NR717 Week 2 ErnestYoung Epidemiology and Health Surveillance Discussion Example Provided
Purpose
The purpose of this discussion is to apply concepts in epidemiology and health surveillance to a selected population.
Instructions
Explore the determinants of health and the National Practice Problems that most affect the population you selected in Week 1. Review the following index to locate an epidemiological report published by the Centers for Disease Control and Prevention (CDC).
Link (website): CDC A-Z IndexLinks to an external site.
This report contains data on specific diseases as reported by state and regional health departments, as well as recommendations that have been issued by the CDC.
Use the index to review the most significant issue pertaining to your selected population and one of the eight National Practice Problems to address the following:
Explore the epidemiologic principles and measures used to address your selected practice problem at the national and specific geographic (city or county level) location for the population you have selected.
Examine the use of descriptive and/or analytic epidemiology to address the practice problem.
Propose how you might use surveillance to influence the determinants of health and improve the health outcomes of your population.
Anticipate any ethical concerns that you might have related to the use of surveillance data in your population.
Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:
Link (webpage): DNP Discussion GuidelinesLinks to an external site.
Program Competencies
This discussion enables the student to meet the following program competencies:
Analyzes health care policies to advocate for equitable health care and social justice to all populations and those at risk due to social determinants of health. (POs 2, 9)
Translates a synthesis of research and population data to support preventative care and improve the nation’s health. (PO 1)
Leads others in professional identity, advanced clinical judgment, systems thinking, resilience, and accountability in selecting, implementing, and evaluating clinical care. (PO 1)
Course Outcomes
This discussion enables the student to meet the following course outcomes:
Synthesize ethical and legal principles to advocate for value-based, equitable, and ethical health policies at the micro, meso, and macrosystem levels. (PC 5; PO 9)
Assimilate epidemiology principles and interventions to impact the social determinants of health, Global Burden of Disease, and population health outcomes. (PCs 7, 8; PO 1)
NR717 Week 2 ErnestYoung Epidemiology and Health Surveillance Discussion Example
Epidemiologic Principles and Measures Used
The health problem selected for the population is health disparities among African Americans in Jackson, Mississippi. Understanding social determinants of health, adopting a lifespan perspective, and creating culturally sensitive interventions are the epidemiological principles used to reduce racial health inequalities (Celentano & Szklo, 2019). The methodology includes analyzing data from population-based surveys on factors such as community environment, incidences, and death rates (Celentano & Szklo, 2019). For instance, because they are less likely to have access to good schools and medical facilities, young black men have a death rate five times greater than young white men.
Use of Descriptive and Analytic Epidemiology
Descriptive epidemiology seeks to understand the nature of health inequalities and the factors contributing to their existence, such as patient and provider demographics and care availability (Platt, 2022). How widespread an illness is, how it varies with age and gender, and whether or not there are any trends can all be answered using this information. On the other hand, analytic epidemiology studies aim to verify a hypothesis on the etiology of health inequalities (CDC, 2019). The goal is to disentangle variations in risky practices or underlying genetic traits from those individuals linked with exposure.
Use of Surveillance to Influence the Determinants of Health
Surveillance would help me take samples from various neighborhood regions and compare them to those from other parts to detect issues in the population and develop viable remedies. This can aid in diagnosing health problems, allowing the most appropriate actions to be implemented. Additionally, it can help identify the intervention requirements and track their success (Celentano & Szklo, 2019). This can be useful for determining if the currently used intervention is working as planned or if it needs to be modified.
Ethical Concerns
The collected and analyzed data should be able to benefit all individuals who have been studied. It is unethical that results from research benefit only a few community members. It is ethically sound to inform the target population about the findings and how well they can utilize them to achieve positive health outcomes.
References
Celentano, D., & Szklo, M. (2019). Gordis epidemiology (6th ed.). Elsevier.
Center for Disease Control and Prevention. (2019). Principles of epidemiology. Accessed on March 5th from https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section7.html
Platt, W. (2022). The importance of descriptive epidemiology. American Journal of Epidemiology. https://doi.org/10.1093/aje/kwac153
Johns Hopkins Nursing Evidence-Based Practice Appendix G: Individual Evidence Summary Tool
Practice Question: Does perceived racial discrimination in African Americans contribute to poor health, obesity, decreased physical activity, and health disparities?
Date: 03/19/
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Article Number |
Author and Date |
Evidence Type |
Sample, Sample Size, Setting |
Findings That Help Answer the EBP Question |
Observable Measures |
Limitations |
Evidence Level, Quality |
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Nam, Jeon, S., Ash, G., Whittemore, R., & Vlahov, D. (2021).
Racial Discrimination, Sedentary Time, and Physical Activity in African Americans: Quantitative Study Combining Ecological Momentary Assessment and Accelerometers
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Quantitative Intensive, observational, case-crossover design. Non-experimental
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The inclusion criteria were self-reported African American or Black, aged between 30 and 55 years, currently employed, ownership of a smartphone, able to respond to smartphone-based random survey prompts at least 3 times per day, and English speaking.
The sample size (n=12) was largely based on guidelines for pilot studies that suggest 10 to 40 participants per cell.
At the baseline visit, they loaded the mEMA app, which is compatible with both iOS and Android operating systems, into each participant’s smartphone. Participants were instructed to wear an accelerometer on their right hip during waking hours for 7 consecutive days to obtain at least three weekdays and one weekend day to determine the daily variability. A paper diary was provided, and participants were instructed to fill out the diary on the time they took off (eg, shower) and wore their accelerometers.
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In the examination of within-person level data, on days when participants reported more perceived racial discrimination than usual, more sedentary time was observed in the accelerometer data. The between-person analysis did not duplicate this finding in the study. However, this is consistent with the findings of between-person analysis in a prior study examining the relationship between general psychological stress and sedentary behaviors in other populations: end-of-day general stress ratings were not associated with sedentary time in the between-person analysis. Although findings are mixed, previous studies have shown that neighborhood environments such as walkability, safety, or crime were associated with individuals’ PA levels in the general population. |
Researchers collected repeated real-time racial discrimination exposure data in the natural environment while simultaneously collecting objective measures of sedentary behaviors and PA among African Americans. They also demonstrated the utility and feasibility of EMA coupled with accelerometers in studying the relationship between daily racial discrimination and PA in African Americans. Conventional accelerometer protocols require only 4 valid days for a 7-day wear period to be considered valid. Approximately 83% (10/12) of the participants met the inclusion requirement for valid accelerometer data (≥10 hours/day wear time) and wore the accelerometer 6 out of 7 days, and they also showed high adherence to the EMA protocol.
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Compared with other studies of general psychological stress, the small sample size offered limited evidence supporting racial discrimination as an antecedent to sedentary behaviors or PA. EMA minimizes recall bias and errors. However, it is also possible that the study findings may have been influenced by vigilance to discrimination from the repetitive assessment involved in EMA. In addition, the high CES-D scores observed in the participants may have influenced the associations with perceived racial discrimination or PA. Further studies are needed to confirm the observed findings in light of the limitations of this study, including its small sample size. |
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Attach a reference list with full citations of articles reviewed for this Practice question.
NR717 Week 3: Prevention, Interventions, and Population Health Programs
Population Health Interventions Discussion
Purpose
The purpose of this discussion is to demonstrate your understanding of interventions to address population health problems and reduce health disparities.
Instructions
Using your selected population, continue your search and appraisal of evidence by analyzing one research study that offers a potential intervention to address your selected population health issue. This intervention must be at the population level. This research study must be new, one that was not used in a previous course.
Appraise a quantitative research study that utilizes an intervention to address the selected health issue identified in Week 2 using the Johns Hopkins Research Appraisal Tool.
- Johns Hopkins Research Appraisal Too https://cdn.brandfolder.io/74235FBJ/as/6f2mgbk5h7bpfnk85t6pgwm/Johns_Hopkins_Research_Appraisal_Tool.docx
- Transfer your findings to the Johns Hopkins Individual Evidence Summary Tool.
Johns Hopkins Individual Evidence Summary Tool https://cdn.brandfolder.io/74235FBJ/as/n32gvzkm765pvb7b5cjp5m5s/Johns_Hopkins_Individual_Evidence_Summary_Tool.docx
Analyze the evidence summary tool of the research study to address the following in the discussion:
- Determine whether the intervention has the potential to impact the issue. Explain your rationale.
- Attach the completed Johns Hopkins Individual Evidence Summary Tool.
- Present the translation science model that would best aid the success of this intervention and discuss how the stakeholders are integrated into the design of the theory or model.
- Identify where your selected intervention is located on the Minnesota Public Health Wheel.
Program Competencies
This discussion enables the student to meet the following program competencies:
- Translates a synthesis of research and population data to support preventative care and improve the nation’s health. (PO 1)
- Leads others in professional identity, advanced clinical judgment, systems thinking, resilience, and accountability in selecting, implementing, and evaluating clinical care. (PO 1)
Course Outcomes
This discussion enables the student to meet the following course outcomes:
- Assimilate epidemiology principles and interventions to impact the social determinants of health, Global Burden of Disease, and population health outcomes. (PCs 7, 8; PO 1)
- Formulate strategies for providing culturally relevant and high-quality healthcare to vulnerable and high-risk populations to address social injustice and health inequities. (PCs 7, 8; PO 1)