NURS FPX 4055 Assessment 1 Health Promotion Research

NURS FPX 4055 Assessment 1 Health Promotion Research

Student name

Capella University

NURS-FPX4055 Optimizing Population Health through Community Practice

Professor Name

Submission Date

Health Promotion Research

Infant mortality is a burning social health issue in most of the underserved communities in the United States. The factors that cause poorer results in vulnerable populations include structural inequities, including poverty, inadequate access to prenatal care, and environmental risk factors.

In Baltimore City, the infant mortality rate stood at 7.5 deaths per 1,000 live births in 2021, which indicates that infant health outcomes have continued to differ (Johns Hopkins Bloomberg School of Public Health, 2024). This evaluation will examine how SIDS is affecting the East Baltimore WIC community and outline specific, culturally sensitive ways of reducing preventable infant deaths. 

Population Health Concern Analysis

The urban poor communities show much higher rates of SIDS, with the poorer populations having a higher incidence than the more affluent ones. By 2022, the population in East Baltimore was mostly African American, with 41.4% of the residents being Black and 36.2% White (Data USA, 2022).

In the neighborhoods of East Baltimore, which are largely populated by African Americans, the family experiences several risk factors such as teenage childbirth, low prenatal health access, and an increased rate of infant mortality. A total of 7.5 deaths per 1,000 live births were the infant mortality rate in Baltimore City in 2021 (Johns Hopkins Bloomberg School of Public Health, 2024).

Effective interventions should include holistic strategies to cover changes in the environment and behavioral education as opposed to the use of information campaigns. Safe sleep recommendations by the American Academy of Pediatrics have had a high degree of efficacy as the rates of SIDS have decreased by 53 percent since 1992-2001 after the introduction of the supine sleeping guidelines (Allam, 2024).

There is also an indication that education-related interventions can be the least effective in comparison with the environmental modification and enforcement strategies, especially in relation to vulnerable groups (Moon et al., 2022). Specific to the community intervention entails culturally competent peer education, supply of safe sleeping gear, and community-specific smoking cessation support programs to pregnant mothers.

• Assumptions and Uncertainties

The assumption in the analysis is that SIDS risk is directly related to the socioeconomic disparity through a behavior changeable factor. Nevertheless, the specific processes that are associated with the relationship between poverty and higher SIDS rates are not fully understood and debatable.

Target interventions assume community approval and long-term practice, which could have a wide range of differences (Ibrahim et al., 2022). There are still critical uncertainties on the contribution of the relative roles of genetic predisposition and environmental stressors in susceptible populations.

Community Audience Characteristics Description

The EBWIC (East Baltimore Women, Infants, and Children) facility is mainly used by African American mothers and African American infants in low-income families. The community has several overlapping risk factors, such as decreased household incomes each year, high rates of tobacco exposure, and bed sharing (Baltimore’s Promise, 2024).

Having social and economic traits, health-seeking behaviors among the population are highly influenced, and specific intervention strategies are needed. The majority of the participants depend on federal aid schemes, such as Supplemental Nutrition Assistance Program (SNAP) benefits and Medicaid, to cover their healthcare expenses (Collin et al., 2023).

The cultural beliefs focus on the support systems in the family, but most of them face social isolation based on single parenthood. The levels of health literacy also differ significantly, and a significant number of people will need visual information and peer-conducted education instead of pamphlet-based information (FRAC, 2019). Not all of the Hispanic participants comprehend English, and some language barriers will require bilingual educational materials and more culturally competent health message strategies.

Among the highest-risk infants, the community has those born to mothers who have smoked during pregnancy, and the risk of increased mortality is tripled as compared to non-smoking households (Hauck and Blackstone, 2022).

The prevalence of bedsharing is high among the low-income groups, especially among African American families and teenage mothers. Infants are exposed to secondhand smoke, and the number of cases of SIDS doubles based on the established research findings (Rubinstein et al., 2024). Poor environmental risk factors to vulnerable infants are further exacerbated by limited accessibility to safe sleep equipment and overcrowded housing conditions. 

• Relevance to the Larger Target Community

The population features also indicate the trends of the rest of urban low-income populations in the country, in which disadvantaged groups have threefold higher SIDS rates. Teenage pregnancy, low prenatal care, and exposure to substances are in line with national trends of high-risk populations.

Systemic problems such as the lack of proper housing, food insecurity, and accessibility to healthcare are socioeconomic problems that impact similar communities in the United States. Knowledge of the local features has made it possible to develop evidence-based interventions that address the underlying causes and not isolated risk factors. 

Health Concern Importance Justification

Realistic Health Goal Setting

WIC mothers at the East Baltimore center show low awareness of risk factors of SIDS and safe sleeping behaviors. Presently, a large number of them are not able to recognize such risk factors as a prone sleeping position or the impact of smoking effects. Culture and lack of knowledge often result in the sleeping habits among them, where they bedshare and use soft bedding.

When working with the participants, the preference is expressed towards peer-based education sessions, 45-60 minutes in duration, which involve group discussions. The participants asked for the use of culturally-related materials, practical demonstrations with actual cribs, and reminder cards that families can keep at home. The sessions to address the needs will start with a knowledge assessment, then a safe sleep demonstration, and smoking cessation counseling in an interactive way.

SMART Goal 1: Safe Sleep Knowledge

• Specific: The participant will properly recognize three main safe sleep behaviors (supine positioning, firm sleep surface, smoke-free environment) and describe two risk factors of SIDS.
• Measurable: Mastery will be determined through the use of a pre-post knowledge questionnaire, with the target of improvement being 80 percent (Abuhammad et al., 2024).
• Achievable: Content provided by a 60-minute peer-led workshop based on visual aids, crib demonstration, and culturally modified content to low-literacy groups.
• Relevant: It is demonstrated that safe sleep training results in a higher compliance rate when a culturally appropriate strategy is applied (Williamson et al., 2021).
• Time-constrained: The participants will undertake post-education assessment immediately after the session, and will show their knowledge retention after two weeks.

SMART Goal 2: Smoking Cessation Behavior

• Specific: The participant will decrease cigarette smoking by half in the course of four weeks or stop altogether should he or she smoke fewer than five cigarettes in a day.
• Measurable: Smoking cessation as measured by self-report and documented with the support of expired carbon monoxide levels assessed weekly, in accordance with the evidence-based cessation guidelines.
• Achievable: The participants are provided with short-term counseling using motivational interviewing methods and referral to nicotine replacement therapy in the cases of heavy smokers.
• Relevant: Consumption of smoking directly reduces or stops the risk of sudden infant death syndrome (Hauck & Blackstone, 2022).
• Goal-Oriented: Objectives of reduction of smoking were measured every week over the course of four weeks with biochemical confirmation at the two and four-week levels.

SMART Goal 3: Safe Sleep Environment Implementation

• Specific: The patient will establish and ensure a safe sleep position, which is the supine position, the use of firm mattresses, and the removal of soft objects.
• Measurable: Home environment evaluated with the standardized checklist at two home visits, with the record of compliance with five key safety elements.
• Achievable: Fee portable cribs and safe sleep education materials are provided to the participants, and the barriers to implementation in the low-income population are identified and addressed.
• Relevant: Literature indicates that the provision of cribs and education can enhance safe sleep practices among the population of similar demographics (Ward et al., 2021).
• Time-bound: First home assessment during the first week of the education session, and second assessment after four weeks of the intervention to allow the continuity of the implementation.
• Conclusion

The overall health promotion study forms the strategic base in responding to SIDS in the East Baltimore WIC community through the use of evidence-based intervention. The review of the literature indicates that specific interventions based on safe sleep habits, smoking cessation, and environmental changes can substantially decrease the risk of SIDS in high-risk groups when provided in a culturally suitable and peer-led intervention.

In dealing with the social determinants of health underlying the need to overcome challenges and set realistic and measurable objectives, the health promotion plan offers a platform through which the alarming racial disparities in infant mortality can be reduced. This participatory process, which includes community involvement, is guaranteed to have a higher probability of maintaining behavior change and health outcomes of vulnerable infants and their families.

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