NR717 Week 1 ErnestYoung Leading Culturally and Linguistically Appropriate Healthcare Discussion Exa

NR717 Week 1 ErnestYoung Leading Culturally and Linguistically Appropriate Healthcare Discussion Example Answer Provided

Purpose

This week you discovered that the focus of healthcare has a growing emphasis on population health. This includes an emphasis on quality improvement and tracking outcomes. The purpose of this discussion is to apply the key concepts in population health to a selected population.

Instructions

Select a population you would like to engage throughout the course to explore important population health and health policy concepts. Potential populations to consider are listed below. You may want to refer to the Global Burden of Disease or one of the eight National Practice Problems to identify the population you will be examining in this course. You may examine the same health issue you have been researching in the previous courses, or you may select another topic of interest to complete the assignments unique to this course.

Address the following as they relate to the population you have selected:

Create a culturagram for your selected population. Refer to the lesson for guidance in creating a culturagram. You may use the attached template if you desire.

Culturagram Template https://cdn.brandfolder.io/74235FBJ/as/b6c6fmq87k3zmkg8wrgfgqk/NR717_W1_Discussion_CulturagramTemplate.docx

Identify three key social determinant risk factors associated with the population.

Conduct a search of the literature. Identify one evidence-based intervention to reduce health disparities in your selected population.

Examine how the selected intervention addresses at least one of the standards from the Culturally and Linguistically Appropriate Standards (CLAS).

Potential Populations

Asian population in Torrance, California

Somali-Americans in Minneapolis, Minnesota

African American population in Jackson, Mississippi

Hopi Indians in Kykotsmovi Village, Arizona

Caucasian population in Martin County, Kentucky

Hispanic/Latino population in Hialeah, Florida

Note: You may consider a different population as long as there is an abundance of literature related to social determinant risk factors and statistical data (prevalence, incidence, and economic ramifications) available for the selected health issue so that you can complete the required assignments each week.

Program Competencies

This discussion enables the student to meet the following program competencies:

Translates a synthesis of research and population data to support preventative care and improve the nation’s health. (PO 1)

Leads others in professional identity, advanced clinical judgment, systems thinking, resilience, and accountability in selecting, implementing, and evaluating clinical care. (PO 1)

Course Outcomes

This discussion enables the student to meet the following course outcomes:

Assimilate epidemiology principles and interventions to impact the social determinants of health, Global Burden of Disease, and population health outcomes. (PCs 7, 8; PO 1)

Formulate strategies for providing culturally relevant and high-quality healthcare to vulnerable and high-risk populations to address social injustice and health inequities. (PCs 7, 8; PO 1)

NR717 ErnestYoung Leading Culturally and Linguistically Appropriate Healthcare Discussion Example Solution

Identify three key social determinant risk factors associated with the population.

Social determinants of health play a significant part in an individual’s health outcomes (Kim et al., 2020). Blacks in Mississippi comprise 37 percent of the population and are responsible for the highest mortality rates of heart disease, hypertension, stroke, diabetes, and cancer (Mississippi State Department of Health, n.d.) In this discussion, I have reviewed three key social determinant risk factors associated with the black population in Jackson, Mississippi. The top three are poor economic stability, lack of education, and limited access to healthcare resources. These factors are complex and have overlapping with significant implications to this population’s health.  

Economic stability is the most influential of the three, influencing many other social determinants. Economic factors, including employment, income, community safety, and social support, affect how well this population can live and thrive. The economic climate determines a person’s ability to make healthy choices, afford housing and medical care, and become educated (Kim et al., 2020).

Education is an essential factor in a person’s overall health risks. Research shows a significant increase in poverty rates among people 25 years and older who have not completed a high school education (Smegma et al., 2018). Education influences employment opportunities, income level, and ability to afford health insurance (Gottlieb et al., 2019).

Health care is essential to the health of all Americans. Mississippi is one of the 12 states that has not expanded Medicaid under the Affordable Care Act. If Medicaid were expanded, the federal government would cover 90% of healthcare costs, and the state would cover the additional 10% (Mississippi Today, 2022). This would allow for increased healthcare access in Jackson and the rest of the state.

Conduct a search of the literature. Identify one evidence-based intervention to reduce health disparities in your selected population.

Cervical cancer rates among women in Mississippi are among the highest in the country. The Centers for Disease Control reported that women in Mississippi develop cervical cancer at a rate of 9.3 for every 100,000, compared to 6.8 per 100,000 for those women in California (2019). Not only are cervical cancer rates higher in Mississippi, but mortality rates from this preventable disease are also high compared to other states. In Mississippi alone, cervical cancer deaths are 3.9 per 100,000, the fourth highest in the country (CDC, 2019).

As discussed above, the risk factors related to the social determinants of health in Jackson, Mississippi, play a significant role in these staggering statistics. Lack of education can influence a person’s ability to gain employment and therefore have inadequate access to health insurance. Furthermore, a lack of economic stability can lead to insufficient healthcare resources within a community and a lack of transportation to healthcare clinics to receive care.

In my literature search, I have identified an evidence-based intervention to decrease the rates of cervical cancer-related deaths by increasing cervical cancer screening and surveillance. The proposed intervention is to mail human papillomavirus (HPV) test kits to women’s homes in Jackson, to improve the uptake of cervical cancer screening based on a study by Winer et al. (2019). This will eliminate the need to women to travel to receive GYN services, pay costly co-payments for an in-person appointment, and reduce the need to take time off work to attend an office visit to receive their cervical cancer screening.

Examine how the selected intervention addresses at least one of the standards from the Culturally and Linguistically Appropriate Standards (CLAS).

My selected intervention meets the Culturally and Linguistically Appropriate Standards (CLAS) by addressing the principal standard of, “providing effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs (HHS, n.d).” This low-risk intervention meets the needs of the black, female community in Jackson while working within the current infrastructure.

It improves women’s healthcare access while being sensitive to the effects of previous trauma and discrimination this population has experienced in the healthcare community. The mailed kits can also be a means to provide additional education and knowledge around cervical cancer prevention and screening in the comfort of the home so the woman can feel empowered to learn more.

NR717 Week 1 ErnestYoung Leading Culturally and Linguistically Appropriate Healthcare Discussion References

Bleich, S., Findling, M., Casey, L., (2019). Discrimination in the United States: Experiences of black Americans. Health Services Research. 54: 1399– 1408. https://doi.org/10.1111/1475-6773.13220

Center for Disease Control and Prevention. (2019). Cancer Statistics at a Glance. https://gis.cdc.gov/Cancer/USCS/#/AtAGlance/ 

Gottlieb, L., Fichtenberg, C., Alderwick, H., & Adler, N. (2019). Social determinants of health: What’s a healthcare system to do? Journal of Healthcare Management, 64(4), 243–257. https://doi.org/10.1097/JHM-D-18-00160

Kim, E., Abrahams, S., Uwemedimo, O., & Conigliaro, J. (2020). Prevalence of social determinants of health and associations of social needs among United States adults, 2011–2014. Journal of General Internal Medicine?: JGIM, 35(5), 1608–1609. https://doi.org/10.1007/s11606-019-05362-3

Mississippi State Department of Health. (n.d.). Health Equity. https://msdh.ms.gov/page/44,0,236.html

Royals, K. (2022, March 9). It makes it hard to work: the real cost of not expanding medicaid in Mississippi. Mississippi Today, https://mississippitoday.org/2022/03/09/mississippi-medicaid-expansion-cost-work/

Semega J., Kollar M., Creamer J., Mohant A. (2018). Income and poverty in the United States. https://www.census.gov/content/dam/Census/library/publications/2019/demo/p60-266.pd

U.S. Department of Health and Human Services. (n.d.). National culturally and linguistically appropriate services standards. https://thinkculturalhealth.hhs.gov/clas/standards

Winer, R., Lin, J., Tiro, J. A., Miglioretti, D. L., Beatty, T., Gao, H., Kimbel, K., Thayer, C., & Buist, D. S. M. (2019). Effect of mailed human papillomavirus test kits vs usual care reminders on cervical cancer screening uptake, precancer detection, and treatment: A randomized clinical trial. JAMA Network Open, 2(11), e1914729–e1914729. https://doi.org/10.1001/jamanetworkopen.2019.14729

NR717 Week 2: Epidemiology and Health Surveillance Discussion

Purpose

This discussion aims to apply concepts in epidemiology and health surveillance to a selected population.

Instructions

Explore the determinants of health and the National Practice Problems that most affect the population you selected in Week 1. Review the following index to locate an epidemiological report published by the Centers for Disease Control and Prevention (CDC).

• CDC A-Z Index https://www.cdc.gov/az/a.html

This report contains data on specific diseases as reported by state and regional health departments, as well as recommendations that have been issued by the CDC.

Use the index to review the most significant issue pertaining to your selected population and one of the eight National Practice Problems to address the following:

1. Explore the epidemiologic principles and measures used to address your selected practice problem at the national and specific geographic (city or county level) location for the population you have selected. 
2. Examine the use of descriptive and/or analytic epidemiology to address the practice problem.
3. Propose how you might use surveillance to influence the determinants of health and improve the health outcomes of your population.
4. Anticipate any ethical concerns that you might have related to the use of surveillance data in your population.

Program Competencies

This discussion enables the student to meet the following program competencies:

1. Analyzes health care policies to advocate for equitable health care and social justice to all populations and those at risk due to social determinants of health. (POs 2, 9)
2. Translates a synthesis of research and population data to support preventative care and improve the nation’s health. (PO 1)
3. Leads others in professional identity, advanced clinical judgment, systems thinking, resilience, and accountability in selecting, implementing, and evaluating clinical care. (PO 1)

Course Outcomes?

This discussion enables the student to meet the following course outcomes:

1. Synthesize ethical and legal principles to advocate for value-based, equitable, and ethical health policies at the micro, meso, and macrosystem levels. (PC 5; PO 9)
2. Assimilate epidemiology principles and interventions to impact the social determinants of health, Global Burden of Disease, and population health outcomes. (PCs 7, 8; PO 1)

NR717 Week 3: Prevention, Interventions, and Population Health Programs

Population Health Interventions Discussion

Purpose

The purpose of this discussion is to demonstrate your understanding of interventions to address population health problems?and reduce health disparities.

Instructions

Using your selected population, continue your search and appraisal of evidence by analyzing one research study that offers a potential intervention to address your selected population health issue. This intervention must be at the population level. This research study must be new, one that was not used in a previous course.  

Appraise a quantitative research study that utilizes an intervention to address the selected health issue identified in Week 2 using the Johns Hopkins Research Appraisal Tool.  

• Johns Hopkins Research Appraisal Too https://cdn.brandfolder.io/74235FBJ/as/6f2mgbk5h7bpfnk85t6pgwm/Johns_Hopkins_Research_Appraisal_Tool.docx
• Transfer your findings to the Johns Hopkins Individual Evidence Summary Tool. 

Johns Hopkins Individual Evidence Summary Tool https://cdn.brandfolder.io/74235FBJ/as/n32gvzkm765pvb7b5cjp5m5s/Johns_Hopkins_Individual_Evidence_Summary_Tool.docx

Analyze the evidence summary tool of the research study to address the following in the discussion:    

1. Determine whether the intervention has the potential to impact the issue. Explain your rationale.??
2. Attach the completed Johns Hopkins Individual Evidence Summary Tool.
3. Present the translation science model that would best aid the success of this intervention and discuss how the stakeholders are integrated into the design of the theory or model.   
4. Identify where your selected intervention is located on the Minnesota Public Health Wheel.

Program Competencies

This discussion enables the student to meet the following program competencies:

1. Translates a synthesis of research and population data to support preventative care and improve the nation’s health. (PO 1)
2. Leads others in professional identity, advanced clinical judgment, systems thinking, resilience, and accountability in selecting, implementing, and evaluating clinical care. (PO 1)

Course Outcomes

This discussion enables the student to meet the following course outcomes:

1. Assimilate epidemiology principles and interventions to impact the social determinants of health, Global Burden of Disease, and population health outcomes. (PCs 7, 8; PO 1) 
2. Formulate strategies for providing culturally relevant and high-quality healthcare to vulnerable and high-risk populations to address social injustice and health inequities. (PCs 7, 8; PO 1) 

NR 717 Week 3 Population Health Interventions Discussion Example Answer

Intervention Impact

Over the past couple of weeks, I have focused on obesity and increasing physical activity within the African American population in Jackson, MS. Compared to Caucasians, African Americans experience much higher incidences of metabolic disorders and cardiovascular disorders.

I have covered several risk factors in my previous posts; however, through my research, I found an article by Nam et al. (2021) that provided insight into a risk factor that I had not considered before. This study examined how perceived racial discrimination in African Americans contributes to poor health, obesity, decreased physical activity, and health disparities.

While several factors influence health disparities, African Americans report perceived racial discrimination more than any other ethnic or racial group. The pilot study used an intensive, observational, case-crossover design of African Americans (n=12) recruited from the community (Nam et al., 2021).

The inclusion conditions were that all participants self-reported as African American/Black, English speaking, employed, were between the ages of thirty and fifty-five, owned a smartphone, and were able to reply at a minimum of three times daily to random survey prompts (Nam et al., 2021). Those who were pregnant or afflicted with serious acute or terminal medical illnesses were excluded from the study as this would interfere with physical activity (Nam et al., 2021).

Forty percent of the participants were obese. The twelve participants were asked to complete baseline surveys and over the course of the next seven days, they were instructed to wear accelerometers. Accelerometers are devices that capture and measure the participants’ physical activity levels. The participants also received Ecological Momentary Assessments five times daily over the next seven days.

The goal was to capture and assess racial discrimination in real time each day. In the analysis of within-person level data, the accelerometer observed that the participants were more sedentary on the days when they experienced more perceived discrimination than usual.

As with many studies, this one came with limitations. The small sample size offered limited evidence to support whether or not racial discrimination is a precursor to decreased physical activity or other sedentary behaviors when compared with other studies of general psychological stress (Nam et al., 2021). Future studies should consider more extensive racial discrimination approaches, a larger participant sample, and ecological momentum assessments to decide their ideal frequency to capture discriminatory encounters accurately and survey their relationship with health behaviors (Nam et al., 2021).

Despite the mixed findings, safety, walkability, and crime in neighborhood environments are all associated with a person’s physical activity levels. Location is everything and where African Americans live is absolutely crucial for their quality of life. The fact that many neighborhoods are still very much segregated, with African Americans often residing in poorly funded communities, perplexes me. Social stresses such as discrimination may provoke unhealthy behaviors and are linked to the consumption of smoking, alcohol, and fatty food consumption.

As obesity among African Americans can occur for a variety of reasons, it is crucial to properly assess patients in order to get to the root of their problems. Questions we may wonder as healthcare professionals are: What does your diet consist of? What do you typically consume in a day? What medications are you taking? Have you ever had issues with your thyroid? Are you employed? What is your family history?

Are you able to purchase healthy food options? How many days per week are you able to exercise for thirty minutes or more? Once the causative factors are identified, implementing an intervention will make it easier. If their obesity is linked to an organic cause, treat the disease. If finances are an issue, refer them to those who will be able to assist.

My intervention absolutely has the potential to impact my practice problem. The intervention I will be addressing is making the neighborhood safer, which will increase the likelihood that people in the community will become more physically active. At the population level, a strategy to design changes within the community may need to be implemented. In overweight children, school-based physical education can be enhanced.

Free suggestions to patients would be to become more active by avoiding elevators and taking stairs instead. Parking their cars further from their destination will encourage them to walk further. Participating in sports or other physically challenging activities, such as skating or even walking through malls, can be safe alternatives to walking outside. New walking trails can be created to increase availability, or a heavier police presence can be made at existing ones.

Creating walking groups can be beneficial as there is usually more safety in numbers. Offering more free gym memberships to those in need within the community can also be beneficial. I am pretty sure that the Young Men’s Christian Association/Young Women’s Christian Association (YMCA/YWCA) already offers free memberships to low-income individuals and families. Providing equitable and inclusive access is foundational to my practice problem (Centers for Disease Control and Prevention, 2019).

Translation Science Model

Translation science is defined as an area of research that constantly advances translation models that work in the unpredictable reality of daily practice. It is essential to be able to influence practice problems by having the capability to translate research evidence into day-to-day clinical practice. The probability of effective evidence implementation into practice increases when using a systematic conceptual model/framework approach.

The translation science models are a diffusion of Innovation, Knowledge-to-Action (KTA), Normalization Process Theory (NPT), and I-PARIHS model. It was difficult for me to choose between the I-PARIHS model and Knowledge-to-Action. However, I ultimately felt that Knowledge-to-Action would best aid in the success of my intervention’s implementation into practice. Knowledge-To Action is appropriate for the sustainability approach.

Knowledge-to-Action concentrates on bridging gaps between what is known versus what is implemented into practice (Kim et al., 2021). The Knowledge-to-Action Framework comprises two parts: The Knowledge Cycle and the Action Cycle (Field et al., 2014). The Knowledge Cycle and the Action Cycle encompass multiple phases. Each component involves several segments, which are sometimes repetitive or overlap one another. The Action Cycle exhibits activities necessary for data to be implemented in practice (Graham et al., 2006).

The action phase of the Knowledge-To Action model encompasses recognizing and assessing the problem and established research, identifying obstacles and achievements, planning, implementing, monitoring, analyzing, and making adjustments (Burd et al., 2020). The final stage of the Knowledge-To Action model is knowledge use sustainment. Regarding the knowledge phase, what is known is that obesity is a major problem for African Americans in Jackson, MS.

The action is devising a plan to help reduce obesity in my selected population. This will bridge the gap between what is known (obesity) versus what is implemented into practice. I would integrate the stakeholder into the model’s design by first deciding who the appropriate local-level stakeholder would be to propose my intervention. Networking with stakeholders, both informal and formal leaders, is crucial as a practicing scholar. This also establishes a collaborative relationship that is necessary to concentrate on a practice problem with the goal of translating the best obtainable evidence.

Stakeholders also possess a deep level of understanding and knowledge as it relates to practice priorities and available resources. Interprofessional Collaboration (IPC) is the practice where several professional groups work in unison and value the knowledge set and contributions one another brings to the team (White et al., 2021). This, in turn, positively impacts healthcare processes and delivery (White et al., 2021). Keeping a constant line of communication with local-level stakeholders is just as important as it is with national-level stakeholders.

Minnesota Public Health Wheel

Again, this was difficult to choose from as several of the Minnesota Public Health Wheel stages were applicable to my intervention. I feel the two most relevant are advocacy and policy development/enforcement. By collaborating with stakeholders, I am protecting and promoting the health of my chosen population as well as the overall community. I also feel that I am ready to put my concerns and interventions on the decision-makers’ radar at this stage.

References

Burd, C., Gruss, S., Albright, A., Zina, A., Schumacher, P., & Alley, D. (2020). Translating Knowledge into Action to Prevent Type 2 Diabetes: Medicare Expansion of the National Diabetes Prevention Program Lifestyle Intervention. The Milbank Quarterly, 98(1), 172–196. https://doi.org/10.1111/1468-0009.12443Links to an external site.

Centers for Disease Control and Prevention. (2019) Strategies to Increase Physical Activity. Retrieved on March 19, 2023. https://www.cdc.gov/physicalactivity/activepeoplehealthynation/strategies-to-increase-physical-activity/index.htmlLinks to an external site.

Field, B., Booth, A., Ilott, I., & Gerrish, K. (2014). Using the Knowledge to Action Framework in Practice: a citation analysis and systematic review. Implementation Science, 9(172). https://doi.org/10.1186/s13012-014-0172-2Links to an external site.

Graham, I. D., Logan, J., Harrison, M. B., Straus, S. E., Tetroe, J., Caswell, W., & Robinson, N. (2006). Lost in knowledge translation: Time for a map? The Journal of Continuing Education in Health Profession, 26(1). DOI: 10.1002/chp

Kim, E., Lee, M., Kim, E.-H., Kim, H. J., Koo, M., Cheong, I. Y., & Choi, H. (2021). Using knowledge translation to establish a model of hospital-based early supported community reintegration for stroke patients in South Korea. BMC Health Services Research, 21(1), 1359–1359. https://doi.org/10.1186/s12913-021-07400-5Links to an external site.

Minnesota Department of Health. (2019). Public health interventions: Applications for public health nursing practice (2nd ed.). https://www.health.state.mn.us/communities/practice/research/phncouncil/docs/PHInterventions.pdfLinks to an external site.

Nam, Jeon, S., Ash, G., Whittemore, R., & Vlahov, D. (2021). Racial Discrimination, Sedentary Time, and Physical Activity in African Americans: Quantitative Study Combining Ecological Momentary Assessment and Accelerometers. JMIR Formative Research, 5(6), e25687–e25687. https://doi.org/10.2196/25687Links to an external site.

White, K., Dudley-Brown, S., & Terhaar, M. (2021). Translation of evidence into nursing and health care (3rd ed.). Springer Publishing Company.

NR717 Week 4: Evaluation Processes in Population Health

Evaluation Processes in Population Health Discussion

Purpose

The purpose of this discussion is to evaluate strategies to address your selected population health practice problem to reduce health disparities.

Instructions

1. Compose a brief statement introducing the selected practice problem (to remind readers of your selected topic).
2. Summarize a related Healthy People 2030 Goal that applies to your selected population and health issue.

o Healthy People 2030 ?http://www.healthypeople.gov/

3. Propose one evidence-based intervention to address the Healthy People 2030 goal. You may use the same study from Week 3 if it aligns with the selected Healthy People 2030 goal, or you may select another evidence-based intervention after reviewing the literature.
4. Describe how you would determine if your evidence-based intervention was efficient, effective, and efficacious. Each of the 3 E’s must be addressed.

Program Competencies

This discussion enables the student to meet the following program competencies:

1. Analyzes health care policies to advocate for equitable health care and social justice to all populations and those at risk due to social determinants of health. (POs 2, 9)
2. Translates a synthesis of research and population data to support preventative care and improve the nation’s health. (PO 1)
3. Leads others in professional identity, advanced clinical judgment, systems thinking, resilience, and accountability in selecting, implementing, and evaluating clinical care. (PO 1)

Course Outcomes

This discussion enables the student to meet the following course outcomes:

1. Synthesize ethical and legal principles to advocate for value-based, equitable, and ethical health policies at the micro, meso, and macrosystem levels. (PC 5; PO 9)
2. Formulate strategies for providing culturally relevant and high-quality healthcare to vulnerable and high-risk populations to address social injustice and health inequities. (PCs 7, 8; PO 1)

NR717 Week 4 FEMA Emergency Management Course Assignment

Purpose

The purpose of this assignment is to introduce you to the Federal Emergency Management Agency’s (FEMA) basic incident command system.

Instructions

1. Complete the following FEMA Emergency Management Institute course which should take about 4 hours to complete:

o IS-200.C: Basic Incident Command System for Initial Response https://training.fema.gov/is/courseoverview.aspx?code=IS-200.c

o There are several different courses (i.e.,100, 200, and 700). You are only required to complete the IS200 course.

2. Download and save the Certificate of Completion with a file name: Last NameFirst Name_ISCOURSENUMBER Certificate Completion (ex. StudentSally_IS200 Certificate Completion).
3. Submit the certificate of completion in pdf format to the assignment folder.
4. This assignment is pass/fail. You will receive 150 points after successfully passing the IS-200 course and uploading your certificate of completion in the course assignment folder.

Program Competencies

This assignment enables the student to meet the following program competencies:

1. Translates a synthesis of research and population data to support preventative care and improve the nation’s health. (PO 1)
2. Leads others in professional identity, advanced clinical judgment, systems thinking, resilience, and accountability in selecting, implementing, and evaluating clinical care. (PO 1)

Course Outcomes

This assignment enables the student to meet the following course outcomes:

1. Analyze the role of advance nurs

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