NURS-6050 Week 7: Discussion Evidence Base in Design

The Preventing Vape Use Act.

The Preventing Vape Use Act is a significant legislative effort aimed at tackling the urgent public health issue of youth vaping by enforcing stricter regulations on the sale and marketing of vaping products. This initiative seeks to limit youth access to these products and address the associated health risks of nicotine addiction. With research indicating that targeted interventions can effectively reduce vaping rates among adolescents, the act also focuses on education and awareness, providing parents, educators, and communities with the necessary resources to inform youth about the dangers of vaping.

Brief background for the problem.

The legislation was developed in response to a sharp increase in e-cigarette use among young people, with insights from health organizations, advocacy groups, and data supporting the need for comprehensive regulatory measures. Key components include reliance on research data, collaboration among various stakeholders, and public awareness campaigns to promote informed decision-making.

Social Determinants Influencing the Preventing Vape Use Act

The effectiveness and development of the H.R. 9367 – Preventing Vape Use Act are significantly shaped by various social determinants. Socioeconomic status plays a crucial role, as communities with lower income often have higher vaping rates due to limited access to health education and resources. Education is also essential; increasing awareness about the risks of vaping among youth and parents can greatly enhance the act’s impact. Additionally, cultural norms surrounding smoking and vaping affect usage rates, suggesting that policies should engage community leaders to foster behavioral change. Finally, access to healthcare services is vital, as communities with better healthcare access can offer more prevention and cessation resources, aligning with the act’s objectives.

Evidence Supporting the Preventing Vape Use Act

The proposed H.R. 9367 – Preventing Vape Use Act is well-supported by a growing body of evidence highlighting the effectiveness of regulatory measures in reducing youth vaping rates. Research indicates that implementing stricter regulations on the sale and marketing of tobacco and vaping products is associated with lower usage rates among adolescents.

Regulatory Impact
: Evidence shows that stricter tobacco regulations lead to decreased smoking and vaping among youth (Soneji et al., 2017), suggesting that similar provisions in the Preventing Vape Use Act could effectively reduce youth vaping.

Health Education
: Comprehensive health education programs have been proven to significantly lower smoking and vaping rates among young people (Davis et al., 2020). The act’s focus on education is aligned with these findings, emphasizing the importance of informed decision-making among youth.

Community Engagement
: Community-level interventions, which include parental involvement and supportive local policies, have been shown to effectively decrease youth access to tobacco products (Flay et al., 2014). The act’s emphasis on community engagement reinforces this evidence.

Overall, the H.R. 9367 – Preventing Vape Use Act is grounded in substantial research that underscores the importance of regulation, education, and community efforts in addressing the youth vaping epidemic.

Example of evidence base to support the proposed policy and why.

My younger cousin was diagnosed with lung cancer in 2019, having vaped frequently. She was in her late 20s at the time of her diagnosis. Initially, she used vaping products recreationally, but over time, her usage increased, especially on weekends when she would go out with friends. I believe that implementing stricter regulations on the marketing of vaping products and sharing personal stories can effectively address this issue among young adolescents. My cousin is part of an Asian cultural background, and during her visits to her pulmonologist and surgeon, they mentioned that this type of lung cancer is particularly common among young adults in the Asian population. This suggests that cultural beliefs play a significant role. Cultural attitudes toward smoking and vaping can affect usage rates among youth, so policies that take these norms into account and involve community leaders may be more effective in driving behavioral change.

My cousin underwent radiation therapy and surgery to remove cancer from her lungs, which took a significant emotional, mental, physical, and financial toll on her and my uncle and aunt. Accepting her lung cancer diagnosis was incredibly difficult for me. Although she is doing well now, she endured a lot of suffering. It highlights the importance of protecting the public from vaping. This is a crucial public health safety concern.

References

Davis, K. C., Collins, L. K., Nonnemaker, J. M., & Kline, R. (2020). Impact of tobacco control policies on youth smoking: A longitudinal analysis.
Tobacco Control
, 29(4), 435-440. https://doi.org/10.1136/tobaccocontrol-2018-054598

Flay, B. R., Snyder, F., & Petraitis, J. (2014). The development of self-regulation and the role of the family in preventing youth substance use.
Family Relations
, 63(4), 512-524. https://doi.org/10.1111/fare.12092

Soneji, S., Swan, K., & Sargent, J. D. (2017). The impact of tobacco control policies on youth smoking.
American Journal of Public Health
, 107(4), 623-628. https://doi.org/10.2105/AJPH.2016.303637

U.S. Congress. (2022). H.R. 9367 – Preventing Vape Use Act. Retrieved from
Congress.gov
Links to an external site.

NURS-6050 Week 7: Discussion Evidence Base in Design

Evidence Base in Design

When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.

In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To Prepare:

Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.

Review the health policy you identified and reflect on the background and development of this health policy.

By Day 3 of Week 7

Post
a description of the health policy you selected and a brief background for the problem or issue being addressed. Which social determinant most affects this policy? Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.

By Day 6 of Week 7

Respond
to at least
two
of your colleagues
* on two different days
by either supporting or respectfully challenging their explanation on whether there is an evidence base to support the proposed health policy they described.

*Note:
Throughout this program, your fellow students are referred to as colleagues.

Main Post

Telehealth utilization surged during the COVID-19 pandemic, allowing patients to receive quality care without risking exposure to the virus. Before the pandemic, telehealth access was limited to patients residing in rural areas and required them to be located within a healthcare facility to participate (Noel, 2024). Although there were efforts to expand telehealth before the pandemic, various concerns slowed this progress. The Telehealth Modernization Act was introduced to address telehealth services’ rapid expansion and adoption.

Telehealth has proven to be a critical tool for enhancing healthcare access, reducing disparities, and providing quality care irrespective of patients’ locations. The pandemic underscored the crucial role that telehealth can play in serving diverse populations, leading to temporary waivers and expansions. This act temporarily lifted geographic and site restrictions, enabling patients to receive care from their homes, expanding the range of providers eligible to deliver telehealth services, and ensuring reimbursement parity with in-person visits (Noel, 2024). Allowing this act to expire would reduce healthcare access, particularly for rural patients, as it would require them to be in a healthcare facility to use telehealth services, restrict mental and behavioral health services via telehealth, and limit the pool of eligible providers. Conversely, making the act permanent would ensure sustained access to care while providing fair reimbursement for providers.

Social determinants of health (SDOH) significantly influence the implementation and impact of the Telehealth Modernization Act. Key determinants include access to technology, economic stability, and healthcare accessibility. Individuals lacking reliable internet access or digital literacy may face significant barriers to telehealth services, particularly in rural and low-income areas (Health Equity in Telehealth, 2024). Additionally, those with limited financial resources may struggle to afford essential telehealth technology, such as smartphones or computers. Healthcare accessibility is another crucial factor, as telehealth cannot entirely substitute in-person care for certain conditions, potentially affecting those with complex or chronic health needs.

Evidence-based practice supports the Telehealth Modernization Act, with studies consistently demonstrating that telehealth enhances healthcare access, especially for rural and underserved populations. Research links telehealth to improved patient satisfaction, convenience, and care quality, particularly in routine follow-ups, mental health services, and chronic disease management (O’Reilly, 2024). Moreover, telehealth has shown potential cost savings by reducing travel expenses and minimizing emergency room visits. However, evidence also emphasizes addressing the digital divide to ensure equitable access across all populations. Therefore, while the Telehealth Modernization Act is well-supported, policymakers must ensure its implementation does not exacerbate health disparities. Efforts to enhance digital literacy, expand broadband access, and provide affordable technology are essential to realizing the act’s full potential.

Reference:

Health equity in Telehealth
. telehealth.hhs.gov. (2024, August). https://telehealth.hhs.gov/providers/health-equity-in-telehealth

Noel, A. (2024, September 13).
The evolution of the telehealth modernization act: Expanding access to virtual care
. CTeL.org. https://www.ctel.org/breakingnews/telehealth-access-is-at-risk-how-did-we-get-here

O’Reilly, K. B. (2024, April 5).
7 ways telehealth is reshaping medicine for the better
. American Medical Association. https://www.ama-assn.org/practice-management/digital/7-ways-telehealth-reshaping-medicine-better

Description of the Policy

The Better Mental Health Care for Americans Act was introduced to the US Congress by Senators of Colorado, Michael Bennet and Senator Ron Wyden to help Americans with Medicare, Medicaid, Medicare Advantage and Medicare Part D to have access to mental and behavioral healthcare services. The policy aims to address barriers to healthcare access to mental and behavioral health by ensuring there is a full integration of mental health services by expanding access, improving the outcome and reducing the cost of care (Bennet, 2023). More specifically, this proposed health policy provides that there should be parity for the behavior and mental health services in Medicare and Medicaid. The policy would ensure that the plans in Medicare Advantage will maintain accurate directories of the providers that are updated to ensure beneficiaries understand who is in the in-network. Encourages the integration of behavioral and mental health with physical care by increasing the Medicare and Medicaid reimbursement rates (AHA, 2023). Besides, it requires the CMS to establish and implement plans that align with the system of payment, access and quality and enhance prevention services of behavioral and mental healthcare. The bill has been read twice and has been forwarded to the Senate Committee of Finance for consideration.

Problem being Addressed

The issue being addressed by this health policy is the massive mental and behavioral healthcare crisis in the US. According to McGinty (2023), despite the high prevalence of mental and behavioral health issues in the US, many people continue to struggle to get affordable and effective health care. According to Senator Michael Bennet, the US needs to act urgently by improving access to mental and behavioral healthcare. Senator Wayden asserted that mental and behavioral healthcare in the US should be made affordable, accessible and reliable. According to NIMH. (2024), nearly 1 out of 5 adults in the US suffer mental and behavioral health challenges, while 1 in 4 older people have reported having issues of depression and anxiety. Despite around ¼ of beneficiaries of Medicare having mental and behavioral challenges, it is only less than 50% get the treatment. Therefore, the problem the bill seeks to address is the wide gap existing in access to mental and behavioral healthcare services in the US, particularly to vulnerable people such as minority races and low-income people.

Social Determinants Affecting this Policy

The main social determinant affecting this policy is the socio-economic status of the people. In this case, individuals from low-income backgrounds, are highly likely to experience mental and behavioral health challenges, and more likely to be exposed to barriers to assessments of mental health. For instance, the high cost, limited health insurance coverage and lack of affordable treatment options make it hard for low-income individuals to access mental healthcare (Whitman et al., 2022). Rural areas and communities that are underserved such as the ethnic minority communities, usually have limited access to professionals in mental and behavioral health. Finally, in low-income communities, negative attitudes and discrimination lead to stigma, which often discourages individuals from seeking mental and behavioral healthcare services.

The Evidence-Based to support the Proposed Policy

There is evidence that supports the proposed policy. There are studies showing that by enhancing access to mental and behavioral healthcare, particularly among the vulnerable population, health outcomes will be improved and the cost of healthcare will reduce. For instance, Winkelman & Chang (2018), conducted a study that examined the relationship between Medicaid expansion and improvement of mental healthcare in low-income families. This study established that the expansion of Medicaid in terms of access and affordability to low-income families led to significant improvements in mental health outcomes. In another evidence-based study by Breslau et al. (2020) examined the impact of expanding insurance on mental health and behavioral services. Accumulation evidence on the effect of Medicaid expansion on mental health and behavioral care, it was established that the expansion improves healthcare utilization in mental care. Therefore, the policy has been supported by different evidence on the need to make mental and behavioral healthcare affordable and accessible.

References

AHA. (2023, November 6).
AHA comments on the better mental health care, lower-cost drugs, and extenders act | AHA
. American Hospital Association. Retrieved October 9, 2024, from
https://www.aha.org/lettercomment/2023-11-06-aha-comments-better-mental-health-care-lower-cost-drugs-and-extenders-act
Links to an external site.

Bennet, M. (2023, March 22).
Bennet, Wyden introduce bill to increase access to mental and behavioral health care for kids, seniors, and low-income Americans
. Michael Bennet. Retrieved October 9, 2024, from
https://www.bennet.senate.gov/public/index.cfm/2023/3/bennet-wyden-introduce-bill-to-increase-access-to-mental-and-behavioral-health-care-for-kids-seniors-and-low-income-americans
Links to an external site.

Breslau, J., Han, B., Lai, J., & Yu, H. (2020). Impact of the Affordable Care Act Medicaid expansion on utilization of mental health care.
Medical Care
,
58
(9), 757-762.
https://doi.org/10.1097/mlr.0000000000001373
Links to an external site.

McGinty, B. (2023, March 2).
Medicare’s mental health coverage: What’s included, what’s changed, and what gaps remain
. Commonwealth Fund. Retrieved October 9, 2024, from
https://www.commonwealthfund.org/publications/explainer/2023/mar/medicare-mental-health-coverage-included-changed-gaps-remain
Links to an external site.

NIMH. (2024, September).
Mental illness
. National Institute of Mental Health (NIMH). Retrieved October 9, 2024, from
https://www.nimh.nih.gov/health/statistics/mental-illness
Links to an external site.

Whitman, A., De Lew, N., Chappel, A., Aysola, V., Zuckerman, R., & Sommers, B. D. (2022). Addressing social determinants of health: Examples of successful evidence-based strategies and current federal efforts.
Off Heal Policy
,
1
, 1-30.

Winkelman, T. N., & Chang, V. W. (2018). Medicaid expansion, mental health, and access to care among childless adults with and without chronic conditions.
Journal of General Internal Medicine
,
33
(3), 376-383.
https://doi.org/10.1007/s11606-017-4217-5
Links to an external site.

Expand discussion thread from Eric M Arutyunyan

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Julia N Taylor

Oct 10, 2024 7:19am
| Last reply Oct 13, 2024 5:01pm

Reply from Julia N Taylor

MENTAL HEALTH CARE IS HEALTHCARE; Congressional Record Vol. 170, No. 86

Mental health includes several things, such as emotional, psychological, and social well-being. It affects how we think, feel, and act; you may not even realize it. It helps determine how we handle stress and everyday life decisions. Mental health is important at every stage of life, from the beginning to the end. Mental health plays a huge role in a person’s physical and well-being. For example, depression and anxiety can increase the risk for many types of physical health problems, such as hypertension, kidney disease, etc. Chronic conditions can increase the risk of mental illness.

Social determinants of mental health consider conditions to which people are exposed across the life course to death. These structural conditions include income, socioeconomic status, education, food security, housing, social support, and discrimination. They can also include the social and physical conditions in which people live and the ability to access affordable health care. However, psychiatric rehabilitation has been better defined, and its starting assumptions and paradigms have been refined and consolidated by evidence-based research (NCBI).

There are many evidence-based resources related to Mental Health and Mental Disorders. The Community Preventive Services Task Force (CPSTF) recommends mental health benefits legislation to improve financial protection and increase the appropriate use of mental health services for people with mental health conditions (healthy people). There are many people today who refuse to seek mental health for many reasons, such as religion, culture, or simply being unable to afford it. Mental health disorders are proliferating, especially after the covid 19 pandemic. In 2021-2022, 23% of adults experienced a mental illness in the past year, equivalent to nearly 60 million Americans (MHA).

References

https://health.gov/healthypeople/objectives-and-data/browse-objectives/mental-health-and-mental-disorders/evidence-based-resources

https://www.mhanational.org/issues/state-mental-health-america
Links to an external site.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435578/

H.R.485 – Protecting Health Care for All Patients Act of 2023, is a bill sponsored by Representative McMorris Rogers. It was introduced on 24th January 2023. This bill deals with how federal health care programs like Medicaid and health insurance for government employees make decisions about costs and who gets covered for medical treatments.It seeks to prohibit the use of quality adjusted life years (QALYs) by federal health programs when it comes to pricing of services and thresholds for coverage, reimbursements, or incentive programs. The use of QALY is considered discount the value of life on the basis of disability, age, or an existing terminal illness. Apart from that, the bill also seeks to ensure that the Government Accountability Office generates annual reports on how the use of QALYs has a negative impact on individuals who have intellectual and developmental disabilities. Additionally, the bill also reduces funding for the Prevention and Public Health Fund for FY2024-FY2029. The current status of the bill is it has passed House and is currently in the Senate.

This proposed bill mainly affects quality and access to healthcare as a social determinant of health. As previously explained,the use of QALYS is considered to be limiting as it may devalue the need for care for certain patient populations. This bill seeks to ensure that decisions.made in relation to health are access are not biased against patient populations on the basis of age or existing conditions.

Evidence to support this policy exists. According to Sawhney et al. (2023), no one, including the federal government’s berent should make healthcare decisions based on QALYS. This is explained from a mathematical perspective and not from am economist’s perspective. It is explained that as unitary measure should be consistent, linear, symmetrical, and should align with societal values. QALYs lack these properties, thus undervalues the positive effects of therapeutics on people with disabilities.

References

H.R.485 – 118th Congress (2023-2024): Protecting Health Care for All Patients Act of 2023. (2024, February 8). https://www.congress.gov/bill/118th-congress/house-bill/485

Sawhney, T. G., Dobes, A., & O’Charoen, S. (2023). QALYs: The Math Doesn’t Work. Journal of health economics and outcomes research, 10(2), 10–13.
https://doi.org/10.36469/001c.83387
Links to an external site.

Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666)

A description for Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666)

The Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) aims to enhance mental health services and improve responses to mental health crises in the United States (U.S. Congress, 2022). This legislation proposes to establish comprehensive frameworks for crisis response, emphasizing the role of mobile crisis teams and fostering collaboration among various stakeholders, such as law enforcement, healthcare providers, and community organizations. The act also seeks to strengthen the National Suicide Prevention Lifeline, ensuring that individuals in crisis receive effective and timely support (U.S. Congress, 2022). In other words, it focuses on increasing access to services for low-income populations, including veterans, children, and those with apparent disorders (U.S. Congress, 2022). This approach reflects a growing recognition of the importance of mental health care and aims to address systemic gaps in services (U.S. Congress, 2022).

A Brief background for the issue Being Addressed.

The Restoring Hope for Mental Health and Well-Being Act of 2022 addresses the pressing issues surrounding mental health and substance use disorders, which have increasingly escalated in recent years, particularly due to the COVID-19 pandemic (American Psychological Association, 2020). The U.S. has seen a significant rise in mental health crises, with reports revealing increased depression, anxiety, and substance abuse across all demographics (American Psychological Association, 2020). The Centers for Disease Control and Prevention (CDC) noted a surge in mental health-related emergency room visits during the pandemic, highlighting the urgent need for improved crisis response systems (U.S. Congress, 2022). Additionally, the National Institute of Mental Health (NIMH) emphasizes that millions of Americans lack access to adequate mental health services, resulting in many individuals facing barriers to care (U.S. Congress, 2022). The legislation aims to create a more integrated approach to mental health care, emphasizing the need for effective crisis intervention and the expansion of services to vulnerable populations.

Which Social Determinant Most Affects this Policy

The social determinant most affecting the Restoring Hope for Mental Health and Well-Being Act of 2022 is access to healthcare services. This policy specifically targets gaps in mental health and substance use disorder treatment, which disproportionately impact individuals who face barriers to healthcare, such as those in rural or underserved communities. Many individuals in these areas lack access to timely, affordable mental health services, often leading to crises that overwhelm emergency rooms and law enforcement (U.S. Congress, 2022). The act aims to improve crisis response systems and expand access to specialized care, ensuring that vulnerable populations receive the appropriate treatment they need in a timely manner (U.S. Congress, 2022). By addressing these disparities, the policy seeks to reduce the burden on emergency services and provide better long-term mental health care for individuals from all backgrounds (U.S. Congress, 2022).

Evidence Base to Support the Policy

Yes, there is a strong evidence base supporting the Restoring Hope for Mental Health and Well-Being Act of 2022. Mental health crises in the U.S. have reached extreme levels, with outstanding data underscoring the need for enhanced crisis intervention systems (U.S. Congress, 2022). For example, the National Institute of Mental Health (NIMH) reports that suicide is a leading cause of death in the U.S., particularly among youth and veterans, and that timely intervention can significantly reduce suicide rates (U.S. Congress, 2022). Similarly, studies show that mobile crisis response teams are effective in reducing the reliance on law enforcement in providing more appropriate care, mental health emergencies, and lowering the risk of adverse outcomes (U.S. Congress, 2022). Further evidence supports the efficacy of community based mental health initiatives. Research published by the Substance Abuse and Mental Health Services Administration (SAMHSA) highlights that programs merging mental health care with emergency services like those proposed in this act improve long-term health and reduce hospitalizations outcomes for people experiencing mental health crises. Additionally, the expansion of the 988 National Suicide Prevention Lifeline, proposed in this act, is backed by research showing that crisis hotlines are an effective tool for immediate decrease and connecting individuals to long-term care (Substance Abuse and Mental Health Services Administration, 2020). Overall, this evidence demonstrates the effectiveness of coordinated mental health interventions and supports the necessity of the proposed policy reforms to improve crisis care and reduce mental health-related fatalities (Substance Abuse and Mental Health Services Administration, 2020).

Reference

American Psychological Association. (2020).
Stress in America™ 2020: A national mental health crisis
.
https://www.apa.org/news/press/releases/stress/2020/report
Links to an external site.

Substance Abuse and Mental Health Services Administration. (2020).
2020 National Survey on Drug Use and Health
. https://www.samhsa.gov/data/report/2020-nsduh-annual-national-report

U.S. Congress. (2022).
Restoring Hope for Mental Health and Well-Being Act of 2022
(H.R.7666, 117th Congress).
https://www.congress.gov/bill/117th-congress/house-bill/7666/text
Links to an external site.

Reply from

Health Policy

The bill H.R. 3811 – 118
th
Congress (2023-2024), known as the Veterans Mental and Behavioral Health Quality Act, was introduced in the House of Representatives on June 5, 2023. The Veterans Mental and Behavioral Health Quality Act “requires the Department of Veterans Affairs (VA) to use an independent and objective outside organization to study the difference in the quality of care between behavioral and mental health care provided by VA providers and care provided by non-VA providers” (U.S. Senate, n.d.). It was referred to the House Committee on Veterans Affairs on that same date and then referred to the Subcommittee on Health a month later on July 5, 2023. The social determinant that most affects this bill is economic status. Healthcare is expensive, and while the VA offers healthcare to its veterans at a more affordable rate, the quality and access to VA healthcare have been challenged. Therefore, patients may need a service and choose to wait for the VA because they are financially unable to go to the private sector, and their condition worsens due to the delay. Data to study the problems will lead to potential solutions that could save more people.

Background for the Problem

The mental health crisis in America is not unique to civilians. A history of military service increases an American’s risk for mental health issues, such as suicide and post-traumatic stress disorder. “Only about half of all veterans who need mental health care ever receive it, according to RAND research (Navigating Mental Health, n.d.). The Veterans Health Administration is “the largest integrated health care system in the United States, providing care at 1,380 health care facilities, including 170 VA Medical Centers and 1,193 outpatient sites of care of varying complexity (VHA outpatient clinics) to over 9.1 million Veterans enrolled in the VA health care program” (Veterans Health Administration, 2024). However, there is some criticism that the VHA does not offer its veterans high-quality care. “High-quality health care is defined as care that is safe, patient-centered, effective, equitable, timely, and efficient” (Navigating Mental Health, n.d.). “Over and over, the hospitals and clinics in the VA’s sprawling health care network have fallen short when it comes to treating people with mental illness. That conclusion emerges from a ProPublica review of all the reports published by the VA’s inspector general since 2020. That includes 162 regular surveys of facilities and 151 investigations that were triggered by a complaint or call to the office on a wide variety of alleged health care problems. (McGrory & Bedi, 2024). Feedback from veterans, such as “Changes that OEF/OIF/OND [Operation Enduring Freedom, Operation Iraqi Freedom/Operation New Dawn] veterans would like to see at the VA include making the process for scheduling appointments easier, better quality services and customer service, and more available services or facilities” (National Academies, 2018). The request from these individuals for better quality services may be due to “… shortages in the mental health workforce can make it difficult for veterans to schedule a timely appointment. Some providers aren’t as extensively trained as they could be in evidence-based practices, which means fewer veterans are likely to receive the highest-quality care in the private sector (Navigating Mental Health, n.d.).

Evidence to Support the Policy

I support the Veterans and Mental Behavioral Quality Act because objective evidence that the VHA provides its patients with high-quality health care, just like or better than the private sector, will be valuable. The public evidence will reach more veterans and motivate those with mental health issues to seek help. The studies that do exist are encouraging. For example, “… the DoD and VA have taken dramatic steps over the past decade to address barriers to care. For instance, the VA has hired more mental health providers and has established outreach programs to help veterans overcome logistical issues (Navigating Mental Health, n.d.). This could have contributed to the fact that:

… VA hospitals outperformed non-VA hospitals in two major independent, nationwide reviews for patient satisfaction and care quality:

Patient Satisfaction Survey: VA outperformed non-VA hospitals in the most recent Centers for Medicare & Medicaid Services Hospital Consumer Assessment of Healthcare Providers and Systems star ratings, with 79% of VA facilities receiving a summary star rating of 4 or 5 stars compared to 40% of non-VA hospitals. This represents the ninth consecutive quarter in which VA facilities have outperformed non-VA counterparts.

Hospital Quality Ratings: In this year’s CMS Overall Hospital Quality Star Ratings, more than 58% of VA hospitals included received 4- or 5-star ratings compared to 40% of non-VA hospitals. This is only the second year VA hospitals have been included in this review, and VA has outperformed non-VA health care in both years (VA health care, 2024).

Two other claims suggest that VHA is already providing high-quality care. “
Psychiatric Services
, a peer-reviewed journal of the American Psychiatric Association, has published a report showing that the quality of mental health care provided by VA is superior to that provided to a comparable population in the private sector … These findings were based on review of more than 836,500 Veterans and more than 545,400 patients seeking mental health care in the private sector (VA mental health, 2016). The other study showed that “… the available data indicate overall comparable health care quality in VA facilities compared to non-VA facilities with regard to safety and effectiveness. Rates of complications and availability of services had the least favorable results, but these results were mixed rather than consistently poor” (O’Hanlon et al., 2017).

Conclusion

“Many nurses are embracing the whole range of options available in the various parts of the policy process” (Short, 2019, p. 19). Professional associations have laid the foundation for this work by possessing organized ways to participate in public policy. To become involved in political action, like further support for H.R. 3811, nurses who belong to the American Nurses Association may sign up for notifications about latest updates and advocacy campaigns, join the Political Advocacy Committee, donate, or participate in a research study. Two ways to advocate for these opportunities are to lead by example and ensure others are given the time to join if they want. Mental and veteran health have come a long way, but there is still plenty of room for improvement. Nurses can contribute strategies to identify the barriers and develop tangible solutions to make Americans, including our veterans, healthier.

References

McGrory, K. & Bedi, N. (2024 January 9). How the VA Fails Veterans on Mental Health.
ProPublica
. https://www.propublica.org/article/how-veterans-affairs-fails-mental-health-patients

National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Care Services; Committee to Evaluate the Department of Veterans Affairs Mental Health Services.
Evaluation of the Department of Veterans Affairs Mental Health Services
. Washington (DC): National Academies Press (US); 2018 Jan 31. 16, Findings, Conclusions, and Recommendations. https://www.ncbi.nlm.nih.gov/books/NBK499500/

Navigating Mental Health Care for Veterans. (n.d.).
RAND
. https://www.rand.org/health-care/projects/navigating-mental-health-care-for-veterans

O’Hanlon, C., Huang, C., Sloss, E. Price, R.A., Hussey, P., Farmer, C. &Gigdenfil, G. Comparing VA and non-VA quality of care: A systematic review.
Journal of General Internal Medicine
, 2017 Jan, 32(1): 105-121. 10.1007/s11606-016-3775-2.

Short, N. M. (2022).
Milstead’s Health Policy & Politics
. (7th

ed.). Jones & Bartlett Learning.

VA mental health care found superior to care in the private sector. (2016 April 15).
VA News
. VA mental health care found superior to care in the private sector – VA News.

VA health care outperforms non-VA care in two independent, nationwide quality and patient satisfaction reviews. (2024 September 3).
VA News
.

Veterans Health Administration. (2024 September 12). U.S. Department of Veterans Affairs. https://www.va.gov/health/aboutvha.asp https://news.va.gov/press-room/va-health-care-outperforms-non-va-care-in-two-independent-nationwide-quality-and-patient-satisfaction-. reviews/

Veterans Mental and Behavioral Health Quality Act, H.R. 3811, 118th Cong., 1st Sess., (2023). U.S. Senate. (n.d.).

Expand discussion thread from John Dulko

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Lorrissa Lingen

Oct 9, 2024 9:37pm
| Last reply Oct 12, 2024 10:03pm

Reply from Lorrissa Lingen

Right to IVF

Everyone should have the right to access fertility treatments, such as vitro fertilization, and make personal decisions about their reproductive state, such as embryos, without any restrictions or interference. Health care providers and insurers are empowered to offer and cover these services, ensuring that individuals receive the support they need. Also, manufacturers of necessary drugs or devices can provide these essential products. This bill ensures that fertility treatments are covered under Medicare and Medicaid, as well as for members of the uniformed services and veterans. It also mandates that private insurers who cover obstetrical services must include fertility treatments in their coverage (
S.4445 – right to IVF act 118th Congress (2023-2024)
).

Sexual and reproductive health rights are key to achieving sustainable development goals, as they support gender equality, health, and well-being. Article 16 of the Human Rights Declaration states that everyone has the right to marry and start a family, highlighting infertility as a human rights issue. Because of this access to infertility treatments like IVF should be considered a fundamental right.

Infertility is complex and unlike other medical conditions, as treatments like IVF are costly, time-consuming, and have uncertain success rates. This unpredictable and expense can cause significant psychological stress, and the emotional impact of failed treatments can be particularly hard on women. Studies show there can be long term mental impact for women who struggle with infertility (Bagade et al., 2023).

Health inequality is present in a lot of medical specialties, including infertility prevention and treatment. When looking at the cost of treatment, access to care, and differences in success rates, it’s clear that social determinants of health significantly impact individuals struggling with infertility. It’s important to consider how financial, educational, racial, and social differences influence access to and outcomes of fertility treatments in the United States (Byers, 2020).

References

Bagade, T., Mersha, A. G., & Majeed, T. (2023, December 13).
The social determinants of

mental health disorders among women with infertility: A systematic review
. BMC women’s health.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10720205/#:~:text=On%20the%20contrary,%20higher%20education%20of%20partners,%20social%20stigma,%20older
Links to an external site.

Byers, A. V. (2020, November 25).
Women’s Health Education Program Scholars
. College of

Medicine.
https://drexel.edu/medicine/academics/womens-health-and-
Links to an external site.
leadership/womens-health-education-program/whep-scholars/

S.4445 – right to IVF act 118th Congress (2023-2024)
. S.4445 – Right to IVF Act. (n.d.).

https://www.congress.gov/bill/118th-congress/senate-bill/4445

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Lailat Andu

Oct 9, 2024 9:30pm
| Last reply Oct 11, 2024 9:47pm

Reply from Lailat Andu

Telehealth

Telehealth may be described as the delivery of healthcare services through digital communication technologies, allowing patients and providers to interact remotely. It has gained significant traction due to its convenience and the ability to reduce healthcare costs while maintaining quality care (Bashshur et al., 2016). The issue that was being addressed with Telehealth is the expansion of healthcare service. Telehealth Services Expansion Act was enacted in March 2021, which provided temporary measures to expand telehealth during the COVID-19 pandemic. The proposed policy seeks to make many of these measures permanent (U.S. Department of Health and Human Services, 2021). Telehealth simply aims to expand access to healthcare services by using video conferencing, mobile health apps, and remote patient monitoring for healthcare delivery, especially for patients in rural or underserved areas. The need for telehealth has become increasingly apparent after the COVID pandemic due to various challenges in the traditional healthcare system. Geographical barriers, high healthcare costs, transportation and provider shortages often limit access to essential health services. The COVID-19 pandemic highlighted the necessity for remote care solutions, as many patients were reluctant or unable to visit healthcare facilities in person. The sudden shift towards telehealth prompted policymakers to develop frameworks that ensure equitable access, reimbursement for services, and the maintenance of care quality, addressing both immediate healthcare needs and long-term system improvements. I believe telehealth simply represents a significant advancement in the healthcare system, aiming to bridge gaps in access and enhance the delivery of care to diverse populations.

The social determinant most affected by the policy of telehealth expansion is access to healthcare. By improving telehealth services, the policy aims to enhance access for patients, particularly in underserved and rural communities, where traditional healthcare facilities may be limited. This expansion can reduce barriers such as transportation issues, geographical isolation, and the availability of healthcare providers, ultimately leading to better health outcomes and equity in healthcare access. Other social determinants, such as socioeconomic status and education, may also see positive impacts as telehealth can provide more affordable and convenient healthcare options. I believe access remains the most direct and significant factor influenced by telehealth initiatives.

There are multiple evidence supporting that telehealth policy improves access to care, patient satisfaction, and health outcomes. Multiple studies have shown that telehealth significantly improves access to care for patients in rural and underserved areas. For instance, a study by Kruse et al. (2017) found that telehealth interventions increased access to specialists, particularly for patients in remote locations, reducing travel time and costs. It has been proven to be effective in managing chronic diseases such as diabetes and hypertension. A systematic review by Pinnock et al. (2017) indicated that telemonitoring and remote consultations led to better clinical outcomes, including improved blood glucose levels and blood pressure control, compared to traditional in-person visits. Another study by Reay et al. (2020) reported that patients appreciated the convenience, time savings, and comfort of receiving care from home. The study highlighted that over 90% of participants expressed satisfaction with their telehealth experiences. Bakhshaie et al. (2018) indicates that telehealth consultations for mental health services not only improved patient access but also reduced overall healthcare expenditures by decreasing emergency room visits and hospitalizations. NURS-6050 Week 7: Discussion Evidence Base in Design

References

American Telemedicine Association. (2021). Telehealth: A resource for health care providers. https://www.americantelemed.org/

Bakhshaie, J., et al. (2018). Economic evaluation of telehealth for mental health. Telemedicine and e-Health, 24(10), 780-788.

Bashshur, R. L., Shannon, G. W., Smith, B. R., & Schrop, S. (2020). The Empirical Foundations of Telemedicine Interventions in Primary Care. Telemedicine and e-Health, 26(6), 509-525. https://doi.org/10.1089/tmj.2019.0155

Caffery, L. J., Farago, G., & J. C. (2020). Telehealth in Rural and Remote Australia: A Review of the Evidence. International Journal of Environmental Research and Public Health, 17(12), 4587. https://doi.org/10.3390/ijerph17124587

Kruse, C. S., et al. (2017). Telehealth and patient satisfaction: A systematic review. Journal of Telemedicine and Telecare, 23(9), 874-885.

Luxton, D. D., et al. (2016). Telepsychology: A new approach to therapy. Professional Psychology: Research and Practice, 47(1), 14-20.

Pinnock, H., et al. (2017). Integrated self-management support for chronic obstructive pulmonary disease: A systematic review. Health Services Research, 52(2), 645-664.

Reay, T., et al. (2020). The impact of telehealth on patient experience: A systematic review. BMC Health Services Research, 20(1), 87.

Short, N. M. (2022). Milstead’s health policy and politics: A nurse’s guide (7th ed.). Jones & Bartlett Learning

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Brandon Grundy

Oct 9, 2024 9:04pm
| Last reply Oct 12, 2024 10:33pm

Reply from Brandon Grundy

Main Post

Protecting Health Care for All Patients Act of 2023 (H.R.485)

Representative Cathy McMorris Rodgers introduced the Protecting Health Care for All Patients Act (H.R.485) in 2023 to prohibit
the use of
Quality-Adjusted Life Years (QALYs) and similar measures in federal healthcare programs for coverage and payment options. QALYs analyze and determine the value of medical interventions
in relation to
the potential quality and quantity of life they offer. However, opponents argue that using QALYs can lead to the devaluation of
lives
of vulnerable groups, such as the elderly, disabled, or the terminally ill, as it may prioritize younger or healthier individuals in healthcare decisions (Congress.gov, 2023).

Background

As the opening synopsis states, H.R.485 endeavors to address equity issues in healthcare
availability
, particularly concerning how medical “value” is determined for disadvantaged populations. Currently, QALYs are employed in healthcare economics to assign treatments based on cost-effectiveness, often weighing treatments by their potential to increase both the quality and duration of life. This methodology is problematic as disparities in treatment access are often the result, especially for individuals whose lives may not meet these metrics of “quality” improvement, such as those living with disabilities or chronic illness (National Council on Disability, 2019; Ubel & Jagsi, 2020). H.R.485 is meant to level the playing field by eliminating systemic bias in healthcare decis
ions. In theory, with the passing of H.R.485, all lives, regardless of health status or age, are valued equally.

Social Determinant Impact

“Health Equity” is the social determinant of health most impacted by this policy. H.R.485 aims at ensuring that vulnerable populations (the elderly, disabled, and terminally ill) are not forced to submit to discriminatory healthcare
policies. Removing QALYs from federal healthcare decisions promotes fairer access to necessary treatments and reduces the disparities caused by economic-based healthcare rationing
(Patient-Centered Outcomes Research Institute [PCORI], 2020)
.

Evidence Base and Support

There is considerable support for the ethical arguments behind this bill, though the evidence base for
completely
eliminating QALYs is mixed.
Advocacy organizations, such as the National Council on Disability,
argue that QALYs undervalue the lives of individuals with disabilities, leading to inequitable access to life-saving treatments (National Council on Disability, 2019). PCORI has supported patient-centered research that challenges the equality of QALY-based decisions. PCORI has advocated for alternative measures that do not diminish the value of vulnerable/marginalized individuals (PC
ORI, 2020).
On the other hand, proponents of QALYs argue that they help prioritize healthcare resources efficiently in ways that improve overall population health (Ubel & Jagsi, 2020).

Conclusion

While the Protecting Health Care for All Patients Act of 2023 has an ethically solid foundation, the debate over whether or not eliminating QALYs will enhance equity without compromising resource allocation continues. Further research is needed to determine the long-term impact of such reforms.

References

Congress.gov. (2023).
H.R.485 – Protecting Health Care for All Patients Act of 2023
.
Library of Congress. https://www.congress.gov/bill/118th-congress/house-bill/485

National Council on Disability. (2019).
Quality-adjusted life years and the devaluation of life with a disability
.
https://ncd.gov/publications/2019/ncd-letter-pcori

Patient-Centered Outcomes Research Institute (PCORI). (2020).
Patient-Centered Outcomes Research: Evaluating the role of QALYs
. https://www.pcori.org/research-results/2020

Ubel, P. A., & Jagsi, R. (2020).
Can QALYs be used to decide which patients to treat? Ethical challenges in using quality-adjusted life years in healthcare allocation
.
Journal of Medical Ethics
, 46(7), 447-452. https://doi.org/10.1136/medethics-2019-105836

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Stephania A Senter

Oct 9, 2024 8:45pm
| Last reply Oct 12, 2024 10:19pm

Reply from Stephania A Senter

Ohio Administrative Code 4723-4: Standards of Practice Relative to Registered Nurse or Licensed Practical Nurse

Description of the Policy
:

Ohio Administrative Code (OAC) 4723-4 outlines the
scope of practice
for Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) in Ohio. This policy defines the standards of safe and effective nursing care, establishes the procedures nurses can perform, and sets boundaries to ensure that tasks are aligned with the nurse’s education and competency. It also emphasizes patient assessment, care planning, implementation of treatments, and the evaluation of care outcomes.

Background of the Problem or Issue Being Addressed

The primary issue addressed by OAC 4723-4 is patient safety and quality of care. The regulation aims to prevent nurses from engaging in tasks that exceed their training or experience, which could lead to unsafe or ineffective care. By imposing a clear scope of practice, the policy seeks to standardize nursing procedures across the state and ensure that nurses are practicing within their legal and professional limits. This also mitigates risks associated with miscommunication or misinterpretation of professional roles in healthcare settings, reducing the potential for medical errors.

Social Determinants Affecting This Policy

The social determinant of health that most affects this policy is access to education and training. Nurses must meet specific educational requirements to practice safely and competently. In rural or underserved areas, where access to higher education might be limited, nurses may face barriers in acquiring the advanced training needed to meet the demands of increasingly complex healthcare systems.

Evidence Base Supporting the Policy

There is a strong evidence base supporting the structure and limits outlined in OAC 4723-4, particularly in relation to ensuring patient safety. Research consistently shows that clearly defined scopes of practice help reduce errors and improve patient care outcomes. A study published in
Health Affairs
found that when nurses are allowed to practice within well-defined scopes and in collaboration with physicians, patient outcomes improve, and the risk of errors decreases (Aiken et al., 2020). This underscores the importance of a regulated practice framework like OAC 4723-4.

Conclusion

Ohio Administrative Code 4723-4 is an evidence-based policy designed to standardize and regulate nursing practice to ensure safe, high-quality care. The policy addresses issues related to the scope of practice, particularly the need for competency-based nursing procedures. Education and training are key social determinants affecting this policy, and there is strong evidence supporting the structured framework it provides for nursing practice in Ohio.

American Association of Nurse Practitioners (AANP). (2023). State practice environment for NPs. Retrieved from [AANP website].

Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017).
Position statement: full practice authority for advanced practice registered nurses is necessary to transform primary care.Links to an external site
Links to an external site.
.
Nursing Outlook, 65
(6), 761–765.

Ohio Board of Nursing. (2023). APRN practice and prescriptive authority guidelines. Retrieved from [Ohio Board of Nursing Website].

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Qiana Felder

Oct 9, 2024 8:03pm

Reply from Qiana Felder

Health Policy

The health policy selected is H.R.3305, the Black Maternal Health Momnibus Act. This policy, with its potential to significantly improve the maternal health of vulnerable populations such as racial minority groups, veterans, and incarcerated individuals (Congress, 2024), offers a beacon of hope. The bill will ensure that social determinants of maternal health are addressed to increase access to maternal health by improving programs, funds, and access to healthcare.

Background for the Problem

Regardless of how empowered, informed, or motivated a person may be to change their behavior, they might be unable to do so due to structural factors contributing to health inequities (Crear-Perry, 2021). Social determinants in valuable communities significantly impact maternal health. The first one we will touch base on is healthcare access. Prenatal care is imperative to the care of the mom and baby. Underserved communities have inadequate access to healthcare, preventing them from getting the necessary care needed in order to avoid complications and increasing the risk of maternal morbidity and mortality. Another important social determinant to consider is financial stability. Lower-income women need help obtaining quality healthcare, prenatal services, and adequate nutrition.

Evidence to Support the Policy

The research underscores the urgent need for action, revealing that pregnant individuals from underserved groups often face the highest rates of adverse health outcomes. Black women, in particular, face maternal morbidity and mortality rates that are several times higher than those of other groups (NLM, 2022). The rate of severe maternal morbidity during deliveries was 87% higher for non-Hispanic Black individuals compared to non-Hispanic White individuals in 2019 (NLM, 2022). A policy such as the Black Maternal Health Momnibus Act needs to be taken seriously by Congress to improve the quality of maternal care.

References

Congress. (2023).
H.R.3305 – 118th Congress (2023-2024): Black Maternal Health Momnibus Act
. Congress.gov. https://www.congress.gov/bill/118th-congress/house-bill/3305?s=1&r=4&q=%7B%22search%22%3A%22Black+Maternal+Health+Momnibus+Act%22%7D

Crear-Perry, J., Correa-de-Araujo, R., Lewis Johnson, T., McLemore, M. R., Neilson, E., & Wallace, M. (2021). Social and Structural Determinants of Health Inequities in Maternal Health.
Journal of Women’s Health
,
30
(2). https://doi.org/10.1089/jwh.2020.8882

National Library of Medicine. (2022). MATERNAL HEALTH. In
www.ncbi.nlm.nih.gov
. Agency for Healthcare Research and Quality (US). https://www.ncbi.nlm.nih.gov/books/NBK587184/

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Tracy M Chaves

Oct 9, 2024 7:31pm
| Last reply Oct 11, 2024 9:12pm

Reply from Tracy M Chaves

On March 22, 2023 Mr Bennet introduced to Senate the bill S.923 – 118th Congress also known as the Better Mental Health Care for Americans Act (2023). This Act is attempting to modify the payment rates for behavioral health services under Medicare and Medicare Advantage Programs. It also would change restrictions on medications prescribed for behavioral health diagnosis. In short, this bill would require Medicare and Medicare Advantage programs to pay no less for behavioral health treatment as it would for other medical treatments. This bill is making sure that behavioral health services can be integrated into other areas of health services such as primary care practice, preventative screens, and telehealth treatment.

Why is this important? Historically behavioral health providers have reported lower payment rates than those of physical health providers (Office of Attorney, 2020). Due to this, there has been an increase in behavioral health providers not accepting insurances.

The social determinant of health that would most be affected by this policy would be economic stability. If providers of behavioral health are not taking insurances due to low reimbursement rates that means patients have to pay out of pocket for much needed services. If patients cannot afford the services they are going untreated.

In 2020 the state of Massachusetts was able to work with several private insurances and come to an agreement to improve behavioral health services coverage (Office of Attorney, 2020). Part of this agreement was to have same if not higher provider reimbursement rates, but also just as important, reducing the need for prior authorizations for behavior health services to match the requirements for physical health services. This agreement has been success for the state of Massachusetts through changes with private insurances so I believe if Congress could implement a bill like this one it would improve behavioral health service coverage across the country.

References

Better Mental Health Care for Americans Act, S. 923, 118 Cong. (2023).

Office of Attorney General Maura Healey. (2020). AG Healey announces groundbreaking agreements that expand access to behavioral health services for more than one million residents.
Mass.gov
. https://www.mass.gov/news/ag-healey-announces-groundbreaking-agreements-that-expand-access-to-behavioral-health-services-for-more-than-one-million-residents

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Amy Simmons

Oct 9, 2024 6:48pm

Reply from Amy Simmons

Main Post

Health Policy:

S.1120 — 118th Congress (2023-2024)

Health policy S.1120 is intended to broaden the options for eligible product developers in case of delays in obtaining covered products necessary for developing generic drugs or biosimilar biological products (S. 1120 – 118th Congress (2023-2024). Medication costs have emerged as a significant concern in the public, causing an incredible amount of anxiety about the increasing price of medications in the United States. Many patients struggle to access essential treatments due to financial barriers, leading to detrimental health outcomes and increased reliance on the healthcare system. Various factors, including research and development costs, market dynamics, and the role of insurance companies, influence drug pricing.

Background for the Problem

and Social Determinants

Millions of Americans face the stark choice between paying for their medication and meeting basic needs like rent, food, or utilities (Vincent Rajkumar, 2020). This is not a choice anyone should have to make in one of the wealthiest nations in the world. Chronic illnesses such as diabetes, heart disease, and cancer often require ongoing medication. When patients are unable to afford these treatments, they are forced to ration their medications or go without them entirely. The human cost of high drug prices is immeasurable, but the financial cost is equally staggering. Unaffordable medications lead to untreated conditions, preventable hospitalizations, and emergency room visits, all of which strain our healthcare system.

Evidence to Support the Policy

Support for S.1120, the Improved Access to Affordable Medication Act, can be evidenced through several key points. According to Scialli et al., 2021, studies indicate that high medication costs lead to non-adherence, where patients skip doses or avoid medications altogether, resulting in worse health outcomes. An advocacy group, the American Heart Association, has expressed support for policies aimed at lowering drug costs due to non-adherence, resulting in over 100,000 deaths a year that could have been prevented; this aligns with the goals of S.1120. States that have implemented drug pricing transparency and affordability measures have shown positive outcomes in lowering costs and improving patient access. These points collectively support the need for S.1120 and highlight its potential benefits in improving access to affordable medications.

References

American Heart Association. (n.d.).
Facts – a tough pill to swallow: – Medication adherence
… https://www.heart.org/-/media/Files/About- Us/Policy-Research/Fact-Sheets/Access-to-Care/Medication-Adherence-and-CVD-Fact-Sheet.pdf

S.1120 – 118th Congress (2023-2024). Improved access to affordable medication act. (2023, March 30). https://www.congress.gov/bill/118th- congress/senate-bill/1120?q=%7B%22search%22%3A%22S1120%22%7D&s=5&r=1

Scialli, A. R., Saavedra, K., & Fugh-Berman, A. (2021, March 25). The benefits and risks of adherence to medical therapy.
Published in the Journal of Scientific Practice and Integrity
. https://www.jospi.org/article/21386-the-benefits-and-risks-of-adherence-to-medical-therapy

Vincent Rajkumar, S. (2020). The high cost of prescription drugs: Causes and solutions.
Blood Cancer Journal
,
10
(6). https://doi.org/10.1038/s41408-020-0338-x

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Mihret Ghebreamlak

Oct 9, 2024 6:40pm

Reply from Mihret Ghebreamlak

HR 5221 – The Urban Indian Health Confer Act

The Urban Indian Health Confer Act (HR 5221) is a health policy that creates a statutory, permanent conference between the Health and Human Services (HHS) and the Urban Indian Organizations (UIOs). The policy fills the absence of involvement of UIOs in federal healthcare policymaking, which influenced the healthcare inequality among urban Native Americans (U.S. Congress, 2021). While native peoples residing in reservations can easily access IHS services, urban Indians seldom have access to most of these services since most IHS services are targeted at reservation natives.

Problem Background

The issue at the center of information campaigns is that UIOs are left out of federal policymaking, which has dire consequences for urban Native Americans in terms of healthcare availability and service. Some of the difficulties include a lack of culturally sensitive health services, inadequate UIO funding, and a considerably higher prevalence of chronic diseases, mental disorders, and alcohol dependence than in the nonindigenous population and among Native Americans residing on reservations (U.S. Department of Health and Human Services, 2022). These disparities are why the Urban Indian Health Confer Act was passed to legalize the representation of the UIO in federal health policies.

Social Determinant Most Affected

Among social determinants of health, the most relevant to the Urban Indian Health Confer Act is access to healthcare facilities. Many of the urban Native Americans have had their access to unique treatments hindered by geographical distances to tribal-delivered health services that are primarily available in the reservations only. Furthermore, there is unemployment has remained high among Native Americans dwelling in urban areas, limiting their ability to pay for health care services; they experience prejudice or disrespect of their culture within the health care facilities. They lead to a higher prevalence of chronic diseases, including diabetes, cardiovascular issues, mental health disorders, and substance abuse. However, their outcomes worsen because of a lack of culturally competent healthcare services.

Evidence Base Supporting the Policy

There is substantial evidence that supports the need for this policy. Based on available research, it is evident that native Americans in urban areas have poorer health indicators than not only the overall population but also those still residing on reservations. For example, aboriginal people living in urban areas are much more likely to suffer from diabetes, substance dependence, or poor mental health because they have minimal access to healthcare services (Smye et al., 2021). Community-based UIOs that provide culturally appropriate care effectively improve performance but lack adequate resources and are marginalized in decision-making. People’s health is enhanced when UIOs adapt to receive sufficient resources and inclusion (NCUIH, 2024). For instance, examples of effective cross-culturally sensitive diabetes management by organizations such as the UIOs improved patients’ health; this called for policy reforms to include UIOs in federal health planning.

References:

H.R.5221 – 117th Congress (2021-2022): Urban Indian Health Confer Act. (2021). Congress.gov.
https://www.congress.gov/bill/117th-congress/house-bill/5221#citation
Links to an external site.

NCUIH. (2024, July 11). Expanding Maternal Health Services at Urban Indian Organizations. YouTube.

Links to an external site.

Smye, V., Browne, A. J., Josewski, V., Keith, B., & Mussell, W. (2023). Social Suffering: Indigenous Peoples’ Experiences of Accessing Mental Health and Substance Use Services. International Journal of Environmental Research and Public Health, 20(4), 3288.
https://doi.org/10.3390/ijerph20043288
Links to an external site.

U.S. Department of Health and Human Services. (2022, July 20). Testimony from P. Benjamin Smith, Deputy Director, Indian Health Service on H.R. 5221 – Urban Indian Health Confer Act before Senate Committee on Indian Affairs. HHS.gov.
https://www.hhs.gov/about/agencies/asl/testimony/2022/07/20/hr-5221-urban-indian-health-confer-act.html
Links to an external site.

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Nicole Greco Carl

Oct 9, 2024 4:21pm
| Last reply Oct 9, 2024 4:23pm

Reply from Nicole Greco Carl

S.644 – Modernizing Opioid Treatment Access Act

This bill’s goal is to “access to methadone for an individual’s unsupervised use to treat opioid use disorder (OUD)”( CRS, 2023). Currently, the only way to get methadone is to have it “dispensed to individuals in person through opioid treatment programs” (CRS, 2023), by a practitioner who has obtained “registration from the Drug Enforcement Administration (DEA) to prescribe and dispense methadone to treat OUD” (CRS, 2023) The bill proposes to waive this, however, for methadone to be prescribed to individuals “electronic prescribing, establishes prescription limits, and sets out requirements for informed consent” will be required and “telehealth to provide methadone treatment”( CRS, 2023) instead of the current in-person requirement.

What is methadone and what is it used for?

Methadone is a “man-made opioid (also known as an opiate)” (National Health Service, 2021). One of its uses is to assist individuals in stopping their use of heroin, “it reduces your withdrawal symptoms, such as shaking, shivering and other flu-like symptoms” (National Health Service, 2021). Heroin-addicted women can be put on methadone to help the mother “stop taking heroin and having withdrawals… it can also be given to newborn babies in hospital, to help with heroin or methadone withdrawal symptoms” (National Health Service, 2021). Another use for Methadone is “end-of-life care and severe pain” (National Health Service, 2021), management. NURS-6050 Week 7: Discussion Evidence Base in Design

Social determinants

According to the National Library of Medicine, the people with the biggest social determinants are “minoritized groups; people with low income; elderly individuals; people involved in the criminal justice system; pregnant women; lesbian, gay, bisexual, transgender, queer, intersex, asexual and all sexual and gender minority (LGBTQIA+) individuals; and individuals with HIV/AIDS” (Stroud, 2022).

Research dictates “increased access to medications for opioid use disorder (MOUD) has the power to substantially reduce overdose rates” however “ racially minoritized individuals, who are experiencing some of the greatest rises in overdose rates today, have less access to medications for opioid use disorder” (Stroud, 2022). Studies show that “white patients are more likely to be referred to a medical professional and receive medication as part of their treatment plan, and less likely to leave against medical advice or be terminated by the facility than are racially minoritized patients”(Stroud, 2022).

Social barriers to “methadone treatment include stigma, discrimination in health care settings, lack of culturally responsive and respectful care, and the inequalities present in the criminal justice system” (Stroud, 2022).

My Belief

I do believe that the bill has evidence to support it. This will give many individuals the ability to not have to go in person to get their methadone treatment. Also, it will provide practitioners with more flexibility to prescribe and use telehealth. The research shows Methadone Maintenance treatment (MMT), “reduces drug injecting, reduces HIV transmission, significantly reduces the death rate associated with opioid dependence

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Christelle Njieukeng Piemba

Oct 9, 2024 1:54pm
| Last reply Oct 11, 2024 7:46pm

Reply from Christelle Njieukeng Piemba

Health Policy

H.R. 7666 – Restoring Hope for Mental Health and Well-Being Act of 2022

The health policy H.R. 7666 “Restoring Hope for Mental Health and Wellbeing Act of 2022” (H.R. 7666, 2022). It is a bill addressing mental and behavioral health issues by expanding and modifying programs, grants, and activities focused on these areas. Yet, this bill would open more opportunities for help to at-risk youth and adults, people with eating disorders, people affected by homelessness and suffering from mental illness and underage drinking, and maternal mental health and substance use disorders. The bill covers just about anyone who is affected by mental and behavioral health issues.

Background for the Problem

and Social Determinant

that Most Affects H.R. 7666

The social determinants that most affect this policy are income, education, transportation and safe housing. Based on household income, most people will not seek mental and behavioral health help because they fear they are unable to afford it. Education is one of the key social determinants that affect this bill. Geist Hardt and Kloha (2018) state, “Education should begin in K-12 health education but should also be the focus education for adults through broadening the focus of health promotion programs, as well as through public service and social media campaigns” (p. 350). Thus, without the education of how to access resources, people live in silence and suffer. There are many who require mental and behavioral health assistance; however, getting to where the assistance is available may pose a problem due to the lack of transportation services. Regarding those who are homeless, they are more focused on finding shelter day-by-day, instead of their mental and behavioral health needs. These social determinants need to be addressed in the bill for it to be successful. If the awareness of health policies is integrated into institutions, this will allow for the awareness of such policies at an early level helping those needing the services get the help they need (Milstead & Short, 2019).

Evidence based to support the proposed Policy

I believe there is an evidence base to support the proposed policy. The evidence is for a mental and behavioral health bill should be very visible to Americans today. You read about it, you see it in the media, and for most they are living it. Mental and behavioral health have been an issue for decades; however, the availability of social media and the last few years during the pandemic, mental illness has risen to a level never seen before. As reported, “During June 24–30, 2020, U.S. adults reported considerably elevated adverse mental health conditions associated with COVID-19. Younger adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers reported having experienced disproportionately worse mental health outcomes, increased substance use, and elevated suicidal ideation” (Czeisler et al., 2020). Mental illness has exceeded boundaries. All socio-economic classes and statuses have experienced the effects of this problem. Many people are suffering and usually the result of this suffering is death, whether it be suicide or mass shootings. The evidence is all around us.

References

Czeisler, M., Lane, R. I., Petrosky, E., Wiley, J. F., Christensen, A., Njai, R., Weaver, M. D., Robbins, R., Facer-Childs, E. R., Barger, L. K., Czeisler, C. A., Howard, M. E., & Rajaratnam, S. M. (2020). Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020. MMWR. Morbidity and Mortality Weekly Report, 69(32), 1049–1057.
https://doi.org/10.15585/mmwr.mm6932a1
Links to an external site.

H.R.7666 – 117th Congress (2021-2022): Restoring Hope for Mental Health and Well-Being Act of 2022. (2022, June 23).
https://www.congress.gov/bill/117th-congress/house-bill/7666
Links to an external site.

Geist Hardt, C., & Kloha, A. (2018). Gaining Support for Child and Family Policies by Raising Awareness of the Link between Physical and Mental Health and the Impact of Social Determinants on Both. Social Work in Public Health, 33(6), 342–353.
https://doi.org/10.1080/19371918.2018.1482253
Links to an external site.

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide. Jones & Bartlett Learning

Expand discussion thread from Christelle Njieukeng Piemba

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Deco Tanjong

Oct 9, 2024 12:25pm
| Last reply Oct 12, 2024 8:21pm

Reply from Deco Tanjong

Policy consideration for artificial intelligence in healthcare.

Artificial intelligence(AI) in healthcare uses machine learning and natural language processing to analyze medical data and improve patient and healthcare professional experiences( National Institutes of Health). Artificial intelligence has great potential to revolutionize healthcare by developing new cures, improving healthcare delivery, and reducing administrative burdens as well as overall healthcare spending. Edward Markey (2023).

Artificial intelligence will help develop a better standard of care, increase time access to care perhaps most importantly, discover innovative treatments, including monitoring the progress of disease and the effectiveness of those treatments. Edward Markey (2023).

Despite the advantages of Artificial intelligence in healthcare, barriers to artificial intelligence exist, like privacy concerns. In some cases, it might be possible to anonymize the data enough to let the AI machine do its work; however, other areas may be more problematic, such as image-dependent diagnostics like Ultrasounds. And the rising capabilities of cyberattacks.

Lack of empathy and explainability: As a bedside nurse, during an interaction with a patient, the healthcare professional shows empathy, and the level or means of explanation is based on the patient’s behavior or understanding, which helps build trust among the patient and the healthcare provider. Artificial intelligence has no empathy and is explained as programmed, which will create mistrust. Thus hindering patient care and putting patients at risk.

Lastly, Big technology companies Edward Markey (2023) implement technologies on patients and workers without their knowledge and without appropriate testing to prevent harm, discrimination, or interference in their clinical judgment, which shows that big technology companies focus more on profit making as opposed to the healthcare of the people.

Reference:

Congress.govLinks to an external site.
Links to an external site.
. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/

Short, N. M. (2022).
Milstead’s health policy and politics: A nurse’s guide
(7th ed.). Jones & Bartlett Learning.

Chapter 4, “Policy Analysis and Design” (pp. 77–93)

Chapter 9, “The Influence of Patient Health Data on Health Policy” (pp. 197–217)

Chapter 10, “Financing Health Care” (pp. 247–257 only)

Expand discussion thread from Deco Tanjong

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Miriane Meigueu

Oct 9, 2024 11:39am

Reply from Miriane Meigueu

S.631 – COVID–19 Mental Health Research Act

One of the recent congress policy proposals in line with healthcare was the S.631 – COVID–19 Mental Health Research Act (Congress.gov, 2021). Introduced in March 2021, the legislation proposes directing the Secretary of Health and Human Services, through the Director of the National Institute of Mental Health, to expedite research on the mental health effects of the current COVID-19 pandemic and the SARS–CoV– 2 pandemic on nurses who have been directly involved in frontline nursing response as part of the coordinated population health intervention (Congress.gov, 2021). The directive to expedite research and allocate more resources on the mental health impacts of pandemics on frontline-responder nurses supposedly should highlight the traumatic stress impacts, psychological distress impacts, psychiatric disorder impacts, and long-term stress impacts, including burnout, that such nurses experienced because of involvement in the health service provision during the pandemic (Deng & Naslund, 2020). According to the proposed law, increasing research on these areas will help provide insights into how pandemics affect frontline health workers and thus devise strategies on how to increase their effectiveness and efficiency while reducing the underlining impacts (Congress.gov, 2021).

Proposed Legislation

The proposed legislation focuses on the broad issue of the impact of the COVID-19 pandemic on the mental health status of healthcare workers involved in frontline nursing. Health and social care workers have, in this regard, played a crucial frontline role in responding to the COVID crisis (Congress.gov, 2021). The underlining healthcare burden involved in the first-line response to pandemics implies that such nurses worked under the most constraining environments of severe understaffing as well as operating under constrained and challenging situations, including working for extended durations of time (Cheng et al., 2022). The resultant impact thereof is that most frontline health and social care workers suffer burnout. Prolonged exposure to burnout results in severe mental health instability and negative impacts on the nurses’ psychological well-being (De Kock et al., 2020).

Social Determinants of Health

One of the leading social determinants of nurses mental health during the corona virus pandemic has been the existence of health disparities, especially within the health facilities. In practice, health facilities have limited capacities to balance between the availing and allocating sufficient nurses and mainlining their health and wellness through proper allotting of duties and responsibilities. Social economic obstacles in health facilities imply that some facilities have to compel nurses to work under difficult environments of limited human capital resources. This forces nurses to work under difficult circumstances leading to burnout and fatigue (Sauerland, 2021).

As hinted above, therefore, there is an extensive amount of evidence pointing out the need to extend research and understanding of how frontline healthcare and social care workers, working under constrained environments of pressure and limited workforce supply, affect their psychological well-being and mental health stability (Soubra et al., 2023). The scale of the coronavirus pandemic, for instance, has been far more daunting than any other pandemic experienced in the recent past (Khanal et al., 2020). The extensive impact of the pandemic on the healthcare system, including the sheer volume of patients flocking healthcare facilities in need of emergency health services, threatened to generally overthrow the capacity of the healthcare system in general. Nurses, during the peak of the COVID-19 pandemic, were forced to work for extended durations of time beyond the recommended 8-hour shifts daily (Ali et al., 2021).

Evidence-based Support

The underlining mental health impact significantly affects their mental health capacity, and extending research into this area, as proposed in the bill, helps the healthcare sector, in general, to be better prepared to minimize such negative impacts in the future. For example, understanding how working under the constraining challenges of a pandemic affects frontline nurses’ mental and psychological well-being could help to devise strategies for providing mental health counseling services designed to improve the nurse’s mental health capacity and well-being as well as recovery from the traumatic experiences involved in frontline working during a pandemic. The proposed bill of extending research in this area is thus evidence-based, and the outcomes of such an extended and expedited research should help the healthcare sector to be responsive and alert during pandemics while also minimizing the underlining mental health impacts on nurses (van der Goot et al., 2021).

References

Ali, S. K., Shah, J., & Talib, Z. (2021). COVID-19 and mental well-being of nurses in a tertiary facility in Kenya.
Plos One
,
16
(7), e0254074.
https://doi.org/10.1371/journal.pone.0254074
Links to an external site.
.

Cheng, J., Zhu, L., Zuo, Q., Weixue, P., & Jiang, X. (2022). The changes in the nursing practice environment brought by COVID-19 and improvement recommendations from the nurses’ perspective: A cross-sectional study.
BMC Health Services Research
,
22
(1).
https://doi.org/10.1186/s12913-022-08135-7
Links to an external site.
.

Congress.gov. (2021, March 9).
S.631 – 117th Congress (2021-2022): COVID–19 mental health research act
.
https://www.congress.gov/bill/117th-congress/senate-bill/631/text?r=9&s=7
Links to an external site.

De Kock, J. H., Latham, H. A., Leslie, S. J., Grindle, M., Munoz, S. A., Ellis, L., … & O’Malley, C. M. (2021). A rapid review of the impact of COVID-19 on the mental health of healthcare workers: Implications for supporting psychological well-being.
BMC Public Health
,
21
(1), 1-18.
https://doi.org/10.1186/s12889-020-10070-3
Links to an external site.
.

Deng, D., & Naslund, J. A. (2020). Psychological impact of COVID-19 pandemic on frontline health workers in low- and middle-income countries.
Harvard public health review (Cambridge, Mass.)
,
28
,
http://harvardpublichealthreview.org/wp-content/uploads/2020/10/Deng-and-Naslund-2020-28.pdf
Links to an external site.
.

Jeanie Sauerland, M. A. (2021). The social determinants of health, COVID-19, and structural competence.
Online Journal of Issues in Nursing
,
26
(2), 1-13.
https://doi.org/10.3912/OJIN.Vol26No02PPT67
Links to an external site.
.

Khanal, P., Devkota, N., Dahal, M., Paudel, K., & Joshi, D. (2020). Mental health impacts among health workers during COVID-19 in a low resource setting: A cross-sectional survey from Nepal.
Globalization and Health
,
16
(1), 1-12.
https://doi.org/10.1186/s12992-020-00621-z
Links to an external site.
.

Soubra, K., Tamworth, C., Kamal, Z., Brook, C., Langdon, D., & Billings, J. (2023). Health and social care workers experiences of coping while working in the frontline during the COVID-19 pandemic: One year on.
PLOS ONE
,
18
(4), e0284306.
https://doi.org/10.1371/journal.pone.0284306
Links to an external site.
.

van der Goot, W. E., Duvivier, R. J., Van Yperen, N. W., de Carvalho-Filho, M. A., Noot, K. E., Ikink, R., … & Bierman, W. F. (2021). Psychological distress among frontline workers during the COVID-19 pandemic: A mixed-methods study.
PloS One
,
16
(8), e0255510.
https://doi.org/10.1371/journal.pone.0255510
Links to an external site.
.

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Romel Suason

Oct 9, 2024 11:34am

Reply from Romel Suason

Evidence Base in Design

A description of the health policy

H.R. 6205 –Healthcare Workforce Resilience Act was introduced to the House of Representatives on November 11, 2023. The bill intends to enhance the country’s physician and nurse workforce by recapturing unutilized green cards/ immigrant visas. The bill proposes awarding 25,000 and 15,000 green cards/ unused immigrant visas from previous years to immigrant nurses and physicians, respectively, regardless of nationality (Congress.gov, n.d.). The bill is intended to reinforce the healthcare workforce and improve Americans’ access to healthcare.

Background of the issue being addressed

The bill seeks to resolve visa restrictions faced by migrant nurses and physicians in the United States. Currently, thousands of nurses are held up abroad due to green card backlogs, and thousands of physicians working in the United States on temporary visas and are caught up in the green card backlog. According to Tiwari et al. (2020), most migrant doctors get admission to the country for residency training on a J -1 exchange visitor or H-1 B temporary employment visa. Holders of J-1 visas are mandated to go back to their country of origin for two years after they finish their residency or are required to complete a three-year waiver petition in a designated underserved region before filing for a green card or legal permanent status. Holders of H- B1 visas can apply for a green card when they finish their residency. The bill will increase the number of green cards for nurses and physicians and help the country fight the continuing shortage of nurses and physicians.

Social determinants that most affect the policy

Geographical location and socio-economic status are social determinants of health impacting the Health Care Workforce Resilience Act. Americans residing in poor and rural regions often have a shortage of nurses and physicians. As Braga et al. (2024) indicate, it is difficult for poor and rural regions to attract and retain primary care doctors. Although around 20 percent of people in the United States are rural residents, these locations have only 11 percent of practicing physicians. The geographic inequality in patients’ access to doctor services causes significant inequalities the health of rural populations.

Evidence base to support the policy

There is evidence base to support the policy. Over the years, immigrant doctors and nurses have played a crucial role in the United States health care system. As indicated by Braga et al. (2024), it is projected that the United States will have a shortage of around 24,000 doctors by 2034. Thus, immigrant doctors is likely to increase Americans’ access to quality care. Shaffer et al. (2021) emphasize that the employment of foreign nurses varies by state. For example, as the two states most affected by the pandemic, California and New York reported their more than 25 percent of their nurses were immigrants. Foreign-trained are a vital part of the American health system, and hospitals rely on the skills brought and care provided by immigrant nurses. For example, in 2018, the United States health workforce comprised more than 14 million staff, with 18 percent immigrants. In 2018, numerous states, including Florida, New Jersey, California, and New York, had at least 30 percent immigrant healthcare workers.

A 2021 survey by the Commission on Graduates of Foreign Nursing Schools of 1356 nurses demonstrated that 94 percent of these immigrants are registered nurses, and more than half reported having over 11 years of nursing experience. Apart from immigrant nurses providing health care services in the United States health system, their cultural knowledge and language abilities expand care access and can raise patients’ confidence levels and their understanding. Since there have been calls for domestic nursing students to be provided bilingual education and the need for the nursing workforce to have a broader language skillset, this highlights the vital role foreign-educated nurses play in the United States health system. The Healthcare Workforce Resilience Act has the ability to assist hospitals experiencing nursing shortages (Shaffer et al., 2021). NURS-6050 Week 7: Discussion Evidence Base in Design

References

Braga, B., Khanna, G., & Turner, S. (2024). Migration policy and the supply of foreign physicians: Evidence from the Conrad 30 waiver program.
Journal of Economic Behavior & Organization, 226,
106682.
https://doi.org/10.1016/j.jebo.2024.106682
Links to an external site.

Congress.gov. (n. d.). H.R. 6205 – Healthcare Workforce Resilience Act.
https://www.congress.gov/bill/118th-congress/house-bill/6205/text
Links to an external site.

Shaffer, F. A., Bakhshi, M. A., Cook, K. N., & Alvarez, T. D. (2021). The Contributions of Immigrant Nurses in the U.S. During the COVID-19 Pandemic: A CGFNS International Study.
Nurse Leader, 19
(2), 198-203.
https://doi.org/10.1016/j.mnl.2020.11.007
Links to an external site.

Tiwari, V., Bhardwaj, A., Sonani, B., & Mehta, A. (2020). Urgent Issues Facing Immigrant Physicians in the United States in the COVID-19 Era.
Annals of Internal Medicine, 173
(10), 838-839. doi: 10.7326/M20-4103.

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Kailey Wooton

Oct 9, 2024 11:24am
| Last reply Oct 12, 2024 12:20pm

Reply from Kailey Wooton

H.R 6038- PROTECT Act

The “PROTECT Act” is the Preventing Opportunities for Teen E-Cigarette and Tobacco Addiction Act. “This bill requires the Centers for Disease Control and Prevention (CDC) to develop a strategy and carry out a specific initiative to prevent and reduce the use of electronic cigarettes and emerging tobacco products among youth and young adults (
Congress.gov
Links to an external site.
, n.d)”

Social determinants affected

Wang & Wu (2020) conducted a study to determine social determinants of cigarette/e-cigarette smoking among young adults 18 to 25 years old. It was concluded that younger people with lower educational attainment, living below the poverty line, and having poor physical health had a higher smoking prevalence. Younger people who smoked e-cigarettes were also likely to become current everyday smokers. Interventions, such as early education, must be made with teens since they are still in a distinct developmental period. Moreover, public health policies, such as H.R 6038, must regulate prevention programs and prioritize strategies that address e-cigarette use in teens (Wang & Wu, 2020).

Liu et. al, 2022 conducted a study regarding early education to prevent tobacco use among teens. “The core constructs of Social Cognitive Theory explain how individuals learn from modeled behaviors and support how educating adolescents about social norms can help build refusal skills to resist peer pressure and influence behavior change (Liu et. al, 2022). Prevention programs must be made available to teens at no cost. These programs need to contain an updated curriculum for e-cigarettes. The study also looked into suspension for these behaviors in teens. Suspension programs have been inversely associated with achievement and positively associated with dropout and can widen racial disparities within schools. Liu et. al, 2022 states, “This evidence points towards moving away from these suspension-based approaches and instead to Alternative-to-Suspension programs to help address adolescent e-cigarette use in schools. Alternative-to-Suspension programs include a combination of educational content, goal setting, and access to resources to help students quit using e-cigarettes.” I think these are things that must be looked into when proposing and passing policies like H.R 6038.

References:

Liu, J., Gaiha, S. M., & Halpern-Felsher, B. (2022). School-based programs to prevent adolescent e-cigarette use: A report card.
Current Problems in Pediatric and Adolescent Health Care
,
52
(6), 101204. https://doi.org/10.1016/j.cppeds.2022.101204

Wang, G., & Wu, L. (2020). Healthy people 2020: Social Determinants of cigarette smoking and electronic cigarette smoking among youth in the United States 2010–2018.
International Journal of Environmental Research and Public Health
,
17
(20), 7503. https://doi.org/10.3390/ijerph17207503

Wasserman, D. (2023, October 24).
Legislative search results | congress.gov | library of Congress.

https://www.congress.gov/bill/118th-congress/house-bill/6038?s=1&r=5
Links to an external site.
NURS-6050 Week 7: Discussion Evidence Base in Design

NURS-6050 Week 7: Discussion Evidence Base in Design

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