Assignment: Benchmark - Population Heath: Part II/DNP-825

Assignment: Benchmark – Population Heath: Part II/DNP-825

Benchmark-Population Health
The promotion of optimum health outcomes for high-risk populations is important in nursing practice. Often, nurses adopt evidence-based practices to optimize the care outcomes of these populations. Evidence-based practices are adopted from clinical researches with a consideration of the patient’s values and nurses’ expertise in addressing care needs of their populations (Melnyk et al., 2021). The initial project identified African Americans as a high-risk population for obesity. Therefore, the purpose of this paper is to propose an intervention that is applicable to addressing this problem, implementation plan, potential challenges, a theory that will be used, and expected outcomes from the change. It also focuses on other factors predisposing African Americans to obesity and advocacy role for DNP-prepared nurses.

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Proposed Evidence-Based Intervention
The proposed evidence-based intervention to address obesity among high-risk African Americans is the implementation of community-based interventions comprising physical activity and nutrition. Community-based interventions focus on transforming the risk factors for obesity at the community levels. The interventions target a large number of the affected and those at risk rather than interventions delivered in healthcare settings. The rise in obesity and overweight rates in America has largely been attributed to a reduction in the utilization of healthy lifestyles and behaviors by the population. For example, Berry et al., (2018) report that there has been a continuous decline in children and adult engagement in physical activity over the last four decades. The authors also note an increase in sedentary activities in the entire population in the USA, translating into the high rates of obesity (Berry et al., 2018). Therefore, community-based interventions comprising physical activity and nutritional modification may result in lifestyle and behavioral change among African Americans for their health and wellbeing.
Evidence Supporting the Proposal
Evidence-based data supports the use of community-based interventions to address the problem of obesity among high-risk populations. Berry et al., (2018) implemented a community-based weight management program targeting African American and white low-income children in the USA. Community-based intervention that focused on physical activity and dietary modification was associated with a significant reduction in weight among the African American and white children in the intervention groups than in control group. The program also led to increased engagement in physical activity and improved stress management among African American parents in the intervention groups (Berry et al., 2018).
Frerichs et al., (2020) found similar results in their study where a community-based lifestyle change intervention targeting African Americans in two rural counties in North Carolina led to significant positive improvement in healthy eating and physical activity. The improvements were more pronounced in the intervention group as compared to the control group (Frerichs et al., 2020). Based on these studies, community-based intervention is effective in addressing the problem of obesity among the affected or at-risk African Americans. The proposed intervention is realistic and appropriate for the population since it raises awareness among them and stimulates change. It does not require significant use of resources other than transforming the participants’ lifestyles and behaviors, hence, its efficacy.
Implementation Plan
A systematic approach to implementing the proposal will be adopted. The first step will be identifying obese and those at-risk patients at the outpatient department. African American patients visiting the department for assessment will be assessed to determine their weight status. Those found obese or at risk of obesity will be informed about the project and recruited if they are willing to participate in it. The second step will be organizing for a community meeting with them. They will be educated about the community-based interventions they should embrace for weight reduction. Nurses will be trained on the project implementation, as they will be largely involved in the delivery of the interventions. Weekly follow-ups will be done to determine the participants’ experiences and their adherence levels.
The implementation will involve collaboration with interprofessional stakeholders. They will include nurses and nutritionists working in the facility. Community stakeholders will include religious leaders and informers. Permission for the project will be sought from the hospital and local community leadership. Some costs will be incurred in implementing the project. The cost will include that used in training nurses and nutritionists, transportation, printing brochures, data collection, analysis, and presentation, and follow-up costs. The estimated cost of the project is $30000.
Potential Challenges to Implementation and Addressing them
Some challenges may be experienced in implementing the community-based intervention. One of them is resistance from the potential participants. Potential participants may not be willing to take part in the community-based intervention. Factors such as lack of information and their busy schedules may contribute to their resistance (Spetz et al., 2019). Interventions such as educating them about the benefits of the intervention and holding the meetings over the weekend will be adopted to overcome this challenge.
The other challenge that may be experienced is poor adherence by the participants. The proposed intervention seeks to transform the participants’ lifestyles and behaviors. As a result, it may be difficult for them to adhere to the recommended dietary and physical activity regimes. This challenge will be addressed by providing follow-up services on a weekly basis and developing plans that align with the abilities and needs of the participants. The other challenge that may be experienced is inadequate support from the hospital. Support in forms such as financial, material, and human resource is crucial for the success of the proposal (Lotfi Fatemi et al., 2019). Inadequate support will affect its outcomes, hence, the adoption of interventions such as aligning the objectives of the project with those of the organization.
Theory
The health belief model is an appropriate theory that can be used to support the implementation of the proposed community-based intervention. The health belief model is a theory that provides insights into the ways in which people change their behaviors. The theory offers understanding of the relationship that exist between health behaviors and motivation. The theory asserts that factors such as peoples’ desire to get well or avoid illness and their belief on the positive impact of their actions guide human behavior. This model provides increases understanding of the factors that may influence African Americans to change their behaviors. They include their perceived risk of illness or disease susceptibility due to obesity, perceived severity, capacity to engage in skills to promote health, benefits vs costs, and cues for action (Houlden et al., 2021). The role of nurses when utilizing this model is to stimulate interest for change by raising the awareness of African Americans on their health risks.
Expected Outcomes
One of the expected outcomes of the proposed intervention is the positive change in lifestyle and behaviors among African Americans with obesity or those at a risk. The other outcome is the reduction in morbidity due to obesity among African Americans. The other outcome is the sustainability of the positive lifestyles and behavioral decisions African Americans make. The outcomes will be measured by following the project participants. Baseline data will be collected for comparison with the data obtained at the end of the project (Berry et al., 2018). The plan that will be considered if the project does not produce the desired outcomes would be investigating if the participants engaged in the recommended activities as prescribed. The approach to resource utilization will also be re-evaluated to determine if there were any inefficiencies.
Other Factors Contributing to the Health Issue
Some of the other factors that contribute to the increased risk of African Americans being affected by obesity is culture. Culture affects the dietary practices and choices in a population. The other factor relates to the social determinants of health. The prevalence of obesity is high in African Americans who have low educational attainment, unemployed, poor, and living in unhealthy environments (Siddharth & Sharma, 2018; Williams et al., 2018). I can advocate for social justice, ethical policies, and equity for the African Americans at risk and affected by obesity in my role as a DNP-prepared nurse. An example is by ensuring that the policies being adopted incorporate their needs and concerns. The policies should also enhance their access to and utilization of the existing resources, including healthcare (Abbasinia et al., 2020). I can also educate them about their rights and needs and how to achieve them, to stimulate interest among them and empower them to play roles that contribute to their health.
Conclusion
In conclusion, the proposed approach to address obesity among African Americans is implementing community-based intervention comprising physical activity and dietary modification. Interprofessional collaboration will be adopted. The expected outcomes include a reduction in disease risks and rate of obesity among African Americans. DNP-prepared nurses can advocate the adoption of measures that address the needs of African Americans at a risk of or affected by obesity.

References
Abbasinia, M., Ahmadi, F., & Kazemnejad, A. (2020). Patient advocacy in nursing: A concept analysis. Nursing Ethics, 27(1), 141–151. https://doi.org/10.1177/0969733019832950
Berry, D. C., McMurray, R. G., Schwartz, T. A., & Adatorwovor, R. (2018). Benefits for African American and white low-income 7–10-year-old children and their parents taught together in a community-based weight management program in the rural southeastern United States. BMC Public Health, 18(1), 1107. https://doi.org/10.1186/s12889-018-6006-4
Frerichs, L., Bess, K., Young, T. L., Hoover, S. M., Calancie, L., Wynn, M., McFarlin, S., Cené, C. W., Dave, G., & Corbie-Smith, G. (2020). A Cluster Randomized Trial of a Community-Based Intervention Among African-American Adults: Effects on Dietary and Physical Activity Outcomes. Prevention Science, 21(3), 344–354. https://doi.org/10.1007/s11121-019-01067-5
Houlden, S., Hodson, J., Veletsianos, G., Reid, D., & Thompson-Wagner, C. (2021). The health belief model: How public health can address the misinformation crisis beyond COVID-19. Public Health in Practice, 2, 100151. https://doi.org/10.1016/j.puhip.2021.100151
Lotfi Fatemi, N., Karimi Moonaghi, H., & Heydari, A. (2019). Perceived Challenges Faced by Nurses in Home Health Care Setting: A Qualitative Study. International Journal of Community Based Nursing and Midwifery, 7(2), 118–127. https://doi.org/10.30476/IJCBNM.2019.44883
Melnyk, B. M., Tan, A., Hsieh, A. P., & Gallagher-Ford, L. (2021). Evidence-Based Practice Culture and Mentorship Predict EBP Implementation, Nurse Job Satisfaction, and Intent to Stay: Support for the ARCC© Model. Worldviews on Evidence-Based Nursing, 18(4), 272–281. https://doi.org/10.1111/wvn.12524
Siddharth, S., & Sharma, D. (2018). Racial Disparity and Triple-Negative Breast Cancer in African-American Women: A Multifaceted Affair between Obesity, Biology, and Socioeconomic Determinants. Cancers, 10(12), Article 12. https://doi.org/10.3390/cancers10120514
Spetz, J., Stone, R. I., Chapman, S. A., & Bryant, N. (2019). Home And Community-Based Workforce For Patients With Serious Illness Requires Support To Meet Growing Needs. Health Affairs, 38(6), 902–909. https://doi.org/10.1377/hlthaff.2019.00021
Williams, A. S., Ge, B., Petroski, G., Kruse, R. L., McElroy, J. A., & Koopman, R. J. (2018). Socioeconomic Status and Other Factors Associated with Childhood Obesity. The Journal of the American Board of Family Medicine, 31(4), 514–521. https://doi.org/10.3122/jabfm.2018.04.170261

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Assessment Description
The purpose of this assignment is to develop an intervention for the at-risk population selected for your Population Health: Part I assignment.

General Requirements

A minimum of three scholarly or peer-reviewed research articles are required. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Learners will submit this assignment using the assignment dropbox in the digital classroom. In addition, learners must upload this deliverable to the Learner Dissertation Page (LDP) in the DNP PI Workspace for later use.

Directions

For Part II of the Population Health assignment, propose an intervention to address the health issue for your selected at-risk population.

Include the following in a 1,250â€“1,500-word paper:

Prior to beginning Part II, review feedback and revise your initial paper (Part I) as indicated by your instructor. Based on these revisions and potential changes, complete Part II. Synthesize Parts I and II into a final paper.
Propose an evidence-based intervention relevant to your population-based health issue that can be implemented to improve health outcomes or decrease disparities for the at-risk population. Discuss the evidence supporting your proposed intervention and explain why your proposed intervention is realistic and appropriate for the population.
Outline a plan for implementing your proposed intervention for your at-risk population. Include community and interprofessional stakeholders needed for collaboration, permissions needed, and potential costs for implementation.
Discuss potential challenges to implementation and ways these can be addressed.
Identify a public health or health promotion theory and explain how it can be used to support the implementation of your intervention. Refer to and cite the seminal article for your theory.
Discuss the expected outcomes for the proposed intervention and how the outcomes will be measured to determine the efficacy of your proposed intervention. What is your plan if your outcomes do not show the desired improvement?
As a doctoral learner, what other factors do you believe contribute to the pervasiveness of the health issue for the at-risk group? Provide examples. Explain how you, as a doctoral learner, can advocate for social justice, equity, and ethical policies for this at-risk group. How can this be applied to different arenas in health care?
Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

DNP

4.4: Advocate for social justice, equity, and ethical policies within all health care arenas.