Discussion 1: Evidence Base in Designs

Discussion 1: Evidence Base in Designs

Discussion 1: Evidence Base in Designs

Hi Debbie Powell-Buchanan

The policy you have selected for discussion is something close to my heart. Racial disparities and inequalities have affected the United States for many years. It is still a thorn in the flesh in the healthcare delivery industry. The American healthcare system has disproportionate inequalities affecting marginalized groups and people of color. These inequalities have resulted in gaps in health insurance coverage, unequal access to healthcare services and poor healthcare outcomes among marginalized groups (Ortega & Roby, 2021). African Americans are most affected by these inequalities. I thus believe that the Health Equity and Accountability Act will help reduce healthcare disparities and inequalities.

References

Ortega, A. N., & Roby, D. H. (2021). Ending structural racism in the US health care system to eliminate health care inequities. JAMA326(7), 613.  

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Main Question Post

 Families First Coronavirus Response Act

The Families First Coronavirus Response Act 2020 is a response strategy to the coronavirus outbreak. Particularly, it focuses on the provision of free coronavirus testing, paid sick leave, food assistance, and unemployment benefits. Under the regulation, employers should offer additional protection for clinical care professionals, including personal respiratory protective devices. Through the bill, the federal government seeks to acquire supplemental appropriations to the United States Department of

NRSE 6050 Policy and Advocacy for Improving Population Health

Agriculture (USDA) to increase food assistance and nutrition programs. Specifically, the law guarantees certain waivers for school meal programs and expand Medicaid federal medical assistance percentage (FMAP). The legislation helps to safeguard the populace and enhance emergency preparedness and public health education (Wyte-Lake et al., 2018). The successful implementation of this health policy will necessitate proper coordination of the clinical and social interventions during the pandemic.

Discussion 1: Evidence Base in Designs

Background of the Problem

The coronavirus epidemic has significant adverse effects on the global population. The respective governments ought to formulate and implement robust measures to promote disaster preparedness to counter the prevalence of infection. The Families First Coronavirus Response Act proposes a review of the national budget to increase allocations for the Emergency Food Assistance Program (TEFAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and nutrition assistance grants for U.S territories. The approach is in line with the Global Health Security Agenda (GHSA) for the revamping healthcare sector. In addition, it denotes the commitment of the government to build a strong health system to stop, detect, and contain the spread of illnesses (Gostin, 2017). Therefore, increasing the funding for basic healthcare amenities, screening, and testing for the viruses is in line with the World Health Organization (WHO) directives for ensuring a safer world.

Evidence for the Policy

There is a lot of evidence to support the enactment of the Families First Coronavirus Response Act 2020. Primarily, governments across the world are initiating appropriate measures to ensure containment of the spread of the virus. Some of the key recommendations encompass proper hand hygiene, coughing and/or sneezing in your elbow, working from home, distant learning, social distancing, and staying at least six feet away from one another. However, there are critical implications on the supply of food, drugs, and testing kits. Besides, the federal policymakers are interested in preventing any possible economic downfall. The policy is handy in supporting corporate interventions like providing paid leave for workers and personal protective equipment.

The government has a fundamental responsibility for developing and maintaining healthcare infrastructure and service delivery. Nonetheless, there is always a conflict between public health objectives and industry interests (Collin et al., 2017). The legislators must strive to determine the mechanism to build consensus within and across the sectors of the economy. An integrated policy, such as the Families First Coronavirus Response Act 2020, will help achieve healthcare goals. Furthermore, the legislation will be essential in promoting a synchronized medical response to the virus. It shows the need for a holistic and joint collective approach to eradicating the risk factors for the complication, as well as guaranteeing public and private sector participation in the process.

Families First Coronavirus Response Act 2020 is a government guideline to support the implementation of emergency interventions. The health policy covers the broad areas of healthcare financing and the provision of appropriate clinical services like screening and testing. Also, through the policy, the government proposes to offer subsidies for nutritional and food programs to ensure social distancing and self-quarantine. The policy plays an important role in the attainment of universal healthcare coverage and public safety. Furthermore, its proper enforcement will necessitate coordination of decision planning to accomplish the global and national health goals during this pandemic.

References

Collin, J., Hill, S. E., Kandlik Eltanani, M., Plotnikova, E., Ralston, R., & Smith, K. E. (2017). Can public health reconcile profits and pandemics? An analysis of attitudes to commercial sector engagement in health policy and research. Plos One, 12(9), e0182612. https://doi-org.ezp.waldenulibrary.org/10.1371/journal.pone.0182612

Gostin, L. O. (2017). “America First”: Prospects for Global Health. The Milbank Quarterly, 95(2), 224–228. https://doi-org.ezp.waldenulibrary.org/10.1111/1468-0009.12254

Wyte-Lake, T., Claver, M., Der-Martirosian, C., Davis, D., & Dobalian, A. (2018). Education of elderly patients about emergency preparedness by health care practitioners. American Journal of Public Heath, 108, S207–S208. https://doi-org.ezp.waldenulibrary.org/10.2105/AJPH.2018.304608

By Day 6 of Week 7

Respond to at least two of your colleagues* on two different days by either supporting or respectfully challenging their explanation on whether there is an evidence base to support the proposed health policy they described.

Hello Dr. D..,

Without a doubt, COVID-19 has blurred the role in public health. On a daily basis, whether it is through watching television, listening to the radio, or scrolling though social media, we are educated by healthcare professionals, the president, the governor, etc. on how to contain this virus – social distancing, hand hygiene, staying 6 feet away from one another, at first wearing a mask if you had a cough, but now requiring individuals to wear a mask whenever in public, no visitations in healthcare settings, and coughing/sneezing in your elbow. Although these are all effective measures to take, there are still dilemmas in efforts to flatten the curve. This pandemic is demonstrating the consequences of underfunding public health. For example, delays in diagnostic testing and results, shortage of personal protective equipment (PPE), and shortage of ventilators. As the federal government scrambles to rapidly boost the nation’s capacity to test for the novel coronavirus, cutting red tape and leaning on the speed and technology of the private sector, new delays are developing because of a shortage of raw materials and vital items: chemical solutions, swabs and even face masks for health-care workers (The Washington Post, 2020). Not as if this is new news, but healthcare professionals are being asked to reuse surgical masks, N95s, surgical caps, etc. Furthermore, the Centers for Disease Control and Prevention (CDC) is recommending wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission (CDC, 2020). This is recommended for our public, in attempts to reserve N95s and surgical masks for healthcare professionals. I believe these measures are put into place, simply because there is a mass shortage of PPE. In addition, I have seen firsthand what delays in diagnostic testing results look like. Thankfully, we have rapid testing, in which individuals receive their results within 24 – 48 hours, but prior results took 5 – 7 days to come back. Unfortunately, some samples were lost, resulting in individuals needing to be re-swapped, contributing to spreading the virus to the community.

References

Centers for Disease Control and Prevention. (2020). Use of Cloth Face Coverings to Help Slow the Spread of COVID-19.

Retrieved from  https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html

The Washington Post. (2020). Shortages of face masks, swabs and basic supplies pose a new challenge to coronavirus

testing. Retrieved from  https://www.washingtonpost.com/climate-environment/2020/03/18/shortages-face-masks-

cotton-swabs-basic-supplies-pose-new-challenge-coronavirus-testing/

*Note: Throughout this program, your fellow students are referred to as colleagues.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 7 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 7

To participate in this Discussion:

Week 7 Discussion

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Learning Resources
Required Readings
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.).
Burlington, MA: Jones & Bartlett Learning.

 Chapter 5, “Public Policy Design” (pp. 87–95 only)
 Chapter 8, “The Impact of EHRs, Big Data, and Evidence-Informed Practice” (pp.
137–146)
 Chapter 9, “Interprofessional Practice” (pp. 152–160 only)
 Chapter 10, “Overview: The Economics and Finance of Health Care” (pp.
183–191 only)

American Nurses Association (ANA). (n.d.). Advocacy. Retrieved September 20, 2018, from
https://www.nursingworld.org/practice-policy/advocacy/

Centers for Disease Control and Prevention (CDC). (n.d.). Step by step: Evaluating violence and
injury prevention policies: Brief 4: Evaluating policy implementation. Retrieved from
https://www.cdc.gov/injury/pdfs/policy/Brief%204-a.pdf

Congress.gov. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/

Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementation. Academy of
Management Review, 21(4), 1055–1080. doi:10.5465/AMR.1996.9704071863

Sacristán, J., & Dilla, T. D. (2015). No big data without small data: Learning health care systems
begin and end with the individual patient. Journal of Evaluation in Clinical Practice, 21(6),
1014–1017.

Tummers, L., & Bekkers, V. (2014). Policy implementation, street level bureaucracy, and the
importance of discretion. Public Management Review, 16(4), 527–547.
doi:10.1080/14719037.2013.841978

Required Media
Laureate Education (Producer). (2018). Getting your Program Designed and Implemented
[Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018). Health policy and politics [Video file]. Baltimore, MD:
Author.

RE: Discussion – Week 7

On February 13, 2020,  H.B. 5886- Vaping Prevention on College Campuses Act of 2020 was introduced to the House (Congress.gov, n.d.). Congressman Eliot Engel introduced the bill due to a recent spike of college students who are vaping. It instructs federal agencies such as the Department of Education and the Department of Health and Human Services to create a toolkit to help colleges reduce e-cigarette use among their students. The kit includes; visual aids related to the hazards of e-cigarette use, teaching resources to prevent use, and a plan to stop use on campus. Additionally, a directory of providers that treat nicotine addiction will be included (Engel authors legislation to reduce vaping on college campuses, 2020).

E-cigarettes heat a liquid turning it into an aerosol that is inhaled into the lung. The fluid may contain substances such as nicotine, tetrahydrocannabinol (THC), and cannabinoid (CBD) oils, flavoring, and additives. In January 2020, the Centers for Disease Control and Prevention (CDC) reported 2,668 hospitalizations or deaths related to e-cigarette, or vaping, product use-associated lung injury (EVALI). Of those cases, thirty-seven percent were age eighteen to twenty-four years old (CDC Centers for Disease Control and Prevention, 2020).

In 2011, e-cigarette use among those aged eighteen to twenty-four was 6.9%; however, in 2014, the usage among this age group rose to 14.3%. This age group stated the main reason they began using e-cigarettes was due to peer pressure. Additionally, this age group believes that e-cigarette use is less detrimental than traditional cigarette use (Wallace & Roche, 2018).

Additional factors that make e-cigarette use popular among the youth include; advertising aimed at the youth, appealing flavors, easy to hide devices, and the ability to provide high levels of nicotine. While the ability to deliver high concentrations of nicotine is attractive to the youth, it is very harmful. Nicotine is very addictive and can impair brain development, which lasts through the mid-twenties (King, Jones, Baldwin, & Briss, 2020).

I believe there is enough evidence to support this bill. The number of injuries or deaths among college-aged students is staggering. The attitudes related to e-cigarettes are detrimental to the well-being of the youth. While the toolkit may not wholly stop e-cigarette use, hopefully, the information will make this age group stop and think about the lasting effects of e-cigarette use.

References

CDC Centers for Disease Control and Prevention. (2020). Outbreak of lung injury associated with the use of e-cigarette, or vaping, products. Retrieved April 5, 2020, from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html

Congress.gov. (n.d.). Retrieved April 5, 2020, from https://www.congress.gov

Engel authors legislation to reduce vaping on college campuses. (2020). Retrieved April 5, 2020, from https://engel.house.gov/latest-news/engel-authors-legislation-to-reduce-vaping-on-college-campuses/

King, B., Jones, C., Baldwin, G., & Briss, P. (2020). The EVALI and youth vaping epidemics- implications for public health. The New England Journal of Medicine, 382(8), 689-691. doi: 10.1056/NEJMp1916171

Wallace, L. & Roche, M. (2018). Vaping in contexts: Links among e-cigarette use, social status, and peer influence for college students. Journal of Drug Education, 48(1/2), 33-53. doi: 10.1177/0047237918807706

RE: Discussion – Week 7
Collapse

Hi J…,

I enjoyed reading your post. While this legislation deals mainly with college campuses, it would be wonderful to see it expanded into middle school and high school-aged children as well. The FDA and CDC reported in 2018, over 3.6 million kids used e-cigarettes (Products, C. for T., 2018). I agree that this topic should be addressed to college-age as well, however, many of them begin using this product in middle school and high school. So, if we can educate them on the risks involved at a younger age, perhaps we can make a greater difference. Many people believe vaping is a safer alternative to smoking. Therefore, educating young people about all the dangers of vaping might get them to seek a safer or healthier alternative.

Nicotine is a highly addictive and toxic chemical that causes blood pressure and adrenaline spikes, which raises heart rates and increases the potential for heart attacks and strokes (Blaha, M. J., n.d.). Some studies suggest nicotine may even be as addictive as heroin and cocaine (Blaha, M. J., n.d.). E-cigarettes can administer higher levels of nicotine than actual tobacco products due to the ability to purchase different strengths of nicotine for vaping (Blaha, M. J., n.d.). Other factors as well make e-cigarettes appealing to young people. They often cost less than traditional cigarettes or other tobacco products (Blaha, M. J., n.d.). Also, these vaping products come in a wide variety of flavors like watermelon and apple, which appeals to younger people (Blaha, M. J., n.d.). In 2015, the US Surgeon General reported a 900% increase of high school kids vaping and 40% had never used traditional tobacco products before (Blaha, M. J., n.d.).

This information alone is enough evidence for legislation to be enacted to get the word out to young people about this dangerous practice and that it is not a safe alternative to traditional cigarette smoking.

References

Blaha, M. J. (n.d.). 5 Vaping Facts You Need to Know. Retrieved April 8, 2020, from https://www.hopkinsmedicine.org/health/

wellness-and-prevention/5-truths-you-need-to-know-about-vaping

Engel, & L., E. (2020, February 13). Text – H.R.5886 – 116th Congress (2019-2020): Vaping Prevention on College Campuses

Act of 2020. Retrieved April 8, 2020, from https://www.congress.gov/bill/116th-congress/house-bill/5886/text?r=43&s=1

Products, C. for T. (2018). 2018 NYTS Data: A Startling Rise in Youth E-cigarette Use. Retrieved April 8, 2020, from

https://www.fda.gov/tobacco-products/youth-and-tobacco/2018-nyts-data-startling-rise-youth-e-cigarette-use

Hi Debbie

Thank you for talking about this as a discussion. I also work at what the world considers a top 5 hospital in the Nation which is also located in the inner city.  I have witnessed disparities in the health care of people of color. And as you stated “health care professionals are dismissive” to care of people of color. I have also witnessed social work rounding groups offer fewer resources made available to people of color vs other cultural groups. Often, I do have to advocate for people of color and other minority groups to help connect the lines of education if there are health care disparities involved. The Henrietta Lacks Enhancing Cancer Research Act is also a bill in which I support and feel there is evidence to support this act. The family of Henrietta Lacks is still fighting presently for compensation due to the family for which the family feel samples were used without permission of the patient. This bill requires the Government Accountability Office to complete a study reviewing how federal agencies address barriers to participation in federally funded cancer clinical trials by individuals from underrepresented populations and provide recommendations for addressing such barriers. Here is a link below to the bill.

Congress. Gov (n.d.). Henrietta Lacks Enhancing Cancer Research Act.

https://www.congress.gov/bill/116th-congress/house-bill/1966

Rubric Detail

 

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Content

Excellent Good Fair Poor
Main Posting
Points Range: 45 (45%) – 50 (50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

Points Range: 40 (40%) – 44 (44%)

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

Points Range: 35 (35%) – 39 (39%)

Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

Points Range: 0 (0%) – 34 (34%)

Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness
Points Range: 10 (10%) – 10 (10%)
Posts main post by day 3.
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Does not post by day 3.
First Response
Points Range: 17 (17%) – 18 (18%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Response is effectively written in standard, edited English.

Points Range: 15 (15%) – 16 (16%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

Points Range: 13 (13%) – 14 (14%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

Points Range: 0 (0%) – 12 (12%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Second Response
Points Range: 16 (16%) – 17 (17%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Response is effectively written in standard, edited English.

Points Range: 14 (14%) – 15 (15%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

Points Range: 12 (12%) – 13 (13%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

Points Range: 0 (0%) – 11 (11%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Participation
Points Range: 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100