Health promotion about raising awareness of Human Immunodeficiency Syndrome (HIV). Group members– Grace Gaisey, Ethel Onyewuotu, Isabelle Bialan, John Daramewa, Nana Sarpong- Mensah and Peace Uzoma.
This essay highlights assessing, planning, implementing and the evaluation of a health promotion activity on HIV.
The World Health Organisation (WHO), 2013) defines HIV as a virus which infects the cells in the immune system by destroying its function to a stage that infections may begin to occur as a result of weakening the immune system.
Assessment of Health Need
Health needs assessment is an efficient method in reviewing health issues involving a population which leads to approved priorities and allocation of resources that assist in the improvement of health and reduce inequalities (National Institute for Health and Care Excellence (NICE), 2009).
This is beneficial as it contributes to the description patterns of disease in a local population and the differences from other location, such as districts, regional or national disease patterns such as HIV as it is a pandemic disease (National Aids Trust (NAT), 2014), and creates the opportunity in learning more about the needs and priorities of the local population to provide the objectives needed to work towards meeting those needs (Wright, Wilkinson and Williams, 2009).
Epidemiology and demographic statistics
Naidoo and Wills (2009) defined epidemiology as the study of occurrence and spread of disease in a population. Demography on the other hand is the size, composition and the distribution of human populations and their changes resulting from fertility and mortality (Dudley, Poston & Bouvier, 2010).
HIV is a transmitted disease with almost 75 million people infected with the virus worldwide, with data trends indicating it has increased as 36 million people were living with HIV by the end of 2012 (WHO, 2014). It has also been estimated that the 75 million infected with HIV caught the virus by means of transmission, such as sexual intercourse and mother to child transmission (WHO, 2013).
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For instance, it has been estimated that 5.1 million of children worldwide have been infected with HIV through mother to child transmission (NAT, 2013). Thus, early infant diagnosis is being scaled up in many countries, but in 2011 only 35% of the infants born to mothers living with HIV received HIV test and has been increased by 46% between 2010 and 2012 from 2.4 million to 3.5million (WHO, 2013).
The demographic statistics from data trends indicates that, about 36 million people have died of HIV globally since 2012 compared to 30.3 million people in 2001 which shows an increase of 17% (WHO, 2014). Although the mortality among the population are infants aged 1-5 years and has increased with 3.34 million (NAT, 2013). HIV causes mortality among adults, however, according to estimates by WHO (2013), infants who has HIV are more likely to die between the ages of 1 and 5 years, respectively, with 2.3 million dying as a result while adults have the likelihood of dying between 15 and 60 years.
The target group for this HP activity is 15-24 years as statistics shown by the Public Health England (PHE) (2013) indicate young people under 25 are more at risk of contracting HIV with a peak age of women between 15-20 years and 20-24 for men. This has been indicated as a public health issue in many countries as 40% of new HIV infections are seen among 15 to 24 year olds (PHE, 2013).
WHO (2013) further corresponded stating, half of the 75 million people infected with HIV in the world are young women aged 15 to 20 years, accounting for all new infections, and there is a growing recognition that these women and girls with HIV infection is shaped by gender inequalities and violence against them.
Behavioral aspects that might affect this health issue.
According to the National Institute of Allergy and Infectious Disease (2014), behavioral aspects that can affect the risk of HIV includes individual sexuality and self-esteem. For instance, research indicates that most ongoing risk behaviour for HIV transmission has been described for men who have sex with men (MSM) (NAT, 2014). It has also been estimated that, 10 million people of MSM are living with HIV globally and in 41,100 in the UK in 2012 which has been increasing in the recent years, making public health experts have concerns about the rising rate among MSM (NAT, 2014).
In 2013, World Health Organisation published a global policy in which they provided recommendations on HIV testing and counselling. They estimated that about 20 million adolescents aged 10-24 years are living with HIV worldwide with half of them unaware of their infection. This policy aims at giving a high priority to enhance access to HIV testing and counselling globally, which is beneficial as it involve the improvement of health and is appropriate for the HP activity as advising people on HIV testing and offering counselling gives the opportunity to care, treatment and support for people and permit them to know their status (British HIV Association, 2014).
In addition, the policy also outlined the need for giving sufficient information on HIV awareness and an early diagnosis and treatment as it can reduce the progression and the prevention of HIV transmission. Thus, the WHO (2013) corresponded by recommending that HIV testing and counselling should be offered in global hospitals as this will assist the diagnosis and management of the infection.
In the UK, the NAT (2012) provides a policy based on HIV prevention and its aim is to promote health of the UK population with a prevention of an HIV test action plan to reduce late diagnosis of HIV in the UK. This is a relevant policy as HIV has become a generalised epidemic in the UK that affects the health and well being of enormous people from all social classes (NAT, 2014). HIV is not only a health issue, but also a developmental issue that affects the social, cultural, political and the economics of the country (British HIV Association, 2014) as it is associated with serious morbidity that includes a high cost of treatment and care (PHE, 2013).
The initiative of this policy is to facilitate an increase in HIV testing in all healthcare settings in order to reduce the proportion of individuals who are unaware of their HIV infection with the motive of benefitting the individual and the public health. This is vital as maintaining focus on increasing regular HIV testing is a key component of the prevention and care of the people in raising the awareness of HIV of the people in the UK. As a result, the UK national guidelines for HIV testing from the British HIV Association, (2008) recommends that an HIV test should be offered to all newly registering patients in general practice and general hospital admissions and promote the awareness of HIV which will assist in reducing late diagnosis of HIV.
Type of needs
According to NICE (2008), an understanding of the assessment of health needs requires a definition of need which indicates the capacity of a benefit from an intervention. Bradshaw (1972) suggests there are four dimensions of need; however, the Bradshaw need chosen was the normative need as it is based on professional judgement (Coles & Porter, 2008). It creates the need for professionals to identify standard requirements (Gruen & Black, 2006). For instance, the WHO (2013) recommended that HIV testing should be offered in global hospitals. This indicates a health need as data indicates that most people are unaware of their infection (NAT, 2013).
Ewles and Simnett (2003) model comprises of five approaches to health promotion which consists of medical approach, behavioural change approach, educational approach, societal change approach and client-centred approach. Thus, the educational approach was chosen as having an educational approach in health promotion offers individual information to ascertain health benefits for themselves (Ewles and Simnett, 2003). The health belief model is seen to be the most common theory used in health promotion, providing the benefits of educational approach (Glanz, Rimer & Viswanath, 2008). The model is essential for addressing problem behaviours that raises health concerns (Black, Hawk & Keene, 2006). For example, high risk of sexual behaviour and the possibility of contracting HIV, this is an identification of individual behaviours. Willz (2007) further suggested that health professionals need to be mindful of this model so as to enable them in educating and promoting health in individuals from various cultural and ethnic groups.
The strength of the educational approach is based on the fact that it permits people to make an informed decision about their health by providing knowledge and information to different cultural and ethnic groups which the health belief model corresponds to. However, Naidoo and Wills (2009) further explain that the educational approach differs from the other approaches as it does not use reinforcement to achieve its aim which is a limitation. The Royal College of Nursing (2011) corresponded with this view advocating that the role of the nurse is to inform and not persuade.
Aims and Objectives
The group had aims and objectives to ensure everyone recognizes what needs to be achieved. For that reason, the group identified the aim as raising awareness for HIV and with the objectives that comprises participants will be able to identify the main differences between HIV and AIDS, identify the symptoms of HIV and the safest option to fight off the menace, able to understand three risk factors of transmitting HIV and identify three places to access information on HIV.
Stufflebeam and Shinkfield (2007) explained health promotion evaluation as a process that is concerned with assessing health related activity against the goals in a way that results and contributes to future decision making. In addition, Black, Hawks & Keene (2006) further stated that evaluation is made so as to determine if aims and objectives have been met and determine the efficiency of the methods used. This is vital as without evaluation, the idea of if objectives are met would not be known and also problems and weakness encountered would not be seen to rectify.
Thorogood and Coombes (2010) states there are three stages of evaluation in health promotion; this includes process, impact and outcome.
In the process of the health promotion activity, the group utilised a method of approach so as to achieve the aims and objectives. Thus, the educational approach was chosen as the group used educational materials such as penis model as an illustration on safe use of condom, posters which were clear and easy to read, distributed leaflets to assist in expanding the knowledge of the participants on HIV awareness as Linsley, Kane and Owen (2011) states, good quality health information leaflets assist individuals to make informed choices about their health.
In addition, Health belief model (1974) suggests that, people need to have some kind of knowledge, such as information given to them through leaflets and posters to take actions in changing their behaviour or make a health related decision.
The interactions that took place during the health promotion(HP) activity was done through raising awareness of HIV to our target group by explaining and discussing the health issue with the participants and after giving a questionnaire for them to answer to enable the group gather information on as to whether the objectives has been met.
The impact evaluation involves in assessing the activity in regards of the aims and objectives set by the group. Naidoo and Wills (2008) state that the impact evaluation is the immediate effect the health promotion have on people. Essentially, this refers to the measurement of what has been achieved by the group.
The questionnaire given to the participants were analysed by the group which indicated that 87% in 27 people tick the right answer and 3 people in 13% had the wrong answer. From the evaluation carried out, 13% of the participants answered the questionnaire wrongly because it was distributed to them before explaining what the health issue was about. Out of the 30 questions set, only 3 participants had it wrong, which means the group was able to expand the knowledge of the participants and their understanding on HIV.
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Green and Kreuter (2008) explained outcome evaluation measures as the long term effects of HP activity and whether it has achieved its goals. The outcome effect of the HP activity will be difficult for the group to identify as it there will be a follow up which will be difficult to contact participants again.
There are some improvements that could have been made to improve the HP activity. Hence, demonstration of the penis model should be kept in a discreet position and not visible to the audience so as to not be seen as offensive to others. In addition, the standing poster should be clear and group members must ensure it is not blocked from the audience whiles interacting with them.
Royal College of nursing (2007) states health promoters are in the contribution to improving the health of the public. Thus, their role as a health promoter is to plan and develop ways that assist people improve and manage their health. Linsley, Kane and Owen (2011) further corresponded saying health promoters must have an evidence-based understanding of the important effects that can be made through health promotion interventions and communicating with people to develop their awareness of activities leading to better health and become knowledgeable about their own health status which will improve the overall health population.
The HP activity on raising awareness on HIV could be carried out in Gum clinics within the target group of 15- 24 years. According to French (2009), people can go to gum clinics no matter their age. As stated by the RCN (2012), nurses are health promoters and in an ideal position to influence the people they interact with in order to empower positive health outcomes. Thus, the role of the nurse as a health promoter is to provide advice and support through one to one interventions with clients to improve their sexual health (French, 2009). The nurse can also implement guidance on prevention and risk reduction support of HIV to clients by providing relevant information, leaflets and condoms so as to raise their awareness on HIV.
This essay has outlined a health promotion activity based on raising awareness of HIV, with a health need assessments and target population identified. The essay has also outlined epidemiology and the demographic trends associated with health policies that govern it. The writer also identified the approaches and the aims and objectives with an evaluation of the effectiveness of the health promotion activity and the role of the health promoter.
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