Assigment .Apa seven . All instructions attached.

7

Health Promotion Proposal

Marcos Martin Bello

Florida National University

Health Promotion and Role Development in Advanced Nursing Practice

Dr. Nora Hernandez-Pupo

July 23, 2025

Health Problem: Untreated Substance Use Disorder in South Florida

Substance Use Disorder (SUD), particularly OUD, is a major public health issue in South Florida. The prevalence of SUD, particularly synthetic opioid use like fentanyl, endangers local communities. Over 7,000 drug overdose deaths occurred in 2022, with over 60% involving synthetic opioids, according to the Florida Department of Health (2023). Southern Florida has the highest overdose death rates: Miami-Dade, Broward, and Palm Beach. About 23% of individuals in Florida with SUD do not get treatment, according to Ryan & Rosa (2020). Hospitalizations, homelessness, jail, and mortality increase with untreated SUD. The limited availability of comprehensive, accessible treatment options exacerbates the problem, particularly for marginalized and economically disadvantaged populations. Through community outreach and telehealth, my proposed health promotion program would enhance the early identification and intervention of individuals with opioid use disorder. This strategy will reduce the number of individuals with OUD in South Florida by 15% over a two-year period. Local treatment clinics, outreach logs, and telehealth appointment records will track this outcome, making it practical and tangible.

In South Florida, underserved adults are vulnerable.

In South Florida, OUD mostly affects low-income, uninsured, and underinsured African Americans and Hispanics. Poverty, limited healthcare access, unemployment, housing instability, and systemic discrimination disproportionately impact these populations as social determinants of health. Census Bureau indicate that 18% of Miami-Dade County residents live below the poverty line, and 21% lack health insurance (U.S. Census Bureau, 2024). Socioeconomic vulnerabilities increase SUD risk and cut treatment access. Drug use stigma prevents many individuals in these communities from seeking help. Inaccessible culturally appropriate mental health and substance use care puts this population at risk. According to research (Alegra et al., 2020), minority populations face language barriers, healthcare system skepticism, and provider bias, which results in worse drug use and treatment outcomes. These individuals may also use drugs due to violence, incarceration, and familial instability. Those with ACEs and ongoing community trauma were more likely to become opioid dependent and drop out of treatment (Dydyk et al., 2024). These factors make this population vulnerable to untreated OUD and in need of targeted, accessible, and evidence-based treatments.

Another risk factor is poor primary care-behavioral health integration. Many OUD patients in underserved communities only see healthcare providers in times of crisis, such as an overdose or severe withdrawal, and typically only in hospitals. The episodic treatment approach overlooks drug use's chronicity, resulting in repeated hospitalizations and missed treatments. Long wait times, transportation barriers, and restrictive admissions processes limit access to traditional in-person treatment institutions, particularly for individuals without stable housing or employment. The proposed health promotion program tackles these risk factors to ensure fair, coordinated, and successful treatment of untreated OUD in South Florida.

Evidence-Based Interventions

Community-based OUD interventions have shown effectiveness. Hogue et al. (2021) studied low-threshold buprenorphine programs with peer outreach and harm reduction interventions in urban settings. A 12-month study of over 500 participants in Baltimore, Maryland, demographically similar to South Florida's metropolitan core, found that these interventions improved treatment retention and opioid use. Study strengths included real-world, scalable therapy without abstinence or strict intake protocols. More individuals may use this flexibility. A limitation was self-reported data that may be subject to bias. The findings support the hypothesis that removing OUD structural barriers and increasing peer support may increase OUD treatment participation and outcomes.

The effectiveness of telehealth-delivered medication-assisted treatment (MAT) in rural and underserved populations during the COVID-19 epidemic was also examined by Lin et al. (2020) in the American Journal of Psychiatry. Researchers compared telehealth MAT (buprenorphine and behavioral therapy) to in-person treatment in a randomized controlled trial. The telehealth group reported comparable or better treatment adherence and an increase in service satisfaction. Solid methodology, a diverse sample, and urban and rural involvement are research strengths. Long-term outcomes were undetermined since the investigation was limited to six months. The findings underscore the potential challenges that telehealth access confronts, particularly for populations with mobility barriers or stigmas. Telehealth may increase OUD treatment access.

Community-based outreach and telehealth MAT are effective untreated OUD treatments after analyzing their strengths and weaknesses. Hogue et al. (2021) suggest lowering bureaucratic barriers and fostering peer-led trust to meet patients physically and metaphorically. Harm reduction strategies involve the concept of influence over abstinence and treatment. For addressing rural populations, Lin et al. (2020) underscore the significance of technology. The two results address patient-centered health care that is accessible and is in alignment with the health promotion goal of South Florida. They both point at the risks associated, in terms of data gathering, money, and legality. These issues require planning, community involvement, and a regular check. The research indicates the comprehensive approach that involves outreach, telehealth, medication assisted treatment and culturally competent counseling.

Health Promotion Theoretical Model for Belief

The Health Belief Model (HBM) will be used in health promotion. According to people, the HBM is appropriate to cover chronic behavior, such as drug use disorders, through their perceptions about the severity of an illness, feelings of vulnerability, favorability of a change, and impediments to change. The model also includes the notion of self-efficacy and signals to action that are essential in coming up with therapies to help with populations that are disempowered or discouraged by healthcare. In this recommendation, the HBM explains the lack of desire to get treatment in case of individuals with OUD. If their social networks have normalized opioid use, many may not regard themselves as at risk of overdose or long-term harm. Compared to the perceived benefits of opioid use, treatment may reduce it (Ryan & Rosa, 2020). Also, stigma and logistical challenges associated with getting treatment, such as childcare, transportation, or legal ramifications, operate as entrance barriers. The health promotion program will use targeted education and motivational interviewing to shift these perceptions, helping individuals understand their sensitivity to injury, the severity of untreated OUD, and the benefits of OUD treatment.

HBM influences the recommended intervention structure. Peer outreach workers offering health information at community centers, churches, and shelters or street-level engagement are “cues to action.” Online telehealth appointment scheduling and text message reminders may also send similar signals. Participants' self-efficacy, a vital step in behavior change, is improved by the program's accessible, nonjudgmental, and successful message. Medication-assisted treatment and counseling are personalized, like the model's individual assessment. The HBM provides a realistic and evidence-based framework for fostering behavior change in South Florida OUD individuals. HBM has limitations being applied by public health programs. Critics argue that it oversimplifies the behavior change problem and lays too much emphasis on the personal level of cognition and not enough on structural explanations of behavior such as poverty, racism and housing instability. This concept should have a systems-based type of solution to surmount mental and environmental obstacles. In contrast to healthcare, peer navigators help with housing, Medicaid, and job training. Socioeconomic factors are included in this comprehensive treatment of South Florida opioid use disorders.

References

Alegría, M., Green, J. G., McLaughlin, K. A., & Loder, S. (2020). Disparities in child and adolescent mental health and mental health services in the U.S. William T. Grant Foundation Research Digest. https://wtgrantfoundation.org/

Dydyk, A. M., Jain, N. K., & Gupta, M. (2024). Opioid use disorder. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK553166/

Florida Department of Health. (2022). Florida drug overdose surveillance and response. Www.floridahealth.gov. https://www.floridahealth.gov/

Hogue, A., Becker, S. J., Wenzel, K., Henderson, C. E., Bobek, M., Levy, S., & Fishman, M. (2021). Family involvement in treatment and recovery for substance use disorders among transition-age youth: Research bedrocks and opportunities. Journal of Substance Abuse Treatment, 129(129), 108402. https://doi.org/10.1016/j.jsat.2021.108402

Lin, L. (Allison), Fernandez, A. C., & Bonar, E. E. (2020). Telehealth for substance-using populations in the age of coronavirus disease 2019. JAMA Psychiatry, 77(12). https://doi.org/10.1001/jamapsychiatry.2020.1698

Ryan, J. L., & Rosa, V. R. (2020). Healthcare cost associations of patients who use illicit drugs in Florida: A retrospective analysis. Substance Abuse Treatment, Prevention, and Policy, 15(1). https://doi.org/10.1186/s13011-020-00313-2

U.S. Census Bureau. (2024). QuickFacts: Miami-Dade County, Florida. Census Bureau QuickFacts; United States Census Bureau. https://www.census.gov/quickfacts/fact/table/miamidadecountyflorida/IPE120223