NTERVENTION PLAN
Rationale
The coronary heart disease has been identified as a major cause of death and disability in the United States of America. It comprises of 67.4% of all deaths that result from heart diseases (Keenan & Shaw 2011). The government spends about $500 billion on programs of fighting the coronary heart disease (CDC 2010). Deaths that occur due to this condition are 15% higher among the African Americans as compared to the European Americans (Bailey P. 64). The disease is experienced among the African Americans at a much younger age as compared to their white counterparts. It is estimated that the risk ratio between the African-American and the whites is 2:1. This disparity has been widening over the decades with the mortality rates among the whites decreasing at a lower rate among the blacks as compared to the whites. The existing differences among the African Americans and other communities in the US have been associated with several factors. Among them is the social economic differences; the blacks experience lower levels of education low income that affects their purchasing power. This status denies them the ability to lead healthy lifestyles due to lack of adequate knowledge. The fact that they cannot afford to access quality health care services makes them vulnerable to advanced effects of heart diseases (Wyatt et al. 2003).
Figure 1Race of Ethnic Group
% of DeathsAfrican Americans
24.4American Indians or Alaska Natives
17.9Asians or Pacific Islanders
23.2Hispanics
20.7Whites
25.1All
24.9Source: Centers for disease Control and Prevention 2008.
Another reason associated with a higher prevalence among the African American is the differences that exist in availing health care resources to the US population. For instance majority of the black population are poor and unemployed they live in the rural where they cannot easily report the problems that they experience in their efforts to access health care services (Diex-Roux et al. 1997). Health insurance is used as a means of reducing the financial risk that is associated with health care expenses. The African Americans are not in a position to afford private insurance or even the public insurance programs. Such neighborhoods deny the blacks an opportunity to protect themselves against the potential causes of death due to adverse conditions that result from heart diseases (Wyatt et al. 2003). Risk factors are greatly influenced by the living standards and conditions that a particular ethnic groups lives in. A neighborhood determines the cost of food distribution of recreational facilities and publicity of products that degrade health like cigarettes. It also determines the level of stress that a particular neighborhood is likely to experience. Communities that belong to the lower social class experience more deaths as a result of the coronary heart disease and vice versa (Bransford & Ofili 2000).
African-American women believe that they cannot develop heart diseases. This attitude has been major causes of late diagnosis in which these people ignore the disease symptoms and only seek medical help when it is already too late. This has been attributed to the many deaths that have resulted from the coronary heart disease. Some African Americans have been known to take this disease as a way of life among their community; they assume that if the disease resulted to the death of their parents then their fate is defined. This has resulted to the disparities that have been witnessed in the utilization of coronary procedures among the African Americans. For instance less African American patients are willing to undergo the medical therapy rather than revasculization when treating heart disorders (Shaw & Redberg P. 123-124). This is not the case because this condition can be avoided or managed by observing healthy habits and following the health care guidelines. If the perception was avoided through health care education it is likely that a lower rate of mortality would be experienced (Bransford & Ofili 2000).
A lot of disparity in medical care is experienced among the different ethnic communities in the United States. Concern has been raised as to whether doctors base their assumptions on the race for them to define the kind of service to offer to their patients. It has been observed that less African Americans are likely to be referred to rehabilitation or diagnostic care as compared to their white counterparts. This is attributed to lack of knowledge by the patients; on most occasions they dont know the risk factors that may compromise their health. If they are enlightened on this they will know what to expect from their health care providers this also improves their knowledge about their health status enables them to manage their health conditions better. This knowledge helps in improving the quality of health services that they get; the medical health practitioners will be challenged to offer better services (Ebony P. 150).
A racial disparity in the U.S is common and pervasive in health. This has persisted from the 1950s up to 2005 whereby the blacks have been gaining life expectancy at a lower rate (Williams & Mohammed 2009).
ObjectivesTo establish preventive techniques that can be employed among individuals who are likely to develop coronary heart diseases.
To focus on programs that can be used to enlighten the communities about the coronary heart diseases
To provide ways in which the patients can access better medical care
Provide knowledge to communities on how to manage the coronary heart diseases efficiently
To encourage high risk groups to interact with health care providers and utilize these services fully.
Analyze the risk factors associated with coronary heart disease and provide guidelines on healthy lifestyles.Target group
The target group for the chronic disease intervention plan will comprise of the African Americans from age 25 up to the aged. It will involve both patients and non patients. This will give priority to the families who are challenged economically Families who have a history of coronary heart disease families in the neighborhoods where risk factors are evident. People who lead lifestyles that promote the development of this disease like smoking and drug misuse. It will also involve health care providers who will be assisting the patients in the screening centers and the treatment process.
Methods
The disparities that exist among the US population occur during prevention when the patients are being diagnosed the treatment process as well as the outcome that is given after treatment. The available data on the progress of the African-Americans in fighting the coronary heart disease is insufficient and therefore not reliable. Coming up with modifications has been a challenge because the health care providers do not have the existing diagnosis and lack the starting point due to the limited information. (Kwong Chung Wang 2006). A pilot study conducted by Sheridan et al. (2006) discovered that patients sought aid from their health care providers if they had knowledge about the risk factors. Given that these patients had knowledge about the risk factors that threaten their health these patients were free to discuss their health with the health care providers. This further enhanced the preventive measures that they took about their health because by interacting with the health care providers they increased their knowledge further. On the other hand patients who had limited knowledge experienced poor health simply because they lacked know how. Their health management strategy was low and insufficient for them to steer away from lifestyles that put their health into risk. They were not free to discuss their coronary heart condition with the health care providers. This only makes the situation worse because the disease is likely to progress to unmanageable levels which can even result to death. It was also found out that the patients who were informed were keen on taking drugs as prescribed. The information about their health gave them the will to overcome the disease unlike their counterparts who let the disease drain their health (Kwong Chung Wang 2006).
Being informed not only decreases the chances of contracting this disease but also increases the chances of survival for the people who develop the condition. This is a major step towards decreasing the deaths associated with the coronary heart disease. When the disease is diagnosed in good time then the treatment process is successful and the disease is not likely to cause death. This study identified inaccessibility to screening centers as a major cause for late diagnosis. Patients only realized that they had the disease has already advanced to show its symptoms (Sheridan Shadle Simpson & Pignone 2006). In this research there are several areas of research that were addressed. First is the pathogenesis and pathophysiological processes which are important in determining the likelihood of the disease developing and advancing to cause death. This area involves all the members of the community whether suffering from the heart disease or not. Secondly clinical activities which comprise of diagnosis and treatment are addressed. The way in which this activity is conducted determines whether the individual can be saved before it is too late. It also involves monitoring the disease patterns and the factors that pose risk to the development of this disease. Finally actions that should be taken so as to ensure that people are educated about health management. This enhances disease prevention (Washington et al. 2007).
Therefore this intervention plans aims at ensuring that the chances of African Americans developing this disease are minimized. In cases where these people are diagnosed with the condition they will overcome the disease. This will ensure that the number of coronary heart disease related deaths is kept at the minimum. This will ensure that the African Americans do not experience higher chances of developing this disease than the rest of the communities in the U.S. This will be achieved through a step by step process. First the plan will expound on why the African Americans have higher chances of developing coronary heart disease. Secondly it will enlighten the African American on the risk factors that make them prone to coronary heart disease. Third the plan will involve the communities by establishing screening centers in different locations among the community. This will give a chance to all the willing participants to whether they have developed this disease. It will also offer an opportunity for the community to interact with the health care providers and learn more about health management.
Fourth the plan will seek to ensure that as many people as possible participate in this exercise and learn about their health and the risk factors that may be affecting them. This will be achieved through extensive campaigns in which individuals will be lured to utilize the screening centers whether they experience symptoms or not. Fifth the plan will ensure that people who are diagnosed with the coronary heart disease receive medication in the screening centers. They will further be educated on the importance of this medication and guided on how to take medication. This will ensure that the patients adhered to medication and get the value of diagnosing and treating this disease early. Finally the intervention plans will establish a close relationship between the health care providers patients and the whole community as a whole. This relationship will encourage the people to share their health issues with the health care providers and encourage them to take charge of their health. It will provide an environment in which health issues can be addressed even before the symptoms are clinically diagnosed. This process will promote health and reduce the risk factors experienced by the African American community.
The sampling method will be purposive to ensure that members from the risky families are involved. It is expected that not more than 5 individuals are taken from the same family. This figure will ensure that majority of the community members participate in this exercise. Two to three health care providers will be asked to participate in each screening center. The health care providers will change from time to time for the purpose of measuring patient confidence in different health care providers. This will promote a free environment for the patients to express their health issues.
The plan will be evaluated using qualitative methods while Quantitative data will be obtained to support the qualitative research. The quantitative variables that will be used include; the number of people who visit the screening centers the health care providers involved against the number of people who participate risk factors that are specific to African American population and the number of deaths experienced due to coronary heart disease before and after the intervention.
Evaluation Plan
The evaluation plan will answer key questions about the disparity experienced in the development and mortality of the African-American community of the United States. First the evaluation will answer whether the community members have developed preventive techniques that promote good health. Whether the patients have received adequate treatment; whether the patients are free to contact and share about their health issues with the health care providers; whether the community members are aware of their status on the coronary heart disease and; are educated about the coronary heart diseases and risk factors that make them vulnerable.
For this plan to be effective data obtained from the screening centers will be analyzed to measure the performance. This will be carried out after every three months for a time period of one year. It will concentrate on evaluating new patients patients who are on return visits and monitor how these patients are taking the medicine administered to them. It will also seek to establish whether the members of the community change their behavior and lifestyles which make them vulnerable to coronary heart disease. It will also establish whether the patients and the health care providers develop bonds that will make the treatment process easy and more effective. This will be realized by observing how the patients express themselves as the visits increase. This will be observed during every visit that the patients make. This evaluation will also analyze the number of deaths resulting from coronary heart disease after every four months. The evaluation plan will take a time period of one year so as to present efficient results.
The evaluation process will be carried out as indicated below;
Figure 2.Time Period
Activity
Area of focus
Expected outcomeFirst time visit
Diagnosis
The patients will be screened.
Those that have developed the disease will be administered drugs.
Those without the disease will be guided accordingly.
The first session will involve sharing of information between the health care providers and the African Americans.
The visit will aim at finding out if the patient has the coronary heart disease.
It will also identify the risk factors exposed to the community members.
Some of the members may have developed the disease while others may be exposed to the risk of developing coronary heart disease.Three month period
Patients will share their experience with the health care providers. The rest of the members will do a repeat test to confirm their status.
To monitor whether the patients are adhering to the prescriptions and register the improvement experienced.
The patients are expected to show a positive response to the drugs.
Non patients will be freer to acquire knowledge from the health care providers.Six month period
More screening activities for non patients and dialogue with the patients.
Measuring the treatment progress.
It is expected that the patients will show signs of conquering the disease.
Non patients will change their behaviors to prevent chances of disease occurrence.Nine month period
Screening. Monitoring patients and administering drugs according to the treatment process
To identify the change in behaviors that promotes the development of the disease.
That the number of and the members are free with the health care providers.One year period
Guidance for patients and non patients by the health care providers.
Identifying how the risk factors are conquered.
The number of deaths as a result of coronary heart disease will decrease significantly.Source; Author.
Conclusion
A disparity exists among the different ethnic groups in the US. The African Americans comprise of the most affected group which has experienced a very low improvement rate over the years. The intervention plan discussed will involve the members of this community in improving the current situation and promote a healthy life with fewer cases of coronary heart disease development. Establishing the prevention programs will reduce the risk factors which will consequently eliminate mortality cases resulting from this disease. Through these programs community members and health care providers will create a friendly environment. Such an environment will promote openness and patients will share health issues affecting them. This reduces the risk factors and promotes a healthy living and better disease management strategies in future. Through these programs the African American will seize to be among the vulnerable population by progressing in disease prevention as the rest of the communities in the U.S.