Assignment 5 Application of Theory to Practice, Presentation of Proposal

Sample Answer

Identification of the Community

African Americans form a significant proportion of population in Maryland and the US as a whole. It is estimated that 60% of the population in America is obese. Population estimates reveal that about 29.4% of the population in Maryland comprise of the African Americans. There is a high prevalence of obesity in African Americans living in Maryland. For example, it is estimated that 38.1% of the African Americans who are living in Maryland are obese.

Furthermore, 33.6% of the African American adolescents are obese, making the state ranked 13th leading in obesity among the adolescents. The risk o obesity among African American people is high when compared to other ethnicities. This is attributed to a number of factors that include biological, behavioral, individual, community, and political factors. Biological factors include being born to a mother with gestational diabetes, ethnicity, breast feeding and birth weight.

Behavioral factors include dietary intake, physical activity, screen time, and duration of sleeping hours. Individual factors include food preferences, knowledge about food, and addictive behaviors such as eating disorders. Family factors include eating practices and family income. Lastly, community factors include built environment and food availability (Vedovato et al., 2016).

Health Resources and Environmental Conditions

The prevention of the high prevalence of obesity among African American populations is dependent on the availability and use of the existing community resources. These resources include health institutions that offer care to patients with risk of or having obesity. Health institutions can act as source of information concerning the healthy behaviors that these communities can adopt for their health and wellbeing.

The other health resource that is available in the Hyattsville in Maryland include community support groups for those with obesity and its related complications. Those at risk of affected by obesity and its complications can gain the support that they need for effective management of their condition. There is however the challenge of the existence of significant disparities in access to healthcare by African American adults with diabetes in Hyattsville.

This is attributed to significant disparities in the household income that limits the affordability of the available health services. There is also low insurance coverage among the African American populations in the region, which translate into low utilization of the existing healthcare services by them. As shown earlier, environmental factors also contribute to the high prevalence of obesity among adult patients from African American origin.

The environmental factors include the difficulty in accessing health foods and living in built environments where stereotypes is prevalent. Therefore, most of the African American adults end up making unhealthy decisions on the diets they consume, increasing their risk of obesity among them (Vedovato et al., 2016).

Description of the Agency

The agency that was visited for this project is Joslin Center Care that is located in Hyattsville in Maryland. The agency provides its populations with a wide range of services. Most of the services aim at promoting the health and wellbeing of the population. They include screening, health education, diagnosis, treatment, and referral of cases. The agency works closely with community health workers to monitor disease incidences and the needs of the surrounding communities.

It was identified during the agency visit that the most prevalent health issues that is affecting the performance of the agency were obesity and lifestyle problems among the adults from African American backgrounds. Therefore, it increased the need for the adoption of interventions that focus on ensuring that healthy lifestyles is promoted in this population to decrease the prevalence of obesity and its associated complications.

Agency Purpose and Funding

As shown earlier, the purpose of the agency is to provide services that include preventive, curative, and healthcare that promote the health of the populations it serves. It also acts as a referral center for the most critically ill patients. The curative services that it offers include treatment of the diagnosed conditions and active follow-up of cases. Some of the preventive services it offers include immunization of the vulnerable populations.

Lastly, health promotion services offered in the agency include health education to promote lifestyle and behavioral change in the population. The agency receives its funding from a number of sources. One of them is the insurance payout for the services that it offers to the patients that have medical insurance coverage. The second source of funding is out of pocket payments for the patients who are uninsured.

This exist in the form of cash payments for the services that are rendered to the populations in need. In some cases, the agency receives funding from the state government. The funding is largely utilized in the provision of health promotion and preventive services such as screening and immunization. Therefore, these sources of funding have enabled the organization to become operational in its markets.

Community Health Need

Access to the available healthcare services remain a challenge in most of the states in America. A significant ethnic disparity exist in the access to and utilization of the available healthcare services in America. Individuals from ethnic backgrounds such as American Latinos and African Americans have been found to experience significant challenges in accessing their needed care when compared to American natives.

Some of the factors contributing to these differences include socioeconomic differences, stigmatization, and stereotypes in the American communities. Demographic factors such as age also influence the access to the available services since the elderly do not access high quality care due to lack of financial support and insurance coverage (Allen et al., 2016). These factors were evident also in Hyattsville, hence, the identification of the need.

The other need that was identified was the high prevalence of obesity among adults of African American ethnicity. According to the data obtained from the agency, three in every ten patients who sought healthcare services were African American adults with obesity. This raised the need for the adoption of interventions that aim at addressing the issue in this population.

As shown earlier, the elderly in the rural areas were found to experience significant challenges in accessing the care that they needed. The identified factors contributing to the challenges included lack of insurance coverage and loss of productivity, which meant their inability to afford the care that they needed. The existence of socioeconomic inequalities was also identified to contribute to the poor access to care among the elderly in Hyattsville.

Accordingly, the elderly patients with medical insurance coverage were found to have a high rate of utilization of healthcare services when compared to the uninsured elderly patients (Allen et al., 2016). The factors contributing to the high prevalence rate of obesity among African American adults were also investigated. It was found that environmental, behavioral, individual, and biological factors played a great role in the high rate of obesity among this population.

Environmental factors that were identified included limited availability of health foods and lack of healthy food choices for them. The biological factors that were identified to contribute to the issue included family history of diabetes and unhealthy breastfeeding patterns in families. The individual factors that were identified included lack of or limited involvement in active physical activity, consumption of unhealthy diets, lack of information on healthy diets, and too much screen time.

Therefore, this information on the predisposing factors to the identified health needs aided in the formulation of the interventions to address then issue.

Recommended Intervention

One of the recommended interventions that was to be used in addressing the identified health needs was the establishment of weight reduction programs in Joslin Center Care. It has been shown in studies that weight reduction programs are highly effective in reducing the rates of obesity in a population. The programs aim at promoting lifestyle and behavioral change in the population.

It entails the utilization of interventions that include physical activity and adoption of healthy eating habits to minimize the risk of obesity. The population is educated on the importance of engaging in active, moderate physical exercises and healthy food choices (Cohen & Boersma, 2019). These interventions also reduce the risk of insulin resistance in patients with diabetes due to obesity.

Therefore, it is expected that the intervention will result in positive lifestyle and behavioral change in the target population, hence, a reduction in the rates of obesity. The other recommended intervention is encouraging the population to enroll in a health insurance policy. This will eliminate barriers to access to healthcare in the target populations. This will be seen in the reduction in the costs incurred by the vulnerable populations in seeking the care that the need.

Plan for Implementation

The implementation of the proposed interventions is expected to take a period of six months. The period will encompass all the project activities that include assessment, planning, implementation, monitoring, evaluation, and communication of findings. The success of the implementation process will require active stakeholder involvement. All the parties to be affected by the interventions will be involved in the project.

They will provide their inputs on the health interventions that must be prioritized for the desired outcomes to be achieved. The proposed interventions also act as change initiatives in not only the agency but also the target populations too. As a result, interventions to minimize resistance to change will be adopted. They include training the implementers, promoting active stakeholder involvement, and ensuring that the goals of the program are realistic to the adopters.

Leaders from the Diabetes Education Center and stakeholders from the agency will implement the project. It will be implemented at the communities with high prevalence of obesity in African American adults.

Resources Needed to Implement the Plan

One of the resources that are needed for the successful implementation of the project is the healthcare personnel. The healthcare providers will be the frontline staff involved in implementing the project. They will monitor weight changes and provide health education on weight reduction program and initiatives. Financial resources will also be required for purchasing the needed equipment.

This will include weight loss tools and prescription of medications for weight management. Financial resources will also be required for providing the healthcare providers with the necessary training for them to have the desired competence in implementing the project (Tucker & Gallagher-Ford, 2019). Time is another resource that is needed in this project. the healthcare providers and other stakeholders involved in it will have to spend most of their time in activities that will ensure the success of the project.

Expert assistance or opinion is the other resource for this project. The key drivers in the implementation process will have to seek opinions from experts in the program. This might include the organizations that have implemented similar programs in the past. An example will be seeking assistance in the determination of the resources that should be provided for the successful implementation of the project.

The implementation process will also require financial assistance from external donors. It is anticipated that external donors will provide finances that will be used in procuring the equipment for use in the project (Tucker & Gallagher-Ford, 2019). The last resource is community inputs. The members from the target communities will be involved to provide their insights into the manner in which the available resources can be used efficiently to meet their health needs.

Expected Outcomes

It is expected that the program will result in the reduction in the incidence and prevalence rate of obesity among African American adults. This will be attributed to their enhanced level of awareness on the risk factors of obesity and its associated complications. It is also expected that a significant reduction in health complications of obesity will be reported in the agency (Jalali et al., 2019).

This will be attributed to elimination of adverse events such as insulin resistance and health problems associated with obesity. It is also expected that the target population will embrace the desired lifestyle and behavioral interventions that are needed to prevent obesity. The adoption of the desired lifestyles will imply that the target population has been empowered to live a healthy lifestyle and make healthy decisions.

Project Life Cycle

The above cycle represents the project life cycle that will guide this research. The first step will be assessment where the needs of the organization will be identified. It will be followed by planning where the needed resources and strategies will be developed. The third step will be implementation where the strategies will be put into practice. Monitoring is the next step where the stakeholders will be followed up to determine their level of adoption. The last step is evaluation where the focus will aim at determining whether the set goals and objectives of the project were met or not.

References

• Allen, D., Belcher, H. M., Young, A., Gibson, L. W., Colantuoni, E., & Trent, M. (2016). BMI, body image, emotional well-being and weight-control behaviors in urban African American adolescents. International journal of child health and nutrition, 5(3), 55.
• Cohen, R. A., & Boersma, P. (2019). Strategies used by adults aged 65 and over to reduce their prescription drug costs, 2016-2017. https //www.cdc.gov/nchs/data/databriefs/db349-h.pdf
• Tucker, S. J., & Gallagher-Ford, L. (2019). EBP 2.0 From Strategy to Implementation. AJN The American Journal of Nursing, 119(4), 50-52.
• Vedovato, G. M., Surkan, P. J., Jones-Smith, J., Steeves, E. A., Han, E., Trude, A. C., … & Gittelsohn, J. (2016). Food insecurity, overweight and obesity among low-income African-American families in Baltimore City associations with food-related perceptions. Public health nutrition, 19(8), 1405-1416.
• Jalali, M. S., Rahmandad, H., Bullock, S. L., Lee-Kwan, S. H., Gittelsohn, J., & Ammerman, A. (2019). Dynamics of intervention adoption, implementation, and maintenance inside organizations The case of an obesity prevention initiative. Social Science & Medicine, 224, 67-76.