African American Girls: Program Planning, Research, and Evaluation - Essay Example

Needs assessment and community diagnosis 3 This community needs the health promotion program because there is a high possibility of anxiety in girls during adolescence. According to Weiner (2003), studies have confirmed that African American girls suffer from a higher number of anxieties (p. 40). Integrating environmental and biological factors causes an anxiety disorder. Many families in Everest are poor. This would, therefore, imply that their children have an increased risk of developing anxiety disorder. This is because these children will be deficient of some of their basic health needs required for them. 3 Since the children cannot access most of the health check-ups and treatments due to lack of resources. This health promotion program will be developed in conjunction with Everett Community Health Partnership (ECHP). The mission of ECHP is to enhance health and the standard of life of the community of Everett. This is done by generating chances for the organizations, individuals, and families to work together and strategically in solving essential difficulties in the community (Cambridge Health Alliance, 2014). 3 Basics community health care assessment 3 The basic community health care assessment provides an evaluation of the general health status by the community members. However, this assessment has been difficult to be determined in the Everett, MA Public School System due to community violence. This research is important in establishing the effect of the persistent community violence on their (community members, that is, children) academic ability, substance use, as well as behavioral and emotional factors. This is because the African American girls are from an ethnic minority group that is prone to persistent community violence (Cooley-Strickland et al., 2009). 3 History, location and economy of the community 4 The city of Everett is in Middlesex County, Massachusetts, close to Boston. At the time of the United States Census in 2011, the total population estimate of the city was 41,079. The Everett, MA Public School is located at 100 Elm St, Everett, MA 02149 (Everett Public Schools, 2014). 4 However, MA Everett public school has a drop-out rate of 3.3%, which exceeds the state’s rate of 2.2%, but performs better than the state in regard to in-school suspensions with 1.4% as compared to 2.2% (Cambridge Health Alliance, 2014). The Everett High School graduation rate is 86.5%, which is in accordance with 85% state graduation rate (Massachusetts Department of Elementary and Secondary Education, 2014). Hospitalization as a result of mental disorder is high in Everett in all age groups (Cambridge Health Alliance, 2014). 5 The economy of Everett is supported by industrial and commercial bases. The community has an industrial base which is well diversified with the manufacturing sector accounting for 31% of the total jobs. The commercial base consists of various small businesses with less than ten workers. These businesses are the main source of labor in the city. The population is larger than the available employment opportunities, so the locals are forced to engage in other ways of taking care of their families (Cambridge Health Alliance, 2014). People engage in community jobs such as retail and food services that normally offer low salaries, which force the citizens to secure several employments to meet their family needs. 5 According to a report by Cambridge Health Alliance (2014), 10.7% of the total population in Everett lives below 100% poverty level, 12.9% between 100-200% poverty level and 76.4% above 200% poverty level (p. 26). 5 Community Demographics 5 In the past decade, the City of Everett and Everett public schools have become more diverse with the African American population doubling between 2000 and 2011 (Cambridge Health Alliance, 2014). Everett has a higher population of African American citizens than the white citizens. The African American citizens are of a 60% representation of the total population. According to the American community Survey Estimate (2011), the population of Everett presently is 41,079, which constitutes 8% growth from the 2000 United States Census quantity (Cambridge Health Alliance, 2014). 6 Everett is ranked as the fifth highest populated city in Massachusetts, with a total number of 12,082 individuals per square mile. The biggest number of population composition in the population statistical structure exists between the years of 40 to 64, which is a representation of 24.5% to the total population. The populations have changed between 2000 and 2011 with the number of young children less than five years increasing from 5.9% to 6.7%. In addition, the population of adults has changed as well for individual aged 45 to 64 years, increasing from 24.5% to 27.4%. On the other hand, the population of people above 65 years has reduced from 14.8% to 11.7% between 2000 and 2011. Everett has a youthful citizen population of an average year of 35.6 compared to 38.9 in MA that constitute 54.2%. In Everett, women aged 20 to 29 years have twice the birth rate of the state’s birth rate in the same age group (Cambridge Health Alliance, 2014). 6 7 Infrastructure relevant to the health promotion program 8 Community diagnosis 8 i. Data to support the diagnosis and the need for intervention 8 Target population 9 a. Specific target population for the program 9 Stakeholders, parents and other partners 9 Health promotion program goals and objectives 11 Development of at least one primary goal and two clear, measurable objectives 13 Methods and activities 14 a. Discussion of the theory or model 14 b. Description of the specific program activities planned 16 The program will first carry out a thorough examination of the African American girls between 12-18 years in the City of Everett Public School System. The girls will be separated and categorized into groups. The girls are separated by identifying those with anxiety and those with no anxiety. The ones with anxiety are then selectively removed from the others who have no anxiety when conducting the process of separation. Grouping is done by classifying the girls with anxiety into distinctive units with each unit containing a specific range of years. For instance, a 5-year range distinction, where those girls aged from 14 years to 19 years are grouped together in one group (Clark & Beck, 2011). The groups will utilize one specific treatment. The girls will then be evaluated on their progress and finally dissemination of the outcomes. To ensure that more and more girls are constantly recruited into the program, the girls identified to be affected by anxiety will be admitted into educational and rehabilitation programs. The girls are also provided with an incentive provision assuredness of their basic needs like food, clothing, security and education sponsorships. This will therefore entice many more girls to get recruited to the program owing to the benefits standing to be provided and gained. The assessments that will be carried out are time based assessment and output-volume assessment. The time based assessment concentrates on determining how fast the girls affected by anxiety take to recover to normalcy when put under the health program model. The output-volume is much centered in determining the total impact achieved or created by the health program. It examines the total number of girls who shall have been helped to fully recover from anxiety after the 6 months period of the program (Coon, Mitterer, Talbot, & Vanchella, 2010). 16 Identification of resources and constraints 16 The ethical resources that aid the program and assist it to progress are the experiential support references chosen from various researchers to assist in providing efficient treatments. Other resource materials that consist of manual and book to direct clinicians on the way the treatments will be implemented. The use of DVD will play an important role of assisting girls who may not understand the concept of the program (Jongsma & Bruce, 2010). The financial resources that are utilized by the program will be derived from pooling of money from the community, the leaders, and business people in Everett City. The community will also be useful to outline the acceptable cultural behaviors that are applicable to the program. The program will work in collaboration with National Alliance for Mentally Ill (NAMI) that gives financial assistance to institutions dealing with psychiatric programs (National Alliance on Mental Illness, 2014). This will enable the community to take part in the health promotion program and hence the program will be trusted and accepted by the community (Minelli, Breckon & Breckon,2009). 17 Limitations which may hinder the program 17 The program may come across some obstacles such as implementation of evidence-based treatment, resistance from the student to adhere to the set sessions of treatments. From the outlook of health care professionals, there is a challenge in the way care is provided that is some may not be able to adjust to the norms of the students. There is also a possibility that the resources available are not enough for the running of the program till end (Gabbard, 2007). 17 Program evaluation 17 Program evaluation is a process of analyzing the research findings of a specific undertaking or activity so as to deliver on the specific deliberations stated in the objectives of a program. In this paper, the program evaluation gives data on the operations of the health program and how the program is to be implemented. Program evaluation is one of the techniques for identifying the impact of the program. Conducting a program evaluation, especially for the African American girls with anxiety, is imperative because it helps to form the foundation for quality policy making. The policy to be made in this case is to formulate ways and processes that may help one helping the girls to recover from effects of anxiety illnesses. The program is desired to be of positive impact to the targeted group of African American girls with anxiety. The critical area of program evaluation is its efficiency. The efficiency of a program evaluation is to concentrate on the existing advantages or the advantages that can be derived from a program on the perspective of costs and financial welfare to those with anxiety or affected by anxiety (Coon, Mitterer, Talbot, & Vanchella, 2010). 18 The program implementation evaluation will be carried out using recognition of principle results, the organized practice of gathering information to advice the stakeholders on the effectiveness of the program in achieving the results. The health promotion program will be conducted in accordance to the logic model. This implies that the program will be successful if not then it means the program failed. In the evaluation of the health promotion program impact meticulous techniques are used to assess the cause and effect association with the accomplishment of the program objectives and goals. If the evaluated program is determined to have comprehensively covered all the variables relating to the identified groups of girls with anxiety like for instance, the causes, effects and solutions of anxiety. Then this shows, based on evaluation, that the program was victorious. In the case of program efficiency evaluation the evaluators use a technique that will describe the convenience and expenses of the program in the form of money. The program benefits are compared to the money spent to run it hence if the program achieved its objectives and goals then it means that it is successful (Scaffa & Reitz, 2014). 19 Conclusion 19 In conclusion, anxiety is a common illness among majority of individuals in the U.S. It is a general kind of psychiatric disruptions that comprise of different fears when severe results to anxiety illness. Early detection and treatment will help the patient to overcome the illness and regain their normal life. Various models and approaches are utilized to intervene on the illness. 19 Appendix 1 20 Hypothetical Logic Model of Program for Reducing Anxiety in African American girls aged between 12-18 years 20 References 20 Introduction This paper will focus on a health promotion program plan based on mental health anxiety. The target population is African American girls. The particular objective of this program is to reduce the rate of anxiety among African American girls between the ages of 12-18 years, and the study area is the City of Everett Public School System. Anxiety is a mental disease that is experienced psychologically and includes feelings of terror, depersonalization, fear and emotional worries (Kahan, Gielen, Fagan, & Green, 2014). In some circumstances, individuals experience compulsion-like ideas in regard to fear of death and well being of others (Emilien, 2002). The disease has various signs and symptoms that constitute hot flashes, breathlessness, restless legs, headaches, nausea, vertigo, abdominal pains, dry mouth, hyperventilation and palpitations. In some cases, for example, students experience various anxieties resulting from their academic interactions (Cassady, 2010). In a real sense, students’ assessment in particular areas of an educational program initiates anxieties that hamper their potential to achieve results. Anxiety is partially passed on from parents. Research has proven that high emotion is experienced throughout a family (Everett Public Schools, 2014). A perfect example is that sixty percent of children whose parents experienced anxiety develop an inhibited temperament and fear (Coon, Mitterer, Talbot, & Vanchella, 2010). These children have a character that is wary and irritable when young, and when they become toddlers, they are fearful and shy. When they enroll in elementary school, they are often cautious and quiet. As adults, they experience high possibility of anxiety difficulties like panic attacks (Everett Public Schools, 2014). Needs assessment and community diagnosis This community needs the health promotion program because there is a high possibility of anxiety in girls during adolescence. According to Weiner (2003), studies have confirmed that African American girls suffer from a higher number of anxieties (p. 40). Integrating environmental and biological factors causes an anxiety disorder. Many families in Everest are poor. This would, therefore, imply that their children have an increased risk of developing anxiety disorder. This is because these children will be deficient of some of their basic health needs required for them. Since the children cannot access most of the health check-ups and treatments due to lack of resources. This health promotion program will be developed in conjunction with Everett Community Health Partnership (ECHP). The mission of ECHP is to enhance health and the standard of life of the community of Everett. This is done by generating chances for the organizations, individuals, and families to work together and strategically in solving essential difficulties in the community (Cambridge Health Alliance, 2014). Basics community health care assessment The basic community health care assessment provides an evaluation of the general health status by the community members. However, this assessment has been difficult to be determined in the Everett, MA Public School System due to community violence. This research is important in establishing the effect of the persistent community violence on their (community members, that is, children) academic ability, substance use, as well as behavioral and emotional factors. This is because the African American girls are from an ethnic minority group that is prone to persistent community violence (Cooley-Strickland et al., 2009). History, location and economy of the community The city of Everett is in Middlesex County, Massachusetts, close to Boston. At the time of the United States Census in 2011, the total population estimate of the city was 41,079. The Everett, MA Public School is located at 100 Elm St, Everett, MA 02149 (Everett Public Schools, 2014). The history of Everett community in relation to the girls under the program planning study is tied to the Mystic River. The Mystic River, in history, has helped in shaping the development of the community in the Everett city since European settlement. The river’s nature of having a great tidal range made it attractive to a number of the community members since it could provide wide potential of industrial uses. The community in Everett became an independent town in the year 1870 and after 2 years it was incorporated as a city in the year 1892. Everett plays the role of a gateway city to foreigners for a long time of its history. Everett is home to Revere Beach Parkway, which is one of the historic destinations in the country of U.S (Cambridge Health Alliance, 2014). The public facilities of the City’s community are seven elementary schools, one junior High school and one senior High School. The girls used in the study were those from the senior High school known as MA public High School. Most of the children in Everett public schools are offered free education and 79% of the total school population received subsidized lunch in 2013-1014 (Cambridge Health Alliance, 2014). However, MA Everett public school has a drop-out rate of 3.3%, which exceeds the state’s rate of 2.2%, but performs better than the state in regard to in-school suspensions with 1.4% as compared to 2.2% (Cambridge Health Alliance, 2014). The Everett High School graduation rate is 86.5%, which is in accordance with 85% state graduation rate (Massachusetts Department of Elementary and Secondary Education, 2014). Hospitalization as a result of mental disorder is high in Everett in all age groups (Cambridge Health Alliance, 2014). The economy of Everett is supported by industrial and commercial bases. The community has an industrial base which is well diversified with the manufacturing sector accounting for 31% of the total jobs. The commercial base consists of various small businesses with less than ten workers. These businesses are the main source of labor in the city. The population is larger than the available employment opportunities, so the locals are forced to engage in other ways of taking care of their families (Cambridge Health Alliance, 2014). People engage in community jobs such as retail and food services that normally offer low salaries, which force the citizens to secure several employments to meet their family needs. According to a report by Cambridge Health Alliance (2014), 10.7% of the total population in Everett lives below 100% poverty level, 12.9% between 100-200% poverty level and 76.4% above 200% poverty level (p. 26). Community Demographics In the past decade, the City of Everett and Everett public schools have become more diverse with the African American population doubling between 2000 and 2011 (Cambridge Health Alliance, 2014). Everett has a higher population of African American citizens than the white citizens. The African American citizens are of a 60% representation of the total population. According to the American community Survey Estimate (2011), the population of Everett presently is 41,079, which constitutes 8% growth from the 2000 United States Census quantity (Cambridge Health Alliance, 2014). Everett is ranked as the fifth highest populated city in Massachusetts, with a total number of 12,082 individuals per square mile. The biggest number of population composition in the population statistical structure exists between the years of 40 to 64, which is a representation of 24.5% to the total population. The populations have changed between 2000 and 2011 with the number of young children less than five years increasing from 5.9% to 6.7%. In addition, the population of adults has changed as well for individual aged 45 to 64 years, increasing from 24.5% to 27.4%. On the other hand, the population of people above 65 years has reduced from 14.8% to 11.7% between 2000 and 2011. Everett has a youthful citizen population of an average year of 35.6 compared to 38.9 in MA that constitute 54.2%. In Everett, women aged 20 to 29 years have twice the birth rate of the state’s birth rate in the same age group (Cambridge Health Alliance, 2014). The total percent of the African American public school enrollment in 2013 is at 8.6% of the total school population. Changing global, state, local and national economics influences the student population movement in the Everett schools. According to Cambridge Health Alliance (2014), drug use and addiction is high in adolescents and is the major factor for the development of anxiety. The factor has been of national public health concern since majority of the young girls who suffer from anxiety are those using Marijuana, alcohol, and other drugs. The drugs interfere with the brain growth (Cambridge Health Alliance, Institute for Community Health, 2014). The other factor explaining why African American young adolescent girls develop anxiety is that the girls are at puberty and most of them do not appreciate how they look (Hecht, Jackson, & Ribeau, 2003). Also, most of these girls are from unstable families that are broken and this causes anxiety (Hales, 2009). The African American girls also suffer from anxiety because of the ethnic background and misconceptions surrounding their race. They feel inferior to children from other races and therefore they are not confident (Ingram & Price, 2010). Infrastructure relevant to the health promotion program The facilities that are important for this program are Whidden Hospital Campus and Everett High School. Learning institutions, sports clubs and the Healthy People 2020 Topics and Objectives are as well other facilities for the health promotion program (Cambridge Health Alliance, 2014). The infrastructures that have been vitally important towards the developments and promotions of health programs include roads, rail, water, and sewer systems. Everett health facilities benefit in its programs from an array of roads linking them to the entire metropolitan area. Numerous fixed routes of MBTA bus lines provide a connection of the Everett health facilities to Boston. This allows for quicker access of any of the needed resources, health program services and efficient transportation. The Mystic River provides water supply to all the health facilities in proportionate quantities required to carry out their programs. The sewer services are provided by MWRA and extend throughout the city including all the health facilities (Cambridge Health Alliance, 2014). Community diagnosis Community diagnosis by the program will be based on the statement evaluation of major health concerns relating to anxiety. i. Data to support the diagnosis and the need for intervention Anxiety is caused by factors such as alcohol and drug abuse, ethnicity, social status, puberty, family history of anxiety, and the environment (Ogden &Hagen, 2013). In the Everett public school system, students report to engage in use of heroin, methamphetamines, cocaine, inhalants and ecstasy (Cambridge Health Alliance, Institute for Community Health, 2014). The total population of the school is 5,889 students in grades PK to grade 12. The African-American population is 8.6%, and, therefore, the total number of African American students is 8.6% x 5,889 that is equal to approximately 506 learners. According to Cambridge Health Alliance, Institute for Community Health (2014), high school girl’s percentage of alcohol use was 57.2, and middle school girls was 18.4% in 2013 (p.95). From our population, the African American girls involved in alcohol are 57.2% x 506 equal to 289 in high schools and 18.4% x 506 equal to 93 girls in middle school. The total number of girls is 289 add 93, which is equal to 382 students with a percentage of 75% of the African American students. This implies that the possibility of anxiety occurring in girls is 75%, which implies that the majority of the students suffer from anxiety. Target population a. Specific target population for the program The specific population that is targeted for this program is African American girls aged between 12 years to 18 years. The estimated number of eligible girls is 8.6% of the 5,899 students that represents 506 students. The students’ population of 5,889 was a data collected from ten of the schools in Everett city including Everett High School and other nine schools selected through a sampling process (Cambridge Health Alliance, Institute for Community Health, 2014). Stakeholders, parents and other partners In this particular program, the community and the stakeholders will hold equal status of membership and participation as the major partners in the program (Kahan, Gielen, Fagan, & Green, 2014). The program will use community-based interventions. This will therefore regard the primary stakeholders and partners to be the management of Everett MA Public School System and the parents. The parents and the MA school management are the primary stakeholders because the program is based on the African American girls in the school. And the girls are always either under the care of parents or the school’s management in most of their time spending and activities involvements. MA Public School System students in Everett have been identified to constitute of a huge number of girls affected by anxiety, mainly the African American girl students. They are therefore important in the carrying out of the program and its success (Kahan, Gielen, Fagan & Green, 2014). The Everett city community will help the health promotion program by bringing out the essence of environmental set up in which the students live. The community will also assist in knowing the cultural values and beliefs of Everett. The local hospitals will help to determine the actual number of students who suffer from anxiety who have consulted their services and the treatment given and the outcomes. The local authorities through the assistance support of stakeholders like parents and the MA schools management. Provide information and data that shows the number of girls who might be involved in bad behaviors. The bad behaviors are mostly caused by the illnesses that result from anxiety. Consequently, since such bad behaviors like drug abuse are blatantly unaccepted and prohibited in the U.S law, the behaviors therefore warranties the rule of law to take course. Enforcement of the law is to be exercised against such girls who are found to be involving in bad behaviors under the influence of anxiety. Other health practitioners will assist with more evidence-based knowledge of how to manage anxiety. The professionals could also assist in counseling and guiding the girls (Gofin, J., & Gofin, R., 2011). The stakeholders will take a role in the intervention process of influencing the behavior change in the African American girls. They will assist in describing the issue of anxiety and creation of the health promotion program framework to circulate the outcomes. In this health promotion program, the intervention is to reduce or stop anxiety among the African American girls between the age bracket of 12 and 18 years. The broad involvement of the stakeholders will enrich the program with different views from a diverse group to create the intervention (Kahan, Gielen, Fagan & Green, 2014). The contracts made between the program and the stakeholders will prove a long-term commitment of team members that will produce quality outcomes. This will guarantee that the program will continue for a long time and have time to evaluate the results. The human resource availability in Everett will be strengthened to enable the program to begin and run smoothly (Gofin, J., & Gofin, R., 2011). Health promotion program goals and objectives The health promotion program will address the mental health and mental disorders of the Healthy People 2020 topics and objectives. The main objective is to enhance the mental well being of African American teenage girls by stopping the illness through the provision of correct and standard mental health services (U.S. Department of Health and Human Services, 2014). The primary goal and objective of the program will derived from the existing and underlying assumption stated. The assumption is that African American teenage girls have greater levels of stress and anxiety than both the girls or boys of other racial groups (Hecht, Jackson & Ribeau, 2003).The aim of the health promotion program is to cater for the African American girls aged 12-18 years. The other purpose will be to determine the specific factors that cause anxiety. This health promotion program will involve religion as it is proven that it helps in reducing anxiety in girls. The church is a cathartic retreat from subjection to stress-affiliated stimuli and racism (Hecht, Jackson & Ribeau, 2003). According to the U.S. Department of Health and Human Services (2014), mental diseases among African American girls aged between 12-18 years is one of the major roots of disability. The outcome of disability results to a lot of financial implications on families compared to other illnesses (Ogden & Hagen, 2013).The health promotion program will incorporate various treatment programs to promote the mental well being of African American girls. To start with the program will utilize Adolescent Coping with Depression (CWD-A) treatment (Ogden & Hagen, 2013). In this treatment, a cognitive behavioral and psycho-educational intervention method is used for adolescent depression. The treatment schedule will be performed in a classroom setting to help minimize the stigma the participating students may experience. The therapy session will consist of sixteen two-hour meetings carried out in eight weeks (Ogden & Hagen, 2013). The other treatment which is applicable in this health promotion program is the Copying cat therapy (referred as CAT). CAT is an intervention treatment program that is done within a period of sixteen weeks with the treatment being administered in time duration of two hours per week. The treatment is carried out in sixteen meetings and is given in a group or personal environment. The first eight sessions will offer psycho-education where the girls will train on how to identify things that cause anxiety, physical symptoms and cognitions. The remaining eight lessons will focus on behavioral assessment and evaluation, and includes discovery methods where the girls will face their fears in a classified order (Ogden & Hagen, 2013). This health promotion program will also incorporate the Coping and Support Training (CAST) schedule that is normally aimed at middle and high school learners aged 12-18 years (Ogden & Hagen, 2013). This program is created to minimize suicide risk, emotional distress and depression. The CAST looks for and recognizes young people living with various health risks. These young people living are regarded as those having less access to protective elements against suicide and depression. The CAST training program is executed in small groups of the young people. Individual groups, especially those of girls comprise of six to eight girls, and they do hold meetings twice a week for a total period duration of six weeks (Ogden & Hagen, 2013). This program will enhance personal control, decision making, plan for getting support and help and concentrate on the development of dignity (Ogden & Hagen, 2013). According to Mental Health America (2014) many African Americans have been excluded from health, economic, educational and social resources for long. This means that most of the African Americans do not seek medical help to avoid being rejected. All this incorporated together can ensure access of mental care to the marginalized group. Development of at least one primary goal and two clear, measurable objectives The principal implementation of this health promotion program is to reduce or eliminate anxiety among the African American girls in Everett, MA Public School System. The measurable objective will assist in knowing if the program has achieved its goal, or there is a need to continue with it (Kirst-Ashman & Hull, 2014). The first objective is to enroll the African American girls who are willing to participate and to be involved into the program. The enrollment is carried out for a period of 3 months and only those girls who have voluntarily accepted to be involved in the program’s processes will be included. The second objective is to single out the affected girls from the total population. The singling out is done by either conducting a monitoring research on the behaviors of the girls to identify those are showing to be likely affected by anxiety. Or, a medical test may be administered to the girls involved in the program in order to determine those with the signs probable as in indication of anxiety. Methods and activities a. Discussion of the theory or model This health promotion program is guided by the cognitive model of anxiety. The model views anxiety from the point of vulnerability where vulnerability is considered as the individual’s awareness of herself as prone to external and internal jeopardizes, in which she is not in control or is not enough to provide her the feeling of safety (Clark & Beck, 2011). The model describes the principal appraisal of threat that includes an inaccurate view where the possibility that trauma will happen and the recognized severe condition of the trauma is estimated more than it is (Clark & Beck, 2011). In this concept, people with a lot of fear have a possibility of overestimating the magnitude of harm that results to withdrawn behavior. Moreover, people who are anxious fail to see the precaution factors of the evaluated harm (Clark & Beck, 2011). The secondary elaborative reappraisal happens as a consequence of the principal appraisal of threat and in the condition of anxiety it accelerates the original recognition of harm (Clark & Beck, 2011). Therefore, the strength of anxiety condition is influenced by the equilibrium of the principal examination of harm and the secondary assessment of coping capability and well being (Clark & Beck, 2011).The strength of anxiety is communicated as follows: High Anxiety = high probability or severity of threat + low coping ability and safety Low Anxiety = low probability or severity of threat + high coping ability and safety Moderate Anxiety = medium/moderate probability or severity of threat + medium/moderate coping ability and safety The model explains that the recognition of harm ignites the “alarm system demand for cognitive, behavioral and psychological procedures that rotate to safeguard individuals from physical jeopardy and threat (Coon, Mitterer, Talbot, & Vanchella, 2010). The behavioral reaction is fight to handle the threat and can also include other ways, for instance, shouting for help, negotiating to reduce the risk of harm and to take a protective posture. Another behavioral reaction in anxiety in view of danger is immobility, which is evident in the form of feeling ‘woozy’ or faint and freezing. The model is founded on the data-processing point of view where the emotional distraction happens as a result of more or less operation of the cognitive system. Anxiety is viewed as a result of data-processing operation that sees a circumstance as threatening to the important attraction and welfare of a person (Clark & Beck, 2011). b. Description of the specific program activities planned The program will first carry out a thorough examination of the African American girls between 12-18 years in the City of Everett Public School System. The girls will be separated and categorized into groups. The girls are separated by identifying those with anxiety and those with no anxiety. The ones with anxiety are then selectively removed from the others who have no anxiety when conducting the process of separation. Grouping is done by classifying the girls with anxiety into distinctive units with each unit containing a specific range of years. For instance, a 5-year range distinction, where those girls aged from 14 years to 19 years are grouped together in one group (Clark & Beck, 2011). The groups will utilize one specific treatment. The girls will then be evaluated on their progress and finally dissemination of the outcomes. To ensure that more and more girls are constantly recruited into the program, the girls identified to be affected by anxiety will be admitted into educational and rehabilitation programs. The girls are also provided with an incentive provision assuredness of their basic needs like food, clothing, security and education sponsorships. This will therefore entice many more girls to get recruited to the program owing to the benefits standing to be provided and gained. The assessments that will be carried out are time based assessment and output-volume assessment. The time based assessment concentrates on determining how fast the girls affected by anxiety take to recover to normalcy when put under the health program model. The output-volume is much centered in determining the total impact achieved or created by the health program. It examines the total number of girls who shall have been helped to fully recover from anxiety after the 6 months period of the program (Coon, Mitterer, Talbot, & Vanchella, 2010). Identification of resources and constraints The ethical resources that aid the program and assist it to progress are the experiential support references chosen from various researchers to assist in providing efficient treatments. Other resource materials that consist of manual and book to direct clinicians on the way the treatments will be implemented. The use of DVD will play an important role of assisting girls who may not understand the concept of the program (Jongsma & Bruce, 2010). The financial resources that are utilized by the program will be derived from pooling of money from the community, the leaders, and business people in Everett City. The community will also be useful to outline the acceptable cultural behaviors that are applicable to the program. The program will work in collaboration with National Alliance for Mentally Ill (NAMI) that gives financial assistance to institutions dealing with psychiatric programs (National Alliance on Mental Illness, 2014). This will enable the community to take part in the health promotion program and hence the program will be trusted and accepted by the community (Minelli, Breckon & Breckon,2009). Limitations which may hinder the program The program may come across some obstacles such as implementation of evidence-based treatment, resistance from the student to adhere to the set sessions of treatments. From the outlook of health care professionals, there is a challenge in the way care is provided that is some may not be able to adjust to the norms of the students. There is also a possibility that the resources available are not enough for the running of the program till end (Gabbard, 2007). Program evaluation Program evaluation is a process of analyzing the research findings of a specific undertaking or activity so as to deliver on the specific deliberations stated in the objectives of a program. In this paper, the program evaluation gives data on the operations of the health program and how the program is to be implemented. Program evaluation is one of the techniques for identifying the impact of the program. Conducting a program evaluation, especially for the African American girls with anxiety, is imperative because it helps to form the foundation for quality policy making. The policy to be made in this case is to formulate ways and processes that may help one helping the girls to recover from effects of anxiety illnesses. The program is desired to be of positive impact to the targeted group of African American girls with anxiety. The critical area of program evaluation is its efficiency. The efficiency of a program evaluation is to concentrate on the existing advantages or the advantages that can be derived from a program on the perspective of costs and financial welfare to those with anxiety or affected by anxiety (Coon, Mitterer, Talbot, & Vanchella, 2010). The program implementation evaluation will be carried out using recognition of principle results, the organized practice of gathering information to advice the stakeholders on the effectiveness of the program in achieving the results. The health promotion program will be conducted in accordance to the logic model. This implies that the program will be successful if not then it means the program failed. In the evaluation of the health promotion program impact meticulous techniques are used to assess the cause and effect association with the accomplishment of the program objectives and goals. If the evaluated program is determined to have comprehensively covered all the variables relating to the identified groups of girls with anxiety like for instance, the causes, effects and solutions of anxiety. Then this shows, based on evaluation, that the program was victorious. In the case of program efficiency evaluation the evaluators use a technique that will describe the convenience and expenses of the program in the form of money. The program benefits are compared to the money spent to run it hence if the program achieved its objectives and goals then it means that it is successful (Scaffa & Reitz, 2014). Conclusion In conclusion, anxiety is a common illness among majority of individuals in the U.S. It is a general kind of psychiatric disruptions that comprise of different fears when severe results to anxiety illness. Early detection and treatment will help the patient to overcome the illness and regain their normal life. Various models and approaches are utilized to intervene on the illness. Appendix 1 Hypothetical Logic Model of Program for Reducing Anxiety in African American girls aged between 12-18 years Assumptions Inputs Activities Out puts Short-term results Long-term results Mental illness is a serious disease that affects mostly the African American girls aged between 12-18 years. Program professionals: psychiatrists, physician and registered nurses Create a timetable and establish the information system to be used. The quantity of training equipment, guidebooks and trained staff. More information on anxiety and the signs of the illness. The total number of girls who have overcome anxiety and got their lives back. The African American teenagers have access to treatment on anxiety The program will run for two years and the participants will be followed up to check on their progress. Offer training to the staff involved in the program. Design the program contracts and guidebook. Number of African American girls who exhibited symptoms of anxiety and were put on therapy. The number of girls who are able to manage anxiety. References Clark, D. A., & Beck, A. T. (2011). Cognitive therapy of anxiety disorders: Science and practice. New York: Guilford Press. Cassady, J. C. (2010). Anxiety in schools: The causes, consequences, and solutions for academic anxieties. New York: Peter Lang. Coon, D., Mitterer, J. O., Talbot, S., & Vanchella, C. M. (2010). Introduction to psychology: Gateways to mind and behavior. Belmont, Calif: Wadsworth Cengage Learning. Cambridge Health Alliance, Institute for Community Health. (2014). 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