Evaluation of the Community Health Program

Introduction

The Indian community is a prime victim of many health concerns especially elevated levels of cholesterol, diabetes, and heart attacks. Although, most of the people who live in the community are educated, such health problems have been dominant in this community. According to Centers for Disease Control and Prevention (2012), heart disease has been the leading fatal cause among the Indian community in America (center for disease control and prevention, 2012). Heart-related diseases have been responsible for the majority of the cases of disability as well as the decreased quality of life among American Indians. The prevalence of heart disease among Indians in America seems to be a long time trend. Records show that from 1996, the fatality rate from heart disease among Indians was 20% greater than that of all other races within the United States put together. This indicates that the disease has remained rampant among the community members to date. Similarly, a study conducted to compare the prevalence of heart disease among South Asian women revealed that the rate of heart disease was more widespread among the South Asian women. They were rated at 4.2% while white women were rated at 1%. Equally, the same study revealed that the Indian women’s total cholesterol level was higher than that of Caucasian women (Healthealthywomen.org, 2012). Furthermore, such findings indicate the need for an independent intervention program that is specially designed for this community (Diabetes Public Health Resource, 2012). The intervention plan is to help the Indian community become aware of the rising problem of diabetes and heart disease in the population.

History

The combination of an unhealthy diet and lack of exercise in the Indian community has put the population at an incredibly significant risk for all sorts of ailments. Most in the Indian community have achieved some higher-level education. It is notable that 85 % of the group at least completed high school and 58% of them posses a bachelor’s degree. This is the level of higher education is impressive, in cooperation to 20% of the whole population in possession of a bachelor’s degree. It is clear that high levels of education have l; helped Indian Americans on production population segment with 72.3% taking part in the work force, where 84% of men working. In this labor force participants, 43.6% of the population works in managerial and professional posts (Mayo clinic, 2008). Because of the high employment rate of the Indian community, most are at a loss for energy after a long day work, which leads them to exclude the effort to exercise. In addition, most Indian foods are saturated with carbohydrates, fat, and oil. All three of these ingredients are the leading causes of heart disease. Without proper diet and exercise, the Indian community may fail to achieve a healthy lifestyle. In a major city, such as Philadelphia, many community hazards can affect the health of its inhabitants. An enormous Indian population of immigrants can be found in the region of Northeast Philadelphia areas of Somerton, Bustleton, and Penny pack. Many of those living in the far Northeast tend to be white-collar professionals. These areas are within 3-5 miles of the project venue, St. Thomas Syro Malabar Catholic Church.

Statistics

Despite the fact that the levels of death in the American society in the recent past has improved, there remains an ever-growing gap in the heath status of the American Indians. A report by CDC indicates that American Indians have a high prevalent to many diseases (Barnes, Adams, & Powel – Grinner, 2010). Nevertheless, they are more likely to seek preventive measures than any group. In a study conducted in 1990 to 1998, the number of American Indians diagnosed with diabetes increase by about 71 percent from 4534 to 7736. Among the adolescent youths, the prevalence was noted to be high. On this study, it was noted that the prevalence of diabetes was higher in females than in males, in all the age groups, (Acton, Moore, Querec, Geiss, & Engelgau, 2002).

In another report by CDC, it was indicated that American Indians holds a greater health risk factors of many chronic diseases among all the minor ethnic groups and races. However, earlier investigations had indicated the low prevalence of hypertension on American Indians who do not have diabetes the incidences are now increasing. In the survey conducted in this report, hypertension was common among American Indians more than in any other race, in the world. The strong heart study, which was conducted during 1989 to 1992, indicated that darned few American Indians had high cholesterol levels in the blood in comparison to samples from national health and examination survey. However, in a survey by REACH 2010 it is indicated that almost a third of American Indians had high levels of blood cholesterols and at the same time, the levels of cardiovascular diseases were high as compared to other minority races (CDC, 2003).

Development of Plan

In the development of the community project, the foremost issue that would do in a various ways thoughts in the planning of the project and visualizing how the project would truly affect the participants. Although a lot of valuable information was provided, I am doubtful as to how many of the participants adopted this information. With some of the participants, I connected extremely well. However, few of them did not keep interest, therefore, did not benefit from the lessons provided. I realized multi-style of presentation could improve the quick and better progress in knowledge level. In addition, self-confidence and self-knowledge of the educators regarding the topic can improve the efficiency of the presentation. In the future, I would try to structure the program to be more engaging so that it will contain the influence in all of the participants. In addition, I would spend more time assessing the audience so that I would be better prepared to meet their needs.

Implementation process:

• Week 1- Implementing Project Goals

After church service, the project conductor will inform participants of the causes and effects of heart disease and diabetes via power point presentation. Make note of the blood pressures, weights, and cholesterol levels of the Indian population chose to represent the community as a whole. Develop training programs and support mechanisms for this partaking in the project.

• Week 2- Consultations with the participants

Regroup with parishioners after mass and brainstorm about the negative health functions that are accepting a toll on one’s life. Follow up with group work, planning health care interventions for everyone. Indian lecturer who suffers from chronic diabetes will speak to the participants to emphasize the dangers of the unhealthy diet, smoking, and lack of exercise.

• Week 3- Conduct Base Study

Conduct five focus group discussions with a minimum of 20 individuals. Conduct a base study to identify the problems related to the increase in cholesterol, diabetes, and heart disease in the community. Then distribute articles found via online articles, book sources, and encyclopedia excerpts describing the harmful nature of heart disease and diabetes.

• Week 4- Problems and Solutions

Use the information collected in the initial study to address the social, economic, and ulterior issues that have caused unhealthy life habits. Also, address solutions to reducing heart disease and diabetes. Discuss the importance of proper diet with a food pyramid. Discuss the necessity of exercise for a healthy lifestyle.

• Week 5- Solutions to Unhealthy Habits

Distribute bulletins and leaflets to members of the Indian community, mainly at the Indian Catholic Church, to spread the awareness of heart disease and diabetes. Lastly, check the blood pressures, weights, and blood sugars of the participants of the project to note any positive changes in health condition.

• Week 6- Implementing the Literacy Tactic

Emphasize the importance of literacy and awareness of heart disease and diabetes. Using circle graphs and statistics exhibit the likelihood of contracting a heart disease and diabetes. Ask participants to focus the changes they have encountered in their lives after learning preventative measures against heart disease and diabetes.

Evaluation of Implementation Process

A two-stage process is required to evaluate the results of implementation. These are:

• assessing the planning process to determine if the steps have been implemented
• determining the quality of implementation This plan to evaluate implementation includes,

I. Discuss with other team members about how effective the intervention was and did the targeted population benefit from implementations

II. Conduct post intervention surveys in the targeted population with preprinted questionnaires about risk behaviors

III. Conduct post intervention surveys in a selected group of people about their knowledge about prevention of diabetes and management

Cultural and Ethical Issues

The guideline on ethics was adopted by the American College of Epidemiology, which discusses the core values, duties, and virtues in epidemiology. The professional role of epidemiologists is minimizing risks and protecting the welfare of participants; providing benefits; ensuring an equitable distribution of risks and benefits. The serious ethical concerns experienced where protection of confidentiality and privacy, upholding community trust; doing away with interest and partiality, enlightened ethical requirements, condemning wrong conduct, and responsibilities to communities. My community program is about the health awareness for the Indian community. In this community, although most of them are educated still has their own belief about the way they handle their health issues. This concept will enable the project to acknowledge that such a community has its own traditional ways of dealing with every health problem it is seeking to address. Moreover, this will enable the project to identify and address the gaps in the already existing approaches of doing away with such conditions and use them in persuading the community to embrace the new interventions. At the same time, the various health care providers from the involved organizations will also be able to incorporate such community interventions in their programs in a bid to make the project widely acceptable to the members of the community.

Barriers Encountered and Solutions

The initial barriers and challenges encountered in the conduction of the project was on deciding on a topic that I felt was proficient enough. This was a way of presenting what was going to be meaningful to the target audience, as they would come. The further collection of data and research materials was also a difficult task. The fact that the project was race-specific, finding research materials on Indians who suffer from heart disease and diabetes was another challenge. Nonetheless, I did find a few informative articles on the subject. My second concern was how I would attract people to attend my presentation. People are busy with their work and other factors, which makes it hard for the subject to follow up with the project guidelines. In order to make the implementation plan more productive, I am planning to have maximum group participation with more fun. My greatest challenge in planning my community health project was gathering and organizing enough relevant support information’s. This included the duration of 6weeks to teach the selected group effectively regarding heart disease and diabetes in Indian population. I will provide them more information about the healthy meal plan, daily physical activities, and how to access the food and exercise activities easily. In addition, hands on activities such as preparing a personal healthy menu on a chart and healthy drinks and snacks are introduced to the audience.

Role of the Project

The project goal was met by improving the knowledge of nutritional deficits to the participants.

The information’s and leaflets provided to the participants will allow the participants to count the calories they are consuming. This information has also provided alternative meal ideas.

Participants were able to measure their blood sugar and blood pressure and manage the symptoms effectively.

The importance of including cultural valued and respecting them are extremely valuable in the teaching process, to help with open communication and also will create trust between the educator and group.

Overall, the plan progressed smoothly. Community nurses are able to educate their communities by providing information through literature and discussion such as used in this project.

The provided guides such as nutritional guides allowed the participants to count the calories that they were consuming. The guides also provided information on alternative meal ideas.

Conclusion

The goal of this health awareness program is to educate the Indian American community on the risks of unhealthy diets, and lack of exercise. They also aim at encouraging healthy lifestyle changes to improve their quality of life. The participants are expected to see positive changes in objective data such as decreased blood pressures, weights, and blood sugars. This data will act as proof that healthy lifestyles are possible and beneficial. If there is a positive change in the participant’s health, it will be evident that the lectures, leaflets, and power point presentations are effective education tools.