Category: NURS-FPX4060

NURS FPX 4900 Assessment 2 Assessing the Problem Quality Safety and Cost Considerations Name Capella university NURS-FPX 4900 Capstone project for Nursing Prof. Name Date Introduction This assessment of the capstone project discusses the case of my mother, who recently got diagnosed with diabetes, and how it impacts the quality of care, costs to hospital setting, and patient and patient safety. The discussion will proceed to policies from nursing state board practice and government that impact diabetes care, patient safety, and cost. Furthermore, the assessment includes strategies to improve the quality of care and patient safety and reduce costs to healthcare systems and patients. Diabetes’ Impact on Quality of Care, Patient Safety, and Costs to System and Individual Type 2 diabetes is a chronic health disorder that requires ongoing care and adherence to medication and treatment.  The nurses and other healthcare professionals are expected to monitor patients’ blood glucose levels intricately for effective management. Furthermore, it requires consistent modification to a healthy lifestyle where patients must intake healthy food and practice physical activity. When healthcare professionals fail to educate and convince patients about diabetes care, the quality of care is badly impacted. Diabetes effective care requires care coordination from a multidisciplinary team of physicians, nurses, dieticians, endocrinologists, pharmacists, and fitness experts, This is necessary for providing comprehensive care to diabetics to avoid gaps in treatments (Bilous et al., 2021). In the case of my mother’s diabetes, the quality of care was due to fragmented care coordination while she had not been instructed about diabetes self-management, as she wasn’t monitored at her home.  NURS FPX 4900 Assessment 2 Assessing the Problem Quality Safety and Cost Considerations Patient safety is another paramount factor that is impacted by diabetes. If left untreated, diabetes can lead to hyperglycemia, which causes peripheral neuropathy, blindness, and life-threatening conditions such as ketoacidosis (ADA, n.d.). Hence, poorly managed diabetes impacts patient safety. In the case of my mother, her safety is at stake as her unhealthy lifestyle and poor control of blood glucose levels can lead to these complications. Similarly, patients suffering from diabetes may bear direct medical costs, including medications and medical supplies for monitoring blood glucose levels. Furthermore, a healthcare organization can incur indirect costs due to the need for specialized care for diabetes emergency room visits and increased hospitalization visits. About $237 billion is spent on direct medical costs annually, and a further $90 billion is incurred by the US nation due to reduced productivity (CDC, 2020). This shows the financial burden of diabetes on healthcare organizations and patients cumulatively. My mother is suffering from considerable costs due to medications, monitoring devices, and purchasing healthy food. This is leading to financial constraints, requiring monetary assistance for managing healthcare expenditures. State Board Nursing Practice Standards and/or Organizational/ Governmental Policies and Their Impact on Care Quality, Patient Safety, and Costs The California Board of Registered Nursing has provided standard guidelines in the Nursing Practice Act Section 2725, guiding nurses in improving quality of care and patient safety. The standard guidelines state that registered nurses must collaborate with healthcare providers to care for patients with chronic diseases like diabetes. Furthermore, they must monitor the patient’s health records for outcome evaluation and further treatments. This will enable them to monitor diabetics’ consistent fluctuations of blood glucose levels that can be regulated accordingly, improving the quality of care provided (California Board of Registered Nursing, n.d.). The American Diabetes Association also provides guidelines on diabetes, such as measuring blood glucose levels through A1C tests and estimating their status of standard, pre-diabetes, and diabetes. These guidelines help nurses evaluate the current diabetes condition in patients based on regularly monitored blood glucose levels (ADA, n.d.). Furthermore, it provides resources on diabetes education, which nurses can avail to provide education and support to patients for diabetes self-management. These guidelines help improve the quality of care and enhance patient safety as patients strictly adhere to treatment plans and control their diabetes (Alshammari et al., 2021). The Affordable Care Act (ACA) helps patients manage their financial burden due to diabetes as it has policy provisions on providing health insurance coverage to low-income people through Medicaid and Medicare expansion. NURS FPX 4900 Assessment 2 Assessing the Problem Quality Safety and Cost Considerations Moreover, the ACA has provisions in policies about pre-existing conditions like diabetes, which bound health insurers not to charge higher premium prices to these patients. Consequently, they can obtain medication for diabetes at a low price (Furmanchuk et al., 2021). This is helpful in the case of my mother’s diabetes, as exorbitant costs can be alleviated through this policy. This also facilitates hospitals as more and more diabetics will be able to manage their condition without worrying about financial constraints. The healthcare systems will tolerate less diabetes burden, leading to better allocation of resources for managing other patients and contributing to lowering costs overall in the organization.  Nursing scope of practice describes nurses on their responsibilities, duties and activities towards patient care. These activities are governed by certain guidelines and policies. The aforementioned policy and guidelines will impact the nursing scope of practice as nurses will acquire better knowledge of managing diabetes and improve the quality of care, ultimately enhancing patient safety. The guidelines from the ADA will inform them about choosing a particular intervention that can manage diabetes and guide patient-centered care. Furthermore, the availability of financial assistance will enable patients to seek care treatment from nurses and can select an intervention for them based on their health needs and preferences.  Strategies to Improve Quality of Care, Enhance Patient Safety, and Reduce Costs The evidence-based strategies to treat diabetes in my mother, which will ultimately improve quality of care, enhance patient safety, and reduce costs, must be investigated and implemented. These strategies include diabetes self-management education and support (DSMES) program and adherence to medication therapy. Diabetes self-management education and support program is an evidence-based strategy that can potentially improve the quality of care among patients and enhance safety. The DSMES program involves nurses

NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations Name Capella university NURS-FPX 4900 Capstone project for Nursing Prof. Name Date Identification of Patient Healthcare Issue  This capstone project aims to tackle type 2 diabetes in my mother case. My mother is 60 years old patient, who experienced excessive thirst, tingling sensation in his toes and fingers, and unintentional weight loss around a year ago. After that, I took her to the laboratory for a fasting blood glucose test. Her laboratory investigations were conducted, and her fasting blood glucose was 280 mg/dL (higher than the normal range of 70-100 mg/dL) with HbA1c 10%. This showed that my mother was suffering from type 2 diabetes. Her treatment occurred in Alhambra Hospital Medical Center, where I worked as a registered nurse. Her history showed she was a hypertensive patient, effectively controlled by medication medication adherence was the only factor that maintained his blood pressure. However, her sedentary lifestyle, lacking physical activity, alcoholism, and unhealthy diet is a crucial factor that needs to be addressed. Another important issue in my mother’s case is our middle-class background, where financial responsibilities doesn’t allow her to effectively manage the disease condition.  NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations Type 2 diabetes is a common health problem experienced by older people. In 2019, about 19.3% of the population aged 65-99 suffered from diabetes. Moreover, the incidence rates of type 2 diabetes in elderly people will increase to 195.2 million and 276.3 million by 2030 and 2045, respectively (Sinclair et al., 2020). This shows that type-2 diabetes is highly relevant to our professional practice, which many older people experience later in their aging lives. Furthermore, diabetes is a significant healthcare issue that impacts patients’ quality of life.  Diabetes, if left untreated, leads to various complications, such as eye blindness, peripheral neuropathy, kidney damage, and mental health issues (Centers for Disease Control and Prevention, 2022). As a baccalaureate-prepared nurse, this problem is relevant to my nursing practice personally and professionally. Many diabetes cases are admitted regularly due to their high prevalence, and I provide nursing care treatment to them daily. Moreover, it relates to me personally as my mother is a diabetic patient. Therefore, I am on a grave mission to provide care, treatment, and support to my mother in improving his diabetes.  Evidence-Based Approach to Guide Nurses Nurses play a significant role in managing chronic conditions like diabetes as they are primary caretakers who monitor consistent changes in patients’ health, deliver medication, and provide supportive care. Managing diabetes requires a multifaceted approach of medication adherence, lifestyle modification, and constant monitoring of blood glucose levels. Nurses can educate patients on modifying their lifestyles, particularly patients like my mother, who indulge in unhealthy eating habits and alcohol consumption. This is possible by providing counseling sessions and educating patients on self-management behaviors where they are actively involved in improving their lifestyles, such as enhancing their intake of fruits and vegetables instead of processed food (Hermanns et al., 2020). Additionally, they can collaborate with dieticians to create healthy meal plans that consider patient preferences to make a patient-centered care plan. These actions can be introduced into my mother’s life, and her lifestyle can be modified by providing her with DSMES programs. This will educate her about the harmful impact of consuming alcohol and processed food in her daily life and empower her to take care of her health. Furthermore, her meal plans can be created considering her preferences and cravings to deliver patient-centered care.  NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations Nurses can manage patients’ diabetes by regularly monitoring their blood glucose levels. They can monitor their glucose levels remotely by using a remote monitoring approach. In remote monitoring, patients and healthcare providers coordinate remotely to manage their health conditions. Remote monitoring of blood glucose levels can facilitate patients and nurses as patients need to update their HbA1c levels at home without visiting the hospital (Shehav-Zaltzman et al., 2020). Moreover, nurses can use their time productively by caring for more patients when the monitoring is conducted remotely. Additionally, nurses can engage with diabetic patients in promoting medication adherence to anti-diabetic drugs to regulate their blood glucose levels. By supporting my mother in providing her medication regularly on time, I can help my mother promote medication adherence to her anti-diabetic drugs. Lastly, nurses can provide supportive care to chronic patients of diabetes by connecting them with social support groups for diabetes and physical activity platforms like fitness centers and gyms to improve their physical activity and health conditions (Saffari et al., 2019). This will help my mother be physically more active by engaging her with fitness clubs or support groups where she can connect with people who are also fighting with diabetes and increase her motivation and dedication in managing her diabetes.  Criteria to Evaluate Evidence These sources of evidence can be evaluated based on CRAAP criteria. These criteria test sources’ currency, relevance, authority, accuracy, and purpose. All the sources of evidence used fulfill the CRAAP criteria, as all articles were published in the past five years and are relevant to diabetes care. Furthermore, the authors mainly specialize in chronic care and have sound medical knowledge. Lastly, the results are accurate and statistically proven to draw valuable outcomes in improving diabetes. Moreover, these evidence-based sources aim to improve health outcomes in diabetics and long-term management of diabetes. Barriers to Evidence-Based Practices In implementing the aforementioned evidence-based practices, several potential barriers may be encountered. For instance, the patients may show indifferent attitudes or negligent behavior in practicing self-management of diabetes. They may lack the motivation to quit alcohol and implement a healthy lifestyle (Adu et al., 2019). Moreover, nurses and patients may experience technological barriers in conducting remote monitoring, and they may experience communication barriers due to glitches in technology. Patients may need help to comply with medication

NURS FPX 4060 Assessment 4 Health Promotion Plan Presentation Name Capella university NURS-FPX 4060 Practicing in the Community to Improve Population Health Prof. Name Date Health Promotion Plan Presentation Good day, everyone. My name is ——-, and I’m delighted to welcome you to today’s presentation. Today, we’re delving into a critical health concern that affects a significant segment of our community: hypertension among the Latino population. Before I discuss a particular health promotion plan for our target community, I would like to briefly explain what a health promotion plan is. What is a Health Promotion Plan? A health promotion plan represents a strategic initiative to improve the overall well-being of individuals within the community. It encompasses a range of activities and interventions designed to alleviate illnesses and encourage healthier behaviors. Implementing a health promotion plan enhances individuals’ health outcomes and sustains the overall health of the community. This presentation aims to improve hypertension outcomes in the Latino community (McKenzie et al., 2022). Agenda The agenda to be discussed in this presentation is as follows: Health risks of hypertension in the Latino community The plan is tailored to address specific health needs Achievement and future adjustments of educational objectives Assessment of outcomes aligned with Healthy People 2030 and future adjustments Conclusion Health Risks of Hypertension in the Latino Community Hypertension poses significant health risks within the Latino community, exacerbating existing disparities and vulnerabilities. With nearly half of the U.S. population affected by hypertension, as reported by Chobufo et al. (2020), Latinos face a disproportionate burden of this condition. The Latin America and Caribbean region also grapples with low counseling rates for hypertension, further complicating the management of this health issue (Regional Health–Americas, 2022). Left untreated, hypertension increases the risk of numerous severe health issues, such as renal failure, heart disease, and stroke. These risks are particularly alarming within the Latino community due to factors such as dietary practices, limited access to healthcare services, language barriers, and socioeconomic disparities (Maldonado et al., 2023). These factors contribute to the challenges faced by Latinos in managing hypertension effectively, leading to higher rates of uncontrolled blood pressure levels. The Plan Based on Health Needs This health promotion plan is designed with a focus on addressing the specific health needs of the Latino community affected by hypertension. One of the identified needs is the prevalence of dietary practices that contribute to hypertension among Latinos. Traditional Latino diets often contain high levels of sodium, saturated fats, and sugars, which can exacerbate hypertension (Ma et al., 2020). Additionally, many members of the Latino community face challenges in effectively monitoring their blood pressure and adhering to prescribed medications due to various factors such as limited access to healthcare services and language barriers (Abrahamowicz et al., 2023). The health promotion plan for hypertension among the Latino population served by Vila Health is structured around specific, measurable, achievable, relevant, and time-bound (SMART) goals aimed at addressing the unique challenges faced by this community. The first goal focuses on dietary modification, with the specific aim of reducing daily sodium intake. Participants will swap one high-sodium meal with a healthier alternative, track their sodium consumption using a weekly food diary, learn about low-salt substitutes for traditional Latin meals, and implement dietary changes within the next fortnight. This goal is relevant because reducing salt in meals can help decrease blood pressure levels and minimize the chances of hypertension-related complications (Ma et al., 2020). The second goal revolves around blood pressure monitoring and medication adherence. Participants will be encouraged to check their blood pressure at home twice weekly using a home blood pressure monitor, record their results and medication adherence in a dedicated note, and maintain consistency in monitoring for 12 weeks (Marseille et al., 2021). This goal is relevant because consistent monitoring of blood pressure levels and adherence to prescribed medications is essential for successful hypertension management and prevention of complications. The Attainment of Health Goals After conducting educational sessions focused on dietary modification, blood pressure monitoring, and medication adherence, attainment of agreed-upon goals was evaluated. This assessment was based on data collected through participant self-reports, such as adherence to dietary recommendations and completion of food diaries. Additionally, qualitative evaluation was done to gather participant feedback through surveys and focus group discussions to understand their experiences, challenges, and perceptions of dietary modifications. Upon evaluation, it was found that 80% of participants successfully implemented the dietary modifications within the specified time frame. They reported substituting high-sodium meals with healthier alternatives, such as replacing processed snacks with fresh fruits or swapping out salty condiments for herbs and spices. Participants diligently tracked their sodium intake using the provided food diaries, demonstrating a commitment to monitoring their dietary habits. However, 20% of participants struggled to fully adhere to the nutritional recommendations due to limited access to healthier food options or difficulty finding suitable low-sodium substitutes for traditional dishes. Similarly, goal two was evaluated using objective data collected from participant records and monitoring logs. 90% of participants successfully acquired home blood pressure monitors and consistently monitored their blood pressure as instructed. They diligently recorded their blood pressure readings and medication adherence in the provided notes, demonstrating a proactive approach to managing their hypertension. However, 10% of participants faced challenges acquiring a home blood pressure monitor or experienced difficulty understanding how to use it correctly, leading to inconsistent monitoring practices. Need for Revisions While attaining both goals is commendable among the hypothetical participants, the evaluation highlights areas for potential revisions to future educational sessions. For example, additional community and organizational support may be needed to address barriers such as limited access to healthier food options or difficulties acquiring home blood pressure monitors. Furthermore, providing more comprehensive guidance and resources such as educational brochures and inforgraphics on dietary modifications and blood pressure monitoring techniques could enhance participant engagement and adherence. By incorporating participant feedback and addressing identified challenges, future educational sessions can be revised to better meet the needs of the Latino community and improve hypertension management outcomes. Healthy People 2030 Goals on Hypertension Management in

NURS FPX 4060 Assessment 3 Disaster Recovery Plan Name Capella university NURS-FPX 4060 Practicing in the Community to Improve Population Health Prof. Name Date Introduction Greetings, everyone; my name is ____, and today, my presentation revolves around developing a robust disaster recovery plan tailored specifically for the resilient community of Carterdale. In light of recent events, particularly the devastating tornado that swept through this region, it has become imperative to fortify the preparedness and response mechanisms. Through collaborative efforts and strategic foresight, we aim to chart a course that ensures our community’s safety, well-being, and swift recovery in the face of adversity without inflicting the harms of health disparities. Today’s discourse marks a pivotal step towards safeguarding Carterdale’s future resilience against unforeseen challenges. Let’s begin.  Disaster Recovery Plan A catastrophic tornado that struck Carterdale, Mississippi, caused massive destruction and significantly impacted the community. The tornado, which had an Enhanced Fujita rating of 4, caused significant damage, especially in Carterdale and Silver City. Residents, many living below the poverty line, faced challenges exacerbated by insufficient warning systems. Recovery efforts are underway, but the emotional toll on affected families is profound. Staff at Carterdale Regional Hospital report difficulties in delivering medical care due to havoc and resource shortages. Past catastrophes, such as the tornado that struck Joplin, Missouri in 2011, have taught us the value of early warning systems and community support. As a senior nurse at Carterdale Regional Hospital, I must create a disaster recovery plan that addresses health inequities, is specific to the needs of this community, and improves access to immediate community health services. Determinants of Health The many variables that affect people’s health and well-being both directly and indirectly are referred to as determinants of health. Broad categories for these variables include those related to the healthcare system, policies, social, behavioral, biological, and economic aspects. Biological elements comprise heredity and personal characteristics, whereas behavioral factors include habits and way of life decisions. Social and economic factors, such as income, education, and social support, significantly impact health outcomes (Kleinman et al., 2021). Environmental factors, including living conditions and access to resources, also play significant roles. Additionally, the healthcare system’s accessibility, quality, and infrastructure, along with government policies and regulations, shape overall population health. Understanding and addressing these determinants are essential for fostering health equity, disease prevention, and improved community well-being (Evans et al., 2021). Barriers Impacting Safety, Health, and Disaster Recovery Efforts The efforts of a community to promote safety and health and recover from disasters can be significantly impacted by cultural variations. These barriers arise from diverse cultural beliefs, values, and practices that may influence individuals’ perceptions and behaviors during emergencies. Cultural Language barriers can hinder effective communication and dissemination of critical information, leading to misunderstandings and delays in response efforts (Safapour et al., 2021). Cultural norms and traditions may also affect help-seeking behaviors, as individuals may be reluctant to seek assistance from authorities or utilize available resources due to cultural stigma or distrust. Additionally, cultural differences in beliefs about illness, treatment, and healthcare practices can impact access to care and adherence to disaster preparedness measures (Rouhanizadeh et al., 2020). The diverse racial composition of Carterdale’s population, including Black or African American (73.25%), White (24.25%), Native American (1.5%), and other races (1%), highlights the importance of culturally sensitive approaches to disaster preparedness and recovery. Language barriers, cultural norms, and beliefs may affect residents’ understanding of emergency protocols and willingness to seek help, thereby impacting the effectiveness of response efforts. NURS FPX 4060 Assessment 3 Disaster Recovery Plan Social barriers can significantly impede efforts related to health, safety, and disaster recovery within a community. These barriers often stem from complex social dynamics, including community cohesion and access to social support networks. Lack of cohesion or trust may result in fragmented response efforts during disasters, hindering effective communication and coordination among residents and emergency responders. Additionally, limited access to social support networks can exacerbate vulnerabilities, particularly for marginalized or isolated populations, impeding their ability to access resources during emergencies (Weir et al., 2020). In Carterdale, Mississippi, social barriers are evident in the close-knit community dynamics. With a population of 1,800 people and a high poverty rate of 39.1%, the community may face challenges in accessing social support and resources during disasters. Additionally, shortcomings in communication and warning systems, as reported by residents who did not hear sirens during the recent tornado, underscore potential barriers to coordinating disaster response efforts effectively. NURS FPX 4060 Assessment 3 Disaster Recovery Plan Economic barriers can pose significant challenges to efforts aimed at promoting health, safety, and disaster recovery within a community. These barriers arise from disparities in income, employment opportunities, and access to resources, which can exacerbate vulnerabilities during emergencies. Inadequate financial resources may limit individuals’ ability to access healthcare services, secure essential supplies, or evacuate safely during disasters (Rouhanizadeh et al., 2020). Moreover, low-income households may face difficulties in rebuilding and recovering from the impact of disasters, further widening socioeconomic disparities within the community. The high poverty rate (39.1%) and low median household income ($30,092) in Carterdale exacerbate the community’s vulnerability to disasters. Limited financial resources may impede access to essential services and hinder recovery efforts for individuals and families. The interrelationships among social, economic, and cultural factors are intricate and collectively influence health outcomes, safety, and disaster recovery efforts within a community. Social dynamics, such as community cohesion and trust, can affect individuals’ access to economic resources and social support networks. In turn, economic inequality may make social inequality worse and make it more difficult for people to prepare for and recover from disasters adequately. Cultural beliefs and practices influence social norms and behaviors, shaping how individuals perceive and respond to health risks and emergencies (Rouhanizadeh et al., 2020). Proposed Disaster Recovery Plan The disaster recovery plan is developed for Carterdale, Mississippi, using the MAP-IT approach. This approach expands to Mobilize, Assess, Plan, Implement, and Track (American College Health Association, 2023). Following this plan, Carterdale Regional Hospital can enhance its resilience and capacity to

NURS FPX 4060 Assessment 2 Community Resources Name Capella university NURS-FPX 4060 Practicing in the Community to Improve Population Health Prof. Name Date  Community Resources This assessment entails a comprehensive evaluation of a particular community resource, i.e., the Centers for Disease Control and Prevention (CDC). With the rapid proliferation of health issues, the CDC plays a significant role in improving public health and safety through its continuous endeavors to promote health initiatives and disease prevention. This organization also advocates and promotes equal opportunity and health equity for the public. Moreover, the paper will discuss how external bodies like funding agencies, policies, and law enforcement influence the organization’s services. Lastly, the impact of the CDC’s services on the health of the local community will be discussed. CDC’s Mission and Vision in Improving Public Health and Safety The goal of the CDC is to safeguard American citizens against internal and foreign dangers to their health, safety, and security. It seeks to achieve this by advancing health equity and ensuring that the country is equipped to handle public health emergencies through science, policy, and leadership. The CDC envisions a world in which all people live healthy lives, free from preventable illness, injury, and premature death. Additionally, it strives to achieve this vision by collaborating with partners to improve health at every stage of life (CDC, 2022). Contribution to Public Health  The CDC’s mission and vision empower it to conduct vital research, provide evidence-based guidance, and implement interventions to prevent and control the spread of diseases and health threats. Through surveillance systems, the CDC monitors the prevalence and distribution of diseases, identifies emerging threats, and tracks trends in public health. The agency also offers assistance and technical aid for state and local health agencies. For instance, it has provided short technical assistance like Epi-Aid (for epidemic outbreaks), Lab-Aid (for Laboratory assistance during outbreaks), and Info-Aid (helps in the meaningful use of EHRs), etc. for public health communities (CDC, 2020). This support aims to strengthen their capacity to respond to health emergencies and implement effective public health interventions. Example of Initiative Supporting Mission and Vision One specific initiative that exemplifies the CDC’s commitment to its mission and vision is its global efforts to combat infectious diseases. One such initiative is the Global Health Security Agenda (GHSA), which was launched in 2014 in partnership with other nations, non-governmental agencies, and international organizations. The GHSA aims to enhance countries’ capacities to prevent, detect, and respond to infectious disease threats, whether naturally occurring, deliberate, or accidental (CDC, 2022). It focuses on strengthening health systems, improving laboratory and surveillance capabilities, and fostering collaboration and coordination among nations. By supporting the GHSA, the CDC contributes to global health security and helps prevent outbreaks from becoming pandemics (CDC, 2022). This program supports the CDC’s goal of safeguarding Americans from foreign health threats and its vision of a world free from preventable illness and premature death (Moolenaar et al., 2020). CDC’s Efforts for Equal Opportunity and Improvement of Community Quality of Life The Centers for Disease Control and Prevention (CDC) demonstrates a strong commitment to promoting equal opportunity and improving the standard of living in local communities through various efforts. The CDC conducts extensive research, implements targeted interventions, and collaborates with stakeholders to address health disparities and advance health equity. For example, it provides recommendations for improving access to healthcare, promoting healthy behaviors, and reducing the burden of chronic diseases in underserved communities (CDC, 2023). The CDC collaborates with local health departments, community organizations, and other stakeholders to implement programs tailored to the specific needs of diverse communities. These partnerships facilitate the delivery of culturally competent services and interventions that address social determinants of health. The CDC educates the public about health risks, preventive measures, and available resources through various channels, including educational campaigns, workshops, and online resources such as WeChat (Ma et al., 2021). Through increasing public awareness and enabling people to make knowledgeable decisions about their health, the CDC enhances the general well-being of the community. Barriers and their Implications Health equity is severely hampered by social determinants of health, such as discrimination, poverty, and poor access to healthcare. Disparities in health outcomes based on race, ethnicity, socioeconomic level, and other characteristics may arise from these barriers. The ramifications for marginalized people include worse overall health outcomes, increased incidence of chronic diseases, and restricted access to healthcare services. Cultural differences and language barriers can hinder effective communication and access to healthcare services (Butkus et al., 2020). The CDC’s efforts to address cultural barriers include providing culturally competent care, offering language assistance services, and promoting diversity and inclusion in healthcare settings. Economic disparities, such as restricted availability of cheap housing, wholesome food options, and transportation, contribute to health inequities. These barriers can result in higher rates of preventable diseases, limited opportunities for health promotion, and increased healthcare costs (Butkus et al., 2020). The CDC advocates for policies that address economic barriers, such as increasing access to affordable healthcare, improving social support systems, and promoting economic empowerment initiatives. Physical environments that lack access to safe and walkable neighborhoods, parks, and recreational facilities can negatively impact health outcomes. The CDC’s efforts to address physical barriers include promoting urban planning strategies that prioritize health, advocating for built environments that support physical activity, and improving access to healthcare facilities in inadequately supplied areas. By addressing physical barriers, the CDC aims to create healthier environments that support overall well-being and reduce disparities in health outcomes (Centers for Disease Control and Prevention, 2022). Impact of Funding, Policy, and Legislation on Service Delivery Funding Sources The availability and allocation of funding significantly influence the CDC’s ability to fulfill its objective and offer crucial public health services. Decreased financing may lead to staffing reductions, program cutbacks, and limited resources for research, surveillance, and emergency response efforts. Conversely, increased funding enables the CDC to expand its programs, invest in innovative research, and enhance its capacity to effectively address emerging public health threats (CDC, 2024). Policy and Legislation Policy decisions and legislation at the local, state,

NURS FPX 4060 Assessment 1 Health Promotion Plan Name Capella university NURS-FPX 4060 Practicing in the Community to Improve Population Health Prof. Name Date Health Promotion Plan In-Depth Analysis of Tobacco Use and its Cessation in California Tobacco use and cessation in California pose a substantial community health concern despite notable strides in tobacco control efforts. While overall smoking rates have declined, certain demographic groups, particularly those with lower socioeconomic status and specific racial or ethnic backgrounds, continue to experience higher rates of tobacco use. For instance, the percentage of tobacco use among males and females in California is 14.7 % and 7.2%, respectively. Similarly, 9.8% of Hispanic or Latino groups are using tobacco in different forms, while 15.8% tobacco prevalence is among the American Indian group (CDPH, 2022). This persistent prevalence of smoking contributes to significant health burdens, including increased risks of lung cancer, heart disease, and other chronic conditions. Ultimately, the consequences place strains on healthcare systems and diminish quality of life. Social and environmental factors, such as peer influence and exposure to tobacco advertising, shape individuals’ tobacco use behaviors. In contrast, policy interventions, such as tobacco taxes and smoke-free laws, have proven effective in reducing smoking rates (Mills et al., 2020).  NURS FPX 4060 Assessment 1 Health Promotion Plan While evidence-based interventions for tobacco cessation exist, there may be uncertainties regarding their effectiveness in diverse populations and contexts. Factors such as cultural beliefs, access to healthcare services, and individual motivations can influence the success of cessation efforts (Minian et al., 2020). The rapid proliferation of novel tobacco and nicotine products, such as e-cigarettes and vaping devices, introduces uncertainties regarding their long-term health effects and implications for tobacco control efforts. Moreover, while some individuals may use these products as cessation aids, others may transition to them or initiate tobacco use due to their perceived safety or appeal (Sapru et al., 2020). Addressing tobacco use and cessation requires addressing underlying socioeconomic disparities that contribute to disparities in tobacco use prevalence and access to cessation resources. Overcoming these challenges requires a comprehensive approach that addresses the multifaceted determinants of tobacco use (Kastaun et al., 2020). Moreover, the plan must prioritize equity in access to cessation resources and leverage evidence-based strategies to promote tobacco-free communities and improve public health outcomes in California. Why is Tobacco Cessation Important for the California Community and its Health Promotion? Tobacco cessation is a critical health concern for the population of California due to its significant impact on public health and well-being. Despite the state’s reputation for progressive health policies, tobacco use remains a prevalent issue, particularly among certain demographic groups. According to data from the California Department of Health, approximately 1.8 million (6.2%) adults in California reported being current smokers in 2021, representing a considerable proportion of the population at risk of tobacco-related health consequences (CDPH, 2022). Moreover, smoking rates vary significantly across demographic factors, with disparities evident in terms of socioeconomic status, race, ethnicity, and geographic location. Additionally, the costs incurred by community members due to smoking are $13.29 billion annually. Furthermore, the productivity loss as a result of smoking tobacco incurs $10.35 billion in one year (Truth Initiative, 2022). Tobacco use in California has resulted in 45.8% of deaths from 2014 to 2019 due to cancers caused by smoking and other tobacco products (Maguire et al., 2022). These statistics demand a pressing need for tobacco cessation efforts in California to promote the well-being of the community. NURS FPX 4060 Assessment 1 Health Promotion Plan Furthermore, tobacco use exacerbates existing health disparities within California’s population. Vulnerable groups, including individuals with lower income levels, less education, and specific racial or ethnic backgrounds, are disproportionately affected by tobacco-related health consequences. A study reveals that smoking rates are higher among individuals with lower educational attainment and those living below the federal poverty level (Weinberger, 2022). Additionally, certain racial and ethnic minorities, such as American Indians/Alaska Natives and LGBTQ+ individuals, experience elevated rates of smoking and related health disparities (CDPH, 2022). Disparities in access to tobacco cessation services persist in California, particularly among individuals from disadvantaged backgrounds. Barriers such as lack of insurance coverage, limited healthcare access, and insufficient awareness of available programs hinder their ability to quit smoking. Additionally, geographic disparities exacerbate the issue, with rural and underserved areas lacking adequate healthcare facilities and cessation resources (Hirko et al., 2023). Addressing these disparities is crucial for reducing tobacco prevalence and improving public health outcomes statewide. Individual Demographics Jenny Rosemary, a 45-year-old Hispanic woman, embodies the challenges faced by many individuals in her community i.e. Los Angeles, California. Married with two teenage children, she works tirelessly as a cashier in a local grocery store, earning minimum wage to support her family. Despite completing high school, financial constraints prevented her from pursuing further education opportunities. The factors like low income and limited access to education contributed to tobacco addiction in the form of smoking. Cultural norms within the Hispanic community, where smoking is often normalized, further perpetuated her tobacco use. Additionally, the stress of financial instability pushed Jenny towards smoking as a coping mechanism. Considering these demographic details, Jenny requires a health promotion plan to address her tobacco use and promote tobacco cessation to improve her health. Establishing SMART Goals for the Target Individual In collaborating with Jenny on discussing her serious health concern relevant to tobacco use, we established the following three goals that are Specific, Measurable, Attainable, Relevant and Time-Bound (SMART): Goal #1: By the end of three months (Time-Bound), Jenny will decrease her daily cigarette consumption (Specific, Relevant) from a pack to half a pack (Measurable) with the help and support of tobacco cessation program (Attainable) (Lee et al., 2021). Goal #2: Over the next three months (Time-Bound), Jenny will attend weekly (Measurable) local free of cost tobacco cessation support (Specific, Attainable) to enhance health literacy and willingness to quit smoking (Relevant) (Pettigrew et al., 2020). Goal #3: Jenny will identify and practice two (Measurable) alternative coping strategies (Specific, Attainable) with the help of tobacco cessation program for stress management (Relevant) and integrate them into