Strategies for Community Health Promotion - Essay Example

? Community Health Promotion Ricardo A. Valera Athabasca Yvonne Moore Community Health Promotion Health promotion is defined as the process where people are empowered by the health sectors so that they have control over their health and in its improvement (Bracht, 1999). Strategies that are included in this process can range from anything: from counseling to screening, to immunizations and other medical interventions as needed by the people (Hunt, 2009). In this light, the implication of an active health promotion is that the health sectors are not just the only ones responsible for the overall well-being of the people, but the people are also held responsible too. Thus, when the people’s health is at stake, while healthcare personnel might be responsible for initiating such moves, it would also be up to the people on whether or not they would do steps in order to keep their health at the most optimal state. Most people are more than willing to do things in order to keep themselves healthy. Some change their lifestyles, eating habits, and get regular checkups to maintain their health, which shows that people are capable of improving their lives. However, there are many instances that despite having the will to participate in such activities, some people encounter various hindrances that prevent them from attaining optimal health. Various factors can be attributed to such issues, such as socio-cultural factors, economic factors, or lacking information with regards to the importance of promoting health (Sines, et al.; 2009). Some persons may not be able to get proper medical attention due to their attitudes on health, such as deeply-rooted belief systems, or they may not have enough money to pay for doctors or medicine since they had to use money for much more important things, or simply because they feel that as long as they do not feel ill or they could still stand, they do not need to get any kind of medical attention (Hernandez, 2011). These kinds of outlooks regarding how overall health are viewed show that health promotion is not something that is solely affected by an individual’s attitude on health, but is also affected by other factors, whether external or internal. Thus, it is up to medical personnel such as community health nurses to create additional efforts in the creation of various methods by which interventions regarding the promotion of health within communities can be made, as well as identifying whether certain social or economic factors can be mediated to improve the outlook on health and wellness of people within an at-risk population. Description of an Aggregate Group for Community Health Promotion People belonging to at-risk populations mostly belong to either or both of the following: a population with high instances of developing the disease due to genetic factors; and a financially-disadvantaged population (Piper, 2009). In some communities or families it is the combination of having high disease risks and having financial limitations that cause problems in terms of keeping themselves healthy, and thus this describes the target group for the creation of health promotion strategies. For this study, Latino women living in Los Angeles were initially targeted as an aggregate group for community health promotion with focus on their outlook on health, particularly with breast cancer, an inherited disease. While their population in general is seen as a group with comparatively lower risks for breast cancer, some factors were identified to increase their risks for the disease such as socio-cultural and economic factors (Winchester, 2006). Due to the underlying problems surrounding the increase in their risks for the disease, some interventions are to be made to inform them regarding how the disease attacks the body, what treatment or other options are available for them within the community setting, as well as lobbying for them and raising their causes to at least the state government level. However, in order to understand their conditions completely and before raising their issues to policy-makers, there must first be a health promotion program designed for them that integrates their socio-cultural background and economic status within the program. This is in order for them to be much more receptive to such an intervention, to increase their awareness with regards to the disease, as well as to improve their chances of either avoiding breast cancer or treating the disease as early as possible. Outline of a Health Promotion and Awareness Program for the Aggregate Group In order to bring the information to the target group, their conditions must also be taken into account. For example, it is probable that most Latino women in Los Angeles have varying daily schedules, as well as different kinds of jobs, and this could cause problems such as making a common time for health sessions, setting a location that would be accessible to all, having to spend both time and money in going to these health promotions, as well as addressing their individual questions. Also, because of the nature of the disease, it is also anticipated that even if many members of the aggregate group get informed of the counseling and health promotion program, not all of the informed women would be willing to attend due to either their reservation with regards to the discussion of a disease of the body’s private parts, their feeling of shame in discussing something that they feel must be left alone or not shared with others, or even the presence of a language barrier (Aguirre-Molina, et al., 2001). In addition, not all women might be open to the possibility of getting checked up by either a male oncologist or medical technician or one that belongs to another race, thus their fears with regards to interacting with medical personnel from different cultural backgrounds must also be addressed. In relation to the program, facilities or clinics that are able to serve patients with a multicultural background would also be outsourced and informed with regards to the health promotion program as well as to find out if they would be willing participants in the program as contacts readily available for the participants so that whenever any of the participants decided to take a visit or to call for arranging a schedule, they can be assured that these facilities and personnel can assist them according to their needs. The community health nurses would have a major role in this health promotion program since not only would they be facilitating most of the program’s parts, but also they would be directly communicating with the participants, as well as being the people that each participant can talk to, whether within or outside of the program sessions. Also, they would be coordinating with healthcare facilities and personnel by informing them of about the program and asking them whether they would be willing to participate in the program, acting as mediators between the participants and members of the healthcare industry. In the following outline, a proposed health promotion program would be made not just for the aggregate groups but also for healthcare members and facilities, especially since it is expected that after the information promotion part some of the women would be trying to reach out to medical personnel to gain more information with regards to the disease, or to have checkups that would assess whether they have risks of developing breast cancer or if they need to be screened for the disease. The outline of the program is based on the Health Communication Unit (2001) from the University of Toronto’s six-step planning and would be restructured as needed for the aggregate group. Step 1: Pre-planning and Project Management The health promotion program would be designed based on the outcome of surveys from Latino women. Among the identified hindrances in promoting health, deeply-rooted socio-cultural views regarding getting treatment for modern diseases would first be addressed. Presenting the program based on the perspective of the participants would prevent them from feeling alienated in the process, as well as to improve their receptiveness with regards to health promotion strategies since they would most likely listen when they could relate to the situations given to them (Hunt, 2009). If the mindset of the participants would change after the program, then there would be lesser problems with regards to healthcare interventions since they have become much more open to modern medicine. Since the program would be in small scale, community health nurses would be leading in the tasks necessary for its success. The group would be consisting of nurses that would be facilitators for the program, preferably those with enough knowledge of the socio-cultural background of the participants since they would be interacting with them and their families directly and constantly, as well as a group that handles most of the coordination to medical personnel and sponsors. In case there is not enough nurses for facilitating the program, bilingual volunteers would also be scouted to assist them during the sessions, especially when there are older participants that experience language barriers. Before the program would be done in full-blast, initial trials with regards to the program’s content and the participants’ receptiveness would first be assessed. Funds for the initial trials would be outsourced (federal or state government, or from private institutions), and they will be asked if they would be willing participants for certain periods. After sending them the proposal for the program and if they would be willing, the program could commence. Step 2: Situational Assessment After assessing the situation using survey questionnaires, it was found out that hindrances such as the lack of medical insurance coverage and cultural beliefs were present in most of the respondents. The members of the aggregate group had problems with regards to medical insurance coverage, saying that they did not avail due to various reasons (e.g. came to the country illegally, employer does not grant insurance, salary is too little to pay for insurance, etc.). In terms of the socio-cultural hindrances, most of the women believed that there is a stigma attached to having breast cancer, or any kind of disease, thus it was harder for them to confide to others regarding the condition, unless it was their closest friends or family members. They also have deeply-rooted beliefs that any kind of disease is a curse and may not be treatable using modern medicine, or that having the disease was meant to happen, which prevents them from going to medical doctors or even resorting to traditional healing methods. Also, because they trust people that they know more than healthcare personnel with regards to the disease, it would be much harder for them to open up to people not belonging to the same cultural background. Step 3: Identify Goals, Populations of Interest and Objectives The program’s main goal would be to increase breast cancer awareness and increase health promotion among Latino women in Los Angeles, which in turn would decrease their risks to the disease. The program’s objectives are: To successfully implement a health promotion program for Latino women, with regards to breast cancer; To improve their attitudes with regards to the disease by helping them develop an open mind and decrease their perception of social stigma in relation to diseases and modern medicine in general; To increase their knowledge of the disease, as well as their awareness of economic solutions for preventing or managing the disease; To inform families and communities of their important role in supporting the need not just of Latino women, but of all community members in general to have access to modern medicine; To identify facilities or medical personnel with a knowledge on diverse cultures who are willing to participate in the program; and To create good relations between health care personnel and Latino women. The economic aspects of the program such as lobbying to the congress with regards to the improvement of the health care system by decreasing healthcare disparities may be done once the health promotion program becomes successful, and thus it would be a separate proposal to be done once the health promotion program becomes a success. Step 4: Identify Strategies, Activities and Resources Some possible strategies and resources that can be used for the program are: Identifying potential participants and developing surveys to find out their receptiveness to a health promotion program about breast cancer Outsourcing funds needed to help run the program for two months Identifying potential facilities or medical personnel with multicultural background familiarity and are willing to participate in the program Finding possible venues for the program that would not intimidate the participants and help them open up with the issue on breast cancer Finding resource persons such as breast cancer survivors with similar cultural background Finding volunteers that could address language barriers (e.g. translators) for older participants Having sessions with the family or community where majority of the participants reside to increase awareness and gain their support of the participation of women in the program Proposed activities would include a simplified approach in explaining the mechanisms of breast cancer development, hereditary nature of the disease, as well as the importance of regular checkups and getting screened early. Also, Latino women who were also cancer survivors would be invited to talk to the women about the disease, so that they could share their experiences and help increase the awareness among their own people. Step 5: Develop Indicators Several indicators for program’s effectiveness would be the following: Attendance of at least 50% of number of invited participants for the first month of the program. Retention of at least 50% of participants during the two-month weekly breast cancer awareness and promotional program. Increased participation (at least five questions per weekly session) among attendees. Increased self-reports of having more awareness and openness of the disease among attendees (monthly). Increased numbers of attendees that visit doctors or healthcare with regards to the disease (will be reported by participating healthcare personnel). Increased number of attendees that referred the health promotion program to others within their community (attendees will be asked whom or where they learned about the health promotion program). Increased self-reports of better health and wellness, as well as indications of following-through after the health promotion program (to be given to attendees 12 months after finishing the program). Step 6: Review the Program Plan The above-mentioned indicators would be used in assessing whether the program was a success or not, as well as to review whether the program was able to speak to the participants effectively based on their socio-cultural and economic background. In order to check for other potential issues that could arise, a small cohort would be initially tested for the program’s effectiveness and soundness. These initial attendees would be given self-satisfaction surveys with regards to how the program was given to them, as well as to whether they would have suggestions for the improvement of the presentations and if they would be willing to attend to similar programs in the future. After reviewing which areas were in need of improvement or are already acceptable or satisfactory for the attendees, solicitations for additional funds or sponsorships can commence and the program may now start. Comparison of Two Health Promotion Approaches for the Aggregate Group The following are the comparison and contrasts of two approaches for promoting health and awareness of breast cancer to the target group. First is the Individual lifestyle approach, which assumes that people or individuals would change their behaviors once they get properly informed of ways on how to better keep their bodies fit and healthy (Lundy & Janes, 2009). In using this approach, it is expected that Latino women would gain more insight with regards to how breast cancer can be prevented, as well as removing the social stigma of the disease and to help the women open up about it to doctors or other healthcare personnel. In this regard, community health nurses have a role for this to happen by interacting with the Latino women in a non-judgmental manner, as well as consoling them with regards to their fears surrounding either the disease or the effectiveness of modern medicine in general. In order to effectively inform the women, the community nurses must have sufficient knowledge on how to communicate with the women using either or both their language or culture, otherwise they would feel like being coerced and would be less receptive to the program (Aguirre-Molina, et al., 2001). However, a possible setback for this approach is that Latino women, like most of the minority groups have collectivist attitudes, and thus they would be much more comfortable participating in programs where they know a lot of people rather than connecting one-on-one with nurses or facilitators (Huff & Kline, 1999). Also, the same collectivist attitude prevents them from having much more open attitudes with regards to modern conveniences since they would most likely not want to stray away from traditions. Thus another approach may be used in implementing the program successfully. If an individualist approach would prove to be unsuccessful in promoting health and health programs for people with a collectivist ideology, a socio-environmental approach might be a better option since it is expected that such mindsets are affected by multiple levels of influence (Hernandez, 2011). In using an approach to deliver the program for Latino women, it is useful to tackle the problem through various approaches, such as the impact of religion, family, society, economics, among others, since more often than not these people take into consideration many things before they act or decide on something (Sines, et al., 2009). Also, it would take a considerable amount of time before most of the Latino women would be very much open in discussing an intimate disease, thus by using the socio-environmental approach they would be given enough time to acclimate or adjust to this mindset before they could approach medical practitioners with greater confidence. The community health nurses would still have a major role with regards to this approach, which are similar to their roles in using the individual lifestyle approach as non-judgmental confidante of the program participants and as mediators between the Latino women community and the healthcare industry. However, they also have additional functions such as interacting with the participants’ families apart from simply facilitating within the program session itself, since the families also play a vital role in the adherence of the participants to the program’s regimen. For the Latino community, the family is important because they are sources of support and comfort, and thus it is essential that the nurse not only gives information to one member of the family but to all of them so that the whole family would understand the purpose of the program and would subsequently lend their support to family members attending the sessions (Hernandez, 2011). In addition, the nurses would also have to take into consideration the role of the community in the program, and would not only be informing the family but also the whole community as well in order to increase their awareness and knowledge of the disease and gain their support not just to the health promotion program, but to all sick people in general. While it may take greater measures in implementing the socio-environmental approach in comparison to the individual lifestyle approach, it is expected that a well-rounded solution would be able to make the program and health promotion much more sustainable as opposed to handling health linearly and on an individual basis. This is because of the collective mindset of people such as the Latinos, wherein they give importance to the consensus of the whole community or the family (Sines, et al., 2009). Thus, for a successful implementation of health promotion programs, community nurses must not only inform the aggregate population but also their whole community as well, so that the women would feel that their community is supportive of their decisions on whether to have themselves screened for breast cancer or in finding doctors that would help them get better. If the whole mindset of the community with regards to the use of modern medicine would become positive, it is more likely that the people would also find ways in getting proper treatment well within their budget rather than just resorting to alternative medicine most of the time. In a way, community health nurses have the major role of being the leaders with regards to opening ways for aggregate groups and communities to connect with the healthcare industry, and vice versa. Conclusion Health promotion is not simply a process that relies mostly on medical personnel. Individuals and communities must also have an active participation in keeping themselves healthy, and with the assistance from health care personnel such as community health nurses, it can be possible. It can be said that because of the direct and daily interaction of community health nurses to many people, they play a vital role in the promotion of health to a wider audience. In programs that aim to increase the promotion of healthy living among certain aggregate groups such as Latino women, community health nurses have vital roles in making these happen, such as creating programs designed to inform them about diseases such as breast cancer in a way that is not judgmental of their socio-cultural and economic backgrounds, as well as including communities and families in their program. This is done in order to create an environment that gives support in the promotion of not just the women’s health, but every community member’s health in general. Aside from these roles, community health nurses also have to coordinate the needs of their patients to larger health care facilities since most of these patients have fears of entering the facilities through various reasons. By speaking in behalf of their patients, community health nurses initiate a relationship between patients and other members of the health care industry. Lastly, because of the nature of the role of community health nurses in interacting directly with their patients, they also gain insights as to what other things are needed in order to provide better care for them. This could help them prepare health promotion programs as needed or as how the patients and community would accept them. Thus, community health nurses have various roles in the promotion of health within the community, as well as in creating the relationships of their patients to other members of the healthcare industry. References Aguirre-Molina, M., Molina, C., & Zambrana, R. (2001). 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Introduction to health promotion program planning. Ontario: Centre for Health Promotion, University of Toronto. Winchester, D. (2006). Breast cancer. Ontario: BC Decker Inc. Read More