Discussion 2: Program Funding

Running head: COMMUNITY HEALTH ASSESSMENT PROJECT
Community Health Assessment Project
Layal Mansour
Walden University
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COMMUNITY HEALTH ASSESSMENT PROJECT
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Community Health Assessment Project
Demographics and Health Status
Sarnia city is situated to the Southwestern side of Ontario in Canada. It is the largest city
in Lambton County with a population density of about 434 per square kilometers (Weichenthal,
2016). As at 2016, Sarnia had a population of 71,594. The city’s population is predominantly
white, with only about 5% minorities. The median age for the city is 46 years. This age is
slightly higher than the national figure, which stands at 41. The population of Sarnia city is
relatively aged compared to the rest of Canada. In 2015, the median income for individuals aged
15 years and above stood at about $35,000. On the other hand, the median family income was
about $87,000. These figures were fairly comparable with state figures which stood at about
$35,000 an $90,000 respectively. The cost of living in the city is low in comparison to that of
Ontario. In Sarnia, the median value of dwelling is about $200,000 compared to Ontario’s
$400,000. Older adults, aged 65 years and above, constitute about 17% of Sarnia’s population.
The dependency ratio for this age bracket is about 29 percent. The youth constitute about 8% of
the population.
Sarnia has been christened Canada’s toxic town. The presence of huge petrochemical
complexes has exposed the population of this city to serious lung and respiratory health risks. In
addition to lung and respiratory conditions, the other chronic disease troubling the city is cancer.
The two are the major contributors to Sarnia’s mortality. Notable diseases that are prevalent in
Sarnia and that relate to exposure to toxic fumes include COPD, asthma, and ischemic heart
conditions. Osteoarthritis is also prevalent, especially given that the population is relatively aged.
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The prevalence of diabetes in the city is significant as is cerebrovascular disease. In recent years,
the city has also had to give significant focus to the prevalence of mental health issues.
Health Access
Sarnia is served by Bluewater Health. The hospital has about 190 acute care beds and 70
complex continuing beds. Additionally, it has 27 rehabilitation beds. It is an umbrella healthcare
provider which brought together multiple facilities in 2010 and boasts of its commitment to care
quality and patient safety. The 7% of the population classified as having low-income status
cannot access affordable healthy foods. This prevents the achievement of holistic health
coverage. Whereas diabetes remains a significant health concern, there is little attention directed
to its early diagnosis and proper management. This is evidenced by the limited access to
recreational and physical facilities. Bluewater health is marked as having registered nurse
shortage, with a low patient-nurse ratio, especially for chronic diseases. Of Bluewater Health’s
close to 2,000 staff, only about 200 constitute the professional staff with the rest being
volunteers. Most of the hospitals are in need of modernization and facelift, limiting their
capacities to provide premium care.
Primary Health Issue
Sarnia suffers two primary health issues that affect the population which is constantly
exposed to the risk of lung and respiratory diseases and cancer. The first primary health issue
affecting Sarnia is the constant exposure to pollutants. Sarnia is an international industrial city
which hosts one of the world’s largest petrochemical industries. Gaseous industrial wastes
pollute the environment, exposing the population to respiratory diseases and cancer. Secondly,
there is a shortage of registered nurses to attend to the patients suffering from chronic diseases,
and who need constant monitoring.
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Barriers to Access to Health Care
There are both system and individual barriers to health care access in Sarnia. Foremost,
the allocation of health care resources on the basis of individual needs rather than community
need limits the scope of treatment of chronic diseases that are caused by a polluted environment
(Bergstra, Brunekreef, & Burdorf, 2018). The challenge here is that health care providers are
unable to identify those who do not present themselves as patients, making it impossible to make
early diagnosis. Secondly, the low numbers of registered nurses make it difficult for patients to
have regular care. This especially arises since it is difficult to acquire a family doctor, especially
among the aged and those with chronic diseases. Consequently, home-based care also becomes
inadequate.
Behavioral Risk Factors
There are high youth smoking rates. Besides the active smokers being at risk, passive
smokers are at a higher risk of developing respiratory diseases. Alcohol and substance misuse is
equally high among the youth. Young people are also less likely to adopt healthy eating which
results to the poor management of chronic diseases at individual level.
Local Health Care Environment and Capacity
Low income earners in this region are slightly more compare to the state number. There
is a permanent exposure to industrial fumes given that Sarnia has its foundation on industry. The
shortage of registered nurses and resource allocation which targets the individual rather than the
community means that respiratory complications remain a going concern.
Unmet Need for Health Care Services
A review of Sarnia’s performance compare to that of Ontario indicates that, as one of the
largest areas in terms of population, there is need for proper planning to comprehensively
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address the risk that exposure to industrial fumes leads the population. Sarnia’s population is at a
constant risk of respiratory diseases and cancer which has not been appropriately addressed.
One Possible Theory that Might Guide the Intervention and Justification for its Selection
The community coalition action theory involves the use of inter-organizational
relationships through a coalition of communities to achieve success. This theoretical approach
was selected as most appropriate for Sarnia because it provides an overview of the development
of the coalition, its functions, coalition synergy, and community change process. In the long run,
it will help Sarnia reach to enhance the capacity of the community to improve the social and
health outcomes (Butterfoss, Kegler & Francisco, 2008). By implementing the intervention in the
context of the community, this theoretical approach will guide the Sarnia use the 14 constructs
beginning from the structure of the coalition, pooled resources, staffing engagement of members,
and leadership.
Additionally, this theory guides the intervention beginning from the problem definition to
familiarize with the problem and create awareness among the stakeholders. The next step is to
initiate action that will enable Sarnia to adopt the appropriate actions to implement healthcare
changes in Sarnia (Butterfoss, Kegler & Francisco, 2008). During the implementation process,
the Sarnia will focus on providing solutions to the various healthcare challenge identified in its
healthcare assessment report. Finally, Sarnia will institutionalize the change and make it a policy
and practice within its healthcare sector.
The Key Objectives of the Intervention and How They Link To the Theory or Parts of the
Theory
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The key objective of the intervention in the Ontario Health Care assessment is to make
the Ontario healthcare meat that of Sarnia’s performance. Being one of the largest areas in terms
of population, there is a need for proper planning to comprehensively address the risk that
exposure to industrial fumes leads the population. Sarnia’s population is at a constant risk of
respiratory diseases and cancer which has not been appropriately addressed (Butterfoss, Kegler
& Francisco, 2008). The community coalition action theory can be linked to this intervention
objective by using the community coalition to champion the health care needs of Ontario through
interaction between the various healthcare stakeholders. Taking into consideration the social
factors affecting the population of Sarnia would thus enhance positive outcomes form the
healthcare intervention.
How the Theories Could Drive the Intervention, the Elements of the Theories that Work
Well and the ones that Do Not Apply to The Intervention
The community coalition will thus serve this purpose by analyzing the healthcare issues
affecting Sarnia, conduct an assessment of the assets and needs of Sarnia’s health care sector,
and then develop an action plan to solve the issues identified. The next step will be the
implementation of the key healthcare strategies highlighted in the healthcare assessment report to
enable Sarnia to accomplish outcomes across the community (Butterfoss, Kegler & Francisco,
2008). Above all, Sarnia of Ontario will look forward to creating social change from its
healthcare change process.
The elements of this theory that apply to the Sarnia healthcare intervention is the focus on
the activities taking place within each stage of its health care change process and ignore the
factors leading to the change. Consequently, Ontario will be at will to select the change strategy
to use depending on the stage of change of its healthcare sector (Butterfoss, Kegler & Francisco,
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2008). Although this theoretical framework may help Sarnia to solve its health care issues, the
elements that do not apply to the healthcare intervention needs of Sarnia include the possibility
that the process of building consensus as a way of getting diverse communities actively involved
in the change process may be lengthy and complex. Since the community issues and probes are
of great significance to Sarnia, there is no need of going through the consensus building process
because already the issues have been identified.
Comparison of the Chosen Theory with Two Other Theories reason to their Rejection
An alternative theory that might guide the intervention in Ontario health assessment
program is the psychological theory of aggression. However, compared to the 88888 theory, this
theory is not best suited for providing solution to the healthcare needs of Sarnia because it
focuses on linking the occurrence of aggression to one single factor when seeking to reduce its
impact even though there are multiple factors that may be behind the aggression (Andersen,
Labriola, Andersen et al., 2015). Consequently, it would not be of help to the healthcare
professional to of Ontario when dealing with the healthcare challenges identified in its Health
assessment report. Accordingly, this theory was rejected because it assumes that the healthcare
needs of Ontario can only be equated to the aggressive behavior that originates from the
interplay several situational, social, and personal factors.
A second alternative theoretical approach is the stage theory of organizational change
which asserts that an organization will go through several steps during the change process. This
theory is not suited for the healthcare changes facing Sarnia because the Ontario health
assessment points out to a city whose health sector is still undergoing progressive changes.
Therefore, using this theoretical approach will force Sarnia to recognize these changes so that its
strategies of implementing change are matched to the process of change within its healthcare
COMMUNITY HEALTH ASSESSMENT PROJECT
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department (Andersen, Labriola, Andersen et al., 2015). However, this is not possible because
the current healthcare challenges require the development of new idea, goals, and technologies
which may not come with this theory that emphasizes the use of an evidence-based practice
model to solve the healthcare challenges.
The Strengths and Weaknesses of the Theory Chosen
The advantage of the community coalition is that it is a formal structure that comes with
multiple objectives and purpose. Consequently, it can be used to implement a health care
intervention within Sarnia for a long duration. It also works either locally or regionally, making
it one of the most effective theoretical approach to solving the healthcare challenge identified in
the Ontario health care assessment. In addition, then membership to the community coalitions
varies, making it flexible for Sarnia to include all the key stakeholders into the group.
The weakness of the community coalition is that the structure and purpose of the
coalition may change over time. This means that the working relationships, roles and the overall
expectation of the community form the coalition may also change. Tracing and auditing the
performance of the coalition, therefore, becomes very difficult in cases where there is a need for
a review and assessment of the outcome of the change process.
How the Theory Might Be Applied Using Other Theory-Based Examples from the
Literature of Interventions for this Public Health Issue
The community coalition action theory can be used to implement intervention measures
for the high prevalence of diabetes at Sarnia by creating inter-organizational relationships
through a coalition of communities to achieve success. This theoretical approach will also be
used to implement a community coalition in a progressive manner to create a functional network
COMMUNITY HEALTH ASSESSMENT PROJECT
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of health intervention with coalition synergy (Butterfoss, Kegler & Francisco, 2008). The main
focus will be enhancing the community change process within Sarnia to increase the capacity of
the community to improve the social and health outcomes. In particular, this theory will create an
inter-professional collaborative network between the various health care providers and
community members to ensure that the intervention measures implemented to solve the health
issue of a high prevalence of diabetes.
The community coalition action theory can be used to solve the primary health issue in
Sarnia by implementing the intervention in the context of the community. This will focus on
intervention measures to contain the new incidences of type 1 diabetes whose cause remains
unknown (Butterfoss, Kegler & Francisco, 2008). Since it is believed that it is the result of
contact with a polluted environment, this theory will guide the intervention measure at Sarnia by
making use of the 14 constructs beginning from the structure of the coalition, pooled resources,
staffing engagement of members, and leadership.
To achieve an effective outcome in the intervention measure, this theoretical approach
will be used to guides the intervention measures at Sarnia beginning from the definition of the
problem to enable the health professional and the community members familiarize with the
problem. The next step would be conducting civic education to create awareness among the
stakeholders so that they have a positive attitude towards the intervention measures. It is
important to note that Sarnia is an international industrial city which hosts one of the world’s
largest petrochemical industries. Consequently, this theoretical approach will be applicable in
initiating actions that will enable community members and health professionals to adopt the
appropriate actions to implement healthcare changes in Sarnia (Butterfoss, Kegler & Francisco,
2008).
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Another area of intervention is to contain the gaseous industrial wastes which pollute the
environment. During the implementation process, the Sarnia will rely on the community
coalition action theoretical approach to focus on providing solutions to the various healthcare
challenge identified in its healthcare assessment report. This approach will help the community
to reduce potential exposure to the chemicals which have varied consequences on the Sarnia
population.
Another area of focus in the intervention measure is the lack of clarity on how the
environment can directly be attributed to the high diabetes levels. Such a health issue can be
solved by making the healthcare meet that of Sarnia’s performance specifications (Butterfoss,
Kegler & Francisco, 2008). This can be achieved through proper planning to comprehensively
address the risk that exposure to industrial fumes leads the population. The planning must
address the shortage of registered nurses to attend to the patients who need early diagnosis and
constant care.
With the increasing prevalence of diabetes among the Sarnia’s, the community coalition
action theoretical approach can be used to implement intervention measures through community
coalition to champion the health care needs of Sarnia (Butterfoss, Kegler & Francisco, 2008).
The interaction between the various healthcare stakeholders will enable the healthcare
professional to incorporate the social factors affecting the population of Sarnia into the
intervention approach to achieve a positive outcome from the healthcare intervention measure.
The community coalition action theory can also be used to implement the intervention
measures by analyzing the healthcare issues affecting Sarnia. The views and opinions of various
community stakeholders would also be implemented to help in assessing the assets and needs of
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Sarnia’s healthcare sector. The outcome can then be used to develop an action plan to solve the
issues identified (Butterfoss, Kegler & Francisco, 2008). Consequently, this theoretical approach
will be used to institutionalize the change and make it a policy and practice within its healthcare
sector. In addition, Sarnia will rely on this theoretical approach to implement the key healthcare
strategies that would propel Sarnia to find a solution to its primary health issues revolving
around diabetes type 1 and lack of adequate registered nurses.
Sarnia of Ontario will look forward to creating social change from its healthcare change
process that will enable the registered nursed conduct early diagnosis to ascertain cases of
diabetes type 1. This theory will thus be used to help Sarnia to focus on the activities taking
place within each stage of its health care change process. During this process, Sarnia will be able
to address the root cause of the shortage of registered nurses that has led to an increase in the
prevalence of diabetes type 1 but give less attention to the factors that may have contributed to
the change process (Butterfoss, Kegler & Francisco, 2008). Having identified the frequent
contact with the polluted environment as the major cause of the high prevalence of diabetes type
1 in Sarnia, the community coalition action theoretical approach can be used to address this
health issue by providing a framework of selecting a change strategy to encourage positive
behavior change and attitude of the residents of Sarnia.
The theoretical approach may also be used to build cohesion between various healthcare
care stakeholders to encourage them to actively get involved in the change process. This
approach will be very effective in solving the lack of clarity on how the environment can directly
be attributed to the high diabetes levels (Butterfoss, Kegler & Francisco, 2008). It is also
important to note that the consensus building phase of the community coalition action theory will
enable Sarnia to understand the community issues and probes. In the long run, the community
COMMUNITY HEALTH ASSESSMENT PROJECT
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would embrace the need for more registered nurses to speed up the early diagnosis of diabetes
type 1 to enable Sarnia to provide early diagnosis and constant care to the diabetic patients.
Other theory-based examples that may also be used to address this public health issue is
the psychological theory of aggression. However, this theory only links the occurrence of
aggression to one single factor when seeking to reduce the impact of pollutants to diabetes type 1
even though there are multiple factors that may be behind the aggression (Andersen, Labriola,
Andersen et al., 2015). Since the main objective of the healthcare intervention is to reduce the
high prevalence of diabetes type 1, using this theoretical approach will ignore the factors such as
pollutants and a shortage of registered nurses which leads to a late diagnosis of the health issues.
While this theory assumes that such health care needs are equivalent to the aggressive behavior
that originates from the interplay several situational, social, and personal factors, the community
coalition action approach will view the factors form a wider spectrum and find possible solutions
to the health issue.
Another theory based example is the stage theory of organizational change which asserts
that an organization will go through several steps during the change process. While this theory
may also help implement intervention measures to address the shortage of registered nurses and
pollutants in Sarnia, it may not provide positive outcome because of eth of the progressive
changes that the healthcare sector of Sarnia is still undergoing (Andersen, Labriola, Andersen et
al., 2015). Should Sarnia chose to implement the intervention ensures using this theoretical
approach, there is a high possibility that the strategies may not match the process of change
within its healthcare sector.
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Since the current healthcare challenges in Sarnia healthcare sector require the
development of new idea, goals, and technologies, there is a need to bypass the use of an
evidence-based practice model to solve the healthcare challenges. Consequently, relying on the
health, wellness, and family meal programs will promote dieting approaches. In essence, the
community coalition action approach will bring on board the wider community to create a
community of individuals who have diabetes is created (Butterfoss, Kegler & Francisco, 2008).
This will facilitate effective monitoring of the diet logs, and build partnerships to foster positive
attitudes towards the program. The community coalition action approach will do away with
loneliness and create an environment of uniformity.
The community coalition action theory creates an environment where the patients feel
more energized and in control of their new behaviors. The stakeholders will introduce medical
nutrition therapy accompanied by nutrition counseling that recognizes the willingness of all
diabetic patients to embrace positive change (Butterfoss, Kegler & Francisco, 2008). It is,
however, important to note that behavior change does not result in a total shift in diet options.
Conceptual Framework and How It Fits the Intervention
Diabetes management can be achieved using a conceptual framework that leads to the
existence of an information network. There are several dimensions for diabetes treatment.
Integrating these dimensions requires an effective communication network (Andersen, Labriola,
Andersen et al., 2015). The first element of a diabetes treatment dimension is the identification of
patients. The second dimension is the empowerment of the patient with the right knowledge to
actively engage in the containment of the disease. The final dimension is regular screening. A
COMMUNITY HEALTH ASSESSMENT PROJECT
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feasible conceptual framework will be that which defines how various applications are applied to
achieve a holistic approach to the care of diabetes patients.
At the center of the conceptual framework should be the capacity for risk assessment and
the ability to enable population screening for early identification of those at risk. The second
layer of the conceptual framework should enable the mapping of all the individuals at risk of
diabetes (Butterfoss, Kegler & Francisco, 2008). This will help to determine the extent of the
health concern and guide the strategies that are put in place to address it. This stage shall involve
comprehensive tests to determine the level of contact of each individual with the disease and
how much resources are required.
Once a risk assessment of the population has been conducted and patients identified, the
next stage of the conceptual framework is to determine the type of care that is suitable for each
individual. Depending on the severity of the disease, a patient can be taken through hospital care,
clinical care, or home care. For patients placed under home care, telecare would be the best way
to address their needs. Chronic diabetes cases will be referred for hospital and clinical care. This
is because of the requirement for specialized care which cannot be delegated. However, for
cases, or patients who have been diagnosed early, they will be referred for home care.
Once patients have been assigned to their appropriate care procedures, the next stage in
the conceptual framework involves retrospection of the treatment progress. Follow up procedures
will mark the final stage of the conceptual framework (Andersen, Labriola, Andersen et al.,
2015). Clinical and paraclinical assessment will be recommended for those who are taken
through hospitalized and clinical care, while self-assessment will serve for those undergoing
home care. At this stage, new strategies are sought for those who do not show any progress.
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Summary of the Scholar-Practitioner Project
The most urgent health issue for Sarnia is diabetes. Sarnia has a significantly large
number of adults who are at a high risk of contracting the disease. As such, there is a need for
urgent intervention to address this health issue. However, there exist challenges which hinder the
response process and contribute to the persistence of the disease. One of these challenges is the
shortage of registered nurses (Andersen, Labriola, Andersen et al., 2015). This drawback leads to
late diagnosis and inability to cover all patients effectively. Despite the challenges, alternative
interventions can be applied to stem this problem.
Community coalition action theory can be used to rally the community together towards
adopting the right approaches in the fight against diabetes. Notably, however, is the need for the
patient to play a proactive role in their healing process. Diabetes calls for discipline on the part of
the patient (Andersen, Labriola, Andersen et al., 2015). This can be difficult to achieve is the
environment and community, in general, does not provide the right support. Besides a supportive
environment, finding the right strategies to influence patient perspectives towards exercising and
dieting can go a long way in ensuring the success of the health program that is put in place.
The appropriate intervention aims to place the patient at the center of the treatment
process. For patients that will be put under home care, the aim will be to have them involved in
actions that are conscious of their health risks and influencing them to reduce the consumption of
foods which increase their glucose levels. As such, patients are able to self-heal by internalizing
a positive approach to the medication (Butterfoss, Kegler & Francisco, 2008). This is especially
important given that diabetes is a lifelong health condition. The applied theory pushes the
COMMUNITY HEALTH ASSESSMENT PROJECT
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intervention process towards success by enabling the patient to remain positive about the
strategies while accepting their central role in their healing.
Addressing this community health concern requires a conceptual framework.
Specifically, the conceptual framework must precipitate into a planned information network
regarding the most effective approach to handle diabetes within the area. The various dimensions
for diabetes treatment can be integrated using the conceptual framework, leading to a structured
communication approach among various player in the community (Andersen, Labriola, Andersen
et al., 2015). These interactions must lead to the screening of the community for disease risk,
classifying the identified individuals based on the severity of their disease levels, recommending
the right mitigation approaches, and ensuring an automatic audit system which shall allow for the
relooking of the effectiveness of the approach used. The result of the intervention plan should be
a definite approach for every individual based on their level of interaction with diabetes.
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Bergstra, A. D., Brunekreef, B., & Burdorf, A. (2018). The mediating role of risk perception in
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Butterfoss F.D, Kegler M.C & Francisco V.T (2008) Mobilizing Organizations For Health
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