Advocating for Policy Change to Improve Health Outcomes in the Community

Advanced Professional Nurse as Advocate

Two competencies from the American Association of Colleges of Nursing (AACN) advanced-level Domain 3 that prepares advanced professional nurses to enhance population health are Population Health and Policy and Advocacy. The present competency of Population Health aims to use the required knowledge to improve health, prevent diseases, and minimize the gap in the health status among specific groups of people (Flaubert, 2021). For instance, an advanced practice nurse’s role may include planning and implementing a hypertension screening and education program for the Community, especially the hard-to-reach groups, to address poorly controlled hypertension: Advocating for Policy Change to Improve Health Outcomes in the Community.

The achieved Policy and Advocacy competency allows the nurse to develop health policies that may affect patient and population health. For instance, an advanced practice nurse uses the knowledge in a policy-making process to lobby for the passage of legislation to increase telemedicine access to those who live in rural areas so that they can get proper care when it is required. The competencies’ focus allows advanced professional nurses to attend to public health issues and engage in change processes for improved population health.

Interprofessional Professionalism Assessment

Communication concerns the ability to convey information correctly and efficiently to other individuals in the healthcare department. One of the outstanding achievements in this area is prompt and effective listening during interprofessional meetings and ensuring that all participants contribute (IPEC, 2023). Nevertheless, changes could still be made to reduce scientific terminology, which hinders mutual understanding and cooperation. Simplification of the language can improve communication between professionals in different fields.

Respect integrates appreciation and recognition of each other’s competencies within the teams. The positive aspect found in this category is the cordiality observed in teams while acknowledging the contributions of other members during the decision-making process. However, there is some scope to increase culture to guarantee effective and appropriate communication with professionals from diverse cultural backgrounds (Hosseinpour et al., 2022). Thus, advanced practice nurses can improve team situations and respect others by increasing cultural competence.

As for altruism and caring competence, the strength is expressed by caring, helping, empathy, and supporting patients and other healthcare team members, especially during difficult periods (Hosseinpour et al., 2022). Still, self-care should be employed to avoid compassion fatigue; this would reduce the capacity to deliver altruistic care constantly. There exists a need for self-care while being patient-centered to achieve this level of compassionate practice.

Excellence evaluates how hard the organization works to keep a high-quality level and strive for more. One evidence of strength in this area is the current practice where the nurse engages in continuing education to update with current evidence (Hosseinpour et al., 2022). On the other hand, there is the possibility of increasing people’s engagement in collaborative quality improvement activities that can advance the various patients ‘outcomes and employee development.

Ethics appraises and prescribes the standards and ways of decision-making in making confident choices. The patient’s confidentiality and ethical principles during coordination are strong areas. However, there is scope to make more efforts in discussing ethical issues that can enhance understanding and commitment to the decision-making process and use of ethics among the team (Hosseinpour et al., 2022).

Finally, accountability ensures one is answerable for the activities performed and the input given to a specific task. One of the strong points has been accepting responsibility for errors committed and finding ways to avoid further such incidences (Hosseinpour et al., 2022). Nevertheless, there is a possibility of getting more feedback from peers for an increased sense of accountability and a higher level of professional activity.

Interprofessional Team Development

In the forming stage, individuals start working as a team and also develop their appreciation of the roles and goals of the team. An advanced professional nurse can make a suitable introduction and state the group’s goals and the members’ roles and responsibilities. For instance, the nurse can plan the first team meeting during which participants present themselves, their professional focus, and points of view concerning the population health issue under discussion (Flaubert, 2021). If expectations are clearly defined when the project starts, the developed relations are trustful and have a common goal.

Several disputes and dissimilarities can occur during the storming stage since the members are still trying to adapt to the group. Thus, the advanced professional nurse needs to seek conflict resolution in cases of disagreement and argue for cooperation (Malhotra et al., 2022). To ensure and promote interpersonal interactions, they should opt to use structured communication wherein they can effectively manage conflicts necessary through the use of the SBAR communication model consisting of the Situation, Background, Assessment, and Recommendation. Thus, through positive communication and valuing diversity, the nurse can address various issues affecting a particular team and ensure all members remain goal-directed.

The norming stage is characterized by high cohesiveness, trust, and working together. The advanced professional nurse educates the team on how to set aside time to evaluate the day, accomplishments, difficulties, and growth opportunities (Malhotra et al., 2022). It is essential to celebrate the achievements of the process, archive the experiences, and effectively present such information to other practitioners to help them collaborate.

In the performing stage, there is cohesiveness in the team’s operations, and they are productive. Thus, the advanced professional nurse must acknowledge other team members’ efforts and hold them accountable for their work. One way to sustain the performance is to include data-based evaluation to evaluate the outcomes of the applied interventions and make data-based decisions on the changes to be made. It fosters the best practices in improving what the team serves to advance population health advocacy (Malhotra et al., 2022).

The final stage is the adjourning stage, which is the finalization of the project or the termination of the project team. An advanced professional nurse can provide a debriefing session to discuss the team’s achievements, difficulties, and potential improvements (Malhotra et al., 2022). This insistence on evaluating achievements, capturing best practices and lessons learned, and then communicating these to other stakeholders can help improve interprofessional relations in the future.

SDOH Summaries

Economic stability can be defined as the chance to get a stable job, sufficient and stable income, and essential assets such as shelter and food. Where there is poverty and unemployment, high levels of stress, more incidences of chronic health concerns, and health care insecurity are evident. Eradicating poverty and enhancing employment rates are critical to strengthening health disparities amongst economically deprived communities (Hahn, 2021).

Education Access and Quality are essential as they affect a person’s health literacy, employment potential and lifetime health habits. Poor achievers in educational needs and opportunities are less health literate, locked out of prospective employment, and tend to embrace harmful health practices (Hahn, 2021). Ensuring that every person has an equal chance to receive quality education and health education in school enhances the worth of the people and the ability to make acceptable choices.

Healthcare Access and Quality refer to an individual’s ability to receive desirable medical care, preventive services and adequate health information. Hindrances such as cost implication, lack of coverage, and inadequate providers have been known to cause inequity in access to healthcare. Increasing public insurance coverage, making healthcare more affordable, and growing stakes in the amount of healthcare in shortage areas also improve healthcare access and quality healthcare access and quality (Hahn, 2021).

Neighborhood and Built environment is the external environment within which the Community is located and involves factors such as the state of houses, availability and opportunities to access healthy food, experiences with the crime rate and somewhat hazardous environmental factors. Residing in dangerous or poor areas may constrain physical movement, heighten stress, and elevate disease prevalence (Hahn, 2021). Better housing, more open spaces, and reduced hazardous elements in the Community are suitable for the Community’s health.

Social and Community factors concern social interactions, support structures, and other community factors that affect an individual’s health. Suffering from discrimination, lack of communication with other people, and absence of personal support, one may have a deteriorating mental and physical health. Fostering health communities includes changing the strength of the networks through the Community, decreasing discrimination in the Community and involving improved social support services (Hahn, 2021).

SDOH Improvements

Economic stability

Establishing a Universal Basic Income (UBI) policy can eradicate poverty levels across low-income earners and families (Thomson et al., 2024). Thus, the UBI will provide people with a stable income, allowing them to access healthcare, healthy and safe food, and housing, leading to better health and decreasing the gap between the rich and the poor.

Education Access and Quality

The Head Start Program is designed to deliver early child development, health, and nutrition services to children from low-income families, and it can enhance learning achievements and health literacy (Saoud et al., 2022). Thus, this program aimed at improving children’s early learning can positively affect their employment, educational, and health prospects later in life.

Healthcare Access and Quality

This policy can improve access to healthcare by raising the eligibility of Medicaid to cover adults and children irrespective of disability and increasing the number of people receiving necessary healthcare. They include improved access to prevention and early detection and treatment of health issues common in the less privileged groups by engaging in expanded Medicaid coverage.

Neighborhood and Built Environment

Enhancing the quality of houses, improving the landscape, designing better recreation centers, and having better available food items impact health. Interventions such as constructing cheap houses, developing adequate means of transport, and establishing community gardens are effective ways of encouraging physical activity, decreasing criminal activities, and improving the health of a particular neighborhood (Creedon et al., 2022).

Social and Community Solutions

Through local healthcare providers and social organizations, community support links can help tackle the problem of loneliness, raise awareness of mental health issues, and build closer communities. By creating support groups, mentorship programs, and community centers, discrimination and social exclusion effects can be eliminated, and those affected can quickly obtain resources and make connections (Smith et al., 2023).

Examples of Health Equity

The expansion of Medi-Cal under the ACA at the state level also aimed at health equity by enrolling low-income and vulnerable Californians. This expansion allowed millions of non-insured individuals, such as undocumented immigrants under some circumstances, to gain coverage of preventive and primary care (Babey et al., 2022). This policy has led to increased minority enrollment, closing the racial and ethnic disparities in insurance, improvement of chronic diseases and the situations concerning the use of emergency departments by vulnerable groups.

At the national level of the United States of America, the HHS has developed and adopted Healthy People 2030 objectives targeting eradicating health disparities in all population groups. It has goals concerning poverty, health and other pertinent social determinants of health to reduce the gaps. Through assessing its progress and improving upon it, Developed Healthy People 2030 aims to minimize the prevalence of chronic diseases, enhance health and reduce disparities among particular groups such as the minority, rural residents and people with disability (Santana et al., 2021).

Health Concerns Affecting the Population

Obesity is still a significant problem for the population of Mississippi as it has one of the highest rates of obesity, with 41%. This is a high figure compared to the national average prevalence rate of 32% and higher risks that are associated with other effects such as heart disease, hypertension, type 2 diabetes and some types of cancer (Halfacre et al., 2022). The possible causes of high obesity levels are low availability of good nutritious foods, low levels of physical activity and high levels of poverty.

According to Halfacre et al. (2022), food insecurity is a growing issue in Mississippi, wherein approximately 20% of the residents have poor diets due to scarcity of food options. To reduce the rates of obesity in Mississippi, there is a need for multiple approaches, including policies offered by the Mississippi Healthy Students Act that seek to enhance food and physical activity among school-going children.

Recommendation

High obesity rates in Mississippi can be resolved through evidence-based programs such as the High Obesity Program (HOP) of the CDC. It aims to enhance people’s ability to enjoy healthier food, enhance physical activity, and offer nutrition education for any area where the adult obesity rate is forty percent and above. With the assistance of partner organizations, schools, and health departments, HOP supports better dietary practices and physical exercise through ways of people’s Empowerment in nutrition and physical activities through such strategies as developing and supporting farmer’s markets, improving the school’s nutrition policies, and creating safe physical activity places.

Previous studies prove that community-based interventions such as HOP improved dietary practices and weight control in high-risk groups (Murriel et al., 2020). Moreover, increasing the authority of the Supplemental Nutrition Assistance Program (SNAP) Healthy Incentive could help increase access to fresh and affordable produce among low-income households and decrease the dependence on calorie and nutrient-poor foods. Thus, by incorporating these strategies, it is possible to achieve Mississippi’s goals of reducing obesity and enhancing people’s health.

Public Leader

Concerning the Mississippi State Department of Health, Dr. Daniel P. Edney is the State Health Officer capable of adopting the CDC’s High Obesity Program (HOP). In accordance with his title of State Health Officer, Dr. Edney supervises the implementation of health policies, programs, and campaigns across the state of Mississippi and is thus involved in the fight against the increasing cases of obesity and for the promotion of health communities in the state.

His tasks comprise engaging with state and local government agencies, healthcare organizations and community organizations on the integration of health-improving interventions and food and physical activity. In particular, because Dr. Edney has leadership and professional experience in the sphere of public health, he will be able to demand and enforce the changes required to solve the obesity problem in Mississippi.

Explanation of Public Leader Choice

Dr. Daniel P. Edney is one of the persons who can suit the position of a leader in the implementation of the CDC’s High Obesity Program (HOP) in Mississippi as he possesses all the powers, knowledge, and interest in the overall health of the population in the state. As the state health officer of the Mississippi State Department of Health (MSDH), Dr. Edney has the authority to coordinate and implement health activities in the state of Mississippi, as well as with local organizations and dedicated resources to reduce health gaps.

His experience in public health policy and, more importantly, his knowledge of the key issues affecting the health of the people of Mississippi makes him well-equipped to confront obesity by adopting the proper measures. For this reason, he can easily influence policymakers, healthcare and social service providers, and the Community; all these are critical to the success of the HOP initiative and finding ways to source more funds to support the identified initiative. 

References

Babey, S. H., Ponce, N. A., Becker, T., Rasmussen, P. W., & Scheitler, A. J. (2022). How has access to care for Medi-Cal enrollees fared relative to employer-sponsored insurance 4 years after the Affordable Care Act expansion? Journal of General Internal Medicine, 37(13). https://doi.org/10.1007/s11606-021-07383-3

Creedon, T. B., Zuvekas, S. H., Hill, S. C., Ali, M. M., McClellan, C., & Dey, J. G. (2022). Effects of Medicaid expansion on insurance coverage and health services use among adults with disabilities newly eligible for Medicaid. Health Services Research. https://doi.org/10.1111/1475-6773.14034

Flaubert, J. (2021). The role of nurses in improving health care access and quality. In www.ncbi.nlm.nih.gov. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK573910/

Hahn, R. A. (2021). What is a social determinant of health? Back to basics. Journal of Public Health Research, 10(4). https://doi.org/10.4081/jphr.2021.2324

Halfacre, K., Buys, D. R., Holmes, M. E., King, E., & Roach, J. (2022). Barriers to Healthy Eating and Physical Activity in the Mississippi Delta. Journal of Healthy Eating and Active Living, 2(1), 32. https://pmc.ncbi.nlm.nih.gov/articles/PMC10521985/

Hosseinpour, A., Keshmiri, F., Jambarsang, S., Jabinian, F., & Shiryazdi, S. M. (2022). The effect of interprofessional education on interprofessional professionalism behaviours of the surgical team members. BMC Nursing, 21(1). https://doi.org/10.1186/s12912-022-01015-9

IPEC. (2023). Core Competencies for Interprofessional Collaborative Practice Preliminary Draft Revisions. https://www.ipecollaborative.org/assets/core-competencies/IPEC_Core_Competencies_2023_Prelim_Draft_Revisions%20(2023-04-12).pdf

Malhotra, A., Baker, J., & Mars, J. A. (2022). Group Therapy. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK549812/

Murriel, A. L., Kahin, S., Pejavara, A., & O’Toole, T. (2020). The high obesity program: Overview of the Centers for Disease Control and Prevention and cooperative extension services efforts to address obesity. Preventing Chronic Disease, 17(25). https://doi.org/10.5888/pcd17.190235

Santana, S., Brach, C., Harris, L., Ochiai, E., Blakey, C., Bevington, F., Kleinman, D., & Pronk, N. (2021). Updating health literacy for healthy people 2030: Defining its importance for a new decade in public health. Journal of Public Health Management and Practice: JPHMP, 27(6), S258–S264. https://doi.org/10.1097/PHH.0000000000001324

Saoud, K., Saavedra, J., Hirshfield, L. E., & Barnes, M. (2022). Addressing Barriers to Accessing Head Start Programs via the Medical Home: A Qualitative Study. Maternal and Child Health Journal, 26(10), 2118–2125. https://doi.org/10.1007/s10995-022-03498-z

Smith, M. L., Racoosin, J., Wilkerson, R., Ivey, R. M., Hawkley, L., Holt-Lunstad, J., & Cudjoe, T. K. M. (2023). Societal- and community-level strategies to improve social connectedness among older adults. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1176895

Thomson, R. M., Kopasker, D., Patryk Bronka, Matteo Richiardi, Vladimir Khodygo, Baxter, A. J., Igelström, E., P., A., L., A. H., & S. Vittal Katikireddi. (2024). Short-term impacts of Universal Basic Income on population mental health inequalities in the UK: A microsimulation modelling study. PLOS Medicine, 21(3), e1004358–e1004358. https://doi.org/10.1371/journal.pmed.1004358

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