Precede/Proceed Project California State University San Marcos School of Nursing NURS 445 Practicum: Community Health Nursing and Case Management Online RN-BSN Program Summer 2016 By Cindy R. Coleman, RN-C
Population-Level Health Education Intervention-Proceed
Four Goals for Health People 2020 1.
2.
3. 4.
Access to Health Services: Improve access to early prenatal care for African American women in Sacramento County to decrease the number of babies born prematurely or with low birth weights. Maternal, Infant, and Child Health: Improve the healthy development, health, safety, and well being of African American infants in Sacramento County Family Planning: Reduce teen pregnancy rates in Sacramento County Physical Activity: Improve health, fitness, and quality of life through physical activity
Problem 1: Access to Health Services Goals and Objectives: Improve access to early prenatal care for African American women in Sacramento County to decrease the number of babies born prematurely or with low birth weights.
â—? African American babies are twice as likely to be born with low with low birth weight in comparison to infants of other ethnic or racial groups â—? African American babies are 1 1/2 more times likely to be born prematurely in comparison to white babies
Risk factors for African American babies born prematurely or with low birth weights ● ● ● ● ● ●
Poor Nutrition Lack of Prenatal Care Smoking Illicit drug use and Alcohol Abuse Access to Transportation to attend Appointments Lack of Health Insurance
RISK FACTORS FOR PREMATURITY
Problem 2: Maternal, Infant, and Child Health Goals and Objectives: Improve the healthy development, health, safety, and well being of African-American infants by preventing sleep related deaths (SIDS) ● ● ● ● ●
Every other week in Sacramento County, a baby dies while sleeping and 50% of those babies are African American Nearly 90% of infants were known to be in an unsafe sleeping environment Seventy-eight percent were sleeping in a non-infant bed Fifty-two percent were sleeping in a non-infant beed Thirty-seven percent were placed to sleep on their stomachs or sides
Risk factors for sleep related deaths ● Sleeping in a non-infant bed ● Sleeping with other adults or children (cosleeping) ● Sleeping with objects around the baby such as pillows, blankets, bumpers, or stuffed animals ● Smoking ● Sleeping in the prone position
Nearly 90% of infants were known to be in an unsafe sleeping environment Unsafe Infant Sleep Condition
% All Races (n=156)
# All Races (n=156)
Non-Infant Bed
78%
121
No Crib in Home
64%
99
Co-Sleeping
55%
85
Prone or Side Sleeping Position
46%
71
Problem 3: Family Planning Goals and Objectives: Reduce teen pregnancy rates amongst African Americans in Sacramento County
● Three out of Ten teen American girls will get pregnant before the age of 20 ● There are at least 750,000 teen pregnancies every year ● In 2008, teen pregnancy rates among African American and Hispanic teen girls ages 15 to 19 was over two and a half times higher than the teen pregnancy rate among white teen girls of the same age group
Risk factors for teen pregnancy ● Race or ethnicity ● Engaging in sexual activity at a younger age ● Living in poverty ● Living in a single parent home ● Lack of use of contraceptives ● Early use of alcohol and drugs ● Low self esteem
Risks factors for Teen Pregnancy
Problem 4: Physical Activity Goals and Objectives: To improve health, fitness, and the quality of life through physical activity by providing a variety of health and fitness programs for people at any stage in life to decrease the development of cardiovascular disease, diabetes, and obesity
● The prevalence of obesity and excessive body weight has become a major public health problem in the U.S. ● Nearly two-thirds of adults in the U.S. are either obese or overweight ● The rise in obesity rates among children and minorities suggests that the future population is at an increased risk for comorbidities such as diabetes and cardiovascular disease ● The prevalence of diabetes has soared and the increase in diabetes can largely be attributed to weight gain ● Adults with diabetes are at increased risk (2-4 fold) to develop cardiovascular disease in comparison to individuals without diabetes
Risk factors for developing Cardiovascular Disease, Diabetes, and Obesity ● ● ● ● ● ● ●
Sedentary Lifestyle High blood pressure Lack of access to healthy nutrition options Race/ethnicity Metabolic abnormalities Alcohol use Smoking
Risk factors for Cardiovascular Disease, Diabetes, and Obesity
References 11 Facts about Teen Pregnancy. May 2016. Retrieved from https://www.dosomething.org/us/facts/11-facts-about-teen-pregnancy Black Mothers United. (2015). Retrieved from http://blackmothersunited.org Eckel, R., Kahn, R., Robertson, R., & Rizza, R. (2006, July). Preventing Cardiovascular Disease and Diabetes. Diabetes Care, 29 (7), 1697-1699. First 5 Sacramento Commission. (2012). Retrieved from http://www.first5sacramento.net/Pages/default.aspx Kost, Kathryn, and Stanley Henshaw. (Retrieved May 20, 2016). U.S. Teenage Pregnancies, Births and Abortions 2008: National Trends by Age, Race and Ethnicity. New York: Guttmacher Institute. Task Force on Sudden Infant Death Syndrome. (2011, November). SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for Safe Infant Sleeping Environment. Pediatrics, 128 (5), 1341-1367. United States Census Bureau. (n.d.) . American Fact Finder. Retrieved from http://factfinder.census.gov/faces/nav/jsf/pages/community_facts.xhtml Zheng, H., Pry, J., Chung, H., Lockett, C., & Kasirye, O. (2014). Community Health Status Report 2014: A Description of the Health Status and Mortality Experience of Sacramento County Residents. , 1-69. Retrieved from http://www.dhhs.saccounty.net/PUB/Documents/Disease-Control-Epidemiology/RTHealthStatusReport2014Final.pdf