My project is focused on the primary prevention of opioid use disorder in Hispanic/Latino patients with limited English proficiency (LEP). As discussed in previous weeks, one of the main risk factors associated with the misuse of opioids for my select population is a lack of access to appropriate care. One evidence based behavior change that would promote health in my selected population would be regular visits to a primary care doctor for preventive care visits (Dept. of Health and Human Services, 2017). Establishing a relationship with a provider during times of wellness allows for clinical rapport and trust to be built; as well as providing an opportunity for education, screening, and early intervention of health issues (American Academy of Family Practice, 2019). In the context of substance abuse prevention, it is essential that chronic pain, depression, anxiety, domestic violence, and substance use be identified early on and treated with appropriate intervention.
One specific culturally sensitive, evidence-based, measurable intervention that could address the health problem for my selected population would be to implement a care coordination program that offers culturally competent, trauma informed care by healthcare professionals that have the linguistic capacity to provide education, screening, brief intervention and referral at an appropriate literacy and health literacy level. The Institute of Medicine (IOM) has identified care coordination as a key strategy to increase the efficacy, safety, and efficiency of today’s complex healthcare system (AHRQ, 2018). Care coordination allows for the identification of patient’s needs as well as their preferences. It provides a platform for additional education, patient advocacy, and intervention while strategically communicating with stakeholders in the patient’s care team (AHRQ, 2018). Care coordination programs can be broad or developed to meet the needs of a specific population; in this case our Hispanic/Latinos with LEP. Measurable outcomes would be how many patients are participants in the care coordination program, number and type of screenings completed, number of positive screenings, number of positive screenings provided with appropriate brief intervention and referral, number of patients linked to primary care preventive services, and number of patients educated on risks associated with opioid use.
Once the intervention of providing a culturally competent and linguistically appropriate care coordination program to our LEP patients is in place, I would expect to see an increase in preventive care visits, an increase in identification of conditions that could place the patient at risk of substance abuse such as depression, anxiety, or untreated chronic pain, and an increase in education including opioid medication indications, risks, benefits, proper administration, and proper disposal. By providing a platform for these patients to receive additional education, screening, and early intervention in a language they understand, we can decrease the impact of risk factors associated with opioid misuse; leading to a healthier community overall.
Research shows that within the homeless population one of the key factors that can promote health with Hepatitis A is improving access to the Hepatitis A vaccine. One way to accomplish the tasked is by promoting education by encouraging the importance of the vaccine. Having a public health nurse outreach to the homeless shelter to offer to counsel and to give information regarding Hepatitis A. The nurse will be able to build report within the community so that the members can feel supported and safe to converse with the nurse. Once a relationship has been created with the nurse and the patients, it is easier to provide education as well as care.
Having a public health nurse going to the homeless shelter twice a week opens many aspects. One of the aspects can help combat Hepatitis through the promotion of proper hand washing for the children of the community through fun classes by the nurse. Classes for the adult population would focus ‘For persons at-risk or infected with hepatitis A through unprotected sexual contact, timely referrals for comprehensive sexual health-related services can assist in preventing cases of other sexually transmitted diseases, including HIV,” Per CDC. Which can improve outcomes and help to find additional support for that homeless shelter.
In conclusion, outgoing outreach is key in improving awareness of hepatitis A within the homeless population. This is what I noticed where there is a need for in the homeless community. Using an evidence-based strategy that has proven to work in the previous community is ideal for research and for fieldwork.