Provide justification of an effective community-wide nutritional strategy for the prevention of stroke in community-dwelling people aged 50 years and over

Assignment 2 topic:
Provide justification for one effective community-wide nutritional strategy for the prevention of stroke in
community-dwelling people aged 50 years and over.
Develop a strategy that includes only ONE nutritional recommendation for an effective community-wide
nutritional strategy for reducing stroke in those people aged 50 years and older and living in the
community. Details and a plan for how the strategy will be implemented in the community will need to be
described.
The strategy needs to focus on food/dietary approaches and excludes the use of supplements. You must
ensure that your approach focusses on only one nutritional factor, i.e. a food OR a nutrient OR an explicitlydefined diet.
This assignment will include justification for the effectiveness of the chosen nutritional strategy in
influencing stroke risk and outcomes, utilizing data from the peer-reviewed literature. The policy and
implementation plan must be demonstrated to be feasible, but an extremely detailed implementation plan
is not required. The key emphasis of the assignment is development of ONE effective community-wide
strategy, with adequate justification of the effectiveness of your chosen approach with reference to the
literature.

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Community-Wide Program:

An Effective Nutritional Strategy for Prevention of Stroke

Student’s Name

Institutional  Affiliation

Word Count: 2040

Rationale

Cardiovascular diseases (CVDs) are one of the primary causes of disability and mortality in Australia. In every 12 minutes one Australian dies from CVD [1].  Stroke, one of the prevalent CVDs, is significantly a public health burden in not only Australia but also globally. Worldwide, there are about 60 million survivors of the condition [1].  In Australia, it is the 3rd cause of deaths and the primary cause of disability. The disease kills more males than prostate cancer and more females compared to breast cancer. In 2017, there were almost 55,000 new and recurrent illnesses [1]. Hence, this means that there was one stroke in every 9 minutes [1]. Over 470,000 individuals lived with the impacts of stroke [2]. Unfortunately, this is predicted to rise to approximately one million by the year 2050. It is estimated that the Australian healthcare system incurs $5 billion every year. Nevertheless, funding for the illness research by the National Health & Medical Reach Council (NHMRC) is greatly underfinanced. In 2015, this represented about 4% of the entire investment in health research [1].

Approximately 50,000 individuals suffer a stroke annually [1]. As a result, about sixty-five percent of stroke survivors become either mentally or physically disabled. Thus, this impedes their capacity to carry out day to day activities without assistance. They face difficulty with language and speech, impairments of memory, loss of vision and depression. Consequently, this generates a massive emotional, social as well as financial burden to the society. The article claims that over 80 percent of these cases can be prevented [1].  Such is so as most cases are brought about by the impacts of one’s lifestyle. The disease is caused by smoking, physical inactivity, improper diet and drinking of alcohol. All these factors can be avoided. In turn, this would significantly enhance the situation in the domain of public health in Australia. Moreover, the disease is not only for the older generation. Stroke can happen at any time and to anyone. Thereby, creating a positive nutritional strategy will make the future worthwhile by reducing the rates of morbidity, mortality, and disability.

Chart 1: Preventable cases of Stroke

Stroke-prevention program

With the alarming situation in the country, there is a great need for implementing a practical and effective community-wide strategy. It will minimize the occurrence of stroke in the community [3]. In this case, a healthy living program will be incorporated into every local government hospital. Nevertheless, the program will also collaborate with other private partners like voluntary health organizations and not-for-profit health agencies in the society. With many alternatives, it will not be much more comfortable for individuals to access the program. Clients will be expected to be visiting the nearest health facility to their homes.

The objective of the program is long-term. It will aim at reducing the mortality, morbidity and disability rates in the community. The intent is to encourage individuals, mainly aged 50 years and above, to modify their diets to attain good health in the long run. A primary nurse will be conducting the learning and consultation sessions which will be taking place at the medical facilities. For a reason, one has the competency to design a complete care plan for every client under care [3]. When absent, then an associate nurse can take care of consumers. The healthcare provider will exploit not only one-on-one sessions, but also group sessions.

Both the healthy and the stroke survivors will be encouraged to visit the facilities with the programs. For a reason, this will be of great importance in regards to diet and lifestyle modifications for the two groups. In this case, the clients will be advised on the proper diet to adopt alongside regular exercise. For the survivors, a modification of their meals will be essential to enhance and manage the condition.  Their meal intakes will undoubtedly have to match their prescriptions and medications.

Demonstrations will be highly exploited during the sessions. For instance, there will be displays on the healthy foods that individuals ought to partake and those to avoid. Also, there will be demonstrations of adverse impacts of unhealthy behaviors such as smoking. Regardless of how a conversation or presentation will be perfect, issuing written materials like brochures concerning healthy dietary will be regarded as undoubtedly crucial.

Justification

Dave and Summers (4) argue that retention of information after reading is ten percent, video watching is 20%, whereas performing a demonstration accounts for 30% [4]. More so, they believe that performing demonstrations is way much better when the knowledge is applied immediately. Such is so as in an actual scenario, it accounts for 90 percent effectiveness [4]. Thus, for this reason, demonstrations alongside issuance of written materials will be significantly exploited to ensure the set objectives are met.

Self-care is an essential practice towards prevention as well as the management of stroke [5]. Thus incorporating the healthy living program will be of much significance. The program will provide a platform whereby people will get to apprehend their current health status and the risks involved. Such is so as it is the role of the nurses to explain these aspects thoroughly. Some of the risks involved include high cholesterol levels, obesity, and hypertension. Hence, this will undoubtedly provoke individuals to take suitable actions to minimize their risk of stroke.

Also, such a program is worth as it provides dietary recommendations that are worth the effort to adhere. Main elements of the recommended strategy are a highly nutritious diet which is inclusive of a healthy balanced diet. Most of the times, fruits, vegetables, low-fat dairy, lean meats, nuts, grains and proteins from sea-products are recommended. Also recommended are unsaturated fat oils like safflower, olive, soybean, canola, and corn. Research shows that strict following of such recommendations has enhanced the situation over the past decade in the country [5]. However, adherence remains low since less than sixty percent of the population follow. In this case, such a community-wide strategy concerned with the aspect of nutrition will play a crucial role in encouraging the adoption of a healthy diet. For a reason, this will offer specific interventions to transition the dietary behavior for individuals aiming at both preventing and management of stroke. After sessions, nutritional tools like menus will be provided. Moreover, there will be telephone follow-ups. Other than these, the journal also suggests that such a strategy would help with curbing barriers like cultural practices [5].  For instance, some immigrants find it difficult not to maintain their meals from their native culture. In such cases, the program can help in selecting of comparable means that follow the underlying principles.

Another essential dimension that the program can facilitate with is the maintenance of the healthy body weight. Weight loss for obese people has always been a considered necessary for cardiovascular health.  The self-care behavior is attained through consumption of suitable serving sizes of the meals which are recommended to meet the required caloric level. It is challenging to estimate and track the intake of calories. Hence, healthcare providers regarding these interventions are of the much essence as they provide clients with guidelines for every caloric intake level. The authors depict that nurses can help with setting initial targets as well as in supporting actions like long-term maintenance of weight [5].

The program can also be successful as it focuses on smoking cessation as well as alcohol use. Not smoking has substantial health benefits. Smokers who stop after ailing tend to have enhanced outcomes compared to who continue smoking. For those who quit, the risk of a recurrence is within three years. Also, the danger of death is reduced by two-thirds. Nevertheless, smoking reduction has minimal impact compared to cessation. On the flip side, elimination of alcohol use from the diet of a former drinker significantly enhances their condition. Nevertheless, the authors show no contradicting evidence in regards to alcohol use [5]. Some researchers find that minimal use of alcohol improves one’s health while others disagree. In spite, the non-drinkers should not be encouraged to begin consuming alcohol. Since the cessation of drug use brings about withdrawal symptoms, nurses in these facilities can help formulate appropriate strategies to cease unhealthy behavior over time.

A prospective cohort study amidst around 37,600 women is a reflection of the significant benefit a community can accrue from a healthy living program [6]. The lifestyle parameters of the research comprised of smoking, body mass index (BMI), diet and consumption of alcohol. The women involved were without stroke. According to the findings, the lowest class of healthy lifestyle was highly bound to be comprised of smokers who smoked more than fifteen cigarettes in a day. Also, they were more likely to rarely or never undertake physical activity and with a BMI greater than 35 kg/m2. Furthermore, the category was made up of the lowest diet score. As the index for the healthy lifestyle rose, there was a drop in the prevalence of hypertension, elevation of cholesterol, household income of less than $50,000 annually [6]. Also, there were decreasing the history of migraines. In general, the research concludes that even the slightest change in lifestyle for the better was related to the substantial decline in the condition. Thereby, it is apparent that implementation of a healthy living program would significantly reduce the occurrence of the disease.

The program’s primary intent is diet modification for individuals in the society. Hence, this would transform the situation in Australia even if it is by a slight margin. Other than minimizing the morbidity, death and disability rates, it seems that the introduction of the program would achieve more than this. Such is so as the overall expenses on medication are cut off, and hence it increases the disposable income for most households. Besides, most individuals suffering from a stroke are working class, and the condition paralyzes their ability to be economically productive. Therefore, preventing the occurrence and recurrence of the illness would promote economic productivity in the country.

Outcome

The likely timeframe of the program will be six months. After this, an evaluation will follow whereby several outcome indicators will be used to determine the success of the suggested strategy. First, a reduction of the smoking rate will be a reflection of adoption of the practices encouraged by the intervention. Here, the likely time interval to see a significant positive impact is at the end of the first three months. For a reason, the procedure will intend on reducing tobacco smoking by 50%, 75% and then to 100% in three months. In this case, the health status of an individual will be slightly enhancing and consequently maximize at the end of the 12 weeks.  Second, BMI will also be considered. Constant weight loss will be a depiction of adherence to the dietary plan. The initial results will be expected to be seen at the end of the month. However, the initial weight loss margin will be expected to be minimal to show that the principles being followed are effective.

Another factor to consider is the household income. Following a previous study [6], earning not less than $25,000 within the six months will be a positive indicator of the program. Within the first three months, an increase in the individual’s source of income will be a reflection that the targets of the program are eventually being met.

Data accuracy determines if the content gathered is reliable or not. Information that is error-free is challenging to attain. Hence the program will thus utilize health information technology (HIT). HIT will have many substantial benefits for both clients and the program. HIT will help with minimizing the expenses of operation and facilitates the management of conditions. First, HIT aids with the minimization of risks associated with patient safety and quality of care. In this case, there will be minimal issues of lost patient files and illegibility of handwriting. Moreover, integration of electronic health records (EHR) with decision support and care management tools concerning these conditions plays a significant role. Such helps in monitoring of health conditions as well as prescribing of appropriate drugs even in remotely [7].

Table 1: Measurement of the Outcome

  Healthy Living Program (6months)
  System   Indicators   Time Frame
  Health Information Technology (HIT)   Smoking   1-12 weeks
  Body Mass Index     One month
  Household income   3 months

Reference List:

  1. Thrift AG, Thayabaranathan T, Howard G, Howard VJ, Rothwell PM, Feigin VL, Norrving B, Donnan GA, Cadilhac DA. Global stroke statistics. International Journal of Stroke. 2017 Jan;12(1):13-32.
  2. Krueger H, Koot J, Hall RE, O’Callaghan C, Bayley M, Corbett D. Prevalence of Individuals Experiencing the Effects of Stroke in Canada. Stroke. 2015 Aug 1;46(8):2226-31.
  3. Perry L, Hamilton S, Williams J, Jones S. Nursing interventions for improving nutritional status and outcomes of stroke patients: descriptive reviews of processes and outcomes. Worldviews on Evidence‐Based Nursing. 2013 Feb 1;10(1):17-40.
  4. Davis B, Summers M. Applying Dale’s Cone of Experience to increase learning and retention: A study of student learning in a foundational leadership course. Qscience proceedings. 2015 Jun 14:6.
  5. Riegel B, Moser DK, Buck HG, Dickson VV, Dunbar SB, Lee CS, Lennie TA, Lindenfeld J, Mitchell JE, Treat‐Jacobson DJ, Webber DE. 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. 2017 Sep 1;6(9):e006997.
  6. Rist PM, Buring JE, Kase CS, Kurth T. Healthy Lifestyle and Functional Outcomes from Stroke in Women. The American journal of medicine. 2016 Jul 31;129(7):715-24.
  7. Chaudhry B, Wang J, Wu S, Maglione M, Mojica W, Roth E, Morton SC, Shekelle PG. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Annals of internal medicine. 2006 May 16;144(10):742-52.


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