An Analysis of Asthma Among Black Americans Using the PRECEDE-PROCEED Model - Free Essay Example

Sample details Pages: 8 Words: 2347 Downloads: 1 Date added: 2019/08/08 Category Health Essay Level High school Tags: Asthma Essay Did you like this example? Abstract This paper explores the relationship between asthma and Black Americans through the PRECEDE-PROCEED model of health. The paper first explores the prominent diseases within the black population and then explains the significance of asthma in terms of symptomology, risk factors pertaining to the population, as well as comorbidity between asthma and other diseases prominent in the black population. Behavioral and environmental factors are explored followed by an analysis of available resources and policies. Don’t waste time! Our writers will create an original "An Analysis of Asthma Among Black Americans Using the PRECEDE-PROCEED Model" essay for you Create order Finally, a dual intervention is proposed; the intervention would target parents and children to educate them about asthma as well as the importance of social support for children. Among the diseases prevalent among the black population, such as diabetes, hypertension, and obesity; Black Americans have some of the highest asthma rates in the country (CDC, 2018). Asthma is a chronic respiratory disease which often begins in childhood, can be triggered by environmental irritants and is worsened by certain health behaviors (CDC, 2016). A lack of health education regarding asthma may result in missed school days, increased risk of emergency room visits and errors in emotional/physical perception (Ashley, Freemer, Garbe, Rowson, 2017; Shields, Comstock, Weiss, 2004; CDC, 2012). Although many health organizations have created plans to improve asthma statistics, Black Americans are still over twice as likely to develop asthma than White Americans (CDC, 2018); therefore, improvement in health interventions for Black Americans is necessary. Using the PRECEDE-PROCEED model, data will be used to better identify behavioral and environmental needs, preexisting and enablin g factors, and current and possible resources which may be implemented into a more successful intervention plan. The PRCECEDE-PROCEED model was developed as an all-encompassing planning model, divided between a research/planning phase (PRECEDE) and an action phase (PROCEED) (National Cancer Institute, 2015). The model analyzes behavioral and environmental, internal and external, and predisposing, enabling, and reinforcing factors. The model begins with a social assessment of the communitys perceived needs and is then followed by an epidemiological assessment to prioritize these needs. A behavioral and environmental assessment then researches internal and external factors relating/contributing to the issue. This is followed by an educational and ecological assessment which examines predisposing, enabling, and reinforcing factors. The next step, administrative and policy assessment, begins the second phase of the model and looks at the availability of resources, organizational policies/ regulation that impact the intervention. The final four steps deal with implementation and evaluation of health promotion intervention (National Cancer Institute, 2015, p.41). According to the CDC (2017), Black Americans have higher rates of premature morbidity from all causes than White Americans; morbidity rates escalate the earlier a disease emerges. Certain health disparities, such as heart disease, diabetes, obesity, smoking, HIV/AIDS, and drug overdose; have prominent associations with Black Americans; however, the risk of a Black American developing asthma is over twice as likely compared with a White American (CDC, 2018). Further, other black health disparities, such as obesity and smoking, are strongly associated with asthma risk (CDC, 2016). An epidemiological study from 2001-2010 showed that black childrens rates of asthma grew at almost a 4% yearly rate (Akinbami, Moorman, Simon, Schoendorf, 2014). The study also showed that black children were almost twice as likely to have at least one asthma attack in the past year and over 7 times as likely to die from asthma compared with white children. There are many internal and external factors which contribute to asthma development and aggravation. Internal factors consist of biological predispositions/ resistance to medications, beliefs about asthma severity, symptom detection/alexithymia (not being able identify and describe feelings), stress levels, and emotional/social stability. Black Americans had biological predispositions which showed a decreased response to asthma medications (Gamble, et al. 2010; Akinbami, et al. 2014). Beliefs about asthma, in other words not taking asthma seriously, may contribute to poor symptom detection which may contribute to the development of alexithymia. Stress levels contribute to internal irritation which can lead to asthma development or an asthma attack. Emotional stability relates to stress and may be a result of ones home/school environment. External factors which contribute to asthma were exposure to violence, quality of living/work environment, family/ethnic support, living with a single mother, and living with a smoker. Exposure to violence and living with a single mother were both found to be most relevant to black children (Barile, Edwards, Dhingra, Thompson, 2015). Violence may be found within ones home as well as within ones community. Quality of living/work environments are strongly tied to socioeconomic status both of which are often of poor quality for black individuals. According the United States Census Bureau (2017) Black Americans were the most likely to have only a high school diploma and had the second highest rate of unemployment and poverty. People with lower socioeconomic status (SES) are also more likely to be exposed to toxic living environments such as air/water pollution as well as poor work conditions which are conducive to asthma (Institute of Medicine, 2001). Health-related issues to economic i nstability included stress, sensory impairment, limited educational achievement and adult morbidity/mortality (Knopf et al., 2016). This implies that not only does low economic stability during childhood affect the individual, it may perpetuate the same problem to the next generation. Finally, smoking is a health disparity related to Black Americans (CDC, 2017). Smoking affects air quality and aggravates the lungs of asthmatics, increasing the likelihood of asthma development and attacks (CDC, 2016). Predisposing factors related to asthma were poor asthma knowledge, perception of severity, overall asthma attitude, self-efficacy, and perception of responsibility. A lack of knowledge about asthma can lead to other predisposing factors such as overall attitudes about asthma, severity perception, and possibly self-efficacy (Hopkins Tanne, 2001). Self-efficacy and responsibility perception relate to the performance of maintenance behaviors (Bruzzese, 2012). Enabling factors were available policies/resources which led to a lack of education and influenced asthma perception, transportation, and living/working conditions. Getting access to education may be difficult due to transportation issues and limited resources. Reinforcing factors were family/community support, having a primary doctor, and self-perception. Having social support will aid in performing preventative and maintenance behaviors. Communicating effectively with ones doctor also aids in reinforcement of positive behaviors ( Chiang, Huang, Lu, 2003). After collecting behavioral/environmental data, the two points deemed to be most critical were a lack of asthma education and a lack of social support. Many Black Americans do not have regular doctors, which may relate to their poor levels of, and access to, medical care and information (Hopkins Tanne, 2001). Black Americans are not properly educated on asthma symptomology and therefore may not realize they are suffering from asthma symptoms until symptoms become severe. Further, black children were almost 65% less likely (than white children) to have a follow-up after having an asthma-related emergency room experience (Shields, Comstock, Weiss, 2004). Many of these problems could be solved with effective asthma education (Hopkins Tanne, 2001). Other ramification of a lack of education also manifested in asthma maintenance behaviors. An inverse relationship was found between age and asthma management in black adolescents (Bruzzese, 2012). The older children were, the less likely the y were to effectively schedule taking medication, recognize trigger symptoms, or get help. Although there was a positive correlation with age and perceived responsibility, this may be the result of a disconnect between independence and self-care. This suggests that children with asthma need ongoing education on self-management. Further, mismanagement has been associated with depression, anxiety, (likely related to medical cost and perceived control) and dyspnea (labored breathing which will can make asthma worse) (Baiardini, Sicuro, Balbi, Canonica, Braido, 2015). The other factor targeted by this intervention is social support. Many risk factors of asthma related to a lack of social support such as violence, stress, alexithymia, and low SES (Bellin et al., 2014; Ashley et al., 2017; Baiardini et al., 2015; Akinbami et al., 2014), whereas a significant protective factor is family/ethnic pride (Koinis-Mitchell et al., 2012). A study by Barile et al. (2015) showed that adverse childh ood experiences were associated with lower emotional support, which was associated with a lower health quality of life. Additionally, the study found that low income and high unemployment was associated with lower emotional support. Finally, the study stated that adverse childhood experiences could prevent children from developing social relationships into adulthood. Therefore, childhood environment plays a large role in a childs development and potential. By limiting environmental factors like exposure to education and social support, a childs abilities may be compromised. The proposed intervention will be divided into two components, an educational component and a support component. Each component of the intervention will be geared toward children and parents, with differing curricula. Two different education groups will be administered as parents and children will be taught separately. The first component will be administered in order to educate the target population on asthma severity, prevalence in Black Americans, risk factors, and the importance of maintenance. Maintenance includes (parents) scheduling doctors appointments as well as (children) conducting self-assessment. Self-assessment includes monitoring trigger and asthma symptoms as well as taking medication consistently and responsibly. An effort will be made to explain that ones independence (as they age) means being their own doctor. Additionally, asthma education will include the benefits of performing protective behaviors, such as fewer emergency room visits. The second part of the intervention deals with social support for children. A lack of social support, especially in an environment of violence, can create or exacerbate asthma. Further, children who had a lack of social support have shown to increase in likelihood of developing into an adult with a low SES (Barile et al., 2015). Parents will be taught about the importance of family support and strategies to use inside the home, while ethnic clubs will be offered as a way for children to learn about and take pride in their heritage while making friends. This will create a resource for children in which they celebrate their differences, instead of hiding them, which will increase pride and minimize discrimination. Additionally, children will learn coping techniques that can be used during times of inflammation/isolation. Research by Baiardini et al. (2015) showed that asthmatic people who learned effective coping skills showed less psychological morbidity, greater perception of control , and better disease management. It is also important to look for negative coping efforts, such as avoidance which may indicate risk of emotional instability. This program will take place in community centers in the tri-state area (New York, New Jersey, and Connecticut) which should be easily accessible to community members. The tri-state area will be the preliminary location of the intervention due to its diversity in education, income, and culture (United States Census Bureau, 2009). The educational and support programs will be bi-weekly programs which will alternate programming (between the two components) based on the week; the program will last for four months. However, the childrens clubs (support component for children) will be held weekly. Each component will be taught by a qualified black professional (a black doctor will teach the educational component, a black psychologist/social worker will teach the social support component, and a black cultural educator will be in charge of ethnic clubs) as race may also serve as an additional barrier to asthma education or implementation of positive asthma behaviors (as they will better unde rstand their audiences cultural needs). In order for program effectiveness to be measured, data will be collected during the first, eighth, and final week of the program. Data will be used for formative and outcome evaluation. Data collection will consist of qualitative and quantitative data. Participants will be given surveys (Perceived Support Scale, Brief-Coping Orientation of Problem Experienced (COPE) inventory scale) to fill out as well as have a saliva test to test relevant biomarkers (cortisol and C-reactive protein). It is anticipated that this intervention will yield improvement of 15% over baseline over the course of the program. Improvements of a lesser scale will be further interrogated for variables that may require modification for ideal success. If the program produces significant results, the program will expand to other states across the country. Where applicable, the program will be tailored to account for unique variables (i.e. travel, participant disability) to maximize success. Further, there will be continuous yearly follow-ups to make sure programs are still being run appropriately while still proving effective, which will be used for impact and process evaluation. Instructors as well as community/civic center staff will be evaluated on their maintenance of the program in accordance with intended implementation; further, yearly data reports of the program will be analyzed to assess the programs standing and possible need for refinement. The only resources necessary for this intervention are a community center and black healthcare professionals. Because this is purely an educational intervention it should not conflict with any legislation. Although this study provided an in-depth analysis of relevant factors in asthma development and exacerbation, certain environmental factors like poverty were not explicitly part of the intervention plan. The intervention aids in education, which is often a limited resource as a result of poverty; however, asthma education will not help improve ones living or work conditions. Because the environmental conditions and legislature for each state is different, certain organizations are recommended as resources in order to minimize ones exposure to environmental irritants, such as the National Institute of Environmental Health Sciences (which has blogs and podcasts about reducing allergens in ones environment)(NIEHS, 2018) and the Environmental Protection Agency (which provides networks for community-based interventions as well as lists of local and national agencies that are asthma resources) (EPA, 2018), as well as looking into ones state policies regarding asthma. Asthma is a disease which disproportionally impacts black children and whose effects may still be felt into adulthood. Risk factors for asthma include race/ethnicity, poverty, parental education level, health insurance coverage, environmental (air) quality, living with a smoker, premature birth/ early antibiotic use, Alexithymia, stress, violence, and lack of social support. Through analysis of the PRECEDE-PROCEED model, education and social support were deemed the two most influential factors in asthma related health; therefore, a dual-component intervention was proposed for children and adults. As individuals learn the importance of asthma rates, risks, and symptoms as well as the necessity of family/community support the asthma rates of Black Americans will decrease.

Essay on Effective Approaches to Prevent Teen Pregnancy

Effective approaches to prevent teen pregnancy After reading numerous articles and abstracts in regards to the ever so intriguing topic of teen pregnancy, I’ve come to a conclusion which is a little different than I had expected. Before reading any of the literature on teen pregnancy, I was under the assumption that the sex education classes provided in school were an extremely effective weapon against unwanted teenage pregnancies. Of the literature references that I’ve used and those of which I have haven’t chosen to extrapolate on, many have reported results based on random surveys while others have conducted quantifiable research to reach their findings. In an article by Dryfoos J in the Planned Parenthood Review, Dryfoos mentions†¦show more content†¦This survey also showed that 63 % of teenagers have already had Sexual Intercourse by the time they had completed the 10th and 11th grades. nbsp;nbsp;nbsp;nbsp;nbsp;In the Journal of School Health, in May 2001 was an article entitled â€Å"Effectiveness of the Baby Think It Over Teen Pregnancy Prevention Program† by Cheryl Somers, Cheryl and Mariane Fahlman speaks of a program that many school systems have adopted called â€Å"Baby Think It Over.† This program is a computerized simulation of a baby and the responsibilities that parents have to endure. It is geared towards teen-agers because the teen pregnancy rates in America are at least double of any country with similar economic background and culture. This article further evaluates the effectiveness of this new program using a controlled study in which 151 experimental students and 62 controlled subjects were used. These were all high school students of a suburban area of a Midwestern city. The average age of the students was 16.2 and they were all middle-class primarily white students, both male and female. Numerous studies were conducted, with inconcl usive evidence of the programs effectiveness. One study showed that the subjects understood and had more realistic impressions of having children, while another showed that the students had no change of intentions in regards to teen parenting. 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Due to these unplanned and unwanted pregnancies approximately 4.5 million teenage girls undergo an abortion each year, with an estimated 3 million of them being performe d unsafely (Morris Rushwan, 2015). Some detrimental complicationsRead MoreTeenage Moms That Are Still In High School Get Pregnant1391 Words   |  6 Pagesare still in high school get pregnant at a young age, and are not able to support themselves or their child. There were just under a quarter million pregnancies in women ages fifteen to nineteen in 2014. About eighty-five percent of these pregnancies are unplanned, which in any population can increase the risk for problems. The biggest risk for teen mothers is delaying prenatal care or worse, about seven percent received no care at all. According to CDC, In 2014, almost 250,000 babies were bornRead MoreFixing the Teenage Pregnancy Problem: A Humble Suggestion Essay example1226 Words   |  5 Pagesproblem is no less evident. 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Results: After the assessment of the two research articles

Economies Of Scale - Imperfect Competition And International Trade

Question: Discuss about the Economies of Scale, Imperfect Competition and International Trade. Answer: Introduction It can be evident that market structure and economies of scale have considerable impacts on the pattern of trade and comparative advantage of a nation. There are several assumptions of perfect competition used by the classicist to determine the elements of international trade theory. The study presents a relation between economies of scale and imperfect competition with international trade (Dakhlia and Temimi, 2016). Recently, different theories have been presented by various authors that deal with the economies of scale and imperfect competition to present a general equilibrium framework that modifies the modern theory of international trade (Winters and Wells, 2012). Some authors concentrate of existence of gains and equilibrium from trade in the imperfect competition model, whereas some focuses on differentiation of product as the key to success. It has been believed that differentiation leads to gains from intra-industry trade. Considering the concept of intra-industry trade, it can be seen that maximum benefits are derived from trade between similar countries (Findlay, 2014). Hence, the study has been developed to conduct a theoretical analyse and establish a relationship between economies of scale and imperfect competition with intra-industry trade. Furthermore, the study emphasises on expansion and application of the theories in real world to get benefited from international trade. Hence, the purpose of the study is to present a literature review and explain the theories to understand their importance in international businesses to seek growth over the global platform. External and internal economies of scale Economies of scale present the comparative advantage that can be sought by production of such commodities in which the country has better specialisation (Fujita, 2008). Hence, Economies of scale can be termed as the advantages that a company or nation seeks through large scale production. The economies of scale has been categorised into two segments. One is known as internal economies of scale and the other is known as external economies of scale. Figure: Economies of Scale Source: (Jensen and Wong, 2007) The two different concepts of economies of scale or benefits of mass scale production have been discussed herein below: Internal economies of scale The internal economies of scale occurred due to expansion of business and increase in production. It leads to decrease in the production costs that provide the company with a competitive edge (Krugman, 2010). Internal economies of scale occur within the firm due to its expansion of business. The internal economies of scale can be categorised into real economies of scale and pecuniary economies of scale that are discussed herein below: Real economies of scale The real economies of scale are presented herein below Technical economies: Large firm enjoys higher efficiency in terms of technology from machinery and capital goods. Marketing economies: Large amount of money can be spent on marketing activities, yet per unit cost of marketing remain low. Labour economies: Large scale production provides labour economies because per unit labour cost reduces. Managerial economies: It leads to reduction in the per unit managerial cost due to large scale production. Economies of transport and storage: Large firm enjoys economies of transport and storage with higher level of productivity. Pecuniary economies The pecuniary economies of scale are presented herein below: Large firms can buy raw materials at a lower price due to special discounts offered by the suppliers Large firms are offered with easy loans from banks at lower interest rates. Large firms seek concessional transport facilities due to bulk amount of goods. Large scale firms enjoy low cost of advertising due to bulk production. External economies of scale External economies are the benefits that are accrued by the firms due to large scale operations in a particular industry. The external benefits are shared by a number of firms operating in a particular industry. The external economies are presented herein below: Economies of concentration: The large firms enjoy the benefits of communication and transport, research and invention and raw materials availability with increase in number of firms in an industry (Lo and Fann, 2010). Economies of information: The increase in number of firms makes the industry mutually dependent. It leads to easy flow of information from one firm to another for mutual benefit. Economies of disintegration: With development of industry, every firm specialises in production of particular products. Hence, mutual understanding leads to economies of scale large production (Melvin, 2009). Importance of economies of scale The importances of economies of scale are presented herein below: Nature of Industry: It helps to determine the nature of industry. For example, constant cost industry, increasing cost industry and decreasing cost industry (Mai and Hwang, 2007). Analysis of cost of production: It helps to analyse the cost of production by judging the benefits of large scale production. Imperfect competition and trade The monopolistic competition model The assumption of perfect competition has been overtaken by monopolistic competition model that presents an imperfect competitive situation in international trade. The monopolistic competition model can be derived by the presence of many small businesses that operate with their own policies and strategies. In a monopolistic competitive market every organisation makes it own decision regards to the products, output and pricing. The entrepreneurs play primary role in the market because of high risk involved in decision making. Furthermore, there is no barrier to enter or exit the market. Along with that, the differentiation strategy is not limited to product, but the entrepreneurs can implement differentiation of marketing strategy, human capital and distribution techniques. According to this model, the firms are the price makers due to immense rate of competition in the market. Hence, it can be seen that the firms make a huge supernormal profits in the short run that decreases in the long run due to adoption policy and entry of new competitors. The intra-industry trade The intra-industry trade has been often identified as one of the favouring practical elements in substantial trade theories. By considering the imperfect trade competitions across the global trade industry, organisations have seemed to secure significant returns on investment in compared to perfect competition scenario. In case of intra-industry trade analysis, significant rudiments of Ricardian trade theory can be applied within the Heckscher-Ohlin framework (Davis, 2015). Through the identification of the benefits of intra-industry trade, the paper has been described to evaluate the competitive advantage of such trade. Meanwhile, the traditional theories of proportional advantage have been taken into consideration to identify the contrast scenario of the scale economies model (Bergstrand, 2010). Through the understanding of scale economies perspective, intra-industry trade can provide return to scale in an efficient way. In the contemporary business scenario, scale economies have i nfluenced the rise of intra-industry trade though the relation between substitutes for scale economies and intra-industry trade has shown negative impact (Aquino, 2011). Meanwhile the return of scale economies has been identified one of the most successful element to select intra-industry trade contributing to the maximum profitability of the global business enterprises. Arguably, the introduction of intra-industry trade has improvised business specialisation so that contemporary businesses can increase imperfect competition for further benefits and profitability. Moreover, the intra-industry trade pattern has got significant wide spread acceptance to understand the role of the theories on comparative advantage (Greenaway and Milner, 2011). According to the Ricardian model, economies of scale have been neglected in the large trade flows promoting sustainability. Measurement of intra-industry Grubel and Lloyd present the method to measure Intra-Industry trade of a nation. The measurement of intra-industry trade is known as Grubel-Lloyd index (Chipman, 2010). A formula has been presented below to measure the intra-industry trade of a country. The measurement of intra-industry trade is required to understand the opportunities of trade in an international market. It is important to note that every nation is not specialised in production of all commodities. Hence, every nation export particular commodities to other nations in which it have comparative disadvantage. On the other hand, it exports those products in which it has comparative advantage. Hence, the measurement of Grubel-Lloyd index helps in observing the trade opportunities in different countries to plan the internationalisation strategies to enter those markets. External economies and international trade External economies of scale have held the key to success at the industry level to set remarkable trade standards. By considering the international trade theory, external economies of scales have derived significant factors to support international trade. Meanwhile, whenever economies of scale have been applied at the industry level rather than m enterprise level, it can be identified as external economies. Moreover, in larger business perspective, external economies have been utilised to influence the international trade prospects in countries such as the United States of America, China and other major countries (Suga, 2007). On critical thinking perspective, external economies of an international market must be identified following thorough research so before affirmative decision-making on international trade policy. Through the identification of sustainable external economies of scale attached to a target market can improve the trade relations between two countries (de Groot and Na huis, 2012). Furthermore, as the expansion of trade can be materialised in the target market, the output of the industry will be automatically enhanced due to the present of affordable external economies of scale. Moreover, the international trade and external economies have been significantly benefitted through the implementation of theoretical concepts attached to the scenario of external economies of scale (Ohlin, 2007). The connection point of business and trade perspectives can create new dimensions to be opened up for further trading perspective at the international platform (Sullivan, 2013). Understandably, the external economies can increase the productivity of the industry. As the output of the industry will increase, the costs of the external economies and available market patterns will experience an upward lift. Meanwhile, a discussion on comparative advantage can be evident to explain the trade patterns. As external economies have influenced comparative advantage in the market, a pattern related to industry specialisation can be identified on a historical contingency (Milner, 2008). As the external economies have picked up robust growth model in a relevant industry, the initial advantages will dried up. Therefore, the advantages of the primary stages will be locked in. In such circumstances, the external economies will be no longer relevant to the industry as functionality of the same will be reduced. Evidently, selection of the right country will be manifest for international trade reviewing the external economies for long-run success at the international level (Ta ngkittipaporn and Songkroh, 2009). Extension and applications New theories have been developed by economist in respect to economies of scale. It includes the horizontal and vertical integration of economies of scale (Brakman and Heijdra, 2014). Horizontal perspective presents the quality developed, whereas vertical perspective presents other benefits of intra-industry trade. Furthermore, new approaches of international trade model have been developed by Dixit and Stiglitz, which is known as the new trade theory (Brakman and Heijdra, 2014). Along with that, the Core-Periphery Model has been developed to analyse the concentration and specialisation of particular economy. Hence, these extensions of theoretical models can be applied in the real world scenario to develop international trade patterns relevant for significant economies. Conclusion The dynamic scenario of economies of scale has significantly contributed towards successful management of trade perspective. Identically, the internal and external economies of scale have influenced the international trade at the highest business level. By providing effective changes in international trade procedure, countries with similar types of economies of scale can create sustainable long-run trade relationship. On the other hand, on basis on intuitive views, equal productivity, factor endowments and other significant concepts must be identified through the identification of economies of scales. Moreover, because of the presence of economies of scale, significant international trade concepts can be determined. In this way, international trade can be made possible in the two different countries having different types of economic standards. Moreover, the fundamental objective of return has been fulfilled by utilising both the internal and external economies of scale. Through the identification of classical models such as Ricardian Model and Heckscher-Ohlin Model (H-O Model), comparative advantage and business gains in international trade can be achieved. Furthermore, the specialised goods and intensives services must be endowed according to the factors influencing the business prospects at the global platform. Conclusively, the contribution of economies of scale in international trade can identify the most effective cost structures and sustainable business framework applicable for maximum profitability. References Aquino, A. (2011). The measurement of intra-industry trade when overall trade is imbalanced.Weltwirtschaftliches Archiv, 117(4), pp.763-766. Bergstrand, J. (2010). 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