Community Health Nursing

Introduction

Healthy People 2020 is an initiative funded by the Federal Government of the United States. The Department of Health and Human Services in 2010 launched the program to improve the overall health of the United States citizens. Its overarching goals include creating healthy environments, preventing diseases, promoting quality of life at all stages, and improving the quality of health. To achieve these objectives, the program tracks and collects national data. This program also identifies priorities in national health improvement. Since the initiative is science-based, it monitors progress, provides motivation, and offers guidance in improving the nation’s health. The program states four foundations of health measures; Health-Related Quality of life, General Health status, Disparities, and Determinants of Health. In this paper, we will be assessing the disparities in HIV/Aids with the target audience being teenagers/preteens and individuals already infected. Social determinants such as stigma, unequal access to health care and racism are also related to health disparities (Moore & Bartlett, 2012).

Goals and Objectives of Healthy People 2020

The main goal for Healthy People 2020 is to prevent Human Immunodeficiency Virus (HIV) infection together with other related illnesses and death. In the United States, HIV has over the years, created a major public crisis with an estimation of 1.2 million infected Americans; while 1 out of 8 fail to know their HIV status (Healthy People 2020, 2019). Despite a decline of 18% in infection rates in the U.S. between 2008 and 2014, the spread of HIV is still outrageous. A strategy was put in place in 2015 that narrows down to 3 primary goals, reducing new HIV infections, reducing HIV-related disparities and health inequalities, and increasing access to care. Reducing the number of new infections targets adolescents (preteens and teenagers) who are estimated to be highly infected. In 2006, it is estimated that 48,600 people aged 13 and over were HIV infected (Healthy People 2020, 2019). This number has tended to rise over the years, thus, affirmative actions should be put in place to achieve the Healthy People 2020 goals.

Program plan

The adolescent population tends to be the largest growing population infected with HIV of all the other life stages. Mostly sexual intercourse is the major HIV transmission mode at this stage since many teenagers tend to be curious in experimenting sex. At this stage, many of them fail to use condoms, thus, practice unprotected sex and are likely to be exposed to HIV infections. The average first-time sex encounter for adolescents is at the age of 13 years, thus, for the Healthy People 2020 program to be effective, the first course of action is sex education (Mahat & Scoloveno, 2016).  Sex education has over the years, been a challenge, more so across many conservative communities making it difficult to promote and control safe sex. Educating preteenagers and teenagers (boys and girls), on risks linked with unprotected sex and the importance of visiting Voluntary Counseling and Testing (VCT) centers annually can make dramatic outcomes in reducing HIV infections.

Implementation of Healthy People 2020 HIV/Aids Plan

Public perception of the seriousness of HIV infection has over the years, declined in the United States. Some risky behaviors such as gays and bisexual behaviors have been rampant among infected and uninfected people. To prevent the spread of this infection, Pre-exposure Prophylaxis (PrEP) has been implemented in health care to prevent getting infected by taking a pill. Notably, PrEP has reduced acquisition of HIV among individuals when taken consistently having a 92% significant risk (Healthy People 2020, 2019). On reducing and preventing HIV infections, media campaigns have been emphasized across all social networks. Most preteenagers and teenagers have access to smartphones; thus, can easily access social platforms such as Facebook and Twitter among others. Backed up by this technology it is now easy to realize the Healthy people 2020 goals, since HIV testing can now be emphasized and individuals get information on ways to prevent risky behaviors. Citizens getting care for HIV can access services such as screening and treatment for Sexual Transmitted Diseases (STDs), Antiretroviral therapy, HIV prevention Interventions, and mental health services among other health services.

Budget

Item	Amount ($)
Development, and hosting of online content	7,500
Procurement of teaching materials	5,000
Facilitation fees for trainers and instructors	15,000
Booking of venues	10,000
Total	27,500

Justification for the Healthy People 2020 Project

Foundation Health measures are measures examining Healthy People 2020. These measures reflect on HIV interventions implemented and impact of actions in achieving the project’s goals and objectives. They are also used to monitor and control improvement in population health. In 2016, these measures were categorized into visible, coherent, and conceptually consistent manner in the broad health measurements. In HIV infection, Foundation Health measures the healthy life expectancy in conjunction with the life expectancy, which includes elements such as respondent-assessed health, disability, and activity limitation. In the National Health Interview Survey (NHIS), health can be assessed by answering the following question “Would you say the HIV-infected individual’s health is excellent, good, fair, or poor?” (Kobau et al., 2013).

Besides, there is need to design a rationale, focusing on social determinants of HIV infected persons that include the need to take further steps beyond controlling the infection rate so as to factor the root causes of the spread of HIV infection. Conditions present in both the social and physical environments normally determine a range of options such as whether the infected preteenager, teenager, or other infected individual looks attractive. Symptoms accrued to HIV/Aids require close examination more so for the adolescents as they may result in physiologic changes.

Where and When the Plan Will Be Implemented

The most vulnerable communities to HIV are low-income neighborhoods. Such areas are prime targets of this program. To be specific, the suburbs of Chicago, Baltimore – Maryland, and others will be considered. The appropriate time to implement the program is during the summer holidays when majority of the young people are enjoying their summer holidays. A large part of the target population includes high school and college students. Summer holidays would ensure that our reach is maximized. 

Teaching Materials

To ensure effective delivery of the program, important teaching materials that resonate with the target population will have to be brought in. Top on the list is interactive material, which can be accessed online since the target population have a high affinity for online programs Web based and app-based items will be availed. Second, audiovisual materials will be considered. Third in the list include materials that encourage the interaction of the young people; for instance, coordinated games will be considered. 

Nursing Interventions to Improve the Health Concern

Early health care for the preteenagers, teenagers, and other persons infected with HIV have addressed the physical and spiritual needs. According to Kozier (2008), the psychological and spiritual aspects must be highly emphasized to promote the patient’s health. As scientific knowledge has increased over the years, health care has evolved to prevent the spread of HIV and offer treatment to the infected through Antiretroviral treatment (ARVs). In addition, nurses now provide prescribed treatments. One of the innovative community-based practice that has been established by today’s nurses is the faith community. The practice involves the integration of the mind, body, and spirit. Therefore, it tends to offer a mechanism in promoting the health and wellness of the HIV/AIDS infected persons. This practice personifies the physical, spiritual, and social dimensions of the persons infected and can be used to control the effect of HIV among the youths.

Potential Public and Private Partnership

Public and Private Partnership (PPP) are incredibly necessary in the development of a sustainable HIV combating plan. The private sector is necessary in developing skills for this kind of work. Second, the availability of some of the necessary materials, drugs, and other associated resources will need to come from the private sector to ensure sustainability. The public sector will in most cases, facilitate starting of the project, as well as, the legal and other kinds of soft facilitation. To ensure this kind of partnership succeeds, the public sector will be vigorous and very active in the first three months. In the following three months, the public sector will tactfully retreat and allow the private sector to take over the already established platform. 

Conclusion

Healthy People 2020 has led to multiple efforts in creating awareness to the nation concerning HIV/Aids prevention and control. The initiative has channeled distinct and diverse prevention of HIV more so to the adolescents who are prone to infections and, thus, has promoted good health throughout the United States. This has led to the realization of the project’s common goal of promoting the overall nation’s health.

References

Healthy People 2020. HIV in the United States. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/hiv

Kobau, R., Bann, C., Lewis, M., Zack, M. M., Boardman, A. M., Boyd, R., … & Thompson, W. (2013). Mental, social, and physical well-being in New Hampshire, Oregon, and Washington, 2010 Behavioral Risk Factor Surveillance System: implications for public health research and practice related to Healthy People 2020 foundation health measures on well-being. Population health metrics, 11(1), 19.

Kozier, B. (2008). Fundamentals of nursing: concepts, process, and practice. Pearson Education.

Mahat, G., Scoloveno, M. A., & Scoloveno, R. (2016). HIV/AIDS knowledge, self-efficacy for limiting sexual risk behavior and parental monitoring. Journal of pediatric nursing, 31(1), e63-e69.

Moore, R. D., Keruly, J. C., & Bartlett, J. G. (2012). Improvement in the health of HIV-infected persons in care: reducing disparities. Clinical infectious diseases, 55(9), 1242-1251.