Capella University Health Problem Worksheet

Use the provided template to create an action plan to address a chosen health problem.Introduction
Information technology, specifically electronic health records (EHR) and patient portals, are helping to empower patients to take a more active role with their health care (Nash, Fabius, Skoufalos, & Clarke, 2016). Information technology is also supporting collaborative efforts among multiple health care stakeholders, including providers, insurers, community health agencies, and policy makers (Nash, Fabius, Skoufalos, & Clarke, 2016). The use of decision support systems facilitates the mining of large amounts of data in population health, including data measurement and analysis. Three purposes of measurement include improvement, accountability, and research (Nash, Fabius, Skoufalos, & Clarke, 2016). Decision support systems can also be used for predictive modeling to improve performance and predict potential outcomes (Nash, Fabius, Skoufalos, & Clarke, 2016). As information technology and decision support systems become more sophisticated, and larger amounts of data are captured, the potential to further the IHI Triple Aim initiatives discussed previously in the course increases.Population health continues to evolve, and the Affordable Care Act (ACA) introduced several new regulations and models. The IHI Triple Aim initiative will be an ongoing area of focus, and information technology offers new ways to engage patients in their own health. Smart phones, health and wellness apps, and smart watches will give patients new ways to monitor their behaviors. As providers educate themselves on behavioral change models and economics, they can help patients change unhealthy behaviors. Nash, Fabius, Skoufalos, and Clarke (2016) predict that the next few years will likely result in an updated health risk assessment that includes additional determinants of health and performance, including stress and anxiety, and increased recognition of the importance of thriving and health. Beyond five years, we will likely see shared values among employers, employees, and the community.Taking measurements, regulations, current and evolving technology, and models of care into account is critical to help ensure sound design of population and community health plans. Without a well-thought-out design, a well-thought-out and implementable action plan will prove difficult to impossible. So, these are critical considerations as you approach the Community Health Action Plan assessment.Reference
Nash, D. B., Fabius, R. J., Skoufalos, A., & Clarke, J. L. (2016). Population health: Creating a culture of wellness (2nd ed.). Burlington, MA: Jones & Bartlett Learning.Demonstration of Proficiency

Competency 1: Integrate principles of epidemiology, population health, and community engagement to plan interventions. 

  • Evaluate an organization best suited to implement a community-health intervention.

Competency 2: Differentiate and evaluate evidence-based treatment models and prevention models designed to promote wellness and disease management for population health. 

Formulate criteria for evaluation of task completion.

Competency 3: Create an action plan to promote wellness and disease management in a diverse population. 

Define a goal for an action plan.

Identify roles, tasks, and timeframes required to implement a plan.

Identify human, capital, and material resources needed to complete tasks in a plan.

Competency 4: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with expectations for health care professionals. 

Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

  • Write following APA style for in-text citation, quotes, and references.

Note: It is recommended that you complete the assessments in this course in the order they are presented.Preparation
This assessment brings together aspects of the other three assessments in the course. The goal is to create an implementable action plan to achieve a SMART goal addressing the community-health need you have been exploring throughout the course.To prepare to successfully create your Community Health Action Plan, it is recommended you complete the following:

  • Familiarize yourself with the Action Plan Template you will be completing as your assessment artifact. 
  • Consult your previous assessments, and the feedback you received on them, to focus on what areas you should focus on when completing the template.

It may be helpful to complete the Community Health Programs formative activity.

  • Instructions
    For this assessment, create a detailed action plan to promote wellness and disease management by addressing your chosen health problem you have been working on throughout this course. Based on feedback received on your previous assessments, design a plan you could implement in a health care organization (such as a hospital, physician practice, or federally qualified health center) to address a specific SMART goal.Make sure you download and complete the Action Plan Template. Only submit the completed template for your assessment. Do not submit a paper for this assessment. Papers will not be graded.Consult the scoring guide to ensure that you are addressing all criteria at the level to which you desire. When completing the template, be sure you address the following:
  • Define a goal for an action plan. 

You may want to review either (or both) of the media pieces related to SMART goals to help in addressing this criterion: 

Why is the organization best suited to address your chosen health problem?

  • Why is the organization best suited to implement your potential solution?
  • How is the organization best suited to engage and help the affected populations in the community?
  • Identify roles, tasks, and time frames required to implement a plan. 

This criterion is related to the first two columns in the template. 

Be sure to detail the specific tasks that must be completed based on the research you have conducted in the first column. 

Identify the roles of all stakeholders needed to implement your plan. Explain why they are needed.

  • For each task, be sure to identify an appropriate and realistic timeframe to complete the task in the second column.

Formulate criteria for evaluation of task completion. 

This criterion is related to the third column of the template. 

  • Make specific connections between these criteria and evidence-based strategies to promote wellness and disease management for a population.
  • Identify human, capital, and material resources needed to complete tasks in a plan. 

This criterion is related to the fourth column of the template, as well as the Key Stakeholders section. 

For the stakeholders: 

  • Which stakeholders are required to complete each task?

What are the roles of the stakeholders? 

In other words, why are the specific stakeholders needed?

Additionally, make sure you identify any other people, capital, materials, and so on, needed to complete a task.

Write clearly, with correct spelling, grammar, and syntax, and good organization.

  • Apply proper APA formatting and style.
  • Community Health Programs
    Every community has to consider its own particular circumstances to include factors such as health concerns, demographics, resources and capacities, social and political factors, and competing needs when recommending strategies to address specific community health needs. These factors influence the type, design, implementation, and goals of programs focused on improving the health of communities. The following items are related to these various factors that go into community health programs.Community Health Programs: Monroe Township
    The following questions will use the following scenario as their basis. In your community health assessment, you identified the need to address the alarming childhood obesity rate. Monroe Township’s childhood obesity rate is 31.4% up from 17% in 2000 with the highest obesity rate in the 10-17 age group.1 of 6Which of the following strategies or models would be an appropriate approach to attempt to address at least part of Monroe Township’s rise in childhood obesity?

An education program for caregivers.

A school wellness program.

  • A community nutrition awareness program

A medication-based treatment program

This question has not yet been answered.2 of 6Within the context of the obesity issues facing Monroe Township, what would be an appropriate goal for an action plan to reduce the obesity rate in Monroe Township schools?
This question has not yet been answered.There is no one right answer. An example of an appropriate goal is, “To prevent and reduce childhood obesity by 10% in Monroe Township schools through improved nutrition and physical activity programs.” An example of a goal that would not be detailed enough is, “To reduce the childhood obesity rate in Monroe Township schools.”3 of 6You want to implement a “Keep Moving” program in your county Monroe Township schools to reduce childhood obesity. As part of implementing this program, what are some some possible activities/strategies that you can implement in the schools to reduce childhood obesity by 10%?
This question has not yet been answered.There is no one right answer. Some examples of appropriate and realistic activities and strategies are: Replace vending machines with healthier snacks or have a dietitian or health coach to provide counseling. Another example could be to incorporate a 15 minute of moderate physical activity during recess and encourage playing tag, jumping rope, dancing, etc.4 of 6Which organization are best suited to help you promote and implement a “Keep Moving” program to promote wellness and prevent childhood obesity?

  • Local School District

Centers for Disease Control and Prevention (CDC)

  • State Department of Health

Local Candy Manufacturer

  • This question has not yet been answered.5 of 6You have been given the green light to implement the “Keep Moving” program in your county Monroe Township to reduce childhood obesity by 10%, but you need funding to implement the campaign. What are some potential funding sources that you can use to fund this project in the school district?
    This question has not yet been answered.Some appropriate places to explore for funding would be federal and state grants, donations from community organizations, and philanthropic organizations .6 of 6Currently, there are 15,567 students in the 10-17-year group in Monroe Township schools. What criteria could you you use to measure and evaluate whether the program is successful?
    This question has not yet been answered.There is no one right answer for this question. An example of a good measurement and evaluation criteria is, “. The “Keep Moving” program will be successful if 1,557 students in the 10-17- year group in the school district reduce their weight at the end of the program.”SMART Goals
    When creating an action plan, it’s important to set effective goals. This exercise is designed to help you establish goals for making your decision about a school or program. A useful tool for setting goals is the SMART model.SMART stands for Specific, Measurable, Attainable, Realistic, and Time-Bound. For a goal statement to be effective, it needs to meet all five of these criteria.Let’s start with S, specific. A specific goal is one that is very clear and focused. It answers the “who, what, when, where, or why” questions as specifically as possible. WHO will be affected by this goal, and how many individuals will be affected?Next, ask WHAT specifically are you going to do to meet this goal? Think of this in terms of action words, like delegate, organize, lead, or train.Next, ask WHEN? How long will this take? When will it be finished? Be sure that your goals are scheduled to take place over a set period of time.Next, ask WHERE? Where will you perform the actions needed to meet this goal? Where will the individuals be located who will be affected by this goal?Finally, it’s always important to ask WHY. Why should this goal be developed in the first place? What good will come out of this?The second criteria for measuring goals with the SMART model is that goals need to be MEASURABLE. This means that you need to be able to measure the degree to which your goal was met.The third criteria for measuring goals with the SMART model is that goals need to be ATTAINABLE. In other words, is this goal possible? It’s good to set goals that are a little difficult to meet, but you need to draw the line between a goal and a dream.In addition, goals need to be REALISTIC. It may be possible to meet a goal, but highly unlikely. When setting goals, ask yourself, “How likely is it that this can be accomplished?” Keep in mind obstacles that may make it difficult to achieve your goal, and adjust accordingly.Finally, goals need to be TIME–BOUND. They need a starting point and an ending point. Otherwise, the goal is too vague.Remember, effective goals need to be specific, measureable, attainable, realistic, and time- bound. Keep the SMART model criteria in mind as you set goals for your plan.Evidence-Based Strategies and SMART Goals
    A community health assessment helps organizations identify key health needs and issues through systematic, data collection and analysis to address disparities among the population using treatment and wellness models. The following items can be categorized as community health interventions to address a health improvement need in your community utilizing treatment and wellness modelsQuestion 1 of 7Evidence-based treatment is a method of zeroing in on the best course of action and treatment for a specific patient based on research, clinical expertise and the patient’s values and preferences. What are some of the advantages to using this model? (Select all that apply)
  • It can help health care professionals use real-time data to make care decisions.
  • Health care professionals will be more likely to stay current on evidence-based protocols.
  • The model has been shown to help improve quality of care and outcomes.

Evidence applied via the model can be used as the sole input when making clinical decisions.

  • This question has not yet been answered.Question 2 of 7Rates of tobacco use have been higher in your state than in the rest of the nation. Which of the following are examples of wellness strategies that you could recommend to address this community health need? (Select all that apply)

Cessation help lines

  • School tobacco prevention programs

Counseling services

  • Nicotine replacement therapy
  • This question has not yet been answered.Question 3 of 7A SMART goal is one that is SPECIFIC. Imagine your team is in charge of launching a new Wellness program in your school district, what could be a specific goal for the wellness program? Think about: What exactly will you do? What actions will you take? What do you intend to impact? when writing your specific goal.
    This question has not yet been answered.There is no one right answer for this question. An example of a specific goal could be “To educate all school employees, students and parents about the wellness program by discussing the policy at the back-to-school night, sending reminders in the school newsletter that students take home 4 times a year.” An example of a goal that, while good, is not specific could be “To educate all employees, students and parents about the wellness program.”Question 4 of 7A SMART goal is one that is MEASURABLE. Imagine you are working with a patient who wants to lose 10 pounds over the next three months (July-September). How could they measure their progress towards this goal?
    This question has not yet been answered.There is no one right answer for this question. One example of an appropriate measurement plan for a SMART goal is, “The patient can measure their progress by regularly tracking their weight, number of inches lost, and calorie intake.” Question 5 of 7A SMART goal is one that is ATTAINABLE. The patient who is trying to lose 10 pounds in the next three months is trying to figure out how they will reach their goal. What could they realistically do to attain their goal?
    This question has not yet been answered.There is no one right answer for this question. Some examples of activities that are would likely lead to attaining the weight loss goal are “Walking 3 times a week for 30 minutes” and “Limiting high sugar snacks to one per day.” An example of an action that would likely lead to goal attainment, but might not be possible is “Walking 3 times a week for 30 minutes, plus running 2 times a week for 30 minutes, plus lifting weights 5 times a week.” An example of an activity that is likely possible, but would likely not lead to goal attainment is, “Eat a slice of cake at least once per day.”Question 6 of 7A SMART goal is one that is REALISTIC. Consider the following situation. Shawn smokes two packs of cigarettes a day and wants to quit smoking. Shawn will exercise more and smoke only 20 cigarettes a day and use a nicotine patch, during his break at work he will take a walk instead of going to the smoking area, and when driving he will chew gum instead of smoking. Do you think this is realistic? Why or why not?
    This question has not yet been answered.There is no one right answer. One possible answer would be, “Yes, by exercising more, reducing the number of cigarettes a day, using a nicotine patch, walking during his lunch hour, and chewing gum while driving are all small steps Shawn can take to quit smoking.”Question 7 of 7A SMART goal is one that is TIMELY. Shawn’s goal is to cut his smoking down to 10 cigarettes a day. What is an example of a time-specific goal for Shawn to achieve this?
    This question has not yet been answered.There is no one right answer. One potential example of a time-specific goal is, “Shawn will cut his smoking down to 10 cigarettes a day over the next 90 days.” An example of a goal that is valid, but not really time-specific is, “Shawn will cut down his smoking by the end of the year.

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