In 2009, President Obama signed an executive order calling for improvement of the health of Asian Americans and address disparities in availability of data on Asian Americans subgroups. The executive order was consistent with the Healthy People 2020 program that was based on a simple yet powerful model that sought to:
Establish national health objectives, and
Provide data and tools to enable states, cities, communities, and individuals across the Nation to combine their efforts to achieve them (Office of Disease Prevention and Health Promotion, 2018).
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A teaching work plan is critical as a primary prevention/health promotion strategy particularly against cardiovascular diseases among Indian Americans. A recent study conducted by Jose, Frank, Kapphahn et al. (2014) established that a proportionately high number of Indian men and women bore the mortality burden from ischemic heart disease, hypertensive heart disease and cerebrovascular disease, especially hemorrhagic stroke compared to non-whites Hispanics. The findings were preceded by those in Jernigan, Duran, B., Ahn et al. (2010), which found out that from 1995–1996 to 2005–2006, the prevalence of diabetes among Indian Americans in Alaska increased from 6.7% to 8.5%. Obesity increased from 24.9% to 31.2%, while hypertension increased by from 28.1% to 29.5%. These are risk factors for cardiovascular disease and the trend is a cause for concern. The 2005-2006 population posited little change in risk factors including smoking, sedentary life, or intake of fruits and vegetables. Furthermore, 79% of the population segment had 1 or more of the 6 risk factors studied and 46% had 2 or more (Jernigan et al. , 2010). The following Community Teaching Work Plan Proposal is specific to health promotion and primary prevention of cardiovascular diseases (CVDs) among Indian American communities.
Community and Target Population
The target population is racial or ethnic groups of Indian Americans who are at the highest risk of CVDs. The targeted individuals are those above 45 years of age based on the rationale that they are corpulent, lead sedentary lives, have low high-density lipoprotein (HDL) or high triglycerides, and high blood force per unit area. The teaching program would cover an estimated 200 households of Indian Americans where 60% of the adult population is over 45, and are employed in full time jobs.
Epidemiological Rationale
Presentation of statistics related to the subject would be covered in this section. Among those to be highlighted are trends in CVDs among Indian Americans. Studies from other countries indicate high incidence and prevalence of diabetes, metabolic syndrome, and CVD among immigrant Asian Indians (Misra, Patel, Kotha et al. , 2010). The trends are associated with a number of risk factors:
Diet of a typical American Indians - saturated fat consumption,
Decreased physical activity in the population raises the risk of obesity, blood lipid abnormalities, hypertension, and non-insulin dependent diabetes mellitus,
Increased risk factors in urban population - high serum cholesterol levels,
Low and middle educational status urban subjects in India have greater cardiovascular risk,
Unique biochemical abnormalities in American Indians: increased insulin opposition, higher waits perimeter, higher abdominal adiposeness, increased sensitivity to C-reactive proteins, and
Familial factors.
However, it would be pointed out that etiology of CVD is multifactorial and no single risk factor is regarded as an absolute cause.
Nursing Diagnosis
Emphasis must be placed on early designation of people at risk. The process can utilize simple showing tools that are population particular such as the Indian CVD risk score (ICVD-RS). Appropriate lifestyle intercession can be advocated as a strategy of forestalling and detaining CVD in at risk populations. Population to adopt healthier dietetic regimens and increased physical activity through exercising.
Readiness for Learning
Identify factors that demonstrate the preparedness of the population to learn. Inclusion of emotional and experiential preparedness is imperative. Explore the possibility that the community has healthcare professionals who may aid in the learning process. Emphasize on the need for emotional consciousness about the need for alteration of lifestyle; and social consciousness on increasing physical activity.
Learning Theory to be Utilized
Explanation of how the learning theory would be applied. For instance, for cognitive theory, information accumulation is from the environmental stimulation. Therefore, use ocular techniques such as power point presentation and associated audio. Draw from past experiences or exposure to the information to generate response towards the information goal such as relevance to Healthy Peoples 2020.
Behavioral Objectives
It is important to use the MAP-IT model in the mobilization of partners, assessment of community needs, creating and implementing a plan to reach healthy people 2020 objectives, and tracking the community’s progress. The objectives should include a breakdown of the specifics such as dietary constituents to be eaten within 24 hours to avoid the risk of CVD, and hours of exercise per day.
Overall, it is necessary to give illustrations of how different factors associated with risk of CVD interact and such as a visual representation of fat saturated diet and the building of fat deposits around the heart muscles, subsequently impairing with its pumping mechanism. A general overview of CVD and its development, progression, and symptoms is included. The motive is to inspire an interactive session where the audience can express its understanding of the different aspects of CVD. The interactive sessions advance the objective of the teaching module to ensure at the end of the lesson, learners can determine whether they are at risk of CVD based on their understanding of risk factors. The process will aid in the development of preventative steps, which are generalized based on knowledge that CVD has no one specific absolute cause. Enhancing creativity in responses to prevention and risk reduction is imperative. For each aim, a clear description of what will be measured and how should be provided. This can be done through a quiz or measurement of the intention to have a lifestyle change. The responses are integrated into the preventative steps. Finally, a planned evaluation of the lesson is done to ascertain if the intended areas and objectives have been covered conclusively.
References
Jernigan, V. B. B., Duran, B., Ahn, D., & Winkleby, M. (2010). Changing patterns in health behaviors and risk factors related to cardiovascular disease among American Indians and Alaska Natives. American journal of public health , 100 (4), 677-683.
Jose, P. O., Frank, A. T., Kapphahn, K. I., Goldstein, B. A., Eggleston, K., Hastings, K. G., ... & Palaniappan, L. P. (2014). Cardiovascular disease mortality in Asian Americans. Journal of the American College of Cardiology , 64 (23), 2486-2494.
Misra, R., Patel, T., Kotha, P., Raji, A., Ganda, O., Banerji, M., ... & Balasubramanyam, A. (2010). Prevalence of diabetes, metabolic syndrome, and cardiovascular risk factors in US Asian Indians: results from a national study. Journal of diabetes and its complications , 24 (3), 145-153.
Office of Disease Prevention and Health Promotion. (2018). Program planning. Retrieved from https://www.healthypeople.gov/2020/tools-and-resources/Program-Planning.
