Disease Prevention Problem, Essay Example

Health Promotion

An important health topic impacting modern youth is substance-abuse. According to Dictionary.com substance-abuse is defined as a “long term, pathological use of alcohol or drugs, characterized by daily intoxication, inability to reduce consumption, and impairment in social or occupational functioning; broadly, alcohol or drugs addiction” (Substance-abuse, n.d.).  The population that I would target is that of the adolescent age, according to the World Health Organization (W.H.O.) “an adolescent is a person aged 10 to 19 years inclusive. A child is a person 19 years or younger unless national law defines a person to be an adult at an earlier age. However, in these guidelines when a person falls into the 10 to 19 age category they are referred to as an adolescent” (Definition of key terms, 2013).

Target Population and Setting

Adolescents are highly influenced by the decisions and opinions of their friends, so in many cases peer pressure can result in early drug use. Individuals that become addicted to drugs early in life are more likely to continue this addiction into later stages, contributing to social and economic issues for the individual. Adolescents that become drug users are also more likely to become involved in crime due to the need for them to raise money to support their addictions. Overall, it is necessary to determine how we can work to protect adolescents from harm. This literature review will provide background information about substance use among adolescents and use this information to draw understandings about health programs that could be implemented to prevent their involvement in this behavior. Adolescents between 10 and 19 years of age will be the focus of this study. Furthermore, since early substance abuse typically occurs in suburban environments, this examination will focus on this portion of the subpopulation. It is also important to consider that substance abuse is linked to the transmission of viral disease due to needle contamination. As a consequence, the prevalence of HIV in the adolescent population due to substance abuse will be examined as well.

It would be beneficial for adolescents to have more regular checkups as well as having an open door policy for adolescents, having more in depth one on one conversations about the environment they are most involved with and offering them other alternatives in the community if they are engaging in activities that linked to having an increased risk of substance abuse or perilous conduct. On a personal level, many nurses would also like to provide parents with community programs that are free or reduced that can provide them with information and education related to issues that the adolescents of today face.

Application to Advanced Practice

Nurses are required to have an understanding of the different types of patients they encounter. In this situation, it is necessary to consider that even though adolescents are considered to be innocent beings, it is possible for them to have experimented with drugs and for these drugs to contribute to observable health problems. Thus, medical professionals should not just simply assume that their patients in the 10 to 19 years old age range are drug free. It is important to ask them about their use of drugs, smoking history, and alcohol in order to have a more complete understanding of their health. Since a large portion of this population would not naturally admit to drug use, it is also important to conduct testing to determine whether drugs are within their system.

Theoretical Framework

Drug use is a problem that frequently plagues our society, but its effects become even more damaging when drug users begin these substances at an early age. As practitioners, it is essential to determine why adolescents use drugs and to help implement education programs to help prevent against the damaging effects that it could cause. While many drug prevention education programs are in place, it is important to provide support systems to children to persuade them to ask for help from adults if they are using drugs. Early treatment has the potential to reverse these behaviors and prevent against the harmful health effects that drug use can cause to the body system. Specifically, HIV transmission is an important concern because it can cause irreversible immune system damage. Even if the virus is detected early, these individuals will be required to take HIV medications for the remainder of their lives and experience a diminished quality of life.

Literature Review

A 1997 study was conducted to determine the risk factors and protective factors that children are exposed to with regards to the family, school, and individual environment (Resnick, 1997). This study functioned as a cross-sectional analysis using more than 12,000 data points from the National Longitudinal Study of Adolescent Health. Several risk factors and protective factors were examined, including emotional distress, suicidal thoughts and behaviors, violence, use of substances, and sexual behaviors. It was found that perceived connection with family and school operated as protective factors in this relationship. Individuals that worked more than 20 hours a week in high school were more likely to use alcohol, cigarettes, and marijuana. Students that were repeating a grade were also more likely to use substances. This information could be used to target at risk students and provide them with counseling before they begin substance use.

A recent systematic review reported that a large number of adolescent’s experiment with substances (Sharma, 2015). Approximately 44% of children between the ages of 10 and 19 have tried a cigarette, approximately 38% have tried alcohol, 23% of students have tried marijuana, and a small percentage of students (8%) have even tried more addictive drugs such as heroin. It is important to consider that this is highly problematic with regards to the amount of individuals that engage in these practices. Creating education programs to help these students understand the repercussions of drug use may help contribute to the reduction of use in this population. Since the behaviors of adolescents are directed by their interactions with their families and the community, it is helpful to provide adolescents with a support system to help them make healthy decisions throughout their development (Viner, 2012). Such an approach can reasonably make substance education and prevention programs more effective.

Studies have shown that the implementation of police programs, including after school organized activities has helped adolescents remain off the streets and drug free (Lowinson, 2005). These programs are effective because they provide these individuals with necessary support systems if they are not receiving them at home. Furthermore, since adolescents enrolled in these programs have an opportunity to spend time with their friends in this context, a positive influence is perpetuated and the protection of these children is ensured. It would be beneficial for health care professionals to team up with law enforcement to help make these programs more prevalent for individuals living in areas that are seen as high need.

Nurses can become more directly involved with the care of their adolescent patients by determining which individuals have a medical risk of addiction. Some individuals are provided with prescription medications in hospitals that contribute to their addiction (Alexander et al., 2012). Since these drugs were provided for medical purposes, it is necessary for medical professionals to counsel them regarding proper use and provide them with a follow up schedule to monitor their addiction. For example, morphine is a drug commonly used in medicine and can become addictive when used long-term. It is important for adolescents to understand that they should not attempt to access these drugs without prescriptions. A final important understanding about the medical aspect of addiction is that some individuals are biologically predisposed for such traits. A recent study hypothesized that excessive alcohol use is linked to prefrontal cortex dysfunction (Uekermann & Daum, 2008). While there is a need to conduct more studies of this sort to confirm these findings, it is important for nurses to address the biology of adolescents predisposed for substance dependence as well. Overall, there is a lot of work that has to be done to help professionals gain a better understanding of how to help adolescents engage in preventative practices. However, it is important to consider biological and demographic features in the creation of specialized education programs to ensure that these individuals are able to receive all of the proper information necessary to make their own decisions.

Research-Based Intervention

Specifically, to prevent body damage as a result of HIV infections in adolescents, it is valuable to engage in advanced screening programs for members of this group. Approximately 1.3 million individuals die from HIV-induced AIDS each year and many people with HIV are not aware of immune system damage until it is too late. Thus, advanced screening for HIV can save thousands of lives each year. Currently, this HIV screening legislation is being implemented by New York City. Under this legislation, all individuals who visit the emergency room at any city hospital are asked whether they would like to be screened for HIV. While this legislation is currently only present in New York City, it would be beneficial to expand it to the state and nation (Health NY, n.d.). Because of this legislation, more people are able to recognize the importance of HIV screening and are provided with the opportunity for detection and early treatment methods.

Intended Outcomes

If this initiative is implemented, more people will have access to HIV detection methods, Furthermore, the population will become more educated about HIV because more nurses and medical professionals will have the opportunity to have conversations with their patients about the connection between substance abuse and HIV. Furthermore, since many insurance companies will pay for these tests, there will be no financial difficulties for the individuals that wish to engage in this screening. Since HIV spreads primarily because a lot of individuals are not aware that they are carrying this virus, HIV will be less likely to be unknowingly spread through the population. Overall, it is expected that adverse health effects will reduce in the adolescent population as a consequence of the implementation of this program. There will be a greater degree of knowledge pertaining to substance abuse and HIV transmission that will help protect lives at this early and fragile age.

Evaluation Plan

To determine the efficacy of this plan, it will become necessary to measure the currently incidence of substance abuse and HIV among adolescents in the local area. The same values can be collected from the health records of New York City to act as a control. Incidence values will reflect the frequency of substance use and HIV at baseline, prior to the implementation of this intervention, and select time points following. This data will be collected six months, one year, two years, three years, and five years following the implementation of the intervention to determine if any significant change was made. It the incidence of substance abuse and HIV among adolescents in the local area are diminishing during this time period, it will be concluded that the intervention is effective and should not only be continued, but spread to other areas as well so people could experience the positive effects of this program.

References

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Health NY. (n.d.). FAQ. Retrieved from https://www.health.ny.gov/diseases/aids/providers/testing/law/faqs.htm

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Lowinson, Joyce H; Ruiz, Pedro; Millman, Robert B; Langrod, John G (eds) (2005). Substance  Abuse: A Comprehensive Textbook (4th ed.). Philadelphia: Lippincott Williams & Wilkins.

Resnick, M. (1997). Protecting adolescents from harm. Findings from the National Longitudinal Study on Adolescent Health. JAMA: The Journal of the American Medical Association, 278(10), 823-832. doi:10.1001/jama.1997.03550100049038.

Sharma, Manoj, MBBS, MCHES, PhD., F.A.A.H.B. (2015). Substance abuse in adolescents: Implications for research and practice. Journal of Alcohol and Drug Education, 59(1), 3-6.

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Uekermann J, Daum I. (2008). Social cognition in alcoholism: a link to prefrontal cortex dysfunction?. Addiction, 103(5): 726–35.

Viner, R. M., Ozer, E. M., Denny, S., Marmot, M., Resnick, M., Fatusi, A., & Currie, C. (2012). Adolescent health 2: Adolescence and the social determinants of health. The Lancet, 379(9826), 1641-52.

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