NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan

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NURS FPX 6011 Assessment 2 Attempt 1 Evidence-Based Population Health Improvement Plan

NURS FPX 6011 Assessment 2 Attempt 1 Evidence-Based Population Health Improvement Plan

Community Data Evaluation
Environmental & Epidemiological Data
More than 90% of the diabetic patients in America are diagnosed with T2DM
American Indians are mostly diagnosed diabetic
The AI men are 14%, AI women are 14.7%, and AIs regardless of sex are 14.6% diabetic patients
Prevalent Population Health Concerns among AIs

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Obesity
Hypertension
Cardiovascular Disease
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Epidemiological Data
According to research from the Centers for Disease Control and Prevention (CDC), every tenth American (about 37 million individuals) has diabetes, with type 2 diabetes accounting for 95% of cases (CDC, 2021). The American Indians (Ais) are one of the most affected ethnic groups from diabetes. According to the CDC, one in two AIs has diabetes, and those who were born around 2000 are particularly susceptible. The prevalence of the diagnosis was 16% higher among white non-Hispanics (Saldana & Guarnaccia, 2022). According to a research, AIs have twice as much of a probability of developing type II diabetes and dying as White people do (Elma et al., 2021).
The white American people are less likely to get diabetes diagnosed as compared to other racial groups. Diabetes has decreased among AIs since 2013, according to a new IHS analysis, but it is still one of the main causes of illness and mortality among AIs (Brockie et al., 2018). In Ais, T2DM brings other diseases as well like cardiovascular diseases and obesity. And among AI deaths, CVD is one of the most common causes. The incidence of AIs varies across locations and tribal groups as well. For instance, among Indian tribes, the Pima tribe has the greatest occurrence rate (Hsueh et al., 2018).

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Community Data Evaluation
Environmental Factors
Traumatic events created severe situations of AIs
Dependent on government subsidies, forced immigration, and unwanted lifestyle modifications
Disparities in their healthcare facility such as obesity, causing Diabetes

NURS FPX 6011 Assessment 2 Attempt 1 Evidence-Based Population Health Improvement Plan


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Environmental Factors
Genetics and environmental factors are the two main causes of diabetes in American Indians. After the Indian Removal Act was enacted by Congress, they had to deal with a number of upsetting experiences. Their animals were hunted again and again and Ais were forced to migrate. Their forced lifestyle adjustments and societal insults, which were a major contributor to health inequalities, are documented throughout history. They were forced to relocate historically, and the destruction of their traditional irrigation methods made them dependent on government aid. The consumption of fat rich foods increase the chances of obesity and diabetes in AIs (Lucero & Roubideaux, 2022).

 Relevance and Validity of the Resources
The information extracted from the credible sources helps to gain knowledge about risk factors of environment and T2DM prevalence. The majority of the information is based on reports from the CDC and IHS, two of the most reliable databases for gathering information on health, particularly that of AIs.
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Meeting Community Needs

Population Health Improvement Plan
Five ethical principles, such as equity, empowerment, openness, respect, and participation
For the proper maintenance of budget and training to community members
Cooking classes focused on promotion of culture-relevant T2DM
Ethically spreading the information of diabetes to the community members

Potential Barriers:
Lack of access to low fat and low carbs diet
Preference to cultural meals over western dishes
Rejection of government healthcare medicines

NURS FPX 6011 Assessment 2 Attempt 1 Evidence-Based Population Health Improvement Plan


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The assessment of T2DM in AIs demands a comprehensive and efficient ethical health betterment plan. The important principles of ethical principles are also suggested to include in the plan (Hailes et al., 2020). These guidelines will assist participants, including organizations and health care professionals, in managing risk factors and illness while honoring local customs and cultures. For instance, since eating components directly affect body weight, educating people about healthy food may be perceived as ridiculing their culture or customs (Hailes et al., 2020). Making ethical decisions is therefore essential to developing a health strategy.
The food environment in AI communities is another factor in the prevalence of obesity and disorders like diabetes and type II that are associated to it. It is suggested that AI individuals had obesity rates higher than other ethnic groups (Zamora-Kapoor et al., 2019). Unhealthy dietary conditions are the main cause of obesity. They eat a processed diet that is rich in calories, salt, and fats. Inadequate transportation due to the vast number of AIs living in rural regions, poverty, low-income population, and other environmental constraints all contribute to the lack of availability to good food (Zamora-Kapoor et al., 2019).
The community should be included through techniques like cooking workshops that are culturally appropriate, training in food budgeting, and strategies for health improvement. The fact that these strategies raise awareness of a healthy diet makes them valuable. Cooking workshops and money management lessons can teach individuals how to prepare or buy affordable, healthful food from nearby community markets (Zamora-Kapoor et al., 2019).
Traditional foods and an unwillingness to use medications made by white people are two further cultural hurdles. Their past issues they had to deal with might be the cause. The traditional cuisine is really derived from historically produced government goods that are unhealthy and raise the risk of diabetes. Additionally, people primarily turn to traditional treatments rather than using pharmaceuticals (VanderWeele et al., 2019). The strategy should incorporate moral education tactics to inform people of the significance of sickness treatment in order to prevent this. Here, the ethical elements of the strategy will aid in enlightening people while yet respecting their cultural values.
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Measuring Outcomes
The community will be guided to prefer healthy food in their diets. Consequently, the members of the community will focus on purchasing healthy food.
They will follow the proper diet once they are get to know about the benefits of healthy meal. Their preference to healthy lifestyle will help to decrease the possibility of diabetes
The knowledge of risk factors related to diabetes will make them able to comprehend the significance of diabetic medicines. Their knowledge about risk factor will also help to curb the rise of diabetic patients
The bond between medical staff and AIs will strengthen with help of ethical elements to secure Ais from diabetes
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• Since these strategies raise awareness of a healthy diet, they will be helpful. Cooking workshops and money management lessons can teach individuals how to prepare or buy affordable, healthful food from nearby community markets (Domingo et al., 2021).
• The plan’s ethical elements will aid in educating them while yet honoring their cultural values. They will develop a trusting connection with doctors as a result.
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Communication Plan
Community Stakeholders
Community Leaders
Healthcare Providers
Health Organizations

Communication Strategy
Strengthen community’s traditions and cultures by involving community leaders and members to develop a healthcare plan
Gain the knowledge of culture and tradition of community to understand their interaction
Invite community members to build trust and strengthen communication

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• Studies have revealed that owing to past injustices and marginalization, AIs lack faith in medical treatments and healthcare institutions (Gillson et al., 2022). It’s important to develop such trust in order to carry out the health improvement strategy. That will make it easier for a doctor to interact with AIs. To do this, experts can involve community leaders in the development of the health plan and decision-making. As native tribes revere their customs and elders, community leaders should be informed on the usefulness of treatment and the effects of the condition. Understanding their culture and customs via study and from community members might be another technique to foster trust. So that the experts can interact with them more effectively. The customs, spiritual beliefs, and traditions of the native tribes vary. Understanding them will enable clinicians to consistently offer care while honoring their cultural background, closing the trust gap (Gillson et al., 2022).

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To encourage people to take the right medications, another tactic is to combine western health treatments with the cultural, spiritual, and traditional traditions of the community. This can be accomplished by involving other community members and elders. The inclusion will aid providers in overcoming linguistic or cultural hurdles. Every month, these events might be held with an emphasis on their customs and cultures. The AIs can also benefit from a lifestyle intervention approach for regulating their weight. A comprehensive clinical examination and an evaluation of the lifestyle balancing curriculum are both part of the intervention. Weight loss and the long-term reduction of diabetes risk are related (Magkos et al., 2020).
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Value & Relevance of Evidence
Relevance and Value to Community Health Concerns:
(Carter et al., 2011) – explains five components of ethics
(Lucero & Roubideaux, 2022) – explains the environment of food environment and various causes behind choosing unhealthy food over healthy food
(VanderWeele et al., 2019) – identifies both cultural obstacles that contribute to Diabetes prevalence among AIs

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• (Carter et al., 2011) describes the five fundamental facets of ethics, which is relevant to the ethical health improvement strategy. The research emphasizes the value of facts and morality in health promotion. Evidence helps clinicians make decisions about patient treatment by providing them with knowledge of epidemiological and community statistics. Additionally, ethics may be extremely important in health promotion efforts that involve learning about the cultural and traditional values of a group. Because it went into detail on the food environment and socio-economic elements influencing AIs’ food choices, (Zamora-Kapoor et al., 2019) is pertinent to the proposal. The writers also offered helpful methods for increasing readers’ knowledge of healthy food options and enabling them to get them while staying within their means. Training in financial management and cookery classes are among the initiatives. (Cole et al., 2020) is another piece of supporting data on which I built my health plan proposal. Two significant cultural hurdles that AIs face that have an impact on their health or contribute to the prevalence of diabetes are mentioned by the author. Understanding cultural obstacles enables experts to more effectively develop health improvement initiatives.
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References
Brockie, T. N., Elm, J. H. L., & Walls, M. L. (2018). Examining protective and buffering associations between sociocultural factors and adverse childhood experiences among American Indian adults with type 2 diabetes: A quantitative, community-based participatory research approach. BMJ Open, 8(9), e022265. https://doi.org/10.1136/bmjopen-2018-022265
Carter, S. M., Rychetnik, L., Lloyd, B., Kerridge, I. H., Baur, L., Bauman, A., Hooker, C., & Zask, A. (2011). Evidence, ethics, and values: A framework for health promotion. American Journal of Public Health, 101(3), 465–472. https://doi.org/10.2105/ajph.2010.195545
CDC. (2021, December 16). Type 2 Diabetes. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/type2.html#:~:text=More%20than%2037%20million%20Americans
Cole, A. B., Hébert, E. T., Reitzel, L. R., Carroll, D. M., & Businelle, M. S. (2020). Health risk factors in american indian and non-hispanic white homeless adults. american journal of health behavior, 44(5), 631–641. https://doi.org/10.5993/ajhb.44.5.7
Domingo, A., Charles, K.-A., Jacobs, M., Brooker, D., & Hanning, R. M. (2021). Indigenous community perspectives of food security, sustainable food systems and strategies to enhance access to local and traditional healthy food for partnering williams treaties first nations (Ontario, Canada). International Journal of Environmental Research and Public Health, 18(9), 4404. https://doi.org/10.3390/ijerph18094404

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References
Elma, J. H. L., Hautalab, D., Abrahamson-Richardsa, T., & Wallsb, M. L. (2021). Patterns of adverse childhood experiences and mental health outcomes among American Indians with type 2 diabetes. Child Abuse & Neglect, 122, 105326. https://doi.org/10.1016/j.chiabu.2021.105326
Gillson, S. L., Hautala, D., Sittner, K. J., & Walls, M. (2022). Historical trauma and oppression: Associations with internalizing outcomes among American Indian adults with type 2 diabetes. Transcultural Psychiatry, 136346152210791. https://doi.org/10.1177/13634615221079146
Hailes, H. P., Ceccolini, C. J., Gutowski, E., & Liang, B. (2020). Ethical guidelines for social justice in psychology. Professional Psychology: Research and Practice. https://doi.org/10.1037/pro000029
Hsueh, W.-C., Bennett, P. H., Esparza-Romero, J., Urquidez-Romero, R., Valencia, M. E., Ravussin, E., Williams, R. C., Knowler, W. C., Baier, L. J., Schulz, L. O., & Hanson, R. L. (2018). Analysis of type 2 diabetes and obesity genetic variants in Mexican Pima Indians: Marked allelic differentiation among Amerindians at HLA. Annals of Human Genetics, 82(5), 287–299. https://doi.org/10.1111/ahg.12252
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References
Magkos, F., Hjorth, M. F., & Astrup, A. (2020). Diet and exercise in the prevention and treatment of type 2 diabetes mellitus. Nature Reviews Endocrinology, 16. https://doi.org/10.1038/s41574-020-0381-5
Saldana, S. L., & Guarnaccia, C. A. (2022). Comparing cognitive function in white Mexican & non-Hispanic white Americans with/without diabetes. Journal of Diabetes & Metabolic Disorders. https://doi.org/10.1007/s40200-022-01022-2
VanderWeele, T. J., McNeely, E., & Koh, H. K. (2019). Reimagining Health—Flourishing. JAMA, 321(17), 1667. https://doi.org/10.1001/jama.2019.3035
Zamora-Kapoor, A., Sinclair, K., Nelson, L., Lee, H., & Buchwald, D. (2019). Obesity risk factors in American Indians and Alaska Natives: A systematic review. Public Health, 174, 85–96. https://doi.org/10.1016/j.puhe.2019.05.021
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