Please submit your field experience log for Week 2 in one Word document to this assignment. Access the

Guidelines for the Field Experience Requirement

page for full instructions. As seen below :

 
Guidelines for the Field Experience Requirement

You must “attend” at least 4 policy events, at least approximately 1 hour in length. Attendance of at least one of these events must be in-person.

Up to 3 of the 4 events may be online and they must have a health policy focus. Online health policy events/ webinars will be posted from which you may choose. In addition, you may identify your own online policy events, but please check with your instructor to make sure the events you choose are eligible for field hours.

In-person events must be health-related. For example, an example of in-person event would be attendance at a local board of health meeting, a local school-board meeting, a legislative hearing or meeting, a meeting by an executive branch agency that falls under your governor, a meeting by advocacy organization or special interest group, or a meetings of a political party, political group, or candidate.

General Guidelines

1. At each event, take notes, and then write up an account and analysis of each event, using the template for field experience logs (below), and the Field Experience Rubric posted on Moodle.
2. You are required to complete and post a field event report assignment every other week, in Weeks 02, 04, 06, and 08.

Field Log Guidelines

As a way of demonstrating completion of this course requirement, you must submit, in writing, field logs that detail certain aspects of the event. The template for field experience logs is below.

• Each event log should be three to five double-spaced pages of text.
• Provide only a brief summary of the event itself.
• The analysis section should be 550 to 800 words, and be the most developed component of the report. In the analysis section, you can write about the process of policy being made at this event, and/or you can write about the actual health policy issue being discussed/considered.
• Your analysis should reference at least two sources. They can be from the learning materials in this course or other sources, but should be current (within the last 3 months).
• Use APA format for citations and references.
• Examples of logs are posted on Moodle.

Template for Field Experience Logs

• The name of the event/meeting and who has sponsored it.
• Describe the steps taken in preparation for the event (beyond listening or attending the event).
• Place, date, time, and length of hearing/meeting/event.
• Topic under discussion.
• Names of participants and their titles (to the extent you can get them).
• Brief description of the testimony/meeting/event. (If more than one issue is presented, discuss a sampling of issues.)
• Analysis of the health policy issue and its implications for healthcare. Integrate course content and readings in your analysis. This section should be approximately 500 to 750 words.
• Example of field logs :

HP609 Field Experience Log Example One 

Field Experience Log #1

Title of Event / Sponsors: Rutland County Maternal-Child Health Coalition Tobacco Cessation in Pregnancy Meeting / Vermont Department of Health and the Rutland County Maternal-Child Health Coalition

Preparation Steps Taken: Prior meeting minutes provided by Bethany Yon, Nutritionist at the Vermont Department of Health were reviewed. Pregnancy Risk Assessment Monitoring System (PRAMS) Data from the CDC at https://www.cdc.gov/prams/tobaccoandprams.htm was also reviewed.

Place / Date / Time / Length: Rutland Area Visiting Nurses and Hospice (RAVNAH) in Rutland, Vermont / May 19, 2017 / 9:30 / 2 hours

Topic Under Discussion: Pilot project for smoking cessation program for pregnant women. Names of Participants and Their Titles: Joanne Calvi (District Director / Nursing Supervisor Vermont Department of Health), Jill Hamilton (Registered Dietician / WIC Supervisor, Vermont Department of Health), Bethany Yon (Nutritionist, Vermont Department of Health), Kathleen Romano ( RN supervisor at Rutland Women’s Health Care), Sarah Cosgrove (Respiratory Therapist, Asthma Educator, Community Health Team at Rutland Regional Medical Center), Marjanna Barber-Dubois (QI Facilitator, Community Health Improvement at Rutland Regional Medical Center), Rhonda Williams (Chronic Disease Prevention Chief, Vermont Department of Health), Allison Kurti (University of Vermont Behavioral Health), Marissa Wells (University of Vermont Behavioral Health)

Brief Description of the Testimony / Meeting / Event: Rutland Regional Medical Center’s Women’s Health Clinic is partnering with the Vermont Department of Health to focus on decreasing the rate of smoking in pregnancy. Collaboratively, they are working with area partners to complete a pilot project for an incentive based smoking cessation program, modeled off an University of Vermont based incentive program. This meeting was a review of progress to date, the plans for initial roll out of the pilot project, and the plan for provider education.

Description and Analysis of the Health Policy Issue and Its Implications for Health Care:

Many behaviors and lifestyle choices that individuals choose to take part in significantly impact their health. One such health determinant, the behavior choice to smoke, is the leading cause of preventable disease and death in the United States (Shi & Singh, 2015). Smoking is one of the 3 health behaviors that contributes to four chronic diseases, leading to 50% of deaths in Vermont (Vermont Department of Health, 2017). For women who smoke during pregnancy, there are many additional health concerns related to the impact of smoking on the pregnancy and fetus as well. Some examples of these health concerns are an increased risk for miscarriage, certain birth defects, premature births, low birth weights, and SIDS (Centers for Disease Control and Prevention, 2016).

With the continued high rate of smoking in pregnancy in Vermont, the Maternal Child Health Division of the Vermont Department of Health is focused on addressing this public health concern. Rutland Regional Medical Center was selected as a site for the smoking cessation pilot project for two reasons. First, the Rutland Women’s Health clinic has been working to create smoking cessation programs for pregnant women. Second, the smoking rate during pregnancy is the highest in the state at 29.3%, and has the third lowest smoking cessation rate during pregnancy of 11.2% (Personal Communication, Sarah Cosgrove, May 19, 2017). The grant funded pilot project is looking to provide a financial incentive to women that take part in the smoking cessation program, which includes individual and group counseling, along with urinalysis to confirm compliance with smoking cessation.

Smoking during pregnancy has many implications on health and health care. As noted above, smoking leads to many preventable health conditions. This leads to significant health care costs to treat these medical issues. Between 2000 and 2012, it has been estimated that $133 billion has been spent in health care costs associated to treating tobacco-related illnesses (American Cancer Society, 2016). Melvin, Adams, Ayadi, and Rivera (2004) reported that in 1996, $366 million was spent on neonatal healthcare costs associated to maternal smoking during pregnancy.

The public health program being implemented in this community looks to provide a multidisciplinary team of providers with the education and training they need to educate, support and empower women to make the needed behavior modifications to successfully quit smoking. In addition, they will be utilizing an incentive based program targeted to this specific, high-risk patient population. Shi & Singh (2015) identified such methods as being avenues to motivate behavioral changes in health promotion and disease prevention.

From the public health perspective, it is not the treating of the disease caused by smoking that needs the attention. It is addressing the cause of these conditions, the behavior of smoking, that needs to be the focus to achieve improvements (Harvard University School of Public Health, 2014). Shifting the focus from one of disease treatment to health promotion through primary prevention interventions is key to improving population and public health. Such primary prevention strategies include therapeutic community efforts, such as the program described above, to assists people with smoking cessation to prevent the health conditions that can result from smoking. Hopefully in the future, there will be an increase focus and implementation of such primary prevention programs to improve the health of populations and decrease the costs of healthcare across the United States.

References

American Cancer Society. (2016). Tobacco: The true cost of smoking. Retrieved from https://www.cancer.org/research/infographics-gallery/tobacco-related-healthcare-costs.html

Centers for Disease Control and Prevention. (2016). Tobacco use and pregnancy. Retrieved from https://www.cdc.gov/reproductivehealth/maternalinfanthealth/tobaccousepregnancy/inde x.htm

Harvard University School of Public Health. (2014). United States health policy. Retrieved from https://courses.edx.org/dashboard

Melvin, C. L., Adams, E. K., Ayadi, M. F., & Rivera, C. C. (2004). State estimates of neonatal-healthcare costs associated with maternal smoking: United States 1996. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5339a2.htm

Shi, L., & Singh, D. A. (2015). Delivering health care in America: A systems approach (6th ed.).

Burlington, MA: Jones & Bartlett Learning

Vermont Department of Health. (2017). 3-4-50: Prevent Chronic Disease. Retrieved from http://www.healthvermont.gov/3-4-50