PLEASE FORMAT AS A TRIFOLD BROCHURE TEACHING
• Develop and submit a tri-fold brochure based on the population and disease chosen for the Epidemiology Paper. The brochure must include the following information:
o Present an overview of the issue
o Design appropriate health promotion, disease management, and risk reduction and disease prevention strategies applicable to population care
Include the primary, secondary, and tertiary strategies applicable to the population and focus, (26) presented in language that is understandable and appropriate to the population
o Discuss future prevention techniques
o Provide a minimum of three local, state, and/or national credible and legitimate resources if possible use New Jersey State (e.g., CDC, HHS) for information related to selected population and disease focus.
o Cite and reference a minimum of five valid and reliable sources (submitted separately from the brochure to faculty)
Here is the Epidemiology Paper that was submitted.
HIV in Lesbian, Gay, Bisexual, and Transgender
Epidemiology
Epidemiology is a branch of science that deals with the study of patterns and causes of diseases or conditions in defined populations (Porta, 2014). The defined population pertains to gender, sexual orientation, age, and other individualistic attributes. In epidemiology, the issues concerning public health are addressed. Such issues include the application of evidence-based practices to determine risk factors for diseases, identification of the target population, and the preventive measures to quell the manifestation of the identified disease. The most significant aspect of epidemiology include study designs, collection of data, statistical analysis of data, and statistical interpretation of the collected data as a method of developing the methodology for clinical research (Rothman, 2002).
Most importantly, epidemiology fulfills the objectives of public health by studying etiology, outbreak, transmission, and surveillance of disease (Porta, 2014). Additionally, it deals with biomonitoring and determination of the best treatment approaches through clinical trials. The other disciplines that are beneficial to epidemiological practices include engineering, biology, statistics, and social sciences. The regulations enable the epidemiologists to retrieve relevant information, conduct clinical analysis, and use the statistics to find solutions to the identified public health problems.
Analysis of Steps and Methods of Epidemiology
The methods of epidemiology follow a certain routine that covers all steps of disease manifestation in a particular population. The methods include: the analysis of routine data such as demographic, census, birth, death, and surveillance records; analysis of research data including medical and health records; and analysis of epidemiological data through surveys. The series of stages evident in epidemiological studies are as below.
a. Diagnosis phase – confirms whether the disease exists (Morabia, 2004).
b. Descriptive phase – description of the population at risk and analyzes its description. This stage also allows the formation of a series of hypotheses regarding the determinants of the disease and its effects on the identified population. Therefore, it involves the analysis of routine data such as demographics, census, and surveillance records.
c. Investigative phase – entails field studies and analysis of the stated hypotheses. Survey is highly applicable during this phase.
d. Experimental phase – performance of experiments under controlled conditions to test the confirmed tests in the previous period (Morabia, 2004). Health records may also analyze this time.
e. Intervention phase – examination of the appropriate methods of taming the disease in the field or under controlled experimental conditions.
f. Decision-making phase – the knowledge of the epidemiology is applied to determine the most appropriate options for controlling the disease (Morabia, 2004). Models are used to determining the cost and effectiveness of the previous measures. Additionally, the cost is compared with the benefits of the control measures.
g. Monitoring phase – implementation of the controls determined in the previous phase (Morabia, 2004). It determines the appropriateness of the measures and whether the desired effects are being achieved.
Epidemiological Triangle
The epidemiological triangle of any disease consists of an agent, environment, and the host (Rothman, 2002). It is a general model used for public health to determine the relationship between an agent, environment, and a host. The involved agents are biological, chemical, and physical. The chain of transmission of disease or injury is the environment. The occurrence of illness takes place when the agent interacts with the host. In this case, the encounter of the host with the agent takes place in an environment that allows the interaction to progress. To prevent the occurrence of health problems, the right models should be used to identify the best health strategies.
The epidemiological triangle is applicable to all types of diseases. It covers both infectious and the non-infectious diseases. However, most schools of thoughts showcase their support for infectious disease because of the readily identifiable agents. For instance, virus and bacteria are some of the widely known agents of disease progression. They lead to prognosis of infection when they interact with the host (target population) in a propagative environment. Therefore, the primary task of public health agencies is to identify the agents and make changes on the environment-specific control factors to reduce the spread of the infections within the population.
Selected Population and Disease
Every population group interacts with the predisposing factors in the environment that increase the probability of certain diseases to sprout. The primary option is to reduce the effects of the predisposing factors of the environment. The predisposing factors create the right environment for the interaction of an agent with the host within that environment. In this case, the target group is the gay, lesbian, bisexual, and transgender population. The selected disease is HIV. There is a direct relationship between this population and the prevalence of HIV in the society. HIV is the agent while the individuals that transmit the virus are the hosts. The environment in which such individuals exist makes them engage in activities that predispose them to the infections.
The characteristics of the selected disease and population influence the population’s vulnerability to different forms. This community composed of individuals that are sexually active. Additionally, some of the individuals such as gays and lesbians are profiled differently in terms of character and social behavior. The twist of events links HIV infections among this population about their social behavior. Therefore, their existence increases the vulnerability of the population to the effects of the disease. The fundamental characteristic of the population that creates community vulnerability is that they actively engage in sexual activities. Therefore, the chance of spreading HIV from one individual to the other within this population is high as compared to the case of heterosexuals (Prejean, Song, Hernandez, Ziebell, & Green, 2011).
The selected disease also enhances the vulnerability of the population. The first characteristic entails the failure by individuals to understand its epidemiology. Therefore, they are unable to prevent the interaction between the host and the agents of HIV. HIV is not a readily identifiable infection during early stages, which implies that the rate of infection is likely to increase, unnoticed. The other characteristic of the disease is its non-responsiveness to medication. There is no known cure for HIV and its advanced state, AIDS. Therefore, manifestation of illness in the population has the potential of wiping out a large number of individuals. The prevalence of the disease in the United States was studied in various researches. Consequently, a significant amount of data is available in the databases of the CDC and the WHO. Therefore, epidemiological approaches are the only panacea to solve the spread of HIV among the gay, lesbian, bisexual, and transgender members of the population.
The values and potential cultural biases relating to this population are of mixed quotient, specificity, and implications. For instance, from a cultural perspective, different people have different perceptions of this population. For example, gay, lesbian, bisexual, and transgender individuals are perceived to be deviants of the culturally accepted values. Therefore, this form of bias creates a platform on which segregation is likely to take place. Consequently, the reduced help from the society potentially increases their vulnerability to HIV and, therefore, the leading cause of mortality among the members of this population.
The cultural considerations in the selected population entail engaging in practices that are against the values of the whole society and the outcome of publicly declaring an individual’s sexual orientation. In most cases, victimization of the affected individuals is heightened as they show disrespectful of the cultural considerations or norms of social behavior. Therefore, in the event of any infection among the population, members will be reluctant to seek medical services for fear of intimidation. For instance, it would be quite hard for a gay couple, a lesbian couple, or transgender to visit a medical facility to solve their health issues. Therefore, such environments are likely to augment the intensity of spreading the infection to the healthy individuals.
There are various legal and ethical considerations that must be addressed when working with a population of gay, lesbian, bisexual, and transgender individuals. Likely, this community would form the population sample for data collection. As part of the study design, the ethical and legal considerations must be applied whenever one is dealing with human samples. In this case, it is necessary to seek consent from the members before proceeding with data collection. The members should be in the rightful mind and age to offer an informed consent. Secondly, the issue of anonymity and confidentiality should be significantly considered as an ethics-legal consideration. The participants should be informed that the information would not be made available to third parties. They should also be assured that the information would be used for research purposes only and not to fulfill other unorthodox purposes.
During the epidemiological study, it would be appropriate to manage potential conflict with personal values and biases in the instance of interacting with populations that have different values. The first approach would be to have a researcher’s perspective in mind to create a formal relationship with the community. Therefore, it would be advisable to shun any approach that may seem biased (McCaughan, 2001). In this case, the researcher should not show any partiality in relation to one of the sexual orientations. He or she should be focused to collect data and avoid being personal with some questions. Neutrality and professionalism should be a constant in this form of interaction to avoid causing conflicts of interest regarding their personal values.
Incorporation of evidence-based medicine and evidence-based nursing in the decision-making model in relation to this issue is inevitable, as explained in Stanhope and Lancaster (2012). In medical practice, there is a need to determine the spread of the disease within the population and come up with appropriate working decisions to reduce its impacts. According to Prejean, Song, Hernandez, Ziebell and Green (2011), the percentage of homosexual living with HIV is higher as compared to the heterosexual population. This finding implies that the likelihood of the selected population to continue living and spreading the infection is very high. Therefore, the decisions to be made must ensure maximum productivity and success. The decision-making model should ensure the outcome is appropriate to solve the HIV pandemic among the members of the selected population (McCaughan, 2001). In this case, research evidence would be incorporated in the decision-making approach to induce professional judgment. Evidence-based decision-making approach applies theory to the practice to improve the universal process of decision making (Thompson, Cullum, McCaughan, Sheldon, & Raynor, 2004). The evidence shows that the population is vulnerable to the infection. Therefore, medication should be provided to the infected members. Additionally, they ought to halt further infections by being advised to use protection or restrain from engaging in sexual escapades. They should also seek medical services without fearing oppression or discrimination (Purcell, Johnson & Lansky, 2012). This decision is appropriate because it has the potential of reducing the mortality rate and the rate of new infections.
Relationship of HIV to Various Levels of Prevention
The levels of prevention of HIV are consistent with the epidemiological triangle in relations to how the disease is spread. In this case, the agent and the host are the two main pillars of the triangle that require evidence-based approaches to align. The feasibility of preventing the spread of HIV is very high. The host, the infected, should be enlightened on how they can avoid infecting others. Similarly, the non-infected members of the population should be encouraged to be watchful to prevent new infections from taking place. Therefore, it easier to prevent the progression of the disease within a population is the members are cooperative. The primary, secondary, and tertiary levels of prevention are appropriate to solve the issue of HIV among the population (Stanhope & Lancaster, 2012). The primary level entails enlightening the healthy individuals against any act that would make them vulnerable to the infection. The secondary level implies provision of medication to cover the rate of progression of the disease. The third level involves managing the complications in the chronic states. The evaluation of prevention focuses on the number of new infections after intervention and the mortality rate among the infected.
These references go with the paper. Only include if applicable
References
McCaughan, D. (2001). What decisions do nurses make? In Thompson C, Dowding D,
editors. Clinical decision making and judgement in nursing. Edinburgh: Churchill
Livingstone: 95–108.
Morabia, A. (2004). A History of Epidemiologic Methods and Concepts. Basel: Birkhauser
Verlag.
Porta, M. (2014). A dictionary of Epidemiology, 6th edn, New York: Oxford University
Press.
Prejean, J., Song, R., Hernandez, A., Ziebell, R., & Green, T. (2011). Estimated HIV
Incidence in the United States, 2006-2009. PLoS ONE 6(8): e17502.
doi:10.1371/journal.pone.0017502
Purcell, D., Johnson, C. H., & Lansky, A. (2012). Estimating the population size of men who
have sex with men in the United States to obtain HIV and syphilis rates. Open AIDS
Journal, 6: 98-107.
Rothman, K. (2002). Epidemiology. An introduction. London: Oxford University Press.
Stanhope, M., & Lancaster, J. (2012). Public health nursing: Population-centered health care
in the community. Maryland Heights, Mo: Elsevier Mosby.
Thompson, C., Cullum, N., McCaughan, D., Sheldon, T., & Raynor, P. (2004). Nurses,
information use, and clinical decision making—the real world potential for evidence-
based decisions in nursing. Evid Based Nurs, 7:68-72.
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