Applying Evidence-Based Practice in Population Health Improvement Essay

Introduction

According to the report released by the State of Obesity (2017), the United States, just like many other developed countries, is being faced with a health problem where a large percentage of its citizens are gradually becoming obese. In 2016, at least thirty percent of all U.S citizens were Obese (State of Obesity, 2017). Cases of obese prevalence varied in the states with some states like West Virginia having thirty-seven percent of its population being obese while others like Colorado having only 25 percent of their citizens being obese (State of Obesity, 2017).

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In Florida, which is the subject of this health improvement plan, at least twenty seven percent of the population is obese. Data from the State of Obesity (2017) show that Florida has been having a sharp increase in the number of people who are obese. In 1990, only eleven percent of the people were obese. This number has since increased to at least twenty-seven percent in 2017. This worrying trend is what has prompted the need to develop a health improvement plan to address the growing challenge of obesity in the state of Florida. The health improvement plan will specifically target the African American community living in Miami Dade County. Through evaluation of epidemiological, demographic and environmental data available on Miami Dade's African American communities, reliable evidence will be gained, and it will be used in the development of this health improvement plan. The plan will also use effective strategies in communicating health improvement goals to the African American communities and the healthcare professionals in a culturally sensitive, ethical and inclusive way.

Epidemiological and Environmental Data about the African American Communities

Obesity is a severe health problem in the Florida state, with at least twenty-seven percent of the population being obese. Obesity is of particular concern to the health professionals because it exposes the individual to a myriad of chronic diseases. According to the CDC (2017), obese people have an increased risk of developing many severe health conditions which include: type 2 diabetes, coronary heart disease, high blood pressure, and stroke. In Miami Dade County, which is home to the 6th largest African American population in the United States, at least fifty percent of the African Americans are obese (HHS, 2016). According to the Miami Dade Gov. (2008), at least seventy six percent of the African Americans in the county are either overweight or obese. Such a high percentage shows the risk at which the African American population is in developing the chronic diseases associated with obesity.

According to research, the genetic makeup of an individual has minimal impact in determining whether they would be obese in future (University of Laval, 2018). Environmental factors are, therefore, regarded as the main factors that contribute to obesity among individuals. Among the African Americans of Maine Dade County, the main reasons for the high obesity levels are; physical inactivity, and preference for fast foods, which are high in calories and low in nutrition. Preference for fast food has been associated to the fact that, when compared to other races, African Americans are more exposed to adverts for fast foods. According to the State of Obesity (2012) reports on disparity in the prevalence of obesity, African American neighborhoods have thirteen times more fast food adverts than predominantly white communities. Other factors include; poverty which makes it impossible for African Americans to access healthier foods, lack of access to areas where they can be physically active and finally the very warm Maine Dade weather which get exceptionally high during summer, therefore, limiting the physical activities which one can engage in (Main Dade Gov. 2008).

Health Improvement Plan to Address Obesity Among African Americans The Chronic Care Model (CCM) has over the time proved to be a very successful model in improving the quality of care being provided to patients who are suffering from chronic diseases. CCM has also been successful in improving the effectiveness of preventive care delivery (Strickland et al., 2010). It, therefore, makes CCM to be the best tool to be used in addressing obesity which is becoming a significant hindrance in improving the health of African Americans.

There are six elements which must be considered for a CCM to be effective. These elements are; health systems, community resources and policies, decision support, clinical information systems, self-management support, and delivery system design (Strickland et al., 2010). For the CCM to be implemented there are other assumptions which the healthcare professionals will need to make. These assumptions assume that the plans: needs to comply with evidence-based guidelines for patient care, needs to focus on patient education and lifestyle improvement, needs to be sustained for a long time, needs to be culturally sensitive and equitable for disadvantaged community members, and needs to provide affordable and cost-effective care for the African Americans.

The assumptions and the CCM elements complement each other in promoting quality delivery of health services to patients. When they are applied in a Prevention health Model, they will ensure that the clinical team is prepared to adequately work with an active community that is already informed resulting in improved outcomes in obesity management. For enhanced efficiency, the main components of the health improvement plan that I propose for the Healthcare professionals in Miami Dale are consistent with the CCM elements and the assumptions made by the method. The main components for the program are as follows: Developing a system that will collect data and track the health outcomes among African American patients and coming up with an active leadership which will streamline the staff management policies to make them accommodative to the needs of African American patients. There is also training all healthcare professionals in Miami Dade on cultural competence and CCM, enhanced information sharing with the local health systems, identifying local resources which can be used to improve the interaction between patients and healthcare professionals in the county, and planning meetings regularly with all stakeholders to review the progress of the health plan.

The Value and Relevance of the Chronic Care Model

Although CCM was initially introduced to manage chronic diseases such as diabetes, healthcare professionals have over the years also used it to manage behavior-related conditions. Of the many behavior-related conditions, CCM has been most successful in managing obesity (Strickland et al., 2010). Its effectiveness in managing obesity through improving the quality of diet that patients consume and also increasing the number of times they engage in physical activity makes it to be the best option for the management of Diabetes among African Americans in the county of Miami Dade.

The Project Dulce which was implemented in San Diego is also another classic example of the effectiveness of CCM. Although meant for diabetes care, its implementation model can also be used in Miami Dade. It employed the services of highly skilled medical teams and peer educator in the implementation of the CCM elements in a community which was diverse, racially and ethnically, just like the one existing in Miami Dade.

Although it has a high success rate, CCM has its demerits. One which affects the data collected about its effectiveness is the fact that most healthcare organizations do not apply all the elements of CCM. In most cases, they only use one or two of the items. This partial application of CCM makes it difficult for researchers to determine the exact combination of factors that provide the most success in healthcare delivery (Strickland et al., 2015).

Even though there are several challenges faced in implementing it, CCM remains to be the best option in addressing the obesity crisis in Maine Dade. It is because; CCM can address the needs of more people than other plans effectively. It is also proactive and most importantly community-based making it to be easily implemented by both the healthcare professionals and patients (Strickland et al., 2010).

Criteria to Evaluate Achievement of Health Plan Outcomes

For a population health management plan to be successful, an approach to evaluate the effectiveness of the program should be put in place. The Car Continuum Alliance established five measures which can be used to assess the efficacy of any population health plan. These measures are assessment of the satisfaction of patients with the quality of health care which they receive, use of optimal clinical indicators which include process and outcome measure, functional status and quality of life, impact on known population disparities, and economic and healthcare utilization indicators (CCA, n.d).

To further improve the effectiveness of the evaluation measures above, the disease management evaluation criteria can also be used to establish whether the objectives of the health plan were achieved or not. It will also help the health professionals in Miami Dade county to come up with a record showing the details of the methods and performance indicators used during the implementation of the health plan (CCA, n.d).

Communication Strategy for the Population Health Management Plan

Communication plays a central role in the successful implementation of the population health plan. It is therefore essential for the healthcare professionals executing the health improvement plan to ensure that there is effective communication between them and the African American Community. Some of the barriers to effective communication which should be addressed before execution include distrust, lack of cultural competence, and low levels of engagements between the healthcare professionals and patients due to racial differences (Tiedt & Sloan, 2015).

The healthcare professionals in the county should ensure that the nursing professionals who will be critical executors of the plan are trained in cultural competence to overcome these barriers. It will enable them to understand better the cultures and values of the community where they are to work. Hiring staff of African American descent will also play a critical role in ensuring effective implementation of the plan. Their presence in the staff will increase the confidence of the community and thus enhance its receptiveness to the health improvement plan (Cabassa et al., 2015). Customization of resources and facilities used in the strategy so that they provide graphic description of the issues to be handled will better inform the community than when only plaintexts are used. Peer specialists, individuals who have were once obese, will also play an essential role in communicating the strategy to the community because they will prove to them that this situation that they are in can be managed.

Regular contact can be established through arranging public meetings or through making telephone calls or even sending emails to improve the interaction between healthcare providers and the community members. Frequent face-to-face follow-ups on the patients will also go a long way in improving communication between the healthcare professionals and patients. It will also give the healthcare professionals a chance to assess the progress that the patients are making over time.

Conclusion

The percentage of people that are obese in the United States and more specifically Miami Dade County in Florida state is becoming a source of concern to the healthcare professionals. The large number of people who are overweight or obese especially African Americans mak...