NURS FPX 6218 Assessment 4 Advocating for Lasting Change

Name

Capella University

NURS-FPX 6218 Leading the Future of Health Care

Prof. Name

Date

Advocating for Lasting Change

Welcome to this presentation on Advocating for Lasting Change. This presentation will explore the critical health issues affecting the Jordan community, where significant challenges in mental health, inadequate health insurance, and poor management of chronic conditions are harming public health. I will introduce a change proposal based on data-driven solutions aimed at improving mental health support for school-aged children, expanding health insurance coverage, and managing chronic diseases for low-income individuals. This proposal will leverage government policies that provide free treatment for individuals with pre-existing conditions, particularly chronic diseases, ensuring access to necessary care and support.

Target Role Groups and Stakeholders

This presentation addresses the following key stakeholders whose involvement is crucial to the success of the proposed healthcare changes:

• Policymakers: Your role in developing and enacting effective health policies is pivotal in advancing the proposed change and addressing the community’s health concerns.

• Governmental and Non-Profit Organizations: By expanding health programs and services, you can help alleviate health disparities and work toward achieving the proposed objectives.

• Healthcare Professionals: Your expertise is essential in delivering mental health support and managing chronic conditions within the community, helping to ensure better health outcomes.

• Community Leaders and Advocates for Change: Your continuous support and advocacy are necessary for transforming the healthcare landscape and improving the well-being of the Jordan community.

• Educational Institutions: Collaborating with schools to promote mental health among students will foster a safe environment where youth are protected from the adverse effects of mental health issues.

These stakeholders play integral roles in ensuring the successful implementation of the healthcare change proposal, promoting a community that prioritizes the health and well-being of its population.

Environmental Analysis of Jordan Community Through Windshield Survey

An environmental analysis of the Jordan community was conducted through a windshield survey, offering insights into both the strengths and areas requiring improvement:

Social Determinants Impacting Community Health

Several social determinants significantly affect the health of the Jordan community, particularly education and economic stability. Educational institutions lack sufficient health literacy programs, contributing to mental health issues among students. Additionally, economic instability hinders access to comprehensive healthcare, with many residents unable to afford full health insurance coverage or manage chronic conditions due to financial limitations. These challenges are addressed in the change proposal through targeted resource allocation and local health advocacy.

Change Proposal Framework

The proposed healthcare changes are based on the following framework to address the Jordan community’s health challenges:

• Mental Health Programs: Conducting mental health initiatives in schools to support affected students and guide them toward healthier thinking patterns.

• Health Insurance Access: Advocating for expanded Medicaid and Medicare services to ensure greater health insurance coverage for low-income individuals.

• Chronic Disease Management: Empowering community members to utilize the Affordable Care Act (ACA) to secure treatment for chronic health conditions, improving disease management.

The primary goals include reducing mental health crises, increasing health insurance coverage, and improving chronic disease management by educating the community on available resources.

Rationale for Policy and Financial Support

Addressing the health concerns of the Jordan community requires robust policy support and financial assistance. Government programs like the ACA, which prohibit insurance companies from denying coverage for pre-existing conditions, are essential in ensuring equitable healthcare access. Financial resources are also needed to implement mental health programs in schools and support other healthcare initiatives. The proposed changes align with governmental health objectives, making policy and financial support critical for ensuring long-term improvements in public health.

Evidence for Proposed Changes

Research supports the effectiveness of the proposed changes:

• Mental Health Support in Schools: Evidence suggests that 81% of teenagers worldwide faced mental health challenges during COVID-19, underscoring the need for school-based interventions (Rao & Rao, 2021).

• Expanded Health Insurance Coverage: Studies show that broader access to Medicaid and Medicare can significantly improve community health outcomes (Martin et al., 2021).

• Chronic Disease Education: Educating populations on government policies like the ACA can help individuals with chronic diseases manage their conditions more effectively (Myerson & Crawford, 2020).

The proposed changes are grounded in evidence-based research, making them essential for addressing the pressing health concerns of the Jordan community.

Broad Budget Estimates

To ensure the successful implementation of the proposed healthcare changes, a budget estimate has been developed. The first-year operational costs are projected to be $520,000, with startup costs of $24,000. Major budget allocations include salaries for project managers, support staff, and healthcare professionals, as well as educational materials and health insurance for staff members.

This budget is essential for the successful implementation and sustainability of the proposed changes.

Plan for Transformational, Evidence-Based Change

The proposed change is guided by Prosci’s Three-Phase process, incorporating the ADKAR model:

1. Preparing for Change: Raising awareness within the community and encouraging participation.

2. Managing the Change: Collaborating with stakeholders to implement the proposed initiatives.

3. Reinforcing the Change: Continuously evaluating and sustaining the changes to ensure long-term success.

This strategic plan will drive the transformation needed to improve health outcomes in the Jordan community.

Vision for Future Wellness, Health, and Role of Visionary Leadership

Our vision aligns with the Healthy People 2030 objectives to enhance health equity, reduce disparities, and improve public health. Transformational leadership will be key to achieving these goals, promoting collaboration, empowerment, and resilience among team members. Through this approach, the Jordan community will be well-positioned to address current health concerns and foster a healthier future.

Cultivating Stakeholder Interest and Support

Stakeholder engagement is essential for the successful implementation of the proposed changes. By addressing their concerns about finances, decision-making involvement, and communication, stakeholders will feel empowered to contribute to the healthcare initiatives. Collaborating with key stakeholders will help achieve long-term health goals and improve the well-being of the Jordan community.

Conclusion

Improving the health of the Jordan community requires the collaborative efforts of policymakers, educators, healthcare professionals, and other stakeholders. This change proposal is grounded in evidence-based research and aims to address the pressing health concerns of mental health, health insurance, and chronic disease management. By leveraging the ADKAR model and aligning with Healthy People 2030 goals, this proposal will bring about meaningful and lasting improvements to public health in the Jordan community.

References

Castle, J. T., Levy, B. E., Mangino, A. A., McDonald, H. G., McAtee, E. E., Patel, J. A., Evers, B. M., & Bhakta, A. S. (2023). Impact of the Affordable Care Act on providing equitable healthcare access for IBD in the kentucky appalachian region. Diseases of the Colon & Rectum, 66(9), 1273. https://doi.org/10.1097/DCR.0000000000002942

García-Carrión, R., Villarejo-Carballido, B., & Villardón-Gallego, L. (2019). Children and adolescents mental health: A systematic review of interaction-based interventions in schools and communities. Frontiers in Psychology, 10(918). https://doi.org/10.3389/fpsyg.2019.00918

Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement and implementation meet? A systematic review of the applications of change management models in healthcare. Journal of Healthcare Leadership, 13(13), 85–108. https://doi.org/10.2147/JHL.S289176

Hasbrouck, L. (2021). Healthy people 2030: An improved framework. Health Education & Behavior, 48(2), 113–114. https://doi.org/10.1177/1090198121997812

Martin, H., Kushner, S., Iles, K., & Montgomery, H. (2021). Advocating for expanded access to medical nutrition therapy in Medicare. Journal of the Academy of Nutrition and Dietetics. https://doi.org/10.1016/j.jand.2021.02.024

NURS FPX 6218 Assessment 4 Advocating for Lasting Change

Myerson, R., & Crawford, S. (2020). Coverage for adults with chronic disease under the first 5 years of the Affordable Care Act. Medical Care, Publish Ahead of Print. https://doi.org/10.1097/mlr.0000000000001370

Rao, M. E., & Rao, D. M. (2021). The mental health of high school students during the COVID-19 pandemic. *Frontiers in Education, 6

*. https://doi.org/10.3389/feduc.2021.719539

NURS FPX 6218 Assessment 3 Planning for Community and Organizational Change

Name

Capella University

NURS-FPX 6218 Leading the Future of Health Care

Prof. Name

Date

Planning for Community and Organizational Change Summary

Vaccination hesitancy has become a significant concern at Armatage Elementary School, where the principal has observed a notable increase in parents seeking exemptions from vaccination requirements for their children (Capella University, n.d.). This worrying trend raises the risk of outbreaks of preventable diseases such as measles, mumps, and whooping cough within the school community. The rise in exemption requests is driven by the spread of anti-vaccination information within the community, likely propagated through online sources, social media, and local groups. This misinformation is challenging to counteract and poses serious health risks to both unvaccinated children and the broader community by undermining herd immunity and endangering those who cannot be vaccinated due to medical reasons.

Summary

Benefits and Implications

To address vaccination hesitancy at Armatage Elementary School, a comprehensive approach involving community education and strategic partnerships is proposed. This includes organizing informational workshops led by healthcare professionals and distributing educational materials. These proposed changes at Armatage Elementary School offer significant benefits for the community. By implementing comprehensive educational workshops, partnering with healthcare providers, and enhancing communication strategies, the school can increase vaccination rates, thus reducing the risk of outbreaks of preventable diseases such as measles, mumps, and whooping cough. These measures will protect not only the health of unvaccinated children but also those who cannot be vaccinated for medical reasons, thereby strengthening herd immunity (Siciliani et al., 2020). 

Clear goals for these changes include achieving higher vaccination compliance, improving public health literacy regarding vaccinations, and fostering a community environment that supports evidence-based health practices. These outcomes are supported by credible evidence showing that well-informed communities with high vaccination rates experience fewer disease outbreaks and better overall health outcomes (Robinson et al., 2021). By proactively addressing misinformation and improving access to vaccinations, the school can ensure a safer, healthier environment for all students and their families.

Potential Barriers to Change

Implementing changes to address vaccination hesitancy at Armatage Elementary School may face several barriers, both within the organization and the broader community. One significant barrier is the prevalence of misinformation and lack of trust in vaccines. This misinformation, often spread through social media and community groups, fosters skepticism among parents, making them more likely to resist vaccinations for their children. Studies, such as those by Lee et al. (2022), have shown that misinformation significantly contributes to vaccine hesitancy. Additionally, cultural and religious beliefs can also play a crucial role.

Some community members may oppose vaccination due to deeply rooted cultural or religious views, which can be challenging to counter. Research by Wong et al. (2020) highlights how cultural and religious factors can influence health behaviors, including attitudes toward vaccination. Moreover, fear of vaccine side effects is another common barrier, as parental concerns about potential adverse reactions can deter them from vaccinating their children. Multiple public health studies, including those by Littig et al. (2022), have identified fear of side effects as a primary reason for vaccine refusal, such as the COVID-19 vaccine.

Organizational and community factors further contribute to resistance. Within the school or local health departments, bureaucratic processes can slow down the implementation of new policies or educational programs. At the same time, limited financial and human resources may hinder comprehensive educational campaigns or vaccination drives (Brock et al., 2020). In the community, peer influence and the role of community leaders can significantly impact individual decisions. Negative opinions about vaccines can spread quickly within close-knit communities, reinforcing hesitancy. Additionally, historical mistrust of medical institutions can create resistance to new health initiatives. Research by Qiao et al. (2020) emphasizes that better access to reliable health information correlates with higher vaccine acceptance, suggesting that addressing information gaps is critical for overcoming hesitancy. Therefore, understanding these barriers and their underlying causes is essential for developing effective strategies to promote vaccine acceptance and improve public health outcomes.

Strategies for Changing Barriers into Opportunities and Resolving Conflict

To address vaccination hesitancy and enhance public health at Armatage Elementary School, Vila Health executive leaders can focus on two primary strategies: developing and distributing educational materials and organizing workshops. These strategies will help transform barriers into opportunities and resolve conflicts effectively. The drivers of change in this context include providing accurate, evidence-based information to counteract misinformation and creating interactive platforms where parents can engage with healthcare professionals (Herman et al., 2024).

Our vision is to create a well-informed, health-conscious community where vaccination rates are high, misinformation is minimal, and public health is prioritized. In the short term (0-6 months), we will develop and distribute brochures, fact sheets, and informational pamphlets in multiple languages, making them accessible through the school, community centers, and healthcare facilities. Concurrently, we will organize workshops led by healthcare professionals, providing detailed explanations about vaccines, their safety, and their importance, scheduled at convenient times for parents (Lip et al., 2023).

NURS FPX 6218 Assessment 3 Planning for Community and Organizational Change

Effective communication with stakeholders and overcoming resistance will be achieved through transparent communication, regular updates via newsletters, emails, the school website, and open forums for addressing concerns. Engaging community leaders, healthcare professionals, and local authorities in planning and implementation will lend credibility to the initiative while soliciting feedback from parents will ensure they feel heard and valued. Building trust involves highlighting success stories, providing reassurances from trusted healthcare experts, and sharing personal testimonies from those affected by vaccine-preventable diseases (Thompson et al., 2023).

Resolving conflicts among competing interests will involve mediation and dialogue to understand concerns and find common ground, encouraging compromise and collaboration where different groups can contribute to the overall goal. Basing all decisions on credible evidence and ensuring transparency in decision-making processes will build trust and reduce resistance. By focusing on these strategies, Vila Health can effectively address vaccination hesitancy, improve public health outcomes, and foster a supportive community environment.

Stakeholder Communications

To help organizational stakeholders understand and evaluate the proposed changes of organizing informational workshops led by healthcare professionals and distributing educational materials, it is crucial to identify and engage critical stakeholders effectively. The primary stakeholders in this initiative include executive leaders, healthcare professionals, school administration, parents and students, local health authorities, and community leaders. Executive leaders, such as the CEO, Board of Directors, and senior management, are pivotal decision-makers whose approval and allocation of resources are essential for the success of the initiative.

Healthcare professionals who will lead the workshops provide the necessary credibility and expertise to deliver accurate information and address concerns. The school administration, including principals and teachers, will facilitate the organization of events and distribution of materials within the school. Parents and students, as the primary beneficiaries, are crucial for participation and feedback, determining the initiative’s success. Local health authorities and community leaders will offer additional support, validation, and advocacy, enhancing the initiative’s credibility and community engagement.

The proposed changes will significantly impact the organization by improving public health, building community trust, and enhancing the organization’s reputation. Increased vaccination rates will reduce the incidence of preventable diseases, leading to a healthier community (Vaz et al., 2020). Transparent communication and credible information will foster trust between the community and the healthcare system. While the organization may need to reallocate resources for developing materials and conducting workshops, the long-term benefits, including cost savings from preventing disease outbreaks, will outweigh these initial investments (Rodrigues & Plotkin, 2020).

To support these changes, decision-makers will be provided with comprehensive data and information, including current vaccination rates, health statistics, evidence of misinformation, a cost-benefit analysis, successful case studies, stakeholder feedback, and a detailed implementation plan. With the help of these data, Vila Health can gain the necessary support to implement the initiative and improve public health outcomes in the community.

References

Armatage Elementary School. (2023, December 10). Home – Armatage elementary school. Armatage.mpschools.org. https://armatage.mpschools.org/

Capella University. (n.d.). Vila Health: Planning for change. https://www.google.com/url?q=https://media.capella.edu/CourseMedia/nurs-fpx6218element236957/wrapper.asp&sa=D&source=apps-viewer-frontend&ust=1711700540866615&usg=AOvVaw1f9xRFvtxS70bqp0FAC7KY&hl=en

Brock, K. E., Allen, K. E., Barton, C., Shapiro, R., Weintraub, B., Wasilewski-Masker, K., Escoffery, C., & Johnson, K. A. (2020). A methodologic approach to conducting a statewide community needs assessment of pediatric palliative care and hospice resources. Journal of Pain and Symptom Management, 60(3), 531-538.e8. https://doi.org/10.1016/j.jpainsymman.2020.04.004 

Canada, P. H. A. of. (2020, December 3). What healthcare professionals can do: Vaccine fake news and science deniers, CCDR 46(11/12). Www.canada.ca. https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2020-46/issue-11-12-november-5-2020/vaccine-misinformation-found-online.html 

Herman, B. C., Poor, S., Clough, M. P., Rao, A., Kidd, A., De Jesús, D., & Varghese, D. (2024). It’s not just a science thing: Educating future STEM professionals through mis/disinformation responsive instruction. Journal of Research in Science Teaching. https://doi.org/10.1002/tea.21934 

Lee, S. K., Sun, J., Jang, S., & Connelly, S. (2022). Misinformation of COVID-19 vaccines and vaccine hesitancy. Scientific Reports, 12(1), 13681. https://doi.org/10.1038/s41598-022-17430-6 

NURS FPX 6218 Assessment 3 Planning for Community and Organizational Change

Lip, A., Pateman, M., Fullerton, M. M., Chen, H. M., Bailey, L., Houle, S., Davidson, S., & Constantinescu, C. (2023). Vaccine hesitancy educational tools for healthcare providers and trainees: A scoping review. Vaccine, 41(1), 23–35. https://doi.org/10.1016/j.vaccine.2022.09.093 

Littig, C. H., Frank, T., Schmaderer, C., Braunisch, M. C., Renders, L., Kranke, P., Popp, M., Seeber, C., Fichtner, F., Littig, B., Carbajo-Lozoya, J., Meerpohl, J. J., Haller, B., & Allwang, C. (2022). COVID-19 vaccines: Fear of side effects among German health care workers. Vaccines, 10(5), 689. https://doi.org/10.3390/vaccines10050689 

Minnesota Compass. (n.d.). Armatage | MN Compass. Minnesota Compass. https://www.mncompass.org/profiles/city/minneapolis/armatage 

Qiao, S., Friedman, D. B., Tam, C. C., Zeng, C., & Li, X. (2020). Vaccine acceptance among college students in South Carolina: Do information sources and trust in information make a difference? MedRxiv: The Preprint Server for Health Sciences. https://doi.org/10.1101/2020.12.02.20242982 

Robinson, P., Wiley, K., & Degeling, C. (2021). Public health practitioner perspectives on dealing with measles outbreaks if high anti-vaccination sentiment is present. BMC Public Health, 21(1). https://doi.org/10.1186/s12889-021-10604-3 

Rodrigues, C. M. C., & Plotkin, S. A. (2020). Impact of vaccines; health, economic and social perspectives. Frontiers in Microbiology, 11(1526). https://doi.org/10.3389/fmicb.2020.01526 

NURS FPX 6218 Assessment 3 Planning for Community and Organizational Change

Siciliani, L., Wild, C., McKee, M., Kringos, D., Barry, M. M., Barros, P. P., De Maeseneer, J., Murauskiene, L., & Ricciardi, W. (2020). Strengthening vaccination programmes and health systems in the European Union: A framework for action. Health Policy, 124(5), 511–518. https://doi.org/10.1016/j.healthpol.2020.02.015 

Thompson, S., Meyer, J. C., Burnett, R. J., & Campbell, S. M. (2023). Mitigating vaccine hesitancy and building trust to prevent future measles outbreaks in England. Vaccines, 11(2), 288. https://doi.org/10.3390/vaccines11020288 

Vaz, O. M., Ellingson, M. K., Weiss, P., Jenness, S. M., Bardají, A., Bednarczyk, R. A., & Omer, S. B. (2020). Mandatory vaccination in Europe. Pediatrics, 145(2). https://doi.org/10.1542/peds.2019-0620

Wong, L. P., Wong, P.-F., Megat Hashim, M. M. A. A., Han, L., Lin, Y., Hu, Z., Zhao, Q., & Zimet, G. D. (2020). Multidimensional social and cultural norms influencing HPV vaccine hesitancy in Asia. Human Vaccines & Immunotherapeutics, 16(7), 1611–1622. https://doi.org/10.1080/21645515.2020.1756670

Appendix A: Grant Proposal

Need Statement

The issue this change addresses is the rising vaccination hesitancy within the community of Armatage, particularly among parents of children at Armatage Elementary School. This problem is evidenced by a recent increase in vaccination exemption requests, posing significant public health risks within the school and the broader community. The scope of the problem includes the potential for outbreaks of preventable diseases such as measles, mumps, and whooping cough, which can compromise the health of both vaccinated and unvaccinated individuals due to lowered herd immunity (Capella University, n.d.). Given the densely populated and diverse nature of Armatage, even a moderate level of vaccination hesitancy can have profound implications for community health and safety (City of Armatage, 2015).

Several barriers are likely to be encountered when implementing this change in Armatage. These barriers may include the spread of misinformation, lack of trust in healthcare systems, and resistance from parents influenced by anti-vaccination rhetoric. The sources of information used to define the need for change include the Vila Health: Plan for Change. This highlights the health concerns and vaccination trends within the community. Other change initiatives or studies addressing similar problems include efforts by local health departments, schools, and community organizations to promote vaccine education and improve immunization rates. Collaborating with these initiatives and leveraging existing resources and expertise can enhance the effectiveness and sustainability of the proposed change in Armatage.

Program Description

The proposed change initiative aims to address vaccination hesitancy at Armatage Elementary School through two primary strategies: organizing informational workshops led by healthcare professionals and distributing educational materials to parents and the broader community. This initiative targets parents, students, school staff, and the wider Armatage community to ensure comprehensive coverage and maximum impact. The workshops will provide a platform for healthcare professionals to discuss the benefits and safety of vaccinations, debunk common myths, and address any concerns or questions from parents. These sessions will be scheduled during convenient times, such as evenings and weekends, to accommodate parents’ schedules and will be held at the school and community centers to ensure accessibility.

Simultaneously, educational materials, including brochures, fact sheets, and digital content, will be developed and distributed to reinforce the information presented in the workshops. These materials will be available at school events, through newsletters, and on the school’s website and social media channels. The initiative will begin within the next six months, starting with the development of materials and scheduling workshops. The aim is to create a well-informed community that understands the importance of vaccinations, thereby reducing exemption requests and increasing overall immunization rates. This change is crucial to protect public health, prevent disease outbreaks, and maintain herd immunity within the community. By leveraging the expertise of healthcare professionals and ensuring clear, consistent communication, the initiative seeks to build trust, dispel misinformation, and promote a healthier environment for all residents of Armatage.

Goals and Objectives

The goal of the change initiative at Armatage Elementary School is to combat vaccination hesitancy by educating parents and the community through workshops led by healthcare professionals and the dissemination of educational materials. By providing accurate information about the benefits and safety of vaccinations, addressing misconceptions, and fostering community trust in healthcare providers, the initiative aims to increase immunization rates among students. Partnerships with local healthcare providers will enhance credibility and facilitate access to vaccinations. Monitoring and evaluation will track progress, ensuring adjustments are made as needed to achieve the overarching goal of protecting public health and maintaining herd immunity in the Armatage community.

Program Evaluation

The change initiative at Armatage Elementary School will be evaluated primarily through quantitative data analysis of vaccination rates and exemption requests before and after implementation. Oversight responsibilities will be shared among the school administration and healthcare professionals leading the workshops. Regular monitoring of immunization rates will provide clear metrics on the initiative’s impact, with initial evaluations conducted shortly after the workshops begin and subsequent assessments scheduled at regular intervals thereafter. Reports detailing these findings will be shared with school administrators, healthcare providers, and local health authorities to assess progress, identify any emerging barriers, and adjust strategies as needed. This structured approach ensures that the initiative remains responsive to community needs and effectively addresses vaccination hesitancy among parents and caregivers in the Armatage community.

Summary

This change initiative addressing vaccination hesitancy at Armatage Elementary School is crucial for safeguarding public health within the community. By increasing immunization rates among students, we aim to prevent outbreaks of preventable diseases and maintain herd immunity, which protects vulnerable individuals unable to be vaccinated. The goals and objectives of this initiative align closely with the mission of our funding organization, which prioritizes community health and disease prevention. Their financial support is vital as it enables us to organize educational workshops, distribute informative materials, and collaborate with healthcare providers effectively. We deeply appreciate the funding agency’s consideration and support, which will play a pivotal role in ensuring the success and sustainability of this initiative for the benefit of the entire Armatage community.

Appendix B: Project Budget

NURS FPX 6218 Assessment 2 Assessing Community Health Care Needs

Name

Capella University

NURS-FPX 6218 Leading the Future of Health Care

Prof. Name

Date

Community Health Assessment

This paper focuses on evaluating the Armatage neighborhood in Minneapolis, Minnesota. Through a windshield survey, the general condition and public health needs of the community are examined. Additionally, the analysis delves into the environmental factors and social determinants of health that influence the well-being of the Armatage population. Finally, an executive summary will be crafted to enable community leaders to effectively understand the current health conditions and needs of the Armatage residents.

General Condition and Public Health Needs

In assessing the Armatage neighborhood in Minneapolis, Minnesota, through a windshield survey focused on local businesses, healthcare facilities, and residential housing, key findings emerged. Local businesses like Cindy’s Barber Shop and Kwan’s Chinese Cuisine create a vibrant community hub, yet economic challenges, illustrated by closures like Pennhurst Cleaners, highlight vulnerabilities. Healthcare accessibility, supported by facilities such as Penn Avenue Family Dental and Snap Fitness, is noted, but the absence of major hospitals poses limitations for specialized care. Residentially, a mix of mid-century homes and newer developments suggests stability and growth, though concerns about housing quality and potential displacement persist (Vila Health: Environmental Analysis and Windshield Survey Simulation, n.d.).

Safety concerns were also considered while conducting the survey, including ensuring safe driving practices, avoiding hazardous or high-crime areas, and monitoring weather conditions to avoid extreme weather. These precautions were essential to ensure the safety of the surveyors (Vila Health: Environmental Analysis and Windshield Survey Simulation, n.d.). The observations are inherently subjective, influenced by the perspective and biases of the observer. This subjectivity can lead to variations in the interpretation of the neighborhood’s condition. The survey offers only a snapshot in time, failing to capture the dynamic nature of the neighborhood’s changes and seasonal variations. Additionally, the survey focuses primarily on visible factors, potentially overlooking critical but less visible issues such as indoor environmental quality, residents’ health behaviors, and detailed healthcare access (Brock et al., 2020).

Environmental Analysis 

The Armatage neighborhood in Minneapolis faces several health concerns influenced by economic, social, and technological factors. Economic disparities are evident, with a range of socioeconomic statuses and limited major healthcare facilities, potentially restricting access to specialized care. Socially, the community benefits from vibrant local businesses and accessible primary education, yet there is limited religious diversity. Technological opportunities exist in the form of local fitness centers like Snap Fitness, promoting physical health. Healthcare providers are influenced by the community’s economic diversity, creating both opportunities for growth and threats from unequal access to resources. The analysis reveals a community with strengths in local engagement and education but challenges in healthcare accessibility and economic inequality, as evidenced by the varied housing conditions and business presence (Vila Health: Environmental Analysis and Windshield Survey Simulation, n.d.).

Social Determinants of Health

In the Armatage neighborhood of Minneapolis, several social determinants of health influence community well-being. Access to healthcare services, although somewhat limited in terms of specialized care, is supported by local dental and fitness facilities, promoting physical health. Socioeconomic diversity is evident through a mix of mid-century homes and newer developments, suggesting varying levels of economic stability that can impact residents’ access to resources and health outcomes. Additionally, the total population aged 65 and under, whose health insurance coverage status has been determined, is 4,653 individuals, representing 86.5% of this age group (Minnesota Compass, n.d.).

Educational opportunities at Armatage Elementary School underscore a positive social determinant, while the absence of significant healthcare centers poses challenges for comprehensive care (Armatage Elementary School, 2023). Assumptions include the neighborhood’s active community engagement and the belief that economic disparities may affect health disparities. Uncertainties lie in the scope of healthcare accessibility beyond primary services and the full impact of socioeconomic diversity on health outcomes, underscoring the need for further research and community engagement to address these determinants effectively.

Executive Summary

 The Armatage neighborhood in Minneapolis presents a compelling landscape of opportunities and challenges for community health. Our environmental analysis, anchored in a windshield survey, emphasizes the need to enhance healthcare access, particularly with the absence of significant hospitals within the immediate vicinity. Strengthening local healthcare facilities like Penn Avenue Family Dental and Snap Fitness is crucial to support preventive care and physical health initiatives. Furthermore, expanding educational opportunities beyond elementary levels could enrich health literacy among residents, contributing to overall community well-being (Vila Health: Environmental Analysis and Windshield Survey Simulation, n.d.).

Despite vibrant local businesses and stable residential growth, disparities in healthcare access underscore the need for targeted interventions, potentially through collaborative efforts involving local government and community stakeholders. Challenges in implementation include financial constraints and the need for broader community engagement to address varying health needs effectively. The critical lessons learned include the importance of committed leadership in healthcare improvement, leveraging existing community assets, and mitigating healthcare disparities to foster a healthier living environment for all Armatage residents (Vila Health: Environmental Analysis and Windshield Survey Simulation, n.d.).

References 

Armatage Elementary School. (2023, December 10). Home – Armitage elementary school. Armatage.mpschools.org. https://armatage.mpschools.org/

Brock, K. E., Allen, K. E., Barton, C., Shapiro, R., Weintraub, B., Wasilewski-Masker, K., Escoffery, C., & Johnson, K. A. (2020). A methodologic approach to conducting a statewide community needs assessment of pediatric palliative care and hospice resources. Journal of Pain and Symptom Management, 60(3), 531-538.e8. https://doi.org/10.1016/j.jpainsymman.2020.04.004 

NURS FPX 6218 Assessment 2 Assessing Community Health Care Needs

Minnesota Compass. (n.d.). Armatage | MN Compass. Minnesota Compass. https://www.mncompass.org/profiles/city/minneapolis/armatage

Vila Health: Vila Health: Environmental Analysis and Windshield Survey simulation. 

Appendix

Table 1: Windshield Survey and Environmental Analysis

References 

Vila Health: Vila Health: Environmental Analysis and Windshield Survey simulation.

Minnesota Compass. (n.d.). Armatage | MN Compass. Minnesota Compass. https://www.mncompass.org/profiles/city/minneapolis/armatage

NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change

Name

Capella University

NURS-FPX 6218 Leading the Future of Health Care

Prof. Name

Date

Change Proposal Summary Report

Mental health, an integral part of overall health, is unfortunately underserved in many local and regional healthcare systems. The Appalachian Regional Healthcare System (ARH), which serves a predominantly rural population in Eastern Kentucky and Southern West Virginia, is a case in point. The mental healthcare system in this region is grappling with several challenges, including limited service access, extended wait times, and a need for integrated care. This Change Proposal Summary Report outlines a strategic focus on enhancing mental health services, with the overarching aim of significantly improving patient outcomes and overall community well-being in this underserved region. A comparative analysis of adequate mental healthcare strategies in other non-U.S. healthcare systems has been conducted. The findings from this analysis will facilitate the implementation of adequate changes to enhance the quality of mental health care delivered to patients in the ARH region.

Executive Summary

Proposed Change

The Appalachian Regional Healthcare System (ARH), serving a predominantly rural population across Eastern Kentucky and Southern West Virginia, faces significant challenges in its mental healthcare services. A critical aspect identified for change is the integration and enhancement of mental health services within the ARH. This includes increasing access to mental health professionals and establishing better integration of mental health care with primary care services. The decision to focus on this particular change stems from the acute need to address the mental health crisis in the ARH region. The region is characterized by high rates of mental health disorders, compounded by socioeconomic factors and limited access to care (Morgan et al., 2020).

Geographic isolation and a shortage of mental health professionals exacerbate the problem, resulting in long wait times for patients and a lack of coordinated care. The integration of mental health services within the primary care framework and the expansion of telehealth services are critical steps to mitigate these issues. The expectations for improvements are clearly defined and substantiated by credible evidence. Enhanced access to mental health professionals and telehealth services will reduce geographic and financial barriers to care (Moroz et al., 2020). Additionally, the integration of mental health services with primary care, supported by EHR systems, will facilitate comprehensive, coordinated care (Kariotis et al., 2022). These changes are expected to result in better patient outcomes, reduced healthcare costs due to early intervention, and overall improved mental health and well-being for the population served by the ARH (Torous et al., 2020).

Desired Outcomes

The first desirable outcome is enhanced access to mental health services across the Appalachian Regional Healthcare System (ARH). This improvement aims to address the shortage of mental health professionals and extend services to underserved areas through the recruitment of new professionals and the expansion of telehealth. The cost of care will primarily be covered by Medicaid, Medicare, private insurance, and potential federal grants. The rationale for this outcome is based on evidence showing that increased access to mental health services can lead to earlier intervention, reduced symptom severity, and overall better mental health outcomes (Moroz et al., 2020). However, limiting factors include regional workforce shortages and the existing technology infrastructure, which may impede rapid implementation.

The second desired outcome is better integration of mental health and primary care services. This involves promoting collaborative care models and ensuring shared access to Electronic Health Records (EHR) systems. Funding sources will include Medicaid, Medicare, private insurance, and hospital system investments. This integrated approach ensures comprehensive care, addressing both physical and mental health needs, leading to more holistic treatment plans. Studies have shown that integrated care models and EHR systems improve care coordination and patient satisfaction (Kariotis et al., 2022). Limiting factors include the costs of training and system integration, as well as resistance to changes in clinical practice.

Health Care System Comparative Analysis

Norway’s healthcare system excels in providing community-based mental health services that are deeply integrated into the primary care framework. Norwegian municipalities are responsible for organizing and delivering mental health care services locally, ensuring accessibility and reducing stigma associated with seeking help. These services are often multidisciplinary, involving psychologists, social workers, and psychiatric nurses who collaborate closely with primary care providers (Ruud & Friis, 2021). The emphasis is on prevention, early intervention, and ongoing support within the community. Additionally, Norway’s decentralized healthcare system exemplifies a patient-centred approach by distributing healthcare responsibilities to local municipalities. This structure empowers local authorities to manage healthcare services, ensuring that they are tailored to the specific needs of their communities. Decentralization enhances accessibility and responsiveness, making healthcare more adaptable to local conditions and individual patient requirements (Brkic et al., 2021). 

Australia has implemented innovative telehealth-based mental health services to improve access for rural and remote populations. Telehealth platforms connect mental health professionals with patients in remote areas, allowing for virtual consultations, therapy sessions, and ongoing monitoring. This approach addresses geographic barriers and shortages of mental health professionals in rural settings, ensuring timely access to specialized care and support. Australia’s telehealth initiatives are supported by robust infrastructure and government policies aimed at expanding telehealth services across the country (Hall Dykgraaf et al., 2021).

Appalachian Regional Healthcare System (ARH) currently faces significant challenges in providing equitable access to mental health services, particularly in rural and underserved areas. Geographic isolation and limited resources exacerbate disparities in access, leading to difficulties for residents in receiving timely and comprehensive mental health care. Furthermore, mental health services within ARH often operate independently from primary care, resulting in fragmented care delivery and gaps in service continuity. This disjointed approach contributes to suboptimal patient outcomes and fails to address the holistic needs of individuals requiring mental health support.

Rationale for the Proposed Change

The proposed changes to decentralize mental health services within the Appalachian Regional Healthcare System (ARH) and integrate them with primary care will address several vital barriers currently affecting the system. By adopting a decentralized model similar to that of Norway and leveraging telehealth initiatives as seen in Australia, ARH can effectively enhance access to mental health services, improve continuity of care, and foster a more personalized approach to treatment (Brkic et al., 2021). Norway’s community-based approach to mental health services has demonstrated improved accessibility, reduced stigma, and enhanced patient satisfaction through integrating mental health within primary care and local communities. Likewise, Australia’s telehealth initiatives have proven successful in extending mental health services to remote and underserved areas, ensuring timely support and better management of mental health conditions.

By implementing these models, ARH can expect to see increased access to mental health services, enhanced care coordination, reduced stigma, and overall improved patient outcomes (Morgan et al., 2020). These expectations are reasonable within the existing ARH framework, given the infrastructure already in place for primary care and the growing acceptance and implementation of telehealth technologies (Hall Dykgraaf et al., 2021). The integration of mental health services with primary care and the expansion of telehealth capabilities will make mental health care more accessible, personalized, and continuous, aligning with global best practices and addressing the unique challenges faced by ARH.

Financial and Health Implications

Implementing a decentralized mental health service model within the Appalachian Regional Healthcare System (ARH), integrated with primary care, will have significant financial and health benefits. Initial costs will be high due to establishing community-based clinics, expanding telehealth services, and training healthcare professionals. These expenses can be managed through federal and state grants, budget reallocations, and public-private partnerships. Long-term savings are expected from reduced hospitalizations, emergency room visits, and patient transportation costs. Health benefits include improved access to mental health services, early diagnosis, and intervention, leading to better management of conditions and overall quality of life. Integrating mental health with primary care ensures holistic, continuous care, reducing service fragmentation and improving treatment adherence. Increased accessibility and normalization of mental health services will also reduce stigma (Brkic et al., 2021).

Not implementing these changes will maintain high costs associated with emergency services and hospitalizations, and patients in rural areas will continue to face access barriers, leading to poorer health outcomes and ongoing stigma. Individuals may face copayments and insurance adjustments, while communities will need to invest in infrastructure. However, the benefits include better access to care, improved health outcomes, and long-term cost savings. In the short term, increased access to services and patient satisfaction are expected, with an initial rise in healthcare spending (Ruud & Friis, 2021). Long-term effects include sustained mental health improvements, significant cost savings, and a more robust healthcare system. Evidence from Norway and Australia supports these conclusions, showing the effectiveness of decentralized and telehealth models in improving mental health care ((Brkic et al., 2021; Hall Dykgraaf et al., 2021; (Ruud & Friis, 2021).

Conclusion

In conclusion, implementing a decentralized and integrated mental health service model within the Appalachian Regional Healthcare System (ARH) will enhance access to care, improve patient outcomes, and reduce stigma associated with mental health. Drawing on successful strategies from Norway and Australia, ARH can address current challenges through community-based clinics and telehealth initiatives. The proposed changes promise long-term financial savings and improved health outcomes, making them a sustainable solution for the region. Without these changes, ARH will continue to face high costs and poor mental health outcomes, particularly in underserved areas.

Appendix

Table 1: Health Care System Comparative Analysis

References

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Hall Dykgraaf, S., Desborough, J., de Toca, L., Davis, S., Roberts, L., Munindradasa, A., McMillan, A., Kelly, P., & Kidd, M. (2021). “A decade’s worth of work in a matter of days”: The journey to telehealth for the whole population in Australia. International Journal of Medical Informatics, 151(151), 104483. https://doi.org/10.1016/j.ijmedinf.2021.104483 

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NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change

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Torous, J., Jän Myrick, K., Rauseo-Ricupero, N., & Firth, J. (2020). Digital mental health and COVID-19: Using technology today to accelerate the curve on access and quality tomorrow. JMIR Mental Health, 7(3), e18848. https://doi.org/10.2196/18848