PUBH6006 Community Health and Disease Prevention

Introduction:

With the global burden of the chronic disease, lungs diseases has gained increased attention due to high prevalence of bronchitis, emphysema, asthma and lungs cancers.  2017–18 ABS National Health Survey suggested that in Australia, approximately 464,000 individuals are suffering self-reported emphysema which eventually developed into lungs cancer and population are mostly aged 45 years (AIHW, 2020). Approximately 2.6 million Australia are suffering from lung disease (specifically, accounting for 14% of all deaths each years (Luo et al., 2019). It is common instances where individuals have low awareness, high sedentary lifestyle and frequent habit of tobacco consumption which resulted in high incidence lungs cancer. Therefore, Lung Foundation Australia has developed a program Check. Protect. Connect. Program in order to reduce the high prevalence of lungs disease (Lungs foundation Australia, 2020). The paper aims to discuss the Target population for the program, Conceptual framework of community-based health promotion and Concepts of community empowerment in the Check. Protect. Connect. Program in following paragraphs.

Discussion:

Target population:  

The existing research so far claimed that symptoms of lungs disease and cancer are often neglected by Australian population due to lack of awareness and reluctance.  In Australia, 8,586 deaths are associated with lung disease especially lung cancer. In this case, target population for Check. Protect. Connect program are the individuals with risk of lung cancer, experiencing lung cancer and experience chronic lungs disease, especially older adults with the infection (Lungs foundation Australia, 2020). The program significantly focus on the community health issues such as   lung cancer,  COPD , pulmonary arterial hypertensive,  bronchiectasis, idiopathic pulmonary fibrosis. In the Covid19 outbreak, the lungs health gained increased attention and hence, the program also targeted the population   who are at risk of covid19 infection or experienced the infection so that prevalence of the lungs infection and cancer can be reduced (Koubâa, 2020).

In Australia, approximately 46% of the population are reluctant about lungs health which reflected in high incidence of lungs cancer (1 in 3 individuals with lungs cancer) (AIHW, 2020).    The limited health seeking behaviour of early screening along with poor health habits further intensified the need for preventing the lungs cancer in the target population.  Boretti (2020), reported that significantly important because COVID 19 infection often damage upper respiratory tract which resulted in secondary infection, damaged bronchial and fibrosis.  As older adults are highly vulnerable population due to rapid aging, impaired immune system, and the prevention will reduce the incidence and mortality which increase the awareness for the target population (Akha, 2018).  The significance of the prevention is that it will reduce high prevalence and mortality rate while increase awareness of the population towards vaccination and secondary infection.  

Conceptual framework of community-based health promotion:

Aim:

The aim of the program divided into three parts which reflected in the name of the program. In the “check” part,   the aim is to increase awareness regarding the lung disease and cancer. In the “prevent” part, the aim is to   improve the immunisation in the flu season, especially after the Covid19 outbreak (Lungs foundation Australia, 2020). In the “connect” part, the aim is to provide appropriate resources, guidance and care through the support services even in the situation of isolation.

Level of prevention approaches:

The program applied 3 level of prevention upon such as Primary secondary and tertiary prevention network in order to reduce the lung disease and cancer.   Freeman (2018) reported that primary prevention is often associated with prevention of single individual. In this case the primary prevention applied through immunisation approach in the protect part. Secondary approach is associated with early detection (Freeman, 2018). In this case, this prevention is applied through Lung Health Checklist in the check section of the program. On the other hand, tertiary prevention is associated with   improvement of quality of life through reducing symptoms.  In this case, this prevention is applied through support Centre team   to the population living in isolation or seeking services (Lungs foundation Australia, 2020).

Application of the Ottawa charter:

While Ottawa charter have distinct domains, the program use four of the domains in reducing lung disease and cancer. For example,

• Create Supportive Environment:

Kloc, Ghobrial and Kubiak (2020), majority of the population experience lack of access to the resources due to COVID19 outbreak, social isolation, discrimination and reluctance. In this case, the program created supportive environment through support Centre team where Respiratory Care Nurse,   Support Groups provide telephonic and offline support services to empower the population (Lungs foundation Australia, 2020).

• Reorient Health Services:

While lung cancer and disease support are usually provided through offline services, the program reoriented the health care services through telephone-based information regarding diagnosis, symptoms management and guidance to empower the population (Lungs foundation Australia, 2020).

• Develop Personal Skills and  strengthen community action:

As discussed above, lack of awareness and reluctance are the major driver of high prevalence of the lung cancer and lungs disease (Thompson, Watson & Tilford, 2018). Therefore, the program provided Lung Health Checklist in the check section of the program to which focus on health lifestyle, smoking cessation, understanding of the skills. The guidance provided by the support team also enable the population to involve in the self-management through improving self-efficacy (Lungs foundation Australia, 2020).  The community action is strengthen through vaccination as it promote herd immunity.

Conceptual framework:

Conceptual Framework of Health developed by AIHW   usually focus on health status, determinants of health, and health system performance (AIHW, 2018). The program significantly improve health status of the target population through health information and guide in the lung health checklist as it improved their awareness for the early screening. This early screening test improve also increase their adherence to the other exercise programs (Lungs foundation Australia, 2020).Patients often have limited access to the health care services to due to discrimination , low financial stability.  In this case, the program provided access to determinants through the support team.

Community empowerment:

The intervention approaches of the program used Lavarack’s ladder for community empowerment. The primary claims of the existing study are that patients with high tobacco consumption, asthma and secretary lifestyle worsen the risk of lungs cancer (Luo et al., 2019). As the target population had low self-esteem, poor self-care skills which increase the lung cancers, the program increased the capacity of the community through increasing their knowledge regarding early signs, diagnosis, vaccination and exercise. The exercise programs, support from the respiratory nurse connect to care section increase community engagement (Howard & Alter, 2019). () reported that support Groups have the lived experience of the lung cancer and disease which empower the population. In this case, the support group enable the community engagement through providing them with a sense of belongings.  

Communication strategy:

The program provided online platform such as official page of lungs foundation of Australia.  Haas et al. (2017),  reported that online platform enable the health professionals to   reach wide range of target population with short period of time. Moreover, it is cost effective to reach wide range population. In this case, online platform as communication strategy is suitable to reach target group as user friendly graphics enable them to seek support in appropriate section of the program. Three segmentation of the program enable the population to gain access to the program based on their health status and hence, it is suitable for the population. However, the limitation of the strategy is that many individual might not be  comfortable to use online  resources and hence, poster or any other offline resource might be effective by collaborating with the local community of the  individuals (Dunn & Conard, 2018).

Conclusion:

On a concluding note, it can be said that lungs diseases is highlighted as one of the major chronic disease which influence health care expenditure.  In this case, Check. Protect. Connect. Program developed for individuals with risk of lung cancer, experiencing lung cancer and experience chronic lungs diseases.  The program have three level of intervention which use community engagement and capacity building through using three Ottawa charter.  It will reduce the prevalence of the disease  through increasing  their  awareness.

References:

AIHW (2018).Australian Health Performance Framework:. Retrieved 12 November 2020 from https://www.aihw.gov.au/getmedia/63b4f86e-3453-431b-bc9e-9d3cc4c57ca4/aihw-aus-221-s1-4.pdf.aspx

AIHW (2020). Lung cancer in Australia statistics. Retrieved 12 November 2020 from https://www.aihw.gov.au/reports/chronic-respiratory-conditions/copd/contents/copd#:~:text=In%20the%202017%E2%80%9318%20ABS,464%2C000%20people%20(ABS%202018).

Akha, A. A. S. (2018). Aging and the immune system: An overview. Journal of immunological methods, 463, 21-26. https://www.sciencedirect.com/science/article/abs/pii/S0022175917304878

Boretti, A. (2020). Covid19 Outbreak in Victoria, Australia Update August 1, 2020. Health Services Research and Managerial Epidemiology, 7, 2333392820960350. https://journals.sagepub.com/doi/full/10.1177/2333392820960350

Dunn, P., & Conard, S. (2018). Improving health literacy in patients with chronic conditions: A call to action. International journal of cardiology, 273, 249-251. https://www.researchgate.net/profile/Patrick- Dunn/publication/32 7317147_Improving_he alth_literacy _in_patients_with_chron ic_conditions_A_c all_to_action/links/ 5c21a614458515a4c7f6fbb5/Improving-health-literacy-i n-patients-with-chronic-conditions-A-call-to-action.pdf

Freeman, R. (2018). The idea of prevention: a critical review. Private risks and public dangers, 34-56.

Haas, K., Brillante, C., Sharp, L., Elzokaky, A. K., Pasquinelli, M., Feldman, L., ... & Joo, M. (2018). Lung cancer screening: assessment of health literacy and readability of online educational resources. BMC Public Health, 18(1), 1-7. https://link.springer.com/article/10.1186/s12889-018-6278-8

Howard, T., & Alter, T. (2019). Framing community engagement. Community-based control of invasive species, 74-83. Retrieved from https://books.google.co.in/books?hl=en&lr=&id=Ut KdDwAAQBAJ&oi= fnd&pg=PT77&dq=+ ladder+of+ com m unity+i nte r action +a ustrali a& ots=hOAhdIUVs N&sig=r07jF2tkL agDpNNtWpltCtOg2JY&redir_esc=y#v=onepage&q=ladder%20of%20 communit y%20interaction%20australia&f=false

Kloc, M., Ghobrial, R. M., & Kubiak, J. Z. (2020). How nicotine can inhibit cytokine storm in the lungs and prevent or lessen the severity of COVID-19 infection?. Immunology letters, 224, 28–29. https://doi.org/10.1016/j.imlet.2020.06.002

Koubâa, A. (2020). Understanding the covid19 outbreak: A comparative data analytics and study. arXiv preprint arXiv:2003.14150. https://arxiv.org/pdf/2003.14150.pdf

Lungs foundation Australia (2020).Check. Protect. Connect. Program.Retrieved 2 March 2020, from https://lunghealth.lungfoundation.com.au/about/

Luo, Q., Steinberg, J., O’Connell, D. L., Yu, X. Q., Caruana, M., Wade, S., ... & Canfell, K. (2019). Lung cancer mortality in Australia in the twenty-first century: How many lives can be saved with effective tobacco control?. Lung Cancer, 130, 208-215. https://www.sciencedirect.com/science/article/pii/S0169500219303447

Thompson, S. R., Watson, M. C., & Tilford, S. (2018). The Ottawa Charter 30 years on: still an important standard for health promotion. International Journal of Health Promotion and Education, 56(2), 73-84. https://doi.org/10.1080/14635240.2017.1415765

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