Jonah Kipkemboi Lagat

 Hypertension Name Instructor Institution Course Date Briefly describe Hypertension Hypertension remains a public health condition and its defines elevated blood pressure (Kofi, 2011). Blood pressure is the power of blood inside the arterial blood vessels as the blood circulates in the body. Hypertension is the disease that arises as an effect of continually high blood pressure more than 140/90 mmHg in that a systolic pressure beyond 140 while diastolic pressure above 90 (Kofi, 2011). Blood pressure is characterized by huge spontaneous disparities, therefore the identification of hypertension would be centered on numerous blood pressure measurements taken on severally and separately (WHO, 2011). Age is the risk factor hypertension thus with increases age predisposes a person. Actions and lifestyle-related factors can put individuals at a greater risk of developing hypertensive disorders. Hypertension is called the silent killer because it often has no cautioning signs or symptoms, and many individuals do not recognize they have it; that is why it's essential to get blood pressure checked occasionally (WHO, 2011). Describe one Hypertension project and mention how it complements or adds to other similar initiatives. LILLY AND PROJECT HOPE – An Integrated ideal for tackling Non-Communicable Diseases by a focus on High blood pressure and Diabetes. In 2012, Project HOPE and the Lilly NCD Organization launched the HOPE Center in Zandspruit on the suburbs of Johannesburg, South Africa. The center emphases on teaching the community about chronic infections, specifically diabetes, and hypertensive disorders, providing medical services for cure and management of these ailments, and enabling support through peer group education. As the HOPE Center has just been operational for a few years, they have executed a number of inventive and effective NCD projects. Having a population of 83,600, Zandspruit is the typical peri-urban community along with approximately 90% of the population residing in shacks. 55% of households don’t have accessibility to basic services like water, sanitation, electrical power, street lights, and waste collection. Joblessness is high with 70% estimation rate. Community resources are scarce, with simply two government-financed primary schools and single primary healthcare facility, single community center, and one transportation hub. In 2011, Project HOPE acquired a grant from Eli Lilly and Company Ltd to institute and run the HOPE Centre for a period of five years, with the aim of improving the lives of people at danger from or at present living with NCDs by tackling visible breaches in the healthcare system. It had been hoped that by building inventive approaches, it would cost-effectively increase service to community individuals and offer a replicable model that could easily be scaled up across the nation and further afield. The HOPE Center clinic functions three days weekly to provide screenings, treatment, proper care, and education to the community concerning NCDs. In addition to offering healthcare services in the medical center, the Centre runs several Health Promotion Days usually in partnership with local churches or community groupings to offer to screen in the community. As part of the integrated care strategy, Project HOPE has started a number of extra support programmes for individual patients and the wider community (Kjeldsen, et al., 2014). 2. Community Description a. Describe the target audience, which is individuals in low-income communities Hypertension pushes the global problem of cardiovascular infections, is widely known to be the most common heart-related disease and a risk aspect for death (WHO, 2015). Adults living to 80 years of age, approximately 90% will develop high blood pressure (Al-ghuzi & Al-asadi, 2014). Due to many factors like the continuing nutritional shift, escalating tendencies in sedentary lifestyle, and additional modifiable predisposing factors, and scarce healthcare systems, peoples in low- and middle-income nations may endure a high liability of the disease, as equated with the global average (Ahmed, et al., 2015).  Prevalence approximations are significantly high in the elderly of over 65 years as compared to younger adults below the age of 65 years overall and across the geographical areas; individuals without formal education, overweight/obesity and urban immigrants are most likely to suffer from hypertension, compared with those who are educated, normal weight, and rural settlers respectively (Ahmed, et al., 2015). b. Provide list the geographic location(s) and sites/settings (e.g. hospital, community-based center, school, work setting) where hypertension impacts individuals in low-income communities. Considerably different infections patterns exist between high, middle and low-income countries. The figures relating to hypertension are simply staggering. According to Reiter (2014), the ten nations from which information existed, the frequency of hypertension ranged from 19% in Democratic People’s Republic of Korea to 42% in Myanmar with prevalence of high blood pressure is growing in countless nations in the Asia region, In India, elevated blood pressure rose from 5% in the 1960s to about 12% in 1990s, and to more than 30% in 2008. In Indonesia, the proportion of adult individuals with high blood pressure skyrocket from 8% in 1995 to 32% in 2008. In Myanmar, the Ministry of Health described an increment in hypertension prevalence, from 18% to 31% in males, and from 16% to 29% in females during- thus aging population, fast development and shift from agrarian life to a wage-earning, present city life are reported as main contributors to rising hypertension in urban areas. 3. Needs Assessment How important is a Hypertension assessment? Why is an assessment needed? Which population needs the assessment? Provide statistics Hypertension is a crucial public health problem in the United States and other nations due to its higher occurrence and a strong link with the cardiovascular infections and premature mortality (Cutler et al., 2008; Lawes et al., 2008).  Hypertension assessment is important in identifying a population at risk of the disease. In the initial detection of hypertension, assessment entails carefully observing the blood pressure at frequent intervals and then, after medical diagnosis, at regularly scheduled periods. The purpose of the particular population needs assessment is usually to gather the data required to understand the kind and distribution of services necessary for a population to gain the utmost benefit. It requires an understanding of the health and wellbeing requirements of the population in order to support upgrading through healthcare services along with other initiatives which include self-care. The understanding obtained from the population needs evaluation is then utilized to help make judgments regarding how to prioritize allocation of resources to meet the particular needs that which have been identified, alongside other means in which people’s healthcare needs are met, such as self-care or community support. In the US, black adults have elevated blood pressure more regularly than Hispanic, white, Native American, and other adults defined by race or ethnicity. In Hispanic adults, lower control rates result primarily from lack of knowledge and treatment (Margolis, et al., 2007), whereas black adults’ awareness and treatment are at least as high as white adults’, but their hypertension is often more serious, and some medicines are less effective in Blood Pressure control (Parati, et al., 2014). Hypertension is a severe health disorder that impacts men and women of all racial and ethnic groups in the US. For example, in- nearly 25% of US adults were affected by high blood pressure (Yoon, et al., 2010). Recently, research signposts that the problem is on increase, as one in three adults in the US now have hypertension (American Heart Association 2013). Though individuals from all sex/race categories have experienced an escalation in hypertension occurrence in recent decades, racial discrepancies in the stay, with blacks continually affected more frequently than the whites. The age-adjusted prevalence of high blood pressure amongst blacks and whites was 32.4% and 23.3%, respectively, in- (Yoon et al. 2010), and 40.4% and 27.4%, correspondingly, in 2009 (Yoon et al. 2012). According to the Third National Health and Nutrition Examination Survey (NHANES III) -) and NHANES Continuous -) data, the age-standardized and age-specific occurrence of hypertension amongst black women has constantly been among the uppermost of all race/sex groups in the US (Reiter, 2014). a. Mention assets and capacities that affect individuals in low-income communities with hypertension. Hypertension is a severe medical disorder that affects the black women more than people of all other ethnic groups (National Center for Health Statistics 2013). In low-income countries, individuals with hypertension face challenges like straining healthcare systems and lack of access and disparity due to socioeconomic status. 4. Socio-ecological factors a. Provide a description of the primary socio-ecological factors related to hypertension. Developing person isn’t an active contributor in the particular ecosystem, but the social arrangements and happenings in this purview have a bearing on upon the developing person, these social arrangements include the world of work, informal or formal interpersonal networks, educational system, lawful services, extended family, neighbors, communication systems, and other additional activities that form the impact when, how, and with whom people pass their time with (Hall, 2011). Health promotion actions such as cigarette smoking cessation programs, dietary plus exercise programs are restricted due to targeting a person’s behavior. Health promotion approaches should focus on vigorous contact between people and the environment, a social-ecological approach, which concentrates on the person and the environment to enhance health outcomes (Hall, 2011). This social-ecological standpoint of health and infections enables for a panoramic observation of the interdependence among people and the environment. 5. Stakeholders a. Identify and describe strategies used to identify your program stakeholders (hypertension) and build coalitions and partnerships. Along with multi-agency involvement, it’s occasionally hard to differentiate between the stakeholders and other agencies who might not be stakeholders in the complete feeling of the word yet who are operational in partnership within the intervention (Griffiths, Maggs, & George, 2008). Attaining Hypertension reduction objectives needs cooperation between clinical, public health, and community partnership to produce systems of treatment spanning clinical, community, and public health settings that will support individuals in reaching blood pressure control. The increasing national emphasis on human health and preventive treatment highlights the significance of the stakeholders’ linkages. The stakeholders’ recognition forms the base for identifying every stakeholder's interest’ in the particular project, as well as the project’s most likely impact on them with the process projects, are usually particularly impacted by stakeholder interactions and responses to the project activities. According to (Greenwald & Fronstin, 2004), the following means are widely-used to identify stakeholders; Facilitate relationship‐building between the local public health agencies and providers and the community organizations; Include providers, public health, as well as community services in referral systems, care coordination, and team‐based care models; create state/community‐wide standardized high blood pressure definitions and protocols; Identify, support, and promote integration associated with population and patient‐level information systems that inform quality enhancement and patient panel management; Promote and support integrated healthcare services delivery models; Convene stakeholders across divisions to align state‐level initiatives and resources, and Support sustainability by leveraging various funding sources. b. Identify and describe the types of resources and community stakeholders. Local community blood pressure programs might be employed by groups such as community wellness systems alone and also community-based organizations incorporation along with the local health system organizations. Community-based Hypertension programs show a vital role in linking the gap concerning the particular community and the health care system for several poor, underserved, and uninsured persons and additional community inhabitants. The programs can run on as its own society or a group of societies with a joint determination of improving awareness and understanding of the adversarial effects of high blood pressure and to screen, educate, and refer high-risk individuals to a healthcare facilities for additional assessment and treatment, these are crucial prevention actions that have important public health effects (Fulwood, et al., 2006). A number of Hypertension manage models have remained used to advance hypertensive disorders control in communities. The following are one of the most cited examples:- Community-based organizations, faith-based organizations, beauty/barber stores, fire stations, community medical stores, and other institutions that will conduct blood pressure screenings in the corporation to health care systems to offer care (Fulwood, et al., 2006). These types of efforts drive high-risk people into care and motivate access and continuity of care. Also, in many cases, offers a follow-up to make ensure that patients get care (Nine, et al., 2003). 6. Theoretical framework a. Identify the theory or model used to guide the development of the interventions and provide a rationale for selection. Several behavioral change theories are found to describe why individuals do and do not adopt certain health actions, frequently examine the predictors and precursors of healthy behavior with collective factors such as self-efficacy and motivation, for instance, Health Belief Model (HBM). Health Belief Model. This model was established in 1966 by Irwin and has stood recognized as significant models within health promotion (Raingruber, 2014). High blood pressure requires people habits modification in order to reduce the impacts and results of the infections, Health belief model facilitates the adoption of a behavior like side effects, perceived costs of abiding by the proposed intervention and compliance to healthcare directives. 7. Intervention strategy a. Propose an appropriate population-based program intervention strategy based on your theoretical framework that targets one of the socio-ecological factors associated with this health condition and target population. Dietary intake modification among pregnant mothers Hypertensive illness in pregnancy happens in women with pre-existing primary or secondary persistent high blood pressure, and in females who develop new-onset hypertonic in the second trimester of the pregnancy (NICE, 2018). Hypertensive infections of being pregnant, like preeclampsia and gestational hypertension, are connected with substantial morbidity and mortality for both mother and the child. And thus diet management and modification help in management and prevention by reducing intake of some nutritional tablets like antioxidants. Interactive physical education program, family based education and use of community healthcare works in low income communities, in which such programs results to improving practices, management and control of blood pressure 9. Activities a. Identify at least two specific program activities and explain how it would benefit individuals with hypertension in low-income communities. A dietary modification like reduction in salt consumption and increasing fruits and vegetables intake thus reducing the risk of cardiovascular diseases. Exercise lifestyle, doing regular exercises to avoid a sedentary lifestyle and thus burning calories hence obesity risk reduction. b. Explain how each activity is related to your theoretical framework. Health belief model is a health promotion intervention that requires behavior modification to do or avoid certain lifestyles, thus dietary modification and exercises regularly are part of behavior changes that requires personal efforts in order to maintain and stick to. 10. Logic Model Develop a Logic Model for hypertension Hypertension Reduction Logic Model References. Ahmed M. Sarki, Chidozie U. Nduka, Saverio Stranges, Ngianga-Bakwin Kandala, and Olalekan A. Uthman. (2015). Prevalence of Hypertension in Low- and Middle-Income Countries. ASystematic Review and Meta-Analysis. US National Library of Medicine  National Institutes of Health. Al-ghuzi, A. A. S., & Al-asadi, J. N. (2014). Prevalence and Socio-Demographic Determinants of Hypertension in Thi-Qar Governorate : A Household Survey. American Journal of Advanced Drug Delivery, 2(6), 802–815. American Heart Association. 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