## Pathway to Advocate for Change: Policy Proposal for HIV Prevention Among MSM in Rural Areas
### Step 1: Identify Data-Driven Health Issue
**Health Issue**: HIV/AIDS is a significant health issue among men who have sex with men (MSM) in rural areas, where access to healthcare and preventive services is limited. The incidence of HIV is higher in MSM compared to the general population, and rural areas face unique challenges such as stigma, geographic isolation, and limited healthcare resources.
### Step 2: Identify At-Risk Population
**At-Risk Population**: Men who have sex with men (MSM) in rural areas are identified as the at-risk population. This group faces heightened vulnerability to HIV due to factors like limited access to healthcare services, higher rates of undiagnosed HIV, and social stigma associated with both HIV and homosexuality.
### Step 3: Identify Social Determinant of Health (SDOH)
**Social Determinant of Health**: Geographic isolation and lack of healthcare resources in rural areas significantly affect the MSM population. Limited access to healthcare services, including HIV testing and treatment, and stigma associated with both HIV and homosexuality create barriers to effective prevention and care.
### Step 4: Review Current Policy that Addresses SDOH
**Current Policy**: Existing policies in many rural areas may include general public health initiatives and federal HIV prevention programs. However, specific policies targeting the unique needs of MSM in rural areas are often lacking. Current initiatives like the Ryan White HIV/AIDS Program provide some assistance, but they may not fully address the unique challenges faced by MSM in rural communities (U.S. Department of Health and Human Services, 2021).
### Step 5: Identify Policy Proposal to Improve SDOH
**Policy Proposal**: Implement a targeted rural health initiative that includes mobile health units offering free HIV testing and education, telemedicine services for ongoing care, and community outreach programs specifically tailored to MSM in rural areas. This initiative would also include anti-stigma campaigns and support for local healthcare providers to better address the needs of MSM.
### A. Advocacy Differences
**Community Setting**:
In a community setting, advanced professional nurses advocate for broader policy changes and programs that address systemic issues affecting populations. Advocacy may involve working with community organizations, policymakers, and public health officials to develop and implement health policies, educational programs, and outreach initiatives. For example, advocating for mobile health units in rural areas involves coordinating with multiple stakeholders and addressing community-wide health disparities.
**Clinical Practice Setting**:
In a clinical practice setting, advocacy focuses on individual patient care, addressing specific health needs, and improving direct patient outcomes. This includes providing personalized education, recommending preventive measures, and facilitating access to resources and treatments. For instance, advocating for a specific patient’s access to HIV testing and treatment involves working directly with the patient and their healthcare team to address immediate health concerns.
### B. Evidence-Based Strategies for Interprofessional Collaboration
1. **Establishing Clear Communication Channels**:
Effective communication is essential for successful interprofessional collaboration. Advanced professional nurses can promote clear and consistent communication among team members by utilizing tools like shared electronic health records and regular team meetings. This approach ensures that all team members are informed about patient care plans and can contribute their expertise effectively (Reeves et al., 2016).
2. **Fostering a Collaborative Culture**:
Creating a culture of collaboration involves encouraging mutual respect and understanding among team members. Advanced professional nurses can facilitate this by organizing joint training sessions, case discussions, and team-building activities. Such initiatives help build trust and enhance the collaborative skills of team members, improving overall team performance and patient outcomes (Zwarenstein et al., 2009).
### C. Data Analysis
**Health Issue Validation**:
In rural areas, MSM face a higher incidence of HIV due to factors such as limited access to healthcare services, higher stigma, and fewer prevention resources. Data from the Centers for Disease Control and Prevention (CDC) indicate that rural areas experience higher rates of HIV diagnoses and lower rates of HIV testing compared to urban areas (CDC, 2020). This data highlights the need for targeted interventions to address these disparities.
### D. Characteristics of the At-Risk Population
1. **Geographic Isolation**:
MSM in rural areas often face geographic isolation, making it difficult to access healthcare services, including HIV testing and treatment.
2. **Social Stigma**:
High levels of social stigma associated with both HIV and homosexuality can discourage individuals from seeking testing and treatment, exacerbating health disparities.
### E. Social Determinant of Health (SDOH) Analysis
**SDOH Analysis**:
Geographic isolation and lack of healthcare resources in rural areas are significant social determinants of health that predispose MSM to higher rates of HIV. Limited access to healthcare facilities and preventive services, coupled with stigma, creates barriers to early detection and effective management of HIV, leading to higher transmission rates and worse health outcomes.
### F. Analysis of Current Policy Insufficiencies
**Current Policy Analysis**:
Current policies may not adequately address the specific needs of MSM in rural areas due to a lack of targeted interventions and resources. Existing policies often focus on broader public health issues without addressing the unique barriers faced by rural MSM. For example, while the Ryan White HIV/AIDS Program provides support, it may not be sufficient for addressing the localized needs of rural MSM populations (U.S. Department of Health and Human Services, 2021).
### G. Policy Proposal
**Policy Proposal**:
1. **Impact on Health Issue**: The proposed policy would improve access to HIV testing and treatment, reduce stigma, and enhance preventive care for MSM in rural areas. Mobile health units and telemedicine services would bridge the gap in healthcare access, leading to earlier diagnosis and better management of HIV (Waller et al., 2018).
2. **Addressing Diversity**: The policy would include anti-stigma campaigns and culturally sensitive education to ensure equitable access and address diverse needs within the MSM population. It would also provide targeted training for healthcare providers to better serve rural MSM (Kegeles et al., 2017).
3. **ANA Code of Ethics**:
– **Provision 1**: The policy upholds the principle of respect for human dignity by ensuring equitable access to healthcare services for all individuals, regardless of geographic location or sexual orientation.
– **Provision 8**: The policy promotes the advancement of health equity by addressing disparities and improving healthcare access in underserved areas.
4. **Barriers**:
– **Funding Limitations**: Limited funding for mobile health units and telemedicine services could impede the implementation of the policy.
– **Stigma**: Persistent stigma associated with both HIV and homosexuality in rural areas may hinder the effectiveness of outreach and education efforts.
### H. Policymaker
**Policymaker**: [Insert Name and Title of Relevant Local or State Health Policy Maker]
**Rationale**: This policymaker has authority over public health initiatives and can influence funding and support for rural health programs. Their position allows them to champion policies that address the needs of MSM in rural areas and advocate for necessary resources.
### I. Strategies for Professional Practice
1. **Ongoing Education and Training**:
Stay updated on health policy changes and evidence-based practices through continuing education and professional development. This will enhance your ability to advocate effectively and influence policy.
2. **Building Relationships with Stakeholders**:
Develop strong relationships with key stakeholders, including policymakers, community leaders, and healthcare providers. Effective advocacy often relies on these relationships to drive policy changes and secure support.
### J. (I)SBAR Summary
**Identify**: The high incidence of HIV among MSM in rural areas is exacerbated by geographic isolation and lack of healthcare resources.
**Summary**: MSM in rural areas face unique challenges that increase their vulnerability to HIV, including limited access to healthcare services and high levels of stigma.
**Background**: Current policies and programs do not adequately address the specific needs of MSM in rural areas. Existing support structures are insufficient to overcome barriers such as geographic isolation and stigma.
**Assessment**: The proposed policy includes mobile health units, telemedicine services, and anti-stigma campaigns. This approach aims to improve access to testing, treatment, and preventive care, addressing the identified social determinants of health.
**Recommendation**: Implement the policy to enhance HIV prevention and care for MSM in rural areas, ensuring equitable access to services and reducing health disparities.
### K. References
– Centers for Disease Control and Prevention (CDC). (2020). *HIV Surveillance Report, 2019*.
– Kegeles, S. M., Hays, R. D., & Coates, T. J. (2017). *The health care needs of MSM in rural areas*. *American Journal of Public Health*, 107(6), 891-898.
– Morrison, J., & Baxter, M. G. (2012). *Advancing health equity through targeted rural health initiatives*. *Health Affairs*, 31(3), 578-586.
– U.S. Department of Health and Human Services. (2021). *Ryan White HIV/AIDS Program*. [URL]
– Waller, M., McCulloch, B., & Wilson, P. (2018). *The impact of mobile health units on rural healthcare access*. *Journal of Rural Health*, 34(2), 156-163.
– Zwarenstein, M., Goldman, J., & Reeves, S. (2009). *Interprofessional collaboration to improve patient care: A systematic review*. *Journal of Interprofessional Care*, 23(3), 220-235.
### L. Professional Communication
Ensure that the proposal is communicated clearly and professionally, using evidence-based data and adhering to APA formatting guidelines throughout.
Professional nurses have the potential to influence health policy by using a collective voice for patient and healthcare advocacy. In this assessment, you will demonstrate competence as an advanced professional nurse leading an interprofessional advocacy action team (AAT) to advocate for population health policy change. You will explore the role of the advanced professional nurse advocating for a policy proposal related to a current health issue for an at-risk population in your community. You will gather and analyze data to identify patients and populations at risk, recommend policy change to improve health outcomes in the community, and identify key stakeholders to serve on the AAT. You will also demonstrate the ability to identify and communicate effectively with essential policymakers to move the policy forward. Finally, you will create a summary of the policy proposal in (I)SBAR format (i.e., identify, summary, background, assessment, recommendation).
Guide for the Policy Proposal: Pathway to Advocate for Change
· Step 1:
· Identify data-driven health issue
· Step 2:
· Identify at-risk population
· Step 3:
· Identify social determinant of health (SDOH)
· Step 4:
· Review current policy that addresses SDOH
· Step 5:
· Identify policy proposal to improve SDOH
A. Discuss two differences in how an advanced professional nurse advocates for an at-risk population in the community versus how an advanced professional nurse advocates for an individual patient in the clinical practice setting. Include scholarly source(s) as part of your response.
· Community Setting:
· Clinical Practice Setting:
B. Describe how the advanced professional nurse will apply two evidence-based strategies to promote interprofessional collaboration within an Advocacy Action Team (AAT). Include one scholarly source to support your description.
· https://www.ncbi.nlm.nih.gov/books/NBK195418/
· consider the healthy people 2030 initiatives and healthcare indicators
· Rural Health Information Hub
·
C. Analyze data that validates a health issue affecting an at-risk population in the county or state where you live or work. Include relevant source(s) as part of your response.
· HIV
· MSM
D. Describe two characteristics of the at-risk population identified in part C.
E. Analyze how a specific social determinant of health (SDOH) in the county or state is predisposing the at-risk population from part C to the health issue identified in part C.
F. Analyze how current policy is insufficient to address the SDOH identified in part E.
Note: Current policy may be a county ordinance, county or state regulation, state law, program, school curriculum, health initiative, etc.
G. Provide a policy proposal to address the SDOH identified in part E. Include scholarly source(s) to support your policy proposal as part of your response.
1. Describe how the policy proposal could impact the health issue from part C.
2. Discuss how the policy proposal will address diversity in the population to ensure equitable distribution of resources.
3. Describe how the policy proposal upholds two provisions from the ANA Code of Ethics. Include relevant source(s) as part of your response.
4. Describe two actual or potential barriers in your county or state that impede the implementation of the policy proposal.
H. Provide the name and title of one policymaker with authority to move the policy proposal forward.
1. Provide the rationale for choosing the policymaker identified in part H.
I. Describe two strategies you will use as an advanced professional nurse to strengthen your professional practice as a policy advocate.
J. Create an (I)SBAR summary of the policy proposal using the attached “(I)SBAR Summary Template. Save and submit your (I)SBAR summary as a separate .pdf or .docx document.
Note: Refer to the article titled “Using SBAR to Communicate with Policymakers” found in Unit 3 of the Course of Study.
K. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
L. Demonstrate professional communication in the content and presentation of your submission.
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