Essay on Population Health Policy Change To Address the Issue of Teen Births

Differences in How an Advanced Professional Nurse Advocates for an At-Risk Population in the Community vs. How They Advocate for an Individual Patient in the Clinical Practice Setting

Advanced professional nurses (APRNs) advocate for at-risk populations in the community by influencing policies and legislation meant to improve the quality of life for the population. Notably, APRNs can share their insights and experiences with elected officials, policymakers, and the community regarding the well-being of an at-risk population which makes them key forces in the policy-making process (Villegas & Allen, 2012). Moreover, APRNs champion for fair and equitable social policies to help promote fairness, health equity, justice, and address social determinants of health. On the contrary, APRNs advocate for an individual patient in the clinical practice setting by enlightening interprofessional teams to deliver patient-centered, culturally competence, and evidence-based care to help optimize treatment outcomes (Nsiah et al. 2019). For instance, APRNs can champion for collaborative care between different teams by requesting for implementation of efficient electronic health records systems for ease of information traceability.

At the same time, APRNs advocate for at-risk populations in the community by championing for improvement of social determinants of life. For instance, this entails finding out why diabetes is more prevalent in a certain community and addressing the environmental and social conditions contributing to increased diabetes diagnosis rather than prescribing medication to the patients (Black, 2020). In other words, this requires APRNs to analyze experiences before persuading stakeholders to embrace the proposed changes. On the other hand, APRNs advocate for an individual patient in the clinical practice setting by collaborating with other care providers to optimize the quality of care and reducing challenges like medication errors and wrong diagnoses by ensuring they follow up on their patients. Nurses should not only foster collaboration but should also protect their patients from harm, communicate patient preferences, and provide key information to guide decision-making.

How Advanced Professional Nurses Apply Evidence-Based Strategies to Promote Interprofessional Collaboration within an Advocacy Action Team (AAT)

Evidence-based practice in nursing is a problem-solving approach meant to deliver healthcare incorporating the most sustainable evidence, patient preferences and values and healthcare professionals’ expertise. Through evidence-based practice, interprofessional collaboration within an advocacy action team is optimized since members work towards solving complex healthcare problems with each contributing knowledge to solve the issue at hand. Undoubtedly, one of the evidence-based strategies APRNs apply to promote collaboration within an advocacy action team is identifying the best educational materials, digital decision support, and performance feedback to provide the most sustainable evidence. For instance, APRNs can identify information from peer-reviewed journals like PubMed, EBSCO, and The Cochrane Collaboration (Newhouse & Spring, 2010). Comparatively, the other strategy evidence-based strategy applies to promote interprofessional collaboration within an AAT is by acting as change agents where they act as mentors in the team and guide the team through the 5 EBP steps, asking a question, finding evidence, critically appraising the evidence, integrating it into practice, and evaluating its effectiveness. By acting as change agents, they persuade the team about the significance of interprofessional collaboration using clinical expertise and research.

Health Issue Affecting an At-Risk Population: Teen Births in Florida

Teenage pregnancy is associated with social, economic, and political disparities in the society are have adverse impacts on the mother’s education since majority drop out of high school and end up unemployed. According to the Florida (2020), teenage pregnancies are more prevalent among teens in foster care, American Indian/Alaska Natives, Native Hawaiian, and Pacific Islander females compared to non-Hispanic whites, teens in low-income families, and those living in rural areas. Moreover, according to the Florida (2020), even though teen pregnancies in the state of Florida have depreciated by 76% between 1991 and 2020, there were 9,541 teen births in 2020 representing 16.2% of the population. Out of this, 1% were girls aged below 15, 22% were between 15 and 17 years, and 77% were aged between 18 to 19 years.

Characteristics of the At-Risk Population Matters Teenage Births

Johal and Bhatti (2013) studied 11,464 white and black pregnant teenagers and 28,500 pregnant adults and identified that teenage mothers are of small weight and stature leading to small infant sizes. Equally important, the progeny of teen mothers indicates a higher rate of prematurity and minimal birth size. Equally important, teen mothers have high chances of dropping out of school and usually require assistance raising their children due to unemployment. Generally, their children are at risk of poor birth outcomes as well as developmental challenges making the population to be considered at-risk. Further, teen births tend to have poor health and are at greater risk of having low birth weight, being stillbirth, as well as neonatal death. As already identified above, teenage pregnancy is also associated with social, economic, and political disparities in the societies are have adverse impacts on the mother’s education since majority drop out of high school and end up unemployed.

How Lack of Education About Teenage Pregnancy Social Determinant of Health in Florida is Predisposing Teenagers to Motherhood

Lack of education about teenage pregnancy and its impacts on victims is one of the predisposing factors for the early pregnancies. Undoubtedly, lack of knowledge about the effects of teenage births leads to unhealthy sexual behaviors increasing the number of teen pregnancies. According to Lawlor and Shaw (2002), lack of basic knowledge about the reproductive systems and the various aspects of growth and development in adolescents can be attributed to increased teen births. Undoubtedly, the contemporary era of information globalization and effective communication makes information access more easily so teenagers should be guided to consume the right information and understand the impacts of teen births on their future. At the same time, Adolescent Health Care Services (AHCS) have failed in providing sufficient community and school-based education about teenage pregnancies. Consequently, basic counseling skills should be provided to help girls understand the risks of early pregnancies to their education and competitiveness.

How Current Policy is Insufficient to Address Lack of Education About Teenage Pregnancies

Sex education where teenagers are enlightened about early pregnancies is not currently legislated in Florida. Further, schools that fail to teach sex education only emphasize abstinence as a social standard. Consequently, since schools are not mandated to provide sex education, school districts decide on the type of sex education provided to students. Unfortunately, the lack of rigid policy frameworks leads to disparities in the quality of sex education received by students and can be attributed to the high number of teenage pregnancies in the state. At the same time, there is the “opt-out” policy where guardians can submit a written note requesting the removal of their children from any sexual or reproductive health education (Florida State Profile, n.d.). Clearly, the lack of a comprehensive curriculum about sex education and the definition of the scope teachers should cover in implementing the same is a major hindrance to minimize teen births. On the other hand, Bridges et al. (2002) explain that policy experts and public health officials have for long, highlighted the issue of abstinence till marriage sex education offered in Florida. The issues mainly revolve around the ineffectiveness of such abstinence programs, the moral effects of denying young students access to basic health information, and the political motivation behind the abstinence programs since most of them are sponsored by anti-abortion centers and Christian organizations.

Equally important, the ineffectiveness of health programs has also been highlighted by reputable healthcare organizations like the American Medical Association, The American Academy of Pediatrics, the American Psychological Association, the Society for Adolescent Medicine, among others and they recently addressed the Speaker of the Congress for reconsideration of the abstinence-only education policies. In Florida, the Healthy Teens Campaign comprised of the Florida Healthy Start Coalitions and 3 County Health Departments was also formed in 2017 to advocate legislative changes meant to ensure that teens acquire comprehensive sex education (Cawley, 2004). Generally, abstinence-only sex education has been blamed by stakeholders like public health advocates for its ineffectiveness in reducing teen pregnancy and birth rates in addition to sexually transmitted diseases.

Peer Mentoring Programs Policy Proposal to Address Ineffective Teenage Pregnancies Education in Florida

As already identified above, the abstinence-only sex education programs offered in Florida schools have been criticized for being ineffective and unscientific when it comes to changing sexual behavior and consequently reducing pregnancies among teens. Undoubtedly, Florida should allow counties to adopt the comprehensive sex-education curricula which present abstinence as one of the ways of preventing pregnancies but also embrace the role of contraception in preventing pregnancies meaning sex education is incorporated. As a result, one of the policy proposals that can be implemented to help counter high teen pregnancies and births in Florida is the development of peer mentor programs in all schools in the county to help educate teens about pregnancy and safe sex measures. The peer mentorship programs will help mitigate the challenges of comprehensive education which only permits the discussion of abstinence but discourages the discussion of sex education in classrooms.

Effects of Peer Mentoring Programs in Schools on Teen Births

The development of peer mentorship programs in schools is beneficial since they capitalize on the assets and strengths of the mentor for the development of the teens who are then enlightened about how to positively engage with others for sustainable sex practices. For the peer mentorship program proposed in this case, 5 key indicators shall be used to assess their effectiveness in schools: confidence, competence, connection, compassion, and character. Moreover, the formation of peer mentorship programs will lead to reduced teen pregnancies and births in schools since through the formation of long-term relationships that are beneficial to both the mentors and mentees, the latter feels that they are not alone while navigating through their adolescence challenges (Zavodny, 2020). Additionally, due to merits like increased self-confidence and self-esteem, enhanced interpersonal skills, better lifestyle choices, and the ability to make sustainable decisions regarding sexual activities, the pregnancy rates among teenagers significantly reduce leading to teen births. As if that is not enough, the use of mentors is the most effective approach since they help disseminate age-appropriate and culturally competent information to teens about the impacts of high-risk sexual behaviors like indulging in unprotected sex. Consequently, this opens room for honest discussions about the consumption of contraceptives and the techniques teens can employ to prevent pregnancies and STIs which would otherwise not be achieved in the classroom milieu (Nowell et al. 2017). Further, peer mentoring has the merit of teaching teens effective communication skills that are key in preventing social pressures that might also influence unhealthy sexual behaviors.

How the Policy Proposal Will Address Diversity in the Population to Ensure Equitable Distribution of Resources

The key benefit of the peer mentoring program policy program proposed in this study is that teenagers have increased involvement and ownership in decision-making matters sexual behavior leading to reduced cases of teen births. To add further, diversity among students and mentors is important in ensuring that the mentors deliver culturally competent sex education and that students who are physically challenged do not feel discriminated against (Lawlor & Shaw¸ 2020). To address the issue of diversity, the policy proposal will require all schools to follow 4 key factors in coming up with their peer mentoring programs.

• Detailed program design. The first step is having a clear program design with well-defined outcomes and implementation guidelines outlined. In this case, there should be a training plan which identifies ways in which the specific expectations and responsibilities are to be met by mentors while handling diverse students.
• Mentor recruitment and selection. The selection of mentors to be used in implementing the proposed policy is important in fulfilling the diversity requirement. The mentors should be drawn from various backgrounds like religious, sexual affiliation, and racial diversification to help meet the needs of various teens (Nowell et al. 2017). In this context, it is important to note that while identifying mentors and mentees from a similar diversity program encourages empathy amongst the matched pairs, cross-group members help foster better understanding which is important for the training programs and the reduction of teen births in the state.
• Peer mentor training. The peer mentors require support and continuous guidance come training on how to effectively implement the mentorship programs in the schools. To ensure the programs embrace diversity, there must be clear guidelines on how communication and the various mentorship activities are to be conducted. Most importantly, the benefits of cultural sensitivity will be highlighted and emphasized to the mentors for optimal program efficiency.
• Different activities for mentor-teen interactions. The peer mentorship programs will employ the developmental approach to ensure the activities are diverse, informal, and teen-driven rather than adopting the instructive and prescriptive learning methods (Lawlor & Shaw, 2002). During training, the mentors will be trained on how to include ideas that are not only fun but diverse and creative meaningful experiences to the peers for increased effectiveness in reducing teen births.

How the Policy Proposal Upholds the ANA Code of Ethics

One of ANA’s Code of Ethics states that nurses should collaborate with other healthcare professionals and members of the public in protecting human rights, promoting health diplomacy, and reducing health disparities (What is the Nursing Code of Ethics? n.d). Notably, the peer mentoring policy proposal seeks to reduce sex education disparities in Florida schools and at the same time promote health diplomacy by enlightening the youth about safe sexual practices and the impacts of teen births on their future (Olson & Stokes, 2016). Moreover, the policy proposal seeks to protect the rights of teen mothers since members of the society and education stakeholders are also enlightened about the significance of embracing the population and ensuring that they resume school and engage in profitable life activities to prevent them from slipping into depression.

Different from that, the other ANA’s Code of Ethics that is upheld by the policy proposal is the nurse, in all responsibilities and settings, should advance the nursing profession through scholarly inquiry and research, professional standards development and through the generation of health and nursing policy (What is the Nursing Code of Ethics?, n.d). In this context, APRNs are required to engage in research to identify the best policy that can help reduce teen birth rates in Florida and identify the best stakeholders to collaborate with in ensuring that the proposed policy is successful. Consequently, the research and health policy aspects stipulated in the ANA Code of Ethics are satisfied by implementing the peer mentor program.

Barriers Impeding the Implementation of Peer Mentoring Policy

The main potential barrier impacting the successful implementation of the peer mentorship policy program is the lack of support from the leadership at the state and county levels. Notably, the success of any mentorship program strongly relies on sufficient funding and for leaders to accept and finance the same, they must be visionary and provide the necessary resources needed. The other potential challenge is the limited number of mentors willing to participate in implementing the mentorship programs. According to research by Nowell et al. (2017) which identified factors affecting mentorship programs in nursing schools in Canada and surveyed 935 nursing faculty members, lack of mentors leads to inconsistencies in the program’s success. The shortage in the number of mentors can be attributed to the fact that training to be a competent mentor calls for training which is time-consuming and there is also the general lack of interest among nurses and potential mentors to engaging in mentorship programs.

Policymaker with Authority to Move the Policy Proposal Forward and the Rationale for Selection

Florida Governor

Ron Desantis

(850) 717-9337

Governors have vast powers over the state legislative branch since they serve throughout the year, and they oversee the operations of the state. Notably, the reason for the selection of the Florida governor as the key policymaker who can help oversee the policy’s success is that he influences the legislative process through executive budgetary proposals, vetoes, and policy agendas. Moreover, in the annual State of State address where the governor gives a speech before the state legislature, the governor discusses political and economic achievements while citing data for their major accomplishments. In this speech, the governor can propose the implementation of the peer mentorship program and call for partnership with other stakeholders and organizations to help minimize teen births in the county. Comparatively, the governor can urge state legislators to introduce bills regarding peer mentorship programs and approve funding for the same once a budget proposal is presented (Governors’ Powers & Authority, n.d). Once legislation regarding peer mentorship and comprehensive sex education in schools is introduced, the governor also has powers to sign the bill to law.

Strategies An Advanced Professional Nurse Should Use to Strengthen Professional Practice as a Policy Advocate

The use of the right advocacy strategies by advanced professional nurses is key in strengthening professional practice and for the successful implementation of the proposed peer mentorship program. one of the advocacy strategies that can be employed by APRNs is networking with other healthcare professionals and stakeholders to increase their influence in the successful implementation of a given policy. At the same time, the other advocacy strategy that can be used by APRNs is actively engaging in policymaking strategies like researching about the legislative process, participating in healthcare forums, offering opinions about the effectiveness or gaps in healthcare policies in town hall meetings, working with schools to implement health programs like mentorship programs, and sharing nursing experiences with policymakers and leaders (Hanks, 2007). Equally important, the other strategy that APRNs can employ is teaching the community about the impacts of a certain social determinant of health and the benefits of a relevant policy in improving the situation. Notably, this calls for the utilization of evidence-based practice, culturally competent care, and collaborative practice among the APRN and other healthcare professionals.

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