Care Management, Case Management, and Home Healthcare

1. In thinking of five social determinants of health as identified in Healthy People 2020, identify the social determinants specifically that may be barriers to home care and case or care management services. Explain your answer.

Please use APA style 7 edition. 

Communityhealth care nursing

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Week # 6 Research Paper Comment by Ileana Torres: Look for a more appropriate title

Introduction

Obesity has become a major health problem in the United States that has resulted in several conditions, particularly an increase in the risk of some types of stroke, type 2 diabetes, coronary artery disease, and cancer. This condition has also created a significant increase in early mortality and economic costs in the United States. It is estimated that almost thirty-five percent of Americans have obesity making many health care agencies consider obesity as a chronic disease. It has been defined to be a national epidemic that does not only entail weight problems but may also have severe effects on an individual’s psychological, metabolic, and physical health. Include a statement with the intent of the paper.

Problem statement

Obesity has become a major health condition in the United States with different causes, signs, and symptoms, and in order to facilitate its reduction and prevention, community intervention should be enacted by the relevant authorities effectively and as fast as possible. Comment by Ileana Torres: Support with evidence

Population of interest

The population of interest in this research is children, adolescents, and adults. Children and adolescents suffer from childhood obesity, which is a severe health condition that leads to various problems such as high cholesterol, high blood pressure, and diabetes that were early considered to be adult problems only. According to reports, the prevalence of obesity among adults was approximately forty-two percent, with many related conditions like particular types of cancer, type 2 diabetes, stroke, and heart disease. Comment by Ileana Torres: What reporta?

Obesity

Obesity is determined by using a body mass index, which is a computation of a person’s weight and height in measuring their body size. In adults having a BMI of thirty or more, they are defined as overweight centered on the centers for disease control and prevention. However, the body mass index may have some limitations because some factors such as muscle mass, ethnicity, sex, and age can impact the connection between body mass index and body fat. Additionally, body mass index does not distinguish between bone mass, muscle, or excess fat, and it does not offer any indication of the distribution of fat amongst people. Obesity is categorized into different classes among adults starting with underweight, normal weight, overweight, class 1 obesity, class two obesity, and severe obesity, also called class 3 obesity (Chooi, Ding, & Magkos, 2019). In the class of underweight, the individuals have a body mass index of 18.5 or under, while in class 3 obesity, the individuals have a body mass index of forty and above.

Obesity is majorly caused by the consumption of a lot of calories than a person burns in daily activity and exercise, which in the long term results in obesity by the additional calories adding up and causing weight gain. However, obesity is not just caused by having a sedentary lifestyle or eating more calories; but it also has some factors that cannot be controlled by human beings. Some of these factors that cannot be controlled include pregnancy, not sleeping enough, growing older, and genetics. Genetics usually affects how an individual’s body processes food into energy and how the storage of fat occurs. Genes usually give instructions to the body for responding to alterations in its setting, and differences in many genes may lead to obesity by raising intake of food and hunger. Growing older leads to less muscle mass and a slower metabolic rate, which makes it easier to increase weight. Pregnancy is a condition that cannot be controlled because weight added during pregnancy might be hard to lose, which eventually might cause obesity.

Obesity may also be caused by certain health conditions such as osteoarthritis, hypothyroidism, Cushing syndrome, Prader Willi syndrome, and polycystic ovary syndrome. Hypothyroidism is a condition in which the production of particular important hormones by the thyroid gland is not adequate. Polycystic ovary syndrome is experienced in women, and it causes the imbalance of female reproductive hormones (Flegal, et al., 2016). Some of the risk factors of obesity include psychological factors, environment and community, and genetics. The environment of a person can influence how active they are and how they eat. Some of the environmental things that may increase the risk of obesity are failing to find a better place to play, exercise or walk in the neighborhood, failing to buy healthier foods, have not learned how to cook healthy meals, and living in a neighborhood with limited healthy food options or with high calories food alternatives such as fast-food restaurants. Psychological factors may comprise depression, which at times leads to weight gain because some people may turn to food to acquire comfort emotionally. Some medications such as birth control pills and steroids can also increase one’s risk for weight gain. Comment by Ileana Torres: Remove this comma.

Social determinants of health

Social determinants of health consist of culture, access to mass media and emerging technologies, literacy, residential segregation, socioeconomic conditions, and social norms and attitudes. Socioeconomic conditions include high levels of poverty and the stressful conditions that are accompanied by it, while social norms and attitudes include distrust of government, racism, and discrimination (Taylor, et al., 2016). Other additional social determinants are social support, public safety, options of transportation, quality of education, access to health care services, economic and job opportunities, and the accessibility of resources to attain everyday necessities like local food markets and secure housing. Comment by Ileana Torres: Remove this comma.

Role of community health nurses

Among the major health issues that community health nurses try to do away with or control is obesity. Their main role is to offer treatment to patients, although they have other additional roles they play. Other additional roles they carry out include administering immunizations, dispensing medications, conducting health screenings, planning educational assemblies, and provide education to the members of the community on how to maintain their health so that they can decrease the occurrence of deaths and diseases (Bailey, et al., 2016). Some of the other health problems they control include pregnancy of teens, smoking, substance abuse, poor nutrition, and infectious and sexually transmitted diseases. Community nurses may also offer support to the elderly and their caregivers, help in coordinating needs of care and ensuring equality of health care for vulnerable persons, supporting patients and caregivers after hospital discharge, organizing for disposable items and practical advice on various aspects of health like medication, lifestyle, and diet. They all carry out their activities with the aim of preserving, keeping, and supporting the health of the community. Community health nursing entails several concepts such as carrying out research to improve healthcare, instituting health and wellness programs evaluating the delivery of patient care and wellness projects by the community, teaching the community about dealing with chronic illnesses and making healthy choices, offering direct care, inhibiting disease and health issues and also promoting a healthy lifestyle.

Theoretical frameworks of behavioral change

For health care professionals to carry out their operations effectively in promoting public health, they should understand how to use the different methods, research findings, theories, and principles of the behavioral and social sciences. Understanding these models and theories used in public health will enable me to develop interventions to address those issues and evaluate the important causes of a public health problem. The theories and models that I would use include social norms theory, trans-theoretical model, social cognitive theory, diffusion of innovation theory, the theory of planned behavior, and the health belief model. The theory of planned behavior maintains that behavioral achievement is based on ability and motivation, and it distinguishes various types of beliefs, control, normative and behavioral. This theory has some constructs, namely, perceived behavioral management, perceived authority, social norms, individual norms, behavioral intention, and attitudes.

The health belief model is derived from behavioral and psychological theory centered on the belief that a certain health act will prevent or cure the disease and the need to avoid diseases or get well if already ill (Sulat, et al., 2018). The health belief model consists of self-efficacy, cue to action, perceived barriers, benefits, severity, and perceived susceptibility. The aim of diffusion of innovation theory is to enable people to adapt to new behavior or idea by doing something different from what they had been doing initially. There are some categories in this theory, among them being laggards, late and early majority, early adopters, and innovators. The adoption of an innovation is influenced by various factors such as observability, trialability, complexity, compatibility, and relative advantage. The primary goal of social cognitive theory is to define how persons control their conduct through management and strengthening to attain a directed goal behavior that may be kept over time. The concepts of the social cognitive theory include self-efficacy, prospects, reinforcements, observational education, behavioral ability, and mutual determinism. The Transtheoretical model concentrates on the decision making of an individual and is usually a model of intentional change that assumes persons do not change behaviors decisively and quickly.

Planning community intervention

It is necessary to plan a community nursing intervention because it will help to determine the issues that require intervention with the perception of health needs and issues depending on the results of prioritization. I will plan a community nursing intervention by determining the intervention levels, plan interventions for every system level and then validate the planned interventions’ practicality. I will determine the intervention levels, such as the aggregate system or the subsystem. These systems are interdependent and interacting parts that are arranged with a certain function. My planning interventions for each system level will be based on the tertiary, secondary, and primary levels of prevention that apply to individuals and the community. I will then validate the practicality of the planned community intervention in relation to personal and supra system resources. I will also consider other possible forms of intervention apart from teaching like community service development, policy change, and individual counseling.

Evaluating the community level intervention

I would evaluate the community level interventions by using outcome evaluation, impact assessment, and process evaluation. The process evaluation will help me to inspect if the program was done as intended, and I will create a list of indicators that should be measured centered on the program’s objectives. The evaluation outcomes will aid me determine the program’s weaknesses and strengths and make improvements where necessary. The impact assessment will help me identify if any change has been brought about in the target population that has led to the program’s establishment. Outcome evaluation will enable me to measure if the program was successful. I will be able to know if fewer people are now suffering from obesity than before. This will provide fundamental information if the intervention has made a difference.

Social marketing resources

I would use social marketing resources to change the behaviors and beliefs of people to improve health in society. Social marketing aims at bringing about change in behavior through comprehensive approaches that offer coordinated interventions to particular audiences. This method has been found out to be the most effective behavioral change model for many public health conditions. It includes strategies for change, target behavior, target audience, and the problem of obesity.

Conclusion

Obesity being a major health problem in the United States, it is the responsibility of every person to ensure that they try to eliminate or reduce it due to the adverse health effects it has had on many individuals. People should observe all preventive measures such as eating healthy food to reduce calories in the body and take part in regular exercises. It is also necessary to visit health care facilities more often in order to acquire appropriate treatment to prevent several complications that result from the health condition.

References

Bailey, J. E., Surbhi, S., Bell, P. C., Jones, A. M., Rashed, S., & Ugwueke, M. O. (2016). SafeMed: using pharmacy technicians in a novel role as community health workers to improve transitions of care. Journal of the American Pharmacists Association, 56(1), 73-81.

Chooi, Y. C., Ding, C., & Magkos, F. (2019). The epidemiology of obesity. Metabolism, 92, 6-10.

Flegal, K. M., Kruszon-Moran, D., Carroll, M. D., Fryar, C. D., & Ogden, C. L. (2016). Trends in obesity among adults in the United States, 2005 to 2014. Jama, 315(21), 2284-2291.

Sulat, J. S., Prabandari, Y. S., Sanusi, R., Hapsari, E. D., & Santoso, B. (2018). The validity of health belief model variables in predicting behavioral change: a scoping review. Health Education.

Taylor, L. A., Tan, A. X., Coyle, C. E., Ndumele, C., Rogan, E., Canavan, M., … & Bradley, E. H. (2016). Leveraging the social determinants of health: what works?. PloS one, 11(8), e0160217.

Attached, please find your paper. 

1. I have inserted some comment that you may want to read and make some corrections.

1. The paper needs more in-text citations. You can cite the same author more than once. The theoretical framework needs more in-text citations as well as the rest of the body.

1. I would double space the paper, but then I read that she wants it single spaced.

1.  Take the instructions/rubrics provided by your professor and go over them one by one. I don’t think you followed them a 100%. For example, the Introduction is missing a statement in which you state the purpose, and it is clearly stated on the rubric. 

1. On the Problem Statement she wants you to provide evidence, and you do not have any. You must include some.

1. Observe that she wants evidence on each aspect, so you must have in-text citations throughout the paper.

1. There should be a heading for Research Studies, in which you just state at least 3 peer-reviewed articles about it. Your paper lacks that information as well.

1. Your Conclusion is too brief. You may need to add a little bit more information; reword the main points of the paper.

Make these corrections, and I’m sure your grade will improve.