Advocating for Policy Change to Improve Health Outcomes in the Community
Advanced Professional Nurse as Advocate
An APN’s advocacy for their patients and vulnerable groups is crucial. However, advanced practice nurse advocates for these groups in somewhat different ways. The APN prioritizes health equity and social justice while advocating for vulnerable populations by tackling the socio-economic determinants of health that exacerbate existing health inequalities.
The American Nurses Association (ANA) stresses the need for APNs to understand their at-risk patients’ cultural norms, socio-economic factors, and medical requirements. Culturally relevant health education and resources must be provided, and they must engage with the community to identify and resolve health inequalities and promote health equality (ANA, 2021).
However, while advocating for a particular patient and their family in a clinical setting, the APN’s top priorities are to promote patient autonomy, encourage involvement in treatment planning, and defend legal rights. An APN’s job is to provide patients access to information so they may make educated decisions about their healthcare that respect their values and priorities.
Furthermore, the APN works with the rest of the healthcare team to individualize each patient’s care plan (Buppert, 2021). As such, an APN’s responsibility as an advocate for marginalized populations is to promote health equity. The APN’s role as an advocate for individual patients is to promote patient autonomy and informed decision-making.
Collaborating across disciplines is essential for providing excellent treatment to patients. When it comes to encouraging teamwork among the many members of a healthcare team, an advanced practice nurse (APN) is essential. An advanced practice nurse may encourage teamwork across disciplines by using the following two methods supported by research:
First and foremost, it is essential to communicate clearly with one another to foster cooperation across different professions. According to research by Schot et al. (2019), effective communication among healthcare professionals is crucial for collaborative practice. An APN may improve team communication by instituting practices including frequent team meetings, huddles, and the utilization of communication technologies. These methods promote collaboration, which ultimately benefits patients.
Clarifying roles is another crucial tactic for fostering cooperation across disciplines. California Department of Health Care Services (n.d.) found that when roles across disciplines are made clear, it improves patient collaboration and care. An advanced practice nurse may help the healthcare team define each member’s duties. This method may clarify responsibilities, boost teamwork, and improve patient health. Therefore, effective communication and role definition are two evidence-based tactics that an APN may utilize to encourage interprofessional cooperation within a healthcare team.
Data-Driven Health Issue
Obesity in adults is a severe epidemic in many parts of the world. The Centers for Disease Control and Prevention (CDC) defines obesity as a body mass index (BMI) of 30 or above. Obesity is a severe problem for society because of its dangers to people’s health, such as higher rates of heart disease, stroke, diabetes, and even certain forms of cancer (Endalifer & Diress., 2020). Obesity is associated with an increased risk for chronic health problems such as diabetes, cancer, and hypertension (Bendor et al., 2020). In addition, unlike these health conditions, obesity is preventable through medical and non-medical interventions.
Statistics show that obesity is a serious issue for public health in the community. The state of interest is California. According to County Health Rankings & Roadmaps (n.d.), the adult obesity rate in California is 30% compared to the national average of 32%. However, the obesity rate is still significant in the state despite being lower than the nation because it is high, and a high obesity rate could result in poor population health outcomes. The rates range between 19-39% across the counties in the state.
The issue is closely related to physical inactivity, another health issue with high rates at the state and country level. The high rate of obesity means that one in every three individuals in California is obese, and an individual carries a 30% risk for obesity in this state (County Health Rankings & Roadmaps, n.d.). Obesity increases the risk for chronic and acute health problems. Thus, adult obesity is a health issue of interest and the selected data-driven problem.
Characteristics of At-Risk Population
The adult population is at risk for obesity, and WHO statistics show that obesity rates increase with advancing age. Individuals from 18- 65 carry the highest risk of obesity (WHO, 2021). The major contributors to the problem are increasing consumption of nutrient-dense foods and physical inactivity. The second characteristic is coming from a lower socio-economic group. Gong et al. (2020) state that there is a link between obesity and low-income individuals in California because the rate of obesity is higher in individuals from low-income homes.
Social Determinants of Health
The Social Determinants of Health of interest is healthcare access and quality. Obesity prevention services are vast and often overlooked. The lack of health literacy is the most significant factor associated with healthcare access and quality. Healthcare literacy implies knowledge of health and health management interventions. The population has limited knowledge of the burden of obesity and its prevention interventions. Thus, they are exposed to obesity risk factors such as poor eating habits and inadequate exercise.
The population also lacks knowledge of the available healthcare services to help prevent and manage the problem, further increasing the problem’s burden. O’Conor et al. (2020) show that health literacy significantly impacts care outcomes, especially mortality and patient self-management behaviors. Health literacy also significantly impacts the population’s health-seeking behavior. Health literacy is thus significant in this population to ensure quality patient outcomes and manage the obesity burden.
California is one of the states that embraced and implemented the ACA Medicaid expansion. The expansion drastically improved insurance coverage rates and subsequent healthcare access and population health in California. Reports show that Medicaid expansion improved care services access in various healthcare conditions and improved care outcomes in the nation (Ermer et al., 2022). Medicaid covers a range of obesity prevention services, including BMI screening, physical activity, prescription drugs, nutritional education and counseling, and bariatric surgery.
One of the significant deficits of the policy is the lack of public/population education programs. The Centers for Medicare and Medicaid disseminate information on the policies and their offerings but do not implement robust policies to educate the public on health and healthcare services. In addition, obesity rates have been steadily rising, raising public health concerns about the effects of insurance coverage on obesity. The results of the Counting Ranking Roadmaps show that the rate of obesity is steadily rising, which presents a major risk to the population.
Reynolds & Fisher (2020) note that Medicaid Expansion is associated with an increase in the utilization of preventive health services among patients with chronic illnesses in California. However, the rates of obesity are higher, showing that the ACA Medicaid expansion has been insufficient to address the obesity issue in California. The policy is inadequate in meeting the population’s health literacy needs. Despite the ACA expansion policy in California through the Med-Cal program, there is a need for other interventions to manage obesity. Few individuals seek the services despite smoothened access process.
The social determinant of the health of interest is healthcare access and quality, and the factor of interest is population knowledge. The current policy does not help address health literacy, and the proposed policy should thus target improving population health literacy/knowledge of the condition and its available management options. The proposed policy’s title will be California Obesity Education and Prevention Strategy.
The main parts of the policy change will include mass population education on obesity, investing in research to help increase population services-seeking behavior, and increasing access to obesity prevention and management services in communities. The program will utilize available services such as telehealth and community outreach through mobile clinics and camps to avail services to the community. Education will be robust in person, online, and through print media such as fliers. Programs in the past have had varied success in obesity management by addressing obesity risk factors and management interventions such as dietary changes and increasing physical activity (Kumanyika, 2019).
The proposed policy aims to improve the states’ population’s knowledge of obesity prevention services and their access. Many individuals do not know or understand the potential effects of obesity. Many others do not understand the prevention measures covered by Medicaid and Medicare. Community education will serve various purposes, such as increasing knowledge of available care services, enhancing care-seeking behavior, and utilizing healthcare services (Kumanyika, 2019). Pearce et al. (2019) note that community-based care services, such as screening in the community, are an effective strategy for obesity prevention.
The proposed policy includes measures to expand access to healthcare and eliminate healthcare disparities based on demographic variables like race, ethnicity, and education level. All individuals will be involved in research to help address the racial disparities also experiences in obesity management.
Health Issue Impact
The proposed policy change can significantly enhance the social determinants of health (SDOH) (access to healthcare services) and associated health problems. The strategies outlined in the health policy include steps to increase access to healthcare services, which may lead to better health outcomes for the adult population. The policy can resolve the health issue by giving people who otherwise would not have access to healthcare the chance to get screenings, diagnoses, and treatments (WHO, 2021).
The policy addresses the educational disadvantages (access to health information) linked to health disparities. If passed, the proposed legislation will address the root causes of health inequities and access to healthcare services by fostering collaboration across sectors. The research included in the policy will help address the various health disparities and vulnerabilities associated with obesity. For example, the research will help address the factors leading to poor health-seeking behavior in diabetes. Results from the research will help implement corrective interventions that will, in turn, help address the obesity problem, as Tantengco (2022) supports.
The proposed policy may alleviate the health issue by ensuring that all individuals, regardless of race, ethnicity, or other factors, have access to high-quality healthcare. The policy will enhance the population’s education on the availability of diabetes health services and thus promote their uptake. According to Goodall et al. (2020), education directly impacts health-seeking behavior as individuals make informed health decisions. Goodall et al. (2020) also note that population education promotes healthy behavior and eliminates risky health behaviors.
For example, individuals can adopt appropriate healthy behaviors such as avoiding junk foods and regular exercise, which will help manage obesity. This policy has the potential to help address SDOH by reducing inequities in healthcare access. The policy proposal will boost healthcare access, address the core causes of health disparities, and eliminate healthcare inequalities based on race, ethnicity, and other characteristics.
Equitable Distribution of Resources
Equity refers to accessing the necessary or required healthcare services. Knowledge is one of the significant predictors of equity. Access to information allows individuals to access the services they need. Kumanyika (2019) notes that robust population education is a viable way of promoting equity in obesity prevention. In addition, the increased service delivery will allow patients limited by time and location to access healthcare services in their communities. With the current high insurance rates and Medicaid expansion, almost everyone qualifies or can afford insurance. Thus, increasing the population’s access to information can help improve outcomes related to the health problem: of obesity.
Through outreach and education, the at-risk community may learn more about the support systems that are accessible to them. Community events, online campaigns, and regionally targeted marketing materials are good choices. More individuals may benefit from existing resources and projects if people share them and collaborate with other organizations. Service gaps and high-demand areas for resources may be better identified with the help of these communities.
Mobile clinics and telehealth services can potentially increase the accessibility of medical treatment for marginalized populations in rural and underdeveloped areas. Mobile clinics and telehealth services can potentially provide medical treatment directly to people. Mobile clinics and expanding telehealth services will increase access to obesity prevention services at the patients’ most convenient location. The services will also be free and thus will significantly improve their access and promote quality patient outcomes, particularly obesity prevention.
Providing disadvantaged populations access to interpreters and translated papers is crucial to ensuring they get the services and resources they are entitled to. Therefore, ensuring equitable distribution of available resources requires a diversified approach that addresses the specific challenges experienced by the at-risk population in gaining access to services, education, or planned projects. Education, outreach, and access to services can potentially improve the health outcomes and overall wellness of the at-risk population.
The American Nurses Association (ANA) has a set of ethics guidelines called the Code of Ethics for Nurses. The suggested policy may comply with two provisions of the Code of Ethics. The proposed policy will comply with the second “The nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population,” and the third code of ethics, “The nurse promotes, advocates for, and protects the rights, health, and safety of the patient,” (American Nurses Association, 2021).
The proposed strategy can potentially strengthen these provisions by expanding equitable access to healthcare for underserved populations. The policy will enhance healthcare knowledge through community education and access through telehealth and mobile clinics. The targeted outcomes are improved care-seeking behavior and reduced obesity prevalence. The nurse takes the initiative, individually and collectively, to establish and maintain healthcare environments and working conditions consistent with professional standards and beneficial to providing high-quality care.
The proposed strategy can potentially strengthen this service by fostering cross-sector collaboration to address socio-economic determinants of health. Alfadda et al. (2021) note that obesity management is an area that is affected by many issues, including perceptions and attitudes of the population, which education will promptly address. By focusing on education, access, and research on obesity, the policy will help utilize the ANA provisions.
The policy will help recognize the nursing profession’s value and improve population health and wellness. Addressing socio-economic determinants of health that contribute to health inequities and providing equitable access to healthcare services and resources, the suggested policy may generally support various parts of the ANA Code of Ethics (American Nurses Association, 2021). The concept can potentially improve population health and well-being by giving patients, families, groups, and communities more priority and fostering cross-sector collaboration and coordination.
The following are two potential or actual roadblocks to enacting the proposed policy change in California state. Inadequate funding and a lack of political support are potential policy implementation barriers. Funds are required for the successful implementation of the policy, development of supporting healthcare infrastructure and workforce, and public education initiatives. Without enough funding, the proposed policy may be impossible to implement. There may be fewer doctors and nurses, fewer hospital beds, and less access for low-income people.
Second, the policy may face political opposition from groups who are not happy with the proposed changes or who stand to suffer in some manner. Healthcare providers, insurance companies, pharmaceutical companies, and others may voice opposition to healthcare policy improvements. If legislators oppose the program, it may be adopted more slowly or scrapped altogether.
The proposed policymaker is Anthony Rendon, the 62nd California State Assembly speaker. He is an able leader who has tabled several motions impartially and takes on policies, regardless of their field, as long as they benefit the population. To address health disparities and ensure underserved communities have access to affordable quality treatment, the House passed many laws to improve California residents’ health, including the CA-AB80 Taxation: Coronavirus Aid, relief, and Economic Security Act: Federal Consolidated Appropriations Act, 2021 and CA-ACR143 Public Health: Human Papillomavirus, screenings, and vaccinations.
One way Congressman Rendon may utilize his position as a policymaker to advance health equality would be to advocate for the passage of the California Obesity Education and Prevention among his legislative colleagues and other interested parties. In addition, he is in a position to lead the Congressional State Assembly in shaping and enacting health justice legislation. The policymaker also has vast experience in policymaking and can help push the agenda in the House to increase its successful passage and subsequent implementation.
As Speaker of the California State Assembly, Anthony Rendon has a position of great authority and influence in California. As Speaker, he is responsible for leading the assembly representatives and setting legislative priorities. House Speaker Anthony Rendon is in a strong position to influence the proposed policy change since it requires an amendment to California law. His efforts on behalf of California Obesity Education and Prevention might help it acquire support and convince its detractors on both sides of the aisle, eventually leading to the bill’s passage into law. Assembly Speaker Rendon is a vital legislator who can help push this policy forward and influence its acceptance and enaction into law. The proposed policy aims to narrow that gap by expanding access to treatment. Rendon is obligated to oversee change in the state, address these issues, and take steps to improve their health.
Strategic Next Steps
I can advocate for my patients by doing the following as an individual and a healthcare provider:
The first step in becoming a successful healthcare advocate is disseminating information and understanding healthcare issues and policies. Staying up-to-date on research and policy changes can help you advocate more effectively for your patients and society at large Artiga, S., & Hinton, E. (2019). Attending conferences, reading research papers, and participating in online forums and discussions are all excellent ways to expand your knowledge of healthcare advocacy. In addition, you have a special opportunity to promote health awareness and illness prevention in your community as a doctor.
Connecting with other advocates and healthcare professionals is another important step in making a difference in healthcare advocacy. It is in everyone’s best interest for medical professionals to develop strong friendships for their patients’ benefit and their communities’ greater good. Joining an advocacy organization and participating in its goals and activities is another way to get knowledge and experience in healthcare advocacy. By sharing information, tools, and best practices with your network, you can improve healthcare outcomes and push for systemic change.
Nurses are on the frontline in health policy development. They assess data to determine healthcare issues and implement corrective interventions for better population health outcomes. California is a state facing high adult obesity rates. The problem stems from various factors such as physical inactivity, poor eating habits, and sedentary lifestyles. Lack of access to healthcare services is one of the problems that lead to the social determinants of health and worsen the obesity problem. California expanded Medicaid through the Medi-Cal program, but the policy does not affect access to healthcare services.
Other factors such as perception, attitude, care-seeking behavior, and knowledge affect care access, and a policy is needed to address these factors. The recommendation to address the problem is a policy change, “California Obesity Education and Prevention Strategy’ that will entail various interventions to address obesity. These will include ways to increase the population’s care-seeking behavior, population education, and taking these services to individuals in their communities (remote services delivery). The proposed change will then affect access and reflect a decrease in the rate of obesity in the state.
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