This paper is based on everything posted below the intervention design i include the work that your writers had written so there may be some consistency in writing the Intervention Plan design.
Intervention Plan Design:
While the literature review focused on the research, this assignment starts to move you into applying evidence to practice. Use the material from your Problem Statement and Literature Review to create a high-level design of your intervention plan and provide supporting references. Your design should include the following elements:
Need Statement—Summarize the elements of your Problem Statement to clearly articulate your identified need and the context for your intervention plan.
Intervention Plan Components—Define the major components of your intervention plan and how they correlate to your chosen intervention or strategies you selected from the research.
Population and Setting—Explain the impact of the cultural needs and characteristics of your target population and setting on your intervention plan design. Be sure to identify the impact of resources available and constraints specific to your target population on your design.
Stakeholders, Policy, and Regulations—Describe how your identified stakeholder needs and applicable healthcare policy, regulations, and governing bodies impacted your intervention plan design.
Ethical and Legal Implications—Explain any relevant ethical and legal issues related to practice and change. Describe any applicable conflicts of interest, ethical dilemmas, or legal issues, and explain how you addressed them in your intervention plan design. Describe how you made decisions in your design to align with your personal ethics, stakeholder perspectives, and organizational ethical standards.
Theoretical Foundations—Apply and describe the supporting theoretical nursing model and strategies from other disciplines you selected to design your intervention plan. Explain how the model and strategies are being used in your intervention.
Management and Leadership—Apply and describe strategies for leading, managing, and implementing your intervention plan. Explain why you selected the strategies and how you will use them to influence, gain support, and implement your plan.
Delivery—Identify your delivery method for your intervention plan, including any technological options.
Evaluation of Plan—State your refined outcome and define how you will evaluate the impact of the plan. Apply and describe any specific evaluation models you will use.
Research—Continue to integrate research from diverse sources to support your Intervention Plan Design.
Communication—Clearly, concisely, and cohesively articulate the components of your Intervention Plan Design.
Here is my problem statement:
There is a big disparity in the spread of HIV/AIDS in the US. According to a study by Advocates for Youth (2012), African American and Latina women accounted for seventy-nine percent and seventy-five percent of all new infections of women aged 13-19 and 20-24 years respectively. Moreover, black women and Latina women comprise sixty percent and nineteen percent of all AIDS cases respectively. Although the fact is that this group of women represent fourteen percent and twelve percent respectively. This shows how much disparity exits in the spread. An intervention measure is urgently required to reduce the number of new infections in among the African American and Latina women in the US. This is a problem statement and will only identify the magnitude of the problem and the issues surrounding it.
The stakeholders who are against the HIV/AIDS epidemic include healthcare professionals, any group or organization, the government and Non-governmental organizations system. The CDC would also be interested in this project reducing the number of infections per year among African American and Latina, improving the health situation of those individuals who are already infected with HIV/AIDS, to reduce disparities in health that are associated with HIV/AIDS and to work towards a more coordited response among the young women of color. Targeting African American and Latina women will highly impact the role of HIV and AIDS among women. As shown above, they comprise a majority of all HIV/AIDS cases along with new infections among women. The intervention should be developed such that it meets all medical requirements. This is required to be a medical form of intervention. While sharing of information is vital, other aspects like the use of anti-retroviral therapy (ARTs) used for treatment that can prolong and improve their lives are a similarly important aspect of intervention.
Various ethical and legal issues surround HIV and AIDS. First, while they are the most affected, it may seem improper to target them especially in institutions where multiple races are treated. It is unethical to target anyone race for treatment even when the statistics show a direct need to do so. Secondly, the spread of HIV requires that information be shared. It would be important to encourage infected individuals to share information about their statuses with their sexual partners. This will initiate more caution in the future. However, it is unethical to inform such spouses even if their lives were threatened. While it would help save the lives of many people, health practitioners are not allowed to share the information of their patients without the consent of their patients. Legally, any discrimination would be termed improper. On the other hand, different states require that people inform their past and present sexual partners about their HIV status as soon as they test positive. Failure to do so would amount to a criminal act and, therefore liable to prosecution.
Reports show that different factors contribute to the prevalence of HIV between the two groups. First, there is the increase in the number of gays in both communities. The prevalence is higher among blacks. Blacks contributed to over fifty-eight percent of all cases of HIV spread between men (The Foundation for AIDS Research, 2010). According to Advocates for Youth (2012) report, seventy-seven percent of all new infections comprised of males. Most of the male cases diagnosed were attributed to gay sexual contact. Second, the aspect of multiple partners was especially widely accepted among Latinos. This has helped in the spread of the virus. According to Advocates for Youth (2012), a majority of new infections among women was attributed to heterosexual contact among youthful women.
The risk of contracting HIV through male-to-male sexual contact has been on the rise over the period between 2006 and 2009. The number of cases of infection among African American young men who had sex with other men had increased by forty-eight percent in the period between 2007 and 2010 (CDC 2012). This later impacted on women who had sexual contact with such men. There is an urgent need to take care of those people who are most likely to be infected in these methods.
Another issue that is common between both communities is dating violence. Various issues are at play here. Dating violence was common in twenty percent of the youths reported (CDC 2012). In such situations, women found it difficult to negotiate for condom use. It was therefore less likely for protective sex to be experienced among the population that experienced dating violence.
The presence of other sexually transmitted infections also contributed to the spread of HIV. It was noted that those who have STIs are at a higher risk of contracting HIV. African American and Latino youths showed a higher prevalence of both Chlamydia and Gonorrhea. These infections therefore also contributed to the spread of HIV (CDC 2012). Women are more likely to be infected during virginal sex than men.
Expected outcomes of intervention
All attempts to intervene should be three-pronged or approached from three directions, methods, simultaneously toward solving this problem. First, they should attempt to lower of new infections. If the number of infections is reduced, the impact of HIV will be largely impacted. Second, it should identify methods of managing the infection among those affected. It is important to ensure that those infected are and identified are given ethical and proper treatment. Finally, the intervention should attempt to increase the number of people who are tested and, therefore, know their statuses. People who know their statuses are likelier to take better care of their health. This will impact more on the spread and care of such persons.
In concluding, I have briefly discussed the problem statement surrounding the issues of HIV/AIDS between African American and Latina individuals, stakeholders, ethical issues, research and expected outcomes of interventions for this population.
Centers for Disease Control and Prevention (CDC). (2012). Vital signs: HIV infection, testing, and risk behaviors among youths-United States. MMWR. Morbidity and mortality weekly report, 61(47), 971.
Advocates for Youth (2012). Young Women of Color and the HIV Epidemic
Kaiser Family Foundation, (2014). ‘Black Americans and HIV/AIDS’. http://www.kff.org/hivaids/fact-sheet/black-americans-and-hiv-aids/.
The Foundation for AIDS Research, (2010). Youth and HIV/AIDS in the United States: Challenges and Opportunities for Prevention
Here is my literature review:
HIV/AIDS Between African American and Latina Women: Literature Review
Describe the historical context and justify a need within a target population (HIV/AIDS population in blacks and Latina youth and young adults) and setting
Research has shown that there is an alarming disparity in the spread of HIV/AIDS in the US, with regards to race and gender. For instance, African American and Latina women account for the highest percentage of those infected, approximately seventy nine percent and seventy five percent respectively (Long-Middleton, et al., 2013). On the other hand, age is also a determining factor in the prevalence of HIV/AIDS, and as identified by Williams, Glover, Wyatt, Kisler, Liu, and Zhang (2013), women aged between 13-24 years are the ones at the highest risk. Furthermore, black and Latina women have been proven to comprise of approximately sixty percent and nineteen percent of all HIV cases in the United States. These disparities only serve to show one thing: there are inadequate intervention measures that have been taken to curb the spread of the menace among the population. It is imperative to understand the reason behind this alarming disparity, so as to be able to come up with salient solutions to reduce the spread. This literature review delves into the historical context of the disparity in the spread of HIV among the target population, that is African American and Latina women, reviews the intervention measures that have so far been applied; the prevailing constraints; and critiques the potential theoretical nursing models and strategies from other disciples to provide a framework for the proposed intervention.
Validate and refine the outcome for a health promotion, prevention, or management plan. Select and critique potential intervention strategies and solutions for a need, target population, and setting
A study conducted by Edberg, Collins, Harris, McLendon, & Santucci, (2009), acknowledges that their exist huge disparities in the spread of HIV in the US. The group of researchers posits that the history of the spread of the virus is one that has evolved, but which has kept its boundaries within certain social settings. The understanding of this phenomenon is imperative to the successful development of amicable strategies of intervention. The study revealed that cases of HIV, STIs, substance abuse, and many others related diseases are a consequence of lack of structured and fully victim-centric approaches to curb the spread. Lee, Dancy, Florez, and Holm, (2013) bolster this same analogy by indicating that African American and Latino women are more strategically poised to experience elevated levels of HIV spread. The team further went ahead to give various reasons why such disparity exists. It was revealed that the spread involves a continuum of numerous factors, including religion, familialism, and lack of relevant knowledge/information, gender roles, and confidentiality/privacy. Specifically, gender roles and lack of knowledge were found to be the leading contributors to this menace. According to this study, health care professional should give more attention and focus to providing relevant knowledge on HIV intervention measures, and educating the target population on the contribution of gender roles to the spread. In line with the interventions that were identified earlier in this proposal, these studies supporting evidence on the efficacy of such measures. For instance, Jackson and Pittiglio (2012), in their article ‘Reducing HIV in Michigan African American Young Adult Women’ identified various strategies that can be used to reduce the spread of HIV/AIDS among the target population. The duo posits that all attempts to intervene should be three-pronged. First, health practitioners should attempt to lower new infections. If the number of infections is reduced, the impact of HIV will be largely impacted. Second, they should identify methods of managing the infection among those affected. It is important to ensure that those infected are identified and given ethical and proper treatment. Finally, the intervention should attempt to increase the number of people who are tested and, therefore, know their statuses. People who know their statuses are likelier to take better care of their health. This will impact more on the spread and care of such persons. Under each category of intervention, there are a number of specific strategies that can be applied to ensure that the spread of HIV is curbed. As Warren, Harvey, and Agnew (2012) elucidate, more advanced forms of interventions can be applied, such as stress-focused interventions and general health promotion interventions.
While there are a plethora of interventions that have been proposed and adopted before to curb the spread of HIV as well its disparity, quite a number have failed to meet their set objectives. This is because there are a number of constraints that present themselves in the process of implementing such intervention strategies. For instance, it has been largely hypothesized that gender roles is one of the leading factors promoting the spread of the disease among the population under study (Martinez, Harper, Carleton, Hosek, Bojan, Glum, & Ellen, 2012). While this may be a practical problem, a realistic solution or intervention has not been found.
Select and critique potential theoretical nursing and strategies form other disciples to provide a framework for practice
According to Orem’s Self Care Theory, the nursing process is one that presents a method to determine deficits in self-care, and define each participant’s role in meeting those demands. In respect to the proposed strategy to reduce disparity in the spread of HIV among the target population, this theory is crucial in streamlining issues and roles for each person in the advent of achieving the set objectives (Jackson and Pittiglio, 2012). Since Orem lays emphasis on the technological component of the self-care process, as one that must be augmented with interpersonal and social processes, it is imperative that stakeholders mentioned above adopt the use of technology in implementing the proposed change. Orem’s theory stands out as one that is very applicable in this scenario.
Establish potential legal and ethical issues, conflicts, and dilemmas in defining, developing, and implementing change.
As earlier identified in the preceding sections of this proposal, there are various stakeholders that come to play in the advent of reducing the disparity in the spread of HIV among the target population. According to Davis and Galvan, (2012), stakeholders include the government and non-governmental organizations. In addition, the CDC would also be interested to be party to the project in case it would seek to reduce the number of infections per year among African American and Latina women. It will further enjoin itself in the program if it aims to improve the health situation of those people who are already infected with HIV/AIDS, reduce disparities in health that are associated with HIV/AIDS, and to work towards a more coordinated response among the young women of color. Stakeholder needs, healthcare policies, regulations, and governing bodies that are relevant to this research mainly center on those whose aim is to reduce mortality cases related to the spread of communicable infections. Various stakeholders, as revealed by Andrinopoulos et al. (2011), who target healthcare projects usually have a mundane objective of preventing deaths, and reducing the level of infections that result from pandemics such as HIV. In this case, research has shown the government has put in place various policies and regulations to help reduce HIV prevalence among the US citizens. However, it is still unclear why there is so much disparity in this spread, despite the fact that the interventions are applied uniformly across the States. Gaining of this understanding will form the pinnacle of this research, since it is clear that such a revelation will undoubtedly be indispensible in a quest to offer and achieve a holistic reduction of HIV spread among all citizens.
George, Duran, and Norris, (2014) in their study ‘A Systematic Review of Barriers and Facilitators to Minority Research Participation Among African Americans, Latinos, Asian Americans, and Pacific Islanders’ identified that there are a number of ethical issues conflicts, and dilemmas that arise when defining, developing, and implementing an intervention plan for HIV/AIDS. For instance, owing to the fact that it is the African American and Latina women who are mostly affected by the spread, it is not an easy thing pointedly targeting them with the proposed intervention plans. When such plans are made public in the media, they develop some sort of stigma towards these people, and they as the victims may develop resistance towards such measures. Edwards, Irving, Amutah, & Sydnor (2012) reiterate this point by saying that inasmuch as the African American and Latina women may be the most culpable victims of the spread of HIV, an individual within such social setting may not appreciate the magnitude of the issue, and will, therefore, not appreciate the importance of intervention measures being administered. In addition, one of the most prolific ethical issues, as recorded by Jackson and Pittiglio, (2012) in their research, is the issue of information sharing. Cornelius, Cornelius, and White (2013) posit that it is important to freely share information, especially in healthcare settings in order to get help. However, victims among the targeted population, to whom these interventions are geared, may consider the aspect of information sharing as breach of their privacy. This also raises a legal issue, and may health practitioners and patients have been involved in legal tussled as a result of this same issue. While the United States legislation provides protection for the right to privacy and confidentiality for individuals, including cases such as HIV/AIDS, some other states do not offer such a protection, and a commendable reduction in prevalence has been recorded (Starr, Donenberg, & Emerson, 2012). In the intervention plan proposed in this study, it would be more effective to include the overarching role of the government, policy makers, and governing bodies to enact rules that can eliminate or soften some of the legal restrictions that have been allowed in the past.
Potential management and leadership strategies to influence, gain support for, and implement change
As identified in the literature above, the contribution of stakeholders is a key element in ensuring that the spread of HIV in the target population is achieved. There are various leadership strategies that can be employed to make this a success. For instance, leaders must be collaborative and empathetic to the victims, so that they get to understand their problems. In addition, they must be able to form crucial social links or rapport with the target population. The ability of the leadership and the management to make the population realize the importance of the change strategies is an important aspect, which, according to Starr, Donenberg, and Emerson, (2012), has not been adequately achieved. These must be incorporated to ensure successful implementation of the proposed changes.
Literature Gap and Future Research
While the literature reviewed above provide a comprehensive historical and theoretical framework regarding the spread of HIV/AIDS among African American and Latina women, notable gaps still exist. Practically, the literature fails to establish the main framework behind the alarming disparity in the spread of HIV/AIDS among the targeted population. The data that has been provided only serve to highlight the general factors that promote the spread of the disease, as well as the interventions applied and the constraints experienced. There is need to focus on the target population, understand there unique needs, factors that predispose them more to the spread, and be able to come up with tailored interventions measures to address their plight. This will be the basis of this research.
Concluding, I briefly described the historical context and justified a need within the targeted population and setting, validated and refined the outcome for a health promotion, prevention, or management intervention plan, selected and critiqued potential theoretical nursing models and strategies fro other disciplines to provide a framework for practice, as well as potential intervention strategies and solutions for a need, target population and setting. There was a brief discussion regarding the implications of the stakeholder needs, healthcare policy, regulation, and governing bodies regarding the targeted population. This literature also identified potential legal and ethical issues, conflicts and dilemmas in defining, developing, and implementing change as well as management and leadership strategies to influence, gain support and implementing change and lastly evaluating and synthesizing resources from diverse sources that support evidence-based nursing practice.
Andrinopoulos, K., Clum, G., Murphy, D. A., Harper, G., Perez, L., Xu, J., & … the Adolescent Medicine Trials Network for HIV/AIDS, I. (2011). Health Related Quality of Life and Psychosocial Correlates between HIV-Infected Adolescent and Young Adult Women in the US. AIDS Education & Prevention, 23(4), 367-381.
Cornelius, J. B., Cornelius, M. D., & White, A. C. (2013). Sexual communication needs of African American families in relation to faith-based HIV prevention. Journal Of Cultural Diversity, 20(3), 146-152.
Davis, E. M., & Galvan, F. H. (2012). Alcohol Use Among HIV-Positive Latinas and African American Women. Affilia: Journal Of Women & Social Work, 27(4), 435.
Edberg, M. C., Collins, E., Harris, M., McLendon, H., & Santucci, P. (2009). Patterns of HIV/AIDS, STI, substance abuse and hepatitis risk among selected samples of Latino and African-American youth in Washington, DC. Journal Of Youth Studies, 12(6), 685-709.
Edwards, L. V., Irving, S. M., Amutah, N. N., & Sydnor, K. D. (2012). Am I My Mother’s Keeper? Children as Unexpected Sources of Social Support Among African American Women Living With HIV-AIDS. Journal Of Black Studies, 43(5), 571.
George, S., Duran, N., & Norris, K. (2014). A Systematic Review of Barriers and Facilitators to Minority Research Participation Among African Americans, Latinos, Asian Americans, and Pacific Islanders. American Journal Of Public Health, 104(2), e16-e31.
Jackson, F., & Pittiglio, L. (2012). Feature: Reducing HIV in Michigan African American Young Adult Women. Journal Of The Association Of Nurses In AIDS Care, 23521-530.
Lee, Y., Dancy, B., Florez, E., & Holm, K. (2013). Factors Related to Sexual Practices and Successful Sexually Transmitted Infection/ HIV Intervention Programs for Latino Adolescents.Public Health Nursing, 30(5), 390-401.
Long-Middleton, E. R., Burke, P. J., Cahill Lawrence, C. A., Blanchard, L. B., Amudala, N. H., & Rankin, S. H. (2013). Article: Understanding Motivations for Abstinence Among Adolescent Young Women: Insights Into Effective Sexual Risk Reduction Strategies. Journal Of Pediatric Health Care, 27342-350.
Martinez, J., Harper, G., Carleton, R. A., Hosek, S., Bojan, K., Glum, G., & Ellen, a. J. (2012). The Impact of Stigma on Medication Adherence Among HIV-Positive Adolescent and Young Adult Females and the Moderating Effects of Coping and Satisfaction with Health Care. AIDS Patient Care & Stds, 26(2), 108-115.
Starr, L. R., Donenberg, G. R., & Emerson, E. (2012). Bidirectional Linkages Between Psychological Symptoms and Sexual Activities Among African American Adolescent Girls in Psychiatric Care. Journal Of Clinical Child & Adolescent Psychology, 41(6), 811-821.
Warren, J. T., Harvey, S. M., & Agnew, C. R. (2012). One Love: Explicit Monogamy Agreements among Heterosexual Young Adult Couples at Increased Risk of Sexually Transmitted Infections.Journal Of Sex Research, 49(2/3), 282-289.
Williams, J. K., Glover, D. A., Wyatt, G. E., Kisler, K., Liu, H., & Zhang, M. (2013). A Sexual Risk and Stress Reduction Intervention Designed for HIV-Positive Bisexual African American Men With Childhood Sexual Abuse Histories. American Journal Of Public Health, 103(8), 1476-1484.
Here is the nursing model/theorectical frameworks:
The Health Belief Model
The Health Belief Model or HBM was established in the 1950s by social psychologists Hochbaum, Rosenstock, and Kegels within the US Public Health Services (Current Nursing, 2013). This model was established in an attempt to shed light on the prevalent failure of individuals towards taking action to prevent contracting a disease. It has been established that people take preventive measures towards avoiding a disease if they feel that they would be susceptible to the illness or if the illness is regarded as severe (Monica et al., 2003). Additionally people take the necessary preventive actions if they have a view that it would be beneficial in decreasing the disease’s susceptibility or severity, and if they are of the view that the predictable barriers towards taking action are outweighed by benefits.
For a majority of the African American as well as Latino women with regards to HIV/AIDS prevention through the usage of a condom, the perceived benefits of condom use outweighs the threat of contracting the disease. For instance, producing a condom might suggest mistrust issues, thus, leading to more unstable relationships (Gilbert et al., 2009). Studies have shown that African Americans as well as Latino women view condoms as being an obstruction to lover spontaneity, a distractions to sexual pleasure and unromantic. Both groups associate condom usage to casual relationships, emotional intimacy rejection as well as infidelity (Monica et al., 2003). Every one of the above things occurs in spite of the immense information regarding the risks of failure to use condoms along with the effects of HIV/AIDS. Additionally, these attributions take place despite the actuality that the African American along with Latina Women accounts for a majority proportion of the entire women with AIDS within the US. This kind of mindset as well as attitude within the two groups warrants a comprehensive health education plans through identification of the potential action taking cues in addition to assisting them see the benefits of using condoms and the risks of having unprotected sex.
The Self-Care Model
Dorothea Orem is the author of this model, which was published in 1971and applicable to nurses, and the advancement of nursing sciences. Orem defines nursing as the profession of people in service and consists of three nursing processes. First the nurse needs to determine a patients needs, second the nurses care of delivery, and is the action and management of the nurses care plan. Orem theory is categorized into three general sub-theories; self-care, self-care deficit and the nursing system theory.
The purpose of Orem’s theory is to propose an individual to take action and responsibility to regulate one’s development and function as well as to sustain one’s life and health. (McEwen & Wills, 2011).
The self-care model asserts that every person ought to be self-reliant as well as responsible for his or her individual care. It refers to the practice of activities, which will maintain as well as foster self-wellbeing. With regards to the prevention of HIV/AIDS spread among African American and Latina women, efforts require to be made to enhance their self-care initiatives (McElligott, 2010). It has been established that the two groups of women take little care towards themselves; they are greatly loyal to their men spouses. Additionally, Latina and African American women are known to live carefree lives that mainly are geared towards having unprotected sexual contact.
Thus, a campaign of assisting the two groups establishes that self-care should be carried out. This is for the reason that though all other sensitization programs are carried out, the basis for long standing prevention lies on self-care initiatives. Thus, the women training require making them aware of the importance of avoiding hazards of life. The self-care model in addition fosters and supports interaction within social groups (McElligott, 2010). It is through social groups that individuals will be able to discuss issues regarding self-care, and also train themselves. To stop HIV/AIDS spread within African American as well as Latina women calls for increase in sensitization of self-care through avoidance of having unprotected sex. Further, the younger women from the two communities should be urged to abstain from sexual behaviors as a practice of self-care (Gilbert et al., 2009). Those who already have the disease can be advised to practice self-care by eating proper food as well as taking the prescribed drugs in addition to avoiding unprotected sex.
Gilbert, L. et al. (2009). Addressing the Unique Needs of African American Women in HIV Prevention. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2679773/
Health Belief Model. (2013) Current Nursing. Retrieved from http://currentnursing.com/nursing_theory/health_belief_model.html
McElligott, D. (2010). The Effect of a Holistic Program on Health-Promoting Behaviors in Hospital Registered Nurses. Retrieved from https://fpb.case.edu/News/Docs/ClickMorris_HolisticNursing2010.pdf
McEwen, M., & Wills, E. (2011). Theoretical Basis for Nursing. (3rd. Ed.), Lippincott Williams & Wilkins
Monica, S. et al. (2003). Factors Related To Condom Use Among Sexually Active African American Females Using the Health Belief Model Constructs. Retrieved from http://trace.tennessee.edu/cgi/viewcontent.cgi? article=3738&context=utk_graddiss
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