NRS 429 Family Assessment Part II
Essay: Family Assessment Part II
In a 750-1,000 word paper, create a plan of action to incorporate health promotion strategies for this family.
Include the following:
1. Describe the SDOH that afect the family health status. What is the impact of these SDOH on the family?
Discuss why these factors are prevalent for this family.
2. Based on the information gathered through the family health assessment, recommend age-appropriate
screenings for each family member. Provide support and rationale for your suggestions.
3. Choose a health model to assist in creating a plan of action. Describe the model selected. Discuss the
reasons why this health model is the best choice for this family. Provide rationale for your reasoning.
4. Using the model, outline the steps for a family-centered health promotion. Include strategies
Family Health Assessment is crucial in identifying the family’s strength and weakness in terms of access to quality and affordable care. The assessment also provides crucial information to the healthcare practitioners on the threats to achieving comprehensive health and general wellness for the whole population. Furthermore, the family assessment prepares nurses especially the Family Nurse Practitioners with the relevant skills required in the assessment of the family health patterns and be able to offer family-based solutions (Peterson-Burch, 2018). The concept has also proved to be instrumental in advancement of genetic interventions in some of the complex conditions.
Social determinates of health (SDOH) are described as the conditions in which individuals are born, live, play, work, learn, worship, and age that affect function, health, and quality of life (QoL). SDOHs are classified into five broad areas: health and health care, education, social and community context, economic stability, and neighborhood and built environment (Clements, 2018). In the previous assignment, a family assessment was conducted on Family Y, an African-American lower-middle-class family. The purpose of this paper is to discuss the SDOH associated with the family’s health status, propose age-appropriate screening strategies for the family members, and explore a health model that can be used in a plan of action.
SDOH That Affects the Family Health Status
The SDOHs that affect Family Y’s health status include education, economic stability, health and health care, and neighborhood. All the family members have reached high school education and above, which enables them to understand the importance of healthy lifestyle practices and the consequences of unhealthy habits. Zajacova and Lawrence (2018) explain that individuals who have attained a higher educational level live healthier and longer lives than those with less education. Besides, people with low education levels are likely to engage in unhealthy habits like tobacco smoking, unhealthy dietary habits, and lack of physical exercise.
Due to the high education levels in the family, the members were able to get income opportunities that enabled them to purchase private medical insurance and consequently access healthcare services, including specialized services. Zajacova and Lawrence (2018) assert that education contributes to better, more stable sources of income that bring higher income and enable families to build wealth that is used to enhance their health. Furthermore, the family lives in a safe neighborhood with access to adequate clean water, healthy foods, healthcare facilities, and transportation options. This has significantly impacted the family’s health since they are free from water-borne and water-wash diseases. Besides, access to healthy foods reduces the intake of junk foods which lowers the risk of lifestyle diseases (Clements, 2018). Lastly, the access to healthcare facilities has enabled the family to obtain essential and specialized healthcare services, which improves their health.
Age-Appropriate Screenings for Each Family Member
Family Y members are at risk of chronic illnesses contributed by risk factors such as a family history of diabetes and hypertension, and race. Therefore, age-appropriate screenings are vital to helping identify chronic diseases at an early stage and take appropriate interventions to treat them or delay their progress. Appropriate screenings for Mr. Y (62 years with controlled Type 2 Diabetes and hypertension) include colorectal cancer screening,
The United States Preventive Services Taskforce (USPSTF) recommends screening for colorectal cancer in adults aged 45 to 75 years (USPSTF, n.d.). Cholesterol screening is also needed since he is at risk of heart disease. An annual eye and foot exam are also recommended due to the risk of cataracts and diabetic foot ulcer.
Age-appropriate screenings for Mrs. Y (59 years) include blood pressure, blood sugar, colorectal cancer, cholesterol, cervical cancer,
and mammography screening. The USPSTF recommends screening hypertension from 18 years and diabetes from 35 years. In addition, it recommends cervical cancer screening in women 30-65 years, including three-yearly with cervical cytology alone and five-yearly with high-risk HPV testing alone (USPSTF, n.d.). The USPSTF further recommends biennial screening mammography for females 50 to 74 years. The recommended screening for the daughters (35, 32, and 28 years) includes blood pressure, blood sugar, monthly self-breast exam, biannual dental check-ups, and cervical cancer screening. The appropriate cervical cancer screening for the 28-year-old as per the USPSTF recommendations is three-yearly cervical cytology alone (USPSTF, n.d.). Furthermore, recommended screenings for the son (23 years) include blood pressure and biannual dental check-ups.
Health Model
The Health Belief Model (HBM) was selected to help develop a plan of action. HBM predicts and explains changes in people’s health and lifestyle behaviors. In addition, HBM has explained the core elements influencing health behaviors, including perceived susceptibility, severity, benefits, barriers to action, cues to action, and self-efficacy (Bechard et al., 2021). These elements emphasize individuals’ beliefs about health and diseases, influencing health behaviors. HBM is the ideal health model for Family Y since it can help predict the health behaviors among the family members. Furthermore, the model can give insight into how the members’ beliefs about disease and health impact their lifestyle practices (Bechard et al., 2021). For example, Mrs.Y and the children recognize they are susceptible to developing lifestyle diseases since Mr. Y had diabetes and hypertension. Consequently, they have adopted healthy lifestyle practices like regular physical exercise and healthy dietary habits, which they perceive to be beneficial in lowering the risk of diseases.
Steps for a Family-Centered Health Promotion
The HBM can be applied to family health promotion by first performing a needs assessment to identify the family’s health needs. Besides, the assessment is essential in determining the health risks prevalent among the family members. The next step in health promotion using the HBM is to assess whether the family members believe that they are at risk of any diseases based on the health risks and how they regard them as being severe enough to affect their health (Bechard et al., 2021). The third step is to inquire about the interventions taken by the family to mitigate the health risks, their view on how they will benefit their health, and the barriers limiting them from effectively implementing the interventions. Additional interventions that can help mitigate the health risks should also be provided at this step.
The family should be assisted in identifying approaches to eliminate these barriers to achieve the desired outcome. Communication strategies during the health promotion include involving all the family members by allowing each member to participate in the discussion (Barnes et al., 2020). Furthermore, the provider should acknowledge the family’s rights and privacy and its need for independence in performing their responsibilities.
Conclusion
The SDOH that impacts Family Y’s health status includes high education levels, income, health insurance, healthcare facilities, a safe neighborhood, and access to safe water and healthy foods. The recommended screenings include blood pressure, blood sugar cholesterol, cervical cancer, colorectal cancer, mammography, self-breast exam, and dental check-ups. The HBM is applied in health promotion and disease prevention programs since it helps better understand individuals’ health behaviors.
References
Barnes, M. D., Hanson, C. L., Novilla, L. B., Magnusson, B. M., Crandall, A. C., & Bradford, G. (2020). Family-Centered Health Promotion: Perspectives for Engaging Families and Achieving Better Health Outcomes. Inquiry: a journal of medical care organization, provision, and financing, 57, 46958020923537. https://doi.org/10.1177/0046958020923537
Bechard, L. E., Bergelt, M., Neudorf, B., DeSouza, T. C., & Middleton, L. E. (2021). Using the Health Belief Model to understand age differences in perceptions and responses to the COVID-19 pandemic. Frontiers in psychology, 12, 1216. https://doi.org/10.3389/fpsyg.2021.609893
Clements, D. S. (2018). Social determinants of health in family medicine residency education. https://doi.org/10.1370/afm.2211
United States Preventive Services Taskforce. (n.d.). A and B recommendations | United States preventive services Taskforce. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-and-b-recommendations
Zajacova, A., & Lawrence, E. M. (2018). The Relationship Between Education and Health: Reducing Disparities Through a Contextual Approach. Annual review of public health, 39, 273–289. https://doi.org/10.1146/annurev-publhealth-031816-044628
Social determinants of health are factors within one’s family and community that affect their access to healthcare services. Arthur’s family was interviewed in the previous project. The assessment showed the existence of significant health-related needs for the family. Nurses and other healthcare providers should collaborate with the family in developing healthcare plans to transform their lifestyles and behaviors. Therefore, this paper examines the social determinants of health affecting Arthur’s family, age-appropriate screenings for the family members, and appropriate health model that can be used to develop a plan of care for the family.
Social Determinants of Health Affecting the Family
As noted above, social determinants of health are factors within one’s environment that influence their access to healthcare services. The factors include those in places where one was born, work, grew, aged, and died. The interview with Arthur’s family showed the existence of several social determinants of health affecting them. One of them is the lack of awareness about their health needs. Education is an important aspect in health that increase population’s awareness about health risks and how to avoid them. However, Arthur’s family is not aware of the health risks associated with sedentary lifestyles. The family members rarely engage in active physical activity despite being obese and Arthur suffering from hypertension (CDC, 2022). Arthur and his son consume high amount of high calorie foods, which increases their risk of health complications such as cancer, hypertension, diabetes, and stroke. Therefore, their lack of awareness about the health risks of their lifestyles and behaviors is a crucial determinant of the family’s health.
The other social determinant of health seen in Arthur’s family is the affordability of healthcare services. Despite Arthur and his son suffering from hypertension and obesity respectively, they rarely visit the hospital for assessment and treatment. The family noted experiencing financial hardships, which makes it difficult for them to access and utilize the healthcare services that they need. The American healthcare system is among the most expensive in the world (Palmer et al., 2019). As a result, families from low socioeconomic backgrounds often experience challenges in affording the healthcare services they need for their health and wellbeing.
The other social determinant of health evidence from the family assessment is social and community contexts. Arthur’s family demonstrated the lack of adequate family support system during the assessment. This could be seen from the family members failing to provide their daughter her desired social support when she experienced a relationship failure. The family also does not discuss about issues related to sexuality and relationship due to the influence of their religious beliefs (Palmer et al., 2019). The wider social and community system also does not support healthy habits for its members. This can be seen from the easy access to fast foods for the family members and the lack of community systems to increase the population’s awareness about the importance of healthy lifestyles and behaviors (CDC, 2022). Therefore, Arthur’s family social and community contexts act as their social determinants of health.
Age-Appropriate Screenings
Arthur’s family members should utilize different age-appropriate screenings for their health promotion. The age-appropriate screenings for John Arthur include eye examinations, hearing tests, blood pressure screening, skin, dental, and testicular examinations. Age-appropriate screenings for Cate Arthur includes skin, dental, blood pressure, hearing, and eye examinations. The age-appropriate screenings for Chris Arthur includes eye, blood pressure, hearing, dental, and skin examinations. Mr. Arthur’s age-appropriate screenings include blood pressure, testicular, blood glucose, cholesterol, colonoscopy, and prostate screening tests. The age-appropriate screenings for Mrs. Arthur include ovarian cancer screening, mammography, bone density, cholesterol, blood glucose, blood pressure, pelvic, and cervical cancer screenings (Fragala et al., 2019). These screenings are important for early detection and prevention of potential health problems that may affect the family members.
Health Model for the Family
A health model that can be adopted to assist in creating a plan of action for the Arthur’s family is the transtheoretical model. Transtheoretical model is a theory of change used to facilitate behavioral change among the target populations. It promotes long-term behavioral change through multiple adaptions and actions over time. The model postulates that people are in different stages of readiness to embrace healthy lifestyles and behaviors (Castrucci & Auerbach, 2019). As a result, the nurse should create awareness about the change and provide enabling factors for the process. The transtheoretical model asserts that change occurs in steps that include precontemplation, contemplation, preparation, action, and maintenance. This model is appropriate for the family since it will promote sustained lifestyle and behavioral change among the family members (Pennington, 2021). Since change occurs in steps, it would be possible to implement strategies that will prevent family members from relapsing to their unhealthy habits.
Steps for a Family-Centered Health Promotion
The transtheoretical model provides several steps that must occur for the delivery of family-centered health promotion. The nurse should create awareness among the family members for the change in the precontemplation stage (Pennington, 2021). The family members should be made to understand the health risks associated with their behaviors and the need for a change. The nurse should facilitate them to develop interest in changing their behaviors in the contemplation stage. She should also help them to explore strategies that they need for their optimum health and wellbeing in the preparation stage (Liu et al., 2018). The nurse should then guide them in implementing new, healthy lifestyles and behaviors in the action phase. The focus is on ensuring incremental adoption of healthy lifestyles and behaviors and assisting the family members not to relapse to their unhealthy behaviors. The last stage in creating sustainable change is maintenance where family members have stabilized the desired healthy behaviors (Prochaska, 2020). Therefore, the transtheoretical model of change provides an effective approach to assisting the family achieve their desired health promotion goals.
Conclusion
Overall, Arthur’s family experiences significant social determinants of health that affect their healthcare access and health-related outcomes. The nurse should work with the family in identifying the effective ways to promote the optimum health of the family members. The transtheoretical model of change can be applied in assisting the family to achieve its health promotion goals. The model provides steps for achieve sustained behavioral change in the family.
References
Castrucci, B., & Auerbach, J. (2019). Meeting individual social needs falls short of addressing social determinants of health. Health Affairs Blog, 10(10.1377).
CDC. (2022, May 9). Social Determinants of Health | NCHHSTP | CDC. https://www.cdc.gov/nchhstp/socialdeterminants/index.html
Fragala, M. S., Shiffman, D., & Birse, C. E. (2019). Population health screenings for the prevention of chronic disease progression. Am. J. Manag. Care, 25, 548–553.
Liu, K. T., Kueh, Y. C., Arifin, W. N., Kim, Y., & Kuan, G. (2018). Application of transtheoretical model on behavioral changes, and amount of physical activity among university’s students. Frontiers in Psychology, 9, 2402.
Palmer, R. C., Ismond, D., Rodriquez, E. J., & Kaufman, J. S. (2019). Social Determinants of Health: Future Directions for Health Disparities Research. American Journal of Public Health, 109(S1), S70–S71. https://doi.org/10.2105/AJPH.2019.304964
Pennington, C. G. (2021). Applying the transtheoretical model of behavioral change to establish physical activity habits. Journal of Education and Recreation Patterns, 2(1).
Prochaska, J. O. (2020). Transtheoretical model of behavior change. Encyclopedia of Behavioral Medicine, 2266–2270.