Clinical Preventive Intervention
Topic 6 DQ 1
Evaluate a clinical preventative intervention designed to promote health and wellness for populations. Summarize the intervention and explain whether it has been successful. You will use the clinical preventative intervention you select for DQ2.
Sample student response one
Cervical cancer was once the most common type of cancer in women. However, in the past 40 years, the rates have significantly declined due to various interventions that have led to the health and wellbeing of women. The current statistics indicate that approximately 7.5 women per 100,000 are diagnosed with cervical cancer (US Cancer Statistics Working Group, 2020).
One of the major reasons for the noted reduction of cervical cancer rates in the United States is the increase in the number of women who are now aware and are taking periodical pap tests, that allows early detection and treatment of different cervical anomalies some of which could have otherwise led to cancer. Other than that, the intervention which forms the basis of my post is increased uptake of the HPV vaccine.
In a study quoted by the National Cancer Institute, it was confirmed that the HPV vaccine reduces the risk of getting cervical cancer, other than preventing the HPV virus, a sexually transmitted infection (National Cancer Institute, 2020). HPV16 and HPV18 are known to significantly increase the risk of getting cancer and getting vaccinated at a younger age reduce this risk significantly. T
he American Cancer Society recommends HPV vaccination of children between the ages of 9 and 12. Those between 13 to 26 years who have not been vaccinated, or who haven’t gotten all their doses, should get the vaccine as soon as possible, while vaccination is not recommended for persons above 26 years (Saslow et al., 2020). Therefore, other than increased routine screening, targeted vaccinations is one of the interventions that has led to the gains seen in the fight against cervical cancer.
References
National Cancer Institute. (2020). Large Study Confirms that HPV Vaccine Prevents Cervical Cancer. https://www.cancer.gov/news-events/cancer-currents-blog/2020/hpv-vaccine-prevents-cervical-cancer-sweden-study
Saslow, D., Andrews, K. S., Manassaram‐Baptiste, D., Smith, R. A., Fontham, E. T., & American Cancer Society Guideline Development Group. (2020). Human papillomavirus vaccination 2020 guideline update: American Cancer Society guideline adaptation. CA: A Cancer Journal for Clinicians, 70(4), 274-280. https://doi.org/10.3322/caac.21616
US Cancer Statistics Working Group. (2020). United States cancer statistics: 1999–2018 incidence and mortality web-based report. Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute.
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Sample student response two
A clinical preventative intervention is getting the annual flu vaccine. The flu vaccine is designed to prevent or minimize the severe symptoms of influenza. It can prevent hospitalizations for high-risk individuals that get the flu. Some high-risk populations are those over the age of 65, pregnant women, young children, disabled individuals, children with neurological conditions, and racial and ethnic minority groups (U.S. Department of Health & Human Services, 2021).
The flu is also dangerous if you have diabetes, heart disease, stroke, asthma, cancer, or chronic kidney disease (U.S. Department of Health & Human Services, 2021). Not only does getting the flu vaccine prevents the individual from getting the flu, but it also protects those around that individual. “Recent studies show that flu vaccination reduces the risk of flu illness by between 40% and 60% among the overall population during seasons when most circulating flu viruses are well-matched to those used to make flu vaccines” (U.S. Department of Health & Human Services, 2021).
Flu vaccines are made to promote the health and wellness of our population during the respiratory season. It is especially important for those in the high-risk categories to get the flu vaccine to prevent long-term hospitalizations. The CDC studies and evaluates the vaccine each year to develop the most effective serum to fight the most common flu strains. This intervention has been successful in minimizing hospitalizations and deaths across the United States.
At this time further work and education need to be provided to the public to achieve the Healthy People 2030 goals. The most recent data showed that 49.2% of our population received the flu vaccine in 2017-18, the target is to be at 70% (Office of Disease Prevention and Health Promotion, n.d.). This proves that there is still work to be done to optimize the health and wellness of our population from a preventative standpoint.
Office of Disease Prevention and Health Promotion . (n.d.). Increase the proportion of people who get the flu vaccine every year – IID‑09. Healthy People 2030. Retrieved January 14, 2022, from https://health.gov/healthypeople/objectives-and-data/browse-objectives/vaccination/increase-proportion-people-who-get-flu-vaccine-every-year-iid-09
U.S. Department of Health & Human Services. (2021, October 25). Vaccine effectiveness: How well do flu vaccines work? Centers for Disease Control and Prevention. https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm
Topic 6 DQ 2
Discuss how to integrate appropriate information and communication technologies for the clinical preventative intervention in DQ 1 to improve nursing practice and care delivery for individuals and populations.
Sample student response one
Increasing vaccination coverage against HPV is crucial in the battle against cervical cancer. Statistics have shown that concerted efforts against what was once a leading cause of deaths among women, are paying off, with fewer and fewer women having the condition. HPV is one of the risk factors linked with cervical cancer, and getting vaccinated before the age of 26 significantly reduces that risk (Stockwell & Fiks, 2013). Information and technology can play a crucial role in enhancing vaccination efforts against HPV.
Using tools such as social media platforms can enhance efforts to create awareness on the preventive efforts implemented against cervical cancer. Social media platforms provide a cheaper and effective alternative to communicate with a wide target audience, overcoming barriers common to physical health promotion activities. Information and communication technology can also be used to send alters on vaccination status, or even diagnostic results from clinical visits.
One interesting application of information and communication technologies is the use of patient health records, which can be installed in the patient’s smartphone. Using PHR, patients can keep track of their clinical visits including when their vaccination shots against HPV or even pap tests are due (Ryu et al., 2017). PHR also help patients to keep track of any risk factor they need to be aware of and how to manage and maintain their health and wellbeing between visits. Therefore, it is a tool that could be explore to improve outcomes in prevention of cervical cancer.
References
Ryu, B., Kim, N., Heo, E., Yoo, S., Lee, K., Hwang, H., Kim, J. W., Kim, Y., Lee, J., & Jung, S. Y. (2017). Impact of an Electronic Health Record-Integrated Personal Health Record on Patient Participation in Health Care: Development and Randomized Controlled Trial of MyHealthKeeper. Journal of medical Internet research, 19(12), e401. https://doi.org/10.2196/jmir.8867 .
Stockwell, M. S., & Fiks, A. G. (2013). Utilizing health information technology to improve vaccine communication and coverage. Human vaccines & immunotherapeutics, 9(8), 1802–1811. https://doi.org/10.4161/hv.25031
Sample student response two
The main clinical intervention I chose was colorectal cancer screening. Its aim is to increase the proportion of adults aged 50-75 years received a colorectal cancer screening, this includes a Colonoscopy, a CT colonography, fecal occult blood test (FOBT) and fecal immunochemical test (FIT), fecal DNA test, and sigmoidoscopy (Healthy People, 2020). A computed tomography (CT) colonography produces a 3D image of the colon, which allows the doctor to look for colorectal cancer and precancerous polyps.
The design and development process for an mHealth app uses virtual human technology (VHT) to encourage colorectal cancer (CRC) screening among patients aged 50 years and above. The app features an interaction with Agent Leveraging Empathy for eXams (ALEX), a virtual human health care provider who educates patients about CRC screening and the benefits of FIT. During the clinical trial, the study by (Griffin et al., 2019) screened out patients who were at high risk of CRC (patients whose providers request more frequent colonoscopies or who have had colon cancer in the past) and those who were already within guidelines.
Patients who are eligible for FIT see a series of tailored messages about CRC and its severity, their susceptibility to the disease, and how FIT can help them comply with screening guidelines. After visiting with ALEX, the app delivers an electronic message to patients giving them the option to request FIT from their primary care provider (PCP).
Findings revealed that the app integrates into the UF Health Network and is delivered to patients directly through MyUFHealth (formerly known as MyChart), a Web-based medical portal. MyUFHealth lets patients securely access medical records, view laboratory results, and communicate with their PCP. There are several advantages to integrating with MyUFHealth (Griffin et al., 2019).
First, using MyUFHealth to disseminate the app allows us to select patients with specific medical characteristics (ie, outside guidelines and average risk) for participation in the trial. Second, integrating with MyUFHealth lets us customize ALEX based on the demographic information in the patient’s file. Finally, using MyUFHealth allows patients to quickly and securely request FIT from their PCP.
References:
Griffin, L., Lee, D., Jaisle, A., Carek, P., George, T., Laber, E., Lok, B., Modave, F., Paskett, E., & Krieger, J. (2019). Creating an mHealth app for colorectal cancer screening: User-centered design approach. JMIR Human Factors, 6(2), e12700. https://doi.org/10.2196/12700/
Healthy People 2020. Search the Data. Healthy People 2020. (n.d.). https://www.healthypeople.gov/2020/data-search/Search-the-Data?nid=4054/
Jermaine Byrant
Nicole Johnson
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