PUBLIC HEALTH

An 86-year-old male parishioner is on hospice care at home, and his daughter, who is a nurse, has been trying to meet all his physical needs around the clock. The pastor, who made a home visit, calls the faith community nurse to express his concern that the daughter is becoming “burned out.” How can the faith community nurse engage the faith community as a whole to provide volunteer support to this family?

CAPSTONE

After reading the article, Transforming and Improving Health Care through Meaningful Use of Health Information Technology , discuss how meaningful use of data from electronic health records can be used to improve population health. Have you seen connections between data collection gathered from electronic health records and how you care for patients? Finally, reflect on your nursing experiences to an incidence where the electronic health record improved patient outcomes. How was the electronic health record used to improve outcomes? What negative impact have you seen using the electronic health record?

CLINICAL

Discuss two areas of difficulty you encountered or two new nursing interventions you learned this week at your clinical site. You may also choose to share one of each. CASE MANAGEMENT

1. Oloruntoba EO, Folarin TB, Ayede AI. Hygiene and sanitation risk factors of diarrhoeal disease among under-five children in Ibadan, Nigeria. African Health Sciences. 2014;14(4):1001-1011. doi:10.4314/ahs. v14i4.32.

This study was to decrease the leading cause of mortality and death in children under five in Nigeria. Unsafe water, poor hygiene, and inadequate sanitation were determined to be the primary cause behind these deaths. 440 children children were paired by age, questionnaire and observation checklists were administered to the caregivers of these children as well as, sanitation conditions of 30% of these caregivers were observed for further analysis. With the help of descriptive and inferential statistics it was uncovered that children with caregivers that did not wash their hands with soap before preparing food had higher risk of contracting diarrheal disease. Other factors that were also associated with children contracting diarrheal disease was poor hand washing, clogged drains near the house, presence of flies, and improperly handling water.

2. Idowu A, Olowookere SA, Abiola OO, Akinwumi AF, Adegbenro C. Determinants of Skilled Care Utilization among Pregnant Women Residents in an Urban Community in Kwara State, North Central Nigeria. Ethiopian Journal of Health Sciences. 2017;27(3):291-298.

This study was to determine the progress of maternal health. 400 people took place in this survey in North central Nigeria. They took a pre-test questionnaire that was used to collect data and analyze the statistics. The skilled attendant at delivery or SBA watches 74% of the births this resulted in the need for improvement and implementation of reproductive health policies needing change in Nigeria.

3. Early results of an integrated maternal, newborn, and child health program, Northern Nigeria, 2009 to 2011.Findley SE, Uwemedimo OT, Doctor HV, Green C, Adamu F, Afenyadu GY. BMC Public Health. 2013 Oct 31; 13:1034. Epub 2013 Oct 31

This paper describes early results of an integrated maternal, newborn, and child health (MNCH) program in Northern Nigeria where child mortality rates are two to three times higher than in the southern states. The intervention model integrated critical health systems changes needed to reinvigorate MNCH health services, together with community-based activities aimed at mobilizing and enabling women to make changes in their MNCH practices. Control Local Government Areas received less-intense statewide policy changes.

4. Effectiveness of community health workers delivering preventive interventions for maternal and child health in low- and middle-income countries: a systematic review. Gilmore B, McAuliffe E. BMC Public Health. 2013 Sep 13; 13:847. Epub 2013 Sep 13.

Evidence from this review suggests several strategies that should be further explored, including combining hygiene education with breastfeeding interventions with the prospect of reducing diarrhea rates in infants, using visual aids, which can be left with the mother as educational tools, and specifically targeting health messages. Variations in interventions, training and outcomes make it difficult to compare all included studies, however some important findings emerged from this research. Community health workers are effective at increasing acceptability of mother-performed practices, such as skin-to-skin care and exclusive breastfeeding.

5. Kana, M. A., Doctor, H. V., Peleteiro, B., Lunet, N., & Barros, H. (2015). Maternal and child health interventions in Nigeria: a systematic review of published studies from 1990 to 2014. BMC public health, 15, 334. doi:10.1186/s12889-015-1688-3

This systematic review has provided important lessons for operational research and the application of epidemiological reasoning to the understanding of MNCH problems and institution of relevant interventions. Firstly, the prolonged intervention-publication interval may contribute to delayed management awareness, mobilization of resources and response. We also observed a lack of coordination of policies and interventions either as source of evidence for initiating intervention or its evaluation. Furthermore, the scale and duration of many of the interventions was insufficient to have demonstrable impact on maternal and child health outcomes. A few the MNCH interventions were implemented as pilots or within the framework of vertical programmes thereby raising concerns for scaling-up for wider coverage, integration into the health system and sustainability.

6. An assessment of maternal, newborn and child health implementation studies in Nigeria: implications for evidence informed policymaking and practice. Uneke CJ, Sombie I, Keita N, Lokossou V, Johnson E, Ongolo-Zogo P. Health Promote Perspect. 2016; 6(3):119-27. Epub 2016 Aug 10.

Nigeria, with a population of over 160 million and weak health systems, health outcomes especially those related to maternal and child health remains poor. With approximately 2.5% of the world’s population, the country is reportedly having more than 10% of all under-5 and maternal deaths – more than 1 million newborn, infant, and child deaths and more than 50 000 maternal deaths every year. However, there has been some level of reduction in maternal and child mortality with the last few years. The national maternal mortality rate (MMR) reduced from 800/100 000 in 2005 to 545/100 000 in 2008 and to 110/100 000 according to the recent Nigeria Demographic and Health Survey (NDHS) 2013. The 2008 NDHS reported an under five mortality rate (U5MR) of 157 deaths per 1000 live births, suggesting a 22% decline from the NDHS report of 2003 which had shown an U5MR of 201 per 1000 live births. According to the World Bank recent report, the Nigeria U5MR further declined to 117 per 1000 live births in 2013.

7. Abimbola S, Okoli U, Olubajo O, Abdullahi MJ, Pate MA (2012) The Midwives Service Scheme in Nigeria. PLoS Med 9(5): e1001

These variations in health indices are influenced by the presence of tertiary hospitals, social amenities, and a population that can afford to pay for health services that in turn attract highly skilled health workers. Therefore, in much of rural Nigeria, beyond issues of access, there are inadequate human resources for providing 24-hour health services in primary health care (PHC) facilities. Nigeria faces a crisis in human resources for health (HRH) in the form of health worker shortages, requiring an immediate and significant increase in the number of health workers, or in the meantime a strategic redistribution of health workers to grossly underserved rural areas

8. The influence of the social and cultural environment on maternal mortality in Nigeria: Evidence from the 2013 demographic and health survey

Oluwatosin Ariyo, Ifeoma D. Ozodiegwu, Henry V. Doctor and Imelda K. Moise

Journal: PLOS ONE, 2017, Volume 12, Number 12, Page e0190285 DOI: 10.1371/journal.pone.0190285

Efforts to reduce maternal mortality should implement tailored programs that address barriers to health-seeking behavior influenced by cultural beliefs and attitudes, and low educational attainment. Strategies to improve women’s agency should be at the core of these programs; they are essential for reducing maternal mortality and achieving sustainable development goals towards gender equality. Future studies should develop empirically evaluated measures which assess, and further investigate the association between women’s empowerment and maternal health status and outcomes.

9. A Rapid Assessment of the Availability and Use of Obstetric Care in Nigerian Healthcare Facilities. Daniel O. Erim, Usman M. Kolapo, Stephen C. Resch. Published: June 22, 2012

Most of the primary healthcare facilities we visited were unable to provide all basic Emergency Obstetric Care (bEmOC) services. In general, they lack clinical staff needed to dispense maternal and neonatal care services, ambulances and uninterrupted electricity supply whenever there were obstetric emergencies. Secondary healthcare facilities fared better, but, like their primary counterparts, lack neonatal care infrastructure. Among patients, most lived within 30 minutes of the visited facilities and still reported some difficulty getting there. Of those who had had two or more childbirths, the conditional probability of a delivery occurring in a healthcare facility was 0.91 if the previous delivery occurred in a healthcare facility, and 0.24 if it occurred at home

10. Support for breastfeeding mothers: a systematic review. Jim Sikorski Mary J. Renfrew Sima Pindoria Angela Wade. First published: 17 October 2003

Although the benefits of breastfeeding are widely accepted, the effectiveness of different strategies to promote the continuation of breastfeeding once initiated are less clear. The objective of this systematic review was to describe studies comparing standard care with the provision of extra breastfeeding support and to measure its effectiveness. Outcome measures used were rates of cessation of any breastfeeding or exclusive breastfeeding at chosen points in time. Measures of child morbidity and maternal satisfaction were also used when these were reported.

Title Begin this paragraph with your introduction. The introduction should briefly talk about the purpose for a Community Health Assessments. Introduce your selected Sentinel City community. Assessment Using your eight social determinants of health (subsystems), discuss the living condition within your community. Present your overall findings relative to the assignment’s social determinants of health in weeks 1-4. Analysis From the information you discussed above, analysis the information as the overall health of the community. What are the strengths and the challenges of the community? Describe the data you found that directly relates to the health concern you believe exist for your chosen community or a vulnerable population in the community. This data can be obtained from your templates in weeks 1-4. Make the connection between your community’s major health concerns and the Healthy People 2020/2030 objectives. Nursing Diagnosis You may have to brush up writing nursing diagnoses. Once you identified the leading challenge for the community/population, write a nursing diagnosis. Here is a link to help you figure some out – https://nursekey.com/community-diagnosis-planning-andintervention/ Be thorough and specific related to the problem, interventions, and expected outcomes.  3 Plan In this section, you will detail your plan for improvement for you community. This is the section for your interventions. Interventions must be achievable, measurable, and time limited. Include the information gained from Social Determinate worksheet to build the plan. Include the people from the city and the community you will work with, for example, the mayor, the police, the local church leaders, etc. Plans should be detailed, realistic (funding and supplies type of stuff), time limited, and measurable. Evaluation Because this is a simulation, you will not have an actual implementation for evaluation, but you will have an evaluation plan. How would you measure the success or needed adjustments to the plan? Did the intervention help correct the issue? How would you know? Explain how these interventions will increase the quality of life for the people that live in your chosen SC community. Conclusion Briefly summarize your paper and draw your conclusions. Make observations about the community and its place within Sentinel City. What future do you see for this community?

Budgeting and developing a timeline are important steps in public health program planning. If a budget is properly developed it provides a solid foundation for guiding the implementation of the program as well as sustaining it. A timeline is also essential as it provides program planners a guide to use when determining the progress of a program.

For your Course Project this week, you are given $200,000 to fund your program for one year. You will prepare a budget for your program, considering the resources that you need and how you would allocate funds. Some allocation of funds may include marketing DVDs, time for personnel to hold meetings, electricity, and cleaning services for the office space. For your budget, you do not need to include more complex allocations such as employee salaries, fringe benefits, overhead, phones, etc. Also, you should assume you have some in-kind support to use in your project. In-kind support is any resource you do not have to pay for such as free printing of educational brochures or free telephone services. In addition to your budget, you create a basic Gantt or PERT chart to present your timeline.

To Prepare for this Assignment:

• Review Chapter 13 in the McKenzie et al. text. Pay particular attention to how to create a budget and allocate funds.
• Given the $200,000 you received for your public health program, create a one-year budget.
• Refer to Figure 10.2 on p. 283 of the McKenzie et al. text to view a sample budget sheet.
• Think about potential in-kind support/assets that may influence your budget.
• Review Chapter 12 in the McKenzie et al. text, and see the sample timeline and Gantt charts on pages 325–326. In addition, you may wish to use the Internet to research how to create a Gantt or PERT chart. Microsoft Excel also has some resources available that you can search. Consider what would be an adequate yet basic timeline to execute the program plan you have developed. Think about the tasks and activities that should be included in a basic timeline for your program plan.

The Assignment : Final Course Project Submission (8 – 12 pages total, not including cover page or references)

• Begin with an Executive Summary of your whole project and a Conclusion statement (3 – 4 paragraphs)
• Collate the components from Weeks 2, 3 and 4 with corrections to items noted by the Instructor.
• In addition, add a final 2- to 3- page section on budget and timeline that includes responses to the following prompts:
  • Using the sample budget sheet on page 283 of the text, create a budget allocating $200,000 for your public health program. Include at least one in-kind support/asset in your budget.
  • Provide a rationale for your allocation of funds.
  • Develop a basic timeline using a Gantt or PERT chart. Note: Microsoft Excel provides templates that you can use.
  • Provide a rationale for the basic timeline for your program plan.

Note: To ensure that you are meeting all of the requirements for the Course Project, be sure to review the Course Project Instructions located in the Learning Resources.

Your written Assignments must follow APA guidelines. Be sure to support your work with specific citations from this week’s Learning Resources and additional scholarly sources as appropriate.

All Questions should have 2-apa format references beneath each answer. All answers should be more than 250 words and numbered accordingly

1  What role does health communication have in public health? Provide an example of how health communication is applied in public health and the impact it has had. Describe the key features and characteristics of health communication and comment on which you think are the most important and why.

2  Select a public health problem or health issue and describe communication channels, vehicles, and platforms used to deliver messages related to that problem or issue. What are the limitations of health communication with regard to this problem or health issue?

3  Compare and contrast two different theories described in your textbook reading for this topic. Highlight the key elements, strengths, and limitations of each theory, and provide an example of how each theory has been applied in practice.

4  Why is an understanding of health beliefs, culture, and cultural values relevant in the context of health communication? Describe ways in which health communication messages can potentially be at odds with cultural or spiritual values or health beliefs. Provide an example of a health communication message that illustrates culturally competent communication. How did this message address cultural values or health beliefs for the intended audience?

5  How is health literacy defined according to Healthy People 2030, and how does it differ from previous definitions of health literacy? Describe why health literacy is a critical public health issue.

6  Describe the factors that can contribute to low health literacy and the impact of low health literacy on health outcomes. Give an example of what public health professionals can do to improve individual and organizational health literacy.

7  Describe an example from the research literature of an effective health communication program using mass media. What were the key outcomes of this program? What factors and features made it successful?

8  During Diabetes Awareness Month, you are pitching a local online magazine with a story aimed at raising awareness of the importance of getting an A1C test for the prevention and management of diabetes. Describe the elements, viewpoints, and key health message you would include in your story to attract the reporter’s attention and increase the likelihood of media coverage. Provide a rationale for your approach.

9  Describe the key elements of an effective health communication plan. Why is planning so important? Provide examples of how public health professionals can apply ethical considerations in the planning process.

10  Compare the core communication strategies of engage, inform, and persuade. Provide an example of each strategy for the health issue and each audience you identified in your “Health Communication Plan Part 1” assignment. Provide a rationale for why your selected strategies are appropriate.

11 In previous courses, you have discussed the application and interpretation of data, as well as overarching components of public health, such as epidemiology and environmental health. Describe some of the challenges faced by public health professionals with regard to communicating scientific data and information to the public, policy makers, and news media. What is the public health professional’s ethical responsibility when communicating this information to the public?

12  What is source credibility, and why does it matter so much in public health? Identify at least three credible sources of health and scientific information.  What are some ways in which public health professionals can combat misinformation or misleading information about health? How will you apply the lessons from this course into serving as a trusted source of accurate, relevant public health information?

13  What are the differences between emergency risk communication and routine health communication? Review the recommendations for communicating during an emergency described in your textbook and describe which two recommendations would be the most challenging to apply.

14  Identify a case study from the textbook or research literature on a recent disease outbreak or humanitarian disaster. Describe how the concepts of emergency risk communication discussed in your textbook were applied in this case study. In your opinion, what are the most important ethical factors to consider when communicating during a public health emergency or crisis?

15  Identify an example of a health communication message that was directed to a vulnerable or underserved group in your community. Discuss whether the message was appropriate and whether the communication channel was culturally appropriate for the intended audience. What suggestions would you make for improvement?

16  What role does health communication play in community engagement and community mobilization? Describe the role of trust and factors related to trust that public health professionals must consider when communicating with the community.