Public Health/ Health Evaluation &Implementation FINAL PROJ.

This is Master level, please read. I have a Public Health Program FINAL PROJ.Proposal (15 pages) On High Blood Pressure (HTN) to fill in. The outlines are already created ( TOPIC is HTN, Objectives are determined, Community is chosen). I need someone with Health care experience what has done previous Assignments on HTN and it an exert on how to address the problem on different levels: INTRApersonal, INTERpersonal, COMMUNITY level, SOCIETY levels.

1)TOPIC: High blood pressure (hypertension)

2)OBJECTIVES: My health promotion program proposal will focus on optimization of hypertension management in rural communities; 50% reduction in cases of HTN in West Virginia rural community

3)This project focuses on PROGRAM PLANNING MODELS: planning model I have selected for my proposal is the Intervention Mapping Model.

My Health promotion program proposal will focus on optimization of delivery of rural health care through development of an INTERVENTION PROGRAM that increase hypertension awareness and self-management by using community volunteers as health coaches. YOU will fill in with more details in here.

THE INTERVENTION STRATEGIES are to be filled in, I have already chose a Behavioral theory to be applied.

I have uploaded a FINAL PROJ.EXAMPLE in an adobe, from a collegue, for you to use it as INSPIRATION, please do not COPY PASTE anything from that!

MY OWN PROGRESSES on the FINAL PROJECT

MODULE2 in the CLASS requested to Post an update on the progress you are making on your Health Promotion Program Proposal. Topics for discussion include the community you have identified, the program planning model you have selected, and the rationale for the selection.

Module 2 READINGS:

McKenzie, J. F., Neiger, B. L., & Thackeray, R. (2017). Planning, implementing, and evaluating health promotion programs: A primer (7th ed.). San Francisco, CA: Pearson.

Chapter 2, “Starting the Planning Process” (pp. 17-37)

· Chapter 3, “Program Planning Models in Health Promotion” (pp. 41-63)

MY TOPIC is:

High blood pressure (hypertension) is a common and dangerous condition. Hypertension means that the pressure of one’s blood in the blood vessels is higher than it should be. According to (CDC, 2017) about 1 of 3 adults which is equivalent to 75 million people in the United States have high blood pressure. This common condition increases the risk for heart disease, stroke, and death. My health promotion program proposal will focus on optimization of hypertension management in rural communities. This is because rural populations across United States have an increased likelihood of developing hypertension, therefore, have higher risks associated with hypertension (Bale, 2010).

The program planning model I have selected for my proposal is the Intervention Mapping Model. According to (McKenzie, Neiger, & Thackeray, 2017) Intervention mapping model is designed to fill a gap in health promotion practice by translating theoretical social, epidemiological, educational, ecological administrative, organizational or policy data into appropriate interventions. This model comprises of six basic stages that evaluate theory and then used to plan, design, and implement an intervention model.

The health promotion program proposal will focus on optimization of delivery of rural health care through development of an intervention program that increase hypertension awareness and self-management by using community volunteers as health coaches. I believe this model is a perfect fit for the proposal because it is also the same model that was employed by program planners in a study that focused on the development of a peer support intervention in rural Alabama (Cherrington, et al., 2012).

References:

Bale, B. (2010). Optimizing hypertension management in underserved rural populations. Journal of the National Medical Association, 102(1), 10-17.

CDC. (2017, November 13). High Blood Pressure . Retrieved from Centers for Disease Control and Prevention :https://www.cdc.gov/bloodpressure/index.htm

Cherrington, A., Martin, M. Y., Hayes, M., Halanych, J. H., Wright, M. A., Appel, S. J., . . . Safford, M. (2012). Intervention Mapping as a Guide for the Development of a Diabetes Peer Support Intervention in Rural Alabama. Preventing Chronic Disease, 9(110053). Retrieved from https://www.cdc.gov/pcd/issues/2012/11_0053.htm

McKenzie, J. F., Neiger, B. L., & Thackeray, R. (2017). Planning, implementing, and evaluating health promotion programs : a primer(7th ed.). USA: Pearson.

PROF.suggestions to my 1st part:

I suggest focusing on a particular state. Maybe a state that is primarily rural or a state with health disparities in hypertension rates between rural and urban areas.

MY RESPONSE to PROF after considering the feedback:

Hello Dr. Litton,

Thanks for your insight.

According to (Bale, 2010) West Virginia has the highest rate of hypertension at 43 percent. It is also the second largest rural state in the United States. With such distinguishing characteristics, my health promotion program proposal will aim atoptimizing hypertension management in rural communities of West Virginia. THIS IS MY COMMUNITY, has alreday been decided and Approved by Prof!

Reference:

Bale, B. (2010). Optimizing hypertension management in underserved rural populations. Journal of the National Medical Association, 102(1), 10-17.

A Collegues asked me:

You chose a great topic for your health promotion program. High blood pressure is actually one of the negative health conditions associated with my topic of obesity. Do you think you’ll address the issue of obesity as a factor in developing high blood pressure in your health promotion planning?

MY RESPONSE to collegue:

Thanks for your question Walker,

According to (Landsberg, et al., 2012) there is a frequent concurrence of obesity and hypertension and as the rate of obesity rises, so does the rate of hypertension. This is concurrent with other major studies and as you mentioned, it will be imperative to address the topic of obesity. In relation to that, I will have to develop strategies for the management of obesity in order to reduce the development of obesity-related hypertension and to effectively manage hypertension in obese. MAKE SURE YOU CONSIDER OBESITY

Reference:

Landsberg, L., Aronne, L. J., Beilin, L. J., Burke, V., Igel, L. I., Lloyd-Jones, D., & Sowers, J. (2012). Obesity-Related Hypertension: Pathogenesis, Cardiovascular Risk, and Treatment. The Journal of Clinical Hypertension, 15(1), 14-33

MODULE 3 NEXT UPDATE OF FINAL PROJECT in

MD 3 required this: Post an update on the progress you are making on your Health Promotion Program Proposal. Topics for discussion include methods used to assess the health needs of your chosen community, how program stakeholders were identified, collaboration strategies you propose, and program goals and objectives

READING for MD3:

McKenzie, J. F., Neiger, B. L., & Thackeray, R. (2017). Planning, implementing, and evaluating health promotion programs: A primer (7th ed.). San Francisco, CA: Pearson.

· Chapter 4, “Assessing Needs” (pp. 67-102)

· Chapter 6, “Mission Statement, Goals, and Objectives” (pp. 133-142)

· Chapter 9, “Community Organizing and Community Building” (pp. 237-255)

MY UPDATE in MD3

Health Promotion Program Proposals

Assessment methods depict ways that apply in optimizing hypertension management in rural societies. They are essential to reduce expenses, improve outcomes and enhance care among patients. The methods used to assess health needs of my chosen community include:

Sharing the best practices with the staff; it helps the organization to identify the vital developments that apply in controlling the disease and ways to achieve them. It also incorporates ways that the staff can embrace to determine rates of the disease prevalence among the victims in the community. It entails implementation of standardized approaches and procedures that physicians use to update important details of their patients (Brent, 2013). For instance, this involve cheaper medications and allowing free blood pressure reading in communities.

Disseminating monthly physician report: it is a vital method to assess health needs which enhances a transparent and a timely feedback. It increases the engagement of physicians hence facilitate their performance improvement. It also incorporates use of electric health record data that gives a report concerning their blood pressure and ways to improve their health.

Utilization of patient engagement tools: this is another approach that is used to assess how patients respond to medication in the community. These tools determine whether they maintain a healthy diet, exercise on a regular basis or keep medical appointments. They are key elements in assessing and managing hypertension among patients. Through this procedure, the sick individuals are encouraged to be active participants to cater for their own health. The assessment enables them to indulge in activities that allows them to manage their blood pressure effectively. They incorporate monitoring blood pressure from home. It enables patients to learn on tips to measure, record and provide accurate readings to their physicians. This enables them to determine whether they should change medication and the lifestyle of patients. To assess health needs of the community, it is also significant to involve educational materials.

Additionally, the participating groups require to offer the sick with free reading materials. This will help patients to understand the vital aspects of the hypertension disease and make the necessary adjustments (Brent, 2013).

The program stakeholders were identified based on their interest on knowledge pertaining hypertension disease. This strategy engages stakeholders by identifying experts to aid in expanding the sustainability of the program. These stakeholders are program champions who are influential in their groups and are active in the care management program. They are also recognized in relation to how they can offer feedback about hypertension by suggesting the new initiatives to apply in this health program. The ability to communicate effectively was another strategy that assisted to identify stakeholders. This was determined in the manner in which they planned and designed different stages of the program.

The collaboration strategies that I propose include team based care to improve blood pressure among patients. It is helpful because it involves individuals who communicate with patients to determine their progress. This implies that they reschedule and make follow up appointments especially to patients who fail to see physicians on time (Klag, 2014).

The Program goals is to ensure that free care is granted to patients who are suffering from hypertension in rural regions. It also intends to provide tools to aid for screening to improve the conditions of people with high blood pressure in the community. The objective of this program is to reduce the number of hypertension cases in the society. (PLEASE CHECK the FEEDBACK below) This is by ensuring that physicians access and offer care to the rural population.

References:

Brent, H. (2013). Hypertension and Collaboration Strategies. Journal of Health Programs Issue 85(6), 16-28.

Klag, M. (2014). Hypertension. Baltimore, MD: Johns Hopkins Medical Institutions.

PROF.feedback to me in MD3:

I suggest making the program objective more specific and measurable such as “reduce hypertension in this community by 50% within 1 year of program initiation.” IS BEEN ALREADY DECIDED THIS is FINAL OJECTIVE!

MODULE 4 REQUIRED an UPDATE

Post a final update on your Health Promotion Program Proposal. Topics for discussion include an explanation of the analysis conducted in order to select your chosen behavioral theory, intervention strategy, and program activity.

RESOURCE:

McKenzie, J. F., Neiger, B. L., & Thackeray, R. (2017). Planning, implementing, and evaluating health promotion programs: A primer (7th ed.). San Francisco, CA: Pearson.

· Chapter 7, “Theories and Models Commonly Used for Health Promotion Interventions” (pp. 151-188)

· Chapter 8, “Interventions” (pp. 191-234)

PLEASE READ ch 7+ch8, they are CRITICAL to understand what to apply for my TOPIC in FINAL PROJECT! LOOK at each theory, read APPLICATIONS (see if applied to HTN).

Professor comments : for the purposes of this assignment, please only select 1 theory that fits the best and you can definitely use more than one intervention strategy.

. The intervention strategy must be specific. Students, If your intervention is aimed at the individual level, then you should select an intervention strategy for individuals. Please review Table 8.5 on page 231 in the McKenzie text that depicts the type of objective, outcome, theory, intervention strategy and possible activities

THIS IS an exachnge btw PROF and a COLLEGUE:

Colleague:When I discuss stage theory, my discussion is more focus on TTM. So my theory based on TTM.For the intervention part, I have checked our textbook and chose the intervention strategy that goes with TTM theory construct.My proposed intervention strategy is providing health communication and health education through class seminars and workshop. However not limited to seminars and workshop but create awareness through a mini-organization that invites the priority population to participate in the radical change. For instance, healthy lifestyle matters, stand for the right diet!

PROF said: Thank you for the clarification. These sound good. Just be sure to use the exact wording of the public health terms used in the textbook!!!!

HERE IS FINAL PROJECT MY UPDATE for MODULE 4 (MD4)

MY UPDATE for MD4 FINAL PROJECT UPDATE:

The theory I chose is the SCT Expectation and Behavioral capability.

According to McKenzie, reinforcement is very important in the process of learning, although the reinforcement combined with the expectations developed by the individual from the consequences of a behavior is what determines the final behavior (McKenzie, 2017). ).

Expectations refers to the ability of an individual to think and to foresee a certain outcome to take place in certain situations. If a person is to perform a certain behavior, this person must be informed first what the behavior is and then how to correctly perform the behavior. This is referred to as behavioral capability, according to (Mckenzie,2017)

This theory fits my hypertension topic of my final project proposal.

The intervention strategy is at the interpersonal level. Possible program activities I consider are Classes, Seminars and Workshops to educate my community about the disease.

EMAIL TO BE SENT:

hey,

so let’s have the FINAL WORD!

1) Were you able to access the book? PLEASE be HONEST. I do not need another lier on my money!

2) Can you start working on IT NOW? And by the tiem I wake up you will have a skeleton on what it will look like/ CREATE a skeleton based in FINAL PROJECT INSTRUCTIONS and start filling IN, considering my MD2,3,4 UPDATES, Prof. feedback on Objectives, that REVEW TABLE which is the OST ESSENTIAL ONE:

“””The intervention strategy must be specific. Students, If your intervention is aimed at the individual level, then you should select an intervention strategy for individuals. Please review Table 8.5 on page 231 in the McKenzie text that depicts the type of objective, outcome, theory, intervention strategy and possible activities”””

3) Do you feel confident 100% you can fill in? This is NOT just medcail sentences thrown out there for the sake of filling in the pages: You need to conduct google Research on StakeHOLDERS for filling in STAKEholders paragraph (INSPIRE FROM EXAMPLE I uploaded, but do your own REAL search w REFERENCES provided). KEEP INSPIRING from EXAMPLE PROJECT I uploaded for you, but do stay on HTN topic on my community chosen.

Is everthng CLEAR? Are you confident you can create a skeleton by the tiem I wake up?

MODULE4 FINAL PROJECT INSTRUCTIONS:

Obtaining the funding and/or approval to develop a program is often dependent upon one’s ability to clearly articulate each element of the proposed program. Proposing a health promotion program requires a well-thought-out plan that clearly identifies the health condition, target population, and anticipated activities.

Modules 2, 3, and 4 have covered the steps for planning and designing a health promotion program. For this Assignment,you will submit a proposal for the health promotion program you have been developing that meets a health need for a specific community.

12- to 15-page proposal (double- spaced, Times New Roman font):

Cover page should include:

· Project title

· Primary contact person, title

Sections of your proposal:

1. Introduction

a. Briefly describe the project relevance and need

b. Describe how your project complements or adds to other similar initiatives.

2. Community Description

a. Describe the target audience(s) for the project (e.g. health practitioners, policy-makers, underserved population).

b. Provide list the geographic location(s) and sites/settings (e.g. hospital, community-based center, school, work setting) where the project activities will take place.

3. Needs Assessment

a. Provide a summary of the mini-needs assessment conducted to determine a priority health issue for this community. The mini-needs assessment should be based on available statistics.

4. Socio-ecological factors

a. Provide a description of the primary socio-ecological factors related to the health issue.

5. Stakeholders

a. Identify

and describe types of resources and community stakeholders. Indicate the name of the partners you will work with during the project. Describe the role and contribution of each partner.

b. Provide a description of the stakeholder collaboration strategy that would be used and explain why it is most appropriate.

6. Mission, goals and objectives

a. Identify

· the mission,

· at least one program goal and

· at least two objectives

7. Theoretical framework

a. Identify the theory or model used to guide development of the interventions and provide a rationale for your selection.

8. Intervention strategy

a. Select an appropriate intervention strategy based on your theoretical framework that targets one of the socio-ecological factors associated with this health condition and target population.

9. Activities

a. Identify at least two specific program activities and explain how it would be used in the program.

b. Explain how each activity is related to your theoretical framework.

10. Logic Model

a. Develop a Logic Model for the program.

Support your work with specific citations from this module’s Learning Resources and additional scholarly sources as appropriate. Refer to the Essential Guide to APA Style

MY UPDATE for MD4 FINAL UPDATE

The theory I chose is the SCT Expectation and Behavioral capability.
According to McKenzie, reinforcement is very important in the process of learning, although the reinforcement combined with the expectations developed by the individual from the consequences of a behavior is what determines the final behavior (McKenzie, 2017). ).
Expectations refers to the ability of an individual to think and to foresee a certain outcome to take place in certain situations. If a person is to perform a certain behavior, this person must be informed first what the behavior is and then how to correctly perform the behavior. This is referred to as behavioral capability, according to (Mckenzie,2017)
This theory fits my hypertension topic of my final project proposal.
The intervention strategy is at the interpersonal level. Possible program activities I consider are Classes, Seminars and Workshops to educate my community about the disease.

BRIAN HIV TOPIC:

With HIV/AIDS, communication is the key preventive measure, which is very important in influencing behaviors of an individual and the society. Since many varying contexts determine behaviors, it is important therefore to reevaluate the communication approaches used in the prevention of HIV/AIDS. The above should be applied to areas in the world that the spread of HIV/AIDS infection is very high.

In this case, therefore, many of the theoretical frameworks in the prevention of HIV/AIDS was adopted from the sociological and communication theories, and some of them have been borrowed from activities such as family planning which has successfully used Information, Education, and Communication in fulfilling their strategies. Owing to the case above, this proposal will use the same approach as a method of trying to understand the community and at the same time get into the core of the affected community in the quest of reducing the HIV/AIDS pandemic. In this regard, therefore, this proposal will place its emphasis on the AIDS Reduction Model and the Health Belief Theory.

The Health Belief Model was a health communication theory adopted in the 1950s. Its main aim it predicts a person’s response to, use of, screening and other preventive measures in health services. The theory will be helpful to a wide range of behavior and the community at large due to its vast knowledge in sexual education. The above is due to the emphasis that the theory puts on individuals when it comes to sexuality such as using protection when doing sex. In this manner, the theory focuses on primary prevention strategies such as those which help in reducing the spread of the virus. The theory also focuses on secondary prevention by having programs that increase early detection of the HIV/AIDS virus among individuals. This theory was successfully applied in to determine the use of condoms in female students in Cameroon, and therefore it is one of the best frameworks to use when addressing the issue of HIV/AIDS in Dallas (Zotor and Tarkang, 2015).

Zotor B., F. and Tarkang E., E. (2015). Application of the Health Belief Model (HBM) in HIV Prevention: A Literature Review. Online < http://article.sciencepublishinggroup.com/html/10.11648.j.cajph.20150101.11.html> Retrieved 11/1/2018

PROF. RESPONSE to BRAINBrian,

I think the Health Belief Model is a good choice for your topic and target population. Are you thinking of using health communication and health education intervention strategies?

Do remember to be very careful about using the specific public health terms used in the textbook. Health Belief Theory is not the name of the theory, it has to be Health Belief Model. I realize this is confusing since sometimes we use the term “model” and other times “theory.”

CHUKUMA HEALH PROGRAM PRPOSAL:

Discussion: Project Support Area (Health Promotion Program Proposal)

Hello Class,

For this week’s discussion update on my Health Promotion Program Proposal-The Prevention of Cardiovascular Disease in my community of Saint Joseph County, Indiana State.

I chose to focus on the Intrapersonal level of intervention for my target population. This choice is based on the fact that the decision of the individual to make healthy lifestyle changes that would positively impact his/her health and prevent cardiovascular disease is personal. The Intrapersonal or Individual level of intervention focuses primarily on the individual’s health behavior (McKenzie, Nieger, & Thackeray, 2017).

The Intrapersonal level of intervention focuses on the individual’s knowledge, attitudes, beliefs, self-concept feelings, motivation, skills, and behavior (McKenzie, et al., 2017).

The objective of the Health Promotion Program Proposal is to get individuals to change behaviors that predispose to Heart Disease and embrace those behaviors that prevent heart disease, such as physical activities/exercises to reduce weight and regular blood pressure checks to avoid high blood pressure which are risk factors for heart disease (American Heart Association, 2017).

THE HEALTH BEHAVIOR THEORY:

The Health Behavior Theory I have chosen to address heart disease prevention in my community is Health Believe Model (HBM) which is based on the simultaneous occurrence of three classes of factors, 1) The existence of enough health concerns to make heart disease relevant. 2) The belief that many people in the community are vulnerable to the development of CVD because of physical inactivity, overweight/obesity, and high blood pressure (Passives Threat). 3) The belief that following the recommended health promotion program proposal would reduce the prevalence and high mortality rate of heart disease-related deaths in the community, which is the highest in the State of Indiana at a reduced cost-financial and lack of self-efficacy (Perceived Barriers) (McKenzie, et al., 2017).

These perceived barriers must be overcome by the individuals before they can follow the health promotion recommendation. Self-efficacy is very crucial to the success of the health promotion program proposal for the prevention of CVD. It is essential for the target population that needs a lifestyle behavior change over a long-term should develop self-efficacy (McKenzie, et al., 2017).

For the priority population to embrace behavioral change, they must feel threatened and susceptible by their present behavioral pattern of physical inactivity that has resulted in overweight/obesity and high blood pressure (Passive Susceptibility), which if not addressed by the health promotion program proposal would lead to CVD (American Heart Association, 2017).

The target population must also believe that the behavior change to embark on physical activity/exercises will result in a valued outcome (reduction in the risk and prevalence of heart disease and the resultant mortality) (McKenzie, et al., 2017) Also, the knowledge of the target population that CVD results in death or morbidity (Perceived Seriousness/Severity) or having seen friends and family members who died from CVD would make the individuals think seriously about embracing the health promotion program proposal (McKenzie, 2017).

Physical inactivity, overweight/obesity, and high blood pressure are risk factors that would make individuals become concerned about heart disease (Perceived Threats).

The health promotion program proposal would empower the people to know that physical activities/exercises would postpone the onset of heart disease and would increase the possibility of survival if a heart attack occurs (Perceived Benefits) (McKenzie, et al., 2017).

The confidence of the person to overcome the perceived barriers (weather, lack of self-efficacy, finance) and exercise regularly would determine the success of the health promotion program proposal among the population (McKenzie, et al., 2017).

The target population would examine the threats of CVD against the difference between benefits and barriers. The persons would now decide to embark on the exercise because of the perceived benefits or not (likelihood of taking recommended preventive health action (McKenzie, et al., 2017).

INTERVENTION STRATEGIES:

The Intervention Strategies I would like to employ for the health promotion program proposal for the prevention of heart disease include, 1) Health communication strategies to inform, increase awareness, and impact both individual and community decisions that affect their health (McKenzie, et al., 2017).

The form of the health communication strategies would include the mass media advocacy, risk communication, public relations, print materials, television, radio, electronic communication, billboards, and social media to disseminate the information about the health promotion program proposal for CVD to reach as many members of the community as possible (McKenzie, et al., 2017). Health communication strategies are also crucial in reaching many of the goals and objectives of the Health Promotion Program Proposal. Health Communication Strategies have the highest penetration rate to reach many members of the target population (McKenzie, et al., 2017).

Health communication strategies alone are often insufficient to change the behavior of the individuals and reduce the risk of CVD (McKenzie, et al., 2017).

2) Health Education Strategies would be used in combination with Health Communication Strategies to enable and reinforce voluntary behavior decisions conducive to the health of individuals, groups, or community. The Health Education Strategy would include such settings as classes, seminars, workshops, and courses, both face to face and online, to educate the population about the risk factors of heart disease (McKenzie, et al., 2017).

Though health communication strategies are often used for health promotion program proposal intervention strategies, health education strategies provide the opportunity for the target population to gain in-depth knowledge about the risk factors, prevalence, morbidity, and mortality attributed to CVD (McKenzie, et al., 2017).

HEALTH PROMOTION PROGRAM ACTIVITY:

The health promotion program activity which I would embark on includes, meetings with all stakeholders to increase awareness among the stakeholders about the urgent need of intervention to adequately address this preventable, devastating disease on the public health of the community. I would also organize town hall meetings with members of the community and their leaders to inform, increase awareness of the severity of the heart disease on the community population. I would organize seminars, workshops, and courses to increase the awareness of this preventable silent killer disease in the community. I will organize regular blood pressure checks for the community members through the local or community health centers. I will embark on an aggressive health promotion campaign through advertisements in the print, electronic, social media, brochures, flyers, posters, bill-boards about the severity of the CVD on the public health of the community. I will let the target population understand that CVD is preventable despite its devastating effect on the community, I will encourage the community members to engage in physical activities/exercises on a regular basis in the gyms, at home and also encourage people to join the Zumba dance groups as a form of physical exercise. Thanks.

Chukuma.

References:

McKenzie, J. F., Neiger, B. L., & Thackeray, R. (2017). Planning,

implementing, and evaluating health promotion

programs: A primer (7th ed.). San Francisco,

CA: Pearson. American Heart Association, (2017), What Is Heart Disease.

Retrieved from

https://www.heart.org

COLLEAGUES PRO

GRESS UPDTES on Health PROMOTION FINAL PROJ:

BRIAN HIV TOPIC:

PROF. feedback RESPONSE to BRIAN,

I think the Health Belief Model is a good choice for your topic and target population. Are you thinking of using health communication and health education intervention strategies?

CHUKUMA HEALH PROGRAM PRPOSAL CARDIOVASCULAR DISEASE:

Discussion: Project Support Area (Health Promotion Program Proposal)

Hello Class,

For this week’s discussion update on my Health Promotion Program Proposal-The Prevention of Cardiovascular Disease in my community of Saint Joseph County, Indiana State.

The Intrapersonal level of intervention focuses on the individual’s knowledge, attitudes, beliefs, self-concept feelings, motivation, skills, and behavior (McKenzie, et al., 2017).

THE HEALTH BEHAVIOR THEORY:

Physical inactivity, overweight/obesity, and high blood pressure are risk factors that would make individuals become concerned about heart disease (Perceived Threats).

INTERVENTION STRATEGIES:

Health communication strategies alone are often insufficient to change the behavior of the individuals and reduce the risk of CVD (McKenzie, et al., 2017).

HEALTH PROMOTION PROGRAM ACTIVITY:

Chukuma.

References:

McKenzie, J. F., Neiger, B. L., & Thackeray, R. (2017). Planning,

implementing, and evaluating health promotion

programs: A primer (7th ed.). San Francisco,

CA: Pearson. American Heart Association, (2017), What Is Heart Disease.

Retrieved from

https://www.heart.org

FINAL PROJECT ISTRCUTIONS AGAIN IN HERE, please see the EXAMPLE of FINAL PAPER I uploaded in adobe doc. On homeworkmarket, you follow this exact order and develop on it ( as in EXAMPLE PROJECT):

FINAL PROJECT INSTRUCTIONS:

12- to 15-page proposal (double- spaced, Times New Roman font):

Cover page should include:

· Project title

· Primary contact person, title

Sections of your proposal:

1. Introduction

a. Briefly describe the project relevance and need

b. Describe how your project complements or adds to other similar initiatives.

2. Community Description

a. Describe the target audience(s) for the project (e.g. health practitioners, policy-makers, underserved population).

b. Provide list the geographic location(s) and sites/settings (e.g. hospital, community-based center, school, work setting) where the project activities will take place.

3. Needs Assessment

a. Provide a summary of the mini-needs assessment conducted to determine a priority health issue for this community. The mini-needs assessment should be based on available statistics.

4. Socio-ecological factors

a. Provide a description of the primary socio-ecological factors related to the health issue.

5. Stakeholders

a. Identify

and describe types of resources and community stakeholders. Indicate the name of the partners you will work with during the project. Describe the role and contribution of each partner.

b. Provide a description of the stakeholder collaboration strategy that would be used and explain why it is most appropriate.

6. Mission, goals and objectives

a. Identify

· the mission,

· at least one program goal and

· at least two objectives

7. Theoretical framework

a. Identify the theory or model used to guide development of the interventions and provide a rationale for your selection.

8. Intervention strategy

a. Select an appropriate intervention strategy based on your theoretical framework that targets one of the socio-ecological factors associated with this health condition and target population.

9. Activities

a. Identify at least two specific program activities and explain how it would be used in the program.

b. Explain how each activity is related to your theoretical framework.

10. Logic Model

Develop a Logic Model for the program

Improving Community Health: One Food Desert at a Time

MD4Assgn2 Reynolds K.

Improving Community Health: One Food Desert at a Time

K. Reynolds (student name)

Example of Health Promotion Proposal

*This proposal is being used as an example by Dr. Allison Litton with permission from the student.

Improving Community Health: One Food Desert at a Time

Introduction

Food Insecurity and Food Deserts

According to the United States Department of Agriculture (USDA) food insecurity is the

inability to access to adequate food for an active and healthy life (Camp, 2015). Camp (2015)

goes on to suggest that food insecurity has been increasing since 1995 and that in 20

approximately 15% of all households in America experience food insecurity. The USDA also

proposes that food deserts are areas, often located in low income communities, that do not have

access to healthy food options due to a lack of full service supermarkets (American Nutrition

Association, 2015). Food insecurity and food deserts are increasingly problematic for children

and minorities. A research study conducted in 2012 found that between 12% to 15% of Black

and Hispanic children elementary aged children experienced food insecurity (Xu, Zhu, &

Bresnahan, 2016). Camp (2015) cites that 25.1 % of Black households and 26.2% of Hispanic

households’ experience food insecurity. The US Department of Health and Human Services

(2014) states that approximately 30 million Americans live food deserts with a large percentage

being people of color.

Alabamians also face the complications of food insecurity and food deserts. The

Alabama Food Bank Association (2016) reports that 19.2% of Alabama’s population or almost 1

million people live with food insecurity. Furthermore, 1.8 million Alabamians live in areas

without full service supermarkets (Lang, Koprak, & Treering, 2015). In fact, almost every

county in Alabama has difficulty providing access to healthy food options (Lang, Koprak, &

Improving Community Health: One Food Desert at a Time

Treering, 2015). In Birmingham 40% of the population lives in a food desert and currently there

are only 24 full service supermarkets for a population of 212,000 (Change Lab Solutions, 2012).

Health Problems Related to Food Insecurity and Food Deserts

The impact that food insecurity and food deserts have on public health is unequivocal.

Several studies have noted a possible relationship between obesity and food insecurity (Camp,

2015) Camp (2015) also noted that poorly controlled diabetes, hypertension, and heart disease

are were significantly higher among individuals living with food insecurity. Brown & Brewster

(2015) support this idea by hypothesizing that there is a link between food insecurity and

sedentary lifestyles, cancer, arthritis, and metabolic syndrome. Ortega et al (2014) posits that the

exponential growth of obesity and chronic illnesses can be traced to the insufficient intake of

healthy foods that occurs within food deserts.

Alabamians face even higher rates of obesity and chronic disease. Nationwide the rate

for obesity is 68% and the rate for diabetes is 6% however, 75% of the residents in Birmingham

have been diagnosed as overweight or obese and approximately 11% have been diagnosed with

diabetes (Lang, Koprak, & Treering, 2015). The Alabama Department of Health (2015) states

the following statistics:

 In 2012 Alabama ranked fifth among the nation’s top eight obese states

 From 2010-2012 more than 35,919 Alabamians died from heart disease

 Preventable strokes caused approximately 7,759 Alabama deaths in 2010-20

 In 2008-2010 Alabama had the highest rate of stroke incidents in the nation

Improving Community Health: One Food Desert at a Time

Much current research supports the idea that making healthy food available in food deserts is a

strategy that will help citizens to make better food choices thus improving health outcomes

(Centers for Disease Control and Prevention, 2014). They go on to state that having access to

full service supermarkets increases fruit and vegetable consumption and can possibly lower the

prevalence of obesity for adults. The Alabama Department of Public Health (ADPH) (2015)

cites that 24.3% of adults in Alabama eat vegetables less than once daily and 43.8 % eat fruit less

than once daily. Increasing access to healthy food options within food deserts will improve the

health outcomes of Alabamians and help to alleviate obesity and chronic diseases (The Food

Trust, 2015).

The Program Initiative

The South Park Invests in Fresh Foods (SPIFF) intervention will work collaboratively

with the Urban Food Project to provide access to healthy food choices to the residents in the

West End Area of Birmingham, Alabama. The Urban Food Project, an economic development

organization located in Birmingham, Alabama, believes in developing creative ways to make

fresh fruits and vegetables available to residents of food deserts. Their research has shown that

residents shop in stores that are most convenient to them and providing food in easily accessible

and unconventional venues gives citizens access to healthier foods (Change Lab Solutions,

2012). SPIFF will utilize the South Park Health Food Store as a venue to provide fresh fruits and

vegetables for residents in West End.

Target Audience and Location

Birmingham covers 43 square miles has 23 communities and 99 neighborhoods (Marie

Gallagher Research & Consulting Group, 2010). Per Marie Gallagher Research & Consulting

Improving Community Health: One Food Desert at a Time

Group (2010) 88,409 Birmingham residents live in areas that experience food insecurity or are

food deserts. The West End Community has been identified as a food desert with the closest

healthy food store being twice the distance of the nearest unhealthy food store (Marie Gallagher

Research & Consulting Group, 2010). The West End area is covers 4.7 miles and has a

population of 15, 588 (Urban Mapping, 2016). The target audience for this intervention will be

the residents of West End neighborhood. The South Park Seventh Day Adventist Church located

at 414 South Park Road Birmingham, Alabama will be the selected venue for SPIFF

intervention. Locating SPIFF in the church’s health food store will allow physical space for the

fresh fruit and vegetables as well as affording the opportunity to promote food literacy to

customers.

Needs Assessment

The purpose of the needs assessment was to examine the number of people that

experience food insecurity on a monthly basis and the various ways in which people are food

insecure. The needs assessment identified the target audience by conducting a review of the

available literature on food insecurity and food deserts nationwide and in Alabama, by

examining statistics from the US Department of Agriculture’s Food Environment Atlas (2016),

and by conducting a community assessment. The community assessment consisted of face to

face surveys in the West End area. The surveys sought to understand how the following factors

influenced food insecurity:

 Proximity to a nearest grocery store

 Transportation to and from store

 Type of store available near residents

Improving Community Health: One Food Desert at a Time

 Number of residents receiving food assistance

 Number of days during the month food insecurity is experienced

 Chronic health issues

 Socio-economic factors (race, income, education)

The needs assessment also examined urban maps for the West End Community and noted that

the community had been identified as a food desert. Since the entire community was located

within a food desert all residents of the West End Community would be eligible for participation

in the SPIFF intervention. Surveys were returned and results tabulated and it was discovered that

40% of those surveyed were experiencing food insecurity at some point during the month.

Surveys also showed that residents were interested in having access to healthy foods and

understanding how to properly use healthy foods. Residents were invited to four planning

meetings to discuss health needs related to living in a food desert, healthy food preparation, and

additional community needs that could be addressed by the SPIFF program.

Socio-ecological Factors

The following socio-ecological factors are related to food insecurity and food deserts:

 Median household income

 Availability of food stores

 Neighborhood

 Quality of food accessible

 Dependence on food assistance programs

 Knowledge about managing healthy foods

Improving Community Health: One Food Desert at a Time

 Employment Level

Stakeholders

Stakeholder #1 South Park Health Ministries Committee- The South Park Church Health

Ministries Committee is committed to reducing food insecurity and food deserts in the West End

community by providing financial assistance for the purchase of fresh produce weekly, offering

fresh produce at a reasonable price, providing food bank services, and providing food literacy to

community members

Stakeholder#2 Residents of the West End Community- West End residents have expressed

concern about how residing in food deserts has a direct relationship to years of life (Marie

Gallagher Research & Consulting Group, 2010). They believe that having access to healthy

food options and having food literacy on how to manage healthy foods will improve community

health and add quality years to life. As stakeholders, they will work toward community buy in

by all residents in West End.

Stakeholder#3 Urban Food Project- The Urban Food Project works to create innovative

solutions to food insecurity and food deserts (Change Lab Solutions, 2012). They will provide

training to the SPIFF program on proper food handling techniques, assistance on ordering the

proper amount of produce, as well as provide logistic support such as delivering produce weekly.

Stakeholder # 4 The Alabama Food Bank- The Alabama Food Bank will continue to provide

support to the SPIFF program. The SPIFF program will purchase additional food from the Food

Bank for distribution at no cost to West End residents

Improving Community Health: One Food Desert at a Time

Stakeholder # 5 Jefferson County Department of Health- The Jefferson County Department

of health is committed to developing partnerships with the local community that will build a

healthy community through circulating health data, holding community members accountable for

their health decisions and celebrating each other’s success They will provide nutritional

educational information to support the food literacy component of the SPIFF program.

Stakeholder Collaboration Strategy

Stakeholder engagement will be crucial to the success of the SPIFF intervention.

Insufficient stakeholder involvement can lead to overlooking components that are essential to the

success of the program thus resulting in an initiative that does not function as intended.

Priorities will be developed by the group and based on what the group wants to accomplish

through the SPIFF intervention. Once priorities have been established the group will list the

anticipated goals of the intervention. In the event, there is a conflict the leader of the South Park

Health Ministries committee will act as a facilitator to ensure that a group consensus has been

reached (McKenzie, Neiger, & Thackeray, 2009). The Health Ministries leader will establish

subcommittees that will address ideals that are not listed as primary goals. These special interest

subcommittees will address these sub-goals. The chart below demonstrates the stakeholder

collaboration strategy.

Improving Community Health: One Food Desert at a Time

Collaboration Strategy

Allowing all stakeholders to have a say in the development of priorities and goals will

create buy in from all parties (McKenzie, Neiger, & Thackeray, 2009).

Mission, Goals, and

Objectives

Mission Statement

The mission of the South Park Invests in Fresh Food (SPIFF) health initiative is to eliminate food

insecurity and food deserts in the West End neighborhood by providing regular access to fresh

produce at affordable prices.

Goal

 To reduce and ultimately eliminate food insecurity and food deserts in the West End area

of Birmingham, Alabama

Priorities/Goals •Establisehd by stakeholders

Conflicts

•Addressed by
Health
Ministreis
Leader

Subgoals

•Addressed by
subcommittees
established by
Health Ministries
Leader

Improving Community Health: One Food Desert at a Time

Objectives

 By December 31, 2018 the majority of West End residents will increase fruit and

vegetable consumption from < than one time daily to intake ranges recommended by

Healthy People 2020 (U.S. Department of Health and Human Services and U.S.

Department of Agriculture, 2016)

 By August 31, 2017 food insecurity will be reduced by 50% for the residents of West

End

 By December 31, 2018 one hundred percent of the residents of West End will have

regular access to fresh fruit and vegetables

 By December 31, 2018 the majority of West End Residents will receive food literacy

training in healthy food preparation

Theoretical framework

The theoretical framework that was used in the development of the SPIFF

intervention was the Health Belief Model (HBM). The HBM was selected because it

focused on the concerns the residents of West End have about the relationship between

years of life, diet quality, food deserts and food insecurity (Marie Gallagher Research &

Consulting Group, 2010). This concern led residents to believe that their health was

being impacted by living in a food desert with limited access to fresh healthy food

options. Residents saw the lack of healthy food options within their community as a

barrier to good health and desired to bring

healthier food choices

into their community.

West End citizens believe that if they have regular access to healthy foods community

11
Improving Community Health: One Food Desert at a Time

health will be drastically improved. The chart below demonstrates how the Health

Belief Model was utilized in the SPIFF intervention.

Health Belief Model

Intervention strategy

The intervention strategy that will be utilized by the SPIFF intervention is environmental

change. This strategy will target the lack of accessibility to fresh produce and other health food

options within the West End community. This community level intervention will focus on

providing affordable and open access to healthy food options regularly to program participants.

Activities

The two main activities that the SPIFF intervention program will be involved in are:

 Providing weekly access to healthy food options at an affordable prices

Health Belief Perceptions Eliminating Food Deserts

Perceived susceptibility Not eating enough healthy foods can be bad

for health

Perceived seriousness Too many high fat, calorie foods can cause

chronic health problems (diabetes, high blood

pressure, heart disease)

Perceived benefit Having access to health foods can eliminate

risk for chronic disease and improve health

Perceived barriers No access for healthy foods, cost, knowledge

on preparing healthy foods

Likelihood of taking actions If healthy foods are readily available at a

reasonable cost action can be taken

Self-efficacy Residents will feel empowered to make

healthier food choices

12
Improving Community Health: One Food Desert at a Time

 Providing food literacy to program participants

Each of these activities will be critical to eliminating food insecurity and food deserts in the West

End neighborhood. The HBM suggests that individual health actions depend on the belief that a

one is vulnerable to a particular health threat, that taking a certain course of action might avert

the threat, that there are possible barriers to reducing that threat, and that once barriers have been

removed it is possible to achieve the desired result (McKenzie, Neiger, & Thackeray, 2009).

Many individuals who live in food deserts believe that regular access to healthy food is not

possible because of lack of access to full service food markets, lack of reliable transportation,

and lack of money. According to Change Lab Solutions (2015) many Birmingham residents live

on food budgets of less than $600 monthly making healthy eating difficult. Making healthy

eating more challenging for those living in food deserts is that fact that as much as 15 % of

Birmingham’s population lack reliable transportation (Change Lab Solutions, 2015). Current

research shows that removing the barriers of access improves community health (Lang, Koprak,

& Treering, 2015). Providing weekly access to healthy food options will remove the barrier of

not having regular access to healthy food options at an affordable price.

Having regular access to healthy food options will not be effective without also providing

food literacy. According to Vidgen & Gallegos (2014) Food literacy is composed of being able

to properly manage foods with confidence. Program participants must have a clear

understanding of how to manage healthy food choices. Training classes that focus on the eleven

components of food literacy will target the barrier of not understanding how to utilize healthy

food options. The eleven components of food literacy are:

 Prioritize money and time

Improving Community Health: One Food Desert at a Time

 Plan for regular access to food

 Make good food choices based on food needs and resources

 Access food through a variety of sources

 Demonstrate knowledge about food products

 Demonstrate knowledge about food quality

 Demonstrate ability to prepare palatable food from available resources

 Understand the principles of food handling

 Understand the relationship between food and health

 Understand the need to eat balanced meals

 Enjoying the social aspects of sharing meals (Vidgen, 2015)

Both activities will support the HBM by reducing barriers to healthy food access and helping

program participants to achieve self-efficacy.

Improving Community Health: One Food Desert at a Time

Logic Model

Program: South Park Invests in Fresh Food (SPIFF) Logic Model Situation: Food Deserts/Food Insecurity

Funding from
South Park
Health
Ministries
Department

Produce at
reduced price
from Urban
Food Project

Food Literacy
Training

Fresh Food
Market

Residents of West
End Community

Food Literacy
Training

Increase fruit and
vegetable
consumption to
recommended daily
allowances

Inputs Outputs
Activities Participation

Outcomes
Short Medium Long

Program participants
will receive Food
Literacy training

100% of residents
will participate in
food program

Assumptions:
Health Ministries Department will continue funding as needed
Urban Food Project will continue to deliver produce at reduced prices
Food Literacy Training will increase number of residents utilizing the program

External Factors
Health Ministries may lose funding from church
Program costs may increase
Urban Food Project may not be able to continue food delivery at reduced prices

Reduce food
insecurity by 50%

Eliminate food
desert in West End
community

Improving Community Health: One Food Desert at a Time

References

Alabama Department of Public Health. (2015). 2015 state of Alabama community health

improvement plan. Retrieved from

adph.org/accreditation/assets/CHIP_2015_RevAugust

Alabama Food Bank Association. (2016). Hunger in Alabama. Retrieved from

www.alfoodbanks.org/?page_id=11

American Nutrition Association. (2015). USDA defines food deserts | American Nutrition

Association. Retrieved from http://americannutritionassociation.org/newsletter/usda-

defines-food-deserts

Brown, D. R., & Brewster, L. G. (2015). The food environment is a complex social network.

Social Science & Medicine, 133, 202-204. doi:10.1016/j.socscimed.2015.03.058

Camp, N. L. (2015). Food insecurity and food deserts. The Nurse Practitioner, 40(8), 32-36.

doi:10.1097/01.npr.0000453644.36533.3a

Change Lab Solutions. (2015). Food as a catalyst for change | ChangeLab Solutions. Retrieved

from http://www.changelabsolutions.org/publications/food-catalyst-change

Lang, B., Koprak, J., & Treering, D. (2015). The need for healthy food access in Alabama.

Retrieved from The Food Trust website: http://thefoodtrust.org/uploads/media_items/al-

reportfinalweb.original

Ortega, A. N., Albert, S. L., Sharif, M. Z., Langellier, B. A., Garcia, R. E., Glik, D. C., …

Prelip, M. L. (2014). Proyecto Mercado FRESCO: A multi-level, community-engaged

Improving Community Health: One Food Desert at a Time

corner store intervention in East Los Angeles and Boyle Heights. Journal of Community

Health, 40(2), 347-356. doi:10.1007/s10900-014-9941-8

The Food Trust. (2015). Food for every child: The need for healthy food financing in

Alabama. Retrieved from http://thefoodtrust.org/uploads/media_items/al-

reportfinalweb.original

U.S. Department of Health and Human Services and U.S. Department of Agriculture. (2016,

February 4). 2015–2020 dietary guidelines for Americans – health.gov. Retrieved from

http://health.gov/dietaryguidelines/2015/

United States Department of Agriculture. (2016). Food Environment Atlas. Retrieved from

https://www.ers.usda.gov/data-products/food-environment-atlas/go-to-the-atlas/

US Department of Health and Human Services. (2015). Healthy food financing initiative |

Office of community services | administration for children and families. Retrieved from

https://www.acf.hhs.gov/ocs/programs/community-economic-development/healthy-

food-financing

Vidgen, H. A. (2015). Food Literacy. Nutridate, 26(3), 5-6. doi:10.4324/9781315708492

Vidgen, H. A., & Gallegos, D. (2014). Defining food literacy and its components. Appetite, 76,

50-59. doi:10.1016/j.appet.2014.01.010

Xu, X., Zhu, X., & Bresnahan, M. (2016). Fighting Back: Inner-city community responses to

food insecurity. American Behavioral Scientist, 60(11), 1306-1321.

doi:10.1177/0002764216657380

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