Health Promotion

Health Promotion Plan for African American Adults at Risk for Coronary Heart Disease Community Nursing: NUR 3634 Abstract Coronary heart disease affects a disproportionate amount of African Americans (CDC, 2010a), yet there are modifiable risk factors that can reduce the risk of this disease. These modifiable risk factors include high blood pressure and high cholesterol.This health promotion plan involves a community-based strategy that targets African Americans by offering primary and secondary prevention measures directly accessible at local community churches in Titusville, FL to decrease the prevalence and incidence of coronary heart disease in the African American community. Health Promotion Plan for African American Adults at Risk for Coronary Heart Disease Part I: Community DiagnosisRisk of complications, including death, of hypertension and hyperlipidemia among African American adults related to poor eating habits, poor primary prevention measures, and poor medication complia nce as evidenced by data that show prevalence of cardiovascular disease among African Americans to be 44. 6 percent for males and 46. 9 percent for females (FDH, 2008), and Healthy People 2010 National Health Objective 12-9, which is to reduce the proportion of adults with high blood pressure (USDHHS, 2000), and National Health Objective 12-14, which is to reduce the proportion of adults with high total blood cholesterol levels (USDHHS, 2000).Part II: Review of Literature What is Coronary Heart Disease and how does blood pressure and cholesterol affect it? According to the CDC (2010b), cardiovascular disease is the leading cause of death for both men and women (34. 3 percent of all deaths), and is estimated to affect over 81 million people in the United States (AHA, 2010). Cardiovascular disease includes several conditions (AHA, 2010): high blood pressure, coronary heart disease, stroke, and heart failure. Coronary heart disease is the most common type of cardiovascular disease and accounts for the majority of these deaths (AHA, 2010).Coronary heart disease, also known as coronary artery disease, refers to a condition in which atherosclerotic plaque collects in the arteries and obstructs the flow of blood to the myocardium (Lewis, Heitkemper, Dirkson, O’Brien, & Bucher, 2007). The plaques consist of deposits of cholesterol and lipids, which progressively decrease the diameter of the blood vessel though which blood flows. The stress of a constantly elevated blood pressure increases the rate of atherosclerotic development (Lewis, Heitkemper, Dirkson, O’Brien, & Bucher, 2007). Coronary heart disease is associated with multiple risk factors, some of which are modifiable (e. . , high cholesterol, high blood pressure, diabetes, smoking, and dietary factors) and other risk factors that are not modifiable (e. g. , age, sex, heredity) (CDC 2010b; Lewis, Heitkemper, Dirkson, O’Brien, & Bucher, 2007). Why is high cholesterol & high blood pressure a p roblem for African American Adults? Data from the CDC (2010a) suggest that although African Americans are less likely to be diagnosed with coronary heart disease, which is due to disparities in health care access and delivery, they are more likely to die from it. In fact, the prevalence of cardiovascular disease among African Americans is 44. percent for males and 46. 9 percent for females (FDH, 2008). Related to this are estimates that African American males and females over the age of 20 are more likely to have hypertension than non-Hispanic whites (CDC, 2010a). Although percentage of African American adults over the age of 20 with high cholesterol is less than non-Hispanic whites, high cholesterol is still a problem for approximately 10 percent of African American females and 13 percent of males (CDC, 2010a). Current Nursing Interventions Primary prevention measures generally consist of patient education, behavioral counseling, and support.Secondary prevention measures involve bl ood pressure screening, blood lipid screening, prescription and reinforcement of medication regimes (Taylor & Wright, 2005), and referrals. Successful and Unsuccessful Interventions Current interventions combined with programs such as the Racial and Ethnic Approaches to Community Health (REACH) 2010, which addresses underserved communities (CDC, 2010c), the BLESS project (Williamson & Kautz, 2009), which promotes health through faith-based activities, and community health advisor programs are interventions that are working (Cornell et al. 2009; Plescia, Herrick, & Chavis, 2008; McKinley et al. , 2009; Williamson & Kautz, 2009). Studies suggest that some interventions alone don’t always achieve the intended outcomes due to disparities in related to access and delivery of health care (Niska & Han, 2009; Ratanawongsa, Fisher, Couper, Van Hoewyk, & Powe, 2010). Part III: Plan Title: Health Promotion Plan for African American Adults at Risk for Coronary Heart Disease in Titusville , FL.Short term goal: Before and after Sunday church services at five, mainly African American churches, volunteer nurses will educate 10 individuals on three causes of high blood pressure and three causes of high cholesterol, and screen those 10 individuals for high blood pressure. Three Measurable, Time Specific Learner Objectives 1. By the end of one, 20-minute teaching session, participants will list three ways to decrease coronary heart disease. 2. By the end of one, 20-minute teaching session, participants will list three health promoting behaviors to reduce high blood pressure. . By the end of one, 20-minute teaching session, participants will list three health promoting behaviors to decrease elevated cholesterol levels. These goals and objectives specifically target African Americans living in Titusville. Short, concise educational sessions will precede and follow church services at five predominantly African American churches in Titusville the first Sunday of each month for a year. A booth, consisting of information in the form of posters and pamphlets for participants to take home, will be set up.The booth will be staffed by two nurse volunteers, who will provide basic information to participants, as well as assess participant’s blood pressures. The objectives will be measured and evaluated orally through question and answer sessions at the end a 20-minute session. These objectives are reasonable and feasible because the time frame suggested is enough to engage the participant without overwhelming them with too much information, yet nurses will be available for questions once a month (for a year) should the need arise. Health promotion What is health promotion and why is it important in our world today? I am sure it seems the answer is not very complicated: but is it as simple as promoting health? According to the World Health Organization (WHO), â€Å"Health promotion is the process of enabling people to increase control over, and to improve, their health† (World, 2013). This is a change from the past in that healthcare providers are encouraging our patients to take control of their own health while guiding and educating them in he right direction.Health has been shown not to Just be free from disease but also encompasses physical, mental, and social well-being (WHO 2013). The whole purpose of promoting individual health is to give the communities the ability to feel they have control over their health plan and help them to stay out of the hospitals, which is what they prefer. This takes cooperation by the patient and the healthcare provider. It is imperative that a nurse stay up to date with a continuous c hanging healthcare pattern, since they have a big role in health promotion.A big part of health promotion is related to nurses educating the communities, especially since nurses are becoming more and more involved in the communities. As time advances, researchers are predicting nurses will move more out of the hospital and into the communities. Now, more than ever, nurses are challenged to improve patient outcomes by assessing and creating education plans that will increase the patient's awareness and understanding of their disease process and management. After very thorough assessments and the need for education is completed, nurses must create plan for implementing a strategy to reach the audience targeted.It states in the article Public Health Nutrition: Focus on Prevention, the three different levels of implementation methods utilized today. The first method is individually focused and promotes health outcomes through educating, changes to a healthy lifestyle, and individual beh aviors. The types of interventions are carried out through one-on-one educational discussions and telephone conversations. The next implementation tier is more community-focused. These interventions put the spotlight on the needs of modification.The last method to be identified in the article include system-focused interventions. These interventions shift the focus from the individual to the facilities that serve individuals and the laws and policies surrounding the facility. For example, improvements in school lunches to make them healthier (University, 2012). If the healthcare providers can use the combination of the three methods listed above with the nursing process it can to improve outcomes of the patients and community in all areas of nursing. Health promotion is split by healthcare into three levels: primary, secondary, and ertiary.Primary prevention's main concept is to prevent the disease from occurring and keeping the public healthy. A couple of examples of how this is ac complished are through education, regular exams, and immunizations. A few years ago the Journal of the American Academy of Nurse Practitioners published an article, Reducing heart disease through the vegetarian diet using primary prevention, and it discusses how if a patient leads a vegan lifestyle this could cut out a lot of the processed foods and help the patient to improve chronic heart conditions.If one is unsure exactly how to ursue a vegetarian diet having a consultation with a dietitian is an additional option. Next on the pyramid of health is secondary prevention. This layer of prevention focuses on after an injury or illness has been diagnosed. The goal is to prevent progression or slow down the disease. Using the example of heart disease above, if providers are teaching regarding secondary prevention it would include termination of smoking, diet and exercise, and keeping a healthy weight and blood pressure (Mosca, i. e. 2010). These goals are more patient specific than pr imary prevention.The last tier includes tertiary prevention which focuses on helping the public prevent a further decline in health while maximizing their quality of life after being diagnosed with a chronic condition. In a recent article, The Effects of Cardiac Tertiary Prevention Program after Coronary Artery Bypass Graft Surgery on Health and Quality of Life, it discusses cardiac rehabilitation as a possibility to fall into the tertiary level. This falls into the category in that it helps restore patient's well-being while decreasing the suffering and complications.This does take even more participation and cooperation of the patient. In conclusion, there are many things healthcare providers can attempt to do in order to educate the public. However, utilizing the three tiers of health promotion (primary, secondary, tertiary) shows a well-organized technique that can break down different levels of health. Every patient falls into at least one category on the continuum, so this is also making it easier for the provider when educating in that they can customize the patient's care plan in a more organized way.This includes tilizing the nursing process, critical thinking, and therapeutic communication allowing nurses to identify where the patient fits into the wellness continuum and helping them reach their highest level of wellbeing. Health promotion What is health promotion and why is it important in our world today? I am sure it seems the answer is not very complicated: but is it as simple as promoting health? According to the World Health Organization (WHO), â€Å"Health promotion is the process of enabling people to increase control over, and to improve, their health† (World, 2013). This is a change from the past in that healthcare providers are encouraging our patients to take control of their own health while guiding and educating them in he right direction.Health has been shown not to Just be free from disease but also encompasses physical, mental, and social well-being (WHO 2013). The whole purpose of promoting individual health is to give the communities the ability to feel they have control over their health plan and help them to stay out of the hospitals, which is what they prefer. This takes cooperation by the patient and the healthcare provider. It is imperative that a nurse stay up to date with a continuous c hanging healthcare pattern, since they have a big role in health promotion.A big part of health promotion is related to nurses educating the communities, especially since nurses are becoming more and more involved in the communities. As time advances, researchers are predicting nurses will move more out of the hospital and into the communities. Now, more than ever, nurses are challenged to improve patient outcomes by assessing and creating education plans that will increase the patient's awareness and understanding of their disease process and management. After very thorough assessments and the need for education is completed, nurses must create plan for implementing a strategy to reach the audience targeted.It states in the article Public Health Nutrition: Focus on Prevention, the three different levels of implementation methods utilized today. The first method is individually focused and promotes health outcomes through educating, changes to a healthy lifestyle, and individual beh aviors. The types of interventions are carried out through one-on-one educational discussions and telephone conversations. The next implementation tier is more community-focused. These interventions put the spotlight on the needs of modification.The last method to be identified in the article include system-focused interventions. These interventions shift the focus from the individual to the facilities that serve individuals and the laws and policies surrounding the facility. For example, improvements in school lunches to make them healthier (University, 2012). If the healthcare providers can use the combination of the three methods listed above with the nursing process it can to improve outcomes of the patients and community in all areas of nursing. Health promotion is split by healthcare into three levels: primary, secondary, and ertiary.Primary prevention's main concept is to prevent the disease from occurring and keeping the public healthy. A couple of examples of how this is ac complished are through education, regular exams, and immunizations. A few years ago the Journal of the American Academy of Nurse Practitioners published an article, Reducing heart disease through the vegetarian diet using primary prevention, and it discusses how if a patient leads a vegan lifestyle this could cut out a lot of the processed foods and help the patient to improve chronic heart conditions.If one is unsure exactly how to ursue a vegetarian diet having a consultation with a dietitian is an additional option. Next on the pyramid of health is secondary prevention. This layer of prevention focuses on after an injury or illness has been diagnosed. The goal is to prevent progression or slow down the disease. Using the example of heart disease above, if providers are teaching regarding secondary prevention it would include termination of smoking, diet and exercise, and keeping a healthy weight and blood pressure (Mosca, i. e. 2010). These goals are more patient specific than pr imary prevention.The last tier includes tertiary prevention which focuses on helping the public prevent a further decline in health while maximizing their quality of life after being diagnosed with a chronic condition. In a recent article, The Effects of Cardiac Tertiary Prevention Program after Coronary Artery Bypass Graft Surgery on Health and Quality of Life, it discusses cardiac rehabilitation as a possibility to fall into the tertiary level. This falls into the category in that it helps restore patient's well-being while decreasing the suffering and complications.This does take even more participation and cooperation of the patient. In conclusion, there are many things healthcare providers can attempt to do in order to educate the public. However, utilizing the three tiers of health promotion (primary, secondary, tertiary) shows a well-organized technique that can break down different levels of health. Every patient falls into at least one category on the continuum, so this is also making it easier for the provider when educating in that they can customize the patient's care plan in a more organized way.This includes tilizing the nursing process, critical thinking, and therapeutic communication allowing nurses to identify where the patient fits into the wellness continuum and helping them reach their highest level of wellbeing.