B. Community Health Nursing Diagnosis Statement
The problem is the COVID 19 infection among the older population in L.A. County, related to lower immune response. Community health action involves the social isolation of the elderly. Increased risk of social isolation among the elderly population of L.A. county pertaining to lack of social activities due to the current pandemic as demonstrated by above-average depression rates among the elderly (L.A. County Health Department).
(B1) Health Inequity/ Disparity
Health disparities and imbalances were acknowledged during a community assessment of the general population, especially in older adult populations. L.A. County, in the state of California, is the most popular county in the state and ranks the first in overall health outcomes. However, the county records low older adult access to healthcare. They experience the highest morbidities, physical distress, physical inactivity, and uninsured adults (D’Adamo, Yoshikawa & Ouslander, 2020). The elderly have been affected the most by COVID 19 more profoundly due to misinformation and inadequate educational awareness from multiple sources. About 8 percent of L.A. County’s population is uninsured, and the average life expectancy is around 80 years. According to the census, 45 percent of the county’s population is above 50 years and over 15 percent over the age of 65 years. The older adults are mainly dependent on primary care physicians for access to information.
Among the uninsured in the county, ten percent of those are above the age of 50 years. Their lack of education and sufficient resources in this region has left most with limited knowledge about ways to reduce the effect of the virus and reduce their likeliness to die. Although the health centers are continuously creating awareness across the region, their capacity is insufficient to reach each of these persons. Additionally, there is increased hospital turnover due to other treatments that have become rampant over the last few months. There are outreach programs within the county that help the government in creating awareness. However, social distancing and self-isolation protocols have to be followed. Thus, the spread of information and awareness creation has become a challenge to such organizations.
(B1a) Primary Community and Prevention Resources
During the assessment of the community resources on the COVID 19 situations for older adults, primary care facilities have efficiently combined efforts to provide information about the virus. They have used pamphlets given to the older adults in their visits to hospitals and during health check-ups. The printed brochures were, however, not sufficient for the entire population in the region and were only available in two languages, including English and Spanish. I regularly visited the health facilities and identified gaps in healthcare that required care and provision of adequate information for awareness. In the pamphlets, there were no recommended treatment processes or ways to reduce the impact of the virus on a person. Majority of the information communicated on how to avoid contracting coronavirus and the process that the protocols they would follow to access a health facility (Naja & Hamadeh, 2020). When a patient visited the health facility, there was no additional written education that was provided to educate them on ways they can avoid contracting the virus. Additionally, not most of the elderly visited health facilities despite feeling unwell due to the fear of contracting the virus on their way to hospitals. Similarly, health promotion was lacking, and the pamphlets provided contained graphics and text that the elderly could not read or relate with most of the time.
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(B1b) Underlying Causes
According to the Department of Health and Human Services, older adults were at the risk of the COVID 19 pandemic. They required other ways to increase immunity levels to fight the virus in the case they contracted it. Also, other threatening illnesses related to COVID 19 are pneumonia, meningitis, and influenza. The known information about the virus and its reaction to an elderly is available in pamphlets across all health facilities. According to the U.S. Census Bureau (2011), the white population makes for 52.4 percent of the county’s population, 8.6 percent are African American, 0.5 percent are Native Americans, 13.8 percent are Asian, and Hispanic make up for 47.5 percent. During the time of assessment, most patients were Hispanic and African American (Clement, 2020). Most Hispanic people did not speak English. There were not information pamphlets printed in their specific languages despite that most understood Spanish.
In consideration, the population diversity in the county, as noted above, requires a variety of languages during communications. Additionally, there is about a 10 percent section of the population with no health insurance, have no education, and a lack of adequate resources to access healthcare services (Brown & Ravallion, 2020). L.A. County Health Department has less information about the virus or the best way to ensure people are safe. However, in preparation, the county has created protocols to use in COVID 19. Most of the awareness is done on social media and other digital platforms. This means that 11 percent of the population does not have access to a computer or internet; thus, they cannot follow the updates from the awareness-creation organizations about the virus (The United States Census Bureau, 2019).
(B2) Evidence-Based Practice
Based on the Bureau of Statistics, older adults suffer elevated morbidity from interaction with infectious diseases. In the case of the COVID pandemic, there is a need for more healthcare resources, which leads to higher costs. Preventative medicine and understanding of reducing the impact of the virus can play a significant role in preserving the health of the elderly (Czeisler et al., 2020). This population experiences frailty, which is expected due to increased risk for mortality or poor health outcomes. In that regard, there is a reduced ability to stimulate immunity, which increases the risk of contracting the virus. To date, 14,807 people have died in L.A. County due to coronavirus, and about 777,000 cases registered in the county. Most of the people dying from the disease are elderly, meaning that their immunity levels are low. Also, due to other underlying illnesses such as diabetes, pneumonia, and chronic diseases, most of the elderly are struggling with the disease (Naja & Hamadeh, 2020). The national government, through their science departments, have sought to conduct tests and experiments to determine which type of vaccinations would be sufficient for the virus. However, until now, this process is still underway, and a vaccine may be produced in 2021. The main challenge lies within the failure to conduct outreach initiatives for the population that does not have health insurance. For now, covering the mouth, wash your hands, and sanitizing are the only protocols formulated for the disease.
(B2a) Identification of Data
In Los Angeles County, the lowest population in percentage are the Native Americans. The majority are whites, followed by Hispanics and Latino. According to data, the county receives the highest number of tourists in the State of California. This means that the coronavirus spread was fast and uncontrollable. Preventative care is provided to most dwellers, but about 10 percent that is not insured do not receive. The data also indicates a 3.7 percent increase in the hospitalizations for preventable illnesses in the county (Gibson, Ventura & Collier, 2020). Most of the admitted were from other ethnicities, excluding whites and the Indians. Due to the Corona Virus, there has been an extensive job loss due to social isolation and reduction in trade and movement. The virus has caused approximately 40 million job losses. Most of the currently unemployed are female at 30 percent and males at 20 percent. Due to unemployment, access to healthcare, and followership of the COVID protocols have reduced.
(C1) Social Media Campaign Objective
The measurable objective that would be accomplished here is education to improve knowledge about COVID19 among the elderly in the low socioeconomic households in Los Angeles County. They include the uninsured and underinsured persons across the county. In that regard, this campaign will focus on the older adult population education and information about coronavirus and the preventative measures available. This education will be set in different languages according to the dominant of the target populations within the county. Although social distancing and social isolation are more encouraged this time, a volunteer-based community outreach program with be formed to have nurses and willing professionals in the county provide information and education about the disease in their languages. Every person that is sensitized with this information will be given a unique identifier to enable assessment on the number of individuals educated. The impact percentage from these exercises is aimed to be 30-45 percent of the 10 percent of the population (Meisner, 2020).
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(C2) Social Marketing Interventions
Due to the social distancing and isolation directives, social media platforms are the best ways to reach out to people. The best one for this task is YouTube. Older adults are likely to watch T.V., whereby most families have smart T.V. In that regard, watching YouTube videos would be an effective way to interact with them (Oh & Kim, 2014). Similarly, the team that is selected to carry out the outreach programs can go recommending these videos to the elderly either door to door or in areas where they frequent more often.
After interaction with the YouTube videos, the members of the outreach program will record the feedback they get after asking several questions related to health experiences during the COVID season.
(C3) Description of Social Media Platform
The social media platform to be used in this campaign is YouTube, where most users enjoy the content of different dimensions. YouTube can easily be integrated with Facebook to ensure that people aged 55 years and above have access to it. The information available will be in different languages and different facets. For instance, younger viewers can easily share information with their elderly parents (Ramirez, 2020). Therefore, enhancing interaction and engagement in the posts ensure that the population receives this information.
(C3a) Benefits of Social Media Platform
The social media platform will promote the information disseminated about coronavirus. After integrating the videos on Facebook, the viewers can follow the page, directing them to the YouTube channel where this information is adequate (Eghtesadi & Florea, 2020). On Facebook and YouTube, people can promote and share information over a long time, ensuring that relevant information reaches the targeted audiences.
(C4) Benefits to Target Population
Due to inadequate information available to the elderly in the low socioeconomic households, the information on the platforms will educate them on different aspects of the pandemic. They will change how they interact with people and ensure that the healthcare gaps are closed. For instance, they will be educated on how to obtain alternative forms of insurance.
(D) Best Practices for Social Media
General Principles for best practices in the marketing of healthcare through social media include developing a purpose, which in this case is to promote education about COVID19 among the older adults in Los Angeles County. Also, the development of communication strategies is essential to determine the approval required in providing educational material to the public (La et al., 2020). The collection and presentation of information should inform and educate, meaning that it should be concise and easy to understand.
Weblinks are the best ways to cross-promote the posts on social media for the message to reach a broader audience. Measuring successful campaigns is accessible on social media, especially when the healthcare experience of the people involved across the county report better outcomes. In this campaign, the main focus is reducing the number of people without health insurance; the drive can be measured by the statistics of the percentage of the number left without health insurance after the campaign is over.
(E1) Stakeholder Roles and Responsibilities
Stakeholders in this campaign include healthcare providers, nurses, doctors, social workers, hospitals, insurance companies, and the older adult population. The support from these stakeholders is used to promote primary prevention from coronavirus infection among older adults (Eghtesadi, 2020). Some of the stakeholders that have direct interaction with them are the nurses and doctors. Through the contribution of professional expertise and coordination of services, these stakeholders will help ease the burden of fear for COVID 19 and the entrenchment of its impacts on people’s lives. For instance, the insurance companies will help in reducing the cost of healthcare in the time of the pandemic.
(E2) Potential Public and Private Partnerships
Public and private partnerships are required in this campaign to help in rolling out the outreach programs across the communities. Some of the challenges they can help address include improving and providing access to financial resources, networks, and communication strategies. Also, the nurses, doctors, and other healthcare professionals would give the population access to health information and intervention measures for their conditions.
This campaign may take up to two months for planning and development, webpage development, and social marketing. The project can be completed and ready for the campaigns within another three months. Having the program for five months means there will be progress. The data collected will be evaluated as the campaign continues progressively. This includes the comments and other forms of engagements on social media and in contact with the outreach teams. The process of compiling and evaluation will take two months. Therefore, the timeline for this campaign would be 7-8 months, including planning, developing, implementing, and evaluating.
Evaluation of the effectiveness of the campaign will take place simultaneously as more data is compiled. The evaluation process would involve obtaining data from the department of health in the county to understand how many people were added to the health insurance category. Also, they will have records of COVID 19 severe impact reduction due to the recommendation set in the campaign materials. A randomized control trial (RCT) would be conducted to extrapolate data that is unbiased and has the fewest assumptions. The RCT will help determine the percentages of people that recorded health changes and behaviors after being educated.
(E5) Cost of Implementing the Campaign
There are no direct costs to this campaign apart from time. Most outreach work will be conducted through volunteers offered voluntarily by most health workers in the county. On the materials and the help with technology, the partnerships and collaborations will contribute in-kind services considering that the campaign is for a course.
(F) Reflection on Social Media Marketing
Social media marketing can create healthier communities. Online social networks encourage the building of connections and relationships through the sharing of information. For instance, utilizing Facebook and YouTube helps in marketing and promotion by engaging audiences and promoting conversations with diverse groups. These help in advancing public health.
(F1) Reflection on the Future of Nursing Practice
Looking to the future, I can use social media campaigns to promote a healthier lifestyle for older adults, who face the most health issues in the county. I believe that patients should ask questions about their conditions and take control of their treatment process. In that regard, the promotion of health information online allows people to be informed and educated about their conditions. Therefore, they may have a particular level of control over their health. Through these exercises, I believe hospitals will continuously record low turnout in patients seeking healthcare services even in the COVID pandemic.
D’Adamo, H., Yoshikawa, T., & Ouslander, J. G. (2020). Coronavirus disease 2019 in geriatrics and long‐term care: the ABCDs of COVID‐19. Journal of the American Geriatrics Society, 68(5), 912-917.
Brown, C. S., & Ravallion, M. (2020). Inequality and the coronavirus: Socioeconomic covariates of behavioral responses and viral outcomes across U.S. counties (No. w27549). National Bureau of Economic Research.