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HE 385 Expertise Paper Guide (1).docx

EXPERTISE PAPER

The goal of this writing and research assignment is for you to look in depth at a particular public health problem that is of interest to you and to think critically about how you, as a health professional, are going to contribute to the health and wellness of the people you will someday serve!

Defining a Target Population

Organizations need to be clear about their target populations and know the demographics of the people they wish to serve in comparison to the larger community.

For example, a target population could be all of the people in an organization's local community, everyone in the state, or people living at or below the poverty level within a given community.

After clearly defining who needs to be served, an organization can evaluate whether or not it serves all racial/ethnic groups within that community proportionately.

For example, a fictional nonprofit human services agency's mission is to provide health insurance to local families who are without health insurance. Fifty percent of people without health insurance in the local community are white, 25 percent are Latino, 15 percent are African American, 5 percent are Native American.

Consider the scope of the health issue, any demographic factors (age, race, etc.), setting (urban, suburban, rural, frontier), and location (town, county, city, state, etc.)

Asthma in children ages 6-18 in low-income rural Oregon

The Paper

1. General introduction setting up the paper. What are you going to do in this paper? (Describe a particular issue facing a particular community, and how we can meet Healthy People 2020 objectives by 2020)

2. The Problem Space: What is the issue, and why is it an issue?

· What is the health condition as identified by Healthy People 2020?

· What does it look like now? What are the Healthy People 2020 goals in general? Which goal in particular did you choose to identify as one that aligns with your career goals?

· What is the incidence and prevalence of your condition in general?

· What are the trends over time? Has the issue worsened, or gotten better? Describe.

· Hint: this is an area where time is important. What is the “bigger picture”? How did this become an issue now?

· What are some of the disparities surrounding this health issue? Think about age, gender, race, ethnicity, location, protected populations, minorities

3. Based on information from Healthy People 2020 and your analysis of the health condition in #2 above, who is your target population? What grouping of people do you want to work with and why? How do you think you can help meet the goals and objectives of this particular Healthy People 2020 area

4. What are the predisposing, reinforcing, and enabling factors that might make it easier or difficult for people in your target population to improve their health? This question should also prompt you to think about the risk and protective factors for the community you’ve identified.

· Risk factors are characteristics at the biological, psychological, family, community, or cultural level that precede and are associated with a higher likelihood of negative outcomes.

· Protective factors are characteristics associated with a lower likelihood of negative outcomes or that reduce a risk factor’s impact. Protective factors may be seen as positive countering events.

Risk and protective factors are more “big picture” ideas. Predisposing, enabling, and reinforcing (PER) factors can be too, but for our purposes, PER factors are unique to the individual or community that you are serving.

· Predisposing factors are hereditary conditions and lifestyle factors that contribute to a disease occurring in a person.

· Being African-American

· Family history of heart disease

· Being male

· Enabling factors are factors that make it possible (or easier) for individuals or populations to change their behaviors or their environment. This includes skills or physical factors such as availability and accessibility of resources, or services that facilitate achievement of motivation to change behavior. Think of it like, “Well, I drive past Dutch Bros every morning, so it’s easier for me to just stop and get my coffee there.” Or “How am I supposed to eat healthier when there aren’t any grocery stores around?”

· Resources (not having a car would make it more difficult to go to regular doctor’s appointments)

· Conditions of living (no grocery stores within walking distance of a low-income neighborhood would make it more difficult to eat healthy)

· Societal supports (We have lots of great sidewalks and it makes me feel safe to know that I don’t have to risk getting hurt walking in the street.)

· Skills (knowing how to prepare vegetables in a tasty way would make it easier to eat more vegetables)

· Reinforcing factors include factors that reward or reinforce the desired behavior change, including social support, economic rewards, and changing social norms.

· “If I exercise 8 times a month, I get a $15 credit on my gym membership That’s why I keep working out!”

· “My family never wants to go hiking, so I found a free hiking group in my community. We go out every other weekend! I’m so glad that they help keep me moving”

5. Your professional contribution

· How do you think that you can help meet Healthy People 2020 goals as a professional? Healthy People 2030 goals will be arriving in the next few years. How will you, in your career, help the community you’ve identified reach those goals for health?

6. Conclusion

You should cite sources. As many sources as you can find. If you read something, and then type words in your paper because a piece of writing gave you an idea, you need to cite that source. You must use in text citations using APA format (DeWitt, 2016) or if you’d like to learn a new format, you can also use AMA1. Regardless, you need to have a Resources page at the end of our paper. You should be able to accomplish writing this paper in about 5 double spaced pages. Completing your evidence tables will make this part of the paper less effort!

Focusing your topic area:

Why are you interested in this topic?

Why does this topic matter?

In the following paper, what are you going to talk about?

Incidence:

Prevalence:

Trends over time:

Disparities:

· Age

· Gender

· Ethnicity

· Other

Demographics:

Risk/Protective Factors:

Predisposing, enabling, and reinforcing factors:

What are your recommendations for tackling this problem by the year 2020?

What do you think the new Healthy People 2030 goal should be? How do you think the Healthy People 2020 goal will change from 2020 to 2030?

Evidence Tables

It could look something like this, in Landscape format:

Background.  In conducting research, we often do a review of the literature to help us examine what has been done before with the goal of determining what needs to be done next. We usually search the literature, identify key articles, read the articles, and summarize the literature in a text chapter or paper. Another alternative to the textual literature review is to present the detailed findings from the literature in evidence tables rather than in text. One of the most important steps in writing a paper is showing the strength and rationale of the evidence you chose.  The following document discusses the reasoning, grading and creation of a "Table of Evidence."  While table of evidences can differ, the examples given in this article are a great starting point.

What is an evidence table?  An evidence table is way to present the literature on a research question in tabular rather than textual form. The table is set up with columns describing the study and its results and with rows for each of the relevant studies for a particular research topic. The evidence table captures the key parameters and findings of the study. Different evidence tables are created for different questions.

Why use an evidence table? Put briefly, presenting findings in evidence tables is a more efficient approach to conduct a literature review than summarizing findings in text. Since the table captures the findings, we can review the findings at any point. And we can easily share the findings with colleagues. When we use a textual summary, we often find that we have to go back and read the study again. When we have an evidence table, we can go to the detail in the table. And, if the table is set up properly, it should make the process of writing summary statements easier. We can just read the table and say “Intention was associated with perceived norms for three of the four studies that examined the relationship” or “Most of the interventions designed to increase condom use focused on college undergraduate populations and little is known about the interventions for older adult populations.” An evidence table is dynamic; we can add to rows to the tables as we develop our research and find more studies.  

What goes into an evidence table?  The table can be simple or complex in terms of the information that is entered. The number of columns and the detail you provide is up to you. Tables summarizing the literature on different questions will need different columns. Here we have set the tables up in portrait format but you could use landscape. As entries into the table, you can put in phrases or statements or even summary statistics.  

Primary literature. These sources contain the original data and analysis from research studies. No outside evaluation or interpretation is provided. An example of a primary literature source is a peer- reviewed research article. Other primary sources include preprints, dissertations, technical reports and conference proceedings. Think about witnessing something silly your sister did. You were there, you saw it!

Secondary literature. These sources provide analysis, synthesis, interpretation and evaluation of primary works. A narrative review article is an example of a secondary source. A popular news article (NPR, CNN, Huffington Post) that summarizes research for ease of accessibility for the lay person is also considered a secondary source. Think about your mom telling you a story about something your sister did, but you weren’t there to witness it.