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Context: Community and health.
Recommendations for the community- based health promotion.
Success and sustainability of the program..
The report talks about the Aboriginal community people who are residing in Australia. The community is chosen because they face major disadvantages in term of their medical status. The community is a high risk of cardiovascular diseases and thus requires health promotion. The health concerns which are mortality and morbidity are experienced by Aboriginal people generally because of the disease. Therefore, recommendations have been made for community-based health promotions. Strategies for the success of health promotion are also discussed in the report.
The community which is chosen for the report is the Aboriginal community which resides in Australia. They are taken for the study because the people who belong to this community face more rates of morbidity and mortality than any other community people. This has been well documented also. The disparity among indigenous and non-indigenous people has occurred mainly because of complicated issues such as transgenerational trauma, colonization, racism and dispossession. Other reason can be socioeconomic factors which have lowered the level of employment and education among these people (Durey et al., 2016). Moreover, it is difficult for Aboriginal people to get access to mainstream healthcare services. They are not allowed or unwelcomed in the healthcare facility. Most of the time, they feel a lack of trust in the healthcare services and feel alienated in the facility. Because of this, they do not want to go to any healthcare facility or service. In addition to that, generally, there is a communication gap between them and the healthcare provider and the hospitals and organization lack staff members from the Aboriginal community. Therefore, because of all these problems they have to face multiple health concern (Durey et al., 2016). One of the health problems that are reducing their life expectancy is cardiovascular diseases (Thompson et al., 2016). Cardiovascular diseases include multiple illnesses such as coronary heart disease, cerebrovascular diseases such as stroke, rheumatic heart disease, heart failure and peripheral vascular disease. The key risk factor for such diseases is high blood cholesterol and hypertension that is high blood pressure. According to the statistics, more young people die from cardiovascular diseases. The high level of this disease is due to smoking of tobacco, physical inactivity, being obese, poor diet and nutrition and diabetes. Socioeconomic and psychological factors also play an important role in cardiovascular diseases (Australian Indigenous Health InfoNet, 2020).
The behaviour model which could be applied to explain the health behaviour in this community that lead to a health issue is the health belief model. The health behaviour model recognizes four major aspects of the assessment. They are Perceived severity of the ill-health, perceived barrier to the action taking, perceived benefit of behaviour change and perceived susceptibility of ill-health. Another important factor of this model is self-efficacy. This model thus predicts that whether people are engaged in health promotion or not (Green & Murphy, 2014). Therefore, for Aboriginal community people who have cardiovascular disease, this model can be applied to find out their likelihood in involving in the behaviours which are for their health promotion.
The main constructs of this model are modifying variables which include perceived benefits and perceived barriers. In Aboriginal people, perceived barriers such as complications or death overweighed the perceived benefit like getting better or getting proper treatment, which leads to developing of more cardiovascular diseases in the community people. The aboriginal people also have a high number of threats because of which they do not adapt to advantageous behaviour. Their self-efficacy is also hampered because of this (Sharifzadeh, Moodi, Mazhari Majd & Musaee, 2017). The other major element is perceived seriousness. This factor impacts the mental and physical consequences of dangerous phenomena. Aboriginal people do not perceive cardiovascular diseases and their complications seriously that is why they have more cases of this disease. Another construct is perceived susceptibility of cardiovascular disease. This is the subjective perception of the people of getting the illness (Sharifzadeh et al., 2017). In the Aboriginal community, people perceived susceptibility is less that is why they are not trying to reduce the risks that they have so as to avoid the disease. Because of this, Aboriginal community people also do not engage in taking actions to lessen the rates of cardiovascular disease among them. Thus, they are very less likely to be involved in health-promoting behaviours which ultimately leads to more ration of cardiovascular disease in them as compared to non-indigenous community people (Sharifzadeh et al., 2017).
The approach which can be taken for the recommending strategies is the upstream approach and the first strategy of the Ottawa Charter could be for cardiovascular disease in Aboriginal people would be the aim of involving public participation. Community or public participation involves a process of bringing together different strata of individuals who are being well-informed about the disease and its complication. The community involvement would include planning, controlling, coordinating and organizing so that each and every member of the community could recognize and assesses the major root of the problem (Sadeghzadeh et al., 2019). They can also help by providing better approaches and solutions for the problem which is a cardiovascular disease that is prevailing in Aboriginal people. The individuals of other community can also help the government programs which are in continuation to provide help to the Aboriginal patients who are at risk of developing cardiovascular diseases. People thus could also help with identifying indigenous situations so that appropriate interventions could be implemented by people themselves. Whereas people could also facilitate in health promotion by suggesting changes in policies by looking at rules, indicators and regulations so that better health outcomes could be achieved in Aboriginal people (Sadeghzadeh et al., 2019). Therefore by engaging community people and bringing them together can have a significant impact on the lives of aboriginal people. People could advocate on their behalves and thus can bring changes in the rates of the cardiovascular diseases in Aboriginal people.
The other strategy which could be used is that health professionals could help with cardiovascular problems. They can provide empowerment to the people. They can do this by educating individuals who are at risk so that they can self-manage themselves in order to that they avoid getting the disease. The healthcare professionals could also help them by telling how they can monitor their condition by providing them with strategies and interventions so that aboriginal people health status could be maintained. They can tell them about self-care behaviours such as exercising and having nutritional diet. They can thus tell Aboriginal community people community and family-based approaches so that the rate of cardiovascular disease decreases (Riegel et al., 2017).
Community capacity could be built if the research gets enhanced on the topic of cardiovascular disease keeping in mind the Aboriginal community. This can help in designing and developing the capacity so that research could be implemented (Goytia et al., 2013). Capacity could also be improved with the help of improving and building the infrastructure so that it can provide help and service to the people of the Aboriginal community who are at risk of cardiovascular disease or who already have the disease (Hacker et al., 2012). With that, the people of the community could also aid in making a coherent policy framework which will be in accordance with legislation, public education and regulations. For example, bringing changes in environmental policies could help in reducing the risk factors of cardiovascular disease in aboriginal people. With that, individuals could also set goals and fix some priorities so that self-care education will also be enhanced in the Aboriginal community. People can also take part in campaigns which are initiated so that public awareness can increase on this topic. The aboriginal community by health campaign could thus impart the information about risk factors and implications of cardiovascular disease. It would thus, change or alter the beliefs or attitude of the indigenous community people (Sadeghzadeh et al., 2019). Therefore, by implementing such policies community capacity building could be done and people ongoing participation by making changes in policies could also ensure that the program is a success which would ultimately benefit the Aboriginal people in dealing with cardiovascular disease.
In conclusion, it can be said that Aboriginal people are the individuals who have faced major disadvantages in terms of medical health, socioeconomic and psychologically. Their community members face more deaths as compared to any other community members. The major risk Aboriginal people have is the danger of cardiovascular diseases. It could happen in them because of hypertension, smoking, poor diet or due to increase cholesterol level. The health belief model indicates that due to the prevalence of barriers the people have more cases of cardiovascular diseases. Therefore, it is necessary to recommend dome health promotion strategies. The strategies involve public participation and empowerment from healthcare professionals. These strategies could be successfully implemented and continue to provide benefit to Aboriginal people if the focus is given to community capacity building. The success also depends on the participation of people to increase awareness among the community.
Australian Indigenous Health InfoNet. (2020). Cardiovascular health. Available at https://healthinfonet.ecu.edu.au/learn/health-topics/cardiovascular-health/
Durey, A., McEvoy, S., Swift-Otero, V., Taylor, K., Katzenellenbogen, J., & Bessarab, D. (2016). Improving healthcare for Aboriginal Australians through effective engagement between community and health services. BMC Health Services Research, 16, 224. https://doi.org/10.1186/s12913-016-1497-0
Goytia, C. N., Todaro-Rivera, L., Brenner, B., Shepard, P., Piedras, V., & Horowitz, C. (2013). Community capacity building: A collaborative approach to designing a training and education model. Progress in Community Health Partnerships: Research, Education, and Action, 7(3), 291–299. https://doi.org/10.1353/cpr.2013.0031
Green, E. C., & Murphy, E. (2014). Health belief model. The Wiley Blackwell Encyclopedia of Health, Illness, Behavior, and society, 766-769. https://doi.org/10.1002/9781118410868.wbehibs410
Hacker, K., Tendulkar, S. A., Rideout, C., Bhuiya, N., Trinh-Shevrin, C., Savage, C. P., Grullon, M., Strelnick, H., Leung, C., & DiGirolamo, A. (2012). Community capacity building and sustainability: Outcomes of community-based participatory research. Progress in Community Health Partnerships: Research, Education, and Action 6(3), 349–360. https://doi.org/10.1353/cpr.2012.0048
Riegel, B., Moser, D. K., Buck, H. G., Dickson, V. V., Dunbar, S. B., Lee, C. S., Lennie, T. A., Lindenfeld, J., Mitchell, J. E., Treat-Jacobson, D. J., Webber, D. E., & American Heart Association Council on Cardiovascular and Stroke Nursing; Council on Peripheral Vascular Disease; and Council on Quality of Care and Outcomes Research (2017). Self-Care for the prevention and management of cardiovascular disease and stroke: A scientific statement for healthcare professionals from the American Heart Association. Journal of the American Heart Association, 6(9), e006997. https://doi.org/10.1161/JAHA.117.006997
Sadeghzadeh, V., Jahangiri, K., Farahani, M., & Mohammadi, M. (2019). Designing a community participation management model to control the epidemic of heart coronary artery diseases for Tehran province. Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences, 24, 98. https://doi.org/10.4103/jrms.JRMS_555_18
Sharifzadeh, G., Moodi, M., Mazhari Majd, H., & Musaee, I. (2017). Application of Health Belief Model in predicting preventive behaviors against cardiovascular disease in individuals at risk. Journal of Health Sciences and Technology, 1(2), 64-69.
Thompson, S. C., Haynes, E., Woods, J. A., Bessarab, D. C., Dimer, L. A., Wood, M. M., Sanfilippo, F. M., Hamilton, S. J., & Katzenellenbogen, J. M. (2016). Improving cardiovascular outcomes among Aboriginal Australians: Lessons from research for primary care. SAGE Open Medicine, 4, 2050312116681224. https://doi.org/10.1177/2050312116681224
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