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Page 1: Plan Effectiveness€¦ · Hispanics, just like African Americans have average, if not low, household incomes below $50,000. The rate of unemployment among Hispanics ranges at six

Running head: PLAN EFFECTIVENESS 1

Plan Effectiveness

Student’s Name

Institutional Affiliation

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Introduction

Hispanics are one of the fastest-growing populations in the United States, considering

that by 2017 their numbers were approximately 58.9 million, and their names are projected to

double by the year 2050. Hispanics represented nearly 17% of the U.S population and expected

to reach 30% by 2050. Hispanics are considered to be a group associated with Hispania, Spanish

cultures of Portugal and Spain. Hispanics depict similar traits of ethnicity, culture, and origin

though they cannot be considered a monolithic group as the subgroups within differing in some

aspects. Notable subgroups include people from Mexico, who are the majority, and persons from

Puerto Rio, Cuba, and Central or South America. There are significant states in the U.S that

harbor over a million Hispanics, and they include New York, Colorado, California, Arizona,

Illinois, New Jersey, Georgia, Florida, and Texas (Fernández-Armesto, 2014). This paper aims to

focus on Cardiovascular Diseases among Hispanics to understand their dynamics, culture,

environment, and risk factors that cause high rates of mortality to develop appropriate health

promotion activities that would curb the problem.

A Detailed Description of the Aggregate

Most Hispanics are religious and practice Christianity though others still have a link to

traditional aspects such as the use of herbs and consulting classic folk men for various

interventions. Hispanics, just like African Americans have average, if not low, household

incomes below $50,000. The rate of unemployment among Hispanics ranges at six compared to

an average of 4 among non-Hispanic Whites. It affects their access to basic social amenities such

as education, healthcare, healthy diets, and quality environments. Nearly 75% of Hispanics are

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observed to speak their native dialects at home compared to English. Their life span is longer as

men live to average ages of 82 while the women 84 years.

Cardiovascular diseases (CVD) can generally be described as conditions that affect the

blood vessels, the heart, or both, with the cause being atherosclerosis; it also includes congenital

and rheumatic heart diseases. Cardiovascular-related deaths among Hispanics remain high

though it has been observed that the rate is higher in regions with high Hispanic populations

compared to areas that have distributed mixed ethnic communities. The study by Rodriguez et al.

(2018) does show the relationship between the epidemics of cardiovascular diseases among the

Hispanic dense regions. The researchers in the study did analyze mortality data from 715

counties in the U.S and managed to establish a record of 4,769,040 deaths from cardiovascular

illnesses. From the data, 382,416 were Hispanics, and the rest were non-Hispanic whites, which

shows lower rates of mortality among Hispanics. Assessing the data carefully, it was observed

that regions with dense populations of Hispanics had 60 % more deaths compared to counties

with diverse ethnicities. Such data develops the need to assess the impact of cultural enclaves

within the Hispanic subgroups and health outcomes. Healthcare professionals, therefore, need to

target neighborhoods with the majority of Hispanics and launch cardiovascular disease

management and prevention programs.

A Description of the Aggregate's Strengths and Weaknesses

There are different elements observed in the Hispanic cultures that weigh on their

strengths and weakness in health outcomes, especially cardiovascular diseases. One of the

advantages among Hispanics is that the majority of the population has embraced the idea of

taking health-cover with 38.2 % and 49% of the population having public and private health

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cover, respectively. The other strength is that the Hispanics have a common way of living where

households may involve the extended family or numbers not less than five. Such life is vital in

care as the family members may provide social support, which is essential for in-patient care and

health management. The role of religion in Hispanics cannot be overlooked as there are studies

that have shown positive effects in physical and mental health and controlled negative aspects

such as discrimination from programs conducted under religious umbrellas. Hispanics have a

rich culture and more so a variety of healthy cuisines to choose from, an element that can be used

in controlling health. Their rich culture does have positive aspects that can be combined in health

practice to provide holistic and culturally-based intervention.

On the other hand, Hispanics face a lot of disparities that provide loopholes for weakness

in health and quality of life. Different studies show that the majority of the counties where

Hispanics are most populated are more likely to be low-income neighborhoods with high levels

of illiteracy, and the majority of families live below poverty. Lack of such significant social

determinants limits their access to quality life and positive health outcomes. Poverty inhibits lack

education, which bars comprehending aspects of healthy living and opportunities to well-paying

jobs that aid in improving the living standards of the families involved. The 17% of uninsured

populations in Hispanics still are high and affect the persons involved as they probably do not

afford healthcare, thus worsening their conditions. Observing the counties where Hispanics live

are majorly rural regions and areas with potential environmental hazards such as poor air quality

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and polluted resources. The reason for that is because most of the Hispanics work in the service

industry in factories, farms, and such, which exposes them to multiple potential hazards.

A Risk Assessment of the Aggregate

Cardiovascular diseases among Hispanics are a significant issue with variance among the

subgroups. Hence, healthcare givers rely on risk assessment tools that can accommodate the

differences. Different studies have not focused on risk factors that lead to cardiovascular

illnesses in diverse regions as the interventions to improve care in the areas may have differed

outcomes based on various environments. For example, different studies show that the Hispanic

population face funding constraints, cultural differences, and language barriers, among other

factors that limit access to healthcare.

Modifiable risk factors that affect cardiovascular illnesses include sedentary lifestyles,

smoking, poor eating habits, excess alcohol intake, high cholesterol, diabetes, hypertension, and

obesity. Non- modifiable risk factors that can cause CVD to include age, gender, family history,

ethnicity, psychosocial factors, and erectile dysfunction. Researchers have discovered that

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Hispanics have a higher rate of cardiac problems, but the majority of them rarely know that they

have a heart problem, likely one in every 20 persons understands they have a problem. The study

by Mehta et al. (2016) conducted in four metropolitan states of Chicago, Bronx, San Diego, and

Miami involved 16,415 participants. Still, only 1818 Hispanics from diverse subgroups led an

Echocardiographic study of identifying cardiac dysfunctions using ultrasound images.

The results of the study were that nearly half of the 57.4% female participants were

obese. Almost 50% had hypertension, and pre-diabetes Mellitus or diabetes mellitus was a

condition that two-thirds of them had. The majority of the participants admitted to low levels of

physical activities. 40% had a drinking habit, while a fifth of them were current smokers. The

participants were less than 65 years, but only two-thirds had a high school education. Over 50%

of the participants admitted to having an annual income of less than $20,000.

Diagnoses Based on the Risk Assessment

From the risk assessment, it is evident that there is a dire need to change the mindset of

the Hispanic population to influence their attitude, knowledge, beliefs, and skills. The expected

outcome is that such interventions may help alter unhealthy behavior and instill health-seeking

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behavior in the community. Most of the risk factors can be controlled to minimize the probability

of extreme outcomes, such as damaged organs and mortality. To help the affected members in

the Hispanic community, it is imperative to target the modifiable risk factors such as diabetes,

obesity, unhealthy eating, lack of activity, excessive drinking, hypertension, cholesterol levels,

and insulin resistance (Papa Georgiou, 2016). The community can also be educated on non-

modifiable risk factors such as an inherited risk factor so that the individual can modify their

lifestyle to prolong the onset of the chronic condition.

A Detailed Care Plan for the Aggregate

The plan of care for patients at risk or with CVD needs to be comprehensive. Since the

care plan required to target the Hispanic population, it needs to be a community-based program.

The program needs to involve specialists who, in their respective capacities, will provide

evidence-based interventions to improve the overall quality of life of the affected members of the

community. Some of the specialists to involve include cardiologists, nurses, dieticians,

pharmacists, and physiotherapists. The comprehensive community-based program will include

the use of a quasi-experimental design. The intervention activities will be multiple to ensure a

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wider reach and maximum impact. Some of the approaches to implement will be conducting

innovative media campaigns, encouraging community participation, use local media houses,

offer testing and education centres, cooperate with local businesses and pharmaceutical

companies, collaborate with local and national organizations or healthcare agencies, and involve

legislators at local and national levels to probably influence policies.

The program will target multiple risk factors to manage some of the problems

comprehensively. The program facilitators will offer testing, patient education, and referrals to

given specialists and programs based on the complexity and type of problem. The comprehensive

approach is inspired by the fact that it is possible to get patients who have more than a single risk

factor that may lead to having CVD. The program will involve cultural-based approaches such as

involving specialists who are conversant with Hispanic culture to ensure the community

participants feel free to be helped and trust the plan. The education approach of the program is

expected to change individual behaviour and the environment. The program will be evaluated

frequently to assess its impact and areas that need a different approach.

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A Description of How at Least One Intervention was Implemented in the Aggregate to

Address CDV

One of the responses that the program insisted was on the need for testing to assess a

patient’s health condition and the available risk factors within. The fact inspired the move there

are the majority of people who are at risk or already have cardiovascular problems but are not

aware of it until they feel a problem with their health. Some of the tests conducted were

echocardiography examination, blood pressure test, the measurement for obesity, and obesity

tests such as a test for blood sugar levels. The intervention was implemented with the

collaboration of local leaders, community members, volunteers, and local healthcare, which were

designated as test centers as they were quickly accessible to residents in a Hispanic

neighborhood. Extra volunteer nurses and specialists were scheduled to the centers to aid in the

various processes of testing and patient education.

Patient results were confidential, and patient education was conducted with the inclusion

of family members who would offer social support and also target to enlighten the whole

community of prevention and management of cardiovascular diseases. Patient education was also

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to be done in subsequent phases to avoid impacting the patients and families with excessive

information that would affect comprehension. The local media campaigns worked as members of

the community took a step to visit the clinics for health assessment.

An Evaluation of the Effectiveness of the Intervention

Positive outcomes in health management are expected within six months, considering the

broad spectrum of combating multiple risk factors. Community members are expected to be

aware of cardiovascular problems, some of the management techniques, management of risk

factors, conduct self-care, modify their diet with their limited resources, engage in physical

activities, live a healthy lifestyle, and frequently visit care centers for checkups. The changes are,

of course, expected to be gradual and adoptable step by step.

Evaluation of the program was done every month to assess whether the various processes

were in line with the care plan. For example, the effectiveness of testing was evaluated based on

the return of participants who were considered to be at risk or already have cardiovascular

problems. A come-back for checkup and progress assessment shows that the patient adhered to

education on the need for care and evaluation. The patients were also tested for understanding

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through the teach-back method, which showed encouraging results with patients understanding

CVD management interventions. The program did also show success with an increasing number

of community members willing to check their health in subsequent months.

The evaluation process did also involve taking surveys from returning patients to get

some of their experiences and view of the program. The response was positive and encouraging

as most got to understand their various conditions, management techniques, and were willing to

collaborate with caregivers to improve their quality of life (Howatson-Jones, Standing, &

Roberts, 2015). The approach of testing and screening was more practical and useful in the

program. The health outcomes before and after the program were also compared to assess its

impact on the community, which was positive and should be encouraged in different cities to

given health problems.

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References

Fernández-Armesto, F. (2014). Our America: A Hispanic History of the United States. New

York, NY: W. W. Norton & Company.

Howatson-Jones, L., Standing, M., & Roberts, S. (2015). Patient Assessment and Care Planning

in Nursing. Learning Matters.

Mehta, H., Armstrong, A., Swett, K., Shah, S. J., Allison, M. A., Hurwitz, B., ... & Lima, J.

(2016). Burden of systolic and diastolic left ventricular dysfunction among Hispanics in

the United States: insights from the Echocardiographic Study of Latinos. Circulation:

Heart Failure, 9(4), e002733.

Papageorgiou, N. (2016). Cardiovascular Diseases: Genetic Susceptibility, Environmental

Factors and their Interaction. Cambridge, MA: Academic Press.

Rodriguez, F., Hu, J., Kershaw, K., Hastings, K. G., López, L., Cullen, M. R., ... & Palaniappan,

L. P. (2018). County‐ level Hispanic ethnic density and cardiovascular disease

mortality. Journal of the American Heart Association, 7(19), e009107.

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