• Review the Chronic Disease Prevention and Health Promotion (NCCDPHP) website from the Centers for Disease Control and Prevention (CDC).
• Select one of the identified chronic diseases of national significance that impacts a population of interest to you.
• Consider a health outcome you would like to improve in this population related to the selected chronic disease.
• Develop a program proposal to improve this health outcome for this population using the assignment guidelines below. Select one of the program models in Curley, Chapter 7, to guide your planning.
• Review the SMART objective resources for a review of how to write objectives for your program.
• Use the Walden APA paper template, including appropriate APA 7 headings, to develop this Assignment.
In a 8- to 10-page proposal (not including title page and references), address the following:
• Briefly identify your selected chronic health issue and population.
• Describe the geographic region and important characteristics of this population.
• Describe the patterns of the disease in your selected population using the epidemiologic characteristics of person, place, and time.
• Identify one health outcome you would like to improve for the population.
• Briefly summarize current evidence that supports the importance of improving this health outcome.
• Briefly describe the evidence-based program you are developing, and why this approach will best fit the needs of your population.
• Explain what data you would need to collect, and how you would obtain and analyze it. You may choose to collect primary data or use secondary data. Justify your choice.
• Using the “SMART” method, write short- and long-term objectives for the program.
• Identify the stakeholders who should be involved in program planning.
• Identify which program planning model (see Curley, Chapter 7) you selected for your program. Justify your selection of model. Based on the model, explain how you would plan, implement, and evaluate the program.
• Explain any relevant cultural or ethical considerations related to your program design.
• Explain how you would fund the program.
• Describe strategies that would be appropriate for marketing the program.
Full Answer Section
Introduction
Chronic diseases are a leading cause of morbidity and mortality worldwide, placing a significant burden on individuals, families, and healthcare systems. The National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) at the Centers for Disease Control and Prevention (CDC) highlights several chronic diseases of national significance, including cardiovascular diseases such as hypertension. Hypertension, or high blood pressure, is a major risk factor for heart attack, stroke, kidney failure, and other serious health complications (CDC, n.d.). This proposal focuses on developing a program to improve hypertension management among older adults (aged 65 years and older) in rural Western Kenya, a population experiencing a growing burden of non-communicable diseases and facing unique challenges in accessing consistent healthcare.
Selected Chronic Health Issue and Population
The selected chronic health issue is hypertension. The population of interest is older adults (aged 65 years and older) residing in rural communities in Western Kenya. This population is of interest due to several factors: the increasing prevalence of non-communicable diseases in sub-Saharan Africa, the unique socio-economic and healthcare access challenges faced by rural populations, and the heightened vulnerability of older adults to the severe consequences of uncontrolled hypertension.
Geographic Region and Important Characteristics of the Population
The program will be implemented in rural communities within one or two selected counties in Western Kenya. This region is characterized by dispersed settlements, limited access to healthcare facilities and specialists, reliance on subsistence farming, and a relatively high poverty rate. Transportation infrastructure is often poor, making it difficult for older adults to travel long distances for regular medical appointments. Literacy levels may be lower compared to urban areas, potentially impacting health literacy and the ability to understand complex medical instructions. Strong community ties and social networks exist, which can be leveraged for program implementation and support. Cultural norms regarding aging, health-seeking behaviors, and the role of family in caregiving will also be important considerations. The healthcare system in this region is often characterized by understaffed and under-resourced primary healthcare facilities, with a limited number of healthcare professionals trained in chronic disease management. Community Health Workers (CHWs) play a vital role in bridging the gap between communities and the formal healthcare system.
Patterns of the Disease in the Selected Population
Understanding the epidemiologic characteristics of person, place, and time is crucial for tailoring an effective intervention.
- Person: Older adults (aged 65 years and older) in this population are particularly vulnerable to hypertension. Factors such as age-related physiological changes, co-existing chronic conditions (like diabetes), dietary patterns (potentially high in salt and low in fruits and vegetables), physical inactivity due to limited opportunities or physical constraints, and psychosocial stressors associated with poverty and limited social support can contribute to the high prevalence and poor management of hypertension. There may also be gender differences in prevalence and management, requiring further investigation within the specific communities.
- Place: The rural setting of Western Kenya presents significant challenges. Access to healthcare facilities offering regular blood pressure monitoring and medication management is often limited. The distance to clinics, transportation costs, and the opportunity cost of time spent traveling can be prohibitive. Availability of affordable medications may also be inconsistent. However, the strong community structures present in these rural areas can also be a significant asset for community-based interventions.
- Time: The prevalence of non-communicable diseases, including hypertension, is increasing in sub-Saharan Africa over time, likely due to factors such as urbanization, dietary changes, reduced physical activity, and increased exposure to risk factors. Understanding the temporal trends in hypertension prevalence and management within specific communities in Western Kenya will be important for assessing the urgency and potential impact of the proposed program. Seasonality related to agricultural cycles and access to food may also influence blood pressure and medication adherence.
Identified Health Outcome for Improvement
The primary health outcome this program aims to improve is medication adherence among older adults diagnosed with hypertension in rural Western Kenya. Poor medication adherence is a significant barrier to achieving blood pressure control and preventing cardiovascular complications. Improving adherence will directly contribute to better blood pressure management, reduced morbidity and mortality, and improved quality of life for this vulnerable population.
Current Evidence Supporting the Importance of Improving Medication Adherence
A substantial body of evidence highlights the critical role of medication adherence in managing hypertension and preventing adverse cardiovascular events. Studies have consistently shown that higher levels of adherence to antihypertensive medications are associated with lower blood pressure, reduced risk of stroke, heart attack, heart failure, and renal disease, and decreased all-cause mortality (Haynes et al., 1996; Schroeder et al., 2018). Conversely, poor adherence leads to suboptimal blood pressure control, increased risk of complications, and higher healthcare costs (Cutler et al., 2018). In low- and middle-income countries, factors such as limited access to medications, lack of patient education, complex treatment regimens, cultural beliefs, and socio-economic constraints often contribute to poor adherence rates (Sabate, 2003). Evidence from similar settings in sub-Saharan Africa underscores the need for culturally tailored interventions that address these barriers to improve medication adherence and ultimately blood pressure control (дійсно et al., 2019).
Evidence-Based Program Description
The proposed program will be a multi-component, community-based intervention guided by the PRECEDE-PROCEED model (Green & Kreuter, 2005). This model emphasizes a participatory approach and considers the social, epidemiological, behavioral, educational, ecological, and policy factors influencing health outcomes. The program will incorporate the following key elements:
Sample Answer
Program Proposal: Improving Hypertension Management Among Older Adults in Rural Western Kenya
Abstract
Hypertension is a significant public health concern globally, including in Kenya, and disproportionately affects older adults, increasing their risk of cardiovascular disease and premature mortality. This program proposal outlines a community-based intervention in rural Western Kenya aimed at improving hypertension management among individuals aged 65 years and older. The proposal details the epidemiological characteristics of hypertension in this population, identifies medication adherence as the primary health outcome for improvement, and summarizes the evidence supporting this focus. Utilizing the PRECEDE-PROCEED model, the proposal describes a culturally appropriate, multi-component program involving community health workers, mobile health technology, and community support groups. The proposal also outlines the data collection and analysis plan using a mixed-methods approach, develops SMART short- and long-term objectives, identifies key stakeholders, addresses cultural and ethical considerations, explores potential funding sources,