Professional nurses have the potential to influence health policy by using a collective voice for patient and healthcare advocacy. In this assessment, you will demonstrate competence as an advanced professional nurse leading an interprofessional advocacy action team (AAT) to advocate for population health policy change.

You will explore the role of the advanced professional nurse advocating for a policy proposal related to a current health issue for an at-risk population in your community. You will gather and analyze data to identify patients and populations at risk, recommend policy change to improve health outcomes in the community, and identify key stakeholders to serve on the AAT. You will also demonstrate the ability to identify and communicate effectively with essential policymakers to move the policy forward. Finally, you will create a summary of the policy proposal in (I)SBAR format (i.e., identify, summary, background, assessment, recommendation) and create a SMART goal.

Guide for the Policy Proposal: Pathway to Advocate for Change

· Step 1:

· Identify data-driven health issue

· Step 2:

· Identify at-risk population

· Step 3:

· Identify social determinant of health (SDOH)

· Step 4:

· Review current policy that addresses SDOH

· Step 5:

· Identify policy proposal to improve SDOH

A.  Discuss 
two differences in how an advanced professional nurse advocates for an at-risk population in the community versus how an advanced professional nurse advocates for an individual patient in the clinical practice setting. Include scholarly source(s) as part of your response.

· Community Setting:

· Clinical Practice Setting:

B.  Describe how the advanced professional nurse will apply 
two evidence-based strategies to promote interprofessional collaboration within an Advocacy Action Team (AAT). Include 
one scholarly source to support your description.

·

· consider the healthy people 2030 initiatives and healthcare indicators

· Rural Health Information Hub

·

C.  Analyze data that validates a health issue affecting an at-risk population in the county or state where you live or work. Include relevant source(s) as part of your response.

· Ideas:

· HIV?

· MSM?

· High risk pregnancies?

D.  Describe 
two characteristics of the at-risk population identified in part C.

E.  Analyze how a specific social determinant of health (SDOH) in the county or state is predisposing the at-risk population from part C to the health issue identified in part C.

F.  Analyze how current policy is insufficient to address the SDOH identified in part E.

Note: Current policy may be a county ordinance, county or state regulation, state law, program, school curriculum, health initiative, etc.

G.  Provide a policy proposal to address the SDOH identified in part E. Include scholarly source(s) to support your policy proposal as part of your response.

1.  Describe how the policy proposal could impact the health issue from part C.

2.  Discuss how the policy proposal will address diversity in the population to ensure equitable distribution of resources.

3.  Describe how the policy proposal upholds 
two provisions from the ANA Code of Ethics. Include relevant source(s) as part of your response.

4.  Describe 
two actual or potential barriers in your county or state that impede the implementation of the policy proposal.

H.  Provide the name and title of 
one policymaker with authority to move the policy proposal forward.

1.  Provide the rationale for choosing the policymaker identified in part H.

I.  Describe 
two strategies you will use as an advanced professional nurse to strengthen your professional practice as a policy advocate.

· J.  Create an (I)SBAR summary of the policy proposal using the attached “(I)SBAR Summary Template. Save and submit your (I)SBAR summary as a separate .pdf or .docx document.
Create a goal in SMART format to guide the Advocacy Action Team

· Each component of the SMART goal will be one (1) sentence in length.

· S (Specific)

· M (Measurable)

· A (Achievable)

· R (Realistic/Relevant)

· T (Timebound)

K.  Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.

L.  Demonstrate professional communication in the content and presentation of your submission.

Policy Proposal

Professional nurses advocate for policy changes that target community health issues outside direct patient care. Advocacy strengthens and advances the profession, patient care and outcomes, health systems, and public policy. Nurses are better positioned to connect the dots between policy engagement, research, and practice. Advanced professional nurses are key in leading an inter-professional Advocacy Action Team to advance a policy change for addressing a current health issue for an at-risk population. Subsequently, the process involves identifying a data-driven health issue, analyzing social determinants of health (SDOH), and reviewing current policies. The objective is to present policy change recommendations that will improve health outcomes and effect advocacy with key policymakers.

Advocacy in Community Setting vs. Clinical Practice Setting

In the community setting, an advanced professional nurse promotes and advocates for at-risk populations by focusing on broader public health issues. The nurse collects and analyzes population health data to determine trends and risk factors affecting large groups. The nurse works collaboratively with public health officials, community leaders, and organizations to develop and implement policies and programs designed to improve health status (Chiu et al., 2021). This level of advocacy often includes public speaking, policy development, and participation in community forums geared toward raising awareness and building support for health initiatives.

The nurse’s advocacy is more individualized and patient-centered in the clinical practice setting. The nurse focuses on individual patient needs and ensures that the individual needs of patients are met. The nurse provides education, coordinates care, and works with patients navigating healthcare (Flaubert et al., 2021)
. Advocacy is done for a patient’s rights and access to services needed for treatments and services. Even though the scope may be narrow, the impact is direct and immediate and most often involves one-to-one contact with a treatment plan tailored individually to the client.

Evidence-Based Strategies for Inter-professional Collaboration

Advanced professional nurses can apply regular interdisciplinary meetings and utilize collaborative technology to promote inter-professional collaboration within an Advocacy Action Team (AAT). Regular interdisciplinary meetings provide guidelines for good communication, coordination, and integration of various professionals’ expertise. Information sharing and discussion of strategies in a team will help the members develop collective ways of handling health problems (Martin et al., 2021). Additionally, collaborative technologies supply advanced levels of communication and coordination for team members through aspects like the electronic health record (EHR) and shared digital platforms. Sharing information in real-time with tools minimizes miscommunication and further facilitates collaboration, eventually leading to more cohesive and efficient care delivery.

Data Analysis of Health Issues Affecting an At-Risk Population

Human immunodeficiency virus (HIV) among men who have sex with men (MSM) is a significant public health concern in Miami-Dade County, Florida. The HIV incidence rate in Miami-Dade County stands at 28.4 per 100,000 population, surpassing the state average. Men who have sex with men (MSM) represent the most affected group, accounting for 59% of all new HIV cases in the county. Factors contributing to this issue include high rates of sexual abuse, substance use, family rejection, and poverty (Gonzales-Zamora et al., 2022).

Characteristics of the At-Risk Population

In Miami-Dade County, MSM at-risk for violence are high on substance use and familial rejection. Many MSM practice risky alcohol and drug consumption, and this makes them susceptible to contracting HIV. This practice and unsafe sexual behavior raise the level of HIV transmission noticeably to the female population in Namibia and the region in general. The second major cause of MSM is rejection by one’s family. In many cases MSM face non-acceptance by their families because of their orientation puts pressure on them and engages in them risky behaviors. HIV risk rises as social support declines, and access to health care declines (Gonzales-Zamora et al., 2022).

Social Determinant of Health (SDOH) Analysis

Poverty is a social determinant of health which places MSM in Miami Dade County at a risk of being infected with HIV. Poverty impacts health, proper diet, medical care, and other necessities like heath care, quality education, and the necessary shelter among others. Miami-Dade County MSM has a higher prevalence of HIV infection. As a result of the financial difficulties, patients cannot receive HIV diagnosis, treatment, or prevention by the intake of prophylaxis. Inability to access health care services regularly makes them hardly informed or availed prevention information and services on HIV. According to Gonzales-Zamora et al. (2022), poverty causes instability or lack of decent affordable homes, which increases substance use and risky sexual behaviors, which are considered critical and main HIV infection risk factors. Poverty-related education differences affect MSM’s awareness of HIV prevention measures. It also suggests that most uneducated women may not attain parity in sex protection, increasing HIV risk.

Insufficiency of Current Policy

Current policies in Miami-Dade County, such as the Florida Medicaid program and state-level health initiatives, are small for addressing poverty as a driver of HIV risk among MSM. These policies do not comprehensively cover the poor by paying for all items under care concerning HIV, including prevention, treatment, and allied services. In addition, broader social needs of poor MSM, such as stable housing and access to education, have not been adequately receiving attention in current programs. Since holistic support is lacking, these obstacles to healthcare access and preventive measures are all the more overwhelming, continuing the cycle of poverty and increased HIV vulnerability.

Policy Proposal to Address SDO

Policy Proposal is to design a comprehensive income-based program of HIV prevention and care, housing, education, and health services targeting low-income MSM in Miami-Dade County. This policy will affect the social determinants of poverty by providing the stable resources necessary to access healthcare. In doing this, it increases the uptake and retention of PrEP, reducing HIV incidence among MSM. To ensure equity in dispersed distribution, the policy should address the low-income and minority populations, as well as Spanish-speaking and culturally sensitive education and outreach efforts. This policy aligns with the American Nurses Association (ANA) Code of Ethics provisions that advocate for social justice in the reduction of health disparities and advocate for vulnerable populations. Challenges may pertain to funding and resistance by policymakers or other stakeholders against increasing government spending on social programs. Addressing the identified challenges will, therefore, require increased advocacy efforts in collaboration with local community-based organizations.

Policymaker Identification and Rationale

One policymaker is Dr. Carina Black, Director of the Florida Department of Health. Dr. Carina Black is a great policymaker who furthered the notion. The position gives her complete control over public health policies and statewide health initiatives. She oversees health inequalities, disease prevention, and resource allocation, making her the most influential HIV prevention program champion. Dr. Black’s years of experience and knowledge of state-level public health will help shape and support this policy approach.

Strategies to Strengthen Professional Practice as a Policy Advocate

As an advanced professional nurse, strategies to strengthen professional practice are developing expertise in health policy and building strong professional networks. Updating the knowledge of health policy and public health laws requires continuing education through postgraduate courses, conferences, and frequent reviews of the literature and policies (Mlambo et al., 2021). Grounding in these areas will help me to assess and lobby for the policies that deal with health matters and fairness. Additionally, networking enables coordination, which is important in exchanging information, identifying areas of common interest, and leveraging resources and support to push change policies. Citizenship and interaction with professional bodies will also help in policy change and development regarding public health.

(I)SBAR Summary of the Policy Proposal

I – Identify:

The high incidence of HIV among men who have sex with men (MSM) in Miami-Dade County, exacerbated by socio-economic factors like poverty, is a pressing public health issue.

S – Summary:

Current policies pay insufficient attention to the social and economic factors which contribute to the high HIV prevalence among MSM’s. Major barriers entail a lack of PrEP prescriptions for those at high risk of infection and inadequate sex education. Under this policy reform proposition, we shall seek to expand, educate and increase funding for community health programs for MSM, advocating for increased PrEP availability.

B – Background:

The incidence rate for HIV in Miami-Dade County is at 28.4 per 100,000, and the MSM was identified as being vulnerable. Despite health initiatives, access and education inequalities affect prevention and treatment.

A – Assessment:

To fill these gaps, the proposed policy consists of scaling up PrEP, increasing health education investment in priority areas, and scaling up community interventions. The social determinants of health approach to health promotion focus on reducing HIV infection and improving health equity.

R – Recommendation:

The recommendation
is to ensure the funding of the policy proposal and work with other health institutions and stakeholders in the community. Effective HIV reduction among MSM can be achieved by collecting data and adjusting methods.

References

Chiu, P., Cummings, G. G., Thorne, S., & Makaroff, K. S. (2021). Policy advocacy and nursing organizations: A scoping review.
Policy, Politics, & Nursing Practice,
22(4), 276–296.

Flaubert, J. L., Menestrel, S. L., Williams, D. R., & Wakefield, M. K. (2021). The role of nurses in improving health equity. In
www.ncbi.nlm.nih.gov. National Academies Press (US).

Gonzales-Zamora, J. A., Ponce-Rosas, L., & Martinez, R. (2022). Determinants of public health and interventions to address HIV infection among men who have sex with men in Miami-Dade County, Florida, USA.
Infezioni in Medicina,
30(3).

Martin, P., Pighills, A., Burge, V., Argus, G., & Sinclair, L. (2021). Promoting interprofessional education and collaborative practice in rural health settings: learnings from a state-wide multi-methods study.
International Journal of Environmental Research and Public Health,
18(10), 5162.

Mlambo, M., Silén, C., & McGrath, C. (2021). Lifelong learning and nurses’ continuing professional development, a metasynthesis of the literature.
BMC Nursing,
20(62), 1–13.