Astra Zeneca and Pfizer vaccines (Melbourne Vaccine Education Centre, 2021). The Australian Government Department of Health has two immunization and vaccination for its people. The table below shows the current policies and frameworks for the program.

Table1: Current Policies and Frameworks

Focus the Evaluation Design and Gathering and Analyzing Evidence

An impact evaluation framework is composed of three elements which include the available resources and constraints, the nature of what is being evaluated, and the nature of evaluation itself. Resources include time, staff, money, volunteers, and materials. Illiteracy can impact peoples lives negatively where most may be unaware of simple practices like keeping social distance. Intermediate outcomes such as changes in policies and behavior also have a great impact. Different evaluation designs and methods used include single group (posttest only), single group (pre and posttest), nonequivalent control (pre and post), and single group (time series).

Single group (posttest) involves taking only one measurement at the end of an intervention and its only targets the participants. A single group (pre and post) is where two measurements are taken one before the intervention and another one after (Adeoye et al., 2020). This design is suitable as it gives room for change to be observed appropriately. In a non-equivalent group, two tests are done before and after for two groups (Chesney et al., 2020). Single group time series involves multiple measures over some time only for the participants. The natural changes are being observed and the external influences. Limitations to the evaluation differ depending on the nature and size of the population. The generalization of data can sometimes give false implications of the trends involved. Age difference, inadequate timing, difficulty in locating documents, and writing reports.

Table 2: Threats to Internal Validity

Table 3: Threats to External Validity

Sampling Plans

Sampling plans provide a basis on which research is to be conducted. It has five steps that must be followed beginning with the identifying of the parameters to be measured, range of possible values, and needed resolutions (Wu et al., 2018). A sampling scheme should be designed to determine how and when the data will be collected. Selection of the sample sizes by grouping them if possible by considering similarities and differences. Design of data storage formats if in tables, graphs, or chat formats and finally assigning roles and responsibilities to each stakeholder. The participants were recruited using methods targeting the right audience, screening, incentivizing, and sustaining.

Sampling Methods

Sampling methods like simple random, systematic, and stratified, and cluster were embraced. Simple random sampling provides an equal chance for every member of a population. Tools like random number generators and techniques entirely based on chance are applied. Systematic sampling has similar characteristics to simple but its easier to conduct (Li et al., 2018). Every individual involved in the exercise is listed with a number but they are chosen randomly. Stratified sampling involves small subdivisions of populations into groups and conclusions are drawn (Varshney et al., 2017). Cluster sampling also involves the division of the populations but each group has similar characteristics.

Table 4: Developing an Evaluation Plan

Developing an evaluation plan involves the need to achieve the desired objectives. The various methods applied include interviews, observation, single group tests, using test kits and questionnaires (Quek et al., 2017). Personal interviews cover the interrogation on how people been affected by the virus have been coping with the changing lifestyle and how their relationships have changed (Callwood et al., 2018). Observations were made on the general behavior of people, social interaction, and their day-to-day activities. COVID-19 test kits are also used to give quick and accurate tests for treatment and prevention of the spread. The duration of doing the research varies from weekly, monthly, and even daily for observations.

Tools used in data collection were conducting questionnaires and interviews. The questionnaire method is very reliable and cheap to use. It involves making a photocopy of papers consisting of the questions and administering them to the target group. It can be used to collect data from a large audience over a short period (Cumpston et al., 2019). Both open and closed questions can be used to provide information that can be converted easily into quantitative data (de Block & Vis, 2018). The questions are standardized and can be suitable for all ages as they are easy to respond to. An estimate of 2000 questionnaires can be filled in a day targeting different groups in various locations like churches, schools, and hospitals.

The interview method involves one-to-one interaction where questions are asked and answers were given. It is suitable for obtaining data from a small group of people. Its very private since the information given is kept confidential (Falissard, 2021). Reliability is seen where similar groups are kept together and the others isolated and them comparison of data is made. An estimate of 500 participants can be interviewed during a day making it very reliable. It is highly flexible and can investigate different issues in a period.

The method is suitable for the target population since they have different preferences. Patients with pre-existing conditions also need privacy for to reveal their statuses (Hampton and Lenhart, 2019). Both quantitative and qualitative measures were taken during the research. Qualitative measurements tend to have a deeper understanding of why something happens (Alam, 2020). Quantitative measures involve data that can be put in numbers. The mortality rate among sick adults was very high due to emaciated immunity (Lederer et al., 2018). Conducting it privately without the knowledge of the participants showed deviation as to when conducted publicly (Kizlari & Fouseki, 2021). People tend to vary their behavior and they can pretend in some cases or give false implications.

Table 5: Evaluation Plan for the Process Evaluation

The various question asked are important in determining the components of the program. Since most people prefer privacy, administering personal questionnaires can give them the confidence to give out relevant information (Nguyen et al., 2020). Making a general observation on how persons conduct themselves in society can give a general view of the new infection. Some responses need to be noted immediately as they occur. Correspondingly, some cases involve the synthesis of raw data to come up with better assumptions.

Table 6: Justifying Conclusions

Accuracy calls upon the nature of the problems and behaviors to be observed. Distinct variables are preferred since they give researchers easy time. Awareness should be made on why such an activity is taking place, its importance, and its relevance in the general wellbeing of all the individuals (Pennycook et al., 2020). Honesty value should be emphasized since wrong data can lead to delicate decisions in the final state. The culture of a community is sensitive and must be respected (Mariani et al., 2018). One must learn to be compatible with other cultures despite of their uniqueness. Ethical issues must be adhered to by all and equal treatment of persons must be adopted Feasibility issues refer to the inadequate resources, time, and background knowledge on how to conduct the research. To accomplish the tasks in demand, enough resources must be available and be easy to access (Southwood, 2018). Tools used in data collection must be available and valid to minimize on errors. Having prior information in theoretical form enables its application easily.

Table 7: Use and Share of Lessons Learnt

To ensure that the information gathered is effectively used and analyzed, all the stakeholders must be involved. Monitoring on the use of data by creating online portals for patients to interact with doctors. They can get appropriate guidance on what to do when faced with any emergencies and possible first aids. Members of the public can go for the vaccines to protect themselves from exposure.

Timeline

The procedure shown above was relevant in providing a guideline on the evaluation. The first thing was to select a research area (Palm Island Indigenous Population). Research questions gave direction on what to identify and the unique features. methodologies applied were conducting interviews and conducting of questionnaires. Common open and closed questions were asked to determine the wave nature of the virus (Yassouridis et al., 2018). Various groups of participants included people of all ages with their diversity. Data analysis was done using regression mean to determine variance. after all this was done, the first, second, and final drafts were written to sum up the evaluation.

In conclusion, the CDC framework must follow all the six steps for it to be complete. The plan to vaccinate the Palm Island Indigenous Population followed the procedure as it was the most appropriate. The engagement of stakeholders solved the gap of low income and other economic factors hindering them from receiving better services. Majorly, the government of Australians response was critical. Describing the plan by considering possible risk factors and poor communication created a strong foundation and path to be followed. Goals and objectives set created better pathways to the achievement. Educating the target group and creating governing policies such as wearing masks and keeping social distance.

Evaluation designs and methods used include single group (posttest only), single group (pre and posttest), non-equivalent control (pre and post), and single group (time series). They were able to show the trends of data and variations whenever possible. Threats to both internal and external validity were also examined deeply. Program components like knowledge, attitude, behavior, self-efficacy, and health status, social and environmental support. Ensuring use and share of lessons learned by recalling the stakeholders involved and looking for ways to ensure the finding are used.

References

Adeoye, J., Wan, C., & Thomson, P. (2020). An appraisal of pivotal evaluation designs in validating noninvasive biomarkers for head and neck cancer detection. Acta Oncologica, 59(12), 1500-1502.

Alam, M. (2020). A systematic qualitative case study: Questions, data collection, NVivo analysis, and saturation.Qualitative Research in Organizations and Management: An International Journal, 16(1), 1-31.

Australian Government Department of Health. (2021). Immunization for Aboriginal and Torres Strait Islander people. Australian Government Department of Health.

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Callwood, A., Jeevaratnam, K., Kotronoulas, G., Schneider, A., Lewis, L., & Nadarajah, V. (2018). Personal domains assessed in multiple mini interviews (MMIs) for healthcare student selection: A narrative synthesis systematic review. Nurse Education Today, 64, 56-64.

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Chesney, T., Bogach, J., Devaud, N., Govindarajan, A., & Wright, F. (2020). How we did it: creating virtual interviews for postgraduate medical trainee recruitment and keeping it personal. Annals of Surgery, 273(2), e60-e62.

Cumpston, M., Li, T., Page, M., Chandler, J., Welch, V., Higgins, J., & Thomas, J. (2019). Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database of Systematic Reviews. Web.

de Block, D., & Vis, B. (2018). Addressing the challenges related to transforming qualitative into quantitative data in qualitative comparative analysis. Journal of Mixed Methods Research, 13(4), 503-535.

Falissard, B. (2021). The future of evaluation of the child and adolescent psychiatric treatments. IACAPAP Arxiv. Web.

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Pennycook, G., McPhetres, J., Zhang, Y., Lu, J., & Rand, D. (2020). Fighting COVID-19 misinformation on social media: Experimental evidence for a scalable accuracy-nudge intervention.Psychological Science, 31(7), 770-780.

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Yassouridis, C., Ernst, D., & Leisch, F. (2018). Generalization, combination, and extension of functional clustering algorithms: The R package fancy. Journal of Statistical Software, 85(9).

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