Community Health Promotion

Introduction

Community health promotion is one of the growing concerns in the global health industry. The health care industry focuses on reducing unhealthy tragedies that various communities face. Therefore, the industry has invested resources and efforts to distribute facilities and requirements which can boost the health status and standard of people’s life globally (Self, 2009). One of the strategies that have been identified is the challenge experienced by pregnant women with low income. The condition has highly contributed to the increasing rate of child mortality in the world annually from readily treatable or preventable conditions that are not affordable to the population. To analyze the situation, an assessment of the state has been conducted in order to identify the intensity of the problem in the North East, Alberta region.

The health of expectant women is a crucial concern for the health care industry all over the world. The health situation is influenced by several factors such as economics, society, spirituality, and culture. In the previous study, the community diagnosis was based on the population of pregnant women with low income living in North East Calgary, Alberta. According to the research, the economic stability of the target population proved to be interlinked with their health status. 80% of the sample population involved teenagers who had barely graduated from the school and would not attain a job with a salary more than $2000 (Dolan et al., 2010). Therefore, young mothers are forced to survive on the little income, which deprives them of a chance to live a healthy life. To develop the health status and quality of people’s life, researchers recommend promotion of education among the residents of the region. The researcher perceives that proper education will enable the people in the area to acquire better jobs with a sustaining income. The aim of this paper is to provide an outline for a program to meet the identified need for education and suggest different approaches to implement the change programs in the community. The main changes needed include education for the population to ensure they attain well-paid jobs and affordable health services for the existing low-income population in the region.

The program that will be implemented in the sector is aimed to improve the status quo of the pregnant women with low income in Calgary. Another objective is to reduce the number of pregnancies among the teenagers through education empowerment. A program that can be implemented to resolve the existing challenge in the health sector will be focusing on solving short, medium, and long-term issues to the problem identified. Therefore, the program will be tailored to the preferable operational, strategic, and legislative needs. The program framework will involve primary stakeholders in the sector that include target population, the government, and health sector officials. A financial and service plan will be integrated into the framework for maximum evaluation of the requirements needed. The program will be evidence-based, supported by a robust planning scheme, and delivered to recommendable professional personnel. The main principles to be observed in the program will be sustainability, flexibility, client focus, and availability.

Sustainability

The integrated program will aim at maximum utilization of the resources used in the health sector to help reduce teenage pregnancy and the costs of the prenatal services in North East, Calgary.

Flexibility

To achieve maximum impact on the program implementation, the program has to be flexible enough to incorporate the significant changes that affect its functions in the sector. The program should have a timeframe through effective evaluation and monitoring. It should be easy to adjust to and suit the current situation. The changes may cause delay, skill mix, introduction of new models, or adaptation of new strategies, but all of them should serve for a better outcome.

Client Focus

The targeted group in the community should be provided with care services which render solutions to their problems as per the results of the surveys and interviews performed during the study. Maintaining the relevance of the program makes it easy to implement and transform changes among the population for they readily accept it in their lifestyle. An integrated program with well-planned standards and services makes it easier to focus on the right patients.

Availability

The program should take into account the availability of the resources needed for the implementation and maintenance of the services during the planning process. Some of the crucial resources to be taken into account include facilities and skilled workforce for the program implementation process in the region.

Program Goals

 The program should include the following primary objectives:

• It should be ensured that the planned program has observed the principles outlined in the planning process.
• The program should build and support an evidence-based and integrated strategic change implementation process. The service and financial processes should be taken into account in the planning process. Additionally, the expected outputs should be a guiding measure for all the steps to be taken at each level of the strategic change management concerning the community issue. The outputs should be well-forecast in short, medium, and long-term periods with demand of the suggested services. Afterwards, an evaluation and monitoring process should be done to weigh the success of the program.
• The people concerned with the planning of the program should have adequate capacity and resource availability for an effective strategic planning of the implementation process. The Health Service Executives (HSE) in the region should ensure that there are enough facilities and workforce as per the requirement of the program. The workforce involved should be well-skilled to enable achievement of quality services. The HSE should ensure that the workforce teams are well-motivated to perform their duties despite the changing situations and challenges. Some of the problems include long working hours and harsh working conditions in the field as compared to the hospital environment.
• The program should support the operations of the program through the use of automation system to help in accuracy and faster execution of the process as compared to manual performance. The methods to be used in such programs will include the information management system that will help in robust data collection process and maintenance.

Strategies for Influencing Community Change

In nursing, the approaches used to introduce and implement changes in the community determine its output in the target population effect. The two major approaches used in the influencing community change are behavioral or lifestyle and socio-environmental approaches. The strategies used in the program implementation are well-predicted with utilization of the most useful model for assessment. In this evaluation, the community-as-partner model has been utilized to gather information concerning the focus subject of the study research. The model concentrates on four major subjects: people’s behavior, health, environment, and nursing intervention. The issues cover all the parties involved in the health care change management of the community. Analyzing the influence of every party involved will help determine the most appropriate strategy to use for implementation of the proposed change program. The strategies can be either behavioral or social-economic.

Behavioral Approach

Behavioral approach is based on the different influences that the rationality of people brings to their perception, reaction, and adoption of changes. Human beings are rational in behavior; therefore, they react differently to any change in the environment. Similar results are experienced with the health care changes to their community. The introduction of a health initiative in the community has an influence on the personal, environmental, and behavioral characteristics, which determines the way different people react to the changes. In this study, the program that should be introduced in the community is aimed at bringing changes in the economic and education levels of the pregnant women with low income. Increased education levels and improvement of their economic status will ultimately better their living standards and their health status. The changes will also be equivalently shared with unborn and small children in the region. This approach is based on the lifestyle of various people involved in the community assessment.

Social-Environmental Approach

Health is a social and economic resource for the people living in the community which influences day-to-day lifestyle of the population. Residents of the community have different norms, practices, or beliefs that influence their activities concerning health measures. From the assessment report, the community-as-partner model emphasizes social, personal, and physical resources as factors that affect health practices of people in the target region. The population that has been assessed involves 30 pregnant women with low-income level. An analysis of how they relate to the environment and their social behavior or pattern will ensure good program planned to resolve the existing challenges among the given group.

The status of the environment influences social activities that the residents indulge. Since Alberta City is located in a developed country, fewer people are expected to suffer from low income and poor living standards. The strength of the economic status of the country should be advantageous to the population pursuing the access to proper health facilities, while good jobs should be easily available. However, from the assessment, a majority of pregnant women face the challenge to access good health care services since they are low-income earners not qualified to win royal jobs. 80% of the target group includes teenagers that were unable to finish school and forced to live a low standard life with their children. It is characterized by low-quality house structures, unhealthy or imbalanced diet, and inability to access health facilities. Therefore, the proposed program has to take into account each and every of these challenges to ensure the positive impact on the population.

The approaches to be used in this program will involve educating the existing low-income population with children on how to improve their living standards. Additionally, the teenagers in the community need to be discouraged against early pregnancies. The approaches will utilize all the resources available to create an effective program that will resolve the problem not only in Alberta but also in Canada. The planned strategies will ensure that both the behavioral and social-environmental factors are considered. After that, a comparison between the methods will be done to determine the best approach to be used in order to implement changes in the health sector in North East, Calgary.

Recommendations of the Approaches

The health sector will introduce a program that will involve young mothers struggling to survive. The counselors will help testify to the population on the disadvantages of having a child before they live a well-established life with an excellent source of income. The self-testimonies based on personal experience will help the groups take the lessons keenly. After that, the behavior patterns of the teenagers should be developed personally. Teenagers will be addressed in religious committees, schools, and other social groups, characterized by extraordinary social behavior of different individuals. The institutions helping pregnant women will be encouraged to counsel various groups of young mothers struggling to meet their basic needs and wants. Subsidized health facility services will be created in the country to bridge the gap between the high and low-income earners and help access the health care services. The government should support institutes in providing health care facilities for the low-income earners, making health care sector increase its efficiency and effectiveness. Improving the living standards with available health resources in the region will be the primary aim of the program. Triggering changes in the behavioral pattern of the population will ensure that the number of economically unstable young mothers will be reduced. Moreover, the loss of lives due to unhealthy practices among the low-income earners will also be reduced over time.

Secondly, the health sector could introduce programs aimed at involving teenagers with real tasks of handling babies. The programs are suggested to be incorporated in the education system in the region. Involving teenagers in the tasks of handling children will help them understand the demands of child upbringing and the commitments needed. Child upbringing is not a simple task and, thus, interpreting the real work for the teenagers helps them make better decisions concerning their lives. This program can be handled by different providers in the health sector to enable availability and reliability of the services to a significant range of teenagers in the region. Improving the environment that people live in by increasing the access to the health facilities and improving their knowledge on the issues related to pregnancy and health care will enhance their standard of life. The social-environmental approach would be an effective strategy to implement the program aimed at resolving the existing challenge in Calgary.

The two approaches will be managed by the Health Service Executives in the region to ensure that the policies and principles set for the program are well-observed. Moreover, the integrated program should be consistent with the best health care strategy and involve educationalists, medical staff, academics, and favorable community culture. The regions implementing the change program should be linked together to ensure an integrated health service monitoring and evaluation process. The integrated system will help identify the strengths and weaknesses of each approach used in a certain region. Further, the multi-unified system will help compare the progress and impact of the program in different locations.

Comparison and Contrast of Approaches

Similarities

The criteria exercised based on the principles and regulations of the public health care sector are quite similar. Therefore, the strategies aim at advancing the community resources internally and externally in the health system.

Differences

Policies applied. The Community Public Health Planning in Rural and Remote Areas project (CPHPRRA) will develop strategic directions guided by a partnership principle with articulated equity drivers. The Multi-Purpose Health Services Program policy (MPHS), as influenced by external factors (such as cultural practices) will be set and facilitate future development and site selection via problem-solving within the context of guidelines

Site selection made. The MPHS program is based on planning that has been undertaken to guide site selection and their progression to new models. The CPHPRRA project site selection will be significantly influenced by early negotiations with the community.

Fund-holding practices. Fund holding and management rests with Calgary Health for the MPHS program; however, the CPHRRA project allows the city to hold and manage individual resources related to the public health.

Influences created. The essence of the CPHPRRA project is that of a model under development that will evolve into an agreed set of values and principles. The MPHS program is endeavoring to create a fit between the principles and practices of primary health care in the already established environment.

Work practices. There are inherent differences related to the actual work which will result from the planning processes. The MPHS to a large extent deals with providing health services and reforming them in a way that meets the needs of communities. The CPHPRRA project is connected with community-led planning and implementation of those plans in a way that will facilitate a sustainable increase in community’s capacity to address any issues that affect them.

The analysis of the factors concerning the two approaches will help provide new information on the policies that need to be incorporated in the community health care management (Thaler & Sunstein, 2008).

Roles of Community Health Nurses

The need for hospital quality services at minimum cost is directly dependent on the nursing care in the health care unit. In this program, the approaches focus on harmonizing the nursing care activities with the principles and policies concerning the activities to ensure medical quality of services, safety, and minimum costs. Additionally, the staffing process for the program seeks to recruit professionally qualified personnel to ensure that quality services are rendered to the population. Moreover, the staff members are involved in the processes of implementation, planning, and evaluation of the program to ensure they understand their expected conduct. In each of the approaches given in the program, the nurses have similar roles in the community health care management. The major roles include:

• Ensuring safety and quality. The nurses ensure that the recommended strategies and activities are performed according to the provisions in medical industry policies. Adequate safety and high quality of the services rendered to the community would lead to an increase in the effectiveness of the program.
• Participating of nurses in leadership and creating nursing activity visibility in the project. The nurses are expected to increase the medical service visibility in the community to cause more attention and ensure a bigger number of residents participating in the initiative. Therefore, expanding the engagement of the nursing personnel in the front-line leadership helps capture more clients and increase efficiency on the critical issues concerning nursing roles.
• Enhancing the relationship between the target group and the professional practitioners. The nurses participating in the community change program link the population with better health care services. For example, a nurse will befriend a challenged individual and guide them to the right professional who can tackle their issues. The practitioners may be gynecologists, counselors, or therapists.
• Educating of the population. The nurses participated in both approaches by teaching the community the best ways to handle children in a healthier way. Provide guidance on the importance of pre-natal check-ups and the best way to ensure balanced diet to nursing mothers and the children.
• Providing counseling services. The nurses also act as counselors to the population during the implementation of the program. The nurses will use their medical care knowledge to guide the target group of the program. The target groups include teenagers and young mothers of the community.