MN505 M1-1 Interpret Epidemiologic Data on Morbidity and Mortality Related to Acute and Chronic Dis

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*If work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision without being scored. If the work submitted does not meet the minimum submission requirements by the end of the term you will receive a failing score.

MN505M1-1 Individual Screening Example Solution Paper

Preventive healthcare is integral in preventing mortality and morbidity. Preventing health interventions range from primary to tertiary interventions. Health screening is essential as a preventative measure and also a diagnostic measure. Healthcare providers should assess patient needs to determine the best screening interventions for them. This essay evaluates a condition, the best screening intervention, and the supporting literature for the intervention.

Condition and Screening

The condition of interest is breast cancer. The choice screening is Cervical Cancer screening for women aged 21-65. Cervical cancer is the hyperproliferation of cervical epithelial cells. The type (name) and severity of cervix cancer depend on the affected cells and their location. Cervical cancers are named after the cells involved, and the major type of cervical cancer is squamous cell carcinoma. The choice screening is Cervical cancer screening: women aged 21 to 65. The risk for cervical cancer increases with age and other factors. USPSTF recommends screening for cervical cancer every three years with cervical cytology alone in women aged 21 to 29. For women aged 30 to 65 years, the USPSTF recommends screening every three years with cervical cytology alone, every five years with high-risk human papillomavirus (hrHPV) testing alone, or every five years with hrHPV testing in combination with cytology (co-testing) (Fontham et al., 2020).

Epidemiology of Condition

Cervical cancers are the fourth most diagnosed/common cancer and the fourth leading cause of death. The five-year survival rate for cervical cancer differs in age, ethnicity, and race, with an average of 66%: 71% in white women and 58% in black women (Islami et al., 2019). In 2018, Cervical cancer was the leading cause of cancer death for women. However, the increase in diagnostic and preventive measures has greatly improved prognosis over the last 40 years, reducing mortality and morbidity. Around 600 000 cases and 300000 deaths are reported each year (Islami et al., 2019). Cervical cancer management entails surgical procedures, chemotherapy, and radiotherapy, emphasizing retention of reproductive system integrity. Cervical surgery and hysterectomy in metastatic cancer lead to loss of fertility and pelvic integrity. Thus, cervical cancer leads to mortalities and morbidity in a majority of the surviving population.

Methodology

Cervical cancer screening among women between 21-65 is integral. The growth of reproductive system cells is under hormonal influence. The guideline addresses two risk factors which are sexual activity and hormonal regulations (Fontham et al., 2019). AS mentioned earlier, cell division and growth in the reproductive organs are dependent on hormonal levels. Hormonal imbalance may lead to hyperproliferation of cells creating cell abnormalities, hence cancer development. Infection of the cervix is prevalent in sexually active women because the human papillomavirus has to access the cervix to cause an infection (Kim et al., 2018). The risk is higher in women with higher parities hence the need for additional tests- cytology for women aged 30 to 65 years (Bookswofie et al., 2020). Hormonal regulation is absent or markedly decreased in women. Cytology studies study abnormal cells and diagnose them based on cell characteristics. Unlike other cancers, cervical cancer majorly involves squamous cells. A high vaginal swab collects cells for cytology from women in the mentioned age category. Testing for human papillomavirus is vital because HPV is the leading cause of infective cervical cancer; it causes over 99% of cervical cancers (Swiecki?Sikora et al., 2019).

Guideline

The USPSTF recommended intervention in cervical cancer screening has three options: hrHPV, cytology, and co-testing. It recommends every three years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every three years with cervical cytology alone, every five years with high-risk human papillomavirus (hrHPV) testing alone, or every five years with hrHPV testing in combination with cytology (co-testing). Sexually active women are given more priority in this testing. HPV causes over 99% of all cervical cancers. The American Cancer Society updated the cervical cancer screening tests and recommended preliminary hrHPV testing as the preferred screening option for average-risk women aged between 25 and 65 years in 2020 (Fontham et al., 2020). It also recommends the rise of HPV tests to begin at age 25.

Critical Analysis

The hrHPV tests are preferred to diagnose cervical cancer but are associated with low specificity (hence a high number of false positives) and colposcopy (Bedell et al., 2020). Cytology alone has low sensitivity in detecting high-grade cervical intraepithelial neoplasia. According to Fontahm et al. (2020), hrHPV and cytology tests are recommended for women at higher risks for cervical cancer aged 25 to 65 years. ACS also recommends phasing out cytology testing due to their widespread shortfalls. The acceptability and application of hrHPV tests are limited by the small number of FDA-approved tests (there are only two FDA-approved tests apparently) and their costs. According to Guo et al. (2018), national rates of HPV vaccines have been increasing gradually, hence a gradual decrease in HPV infections and the corresponding cervical cancer rates. However, Swiecki?Sikora et al. (2019) state that the vaccination rates in the country fall way below the national targets. The vaccination coverage and vaccination resistance in the nation are high. Raising the age would place the vulnerable populations without HPV vaccine at risk for developing cervical cancer unnoticed. Thus, that consideration can be made after achieving national HPV vaccination targets. Despite expanding cervical cancer screening options, cervical cytology, hrHPV, and co-testing effectively diagnose precancer and cancerous lesions (Rerucha et al., 2018). Fontham et al. (2020) emphasize that the specific strategy is less important than the overall adherence to testing. Healthcare providers should stress the importance of adherence to cervical screening.

Summary

The screening guideline discussed above helps detect cervical cancer early, thus providing room for treatment. Women of reproductive age and post-menopausal women are the populations of interest due to the risk exposure. Cytology, hrHPV, and co-testing are the available cancer screening methods. These screenings also give room for health education to the clients. As seen above, adherence to these screening tests is more important than deciding on the test of choice because they are all effective. Preventing cancer development is integral to reduce the associated mortalities and morbidity.

References

Bedell, S. L., Goldstein, L. S., Goldstein, A. R., & Goldstein, A. T. (2020). Cervical cancer screening: past, present, and future. Sexual Medicine Reviews, 8(1), 28-37. https://doi.org/10.1016/j.sxmr.2019.09.005

Buskwofie, A., David-West, G., & Clare, C. A. (2020). A review of cervical cancer: incidence and disparities. Journal of the National Medical Association, 112(2), 229-232. https://doi.org/10.1016/j.jnma.2020.03.002

Fontham, E. T., Wolf, A. M., Church, T. R., Etzioni, R., Flowers, C. R., Herzig, A., Etzioni, R., Flowers, c. r., Herzig, A., Guerra, C. E., Oeffinger, K. C., Shih, T. C., Walter, L. C., Kim J. J., Andrews, K. S., DeSantis, E. C., Fedewa, S. A., Manassaram-Baptiste, D., Saslow, D., and & Smith, R. A. (2020). Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA: A Cancer Journal For Clinicians, 70(5), 321-346. https://doi.org/10.3322/caac.21628

Guo, F., Cofie, L. E., & Berenson, A. B. (2018). Cervical cancer incidence in young US females after human papillomavirus vaccine introduction. American journal of Preventive Medicine, 55(2), 197-204. https://doi.org/10.1016/j.amepre.2018.03.013

Islami, F., Fedewa, S. A., & Jemal, A. (2019). Trends in cervical cancer incidence rates by age, race/ethnicity, histological subtype, and stage at diagnosis in the United States. Preventive Medicine, 123, 316-323. https://doi.org/10.1016/j.ypmed.2019.04.010

Kim, J. J., Burger, E. A., Regan, C., & Sy, S. (2018). Screening for cervical cancer in primary care: a decision analysis for the US Preventive Services Task Force. JAMA, 320(7), 706-714. https://doi.org/10.1001/jama.2017.19872

Rerucha, C. M., Caro, R., & Wheeler, V. (2018). Cervical cancer screening. American Family Physician, 97(7), 441-448. https://www.aafp.org/afp/2018/0401/p441.html

Swiecki?Sikora, A. L., Henry, K. A., & Kepka, D. (2019). HPV vaccination coverage among US teens across the rural?urban continuum. The Journal of Rural Health, 35(4), 506-517. https://doi.org/10.1111/jrh.12353

MN505M2-2: Apply a theory or model of health-related concepts to a community intervention.

Community Needs and Health Screening Initiative

Directions

For this assignment, you will pick one recommended screening from United States Preventive Task Force A and B Recommendations. 

An initiative is a project, an event, so something in the community is ideal. Workplace location for employees is fine too. Please include the following suggested level one headings so content is clear and easily identified.

Theory or Conceptual Model

• Identify a health promotion program theory or conceptual model and describe.
• Explain how the model or theory applies to the initiative is present.

Population Screening Purpose

• Identify the screening topic as an A or B preventive screening from the USPSTF.
• Include two components of topic related community statistics numerically (e.g., mortality, prevalence).
• Describe target population characteristics.
• Include age and sex or risk factor and matches the guidelines.
• Clarify the county and or neighborhood of the population.
• Provide descriptions on the local population to be screened, including three components: number of persons in the county possibly affected based on sex, age, and racial diversity of the county or state.
• Include current rates of screening or factors that would impact the need for screening.

Location/ Setting

• Demonstrate details of the community or workplace event, including three components: type of area or building, time, and day (e.g., Monroe County Senior Center at 9 a.m. to 11 a.m. 4/20/21).
• Include reasoning and explanation of appropriateness.

Screening Activity

Screening activity plan meets the preventive guidelines process, is descriptive, and includes:

• Education component description
• Measures tested
• Shows evidence the tests are aligned with guideline recommendations
• Demonstrates possible positive measure/ normal and abnormal ranges
• Follow up and referral content process included
• Three clear and measurable outcome goals are included
• Explanation of how each outcome is affected by the activity

Cost

Detailed cost analysis to perform screening is provided in table form includes the six following line items but not limited to a table containing:

• Testing instrument costs with source for pricing
• Staff costs- as appropriate for screening
• Rental cost- estimate
• Simple supply costs
• Any attendee cost
• Total

(May use volunteer staff but not donations of items. Cost analysis for feasibility needs demonstrated.) Cost analysis total and summary statement should be included.

Summary

Provide a summary of your screening, general benefit to the community, and why it is important. A person should be able to read your paper and understand fully what you are screening, where, when, the costs, and how it is supported in the guideline. Ideally, a person would be able to duplicate your screening initiative based on the clarity you present.

Format expectations:

• Follows all assignment directions.
• Introduction and conclusion are included.
• Information in paragraphs and paper organized to convey the content to the reader.
• Paper length paper should be 3–4 pages of content.
• Follows APA in paper format, reference page, in-text citations, or headings.
• Uses four or more credible peer-reviewed sources.

Master’s-prepared nurse educators, leaders, nurse practitioners, and all specialty nursing fields are contributors to health promotion in populations across the life span. This assignment is focused on preventive screening applications in the community, workplace, or school settings. You should be able to apply this knowledge to their specialty focus related to health promotion and epidemiology.

Minimum Submission Requirements

• This assessment should be a Microsoft Word 3–4 pages of content in document, in addition to the title and reference pages.
• Respond to the questions in a thorough manner, providing specific examples of concepts, topics, definitions, and other elements asked for in the questions. Your submission should be highly organized, logical, and focused.
• Your submission should provide a clearly established and sustained viewpoint and purpose.
• Your writing should be well ordered, logical, and unified, as well as original and insightful.
• Your submission must be written in Standard English and demonstrate exceptional content, organization, style, and grammar and mechanics.
• A separate page at the end of your submission should contain a list of references in APA format. Use your textbook, the Library, and the internet for research.
• Be sure to include references for all sources and to cite them using in-text citations where appropriate. Your sources and content should follow current APA citation style. Review the writing resources for APA formatting and citation found in Academic Tools. Additional writing resources can be found within the Academic Success Center.
• Your submission should:
  • include a title page;
  • be double-spaced;
  • be typed in Times New Roman, 12 -point font; and
  • be free of spelling or punctuation errors.

Competency Assessment Rubric

All competency criteria must be met to earn a B grade and pass this Course Outcome.

A predefined number of mastery criteria must be met to earn an A grade, indicating mastery of the Course Outcome. See the CLA and Grade Criteria Chart below.