NRS 440 Advocacy Through Legislation GCU
NRS 440 Advocacy Through Legislation GCU
Nurses are advocates who champion different healthcare issues that impact patients, the nursing profession, and health system in general. As advocates, they collaborate with other stakeholders like their elected representatives to push for changes aimed at improving care delivery by addressing emerging issues and problems like access to maternal health care, having full practice authority to increase access, and even allocation of more resources for primary health interventions (Hassmiller, 2021). The purpose of this paper is to discuss the need for full practice authority for nurses to increase access to healthcare for different populations, especially those in rural areas.
| Problem
In no more than 250 words, describe the problem, who is affected, and the current ramifications. Explain the consequences if the issue continues. |
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| The increasing demand for healthcare across the population and patient spectra implies that more healthcare providers will be required to offer specialized care to meet patient needs. Currently, the nursing shortage continues to hamper attempts to provide quality and primary care to different populations. Today, more than 25 states, territories, and Washington D.C. allow nurse practitioners to have full practice authority (FPA) to increase access to health services and ensure that more Americans, especially in rural areas have care services that they require (AANP, 2022). Rural populations, marginalized groups, and racial minorities as well as low-income families and individuals without health insurance will continue to suffer due to limited access to healthcare if states like Illinois do not allow nurse practitioners to have full practice authority and deal with rising prevalence of diseases, epidemics like the opioid crisis, pandemics, and overall improvement in primary care (Hassmiller, 2021). Studies are categorical that FPA will lead to increased access to health care, especially in rural and remote communities, lead to better or healthcare efficiency, reduce the cost of healthcare, and improve levels of patient and provider satisfaction (Poghosyan et al., 2022). The implication is that full practice authority is essential in making healthcare access better and improving quality as NPs with their specialization can deal with diverse populations, including the elderly with chronic diseases due to aging. | ||
| Idea for Addressing Solution
In no more than 250 words, outline your idea for addressing the issue and explain why legislation is the best course for advocacy. |
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| Attaining full practice authority is essential and requires a two-pronged approach that entail promoting health equity and removal of practice barriers to nursing. The report by the National Academies of Medicine, “The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity,” places nurses at the center of attaining health equity for millions of Americans (Wakefield et al., 2021). The report recommends efforts to improve the profession, including full practice authority, for nurses to help reduce the health disparities and address the ever-rising social determinants of health (SDOH) that hamper efforts to access healthcare. Through state and federal legislations aimed at making changes to states’ Nursing Practice Act (NPA), legislations can be passed to ensure that qualified nurse practitioners practice to the full level of their education and training as well as their specialty. Full practice authority mandates require legislative actions through the actions of elected representatives at state and federal levels. Full practice authority will help attain health equity and lead to reforms in nursing education and curriculum as nurse will advance equity for all patients through cultivating an inclusive environment, offering support and mentorship, and ensuring that nurse practice cultural humility as well as being aware of their biases (Poghosyan et al., 2022). Legislative actions are the most effective approach in advocating the full practice authority mandates since such laws will be mandatory and state nursing boards will have to oblige and develop mechanisms to realize the new practice standards and requirements. | ||
| Research the Issue
Perform research and compile information for your idea. Present substantive evidence-based findings that support your idea for addressing the problem (studies, research, and reports). Include any similar legislation introduced or passed in other states. |
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| Evidence 1 | Evidence from the report by National Academies of Medicine supports full practice authority because of the benefits it shall provide in addressing disparities and attainment of health equity, especially for vulnerable populations. Nurses with FPA will be primary care providers in rural and remote settings and fill the gaps left by the limited number of physicians. | |
| Evidence 2 | According to Zwilling et al. (2021) utilization of NPs in states with full practice authority has led to better healthcare access, especially at primary care level. The article notes that deploying NPs with FPA will help reduce access barriers, lead to innovative care provision, and reduce the overall costs of care as well as increasing patients’ satisfaction. | |
| Evidence 3 | According to reports by Centers for American Progress (CAP), communities in rural areas will get increased access to healthcare since they are the most affected by any shortage of healthcare providers, including nurses and physicians (Waldrop et al., 2022). Therefore, increasing FPA will address the shortage of primary health providers in rural settings. | |
| Stakeholder Support
Discuss the stakeholders who would support the proposed idea and explain why they would be in support. |
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| Stakeholder(s) Supporting 1 | Nurses will be the most vocal advocates for FPA, especially those with specialization and in states with reduced or restricted practice authority like Illinois. The support for the FPA will ensure that they practice to full level of their training and specialization, can meet patient needs and do not require supervision from physicians. The move will enhance their status as equal primary care providers and raise their esteem. | |
| Stakeholder(s) Supporting 2 | Professional nursing associations that have advocated states to mandate FPA will also welcome such a move as it would improve the overall welfare of nurses and their satisfaction levels. The move will also imply that more NPs will get advanced education and training to meet patient needs and demands. | |
| Stakeholder(s) Supporting 3 | Patients and their families, especially in rural and remote areas will welcome the move as it would improve access to quality and affordable care. These stakeholders will also receive customized services due to cultural competent care that will be advocated by the NPs based on their practice settings. | |
| Stakeholder Opposition
Discuss the stakeholders who would oppose the proposed idea. Explain why they would be in opposition and how you would prepare to debate or converse about these considerations. |
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| Stakeholder(s) Opposed 1 | Physicians may oppose FPA for NPs since it will make them not seek supervision mandates. Physicians stand to lose substantial revenues and may not have the clout since NPs would be equal primary care providers. However, they should understand that having FPA will increase access to quality care and they would also benefit as it will address physician shortage in certain areas. | |
| Stakeholder(s) Opposed 2 | State nursing boards may also be opposed to FPA since it will mean more NPs can offer primary care. The boards will also have to comply with these regulations and ensure that nursing curricula capture the new aspects of health care delivery models. | |
| Financial Incentives/Costs
In no more than 250 words, summarize the financial impact for the issue and the idea (added costs, cost savings, increased revenue, etc.). Provide support. |
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| The financial incentives of having FPA for NPs are bound based on existing studies and reports. The cost of nursing and physician shortage to the healthcare industry is astronomical as patients spend more to access specialized care in far-flung areas. Again, more healthcare facilities and organizations are investing in health technologies like telehealth to improve accessibility. The recent pandemic and an aging population has pushed the demand for care by 20% and healthcare organizations continue to struggle in filling these gaps. Having FPA will reduce and prevent duplication of services and billing costs related to outdates physician oversight over NP (Wakefield et al, 2021). The American Association of Nurse Practitioners (AANP) (2023) asserts that FPA reduces unnecessary repetition of order, physician visits and care services. FPA would also streamline care and make delivery more efficient as it removes delays arising from the regulatory-mandated contracts with physician as a practice condition for the nurses. Therefore, the financial incentives associated with FPA are significant and also the efficiency that will emerge from allowing the NPs to practice based on their training and education levels. States could save up to $872 million by allowing NPs to have full practice. Again, NPs will have more incentives to practice and provide care to patients and populations with full practice authority (Madura et al., 2022). The implication is that the financial incentives arising from FPA will be significant and the expected reduced cost will ensure that patients spend less on care provision. | ||
| Legislature: Information Needed and Process for Proposal
Discuss the how to advocate for your proposal using legislation. Include the following: |
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| Provide the name and complete contact information for the legislator. | ||
| Describe the steps for how you would present this to your legislator. | I would conduct research and develop a proposal on the issue, in this case, need for FPA and the associated benefits. I will present the proposal to the legislator by requesting a formal meeting and if allowed make the presentation developed through slide presentation. I will describe the aspects of the proposal and what it means for the legislator as the main sponsor if he or she decides to present it as a bill in the House or Senate. | |
| Outline the process if your legislator chooses to introduce your idea as a bill to Congress. | The legislator will develop the bill by having professional and expert input. The legislator would then present the bill for first reading on the floor, especially the House. The bill will then be assigned to departmental committees based on the areas it affects. The committees will make necessary changes or amendments and present the bill for a second reading. The House will debate and approve, reject or make more changes before sending back the bill to the committee. Upon making the changes, the committee will bring back the bill for a third reading and debate before members take a vote on it. If passed by majority and move to Senate where upon passage, it will be enacted after a presidential signing. | |
| Christian Principles and Nursing Advocacy
In no more than 250 words, discuss how principles of a Christian worldview lend support to legislative advocacy in health care without bias. Be specific as to how these principles help advocate for inclusiveness and positive health outcomes for all populations, including those more vulnerable, without regard to gender, sexual orientation, culture, race, religion/belief, etc. |
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| God calls on people to be ambassadors and advocate issues that affect a majority of individuals in their practice settings and environments. In this case, irrespective of their racial composition, patients need access to healthcare services across states to improve their health conditions. Nurses should make efforts aimed at advocating better care for patients, especially those with chronic condition in rural and remote locations. Legislative advocacy offers a chance for patients to advocate better care and accessibility to health care services. Having full practice authority (FPA) will lead to better access to care and patients, irrespective of their cultural beliefs, sexual orientation, and religious affiliations (Pembroke, 2019). Since all are created in God’s image and likeness, they should access care and having FPA will ensure that such populations and individuals can get services. Christian healthcare is characterized by works of compassion based on Christian ethos that embrace the teaching of human dignity, solidarity and the common good (Poghosyan et al., 2022). Therefore, nurses and other providers should advance Christian-centered approaches that lead to the greater common good for the majority of the population. Biblical values like love, kindness and generosity should override any decisions and approaches by different stakeholders in making choices to improve care delivery and access among different populations. | ||
Conclusion
Advocacy through legislation allows nurses to identify and advance issues of mutual benefit to patients and health populations. Having full practice authority (FPA) is an issue that requires legislative actions and decisions since it will allow nurses to offer more care services and serve as primary care providers in such areas and remote settings. As demonstrated, FPA will lead to increased access, reduce cost of care, and improve the quality of care. As such, through state and federal legislations, nurses, especially nurse practitioners can have full practice authority in their states, beginning with Illinois.
References
American Association of Nurse Practitioners (AANP). (2023). Issues at a Glance: Full Practice Authority.
https://www.aanp.org/advocacy/advocacy-resource/policy-briefs/issues-full-practice-brief
Hassmiller, S. B. (2021). The future of nursing 2020-2030. AJN: The American Journal of Nursing, 121(5), 7.
DOI: 10.1097/01.NAJ.0000751020.95176.0c.
Madura, B., Zaletel, C. L., & Lancaster, R. J. (2022). Advocating, implementing, and supporting the journey to full-practice authority
in a large healthcare system. The Nurse Practitioner, 47(12), 10-13. DOI: 10.1097/01.NPR.0000884928.05884.8f
Waldrop, T. & Gee, E. (2022 February 9). How States Can Expand Health Care Access in Rural Communities.
Pembroke, N. (2019). Empathic and compassionate healthcare as a Christian spiritual practice. Practical Theology, 12(2), 133-146.
DOI: 10.1080/1756073x.2019.1586343
Wakefield, M., Williams, D. R., & Le Menestrel, S. (2021). The future of nursing 2020-2030: Charting a path to achieve health
equity. National Academy of Sciences.
Zwilling, J., Fiandt, K., & Ahmed, R. (2021). Comparison of rural and urban utilization of nurse practitioners in states with full
practice authority. The Journal for Nurse Practitioners, 17(4), 386-393. https://doi.org/10.1016/j.nurpra.2020.12.033
Poghosyan, L., Pulcini, J., Chan, G. K., Dunphy, L., Martsolf, G. R., Greco, K., … & Solari-Twadell, P. A. (2022). State responses to
COVID-19: Potential benefits of continuing full practice authority for primary care nurse practitioners. Nursing outlook, 70(1), 28-35. DOI: 10.1016/j.outlook.2021.07.012
Currently, the high cost of health care posse a major challenge on Americans as families are finding increasingly hard to pay for health care. The similar situation is found in the state of California where the rising cost of health care remains a key challenge. According to California Health Care Foundation (2020), California spent approximately $292 billion, which is about 12% of the state’s economy. Moreover, Lown Institute (2019) reports that California has spent nearly 146% in health care between the years 2007 to 2018, which is about 26% of the state’s budget. However, this budget goes directly to the health care and leaving out spending on community conditions. This implies that California is compromising the potential long-term health benefits for short-term health temporary solutions. Therefore, the imbalance between health care and community condition spending requires dialogue and actions based on sound policy. Essentially, the increasing cost of health care in the recent decades have prompted California to forgo much needed investment in community conditions such as public health, social services, education, and environmental protections. Therefore, this policy seeks to improve health in people of California by increasing funds to community condition. This initiative can be funded by reducing excessive expenditure and curbing the waste on health care and redirecting the savings to community conditions.
Idea for Addressing Solution
The idea to advocate for balance in the investment in health care and community condition was informed by the need to avoid the focus on short-term health solutions and embrace long-term health benefits. Essentially, if the state can invest in community conditions such as public health, education, environmental protection, and social services, the citizens will be adequately informed on the health issues, leading to positive outcomes. In turn, expenditure in health care will drastically reduced since the community conditions will emphasize on preventive measures. Moreover, this idea will equally address health disparities because the community interventions will target every member of the society including the economically disadvantaged, minority groups, and people living with disabilities. and seek to provide patient-centered interventions. Therefore, this change can be best realized by changing the policy that governs health care spending in California.
In this case, legislation is deemed the best course of advocacy because it will help in soliciting public support for the idea since formulation of legislations is an open process that needs perspectives, participation, and scrutiny by the people. Moreover, legislation will enhance clarity on the idea and act as a basis for policy’s consistency in application and operation.
Assessment Description
Nurses often become motivated to change aspects within the larger health care system based on their real-world experience. As such, many nurses take on an advocacy role to influence a change in regulations, policies, and laws that govern the larger health care system.
For this assignment, identify a problem or concern in your state, community, or organization that has the capacity for advocacy through legislation. Research the issue and use the “Advocacy Through Legislation” template to complete this assignment.
You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Nurses are patient advocates who understand the different issues that impact health populations and communities that they serve. These health issues like public health emergencies as witnessed by the COVID-19 pandemic and other health emergencies implore them to leverage advocacy approaches through legislation to implement evidence-based practice interventions to address them. A core concern that may have long-term health effects in the country is the rise in the rates of underage drinking as millions of young Americans are affected by this public health issue. Developing interventions to address this issue is important and nurses should work with stakeholders, especially legislators at state and federal levels to seek solutions (Bergman & Morley, 2022). The purpose of this essay is to discuss how nurses can use legislative process to conduct advocacy against underage drinking and propose solutions to address the issue.
| Problem
In no more than 250 words, describe the problem, who is affected, and the current ramifications. Explain the consequences if the issue continues. |
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| According to the National Institute on Alcohol Abuse and Alcoholism (2022), underage drinking is a critical public health issue that requires evidence-based solutions to reduce and prevent its occurrence. Alcohol remains the most widely used substance in young people or minors. Underage drinking entails minors engaging in use of alcohol as a substance for leisure and other psychological and physical benefits. Underage drinking affects not just the youth or the implicated minors but has wider ramifications on the entire society and communities most affected. The Centers for Disease Control and Prevention (2022) reveals that close to 29% of high school students take alcohol with 14% having binge drinking. Furthermore, 5% of drivers drive under influence of alcohol with close to 17% of people being driven by drunk drivers.
According to CDC (2022), underage alcohol consumption predicts and increases the risk for deviant attitudes and behavioral issues like school dropout, high absenteeism rate and bad grades, social issues like fighting and a decline in participation in youth initiatives. It also increases the risk for arrests for driving under influence or physical assault against others. Underage drinking causes unwanted, and unprotected sexual activities which are risk factors for unwanted and unplanned pregnancies. Chronic underage alcohol use may cause addiction in the future. Alcohol use heightens the risk for suicidal and physical conduct and sexual violence by partners. |
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| Idea for Addressing Solution
In no more than 250 words, outline your idea for addressing the issue and explain why legislation is the best course for advocacy. |
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| Lowering access to alcohol through regulation of liquor stores and having caps on selling of alcohol products is important in addressing this issue. For instance, lowering the number of outlets will increase the cost of accessing alcohol since young people will walk longer distances to buy their best brands. Further, it would also mean less accessibility and availability thus discouraging consumption among the underage. These regulations require engagement of key stakeholders like elected officials through advocacy.
Advocacy using legislation means engaging and participation of elected officials to create legislative models at state or federal government’s levels on regulation of liquor stores (Pedroni et al., 2020). Reducing their operational hours among other measures using bundled interventions will help address the issue. Imperatively, the state government can make regulations to execute these provisions. Legislation is the most effective approach as elected leaders have a duty to create interventions based on laws and institute mandatory requirements for all stakeholders to comply with in their operational environment (Biggerstaff & Skomra, 2020). The utilization of legislation as an advocacy model shows its importance in creating and enacting effective laws to tackle health-related issues, especially in public health. Nurses are patient advocates and work with stakeholders to create and implement effective and evidence-based practice (EBP) interventions to tackle health issues at different levels of practice and government; from local to federal level (Biggerstaff & Skomra, 2020). Advocacy helps in integrating the primary stakeholders who include parents, school administrators, families and the local communities. The users are also stakeholders in this initiative so that they get better ways of handling their alcohol utilization based on its effects. |
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| Research the Issue
Perform research and compile information for your idea. Present substantive evidence-based findings that support your idea for addressing the problem (studies, research, and reports). Include any similar legislation introduced or passed in other states. |
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| Evidence 1 | In their study, Stellefson et al. (2018) assert that stakeholders can deploy different resources and interventions to lower risks linked to underage drinking and its negative impacts. Using social ecological perspectives, the researchers suggest a host of interventions at different levels to determine the most appropriate resources to reduce alcohol use among college students and the negative effects.
The article is categorical that young people develop drinking behaviors before enrolling in their college studies and programs. As such, it proposes the identification of the possible risk factors before young people join college and entrench this habit while influencing susceptible peers. |
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| Evidence 2 | In their narrative and critical review of current publications on alcohol consumption interventions, Sanchez-Puertas et al. (2022) note that school-based programs are essential and clinically significant in deterring the habit. These initiatives improve attitudes and the intentions to leave the habit and entrench positive social norms and acceptance of alcohol. These programs reduce intoxication and enhance perceptions about the negative impacts of alcoholism among underage individuals. | |
| Evidence 3 | Alcohol consumption increases the risk for uncontrolled sexual behaviors among adolescents. According to Carels et al. (2022), social influences and interpersonal affects increase the probability of underage individuals engaging in alcohol drinking. The researchers propose the use of interventions at individual, parental and community levels as essential to addressing the issue. The study notes that drinking has serious effects on social and personal development of the impacted young persons. These interventions should focus on drinking conduct, degree of usage and treatment interventions for individuals battling alcoholism and addiction. | |
| Stakeholder Support
Discuss the stakeholders who would support the proposed idea and explain why they would be in support. |
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| Stakeholder(s) Supporting 1 | The stakeholders in support of this idea are parents, community members who include teachers and religious leaders are interested in getting solutions to alcohol usage among underage individuals. The presence of many liquor shops without an effective regulatory framework endangers the lives of young people who have taken to its consumption. More young people are vulnerable to alcohol and its usage due to the ease of access in the shops leading to possible binge drinking. | |
| Stakeholder(s) Supporting 2 | The government at state and local level will support this idea since it will allow them to get revenue, enhance performance and productivity, and protect the minors from adverse effects of alcohol. They will also support it so that they can save funds used to treat and rehabilitate the affected minor. These efforts also include expenditure on rehabilitation programs. The proposed initiative will be instrumental in addressing this challenge in the long-term. | |
| Stakeholder Opposition
Discuss the stakeholders who would oppose the proposed idea. Explain why they would be in opposition and how you would prepare to debate or converse about these considerations. |
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| Stakeholder(s) Opposed 1 | The stakeholders opposed to this idea would include owners and operators of the stores as it will impact their revenues and businesses. The regulations will reduce their operational hours and lead to loss of employment. However, they should consider this as part of their corporate social responsibility of improving and advancing community interests and protecting their future customers from bad and addictive drinking behavior. They should comply with the set regulations to protect the common good of all in the community. | |
| Stakeholder(s) Opposed 2 | Manufacturers of alcohol products will be against the idea as it will lead to reduced output and production due to a decrease in demand. The policy will adversely impact their market share and general revenues and productivity as well.
Nevertheless, they need to understand that the development of initiatives to limit the use of alcohol in the community is import to protecting the lives of underage drinkers because of its adverse effects. They must show their social responsibility by discouraging inappropriate use of alcohol among young people. |
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| Financial Incentives/Costs
In no more than 250 words, summarize the financial impact for the issue and the idea (added costs, cost savings, increased revenue, etc.). Provided support. |
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| The idea has positive financial outcomes for the stakeholders in the long-term. The initiative will lead to a reduction in the financial costs on funding programs to address alcoholism and its associated effects like addiction. Early utilization of alcohol has adverse effects on the growth and development of young people, especially the development and functioning of their brain (Pedroni et al., 2020). Alcohol is a risk factor for engaging in dangerous activities and increases possibility of getting accidents, contemplation of suicide and the possibility of engaging in violence and sexual assault.
Treatment for alcoholism and associated addiction as well as mental health disorders constitute significant financial burden to families and individuals as well as their communities and even governments. These stakeholders are compelled to offer limited resources, especially health resources, to address the issue. These resources are deployed to treat associated condition like substance use disorders, sexually transmitted infection, injuries from violence and assault cases among others. The CDC asserts that government spends an estimated $24 billion as economic and health related expense because of alcohol consumption among minors. State and federal governments allocate substantial resources to enhance and offer education and prevent school dropout and susceptibility to engage in criminal activities. As such, this proposed initiative will assist all stakeholders, from parents to governments to save resources and prevent the negative effects of alcohol use among minors. The proposed solution is essential in helping to address these issues and offer quality and healthy living to young people impacted by underage drinking problem. Crime is closely associated with alcohol use and such events lead to increased criminal activities. |
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| Legislature: Information Needed and Process for Proposal
Discuss the how to advocate for your proposal using legislation. Include the following: |
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| Provide the name and complete contact information for the legislator. | ||
| Describe the steps for how you would present this to your legislator. | I will to book an appointment and present my proposal on tackling the issue at hand. My presentation will be based on evidence collected about the negative effects of underage drinking on the users, their families and the community at large. The presentation will show the causes, especially the increased number of outlets selling alcohol, the solution to the issue that requires a legislative solution. I will implore on the legislator to make remarks and what he believes will be the best approach based on legislation route. | |
| Outline the process if your legislator chooses to introduce your idea as a bill to congress. | The legislator craft a bill for introduction to Congress. The bill will be taken to the concerned committee, in this case, the health committee, for amendments and analysis of its content and ask stakeholders to provide their views. The committee will make certain recommendations before approval and referring it back to the House for debate and subsequent amendments. The representative will lobby to get support for its passage as well as getting members of vote for or against it. The bill will then move to the Senate for consideration and debate. Both the House of Representatives and the Senate will approve the bill. A disagreement between the two houses will implore Congress to establish a conference committee to address them before final approval. The president will sign approved bill for its enactment. | |
| Christian Principles and Nursing Advocacy
In no more than 250 words, discuss how principles of a Christian worldview lend support to legislative advocacy in health care without bias. Be specific as to how these principles help advocate for inclusiveness and positive health outcomes for all populations, including those more vulnerable, without regard to gender, sexual orientation, culture, race, religion/belief, etc. |
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| The Christian worldview entails different ethical principles like solidarity, dignity, love and respect. Individuals also make sacrifices for the good of the majority under Christian doctrines. Advocacy is appropriate when addressing issues that impact r vulnerable populations as it mirrors one’s commitment to Christian values like love and sacrifice. Nurses should promote and respect the sanctity of life as man is created in God’s image (Bergman & Morley, 2022). A person’s dignity transcends any aspect of individualism and needs sacrificial actions and decisions through advocacy for approaches to stop underage drinking due to its adverse effects on young people, their families, the community and public health.
The owners of the liquor stores need to understand that they are a part of the community and any actions and decisions that they make have serious implications on the welfare of the members. They need to work for and promote common good and love for all people. Therefore, they should be willing to sell their products as regulated and help address this serious public health issue affecting minors with not capacity to make informed choices and decisions. These approaches underscore the utilization of advocacy as it provides opportunities to engage all stakeholders without any bias or favoritism. The principle ascertain that those involved do not seek self-glorification but for the sacrificial love of others regardless of their political persuasions and socioeconomic conditions or statuses. |
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Conclusion
Advocacy through legislation is an essential yet evidence-based approach to influence the development and implementation of policies to address public health concerns like underage drinking in particular and alcoholism as well as substance use abuse in general. Nurses as patient advocates can present these ideas to their legislators to help them formulate policies and interventions to address them. The proposed initiative to tackle underage drinking is important in assisting community and its members to reduce the financial burdens and promote better behaviors to reduce adverse effects of alcohol among minors.
References
Bergman, E., & Morley, C. (2022). Public Policy: Nurse Licensure Compact as a Lesson in Legislative Action for the Case
Management Community. Professional Case Management, 27(1), 26-29. DOI: 10.1097/NCM.0000000000000542.
Biggerstaff, M. E., & Skomra, T. S. (2020). Nurses as immigrant advocates: A brief overview. Online Journal of Issues in Nursing,
25(2). DOI: 10.3912/OJIN.Vol25No02PPT69
Carels, C., Florence, M., Adams, S., Sinclair, D. L., & Savahl, S. (2022). Youths’ perceptions of the relation between alcohol
consumption and risky sexual behaviour in the Western Cape, South Africa: a qualitative study. Child indicators research, 1-25. DOI:https://doi.org/10.1007/s12187-022-09913-9
Centers for Disease Control and Prevention (CDC) (2022). Underage Drinking.
https://www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm
Finan, L. J., Lipperman-Kreda, S., Grube, J. W., Balassone, A., & Kaner, E. (2020). Alcohol marketing and adolescent and young
adult alcohol use behaviors: A systematic review of cross-sectional studies. Journal of Studies on Alcohol and Drugs, Supplement, (s19), 42-56. https://doi.org/10.15288/jsads.2020.s19.42
Pedroni, C., Dujeu, M., Lebacq, T., Desnouck, V., Holmberg, E., & Castetbon, K. (2021). Alcohol consumption in early adolescence:
Associations with sociodemographic and psychosocial factors according to gender. PloS one, 16(1), e0245597. https://doi.org/10.1371/journal.pone.0245597
Sánchez-Puertas, R., Vaca-Gallegos, S., López-Núñez, C., & Ruisoto, P. (2022). Prevention of alcohol consumption programs for
children and youth: a narrative and critical review of recent publications. Frontiers in psychology, 13. https://doi.org/10.3389/fpsyg.2022.821867
Stellefson, M., Barry, A. E., Stewart, M., Paige, S. R., Apperson, A., Garris, E., & Russell, A. (2019). Resources to reduce underage
drinking risks and associated harms: social ecological perspectives. Health promotion practice, 20(2), 160-166. https://doi.org/10.1177/1524839918814736
Advocacy entails any action aimed at pleading, or arguing for a course, idea or policy with the aim of increasing awareness and ensuring that stakeholders take necessary measures to address any raised concerns or issues. Nurses are patient advocates who seek to enhance the health of the population through policy changes and transformations at organizational, state, and even federal levels of care provision. Obesity remains a national, state, and even organizational issue because of its adverse effects on individuals, populations and health care system. Obesity increases the risk for comorbidities, especially chronic conditions, like diabetes and hypertension (Wolff-Baker et al., 2019). The purpose of this paper is to explore the issue of obesity and advocate interventions through legislative policies, like early care and education (ECE) to prevent the problem among residents of Maryland.
| Problem
In no more than 250 words, describe the problem, who is affected, and the current ramifications. Explain the consequences if the issue continues. |
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| The Centers for Disease Control and Prevention (CDC) (2022) asserts that obesity is a complex condition that happens when a person’s weight is higher than what is healthy based on their height. Obesity is a national epidemic in the United States and affects one in every three adults and one in six children. The alarming rise in childhood obesity shows a future burden of chronic conditions that require addressing by the health care system. Obesity prevention is a critical aspect of controlling obesity-associated non-communicable diseases that include diabetes and coronary artery disease. As a state, Maryland has the 24th highest adult obesity rate in the country with about 31.6% of its adult residents having the condition based on their body mass indices (Southern Maryland Chronicle News Desk, 2022). Public health advocates consider obesity as a the “new tobacco” because of its high levels of morbidity and mortality, its effects on healthcare resources, and its connection to psychological, social, and environmental factors. Individuals from low income households, minority populations like Hispanics and Blacks are more susceptible to obesity due to consumption of fast foods that are generally unhealthy. Obese children are more likely to have cardiovascular risk factors, type 2 diabetes and are at an elevated risk for mortality and morbidity, just like adults who have increased risk for developing diverse types of cancer (Wolff-Baker et al., 2019). Obesity impairs the quality of life as it increases one’s susceptibility to heart disease, kidney failure and pulmonary disease. These chronic conditions exacerbate the need for healthcare resources since they lead to increased demand for healthcare services at different levels of care provision. Obesity as a national health concern requires effective legislative policy and measures, not just at the state but also at the federal level. | ||
| Idea for Addressing Solution
In no more than 250 words, outline your idea for addressing the issue and explain why legislation is the best course for advocacy. |
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| As stated, obesity is a complex issue and no one-size-fits-app approach can be considered as effective. While creating awareness through educational sessions is the most effective way to address the epidemic, other solutions like advocacy through legislation suffice to support the educational strategies. A majority of individuals are not aware of being obese or overweight until they are diagnosed with obesity-associated health issues that include hypertension and type 2 diabetes among others. Over 70 different health conditions are associated with obesity. Stigmatization is a core challenge that hinders healthcare providers from engaging individuals presenting with obesity and overweight condition in their facilities (Blumenthal et al., 2018). Affected individuals, both children and adults, face negative attitudes and are bullied leading to social exclusion and feeling of unworthy. Healthcare providers do not have sufficient skills to handle obese children.
Addressing this issue requires having advocacy that focuses on increasing awareness among healthcare providers to handle the obese patients, reduction in stigmatization, and implementation of childhood obesity prevention programs at school and in other areas of interactions. Healthy eating habits are a core part of this early care and education (ECE) initiatives at school and home for children and adults. Using ECE would allow families and providers to offer quality and health interventions to reduce obesity in the state and the country. Close to 25 states dedicate a part of their funding on obesity to ECE programs and initiatives across the country (Wakefield et al., 2022). Legislation is the best advocacy approach to preventing and reducing the rates of obesity as it will increase mandate and regulatory frameworks for initiatives aimed at health food financing, expansion of market food assistance, promotion of local produce and development of grocery stores as well as research on access to healthy foods. |
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| Research the Issue
Perform research and compile information for your idea. Present substantive evidence-based findings that support your idea for addressing the problem (studies, research, and reports). Include any similar legislation introduced or passed in other states. |
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| Evidence 1 | Studies show that ECE is a critical component of preventing obesity, especially early onset in childhood. Hassnik (2018) asserts that risk factors for obesity in early years are related to obesity in adulthood. These factors include early feeding habits, and activity or inactivity patterns. The study is categorical that preventing obesity in the early stage or age is essential to reducing susceptibility in later years. The article notes that child care centers can implement multi-component interventions to prevent children from gaining excess weight, particularly those with elevated risks who include children from lower socioeconomic backgrounds. The article notes that children should remain the focus of obesity prevention initiatives since they can inculcate better conduct when they learn early. | |
| Evidence 2 | In their article, Jackson et al. (2021) observe that early childhood education and care (ECE) provides the foundation for lifelong learning and development. As such, these centers represent a core setting for the delivery of public health obesity prevention strategies aimed at improving dietary behaviors and physical activity. These interventions and the setting create supportive environments that enhances dietary behaviors to improve one’s health. Multi-component interventions like increasing access to healthier food, promotion of these foods and interactive sessions like taste testing healthier foods and flyers are effective educational approaches that will enhance information and awareness to diverse populations. | |
| Stakeholder Support
Discuss the stakeholders who would support the proposed idea and explain why they would be in support. |
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| Stakeholder(s) Supporting 1 | Stakeholders’ support is a critical aspect of any successful legislative process. In this case, the prominent stakeholders to support this advocacy intervention include parents and families with obese children and individuals. Child care organizations, especially those advocating healthy eating will also support this idea since it provides practical interventions to address the issue of obesity (Ortiz et al., 2019). These entities help child care providers meet local and state program requirements and implementing of certain measures to promote public health. | |
| Stakeholder(s) Supporting 2 | Community health workers, especially nurse practitioners, will also support the initiative as it leads to better ways of managing obesity in the state. Nurses as patient advocates will support the initiative because of its focus on primary care intervention through prevention. Government representatives will also support the initiative through federal and state agencies like Department of Health and Human Services (DHHS). | |
| Stakeholder Opposition
Discuss the stakeholders who would oppose the proposed idea. Explain why they would be in opposition and how you would prepare to debate or converse about these considerations. |
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| Stakeholder(s) Opposed 1 | Stakeholders who may oppose this idea include businessmen and factory owners who specialize in manufacture and distribution of unhealthy foods, especially fast food establishments. Sugar-sweetened beverage tax increment can hurt businesses and consumers leading to resistance from certain quarters. | |
| Stakeholder(s) Opposed 2 | Opposition can also come from politicians if bills aimed at restricting personal choice and raising taxes are introduced into the house. Such initiatives to adopt healthy eating will hurt certain industries whose proprietors may join critics or opponents of the bill. | |
| Financial Incentives/Costs
In no more than 250 words, summarize the financial impact for the issue and the idea (added costs, cost savings, increased revenue, etc.). Provided support. |
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| Obesity is a chronic condition that is associated with comorbidities and increased cost of care for affected individuals and communities. The healthcare system across the country and in the state of Maryland spends billions of dollars on expenses related to obesity and associated diseases like hypertension and diabetes (Chan et al., 2021). Obesity is linked to a higher risk for serious conditions that include hypertension, coronary heart diseases, asthma and stroke as well as arthritis and type 2 diabetes. The increase in the prevalence of these conditions also implies that health care systems and individuals will spend more on added costs to attain better outcomes and quality of life or manage the condition at different stages of their life and care continuum. The costs associated with obesity imply that policies like Affordable Care Act (ACA) must consider making insurance premiums more affordable and sustainable to diverse patient and health populations, especially those from low-income households or settings. Severe obesity’s prevalence is about 8% with projections showing a rise if no measures exist for providers and health care systems to institute early interventions in their settings (Blumenthal et al., 2018). The rise in obesity rates across the nation means that Maryland should develop interventions like ECE through their legislative processes to increase early prevention measures for individuals and health populations at the lower levels. The financial incentives provided by Centers for Medicare and Medicaid Services (CMS) may not be applicable to the issue of obesity based on rewarding of quality care provision by organizations and healthcare providers. | ||
| Legislature: Information Needed and Process for Proposal
Discuss the how to advocate for your proposal using legislation. Include the following: |
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| Provide the name and complete contact information for the legislator. | ||
| Describe the steps for how you would present this to your legislator. | The initial step would be to collect necessary information and supporting data about the issue. The second step would be to book an appointment with the legislator through his office. Thirdly, when granted the permission, I would make the presentation based on facts and data to convince him to adapt the issue and work with his office to draft a bill for presentation to Congress. | |
| Outline the process if your legislator chooses to introduce your idea as a bill to congress. | Introduction of Bill in Congress
Committee Action (vetting by relevant committees) Floor Action (Congress debates) Voting Conference Committees Presidential Action (signature) Creation of Law (The U.S. House of Representatives (2020) |
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| Christian Principles and Nursing Advocacy
In no more than 250 words, discuss how principles of a Christian worldview lend support to legislative advocacy in health care without bias. Be specific as to how these principles help advocate for inclusiveness and positive health outcomes for all populations, including those more vulnerable, without regard to gender, sexual orientation, culture, race, religion/belief, etc. |
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| The Christian principles of justice, fairness, equity are at the core of having strategies to reduce obesity and ensure that all people lead better lives. Justice entails being fair in everything that one does to honor God and show love for their neighbors. Obesity is a public health issue that affects millions of Americans; especially those from low-income households and families. Obese individuals, both children and adults, face increased levels of discrimination and stigmatization due to their conditions (Boroumand et al., 2020). As such, efforts like early care and education (ECE) demonstrate the need to transform their perspectives and ensure that they can access care and primary interventions in an equal manner, just like others, who have sufficient resources. Advocacy is a core aspect of the Christian worldview as it means that nurses take the responsibility of helping those in need, just like Jesus who preached the Gospel for the common good of man. Equality and justice mean that all should be treated in the same way without a consideration of their gender or sexual orientation, culture and race because obesity does not discriminate.
Nurses are pillars of healthcare advocacy (Ortiz et al., 2019). Like Jesus, they should advocate for others who are voiceless and fear for their self-worth or value. Being engaged and talking to legislators, nurses advocate for changes in health care for the underserved population. By serving others, one serves God and shows their love for the neighbor as guiding principle of the Christian faith and worldview. Christian advocacy implores people to seek and bring justice to those faced with violence, poverty, and discrimination and help them experience God in more profound ways. Health disparities are prevalent among low-income households and it is important to advocate for their common good. |
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Conclusion
Obesity is a national health concern that requires different stakeholders to focus on mitigation measures and interventions that can be supported through legislative actions. The implementation of early care and education (ECE) interventions in Maryland would help reduce the prevalence of obesity within the state and improve healthcare outcomes. Again, these measures are critical to addressing associated health conditions like hypertension and diabetes among those at increased risk for obesity.
References
Blumenthal, D., & Seervai, S. (2018). Rising obesity in the United States is a public health crisis. The Commonwealth
Fund. https://www.commonwealthfund.org/blog/2018/rising-obesity-united-states-public-health-crisis
Boroumand, S., Stein, M. J., Jay, M., Shen, J. W., Hirsh, M., & Dharamsi, S. (2020). Addressing the health advocate role in medical
education. BMC Medical Education, 20, 1-5. DOI: 10.1186/s12909-020-1938-7.
Chan, C. D., & Litam, S. D. A. (2021). Mental Health Equity of Filipino Communities in COVID-19: A Framework for Practice and
Advocacy. Professional Counselor, 11(1), 73-85. https://doi.org/10.15241/cdc.11.1.73
Centers for Disease Control and Prevention (CDC) (2022). Causes of Obesity.
https://www.cdc.gov/obesity/basics/causes.html
Hassink, S. G. (2017). Early child care and education: A key component of obesity prevention in infancy. Pediatrics,140(6),
e20172846. doi:10.1542/peds.2017-2846
Jackson, J. K., Jones, J., Nguyen, H., Davies, I., Lum, M., Grady, A., & Yoong, S. L. (2021). Obesity prevention within the early
childhood education and care setting: a systematic review of dietary behavior and physical activity policies and guidelines in high income countries. International journal of environmental research and public health, 18(2), 838. DOI: 10.3390/ijerph18020838
Southern Maryland Chronicle News Desk (2022). This Is Where Maryland Ranks Among the Most Obese States in America.
This Is Where Maryland Ranks Among the Most Obese States in America
Ortiz, J., Hofler, R., Bushy, A., Lin, Y. L., Khanijahani, A., & Bitney, A. (2018, June). Impact of nurse practitioner practice
regulations on rural population health outcomes. Healthcare, 6(2):65). DOI: 10.3390/healthcare6020065
Wakefield, M., Williams, D. R., & Le Menestrel, S. (2021). The future of nursing 2020-2030: Charting a path to achieve health
equity. National Academy of Sciences.
Wolff-Baker, D., & Ordona, R. B. (2019). The expanding role of nurse practitioners in home-based primary care: Opportunities and
challenges. Journal of Gerontological Nursing, 45(6), 9-14. DOI: 10.3928/00989134-20190422-01.
Attachments
Advocacy Through Legislation – Rubric
Criteria Description
Problem, Those Affected, Current Ramifications, and Consequences if Problem Continues
5. Excellent
23.25 points
A well-develop discussion of the problem, those affected, current ramifications, and consequences if the issue continues is presented. Strong and compelling rationale is provided. Insight into the problem and consequences is demonstrated.
4. Good
20.69 points
A discussion of the problem, those affected, current ramifications, and consequences if the issue continues is presented. Some rationale is needed.
3. Satisfactory
18.37 points
A summary of the problem, those affected, current ramifications, and consequences if the issue continues is presented. There are some omissions and inaccuracies. Rationale is needed.
2. Less Than Satisfactory
17.44 points
A partial or vague discussion of the problem, those affected, current ramifications, and consequences if the issue continues is presented. Why the problem would be best addressed through legislation is unclear.
1. Unsatisfactory
0 points
A description of the problem, those affected, current ramifications, and consequences if the issue continues is omitted.
Criteria Description
Idea for Addressing Solution
5. Excellent
15.5 points
A logical and well-developed idea for addressing the issue is outlined. Why legislation is the best course for advocacy is thoroughly explained. Strong and compelling rationale is provided.
4. Good
13.8 points
Idea for addressing the issue is outlined. Why legislation is the best course for advocacy is generally explained. Some rationale is needed.
3. Satisfactory
12.25 points
Idea for addressing the issue is generally outlined. Why legislation is the best course for advocacy is summarized. There are some minor omissions. Rationale is needed.
2. Less Than Satisfactory
11.63 points
Idea for addressing the issue is vague. Why legislation is the best course for advocacy is unclear. There are major omissions.
1. Unsatisfactory
0 points
Idea for addressing the issue and why legislation is the best course for advocacy is omitted.
Criteria Description
Research Supporting Solution for Problem
5. Excellent
23.25 points
Substantive evidence-based findings that support the idea for addressing the problem, including similar legislation in other states, are presented and demonstrate strong and compiling support for the idea.
4. Good
20.69 points
Idea for addressing the issue is outlined. Why legislation is the best course for advocacy is generally explained. Some rationale is needed. Substantive evidence-based findings that support the idea for addressing the problem, including similar legislation in other states, are presented. There are minor inaccuracies. Some detail is needed.
3. Satisfactory
18.37 points
Substantive evidence-based findings that support the idea for addressing the problem, including similar legislation in other states, are generally presented. More information is needed. There are some inaccuracies.
2. Less Than Satisfactory
17.44 points
Some support for the idea and its effectiveness in addressing the problem is presented. Findings presented are not substantiated, or do not provide evidence-based support for the idea.
1. Unsatisfactory
0 points
Substantive evidence-based findings that support the idea for addressing the problem, including similar legislation in other states, are omitted.
Criteria Description
Stakeholder Support
5. Excellent
15.5 points
All significant stakeholders in support of the proposed idea are presented and a well-supported explanation of why they are in support of the idea are provided.
4. Good
13.8 points
Key stakeholders in support of the proposed idea are presented. It is generally clear why they are in support of the idea. Some detail or rationale is needed.
3. Satisfactory
12.25 points
Substantive evidence-based findings that support the idea for addressing the problem, including similar legislation in other states, are generally presented. More information is needed. There are some inaccuracies.General stakeholders in support of the proposed idea are presented. It is unclear why they are in support of the idea. More information is needed.
2. Less Than Satisfactory
11.63 points
At least one stakeholder in support of the proposed idea is presented. The assignment criteria are largely incomplete.
1. Unsatisfactory
0 points
Stakeholders in support the proposed idea are omitted.
Criteria Description
Stakeholder Opposition
5. Excellent
15.5 points
All significant stakeholders in opposition to the proposed idea are presented. A well-supported explanation for why they are opposed to the idea and strategies for debating or conversing with opposing stakeholders is presented.
4. Good
13.8 points
Key stakeholders in opposition to the proposed idea are presented. A general explanation for why they are opposed to the idea and strategies for debating or conversing with opposing stakeholders is presented.
3. Satisfactory
12.25 points
General stakeholders in opposition to the proposed idea are presented. Explanation for why they are opposed to the idea and strategies for debating or conversing with opposing stakeholders is vague.
2. Less Than Satisfactory
11.63 points
At least one stakeholder in support of the proposed idea is presented. The assignment criteria are largely incomplete.At least one stakeholder in opposition to the proposed idea is presented. The assignment criteria are largely incomplete.
1. Unsatisfactory
0 points
Stakeholders in opposition to the proposed idea are omitted.
Criteria Description
Financial Incentives and Costs
5. Excellent
15.5 points
The financial impact for the issue and idea is clearly summarized. Strong rationale and support for claims is provided.
4. Good
13.8 points
The financial impact for the issue and idea is summarized. Support for claims is generally supported.
3. Satisfactory
12.25 points
The financial impact for the issue and idea is outlined. More information or support is needed for claims.
2. Less Than Satisfactory
11.63 points
The financial impact for the issue and idea is only partially presented. The assignment criteria are largely incomplete.
1. Unsatisfactory
0 points
The financial impact for the issue and idea is omitted.
Criteria Description
Legislature Process and Information for Proposal
5. Excellent
15.5 points
Legislative information needed and process to advocate for proposal are clearly and logically presented. The legislative process is clearly understood and insight into legislative advocacy is demonstrated.
4. Good
13.8 points
The financial impact for the issue and idea is summarized. Support for claims is generally supported.Legislative information needed and process to advocate for proposal are presented. Information or detail is needed in some areas for accuracy or clarity.
3. Satisfactory
12.25 points
Legislative information needed and process to advocate for proposal are generally outlined.There are some inaccuracies or omissions.
2. Less Than Satisfactory
11.63 points
Legislative information needed and process to advocate for proposal are largely incomplete.
1. Unsatisfactory
0 points
Legislative information needed and process to advocate for proposal are omitted.
Criteria Description
Christian Principles and Nursing Advocacy
5. Excellent
15.5 points
A well-developed discussion of how Christian principles support unbiased advocacy for health care legislation is presented. The discussion demonstrates an ability to act impartially and in the interest of promoting inclusive patient care without regard to gender, sexual orientation, culture, race, religion, or belief.
4. Good
13.8 points
A discussion of how Christian principles support unbiased advocacy for health care legislation is presented. The discussion generally demonstrates how the principles support positive patient outcomes and inclusiveness for all populations. Some detail or information is needed for clarity.
3. Satisfactory
12.25 points
A summary of how Christian principles support unbiased advocacy for health care legislation is presented. Some rationale or information is needed to demonstrate how the principles support positive patient outcomes and inclusiveness for all populations.
2. Less Than Satisfactory
11.63 points
A discussion of how Christian principles support unbiased advocacy for health care legislation is incomplete. It is unclear how the principles support positive patient outcomes and inclusiveness for all populations.
1. Unsatisfactory
0 points
A discussion of how Christian principles supporting unbiased advocacy for health care legislation is omitted.
Criteria Description
Research
5. Excellent
7.75 points
Research is supportive of the rationale presented. Sources are distinctive. Addresses all of the issues stated in the assignment criteria.
4. Good
6.9 points
Research is timely and relevant, and addresses all of the issues stated in the assignment criteria.
3. Satisfactory
6.12 points
Research is adequate. Sources are standard in relevance, quality of outside sources, and/or timeliness.
2. Less Than Satisfactory
5.81 points
Few outside sources were used to support the assignment. Limited research is apparent.
1. Unsatisfactory
0 points
No outside sources were used to support the assignment.
Criteria Description
Mechanics of Writing (includes spelling, punctuation, grammar, and language use)
5. Excellent
3.1 points
The writer is clearly in command of standard, written, academic English.
4. Good
2.76 points
Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.
3. Satisfactory
2.45 points
Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.
2. Less Than Satisfactory
2.33 points
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.
1. Unsatisfactory
0 points
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is employed.
Criteria Description
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
5. Excellent
4.65 points
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
4. Good
4.14 points
Sources are documented, as appropriate to assignment and style, and format is mostly correct.
3. Satisfactory
3.67 points
Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.
2. Less Than Satisfactory
3.49 points
Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.
1. Unsatisfactory
0 points
Sources are not documented.
Total 155 points