NURS FPX 4060 Assessment 1 Health Promotion Plan

Student Name

Capella University

NURS-FPX 4060 Practicing in the Community to Improve Population Health

Prof. Name

Date

Health Promotion Plan

Community health initiatives aim to target communities’ health concerns in social and cultural contexts. These initiatives enable people in a particular community to take control of physical, mental, social, and cultural aspects affecting their health. The community health concerns are addressed by assessing the conditions and needs of that community (Barker et al., 2021). Multiple factors can hinder the resistance to disease growth, and people repeatedly fall back on the same issues without a long-term solution. It takes a holistic evaluation of factors to prevent diseases and promote better health outcomes. The community initiative includes educational and literacy awareness for disease lingering in a specific community (Naqvi & Gale, 2020). One such health concern is Human Papillomavirus (HPV), a sexually transmitted virus.

Centers for Disease Control and Prevention (CDC) says that every year in the United States, 19,000 women and 12,000 men are infected by HPV (CDC, 2021). HPV cause cancers of many types, for instance, cervical, anal, mouth, throat, and penis. Women are more affected than men, and 4000 women die due to cervical cancer every year. World Health Organization (WHO) says that HPV is diagnosed in men having intercourse with men, people with various sexual partners, sexually abused children, and immune-compromised people (WHO, 2023). There are no symptoms of HPV, and the only way to be aware of this virus is through visible genital warts, which means lumps or blisters at genital or cervical cancer diagnosis. This paper aims to develop a health promotion plan to address this risky and preventive viral disease. 

Analysis of Health Concerns

CDC says that there are 42.5 million people with HPV in the United States (Elflein, 2023). It is a common disease and can affect millions more people over time. This virus can potentially stay with a person hidden and show at any point in life. People with HPV never know that they are infected. The genital warts are expected to be in one of every 100 individuals.

Similarly, cervix cancer affects 12 thousand women every year (CDC, 2021). The existence of HPV depends on how sexually active a person is. However, women are more infected with HPV than men. Around 625,000 women and 69,000 men each year get HPV-caused cancer (WHO, 2023). 

NURS FPX 4060 Assessment 1 Health Promotion Plan

There are 150 types of HPV, but only high-risk types cause genital warts or develop cancer. The interesting fact about HPV is that it can affect any sexually active person. That person can be unaware of that until it worsens to become a genital wart or cancer. Studies have shown that middle and low-income households have more chances of being infected with HPV than high-income households (Galeshi et al., 2022). As women are more affected, it affects their psychological state after being diagnosed with HPV cancer. The emotional state is affected by the diagnosis of cancer, and multiple psychosocial pressures in mind affect the person with HPV. A person may feel fear, anxiety, shame, or guilt after being diagnosed with HPV (Amboree & Darkoh, 2020).

The preventive measures used to address HPV concerns in society are vaccinations and screening tests. Vaccinations are highly recommended for pre-teens, which means children aged 11 or 12, and it is recommended to get vaccinated before turning 26 years old (CDC, 2021). As HPV can occur at any time of life, people above the age of 26 must get regular screening for chances of cancer diagnosis. With its ambiguous existence and critical impact on a person’s physical, mental, and social health, it is important to address HPV preventive health issues by developing preventive measures (Galeshi et al., 2022).

Assumptions and Uncertainties

The common assumption about HPV is that once it has developed cancer, it is not curable. However, it is curable and completely preventive with specific considerations like vaccination and screening. HPV vaccine for people under the age of 26 years is beneficial. After that age group of 26-45, men and women would not benefit from vaccinations, another assumption related to HPV health concerns (Kim et al., 2021). The uncertainties to this health need lie in whether vaccination compliance is accepted at a large scale and whether or not pre-teens, teens, and adults take vaccination doses. The cost of educating and providing vaccination and screening services for women and men of low-income communities is also still being determined. The mental and psychosocial stigmas are also uncertain as they vary from person to person (Kim et al., 2021). 

Need for Health Promotion

WHO states that cervical cancer is the fourth leading cause of death, causing more than 600,000 women and 342,000 deaths in 2020 (WHO, 2022). It is also prevalent in middle and low-income communities, making it hard to access preventive measures and treat HPV. Studies have also shown that women with co-infections like HIV have chances of developing cervical cancer six times higher than other women. Age is an essential factor to consider for the need for health promotion. The age range from 15-25 is considered when HPV is most likely infected in a person, and over time, it becomes prevalent (Clarke et al., 2021). 

Age-related, behavioral, and biological factors can impact a person’s health. As HPV is a sexually transmitted disease, the peak of acquiring this infection is before 26 years of age. Behavioral patterns include the number of partners, unsafe intercourse, and polygamous relations, while biological aspects include a weak immune system or immunosuppressive injections that do not fight HPV effectively (Clarke et al., 2021).

Research has shown that gender-wise, women are diagnosed with HPV more than men, ethnically black women are more affected than white women, socially high class is affected less than middle and low class, and teenagers along with early adults have more chances of HPV-caused genital warts, cervical cancers, and non-cervical cancers (Amboree & Darkoh, 2020). Studies have also shown mental, financial, and emotional burdens on people realizing they have acquired a sexually transmitted disease. This highlights the development of effective health promotion plans to prevent HPV in young women (Naqvi & Gale, 2020). 

Factors Involved in Health Disparities

Multiple factors create disparities, such as race, age, sex, income, geography, and access to vaccination (Correl, 2023). Racially, black women have HPV-based cervical cancers more than white women. In sex, men are less likely to get infected, so they are also not taking preventive measures actively. Low-income households suffer more in terms of the impact of HPV and its prevention. Age-wise, the peak range to get infected is 15 to 25, but the chances of cancer diagnosis are till the age of 60 (Clarke et al., 2021). Geographically, the northern United States has fewer HPV than the southern. All these factors are involved in health disparities, and the attention and beliefs regarding these factors impact access and compliance to vaccination and screening. Minorities are generally treated with a negative attitude by healthcare physicians than their majority counterparts (Correl, 2023).

Agreed Upon Health Goals

In the health promotion plan, 22-year Maria, belonging to a minority group of Latina diagnosed with early-stage HPV cervical cancer, is facing emotional and physical challenges related to the infection and its treatment. Other related dimensions to her case include fear of misjudgment and rejection surrounding social stigma, and owing to rising healthcare costs, she is facing financial constraints as well. The SMART (Specific, Measurable, Achievable, Relevant, and Time) goals are developed to address her concerns and doubts about her treatment (White et al., 2020). These SMART goals will enable her to track her progress and guide Maria to achieve her goal of curing and preventing the re-emergence of HPV-backed cervical cancer. 

• The first goal is to reduce her financial expenses by up to 60% in the next six months by making her aware of insurance policies that can provide financial for medical treatment, as she has no economic means of treating her cancer on her own. 

This goal will be achieved through enrolling Maria in insurance programs and free community healthcare clinics offering screenings and treatments. It helps remove economic strain and promote economic well-being (Glenn et al., 2021). This goal is aligned with SMART goals as it explicitly targets her medical expenses concern for HPV treatment; it is measurable and achievable over six months, relevant to her concern, and time-bound. 

• Another goal is to educate Maria about HPV and break all myths related to the disease by conducting and attending workshops in-person and online. 

NURS FPX 4060 Assessment 1 Health Promotion Plan

After each workshop, Maria will assess her knowledge about her situation and how to overcome doubts. A small session at the end of the educational workshop, where the patient can ask any questions in her mind and better understand information (Khorram-Manesh et al., 2021). This goal also aligns with SMART goals as sexual information is not available in her society, so these workshops intend to educate her, with three to six workshops over three months. Online workshops are conducted to make it an achievable goal so she can easily access and attend these sessions. Relevant material was provided in workshops, and counseling was conducted to overcome her health issues. 

• The next goal is to educate Maria about support groups that will address her social fear and overcome social challenges through community support groups online.

After joining an online support group, she will not feel isolated and share the challenges of people with similar experiences. This goal is flexible but depends on Maria’s need for social support. Social support helps in empowerment, better implementation of treatment processes, and improved health outcomes (Haldane et al., 2019).  It will empower her to face her disease head-on. This goal aligns with the SMART goal because it intends to make her strong mentally, relevant to her fear of social stigma. 

• The last goal for Maria is to improve her emotional well-being through counseling. Therapy sessions are conducted every week for three months so she can communicate her emotional state while coping with disease prevention challenges.

NURS FPX 4060 Assessment 1 Health Promotion Plan

Community-based emotional support saves patients from economic stress, social isolation, or discriminatory services (Siddiqui et al., 2022). These also target different coping mechanisms, including physical activities. The goal aligns with SMART goals as they intend to target the emotional burden of HPV on her mental health. The goal is realistic as it is achievable over a specified period. The SMART goal was planned for over three months, during which commitment to continuous learning and empowerment was gained. After attending the educational workshop, Maria was able to deal with her condition confidently and actively improve her physical and mental health while availing community support in financial and emotional aspects.  

Conclusion 

This health promotion plan was vital for Maria to treat and prevent her HPV-based cervical cancer. Due to the unambiguous and having no symptoms of this disease, it was important as it affected the emotional and psychosocial aspects of her health. SMART goals help them identify the implications of HPV and how it can be prevented through vaccinations, safe intercourse practices, and screening tests. Maria was able to overcome anxiety, fear of social stigma, and guilt at the end of three months of educational workshops.

References 

Amboree, T. L., & Darkoh, C. (2020). Barriers to human papillomavirus vaccine uptake among racial/ethnic minorities: A systematic review. Journal of racial and ethnic health disparities. https://doi.org/10.1007/s40615-020-00877-6 

Barker, S. L., Maguire, N., Gearing, R. E., Cheung, M., Price, D., Narendorf, S. C., & Buck, D. S. (2021). A community-engaged healthcare model for currently under-served individuals involved in the healthcare system. SSM – Population health, 15, 100905. https://doi.org/10.1016/j.ssmph.2021.100905 

CDC. (2021, January 19). STD Facts – Human PapillomaVirus (HPV). CDC. https://www.cdc.gov/std/hpv/stdfact-hpv.htm 

NURS FPX 4060 Assessment 1 Health Promotion Plan

Clarke, M. A., Risley, C., Stewart, M. W., Geisinger, K. R., Hiser, L. M., Morgan, J. C., Owens, K. J., Ayyalasomayajula, K., Rives, R. M., Jannela, A., Grunes, D. E., Zhang, L., Schiffman, M., Wagner, S., Boland, J., Bass, S., & Wentzensen, N. (2021). Age‐specific prevalence of human papillomavirus and abnormal cytology at baseline in a diverse statewide prospective cohort of individuals undergoing cervical cancer screening in Mississippi. Cancer medicine, 10(23), 8641–8650. https://doi.org/10.1002/cam4.4340 

Correl, R. (2023, December 5). How health disparities can impact HPV-related cancers. Verywell health. https://www.verywellhealth.com/health-disparities-in-hpv-related-cancers-4173225#:~:text=Health%20disparities%20are%20differences%20in 

Elflein, J. (2023, August 31). Topic: Human papillomavirus (HPV) in the U.S. Statista. https://www.statista.com/topics/5094/human-papillomavirus-hpv-in-the-us/#topicOverview 

Galeshi, M., Shirafkan, H., Yazdani, S., & Motaghi, Z. (2022). Reproductive health needs of Human PapillomaVirus (HPV) positive women: A systematic review. PLOS one, 17(9), e0266819. https://doi.org/10.1371/journal.pone.0266819 

Glenn, N. M., Allen Scott, L., Hokanson, T., Gustafson, K., Stoops, M. A., Day, B., & Nykiforuk, C. I. J. (2021). Community intervention strategies to reduce the impact of financial strain and promote financial well-being: A comprehensive rapid review. Global health promotion, 28(1), 42–50. https://doi.org/10.1177/1757975920984182 

NURS FPX 4060 Assessment 1 Health Promotion Plan

Haldane, V., Chuah, F. L. H., Srivastava, A., Singh, S. R., Koh, G. C. H., Seng, C. K., & Legido-Quigley, H. (2019). Community participation in health services development, implementation, and evaluation: A systematic review of empowerment, health, community, and process outcomes. PLOS one, 14(5). https://doi.org/10.1371/journal.pone.0216112 

Khorram-Manesh, A., Dulebenets, M. A., & Goniewicz, K. (2021). Implementing public health strategies—The need for educational initiatives: A systematic review. International journal of environmental research and public health, 18(11), 5888. https://doi.org/10.3390/ijerph18115888 

Kim, J. J., Simms, K. T., Killen, J., Smith, M. A., Burger, E. A., Sy, S., Regan, C., & Canfell, K. (2021). Human papillomavirus vaccination for adults aged 30 to 45 years in the United States: A cost-effectiveness analysis. PLOS medicine, 18(3), e1003534. https://doi.org/10.1371/journal.pmed.1003534 

Naqvi, R., & Gale, O. (2020). Preventative health screening community events, a mechanism to target minority ethnic populations in improving primary care utilisation to improve health outcomes. British journal of general practice, 70(suppl 1), bjgp20X711005. https://doi.org/10.3399/bjgp20x711005 

Siddiqui, S., Morris, A., Ikeda, D. J., Balsari, S., Blanke, L., Pearsall, M., Rodriguez, R., Saxena, S., Miller, B. F., Patel, V., & Naslund, J. A. (2022). Scaling up community-delivered mental health support and care: A landscape analysis. Frontiers in public health, 10. https://doi.org/10.3389/fpubh.2022.992222 

Vorsters, A., Bosch, F. X., Poljak, M., Waheed, D.-N., Stanley, M., & Garland, S. M. (2022). HPV prevention and control – The way forward. Preventive medicine, 156, 106960. https://doi.org/10.1016/j.ypmed.2022.106960 

White, N. D., Bautista, V., Lenz, T., & Cosimano, A. (2020). Using the SMART-EST goals in lifestyle medicine prescription. American journal of lifestyle medicine, 14(3), 271–273. https://doi.org/10.1177/1559827620905775 

WHO. (2022). Cervical cancer. www.who.int.  https://www.who.int/news-room/fact-sheets/detail/cervical-cancer 

WHO. (2023, August 23). Human papillomavirus and cancer. www.who.int. https://www.who.int/news-room/fact-sheets/detail/human-papilloma-virus-and-cancer 

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