How do I answer the following posts on Population Health and Care Equity – Concept

How do I answer the following posts on Population Health and Care Equity – Concept analysis competency. Please be as detailed as possible. Please provide a list of references no older than 5 years of age for each answer separately. Answer each post separately. Thank you. Post 1: Nishat Community-based care is characterized by specialized treatment plans tailored to the needs of individuals from various socioeconomic backgrounds with varying social determinants of health (SDOH). In the APN role, I strive to provide community-based care by understanding these SDOHs and subsequently refer my patients to the appropriate resources so that we can optimize their treatment plans. I will take these factors into account when I am making specific recommendations for my patients as well. For example, I am constantly encouraging my patients to take daily brisk walks to ease joint pain (Harvard Health, 2023), however, I do not consider the neighborhood my patient lives in. I have to consider the walkability of the neighborhood. Perhaps my patient lives near a highway or doesn’t have a proper neighborhood to make these walks. I can then look into nearby parks or walking trails to help my patient find a safe place to walk and exercise. Community-based care entails that one size does NOT fit all. Community-based care also promotes the involvement of case managers and social workers to help me as an APN to help identify resources that can ” provide for independent living, residential services, complex medical care, and community-participation services to support personal and professional goals (e.g., education, employment, and recreation-based supports”(Idrees et al., 2024). Community-based care leads to population health which may encompass chronic disease management, access to care, and health care disparities. Certain communities or groups may be more vulnerable to chronic illnesses such as hypertension. This is why preventative healthcare is important to establish in these communities to avoid events such as strokes as a result of chronic high blood pressure. Affluent communities may have better access to healthcare and can therefore manage chronic disease better. In these communities, health fairs may be prevalent where blood pressure screenings are done, which can help encourage individuals to purchase blood pressure monitors and monitor their blood pressure, unlike patients from underserved neighborhoods. The COVID-19 pandemic has taught us a lot about these healthcare disparities’ and how determinantal inequities in healthcare are in certain populations. One study discusses the healthcare barriers that persisted during COVID-19 vaccinations. Historically, It is evident how fair distribution of vaccinations has been a challenge amongst communities from varying geographical and socioeconomic backgrounds. The study continues to emphasize this statistic with the following quotation: “CDC reports that the COVID-19 vaccination rate for African Americans has lagged that of the general US population [7]. Furthermore, survey data from the Kaiser Family Foundation (KFF) show that rural residents and white evangelical Christians continue to lag the general US adult population in uptake of COVID-19 vaccines [6]” (Kuehn et al., 2022). Once again, this reinforces the importance of community-based care. Rural towns may not have the medical personnel and/or equipment to distribute and administer the COVID-19 vaccinations. Unlike an urban city like Newark, where Rutgers Nursing students, Medical students, and Pharmacy students, were allowed to administer Covid-19 vaccinations through the school volunteer programs, these rural locations may not have the means to conduct these mass vaccinations. As a result, collective coordination of healthcare services must be established so that these communities are not falling behind. APNs and other healthcare providers should be allowed the opportunity to provide their services in distant states when there are states of emergencies and there are efforts to provide care to groups of people. Post 2: Nathalie As an advanced practice mental health nurse, care considerations involving community-based care, chronic disease management, access to care and disparities will play a great role in the treatment of behavioral health patients from varying backgrounds. In a comprehensive review by Cook et al. (2019), it is described that ample evidence exists to demonstrate that mental health care disparities exist via socioeconomic and demographic predictors. For instance, racial minorities are less likely to access mental health care and community resources, and more likely to visit the emergency room and receive lower quality care than non-Latino white counterparts (Cook et al., 2019). Nurse leaders can play an important role in evaluating health equity and advocating for their patients (Azar, 2021). Practicing in different types of communities, such as urban versus rural areas, will pose different challenges (Myers, 2019). Advance practice nurses should recognize and accommodate patients based on their specific needs and restrictions (Myers, 2019). One example of tending to a specific community needs is increasing Telehealth availability and utilization amongst rural areas that experience concurrent disparities in access to mental health care and higher rates of untreated mental illness than in urban communities (Myers 2019). Another way that an understanding of population health tenets can be applied within a community is within the realm of treating mental health disorders within the youth population (Rodgers et al., 2022). Rodgers et al. (2022) outlined that significant racial/ethnic disparities exist amongst access and utilization of youth mental health care despite wide range policy reform. It is suggested that along with further insurance adjustments, it is highly important that discrimination in the environment of patient care interactions is limited (Rodgers et al., 2022). Leaders may play the role of making sure there is education and training in place for providers and administration in order to decrease discrimination (Rodgers et al., 2022). When providing care to this population, providers should be aware of their own biases and be in a constant process of unlearning them for the sake of the patient (Rodgers et al., 2022). The COVID-19 pandemic unfortunately highlighted the socioeconomic and racial disparities that exist within the United States healthcare system (Thomeer et al., 2022). For example, Black and Hispanic populations experienced higher rates of COVID-19 related infection, death, and negative effects on social determinants of health such as unemployment, loss of income and loss of childcare (Thomeer et al., 2022). Nurse leaders and advance practice nurses have an important voice in advocating for patients and should be involved in decision making when it comes to reform to reduce the disparities highlighted by the COVID-19 pandemic (Azar, 2021). Evaluating health equity, and possible barriers that patients are facing will help to ensure that patients are receiving the highest quality of care (Azar, 2021). Also, being aware of community resources and connecting patients to these resources will add to the advance practice nurse’s role in healthcare reducing disparities (Azar, 2021). Post 3: Damilola Population Health and Care Equity Incorporation of community-based care, chronic disease management, access to care and disparities in care into my practice as a leader and/or Advanced Practice Nurse will first include collecting data to study for opportunities of improvement in the patient population. A type of data collection to be utilized is addressing the Social Determinants of Health (SDOH). Addressing the Social Determinants of health exemplifies value-based care, which rewards clinicians for results of care rather than activities of care. In addition, it reflects the understanding that the best patient care incorporates all factors pertaining to a patient’s health — including social determinants of health (Health IT, 2021). This can be done by utilizing technology – Electronic Medical Record (EMR) – like Epic or Patient Portal to implement SDOH screening for all patients. According to the U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion (2023), SDOH can be grouped in 5 domains – Economic stability, Education Access and quality, Healthcare Access and Quality, Neighborhood and Built Environment, Social and Community Context. Standardized questionnaires can be built around these domains for patient screening. Then, I offer applicable resources to address the deficient domain with collaboration with social worker and care coordination. Another way of incorporation is to monitor clinical standards of care for quality assurance. In addition, using the health government website (CDC, healthy People 2023) will be used as a guide for clinical measures to focus on in the practice. An impact of the COVID-19 pandemic in the population is the dramatic psychological effects, major disorders, and other negative side effects, such as stress, anxiety, depression, and fear among people (Alizadeh et al., 2023). A way to address this impact in practice is to utilize a standardized mental health questionnaire like the Patient Health Questionnaire -2 (PHQ2) at patient’s visit. Another impact of COVID-19 pandemic is prevention, identification, and management of chronic disease (Hacker et al., 2021). To expatiate, COVID-19 has resulted in decreases of many types of health care utilization, ranging from preventive care to chronic disease management and even emergency care. As of June 2020, 4 in 10 adults surveyed reported delaying or avoiding routine or emergent medical care because of the pandemic. Cancer screenings, for example, dropped during the pandemic. Decreases in screening have resulted in the diagnoses of fewer cancers and precancers, and modeling studies have estimated that delayed screening and treatment for breast and colorectal cancer could result in almost 10,000 preventable deaths in the United States. There have been setbacks in prevention across the chronic disease spectrum and in other areas, including pediatric immunization, mental health, and substance abuse (Hacker et al., 2021). An initiative I will incorporate to address this is to utilize telemedicine, as it offers convenience for the patients and meet them at their place of comfort which thereby will increase patients’ access to healthcare – increasing access to home screenings, such as cancer screening or monitoring (eg, home blood pressure monitoring) where appropriate. Post 4: Adriana In today’s healthcare, there is an intersection seen between population health, quality and safety. This was particularly noticeable in the wake of the COVID-19 pandemic. As an Advanced Practice Nurse there are numerous opportunities to incorporate community-based care with chronic disease management to help address disparities in access to care. Community-based care emphasizes the importance of the integration of healthcare services in communities. As an APN, it will be important to work with local organizations to help better understand the health needs and try to provide for the given population. It is important in addressing social determinants of health and medicalization within a certain population (Lantz et al., 2023). A more holistic view of health can help tailor interventions to be culturally relevant as well as accessible. Building on community-based care, effective chronic disease management relies on the understanding of health needs. The implementation of patient education and regular follow-up care can be vital to keeping patients healthy. With the use of telehealth, it can support the management for patients that have trouble going to in-person visits. There is a consequence to this and that is when talking about individuals that are not technologically -savvy which can cause issues. Odutayo et al., explains how an integrated care model can help effectively support chronic-disease management (2023). When we empower patients/individuals to take charge in their health it can reduce hospitalizations for many. To ensure equitable health outcomes addressing disparities in care is crucial. As a nurse leader/APN I will advocate for my patients through policy changes such as insurance coverage and increasing funding for community healthcare. In the hospital setting, training staff members to recognize and address implicit biases can create equitable care. Leadership training that focuses on health equity to prepare nurses to act on public health emergencies (Levis et al., 2022). The COVID-19 highlighted the importance of being prepared for a pandemic and how to implement strategies for rapid response. Incorporating education sessions/outreaches about the virus, and how to stay vigilant (vaccinations and preventive measures) will better prepare communities. The COVID-19 pandemic was a learning moment for everyone around the world. When prioritizing health equity and quality and safety there can be improved health outcomes for patients and the healthcare system.

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