In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
To Prepare:
- In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
- Review the Resources and reflect on the role of professional nurses in policy evaluation.
- Select an existing healthcare program or policy evaluation or choose one of interest to you. Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described. Post an evaluation topic and a brief description of the evaluation. Discuss how social determinants impact this issue. ( At least 3 references)
- Respond to at least two of your colleagues* by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues. ( At least 2 references each)
Requirements: 01
Nursing
We are on the home stretch. Policy review/evaluation is about research. At one time I was not too interested in research but then I saw the importance in ensuring the research is disseminated. For policy review, think about programs that you have encountered or read about. Remember when HCAHPS came out, there were questions about pain control? Providers gave pain medication just to keep from getting marked down on the HCAHPS. Since then, those questions no longer count. How about Let’s Move? Did it prevent obesity? Are the needle exchange programs preventing STDs? Is Narcan preventing deaths from overdoses? How is effectiveness measured? Look at the Healthy People 2020 programs. Nurses also need to think about how these programs impact other areas. One example is keeping a patient in bed or in a chair to prevent falls. Then when the patient is discharged, they can no longer walk. Rehab is then needed. Or the patient may develop a pressure ulcer from being in bed so much. If you have trouble with ideas, let me know your interest. Be sure to watch the Laureate Education (2018) video.
Suggested APA headings:
Evaluation of the Policy
Social Determinants of Change
Laureate Education (Producer). (2018). The Importance of Program Evaluation [Video file]. Baltimore, MD: Author.
3 mins ago
1st Colleague to respond to
Main Discussion Post
Healthcare Program Description
The healthcare program of my choice is The High Obesity Program (HOP 1809). The goal of HOP 1809 was to put evidence- and practice-based measures in place to enhance physical activity and nutrition, reduce obesity, and prevent or control diabetes, heart disease, and stroke (Murriel et al., 2020). In 2014, Congress authorized $4.7 million in financing (which was increased to $9 million in 2016) for HOP 1809). In counties where more than 40% of individuals were obese, the CDC paid 15 land grants to colleges to collaborate with community extension agencies to enhance access to healthier foods and safe and accessible locations for physical exercise. This program aligned with the CDC’s Prevention Division of Nutrition, Physical Activity, and Obesity’s (DNPAO) aim to lead our country’s efforts to avoid chronic illnesses via proper diet, frequent physical activity, and maintaining a healthy weight (CDC, 2023). The universities and extension agencies in the states of Alabama, Arkansas, Georgia, Kentucky, Louisiana, Mississippi, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Virginia, West Virginia, and Wisconsin collaborated with local agencies like schools, food banks, concession stands, early childcare settings, churches, farmers’ markets, community gardens, and senior meal sites to improve the nutritional value of food and its and availability. They also teamed up with schools, parks, recreation facilities and communities to build and maintain safe and inviting spaces so individuals had access to areas in which they could increase their physical activity.
Effectiveness of Healthcare Program
According to the peer-reviewed study (Murriel et al, 2020), evaluation was set into place during the design and implementation phases of the program. Coalitions and extension agents conducted needs assessments, gathered qualitative and quantitative data, and detailed individual needs of each county. These needs drove the decisions on design and implementation. The framework for the evaluation of HOP 1809 was patterned after the CDC’s Framework for Public Health Programs (Milstead & Short, 2019) in that the stakeholders were engaged, description of the program was presented, conclusions justified, and results were shared. Data was gathered annually and reported over three overarching data sources. According to the results of the study, More than 1.5 million people gained access to healthier diets and over 1.6 million gained access to physical exercise as a result of HOP 1809. More than 100 communities implemented policy, systems, and environmental modifications that improved areas for physical activity throughout the 11 supported grants, while 88 target communities boosted access to healthy meals. The program met its goals, and with that success has come the renewal of the program, as evidenced by the CDC’s announcement of HOP 2023 (CDC, 2023).
According to Murriel et al. (2020), three substantial limitations, or unintended results were identified:
- Anecdotal information shows that citizens from nearby counties may have also accessed locations to be physically active or to acquire better meals in certain regions, thus making the results underreported.
- Because of the small population sizes of the HOP-targeted neighborhoods, the results may not be generalized to the greater United States populations, especially urban areas.
- Funding amounts among the recipients varied and may have placed limitations on the extent of interventions implemented.
Impact of Social Determinants of Health
One goal of Health People 2030 is to reduce overweight and obesity by helping people eat healthy and get physical activity (HP, 2023). Compared to the years 2013-2016 when 38.6% of adults suffered from obesity, in 2017-2020, 41.8% of adults did (HP, 2023). HOP 1809 addresses both this goal, which is currently almost 6% higher than the target of 36% (HP, 2023). It also addresses the social determinant domains of health of Economic Security (by improving the reduction of food insecurity and hunger), Neighborhood and Built Environment (by improving community safety in outdoor activity spaces), and Social and Community Context (by eliminating food insecurity).
Resources:
Centers for Disease Control (2023). CDC-RFA-DP-23-0013: The high obesity program (HOP 2023) https://www.cdc.gov/nccdphp/dnpao/state-local-programs/fundingopp/2023/hop.htmlLinks to an external site.
Centers for Disease Control (2023). Division of nutrition, physical activity, and obesity. https://www.cdc.gov/nccdphp/dnpao/index.htmlLinks to an external site.
Links to an external site.Healthy People 2030 (2023). Reduce the number of people with obesity—NWS 03. https://health.gov/healthypeople/objectives-and-data/browse-objectives/overweight-and-obesity/reduce-proportion-adults-obesity-nws-03Links to an external site.
Links to an external site. Milstead, J., & Short, N. (2019) Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.
Murriel, A., Kahin, S., Pejavara, A., & O’Toole, T. (2020). The High Obesity Program: Overview of the Centers for Disease Control and Prevention and Cooperative Extension Services Efforts to Address Obesity. Preventing chronic disease, 17, E25. https://doi.org/10.5888/pcd17.190235
2nd colleague to respond to
Main Post
Evaluation of the Healthcare Program
In California, the Safely Surrendered Baby Law (SSB) was established in response to the increased number of newborn child deaths brought on by being abandoned in unsafe circumstances (Safely Surrendered Baby Program, 2023). The SSB Law was established in January 2001 and officially enacted into state law in January 2006. “The law’s intent is to save lives of newborn infants at risk of abandonment by encouraging parents or persons with lawful custody to safely surrender the infant within 72 hours of birth, with no questions asked” (Safely Surrendered Baby Program, 2023, para. 1). The law’s criteria is the baby must be less than 72 hours, be willingly given up by a parent or someone with legal custody, and be given to security officials at a designated secure site, such as a public or private hospital, designated fire station or other safe surrender sites, determined by the local County Board of Supervisors (Safely Surrendered Baby Program, 2023). The law protects the surrendering individual from prosecution of abandonment without any questions asked. The infant being surrendered, and the parent are given a unique matching bracelet for identification. The parent or guardian has 14 days to reclaim their baby. A medical questionnaire is provided to the parent or guardian to fill out, but it is voluntary.
Effectiveness of the Program
Since the law’s introduction, the number of infants abandoned since 2001 has significantly decreased and has saved numerous lives. According to data from the California Department of Social Services (2023), 1,247 newborns were safely surrendered between 2001 and 2021. In 2001, there were two babies safely surrendered. In 2021, there were 79. In 2001, there were 13 abandoned deceased. Compared to 2021, there was one.
Social Determinants of Change
Health inequities between various racial, social, and economic groups as well as gender and ethnic group, contributes to social determinants of health (SDOH) (“Social Determinants of Health (SDOH),” 2017). Neonatalicide, or killing an infant within the first 24 hours of life, is typically committed by the mother, who may be young, single, less educated, and most often involved in concealing an unplanned pregnancy and giving delivery outside a hospital (Wilson et al., 2020). These are the major SDOHs regarding infant abandonment. The Safe Surrender Baby Law has helped save lives. We as providers must educate our patients, especially those in the target socioeconomic group, about the program and direct them to more information about it as needed. With proper education and the use of this law, we can continue to save infant lives.
References
Safely surrendered baby program. (2023). California department of social services. Retrieved April 24, 2023, from https://www.cdss.ca.gov/safe-surrender-babyLinks to an external site.
Social determinants of health (SDOH). (2017). NEJM Catalyst. Retrieved April 24, 2023, from https://doi.org/full/10.1056/CAT.17.0312Links to an external site.
Wilson, R. F., Klevens, J., Williams, D., & Xu, L. (2020). Infant homicides within the context of safe haven laws — united states, 2008–2017. Morbidity and Mortality Weekly Report (MMWR), 69(39), 1385–1390. Retrieved April 24, 2023, from https://doi.org/10.15585/mmwr.mm6939a1external iconLinks to an external site.
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