Opioid and heroin abuse epidemic
Introduction
Opioids are those substances that produce morphine like effects when they act on the opioid receptors. These include opiates, which are derived from opium. These drugs are the predominant agents of the central nervous systems that have the medical value of relieving pain. Heroin on the other hand is used as a painkiller medically. It is usually prescribed as analgesic. This drug is also used as a recreational pill due to the euphoric effect that it creates. This drug if administered regularly may lead to tolerance and physical dependence. It may also be used as opioid replacement therapy alongside professional counseling.
Description of Opioids and Heroin Abuse
According to Norah D. Volkow, (2014) in her presentation in the Senate Caucus on International Narcotics Control, the abuse of opioids including heroin and other pain relievers is a global problem that has in the past affect the health, social, and economic welfare of all societies in the world. She narrates that close to 2.1 million people in the United States suffer from disorders that are related to opioids while close to 467,000 are dependent on heroin. Various epidemiology analyses have revealed that middle-aged individuals, women and whites represented the population with most prescription opioids and heroin overdose and that, since 2007, the heroin overdose rates have increased. The study also revealed a direct proportional relation between hospital opiates overdose and subsequent heroin overdose admissions, supporting the hypothesis.
Proposed intervention
The proposed intervention is a study that shall deeply find out how a balance between the provision of maximum relief from suffering as well as the minimization of the adverse effects and risks associated with the use of opioids and heroin can be reached.
Purpose of this Intervention
This will therefore ensure health, social and economic stability amongst the various societies that have for a long time suffered from the adverse effect of opioids misuse.
Literature Review
It is very sad to note that the abuse of opioids have resulted to the high mortality rates as deaths related to the abuse of these substances. Opioids present an intrinsic abuse and addiction liability when wrongly used or probably misused for nonmedical purposes. These drugs are very dangerous when taken for recreational use hence increasing their euphoric effects. These methods may include the crushing pills and injections, taking more than prescribed or rather combining them with other forms of medications without proper control.
Long-term studies to demonstrate that the benefits outweigh the risks are yet to be conducted. Now the regulatory agencies require that the manufacturing companies should conduct the post marketing research to determine safety of these drugs.
Effects of Opioid and Heroin Abuse on the body and Brain
The side effects of abusing opioids may include the following: itchiness, constipation, euphoria, depression as well as nausea. Tolerance and dependence may also develop which in turn lead to the withdrawal syndrome. Recreational use that leads to euphoria may as well result in addiction and take quite a long time to reverse. Extremely potent opioids that are only approved for veterinary use when consumed by humans may lead to even more dangerous effects (BALTIMORE, 2016). Adverse effects of heroin may include constipation. Heroin may as well lead to contracting blood-borne pathogens when needles are uncontrollably shared. There is also increased risk of poisoning by contaminants and decreased kidney function.
Methodology
Behavior change Communication
The governments of the world and specifically the United States should focus on training experts on drug and substance abuse to promote behavior change programs among those who increasingly use this substance. This will assure reduced mortality rate and improved economy as a lot of resources are used to rehabilitate those who are seriously affected by the use of these substances (CDC., 2016). These trainees will ensure that their peers do not fall victims of drug and substance abuse and become the change agents that will ensure proper and medical use of opioids only as prescribed by the doctors to relieve pain. The intervention shall follow the qualitative interviews as the main methodology.
Recreational use of heroin for euphoria effect should be control to ensure stability of the users. As it’s always stated, health is wealth and good health is a fortune. Mental instability only leads to poverty and poverty is a disease especially when it can easily be controlled.
During the behavior change communication process, confidentiality will be highly regarded as participants will be chosen randomly and taken through a special program that will reduce their dependents on drugs and offer alternatives in which they will venture in as opposed to the heroin dependence.
Conclusion
As discussed above, Opioid and Heroin abuse is a health hazard that must be controlled to ensure a healthy society. It should be a responsibility of every patient to ensure that they use the pain relievers as prescribed by the health professional. In a case where by the health practitioner colludes with the patients to abuse these drugs, the law shall take its course to protect the innocence of these patients.
Awareness must be created among all the users to enlighten them on the effects of these drugs and consent given where necessary.
Abusing heroin and opioids is not cool, be warned, the future depends on a healthy current generation, be part of a brighter future and promote proper use of Opioids.
Final Project: Stage I
Annotated Bibliography
According to the Centers for Disease Control and Prevention, one of the most serious public health issues in the United States is the opioid and heroin abuse epidemic, with year record deaths from overdose, in 2014. More than 60% of these deaths involved an opioid (including prescribed opioid pain medication and heroin) (CDC, 2016). 78 Americans die daily, from drug overdose and prescribed opioid pain relievers account as the main factor leading to the opioid overdose death increase of the last 15 years, without changing the amount of pain reported by patients. (CDC, 2016). In this regard, the Obama Administration has recently awarded $94 million dollars in Affordable Care Act. These funds will be available to 271 health centers across the country, for improving and expanded delivery of healthcare services related to substance abuse. Special attention will be paid to treating opioid use disorders in populations that are underserved. This will involve extended access to evidence-based treatment, educational resources to aid health professionals in reducing opioid over-prescribing practices, as well as improved services to aid residents in their recovery and maintain health. (Baltimore City Health Department, 2016). While various methods are used to fight addiction and prevent overdose deaths, more research is needed, for insight into how these methods affect the patients post treatment, in order to prevent harm.
Annotated Bibliography
Unick, G. J., Rosenblum, D., Mars, S., & Ciccarone, D. (2013). Intertwined Epidemics: National Demographic Trends in Hospitalizations for Heroin- and Opioid-Related Overdoses, 1993–2009. Plos ONE, 8(2), 1-8. doi:10.1371/journal.pone.0054496
This quantitative study looks into historical patterns showing who is at greater risk of using opiates and heroin, based on sources and access methods. At present time, there is enough evidence to support the fact that largely available prescription opiates have been fueling the national rate of addiction, drawing in new users. While recent efforts have been made to narrow prescription opiates availability, some addicted individuals tend to switch to other opiates, particularly heroin. Starting from the hypothesis that changes in the rate of prescription opiates are correlated with changes in heroin overdose rates, the researchers compared Nationwide Inpatient Sample codes and Census population data to overdose related hospital admissions, from 1993 to 2009. The analysis revealed that middle-aged individuals, women and whites represented the population with most prescription opioids and heroin overdose and that, since 2007, the heroin overdose rates have increased. The study also revealed a direct proportional relation between hospital opiates overdose and subsequent heroin overdose admissions, supporting the hypothesis. Furthermore, the findings support the idea that limiting prescription opiates supply simply leads to a shift to heroin abuse, rather than harm reduction. The researchers suggest that drug abuse prevention during treatment, coupled with demand-side reduction have more chances to be productive and reduce opiate abuse harm.
This resource is helpful in understanding the effects of supply reduction upon individuals addicted to prescription opiates.
Young, A. M., Havens, J. R., & Leukefeld, C. G. (2012). A Comparison of Rural and Urban Nonmedical Prescription Opioid Users' Lifetime and Recent Drug Use. American Journal Of Drug & Alcohol Abuse, 38(3), 220-227. doi:10.3109/00952990.2011.643971
This quantitative study provides insights into the growing burden of illicit prescription opioid use in the United States and its impact on rural areas. The results showed that rural drug users started at much earlier ages to abuse opiates and had higher lifetime and recent odds to abuse crack and cocaine. On the other hand, urban population showed higher odds in recent use. This also demonstrated that unsupervised prescription opioid use is not similar among urban and rural drug users. Additional research may provide better insights into the factors of individual, social, and structural level nature that contribute to the burden of increased nonmedical opioid use, especially in rural areas, for the purpose of developing specific substance abuse prevention and treatment programs.
This resource will be used in order to illustrate patterns of nonmedical prescription opioid use within various populations and areas of the United States.
Bell, J. (2010). The global diversion of pharmaceutical drugs: opiate treatment and the diversion of pharmaceutical opiates: a clinician's perspective. Addiction (Abingdon, England), 105(9), 1531-1537. doi:10.1111/j.1360-0443.2010.03014.x
This article provides a clinician’s personal account and perspective on issues related to prescribed pharmaceuticals diversion on the context of opioid substitution treatment. With new legislation to contain the treatment in the United Kingdom, Australia, France and the United States, opioid diversion occurred to the black market, proportionally increasing the risks associated with unsupervised opioid use and inverse proportionally with heroin availability. Diversion consequences include risks of overdose death, higher pain killer addiction rates in areas where heroin is less available and increased public reluctance to long-term prescriptions of opioid which require close risk monitoring and appropriate dispensing arrangements. The conclusion of the article is that enhanced compliance through guidelines and clinical audit aid in maintaining the treatment system quality and integrity and acceptable levels of diversion.
This resource is helpful in understanding a clinician’s perspective on prescribing opioids and related ethical issues. It also suggests areas legislation should focus on, in order to prevent harm caused by unsupervised use of prescription opioids and heroin.
Uchtenhagen, A. A. (2011). Heroin maintenance treatment: From idea to research to practice. Drug & Alcohol Review, 30(2), 130-137. doi:10.1111/j.1465-3362.2010.00266.x
This article observes the effects of the United States prohibitionist legislation regarding administering opiates under supervision to opiate addicts. This legislation led to a practice switch from administering pharmaceutical morphine as substitute for street heroin, with methadone. This drug was increasingly accepted and is now regarded as a cornerstone of opiate addiction management and prevention of HIV/AIDS transmitted through opiate injection. A new trend is emerging, due to successful research results in treating treatment-resistant heroin addicts with heroin in Switzerland, the Netherlands, Spain, Germany, United Kingdom, Canada and Belgium. The authors suggest that the United States legislators should be more open to the idea of treating opioid addicts with opioids.
The resource will be used in order to provide new solutions to the opioid and heroin addiction managing treatments.
Torrens, M., Fonseca, F., Castillo, C., & Domingo-Salvany, A. (2013). Methadone maintenance treatment in Spain: the success of a harm reduction approach/ Traitement de maintien a la methadone en Espagne: le succes d'une approche par reduction des risques/ El tratamiento de mantenimiento con metadona en Espana: el exito de un enfoque dirigido a la reduccion de danos. Bulletin of The World Health Organization, (2), 136.
This article studies a harm reduction method adopted in Spain, with successful results. Although the Spanish authorities were focused on reducing harm posed by illegal opioids abuse, by implementing legislation allowing increased access to opioid agonist maintenance treatment, overdose, mortality, and even HIV rates were significantly reduced. Also, in Spain, the rapid spread of HIV, forced the authorities to find a more effective alternative to the drug-free approach, in order to reduce harm. While the opioid dependence in Spain has been heavily influenced by prejudice and moral concepts, rather than scientific evidence, the article strongly supports the idea that opioid agonist maintenance treatment should make integral part of any harm reduction programs in public facilities.
This resource is useful in providing alternative solutions for the opiates addiction problem. However, more studies are needed to evaluate the long-term impact of such programs and their suitability.
Roux, P., Tindall, C., Fugon, L., Murray, J., Vosburg, S. K., Saccone, P., & ... Comer, S. D. (2012). Impact of in-patient research participation on subsequent heroin use patterns: implications for ethics and public health. Addiction, 107(3), 642-649 8p. doi:10.1111/j.1360-0443.2011.03664.x
This study analyses the effects of research requiring drug administration to drug abusers, under controlled laboratory conditions. The researchers aimed to assess post study changes in heroin use patterns of volunteer non-treatment-seeking opioid addicts. A significant number of participants were found to have abstained from heroin, one month after study completion. The findings revealed that participation in such studies not only does not lead to increased subsequent opioid use but for some, opens access to opioid addiction treatment and short-term heroin use cessation.
This reference will be useful in supporting the idea that further research of the opioid and heroin addiction issue may not only be beneficial to future patients but also to volunteer participants and that treating opioid dependence with opioids represents an effective dependence management method.
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Instructor comments: Content: 30/30 Writing: 10/10 Critical Thinking: 10/10
Mohamed: You have chosen an important topic and project. You need to be more specific in describing the intervention that you are proposing. See my comments on your text. Your paper is mostly free of mechanical writing errors and you did a good job with APA form and style for citations and references.
For Improvement: I am not deducting points for this assignment; so be sure to incorporate my feedback in your work and final paper for this class.
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Module 2 Applied Project Rubric Applied Project Section 2: Literature Review and Needs and Assets Assessment (100 points)
Literature Review and Needs and Assets Assessment
Annotated Bibliography
Blanchard, J., Hunter, S. B., Osilla, K. C., Stewart, W., Walters, J., & Pacula, R. L. (2016). A Systematic Review of the Prevention and Treatment of Prescription Drug Misuse. Military Medicine, 181(5), 410-423. doi:10.7205/MILMED-D-15-00009
The study was aimed at providing an evaluation of the existing clinical directions as well as empirical literature in the association of drugs prescription overdose to the defense department directives as well as policies. The study utilized a systematic review of previous studies particularly those that were done on the treatment and prevention of prescription drugs overdose. According to Blanchard, et al., (2009), there was limited evidence in support of the cases. The study concluded that currently the evidence relating to the prevention strategies of drugs overuse as well as treatment is limited as most studies focuses on opioids prescription overdose. Therefore the existing knowledge in the real world in regard to the identification and management of those that are in the risk is a challenge. There is thus a growing need to establish and recommend efficient approaches for the treatment and prevention of drugs overdose long-term effects on patents.
Creech, C. T. (2016). Increasing Access To Naloxone: Administrative Solutions To The Opioid Overdose Crisis. Administrative Law Review, 68(3), 517-550.
According to Creech, (2016), Overdose of drugs can be stated as one of the leading causes of deaths that are associated with injury in the United States. It is approximated that more than a hundred persons in America loses their lives every day as well as the prescriptions of Opioid drugs like vicodin and Tylenol. The study utilized a systematic research in acquiring data. The article proposes that there is a great need of changing the mode of such drugs distribution mechanisms to lower the rate of deaths as well as long term. In addition the article started that political pressure tide has started to change into the favor of opioid overdose treatment as an issue of the public health sector rather than a crime problem. Opioid prevention taskforce needs to be established and the general role that is played by naloxone should be recognized through setting programs into the agency objectives.
Ganem, V. J., Mora, A. G., Nnamani, N., & Bebarta, V. S. (2016). A 3-Year Comparison of Overdoses Treated in a Military Emergency Department-Complications, Admission Rates, and Health Care Resources Consumed. Military Medicine, 181(10), 1281-1286.
According to drug overdose can be regarded as a leading source of death in the United States and this continuous to be a growing issue among the military and civilian population. The rise of substance overuse as well as poisoning, results in increased medical resources utilization. According to Ganem, et al., (2016), the objective of the study was thus to provide a thorough description of overdoses incidences as well as the related outcomes as well as events. The study methodology was accomplished through following a cohort retrospective study on different cases. This included the general collection of variables. The study concluded that the long-term effects of drugs overdose generally depend on the method of prevention that is utilized. Most cases for most patients can thus be prevented through the utilization of better approaches.
Howlett, C., Gonzalez, R., Yerram, P., & Faley, B. (2016). Use of naloxone for reversal of life-threatening opioid toxicity in cancer- related pain. Journal Of Oncology Pharmacy Practice, 22(1), 114-120.
The objective of the study was to evaluate the approach that is based on emergency to treat the overuse of overdose related cases. The extraction of data as well as pain synthesis is a normal occurrence in the entire population. Despite the fact that the general opioid is a common occurrence it is a life threatening substance. According to Howlett, et al., (2016), dosing approaches take takes into account the treatment of drug overuse treatment implications and negative implications reversal that will hold on the patients will be provided. The pre review of the patient’s accounts was also taken into consideration to verify the evidence. Dosing strategies should be fully verified in order to avoid the occurrence of long term effects such as death.
Kennedy-Hendricks, A., Richey, M., McGinty, E. E., Stuart, E. A., Barry, C. L., & Webster, D. W. (2016). Opioid Overdose Deaths and Florida's Crackdown on Pill Mills. American Journal of Public Health, 106(2), 291-297. doi:10.2105/AJPH.2015.302953
The objective of the study was to examine mortality rate of opioid overdose as well as law enforcement methodologies that target drug mills. The method that was utilized by the study was the general collection of data from the health department. The opioid overdose was established to be much lower in several states within the United States as compared to others. According to Kennedy-Hendricks et al., (2016), the anticipated relative transformations in the overdose trends that results into higher and long-term implications on the patients. Based on the results the enforcement of laws in the regulation of may be much effective in the reduction of substances overdose deaths in general.
Milner, A., Spittal, M. J., Kapur, N., Witt, K., Pirkis, J., & Carter, G. (2016). Mechanisms of brief contact interventions in clinical populations: a systematic review. BMC Psychiatry, 161-10.
According to Milner et al., (2016), brief contact intervention (BCI) has been of an increasing interest to the prevention of policy developers, clinicians and researchers. The aim of the study was to offer a systematic evaluation of the proposed BCIs underpinning across case studies. The study utilized a systematic was performed on trials with the utilization of BCIs. Milner et al., (2016), states that based on the review of numerous studies it was established that improved suicide as well as social support literacy prevention are the most underpinning BCIs mechanisms. The research concluded that undermining mechanisms during the study of the effects of overdose prevention methodologies may not develop better grounds in understanding suicide and self-harm interventions needs in the future.
NCPDP recommendations for dose accumulation, monitoring in the inpatient setting: Acetaminophen case model, version 1.0. (2016). American Journal of Health-System Pharmacy, 73(15), 1144-1165.
The study was objected at providing the most suitable practices as well as guidance for developed electronic detection as well as alert of overdoses based on an inpatient setting. According to NCPDP, (2015), despite the growing utilization of safety medication technologies drugs overdose is a continuous issue in most of the inpatient settings. According to, NCPDP, (2015), There is therefore a need to implement procedures and train staffs of the reconciliation process of drugs from the moment that patients are admitted to when the leave the settings. The study utilized a systematic review in gathering evidence to support its objective. The article concluded that the primary factors that leads to the inpatient setting overdose are the lack of adequate recognition in recommendation of daily maximum doses, poor communication, failure of implementing safer technologies for medication safety and fatigue.
Rydberg, D. M., Holm, L., Engqvist, I., Fryckstedt, J., Lindh, J. D., Stiller, C., & Asker-Hagelberg, C. (2016). Adverse Drug Reactions in a Tertiary Care Emergency Medicine Ward - Prevalence, Preventability and Reporting. Plos ONE, 11(9), 1-14.
The purpose of the study was to establish the preventability and prevalence of the effects of drugs adverse utilization in a clinical setting. The study utilized as sectional cross prospective study of observation was utilized. In addition the study additionally reviewed patients data in assessing their general preventability drugs overdose prevalence as well as their parameters on demographic. Based on Rydberg, et al., (2016), the study concluded that the effects of drugs overuse such as death can be prevented or reduced significantly through an increase of the general awareness. The study added that the effects vary with age as well as gender but that generally depends on the availability of information in regard to the risks and the effectiveness of the utilized method in overdose prevention.
White, M., Burton, R., Darke, S., Eastwood, B., Knight, J., Millar, T., & ... Marsden, J. (2015). Fatal opioid poisoning: a counterfactual model to estimate the preventive effect of treatment for opioid use disorder in England. Addiction, 110(8), 1321-1329.
The objective of the study was to provide an estimation of the fatal opioid associated overdose prevention with the utilization of public services of treatment. The study utilized a counterfactual approach as the study method of gathering and justifying its general findings. The study basically targeted non-medical users of opioids mainly individuals between the ages of fifteen and sixty four years. According to White, et al., (2015), that the use of English treatment of the public was effective in the treatment of over 880 death and a general prevention of abuse every year in elation of opioids overdose. It is thus clear that counterfactual approach can be utilized in the prevention of deaths and additional utilized for the monitoring of performance and outcome of the overdose of substances.
Zedler, B., Xie, L., Wang, L., Joyce, A., Vick, C., Brigham, J., & ... Murrelle, L. (2015). Development of a Risk Index for Serious Prescription Opioid-Induced Respiratory Depression or Overdose in Veterans' Health Administration Patients. Pain Medicine, 16(8), 1566-1579.
The objective of the study was to create an index of risk in the estimation of the general likelihood of overdose amid the medical utilizers of opioids prescription. The study utilized a case analysis control method of the healthcare data acquired from the administrative department. The study concluded that when an examination is done correctly it helps in the generation of adequate data on the involved risks of overdose towards the patients. According to Zedler, et al, (2015), the clinical index was thus intended at offering increased clinical support in providing a safer management of pain but it requires further evaluation and revisions in an increased population to increase its general credibility.
Literature Review Synthesis and Description of the Reviewed sources
The reviewed resources are fit for the project as they address substance overdose prevention methods impacts patients’ long term. This will help in bridging the gap that exits in regard to the overdose prevention methodologies. In addition through the reviewed sources adequate data in regard to overdose effects prevention strategies will be gained thus helping in forming the base for future research. In addition through the reviewed sources the research paper will be able to propose better and the most suitable approaches. There is growing need of establishing the most suitable substance abuse prevention strategies currently. This is mainly because the effects of substance overuse are on the rise currently. Substance overuse is a growing public health issue that is highly increasing in the United States and thus there is a growing necessity to address the issue with effective strategies.
PUBH 6640: Applied Project in Public Health
Program Outcomes Mapping Form
For MPH Students
Student Name: Mohamed Kamara
Walden Instructor: Dr Richard Jimenez
Preceptor Information (if applicable)
Name: Nakia Mack
Organization/Agency: Keswick Community Health
Applied Project
How Overdose Prevention Methods Affect Patients in the Long-Term
Project Purpose:
The research paper is aimed at gaining a depth insight into how death by overdose prevention methods affects patients long-term, in order to reduce harm.
Project Significance:
The issue of substance abuse is currently on the rise and it has become a critical public health issue. The research will be useful in bridging the existing gap in regard to literature review on the overdose prevention methods. Most of the existing research is mainly based on the substance abuse rather than the prevention method and the effectiveness. This research will form grounds and recommendations for further research in the near future in order to increase knowledge.
Brief Description of Evaluation Methods:
This research will utilize Secondary Analysis of Archived Data (SAAD) as the evaluation method. Secondary analysis of all the archived data is the utilization of the prevailing data that is collected for the objective of a prior study so that the research interest can be pursued which is different from the original research. This evaluation method has not been utilized widely in connection to qualitative information and thus it will be useful in the review of the existing data in regard to substance overdose prevention methods on long-term effects on patients. Since this research was no part of the previous studies that will be reviewed there will be consideration of the involved ethical and methodological issues in order to increase the associated.
MPH Program Learning Outcomes |
Description of applied project activities |
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1) Utilize culturally appropriate communication skills to convey prevention and intervention strategies used to improve health outcomes among diverse local and global populations. |
Community based and educational programs as intervention as well as prevention strategies in the provision of improved health care to a diverse community are the most suitable. These strategies are mainly effective in enhancing life’s quality, improving health as well as the prevention of injuries as well as illnesses. The programs are mainly objected at reaching to individuals who are located outside the traditional setting of public health. |
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2) Demonstrate an understanding of how research methods, biostatistical data and software, and the epidemiological approach impact the study of patterns of disease, disability and injury. |
Patterns of disability, illnesses as well as injury are impacted research methodologies, bio statistical information, epidemiological method as well as software. This is because the method utilized in study helps in setting grounds for future research. If the utilized study method is effective this thus implies that the information generated is high the rate of information is high. |
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3) Evaluate biological, environmental, legal and regulatory factors that affect the health of local and global communities. |
With legal and regulatory law as well as environment factors in that environmental laws helps in ensuring that there is a good condition for the general wellbeing of individuals. Legal and regulatory policies affect public health through the implementation of policies and regulatory measures. |
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4) Evaluate the major social, behavioral, and cultural factors that affect the health of local and global populations. |
Behaviors impact community health such as the utilization of tobacco, alcohol consumption, sexual practices, unhealthy living and lack of adequate physical activities. The social factors that impacts health in a community setting may include perception elation as well as cultural norms which may encourage of discourage healthy living in some way. Biological factors are through that are mainly acquired from birth due and are transmitted through family link such as a history of diabetes which may recur. |
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5) Appropriately access, interpret and evaluate public health data that is available through the use of information technology. |
The public health data that is present through the internet is adequate as Tit helps in developing knowledge in regard to public health matters. In addition the information in ready and can be accessed in a simplified manner. |
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6) Analyze essential services, systems, public policies, and associated challenges that impact the health of local and global communities. |
Affordable and quality health care services impacts health in a positive manner while expensiveness and lack of quality care results in negative health development. However it is challenging to provide quality and affordable healthcare based on the associated costs. In addition quality healthcare requires qualified personnel are who are expensive to maintain as well as purchasing expensive resources. |
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7) Demonstrate skills needed for sound leadership and decision making in public health, including applications of ethics and professionalism. |
In being a sound leader and a good maker of decisions in public health one should be a holder of integrity, good judge, competence, solution developer and competence. This means that as a leader one should be able to make capable decisions as well as a demonstration of confidence. Running the health sector requires the development of healthy and capable decisions in order to ensure that the wellbeing of the public is achieved fully. |
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8) Apply health management and systems thinking to public health agencies, programs, policies, and issues. |
Public health policies, issues, programs and agencies should be well established and control in order to impact health positively. This therefore means that issues should be identified early and all the solutions should be provided through the implementation of programs and policies. |
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9) Apply the principles of program design, implementation, and evaluation to improve the health of local and global populations. |
In improving global as well as local health effective policy structures and programs should be applied. This helps in establishing and controlling health issues adequately. The policies and programs should be designed in a manner that promotes efficiency. This involves demonstrating the regulatory laws and how the application in general. |
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10) Exhibit a commitment to professional and ethically responsible public health research and practice. |
Maintaining very high scientific and ethical integrity in research helps in sustaining public trust. Scientific integrity is important in the conduct of responsible science research. This is mainly because while conducting health research one holds the responsibility of fostering and exhibiting the uppermost level of scientific integrity. |
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Instructor comments:
Content: 60/60 Writing: 19/20 Critical Thinking: 20/20
Mohamed: Good job with your literature review and program outcomes form. Your paper is mostly free of mechanical errors. You did well with APA.
For Improvement: See note in References
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Research Project Section 3a
- By the end of 2020 the effectiveness of educational and community based intervention programs as substance overdose prevention methods will have been established through the utilization in different diverse communities. In addition more suitable study methods will be utilized in gaining more understanding and setting better grounds for future research to be performed. This will help in developing efficiency as well as effectiveness in the overdose prevention strategies especially in those communities that are diverse. There should be well coordinated legal as well as environmental laws by the end of 2018 in order to ensure that the wellness of the public is maintained. This is because the public wellness is normally affected by both regulatory as well as legal policies and the associated measures. In the implementation of prevention methods behavioral and social factors will be considered as this are the major influence of substance overdose in the modern community.
- The above objectives are SMART because each of them is a reasonable and focused statement that is objected on the long-term desire of the applied intervention project. The objective of having an effective educational program by 2020 is a long term specific goal of the intervention program. The other objective is to spend less than $150, 000 at the end of the follow-up activities. This is a reasonable amount because previous interventions were spending almost equal amount. The priority of the project which is the community’s wellness is well situated in all the objectives. The objectives are specific as all are based on the community through focusing on what the project expects. The objectives are measurable as the resulted can be measured through a time frame and they are all achievable since they do not necessitate much implementation or resources. In addition the objectives are framed on time and they are all relevant to the desired aims of the intervention project.
- The methodology that is utilized in the intervention is a qualitative methodology. This utilized sampling strategies to ensure that the concern of biases, relevance, cost and accuracy is catered for. I found the methodology to be the most appropriate since it saves time, resources and it is quick in collection of the necessary information thus increasing relevance and accuracy of the research (Van, & Bilger, 2009).
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Instructor comments:
Content: 35/55 Writing: 10/10 Critical Thinking: 7/10 Develop Section 3a (1–2 pages) of your Applied Project, which addresses the following: · Revise your process and outcome objectives from your proposed community health intervention to expand them in more detail and ensure they are SMART. Explain how each objective is SMART. · Explain the methodology used in the intervention and why you found this method to be the most appropriate.
Mohammed: The format of your SMART Objectives should be quantifiable and time phased. Your paper is free of mechanical errors. You responded fully to some of the assignment elements. Your TII similarity score is within a reasonable range. You did well with APA format.
For Improvement: See note above.
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Research Project Section 3b
- The kinds of evaluation that are being proposed for the applied project in community intervention is process, outcome as well as impact evaluation. These evaluation strategies were found to be more appropriate for the project because they help in increasing quality of a research (Haukur, & Ingason, 2013). Process evaluation will be utilized in measuring al the projects activities and the targeted population which is the community. On the other hand impact evaluation will be utilized in measuring the immediate impact of the project to ensure that the impact is aligned properly with the objectives of the project. This will help in demonstrating how well the aims of the project have been attained. This will thus be conducted after the project has been completed.In addition the outcome evaluation is basically concerned with the impacts that are long-term for the applied project that is measuring the objective of the project as well as changes measurement.
- The ethical issues that my project is bound to face are confidentiality and privacy invasion, deception, data protection and conflicts and affiliation. This is mainly because the project is dealing with a sensitive health matter.Data protection is the most ethical issue and thus the confidentiality as well as privacy of the participants is highly required which will help in increasing accuracy as well as relevance of the research project.
- The evaluation is aligned to the program outcomes as well as the project in that it will help in monitoring the effectiveness as well as the general impacts. This will help in designing on what the projects needs to do in order to achieve favorable outcomes. Planning as well as management of the program will help in modeling the general outcomes of the project and the program (Morris, 2008).
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Instructor comments:
Assignment Elements:
Develop Section 3b (1–2 pages) of your Applied Project, which addresses the following: · Explain the type(s) of evaluation being proposed in your Applied Project (i.e., outcome or impact) and why this evaluation type is the most appropriate for your proposed community health intervention. Explain any ethical issues inherent in your methodology, and describe any formative, process, outcome and/or impact evaluation methods to be used. · Explain how the evaluation is aligned to project and program outcomes. · Complete the Program Outcomes Mapping Form in the Learning Resources. Content: 55/55 Writing Quality: 10/10 Critical Thinking: 10/10 gMohamed: Very Good job with your paper on evaluation of your project. You responded fully to all of the assignment elements. Your paper is free of mechanical errors. You did well with APA.
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Instructor comments (Timeliness): Timeliness Factor (late points deducted): |
na |
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75 |
Module 4 Applied Project Rubric Applied Project Section 4: Program Timeline and Dissemination Plan (75 points)
Project Timeline
Objective
The research paper is aimed at gaining a depth insight into how death by overdose prevention methods affects patients long-term, in order to reduce harm.
Activity
Responsibility
Deadline
Phase 1: planning
Problem description and definition
Identifying the problem, knowing who are most affected and where the problem
occurs
January 20 2017
Factual information
Conducting a thorough literature review
Data collection analysis and interpretation
April 1 2017
Selection of participant groups
Sampling the target audience based on gender, age, race and locality
April 10 2017
Selection of the setting
Identifying and choosing the best place where the intervention would be held.
April 20 2017
Setting goals and objectives
The goals of the interventions are highlighted
Involve the community in the goal setting
May 12 2017
Preparing the intervention
Training the staff
Assessing the readiness of the staff and participants
Ensuring that everything is okay
October 20 2017
Phase 2: implementation
Conduction of the intervention
The intervention will be done through educational classes
Different methods will me directly applied
Recording of each move shall be done
February 28 2018
Making follow-up emphasis
April 20 2018
Phase 3: Evaluation
Interval evaluation
Will be done at the end of every phase to monitor the progress
At every interval of each phase
Summative evaluation
Will be done at the end of the intervention to determine how successful the
intervention was
Achievement will be measured against the set goals and objectives
May 7 2018
Activity
Who is responsible for implementation?
Implementation date or timeframe
Comprehensive writing of the report
The project’s secretary
May 10 2018
Press release and announcement
Nielsen Press Releases
June 2 2018
Professional presentation
The chairperson of the of the project
June 16 2018
Publication of the report in a scientific journal
Medical Journal Editors
June 30 2018
Promotion of the project findings
Project members
July 1 to December 31 2018
Project management is usually a tedious task because of the fact that it involves dozens of methodologies and steps that require attention. As the project manager, there is a range of tools and processes that need to be employed since the beginning to the completion of the project. The processes are overwhelmingly many and in limitless variety (Abraham, 2014). The project timeline in this regard has come to save the manager and the entire project team from inconveniences and crashing of processes. From the past projects, a timeline was considered as the heart of the project simply because it make planning and implementation easier. Project timeline for this project was specifically essential because of a number of reasons as discussed below.
First, it helps in capturing the most important steps of the intervention project. The flow of these steps and their varying time intervals is important for the project team members since it gives a clue of what will precede the completed activity. In addition, the project timeline displays the activities and how they shall be done at a given time. For this reason, it shall prompt the team members to remain punctual and cautious of time wastage.
Secondly, the project timeline has allocated enough time for each major activity. For instance, the first phase which involves planning has been given 9 months. This is a long period of preparation, planning and making sure that everything is in order. The planning phase may take less time but this shall be to the advantage of the project’s timing. The intervention in the implementation phase only needs three months or less for every single activity to be completed.
When proper timing is done, it is beyond reasonable doubt that no process or an activity shall be left uncompleted (Abraham, 2014). Follow-up activities require the least time in the project simply because they are monitoring activities of the core project. Following the follow-up is the evaluation phase which involves analysis of the project. This phase requires a relatively longer time since it evaluates the outcome with respect to the targeted goals and objectives. It also include the printing the project as a publication and all the finishing processes.
The dissemination table is a highlight of how various tasks of the project shall be distributed to different team members and stakeholders. Most of the dissemination has been at the post intervention process which includes comprehensive writing of the project report, presenting it professionally, printing and publicizing among other activities. The people who have been assigned the various tasked were carefully and professionally selected (Abraham, 2014). This is because each of them requires specialized and extensive skills to handle them. For instance, it is the work of the project’s secretary, Nielsen releases, the chairperson of the project, medical journal editors and the project team members to carry out the specific duties as mentioned respectively.
Both the project timeline and dissemination are designed for common purpose of maintaining order throughout the intervention program. Dividing the workload into phases and setting milestones makes that project manageable despite its complexity (Abraham, 2014).
Project Timeline
|
Objective |
The research paper is aimed at gaining a depth insight into how death by overdose prevention methods affects patients long-term, in order to reduce harm. |
||
|
Activity |
Responsibility |
Deadline |
|
|
Phase 1: planning |
|||
|
Problem description and definition |
Identifying the problem, knowing who are most affected and where the problem occurs |
January 20 2017 |
|
|
Factual information |
Conducting a thorough literature review Data collection analysis and interpretation |
April 1 2017 |
|
|
Selection of participant groups |
Sampling the target audience based on gender, age, race and locality |
April 10 2017 |
|
|
Selection of the setting |
Identifying and choosing the best place where the intervention would be held. |
April 20 2017 |
|
|
Setting goals and objectives |
The goals of the interventions are highlighted Involve the community in the goal setting |
May 12 2017 |
|
|
Preparing the intervention |
Training the staff Assessing the readiness of the staff and participants Ensuring that everything is okay |
October 20 2017 |
|
|
Phase 2: implementation |
|||
|
Conduction of the intervention |
The intervention will be done through educational classes Different methods will me directly applied Recording of each move shall be done |
February 28 2018 |
|
|
Making follow-up emphasis |
|
April 20 2018 |
|
|
Phase 3: Evaluation |
|||
|
Interval evaluation |
Will be done at the end of every phase to monitor the progress |
At every interval of each phase |
|
|
Summative evaluation |
will be done at the end of the intervention to determine how successful the intervention was achievement will be measured against the set goals and objectives |
May 7 2018 |
|
|
Activity |
Who is responsible for implementation? |
Implementation date or timeframe |
|
Comprehensive writing of the report |
The project’s secretary |
May 10 2018 |
|
Press release and announcement |
Nielsen Press Releases |
June 2 2018 |
|
Professional presentation |
The chairperson of the of the project |
June 16 2018 |
|
Publication of the report in a scientific journal |
Medical Journal Editors |
June 30 2018 |
|
Promotion of the project findings |
Project members |
July 1 to December 31 2018 |
Project management is usually a tedious task because of the fact that it involves dozens of methodologies and steps that require attention. As the project manager, there is a range of tools and processes that need to be employed since the beginning to the completion of the project. The processes are overwhelmingly many and in limitless variety (Abraham, 2014). The project timeline in this regard has come to save the manager and the entire project team from inconveniences and crashing of processes. From the past projects, a timeline was considered as the heart of the project simply because it make planning and implementation easier. Project timeline for this project was specifically essential because of a number of reasons as discussed below.
First, it helps in capturing the most important steps of the intervention project. The flow of these steps and their varying time intervals is important for the project team members since it gives a clue of what will precede the completed activity. In addition, the project timeline displays the activities and how they shall be done at a given time. For this reason, it shall prompt the team members to remain punctual and cautious of time wastage.
Secondly, the project timeline has allocated enough time for each major activity. For instance, the first phase which involves planning has been given 9 months. This is a long period of preparation, planning and making sure that everything is in order. The planning phase may take less time but this shall be to the advantage of the project’s timing. The intervention in the implementation phase only needs three months or less for every single activity to be completed.
When proper timing is done, it is beyond reasonable doubt that no process or an activity shall be left uncompleted (Abraham, 2014). Follow-up activities require the least time in the project simply because they are monitoring activities of the core project. Following the follow-up is the evaluation phase which involves analysis of the project. This phase requires a relatively longer time since it evaluates the outcome with respect to the targeted goals and objectives. It also include the printing the project as a publication and all the finishing processes.
The dissemination table is a highlight of how various tasks of the project shall be distributed to different team members and stakeholders. Most of the dissemination has been at the post intervention process which includes comprehensive writing of the project report, presenting it professionally, printing and publicizing among other activities. The people who have been assigned the various tasked were carefully and professionally selected (Abraham, 2014). This is because each of them requires specialized and extensive skills to handle them. For instance, it is the work of the project’s secretary, Nielsen releases, the chairperson of the project, medical journal editors and the project team members to carry out the specific duties as mentioned respectively.
Both the project timeline and dissemination are designed for common purpose of maintaining order throughout the intervention program. Dividing the workload into phases and setting milestones makes that project manageable despite its complexity (Abraham, 2014).
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Instructor comments:
Mohamed: Nice job with your timeline and dissemination plan. Your deliverables target dates seem reasonable given your project scope of work.
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Instructor comments (Timeliness): Timeliness Factor (late points deducted): |
na |
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75 |
Module 4 Applied Project Rubric Applied Project Section 5: Budget with Justification and Sustainability Plan (75 points)
Budget justification
This is a budget that has been designed to cater for every expense in the course of the overdose prevention intervention. The estimates are considerably within the range of realism considering how the previous intervention budgets the research team had incurred. Justification of every expense has been made as follows.
Personnel expenses: the project coordinator is an expert international leader in fighting drug and substance abuse and hence his high rank is worth the $70, 000 basic salary, $17500 project salary and $3500 fringe salary throughout the intervention. The other researchers have been assigned salaries based on the magnitude of duty they hold, the level of education and the agreements that were made during the preparation period. Office supply shall spend $3, 200 which is a considerable amount considering the duration and time that writing and printing shall be used.
Equipment: Since the department does not have all the necessary equipment, 4 laptops, a van and the other included equipment shall be hired. Their prices were confirmed to be as they are in the budget.
Incentives/Promotions: After a lengthy discussion with the project committee members, it was found that online advertising would not pass the information efficiently as we would desire. In this regard, pamphlets, posters and other printouts had to cost $16, 100 for full awareness and reward to the participants. In addition, postage envelops and survey copies were found useful in the intervention.
Transport expenses: We also had to hire a park pavilion which would be large enough to accommodate the expected large number of participants.
Purchasing services: The purchase services were estimated to equal the previous intervention project which amounted to $1, 450.
Project sustainability plan
Mission
The project team is looking forward to have a discussion with community members and staff on the need to embrace the overdose prevention methods that will be proven effective during the intervention.
Goals
The team will also develop logic and specific model of sustainable goals towards overdose prevention.
Relation and involvement of key stakeholders
The team members will closely work with the leadership schools and faith communities in order to uphold the banner of ‘no to overdose’. For the purpose of building the relations with the leaders and teachers, regular meetings shall be conducted with them and the community members.
Awareness
Written materials shall also be distributed to participants for them to understand the vision and mission of the project team.
Project funding
Finance sustainability of the project on future interventions is dependent on personal contributions, support from government health agencies, fundraisers and sponsors. In addition financial strategies shall be developed by the advisory and staff committee to ensure that clarity and transparency of funds is made sustainable.
Being good stewards
Lastly, the sustainability plan calls all the members of the project to be good stewards of time and resources. Celebrations of the continued efforts will be made after every bit of the project shall have come into completion.
PUBH 6640: Applied Project in Public Health
Program Outcomes Mapping Form
For MSHEP Students
Student Name: Mohamed Kamara
Walden Instructor: Dr. Fraser
Preceptor Information (if applicable)
Name: Nakia Mack
Organization/Agency: Keswick Community Health
Applied Project
Title:
How Overdose Prevention Methods Affect Patients in the Long-Term
Project Purpose:
The research paper is aimed at gaining a depth insight into how death by overdose prevention methods affects patients long-term, in order to reduce harm.
Project Significance:
The issue of substance abuse is currently on the rise and it has become a critical public health issue. The research will be useful in bridging the existing gap in regard to literature review on the overdose prevention methods. Most of the existing research is mainly based on the substance abuse rather than the prevention method and the effectiveness. This research will form grounds and recommendations for further research in the near future in order to increase knowledge.
Brief Description of Evaluation Methods:
This research will utilize Secondary Analysis of Archived Data (SAAD) as the evaluation method. Secondary analysis of all the archived data is the utilization of the prevailing data that is collected for the objective of a prior study so that the research interest can be pursued which is different from the original research. This evaluation method has not been utilized widely in connection to qualitative information and thus it will be useful in the review of the existing data in regard to substance overdose prevention methods on long-term effects on patients. Since this research was no part of the previous studies that will be reviewed there will be consideration of the involved ethical and methodological issues in order to increase the associated.
MSHEP Program Learning Outcomes |
Description of applied project activities |
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1) Examine historical milestones, current challenges, and future trends related to health and health education. |
Progress in the health related trends can majorly be achieved through literature review. Materials such as journal articles, health informatics books, magazines and research text books are suitable sources of providing historical information and every milestone that has ever been reached in the health and heath education sector. News articles and reliable internet resources are the most suitable in understanding the present and prefiguring the future trends. |
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2) Analyze biological, social, political, cultural, environmental, and/or behavioral factors that impact individual and population health. |
In order to understand the nature of the population, the project will conduct a demographic analysis. This shall include statistical studies that shall help in understand the population quantitatively. Qualitative analysis such as political and social economic factors shall also be used to understand the nature of the population for better intervention. Data such population size, health status of the sampled individuals, migration and other comparative analytics shall be conducted. |
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3) Assess community needs and capacity for health education. |
Through a community health needs assessment, the team members shall evaluate problems such as limited health care resources, inequalities in health and the availability of public health interventions, a clear understanding of the community needs shall be reached. Areas of improvement shall be identified and strengths being upheld. |
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4) Develop culturally-tailored health education programs and communication using health behavior theories and models. |
Community based and educational programs as intervention as well as prevention strategies in the provision of improved health care to a diverse community are the most suitable. The programs are mainly objected at reaching to individuals who are located outside the traditional setting of public health. |
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5) Evaluate the effectiveness of health education programs, communication, and research. |
The project will use analytic tools such as CEA and AEI to measure the effectiveness of the intervention program. Diagnostic procedures and other assessment techniques that are suitable in analyzing the capacity of the education programs and communication shall be used. |
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6) Apply key leadership concepts and skills to effectively administer health education programs and services. |
Leadership skills shall be highly exercised by all the intervention staff. This shall be first done through training, encouraging self study and soon they will learn from experience. The expected results shall be as a result of team work, technical support and commitment among other concepts of leadership that shall have been applied. |
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7) Utilize best practices of health communication to promote and advocate for individual and population health |
For the team members to perfectly utilize the best practices of a healthy communication, each person shall be required to first gain an understanding of the participants of the intervention program. The nature of the conversations shall also be made goal oriented for the purpose of making the conversation more meaningful to the project. |
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8) Apply research principles and methods to address 21st Century health challenges. |
For the purpose of researching on the various health challenges that face the 21st century generation, the project shall opt to follow the approach of evidence-based research. This is an approach that is evidence oriented and finds solutions based on laid facts concerning a particular health issue. Much is expected from the principles of evidence-based research and practice. |
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Instructor comments: Mohamed: Your budget and justification seem reasonable. Good job with your sustainability plan.
For Improvement: See note on staff line item budget.
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Instructor comments (Timeliness): Timeliness Factor (late points deducted): |
na |
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75 |
References
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