Nurses as Change Agents in the Community

The discussion assignment provides a forum for discussing relevant topics for this week on the basis of the course competencies covered.

For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned.

To support your work, use your course and text readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates’ initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite sources in your responses to other classmates. Complete your participation for this assignment by the end of the week.

In the chapter, “How Community-Based Organizations Are Addressing Nursing’s Role in Transforming Health Care,” the authors describe the community as the focus of advocacy action for change. They list a series of questions that help community teams develop organizing principles to guide their interventions, and the aim is to attack social determinants of health to make community change.

Suppose a community team identifies lack of access to exercise modalities as a public health issue. If the team were to determine that pedestrian walkways need to be constructed, discuss at least two factors that would facilitate the development of the walkways and two that would hinder the development. For the hindrances, discuss ways that the team might work to overcome those hindrances.

Continue to read daily from one of the policy briefs that are included in your weekly readings list. POLITICO Pulse is a daily briefing from POLITICO, and the Kaiser Health News Morning Briefing is a daily briefing from the Kaiser Family Foundation. Both focus on health care. Either one will keep you abreast of what is happening in health care policies and politics.

In addition, subscribe to the “HealthCetera” podcast and listen to the podcast weekly. This is a production of WBAI, free speech radio of Pacifica Foundation Radio in New York City. Diana Mason and Barbara Glickstein are founders and codirectors of the Center for Health Media Policy (CHMP). Both are recognized as experts in media, nursing, health, and health policy. They have a longstanding relationship as producers and moderators of HealthCetera, a live, award-winning radio program on public radio and iTunes. They are bloggers for Disruptive Women in Health Care and for the American Journal of Nursing (AJN). The CHMP is an interdisciplinary initiative for advancing the health of the public and healthy public policies through media, research, education, and public forums. Listen to the podcast throughout the course and think on the topics that are discussed, especially as they relate to how we advocate for issues of importance in this contemporary political environment.

Respond to this post with a positive response :

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Use  references

                                                    INITIAL POST

                                    Diet and Overweight in Tennessee

A significant behavioral risk factor affecting our nation’s population is unhealthy diet resulting in obesity (Knickman & Kovner, 2015).  Unfortunately, this health issue significantly influenced the great state of Tennessee.  Tennessee is ranked 15th out of all the states for highest obesity rates in adults and ranked 20th for ages 10-17 (The State of Obesity, 2018). Tennessee’s obesity rate has increased dramatically in the past few decades.  In 1990, the obesity rate for the state was 11.1%, rose to 20.9% in 2000, and 32.8% in 2017 (The State of Obesity, 2018).  This obesity has affected a rise in health conditions such as diabetes with a current rate of 13.1%, hypertension with a current rate of 38.7%, and heart disease with a current rate of 38.7% (The State of Obesity, 2018).  If the trend of obesity continues at this rate, disease is going to increase substantially in Tennessee.  To stop the trend of poor diet and obesity in Tennessee, drastic interventions are needed.  

Population-Based Intervention Model Examples

According to the Population-Based Intervention Model, effective interventions include downstream, midstream, and upstream (Knickman & Kovner, 2015).  Downstream interventions include interventions based on an individual.  Providers in my community should focus on BMI at well-visits with individuals.  As part of the well-visit, the provider needs to provide education on the individual’s BMI.  Specifically, discussion regarding what it means and how to decrease it or prevent it from elevation is imperative.  The provider should review the patient’s regular diet, make suggestions on improvements, and provide resources related to healthy eating.  In small southern Tennessee towns, education on healthy nutrition is lacking.  However, people seem to trust their doctors in the rural community.  Individual focus on diet by the providers would be beneficial. 

Midstream interventions of the Population-Based Intervention Model are interventions focused on communities (Knickman & Kovner, 2015).  When traveling through Tennessee, the importance of southern cooking and fast food is announced all over the interstate billboards.  Manchester, TN is no exception as Interstate 24 runs straight through it creating the nickname, Interstate Town.  Manchester is the main town in Coffee County with even smaller towns surrounding it.  This is the community in which I live, full of fast food and very limited healthy restaurant options.   The United States Department of Agriculture (2017) reported 38 fast food restaurants in 2014, making 0.71 fast food restaurants for every 1,000 people.  Restaurants with healthy options in Manchester, TN are nearly non-existent.  An example of an effective midstream intervention in Manchester would be to bring in healthier restaurants.  This busy, working-class community full of families eats out a lot while focusing on church events, sports, and volunteering.   Having quick, healthy restaurant options would be helpful in improving health and decreasing obesity in this area.

Upstream interventions of the Population-Based Intervention Model are interventions made by policies at the state and national levels (Knickman and Kovner, 2015).  According to The State of Obesity (2018), Tennessee has yet to make any laws concerning the requirement of posting caloric information in restaurants.  Perhaps, if individuals saw this information on their regularly eaten food options, they would get accustomed to choosing the lesser calorie options.  Also, this policy may help to inform community members as to why eating at home or having healthier restaurants would be beneficial to their health.

Summary

Poor diet and obesity are huge concerns in Tennessee as the increasing trends will only worsen disease rates in the future.  Ideas such as one-on-one nutritional attention by providers, healthier restaurant choices, and policies requiring posted nutritional information could increase the health of the Tennessee population.  

References

Knickman, J. R., & Kovner, A. R. (Eds.). (2015). Health care delivery in the united states (11th ed.). New York, NY: Springer Publishing.

The State of Obesity. (2018). The state of obesity in tennessee [data file]. Retrieved from https://stateofobesity.org/states/tn/

United States Department of Agriculture. (2017). Economic research service [data file].  Retrieved from https://www.ers.usda.gov/data-products/food-environment-atlas/go-to-the-atlas/

In this assignment, you will be writing a 1,250-word essay describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

1. Select an issue from the following : use of contract employees (i.e., registry and travel nurses).
2. Compare and contrast how you would expect nursing leaders and managers to approach your selected issue. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.
3. Identify the approach that best fits your personal and professional philosophy of nursing and explain why the approach is suited to your personal leadership style.
4. Identify a possible funding source that addresses your issue. Consider looking at federal, state, and local organizations. For example: There are many grants available through the CDC, HRSA, etc.
5. Use at least three references other than your text and those provided in the course.

Prepare this assignment according to the APA format

Comment 1

Procreation is the bringing forth of an offspring while reproduction is Meilaender stated in his writing that “we should not hesitate to regard reproduction that makes use of third parties collaborators as wrong- even when collaboration seems to be in a good cause” (Meilaender, 2013). Meilaender referred to begotten as a child that is born in marriage and by natural means. In contrast to being made, which was presented as any child produced outside the of the traditional setting which being born from a marriage between man and woman by natural means. Being born out of wedlock, cloning, and other means of producing a child is seen as “being made.” I do not agree with his descriptions. An individual should not be made to feel like a failure in God’s eyes for wanting to become a parent using alternative methods and or for reproducing out of wedlock. If the child is loved and cared for, then how they came to be should not matter or have a name to describe it. For example, a cousin of  mine couldn’t conceive a child through natural means so instead she had to use IVF. She and her husband are caring people who love their daughter very much.

Comment 2

In this religious and scientific world, procreation and reproduction and being begotten or being made all are quiet complex questions. Procreation is the bringing your offspring to this world and reproduction is the process in which organisms are produced by their parents. However, with different schools altogether with different views they would have various different ways of approaching the same topic. Generally, cloning is replicating genetically identical organisms and replication is the power of science. However, all these issues are based on morality. According to Meileander, by following the Christian theology a child is the gift of God therefore, it holds a lot of importance and is valued a lot (Middletown, J.Richard. (1994)). Basically, I would tend to agree with the description on the basis of its analysis and precision but from the moral point of view it lacks its value.

 For this Assignment, review the Research Methods and Findings of the Verweij study conducted in 2014 in this week’s resources. The primary purpose of this quantitative research study was to investigate the effectiveness of an intervention to decrease medication errors in a hospital. The citation and discussion/conclusion information is intentionally deleted so you can draw your own conclusions.