Prevention of Hypertension - Awareness of Tasmanians of the Modifiable Risk Factors for Hypertension - Research Proposal Example

Health Promotion Project Plan: Prevention of Hypertension Student’s Name Institutional Affiliation Health Promotion Project Plan: Prevention of Hypertension Introduction Hypertension or high blood pressure (BP) is a chronic disease affecting a substantial fraction of individuals in Australia. It is a primary determinant of cardiovascular diseases that are a major cause of death in Australia (Australian Institute of Health and Welfare [AIHW], 2012). In Tasmania, hypertension had the highest prevalence among the Australian states at 30% in a 2011-12 study (National Heart Foundation of Australia [NHFA], 2012). In 2008, circulatory system diseases were the significant cause of death among Tasmania residents causing an estimated 33.2% of all deaths (Australian Bureau of Statistics, 2011). According to a national health survey done in 2007-08, It was demonstrated that Tasmanians have common health risk factors as most of them exhibited negative determinants of health such as unhealthy diet, physical inactivity, alcohol consumption and cigarette smoking (ABS, 2011). 71.7% of the residents aged at least 15 years admitted to rarely exercising and living a sedentary lifestyle (ABS, 2011). For adults aged at least 65 years, 77.7% were sedentary. About 64% of residents assessed aged at least 18 years were confirmed obese through body mass index estimates (ABS, 2011). Over the same period, 2007-2008, of the Tasmania residents aged at least 15 years, 47.1% and 12.6% admitted to low risk and high risk alcohol consumption respectively, 23.9% were current smokers while 28.5% were ex-smokers, and 79.1% ate at most four “serves of vegetables per day” (ABS, 2011). 54.1% of the Tasmania population aged between 18-64 years never ate fruits or only ate at most one “serve of fruit per day” (ABS, 2011). The above statistics highlight the high prevalence of hypertension among the Tasmania residents at least 15 years. In addition the residents reported exhibiting a number of modifiable risk factors for hypertension such as obesity, physical inactivity, and high alcohol intake that predisposed to developing hypertension (Boyden, Anderson, Couzps & Cadilhac, 2012). Therefore, there is a need for a healthcare promotion plan to address primary, secondary and tertiary non pharmacological prevention of hypertension among the Tasmanian residents aged at least 15 years based on a template adapted from "Live Longer! Community Health Action Pack" (Australian Department of Health and Ageing [ADHA], 2011). Project Goals, Objectives, Strategies and Activities The project's aim is to enhance awareness of Tasmanians aged at least 15 years of the modifiable risk factors for hypertension. This primary goal can be subdivided into specific goals from which their objectives, strategies and activities shall be discussed Goal 1, Objectives, strategies and Activities The first goal is to enhance awareness of the impact of risky alcohol consumption to individuals in the community including others close to the individuals and to reduce the number of risky drinkers in the state within two years by at least 30% (Ghezelbash & Ghrbani, 2012); Objectives. At the conclusion of the project in five years time, 90% of Tasmania residents aged at least 15 years will be teetotalers or will be practicing safe drinking. The latter is defined as consuming less than 50ml and 25ml of daily alcohol for males and females respectively. Strategies. There is evidence to suggest that harmful or risky alcohol consumption is a strong determinant of developing hypertension (WHO, 2013). Alcohol is postulated to cause hypertension through various mechanisms such as interfering with the activity of baroreceptors, stimulation of the RAAS system, enhancement of sympathetic activity, increasing the activity of blood vessels and inducing loss of relaxation in the vasculature (Husain, Ansari & Ferder, 2014). Heavy drinkers who consume more than 30g of alcohol per day can lower their systolic and diastolic BP by up to 4mmHg and up to 2mmHg by cutting down their alcohol consumption to moderate drinking (Husain, Ansari & Ferder, 2014). The latter is defined as two drinks per day for men individuals aged less than 65 years, a drink a day for men above 65 years, and for women of all age-group (Husain, Ansari & Ferder, 2014). Therefore, media campaigns, establishment of state and work policies targeting reduction of alcohol consumption and community identification of individuals engaging in risky drinking for assistance or even rehabilitation shall be instrumental in lowering risky drinking among Tasmania residents (WHO, 2013). Hence, creating a good rapport with the various representatives of the state communities such as elders, councils, education institution heads shall aid in the identification process (Fleming & Parker, 2011). Activities. Individuals having difficulties controlling their drinking shall be assisted by liaising with relevant stakeholders in alcohol rehabilitation in Tasmania such the Alcohol and Drug service of the Tasmania State, and non-governmental not-for-profit organizations such as the Bridge Program of the Salvation Army. Health care service providers such as clinics and hospitals shall be used to identify individuals engaging in risky drinking who happen to be admitted or present in such health facilities. Other sources of information regarding risky drinkers shall include elders, community organizations, councils and education service providers as they are closer to members of each community in the State. Implementation of policies and regulations limiting alcohol consumption such as increasing the tax levied on alcoholic drinks, restricting and proscribing activities aimed at marketing alcohol consumption, and limiting the ease of accessing and purchasing drinks at retail shops throughout the State shall be pushed through the state and local governments. Goal 2: Objectives, Strategies and Activities The second goal is to enhance awareness of the demerits of physical inactivity, the significance of a physically active lifestyle and to promote habitually controlled exercise. Objectives. Tasmanians aged at least 15 years would have access to public field and recreational areas after five years of running the program where fitness instructions, programs, exercise activities and demonstrations shall be provided for free by fitness specialist such that by the end of the first year of implementing the program, Tasmanians reporting a physically inactive lifestyle will have reduced to less than 50% (Ghezelbash & Ghrbani, 2012). Strategies. Obesity and physical inactivity are known determinants of hypertension (Boyden et al., 2012). Therefore, the project team shall work with the local elders, education institutions, and councils to identify and develop various recreational activities applicable to residents of Tasmania. Media and communication channels such as the use of posters, and liaising with various private and State employers to facilitate communication of the message that ‘obesity progressively kills' shall be employed. Activities. The project team shall work with other stakeholders in establishing and managing sporting activities and teams including sporting competitions such as football, fishing, hockey, basketball, volleyball and athletics. In addition, regular community walks shall be organized and publicized through the local media and various companies employing Tasmania residents. The residents shall be encouraged to participate in the regular walks or jogging activities. Goal 3, Objectives, Strategies and Activities. The third goal is to enhance awareness of the merits of smoking less and encouraging complete cessation of the habit within two years. Objectives. Within the first two years, the number of reported active smokers will have reduced by at least 30%. Strategies. The strategy shall involve media campaigns and introduction of policies that will discouraging individuals from purchasing and consuming tobacco products such as increasing tax imposed on tobacco products to make them expensive for individuals buying them or even those ones contemplating trying the habit. Since there are certain existing policies on tobacco smoking, enhancement or augmentation of such policies will be necessary. Policies introduction or modifications shall be done in conjunction with state legislative authorities and community leaders (WHO, 2013). Activities. The team leaders shall liaise with legislative authorities for the purpose of introducing and strengthening policies on tobacco. They shall also work with managers of different organizations to see that smoke-free area policies are implemented to the latter. The media shall be used to communicate the negative impact of smoking on the cardiovascular system as it shall be structured in a communication messages. Posters containing the message will be strategically and conspicuously located in areas such as pubs, streets, and residential areas. Support groups for smokers will be established so that they encourage each other to quit the habit (ADHA, 2011). Goal 4, Objectives, Strategies and Activities The fourth goal is to expand awareness of the importance of health checks including frequent blood pressure assessment. Objective. Tasmania target residents will be encouraged to visit clinicians at least once every three months for regular medical checkups that would include blood pressure, cholesterol, glucose, and weight measurement (WHO, 2013) Strategies. Regular check-ups such as measurement of BP is significant in identifying a developing hypertensive condition and allowing an early initiation of treatment (Wang et al., 2006). Individuals who are already in pre-hypertension, stage one or the second stage of hypertension will see the need and urgency of changing their lifestyle to halt the progress of the disease and redeem their health early enough. Regular checkups shall be facilitated with the assistance of health care officers in Tasmania so that designated centers for checkups are conveniently available to every Tasmanian. Activities. The project team shall establish community presentations in the form of drama that will feature local Tasmanians supported by indigenous media in the State. The main message of the dramas will include the abysmal repercussions of exhibiting risk factors for hypertension and early identification and treatment of the disease through regular checkups in health service centers. The drama sessions will be organized quarterly after which BP checkups will be done and designated areas of checkups will be given in portable pamphlets (ADHA, 2011). Community days bringing checkup sessions closer to people will be organized and communicated through local media. Goal 5, Objectives, Strategies and Activities The fifth goal is to widen the knowledge of Tasmanian residents on the need for a healthy diet. Objective. The project team will promote consumption of an appropriate health diet including less salt intake and consumption of fruits and vegetables so that in a years’ time, Tasmanians reporting standard consumption of serves of diet should have increased by over 40% (Haddy, Vanhoutte & Feletou, 2006). Strategy. Diet deficient in potassium, and high in saturated fats and salts increases the risk of developing hypertension (WHO, 2013; Haddy, Vanhoutte & Feletou, 2006). By notifying the residents of the varieties of health diet and what to avoid through public campaigns, the residents shall be informed of the appropriate diet. Activities. This will include production and distribution of a "healthy community cookbook that will be augmented by practical demonstrations of preparing the recipes (ADHA, 2011). Community cooking classes will be regularly provided with the various recommended healthy recipes. Posters and clothing attire with messages such as ‘healthy food to shun hypertension’ and ‘healthy drinks, longer life’ will be prepared and made conspicuously available. Budget and Timeline The financial resources of the project shall cater for salaries, insurance, fitness instructors, travel expenses, catering, accommodation, printing, gym memberships, fitness clothing, exercise equipment, and sourcing consultation services, A breakdown of the cost of the project – financially or in terms of resources, shall be presented to the Tasmania State Government, the Australian government, Non-governmental organizations in the State and the country at large, individuals and companies such as pharmaceutical companies, food manufacturing companies and others whether or not affiliated to health. This shall be done in the first quarter of this year. Thereafter, the various stakeholders consulted and cited to get involved in the implementation of the various elements of the project shall be enlisted and engaged in readiness for the beginning of the project. After agreeing with the relevant stakeholders, the project is expected to begin running in early 2015 year for five years. Evaluation Evaluation shall be through both quantitative and qualitative methods. Quantitative methods shall be based on changes in countable statistics such as records of the number of individuals that will be attending checkups and the changes in the number of individuals diagnosed with hypertension at the end of the program. Qualitative methods shall be used to evaluate the perception of residents on the impact of the project on them. During evaluation, the processes employed in the program, the impact and outcome of the program shall be evaluated (ADHA, 2011). Process evaluation shall be done on a weekly basis in the first months of initiating the project, but it shall be adjusted to fortnight then to monthly basis depending on the evaluation results. It shall assess the participants’ satisfaction with the program, implementation of activities, and if the target group is been reached. Impact evaluation shall aid in assessing the program’s immediate effects compared to prior to initiating the program and after completion of the program (ADHA, 2011). Outcome evaluation shall give information regarding the achievement of the overall goal of the program, that is, if the prevalence of hypertension in Tasmania will have significantly dropped. Conclusion Hypertension is commonly caused by modifiable determinants that if controlled can significantly reduce the occurrence of this diseases among Tasmanians. The project plan is aimed at making the residents aware of these modifiable risk factors and enable them to exercise control over them and prevent themselves from developing hypertension or aggravating an already existing one. The plan highlights the strategies that shall be employed to meet the laid out objectives. If the plan is successfully implemented then, the prevalence of hypertension in Tasmania should significantly reduce after the five years. References Australian Bureau of Statistics. (2011). Tasmania state and regional indicators, Dec 2010. Retrieved from http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/1307.6Main+Features13Dec+2010 Australian Department of Health and Ageing. (2011). Live longer! Community health action pack. Canberra: Australian Department of Health Ageing. Australian Institute of Health and Welfare. (2010). Australia's health 2010. Canberra: AIHW. Boyden, A., Anderson, S., Couzps, S. & Cadilhac, D. (2012). High blood pressure (Hypertension). Retrieved from http://www.carpa.org.au/Ref%20Manual%204th%20Ed/Chronic%20disease/High_blood_pressure.pdf Fleming, M.L. & Parker, E. (2011). Introduction to public health (2nd ed.). Chatswood, NSW.: Elsevier, Australia. Ghezelbash, S. & Ghorbani, A. (2012). Lifestyle modification and hypertension prevention. ARYA Atherosclerosis Journal, 8(Special Issue in National Hypertension Treatment), s202-s207. Haddy, F.J., Vanhoutte, P.M. & Feletou, M. (2006). Role of potassium in regulating blood flow and blood pressure. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology, 290(2), R546-R552. Husain, K., Ansari, R.A. & Ferder, L. (2014). Alcohol-induced hypertension: Mechanism and prevention. World Journal of Cardiology, 6(5), 245-252. National Heart Foundation of Australia. (2012). High blood pressure statistics. Canberra: NHFA. Wang, Z., Knight, S., Wilson, A., Rowley, K.G., Best, J.D., McDermott, R., ...& O'Dea, K. (2006). Blood pressure and hypertension for Australian Aboriginal and Torres Strait Islander people. European Journal of Cardiovascular Prevention and Rehabilitation, 13(3), 438-443. World Health Organization. (2013). A global brief on hypertension. Silent killer, global public health crisis. Geneva: WHO. Read More