Assigment .Apa seven . All instructions attached.

Health Promotion & Role Development in Adv. Nursing Practice

Professor: Dr. Nora Hernandez

September 23, 2023

Health Promotion Proposal, Part 1

Health Problem: Breast Cancer in Miami, Florida

Breast cancer represents a significant health concern in Miami, Florida, particularly affecting the female population. Statistical data indicates an alarming rate of breast cancer incidents in this region. According to the age-adjusted female breast cancer incidence rate per 100,000 female population in single years, the counts for Miami-Dade were 1,825 in 2020 with a rate of 98.3, 2,068 in 2019 with a rate of 112.9, and 2,004 in 2018 with a rate of 111.0 (FLHealthCHARTS, 2023). These numbers suggest that not only is breast cancer prevalent, but its incidence has also been notably high in the recent past. This proposal is designed to tackle this serious public health challenge by focusing on targeted evidence-informed health promotion initiatives aimed at preventing breast cancer and improving its early detection and management.

Vulnerable Population: Black Women in Miami, Florida

Black women living in Miami, FL represent a particularly susceptible group when it comes to breast cancer. One underlying factor is evident inequalities between LGBTQ+ people and other groups in terms of quality of care and clinical outcomes. Per American Cancer Society data (2022), black females have a 34 percent lower chance of being diagnosed in the early stages compared to white women, yet have a higher mortality rate for both in situ and localized breast cancer. This raises concerns of a systemic nature on both early diagnosis and treatment. Plus, they’re more likely to be diagnosed with some of the most aggressive types of breast cancer (triple negative).

Those risks are multi-dimensional. Social determinants of health, like household income and education, can have a significant impact. Poorer individuals who lack access to good healthcare tend to undergo screening and therapy too late or not at all. Also, cultural perceptions and skepticism toward the health system prevent from early access to necessary care. From a biological perspective, data have implicated Black female subjects in having hereditary risk factors for more aggressive types of breast cancer, which is supported by their higher rates of testing positive for triple negative diagnoses (American Cancer Society, 2022). Recently, research from the National Cancer Institute (2022) has pointed out how biological and environmental conditions contribute to these differences. Therefore, this population's vulnerability is underscored by a combination of systemic, cultural, and biological factors, substantiating the need for targeted health promotion strategies.

Review of Literature

1. Takada, M., & Toi, M. (2020) The article from Takada and Toi primarily focuses on neoadjuvant treatment for HER2-positive breast cancer. It suggests that the incorporation of trastuzumab in neoadjuvant chemotherapy approximately doubles the chances of achieving pathological complete response (pCR) in HER2-positive breast cancer patients (Tadaka & Toi, 2020). Furthermore, the article discusses the KATHERINE trial, emphasizing improved disease-free survival with postoperative trastuzumab emtansine in patients who had residual disease after neoadjuvant therapy (Tadaka & Toi, 2020). While the paper offers insightful clinical data on HER2-positive breast cancer, it is limited by its exclusive focus on this subtype, potentially excluding other forms of breast cancer.

2. Kunte, S., Abraham, J., & Montero, A. J. (2020) This scholarly article centers on the discussion of novel HER2-targeted therapies for HER2-positive metastatic breast cancer. It notes the advent of novel treatment options like monoclonal antibodies and antibody-drug conjugates, which have significantly improved clinical outcomes (Kunte et al., 2020). However, it also acknowledges that resistance to these treatments remains a hurdle in metastatic settings. While the article brings forth important innovations in treatment strategies, its application might be limited to the metastatic stage of HER2-positive breast cancer.

Evaluation of Sources

Both articles present evidence-based interventions for HER2-positive breast cancer and provide a solid foundation for the proposed health promotion strategy. However, their primary limitation lies in the narrow scope focusing only on HER2-positive subtypes, which may not fully encapsulate the variety of breast cancer cases observed in the targeted demographic.

Theoretical Framework: The Health Belief Model

The Health Belief Model (HBM) is a well-established theoretical framework that serves as an ideal guiding principle for our health promotion proposal targeting breast cancer among Black women in Miami, Florida. The HBM is rooted in the concept that individuals are more likely to engage in health-promoting behavior if they believe they are susceptible to a specific health problem, perceive that the health issue has severe consequences, and are convinced that taking a specific action will effectively reduce their susceptibility or the severity of the health problem (Darvishpour et al., 2018). This model aligns seamlessly with our goal of promoting breast cancer prevention and early detection within the vulnerable population of Black women (Darvishpour et al., 2018).

Within the context of our proposal, the HBM offers a comprehensive framework for understanding and influencing behavior change. It recognizes the importance of perceived susceptibility and severity, factors particularly relevant to our target demographic given the disparities in breast cancer outcomes they face (Darvishpour et al., 2018). By addressing and tailoring interventions to these perceptions, we can effectively engage Black women in Miami, Florida, in breast cancer prevention and early detection practices. Moreover, the HBM accounts for barriers and cues to action, emphasizing the need for practical strategies to facilitate the desired behaviors (Darvishpour et al., 2018). This aligns with our aim to develop actionable and culturally sensitive health promotion programs that overcome barriers and encourage regular breast cancer screenings, self-examinations, and risk-reduction activities.

In summary, breast cancer incidence in Miami, Florida is alarmingly high, especially among Black women. Existing evidence-based interventions mainly focus on HER2-positive breast cancer, providing valuable but limited guidance for broader application. Utilizing the Health Belief Model, the proposed health promotion program aims to mitigate this significant health problem by focusing on prevention and early detection strategies tailored to the needs and risks of the targeted demographic.

References

Health Promotion & Role Development in Adv. Nursing Practice

Professor: Dr. Nora Hernandez

September 23, 2023

Health Promotion Proposal, Part 1

Health Problem: Breast Cancer in Miami, Florida

Breast cancer represents a significant health concern in Miami, Florida, particularly affecting the female population. Statistical data indicates an alarming rate of breast cancer incidents in this region. According to the age-adjusted female breast cancer incidence rate per 100,000 female population in single years, the counts for Miami-Dade were 1,825 in 2020 with a rate of 98.3, 2,068 in 2019 with a rate of 112.9, and 2,004 in 2018 with a rate of 111.0 (FLHealthCHARTS, 2023). These numbers suggest that not only is breast cancer prevalent, but its incidence has also been notably high in the recent past. This proposal is designed to tackle this serious public health challenge by focusing on targeted evidence-informed health promotion initiatives aimed at preventing breast cancer and improving its early detection and management.

Vulnerable Population: Black Women in Miami, Florida

Black women living in Miami, FL represent a particularly susceptible group when it comes to breast cancer. One underlying factor is evident inequalities between LGBTQ+ people and other groups in terms of quality of care and clinical outcomes. Per American Cancer Society data (2022), black females have a 34 percent lower chance of being diagnosed in the early stages compared to white women, yet have a higher mortality rate for both in situ and localized breast cancer. This raises concerns of a systemic nature on both early diagnosis and treatment. Plus, they’re more likely to be diagnosed with some of the most aggressive types of breast cancer (triple negative).

Those risks are multi-dimensional. Social determinants of health, like household income and education, can have a significant impact. Poorer individuals who lack access to good healthcare tend to undergo screening and therapy too late or not at all. Also, cultural perceptions and skepticism toward the health system prevent from early access to necessary care. From a biological perspective, data have implicated Black female subjects in having hereditary risk factors for more aggressive types of breast cancer, which is supported by their higher rates of testing positive for triple negative diagnoses (American Cancer Society, 2022). Recently, research from the National Cancer Institute (2022) has pointed out how biological and environmental conditions contribute to these differences. Therefore, this population's vulnerability is underscored by a combination of systemic, cultural, and biological factors, substantiating the need for targeted health promotion strategies.

Review of Literature

1. Takada, M., & Toi, M. (2020) The article from Takada and Toi primarily focuses on neoadjuvant treatment for HER2-positive breast cancer. It suggests that the incorporation of trastuzumab in neoadjuvant chemotherapy approximately doubles the chances of achieving pathological complete response (pCR) in HER2-positive breast cancer patients (Tadaka & Toi, 2020). Furthermore, the article discusses the KATHERINE trial, emphasizing improved disease-free survival with postoperative trastuzumab emtansine in patients who had residual disease after neoadjuvant therapy (Tadaka & Toi, 2020). While the paper offers insightful clinical data on HER2-positive breast cancer, it is limited by its exclusive focus on this subtype, potentially excluding other forms of breast cancer.

2. Kunte, S., Abraham, J., & Montero, A. J. (2020) This scholarly article centers on the discussion of novel HER2-targeted therapies for HER2-positive metastatic breast cancer. It notes the advent of novel treatment options like monoclonal antibodies and antibody-drug conjugates, which have significantly improved clinical outcomes (Kunte et al., 2020). However, it also acknowledges that resistance to these treatments remains a hurdle in metastatic settings. While the article brings forth important innovations in treatment strategies, its application might be limited to the metastatic stage of HER2-positive breast cancer.

Evaluation of Sources

Both articles present evidence-based interventions for HER2-positive breast cancer and provide a solid foundation for the proposed health promotion strategy. However, their primary limitation lies in the narrow scope focusing only on HER2-positive subtypes, which may not fully encapsulate the variety of breast cancer cases observed in the targeted demographic.

Theoretical Framework: The Health Belief Model

The Health Belief Model (HBM) is a well-established theoretical framework that serves as an ideal guiding principle for our health promotion proposal targeting breast cancer among Black women in Miami, Florida. The HBM is rooted in the concept that individuals are more likely to engage in health-promoting behavior if they believe they are susceptible to a specific health problem, perceive that the health issue has severe consequences, and are convinced that taking a specific action will effectively reduce their susceptibility or the severity of the health problem (Darvishpour et al., 2018). This model aligns seamlessly with our goal of promoting breast cancer prevention and early detection within the vulnerable population of Black women (Darvishpour et al., 2018).

Within the context of our proposal, the HBM offers a comprehensive framework for understanding and influencing behavior change. It recognizes the importance of perceived susceptibility and severity, factors particularly relevant to our target demographic given the disparities in breast cancer outcomes they face (Darvishpour et al., 2018). By addressing and tailoring interventions to these perceptions, we can effectively engage Black women in Miami, Florida, in breast cancer prevention and early detection practices. Moreover, the HBM accounts for barriers and cues to action, emphasizing the need for practical strategies to facilitate the desired behaviors (Darvishpour et al., 2018). This aligns with our aim to develop actionable and culturally sensitive health promotion programs that overcome barriers and encourage regular breast cancer screenings, self-examinations, and risk-reduction activities.

In summary, breast cancer incidence in Miami, Florida is alarmingly high, especially among Black women. Existing evidence-based interventions mainly focus on HER2-positive breast cancer, providing valuable but limited guidance for broader application. Utilizing the Health Belief Model, the proposed health promotion program aims to mitigate this significant health problem by focusing on prevention and early detection strategies tailored to the needs and risks of the targeted demographic.

References