Public Health- Program Plan

Public Health -- Program Plan

Influenza A H1N1 was first detected in the United States in April 2009. Its first sensationalized case came from Mexico and Canada and it has gotten into the other parts of the world mainly by cross-country travelers.

From these travelers thousands more got sick and hundreds died in a few weeks. The Center for Disease Control advised the public that Influenza A H1N1 is contagious and it is spreading from human to human. Currently, Health Agencies around the world are addressing its prevention and control. However, the fact remains that a new threat to health is existing and steps are necessary to address it.

Influenza A H1N1, although by far the most known type of flu, is actually a new type of influenza. And every year, its predecessors are addressed through a vaccine, which most commonly comes in an injection and nasal spray-type. These vaccines are developed on a yearly basis and everyone are encouraged to have it especially those in the high risk group such as the children under 5 years old, the elderly aged 65 and more, the pregnant women and those with chronic medical conditions.

Immunizations are one way of preventing diseases. The government, health agencies and health practitioners are all advocating for it to ensure a healthy population in an area. Immunizations come in one to several doses that is given from an individual's infancy up to the time when he completely receives the package.

Presently, the National Immunization goal is to have a vaccine coverage level of 90% for preschool-aged children and 90% as well for teens. The National Immunization Survey monitors the progress of the vaccination and the Los Angeles County or LAC is part of their monitoring.

The LAC, as of 2008, has a population of 9,519,338. 737,631 or 8% of them are children under the age of 5 years old.

Trends in the National Immunization Survey showed that the LAC starting from 1997 has experienced occasional negligible declines but altogether, it has reached the standard vaccination coverage. MMR, PCV, Hib, Varicella and Polio have reached more than 90% while only Hep B and DTaP/DTP fell from its 2006 rates. However, despite Hep B's rate decline, it is still at 93% coverage.

Unfortunately, among all the vaccination trends, only DTaP/DTP remained below the standard rate throughout the ten-year period trend.

In addition, according to the same survey, with its estimated vaccination coverage with individual vaccines by age, "the increase in DTaP/DTP coverage levels from 66% at 7 months to 90% at 13 months implies a delay in children receiving the third dose of vaccine. Similarly, the increase from 19 months to 24 months implies that children are also late in receiving their fourth dose of DTaP/DTP vaccine."

Thus, to address the sub-standard coverage, a logic model plan is suggested below to help increase DTap/DTP performance among children in the following years.

Section 1. Increasing DTaP/DTP vaccination coverage in Los Angeles County.

Assessment

Interventions

Input

Activity

Output

Outcome

Delay in children receiving their third and fourth dose of DTaP/DTP

Low DTaP/DTP coverage level

Review of health providers administering DTaP/DTP vaccinations

Public Health Team

Venue

Presentation materials showing DTaP/DTP statistcs

Consultation meeting with health care providers

Record of health providers' views on the vaccine

Record of health providers' views on why many children gets delayed in receiving the vaccine

Information that can be used in the IEC campaign

Formation of coalition among health providers advocating for a timely administration of the vaccine among the target group

Assess reasons for the delay in Children's receipt of their DTaP/DTP vaccines

Self-administered questionnaires answered by Parents

Information Officers/Volunteers

Survey on Knowledge, Attitude, Perceptions and Practices of Parents toward DTaP/DTP vaccination

Specified Reasons as to why children gets delayed in receiving their DTaP/DTP vaccinations

Public Health Department will be able to identify parent's misinformation or misconceptions about the vaccine

Public Health Department will be able to design specific IEC/BCC campaign addressing prevailing practices and perceptions about DTaP/DTP vaccination

Information, Education and Communication Campaign addressing the current practices of parents involving the DTaP/DTP immunization of their children

DTaP/DTP information Fliers/Brochures/Posters

Resource Persons

Information Officers/Volunteers

Free meals and transportation allowance to officers/volunteers

Distribution of Fliers/Brochures in Malls, Markets and Public Offices

Posting of vaccine notices and schedules in billboards, halls and other public-frequented areas

Conduct of symposiums, forums and meetings in Clinics, Health Centers and Town Halls to provide correct information about the vaccine

Conduct of Free maternal and child health education classes in town halls and participating clinics

Conduct of Peer-to-Peer education among parents

Formation of support groups among parents

Better informed public about the vaccine and the disease it is addressing

Corrected misconception or misunderstanding about the vaccine

Timely vaccination of children through the peer-to-peer approach and the support groups

Parents ensure that their children will receive DTaP/DTP as scheduled

The first suggested intervention was to conduct a KAPP survey to come up with the following information: Firstly, an established data on why DTaP/DTP is the only vaccine performing below standard among all the other vaccines. Secondly, an assessed level of knowledge and understanding among parents about Diptheria, Tetanus and Pertussis and its vaccine. And lastly, the identified misunderstanding and misconceptions among parents about the disease and the vaccine.

From the data gathered above, an Information, Education and Communication campaign will be implemented. Specifically, the brochures and fliers will address the misconceptions or misinformation in the population about the disease and the vaccine. The posters will provide correct information, schedule of DTaP/DTP vaccinations and the names of clinics or health facilities that offers DTaP/DTP vaccines. Forums, symposiums and meetings will be conducted in public offices, town halls and other county social activities to further promote correct information and address inquiries or concerns, which may not be done during distribution of reading materials. Peer-to-peer communication and formation of support groups will also be done to ensure that parents who have children due for vaccination will be encouraged and supported as necessary.

Hopefully, with the implementation, continuous monitoring and evaluation of the above plan, the Los Angeles County's DTaP/DTP coverage in the coming months will increase and continually ensure that the population will be free from contracting the concerned deadly diseases.

Section II. Community Health Education Plan for the HIV Testing of Hispanics in Los Angeles County

Of the Total 9,519,338 population of the Los Angeles County in 2008, 4,242,213 or 45% are Hispanics. According to the county Department of Public Health, the cases of AIDS among Hispanics increased from 20% in the 1980s to 43% in 2002. Researchers said that the lack of HIV testing among them is one of the reasons why those found to be HIV-positive develop AIDS in less than a year after their diagnosis.

In a study released by the UCLA, it was discovered that only 41% of the 85 primary care providers surveyed offered regular advice about sexually transmitted diseases during the six-month covered period of the study.

Rosa Solorio, an Assistant Professor of Family Medicine in UCLA who co-wrote the study, said that the following are the issues existing among the Latino population that affects HIV / AIDS testing: their general lack of access to health care, their cultural stigma, their cultural taboo about publicly discussing sex and their fear about HIV testing and its subsequent counseling costs.

Moreover, in another study conducted by the UCLA in 2004, it was discovered that majority of surveyed health practitioners offered fewer than 20 HIV tests during the period when the study was being done. This is despite the Center for Disease Control and Preventions' recommendation that Physicians in high-HIV risk areas should offer HIV testing to all of their patients.

To address the concerns mentioned above in Los Angeles County, below is a Community Health Education Plan:

Community identification: the central cities of Commerce, Huntington Park, Bell, and Maywood; all of unincorporated East Los Angeles; most of Downtown; all of Pico Union, which lies just west of Downtown; and the Eastern cities of Pico Rivera and South El Monte.

Target group: young Latino men aged 20 to 49 years

Rationale for community/target group identification: According to a UCLA study, Latinos comprise the vast majority, or over 80% of the population in the targeted areas.

Education strategy: Formation of a support group who will use Peer-to-Peer communication as a method to encourage the target group to undergo HIV testing.

Rational for education strategy: As mentioned by Rosa Solorio above, sex is not a topic that can be discussed publicly among the Latinos. Therefore, the possibility of enabling those found to be HIV / AIDS positive that will be willing to become part of a support group will be explored. One of the activities that this group will do is to promote HIV testing and counseling among those who they know are at risk. The strategy that will be used in their education will be on a one-on-one basis to promote confidentiality and reduce stigma among those who will…