NUM3511 Community Health Care in Nursing and Midwetry

Introduction

One of the strongest and most crucial risk factors for majority of the cardiovascular disease is hypertension. It is characterized by the increased blood pressure and can lead to chronic health complications, majority of which are associated with the increased risk of cardiovascular conditions. In this common health condition, the blood’s long term force on the walls of the artery is higher than normal levels, which increases the risk of heart diseases and stroke. According to Australian Bureau of Statistics (2021), 34 per cent of the Australian population above the age of 18 years has hypertension, of which, 23 per cent is uncontrolled and 11 per cent is controlled condition using medication. Hypertension is more prevalent in men compared to women, where 25 per cent of the male population had measured hypertension compared to 20 per cent in female population. As about 2015, hypertension accounted for 5.8 per cent of the total burden of diseases in Australia. High sodium content in diet was found to be the cause of 21 per cent of the hypertension burden among Australians in 2015.

According to Australian Institute of Health and Welfare (2019), hypertension is more prevalent among the aboriginal communities in Australia. All epidemiological data hints towards greater prevalence of cardiovascular disease among the indigenous community. The following sections of the paper will highlight and elaborate on the health issue of the concerned population and a health promotion plan will be discussed in details.

Health Issue and Population 

Elderly Aboriginal people in Australia are 7 times more prone than non-Aboriginal people to be hospitalized for a potentially avoidable cause (WACHS, 2018), demonstrating the significant health disparities that exist in this population.

Project Description

This pilot program would address hypertension in the target group with a preventative PHC strategy. The program's long-term mission is to reduce hospitalizations attributable to hypertension in the older Aboriginal community by health education. This will be accomplished by face-to-face community education sessions that will foster personal development and foster the development of inclusive cultures in accordance with the Ottawa Charter for Health Promotion Framework (WHO, 1986). For 2 months, a one- to two-hour educational meeting will take place every two weeks. This workshops will include ten women from the target community who have been previously treated for hypertension and have been assigned to the initiative by the local health service. The workshop will concentrate on the sodium content of the diet, which is a significant risk of developing hypertension (Li & McDermott, 2016), which will be led by a female nurse and, if appropriate, a local Aboriginal Liaison Officer (ALO).

The initiative will offer health information about hypertension by verbal, visual, and hands-on approaches in order to increase health awareness and inspire behavior improvement, as driven by the health conviction model (Talbot & Verrinder, 2018). Enhancing participants' wellness awareness enables them to take control of their health and make safe decisions, a critical principle of community health (Talbot & Verrinder, 2018; ACSQHC, 2014). Arlinghaus and Johnston (2017) address how health education can be effective at improving health behaviors, but it is often insufficient on its own. Creating inclusive spaces is often critical for fostering personal improvement, with small group classes being a popular method (Seear, Lelievre, Atkinson, & Marley, 2019; Borek & Abraham, 2018). As a result of the limited target audience, their age, and history, face-to-face group education was selected as the preferred educational form. This method of education was cited as a strength of alternative services targeted at a comparable population and population, such as the 'Diabetes One Stop Shop' and Ord Valley Aboriginal Health Service's (OVAHS) specialist support systems (OVAHS, 2019; Boab Health Service, n.d). Online and television ads were ruled out as suitable technology due to the high percentage of residents who do not have access to the internet (ABS, 2019) and studies suggesting that television campaigns are often ineffective at improving health behaviors in this age demographic (Berry et al., 2016).

One disadvantage of this pilot project is its modest size. Which makes it impossible to provide definitive data on the efficacy of schooling as a health-related intervention. Another factor to consider is the uncertainty inherent in determining the effectiveness of schooling in permanently altering health behaviors among this focus population. Additionally, challenges such as Aboriginal women often skipping healthcare appointments and the program's progress relying heavily on a project leader and facilitator that are well-known and valued representatives of the group have been established (Nancarrow, Bradbury, & Avila, 2014). These considerations will be taken into account during the risk management process.

Objectives

Three targets have been developed to accomplish the task of growing hypertension sensitivity and lowering rates in the target population. The first goal is to initiate and complete four culturally sensitive hypertension education sessions in the group by October 2021. Ten central Aboriginal women over the age of 60 with a diagnosis of hypertension will attend these workshops. Weekly classes would allow learners to develop relationships with educators and fellow students, promoting a positive atmosphere consistent with the Ottawa Charter for Health Promotion (1986). The second goal is for participants to orally show improved awareness of hypertension, including risk factors, risks, signs, and symptoms, by the end of third session. The third goal is for 80% of attendees to show that they have not experienced hypertension in the six months after the program's conclusion.

Project Activities and Strategies 

The following strategies and actions have been defined and detailed to accomplish these goals: Identify and employ a project manager who is well-connected and known in the industry. Aboriginal communities still harbor suspicions about unfamiliar health care providers and government organizations (Waterworth et al., 2015). Aboriginal Health Care, ideally, would be prepared to partner and inform/run the workshops, since they have a tradition of providing culturally sensitive services to Aboriginal communities. Contact the ALO at AHS to find the most suitable Aboriginal elders for the project and to determine if an interpreter would be needed. If city officials do not approve the initiative, it will not proceed (Mungabareena Aboriginal Corporation, 2016). The dates, locations, and structure of events will be determined in consultation with indigenous leaders in accordance with the PHC concept of public involvement (Talbot & Verrinder, 2018). The community center or AHS are two possible sites that have been established as conveniently accessible and suitable for the target audience. Verbal participant polls would be completed prior to the initiative to gather qualitative and quantitative evidence on the target group's perception of hypertension. The data will be analyzed to determine hypertension-related knowledge differences, attitudes, and worldviews. This will help educators customize education sessions to the group's level of health awareness. The health sector and the surrounding population will be contacted to assist with the development of relevant verbal, visual, and hands-on curriculum materials that are appropriate for the target group's health literacy level. Education sessions will primarily concentrate on delivering instructional material in an informal manner by yarning, in order to increase participant participation (Durey et al., 2016).

Determine the most effective materials and procedures for participant recruitment (Talbot & Verrinder, 2018). This would most likely be accomplished by selling the software to health providers who will assign focus group participants to the program. Local health providers will be consulted to solicit their input on the nature of the software. Make contact with organizations who might be interested in sponsoring the event or providing incentives for attendees to participate. This may include awards for correctly responding to questions or carrying on an outfit. Incentives of this kind have been found to maximize participation in prior services.

Working in Partnerships

Collaboration and engagement with the local community are critical components of program implementation, especially in Indigenous communities (Mungabareena Aboriginal Corporation, 2016). However, teamwork is most effective where there is a common and well-defined objective (Estacio, Oliver, Downing, Kurth, & Protheroe, 2017). Local relationships that include mutual decision-making help ensure the services are aligned with the community's desires, priorities, and values, while also building trust and inspiring the community, all of which are critical components of effective health promotion activities (Talbot & Verrinder, 2018). Local partners and neighborhood participation will be vigorously pursued during the project's design and planning phases. Stakeholders may include the Western Australian Country Health Service, the district government, academic organizations and institutions, and the indigenous peoples of the area. Additionally, interprofessional cooperation will be encouraged in the curriculum, as outlined in Standard 2: Develops professional and respectful partnerships (NMBA, 2016). This enables the program's progress to be informed by the insights, expertise, and awareness of other health providers, resulting in the best potential result (Dias, Vieira, Silva, Vasconcelos, & Machado, 2016).

Evaluation and Sustainability of the Project

To reliably assess the project's progress to ensure that it can be replicated in the future, comprehensive documents would need to be maintained at all times (Talbot & Verrinder, 2018). A weekly summary will be published and sent to all investors, outlining events, correspondence, program participation, and expenses, as well as any other pertinent material. The project will be evaluated by attendance lists, stakeholder input, and casual pre- and post-interviews with the ten concerned women about their awareness, attitudes, and behaviors. Participants' feedback will be solicited during the yarning session. The feedback would be used to assess participants' feelings and perceptions about the curriculum and to suggest improvements that could be made unless the curriculum is replicated.

Comparisons between pre- and post-program interviews would be made to determine whether instruction was successful in improving patient awareness and modifying health behaviors. The program's long-term goal will not be realized for over a year which would necessitate extended follow-up by those involved. Six months after completing the program, participants will be called and asked whether they have been identified with hypertension or have encountered any of the symptoms and signs. Finally, a written summary summarizing the program's constructive and negative results will be collected and distributed to stakeholders. The group will also be informed of the program's results through the hospital's newsletter.

Since the service concludes, all instructional resources will be transferred to AHS for continued patient education. Hired supplies will be returned after the conclusion of the education session; no other funds are allowed to survive. This refers to the efficacy of the strategy, which could require limited investment if cooperation with local health providers is effective. If the curriculum is found to be successful and replicated, digital versions of the instructional materials generated can be preserved and reused. It is anticipated that the health workers hired to run the service would be able to use their newfound experience to inform other members of the society. Future ventures can be considered if a fruitful relationship is established between AHS and the Aboriginal community.