Priority Population & Key Health Issues
Denton, Texas is a city north of Texas being the most diversified city compared to other cities. Denton population is mainly made up of Caucasians, the white population being the largest and American Indian being the least populated in Denton, Texas. The population in Denton is 1292% higher in Texas (areavibes, 2017). The white population makes up 73% of the Denton population followed by Hispanic or Latino 21%, being the second highest populated race in Denton. Other races include those who are of African American, Asian, American Indian, and Native Hawaiian Pacific Islander origin. As of 2016 and 2017, the total population of Denton, Texas consist of 133,383. Denton Female population makes up majority of the Denton population by more than 3,000 residents. However, there are more individuals between the ages of 22 to 29 that make up most of the male population. Being that Denton, Texas is the home of two universities, The University of North Texas and Texas Woman’s University, the education demographics display that 31.5% have obtained a Bachelor’s Degree followed by 15.4% who have obtained a Master’s Degree. The residual consist of those who earned an Associate’s Degree, attended some high school, or perhaps no school at all. The average household income is $76,663 with those over the age of 45 earning the most amount of income and those under the age of 25 earning the least being $30,312. Since the year 2010, the total percent has increased/decreased by 4%. There are 16.4% of Denton residents living in poverty.
Denton, Texas is a city residing many young adults. Due to a high population of young adults, Denton is very much affected by sexually transmitted infections with more cases arising per year. According to the Texas Department of State Health Services, there are also 9.7 new cases of the HIV infection in Denton county per 100,000 population. This indicated Denton County to be the middle median value. A Denton County Health Department spokeswoman, XXXX4 says Chlamydia has been the highest reported and this infection occurs in the age group 15-24. XXXX4 acknowledges a lack of education in many young adults. A lack of sexual health education leads to an increasing rate of new STD cases. In Denton County the STD rates arise with 111 cases per 100,000 individuals who were diagnosed with gonorrhea. As the years passed by, Denton county saw 430 cases of gonorrhea. According to Texas Department of State Health Services, primary and secondary syphilis were six cases per 100,000 individuals. There were 71 cases in Denton and 56 cases in the previous years (Lewis, 2016). This displays the growing sexual health issues that is affecting Denton county and why I chose to focus on this health issue.
The leading health indicators of healthy people 2010 discuss sexually transmitted diseases and reproductive and sexual health. According to healthy people, there are an estimated of 19 million new cases of sexually transmitted diseases each year in the United States. Almost half of them are young people age 15 to 24. For this key health issue, the leading health indicators suggest that an entry to the medical care systems are necessary. Improving this issue will eliminate health disparities, reducing rates of infectious diseases and infertility, and increasing educational attainment, career opportunities, and financial stability (Healthy People 2020, 2014). As spokeswoman XXXX4 mentioned, being educated on sexual health can eliminate and reduce the probability of being infected with the diseases. The relationship between sexual health and the leading health indicators will help improve the sexual health of young adults and the U.S. population.
Sexual health is a very important topic that it seems like nobody wants to talk about. I’m pretty sure if you asked a group of teenagers have they ever contracted a Sexually transmitted disease (STD) most of all of them would say no. The most common STD’s are Human Papillomavirus infection (HPV) which is an infection that causes warts in various parts of the body depending on the strain. Another common STD is Genital Herpes which is an infection accompanied by genital pain and open sores. Chlamydia is another disease which is another infection but may not cause any symptoms. Gonorrhea is a sexually transmitted infection that, if untreated, may cause infertility in young adults mainly women. The one most talked about is HIV/AIDS HIV leads to a severe stage of AIDS and interferes with the body’s capability to attack infections. The last of the most common STD’s is Syphilis is another cause of bacterial infection that usually spread by sexual contact that starts as a painless sore. A sexually activity study shown on KFF.org which was conducted in 2013 shows that Nearly half (47%) of all high school students report ever having had sexual intercourse in 2013, a decline from 54% in 1991. A similar share of male and female students report ever having had sex (48% vs. 46%). (Henry J Kaiser Family Foundation, 2014). The study also shows that there are racial and ethnic differences in sexual activity rates. Black high school students are more likely to have had intercourse (60%) compared to White (44%) and Hispanic students (49%). A higher share of Black high school students (14%) and Hispanic students (6%) initiated sex before age 13 compared to White students (3%) (Henry J Kaiser Family Foundation, 2014).
The racial study could easily be explained, that sexual health like other things aren’t taught in black communities or schools. With sex being shown all over TV and in everyday music it’s not rare that young adults are having sex, the problem is are these young men and women have safe sex. Safe sex meaning condoms for men and women and birth control. With classes like personal health and safety and sex ed. being taken out of schools those diseases with me stated earlier could be a shock to young men and women. The same study shows that Teens ages 15 to 19 and young adults ages 20 to 24 accounted for the most reported cases of Chlamydia and Gonorrhea in 2012. Females are at greater risk than men of acquiring sexually transmitted infections, and the consequences include pelvic inflammatory disease, pregnancy complications, and infertility (Henry J Kaiser Family Foundation, 2014). It also states Over 34,000 young people, ages 13 to 24, were estimated to be living with HIV in the U.S in 2009. This age group accounts for 26% of new HIV infections. Most young people with HIV/AIDS were infected through sexual contact. With programs like free condom and STD testing almost non-existing these number are sure to rise within the year. Sex education classes in high school and college are a must to spread awareness and help decrease these numbers in the youth of America. These young men and women aren’t going to stop having sex, so the only way to prevent these diseases is to get tested, practice safe sex and use birth control. Being cautions of the people you lay down making sure that they as well also get tested. The numbers in the study can and will be decreased if they decided to take the right steps in help the prevention.
The LGBT Community
Let’s talk about Sexual Health in Young Adults pertaining to the LGBT community, which is known to stand for Lesbian, Gay, Bisexual, & Transgender.
An estimated 3.5% of young adults in the United States identify as lesbian, gay, or bisexual and an estimated 0.3% of young adults are transgender. This implies that there are approximately 9 million LGBT Americans, a figure roughly equivalent to the population of New Jersey. Among young adults who identify as LGB, bisexuals comprise a slight majority (1.8% compared to 1.7% who identify as lesbian or gay). Estimates of those who report any lifetime same-sex sexual behavior and any same-sex sexual attraction are substantially higher than estimates of those who identify as LGB. An estimate of 19 million Americans report that they have engaged in same sex sexual behavior and nearly 25.6 million Americans acknowledge at least some same sex sexual attraction.
Statistics show that men who have sex with men have a higher risk of contracting an STD than any demographic. Despite making up a small fraction of the population, men who have sex with men account for more than half of all new cases of HIV each year, due in part to an inflated chance of having sexual relations with an HIV-positive partner. Among women, studies have shown that viral STD rates among bisexual-identifying women aged 15 to 44 years were almost three times higher than women who have sex with women exclusively. Bisexual women have a higher risk of contracting HIV than women who have sex with women exclusively, because they also have sex with men whose semen contains proteins that serve as an extremely efficient carrier of the virus. By the year 2000, reported cases of syphilis had fallen to an all-time low of 2.1 cases for every 100,000 people in the U.S. By 2013, the rate had more than doubled to 5.3 cases per 100,000 people, with men accounting for 91 percent of all cases. 3 out of 4 women will get HPV at some point in their lifetime. Many will clear the virus on their own with no medical intervention. There is no cure for the virus, but steps can be taken to help prevent the formation of cancerous cells. Both men and women can, and should, get vaccinated for HPV because using protection such as condoms or dental dams is only effective at preventing the spread of HPV about 60 percent of the time.
This information and these statistics are reasons why it’s important that we should provide knowledge to not only our young adults but to everyone, about sexual health. My program will teach and target way to protect yourself and others. The only way to avoid STDs is by getting tested frequently and using protection, such as condoms and dental dams, every time you engage in sexual activities. A few years ago, people was afraid of contracting HIV through unprotected sex. The rise in promiscuous activity in young adults. For example, my friend and I were in the store and we noticed females buying male condoms to protect the male during sex however they forget about themselves. Sexually transmitted diseases are also contracted during oral sex as well because of exchange of body fluids. It is not only male and female sexual intercourse is also male and male or female and female. It’s been an incline in HIV in the heterosexual community and a decline in the homosexual community because they are being educated because it is known to more individuals in the LGBT community. Statistics show a decrease in homosexual HIV diagnosis.
XXXX3, Director of Denton County Public Health strives to prevent the spread of disease protecting against environmental hazards, encouraging healthy behaviors, and assisting communities. Partnering with this agency will help me approach this health issue for my program. Denton County Public Health provides services and testing for individuals with diseases such as sexually transmitted diseases. Partnering with this department can give me the ability to help advocate STD testing at DCPH. Also, when addressing sexual health, I will provide educational programs on how to prevent STDs and the necessary steps to take if one becomes infected with the disease. My sexual health promotion will for STD testing at DCPH will ensure that many individuals get tested and educate the public about healthy behaviors.
Key Leaders/Stakeholders and Supporters
The leaders of Denton, Texas has made a positive impact to produce a positive result in the community. These leaders have provided compassion, commitment, and dedication to improve the health of people. XXXX4, Denton County Health Public Information Officer is a leader within her agency in Denton. Her hard work and determination has exceeded and contributes to Denton County being successful. Not only does XXXX4 serve as a PIO for DCHD, she also serves as a project manager. She has led her community by her educational efforts to present STD/HIV educational programs within the Denton County district while also working and presenting information for local health fairs and providing assistance with support groups and grant writing. XXXX4 also serves as a Social Worker and Program manager for Denton County Health Department, her leadership continues today. XXXX3, Director of Denton County Public Health also serves as a Health Director in the Denton County. XXXX3 supervises HIV/STD clinics while also focusing on diseases that are considered a public health threat to communities. His leadership led and directed all public health programs, projects, and committees for public health in Denton County. Both leaders contribute to the Denton Community in different ways. Emerging leaders are ways to uplift and better the community.
The Denton County Public Health Services Department supports the community by offering a Women’s Health Program. The program’s mission is to offer services, provide quality health care to women, and influence the Denton community to make better decisions regarding their health (Denton County Women’s Healthcare, 2016). A phone interview was conducted with Priscilla Wachira, a Women’s Health Program community worker. During the interview, she gives information that will help us understand each service offered by the program. She mentions that the well woman’s exam was the most performed exam at the program. This exam allows women to report health concerns as well as receive tests and screenings for sexually transmitted diseases and other sexual health concerns. Priscilla Wachira is certain that health complications due to sexually transmitted diseases are a major risk in Denton, TX.
Planned Parenthood is an organization that offer care, support, and focus on sexual and reproductive health devoted to women, men, and young adults globally (Planned Parenthood, 2014). The Planned Parenthood Denton Health Center is the largest provider of sex education. The health services provided at this location are for teens, parents, and educators. Services include general health care, STD testing and treatment, men health services, HIV services and more. The staff at Planned Parenthood will provide the necessary care to help and assist the needs of the patient. An interview with a staff member of the Planned Parenthood Denton Health Center was conducted over the phone. As one of the nation’s high-quality care in Denton, sexually transmitted diseases and access to test and screenings are identified as major health issues. According to this stakeholder, many young adults requested STD testing, followed by HIV services. ARCpoint Labs of Denton, Health Services of North Texas, and Medical City Denton are other public and private providers in the Denton community that offer services related to sexual health.
The mission statement of the program is to promote sexual health care for all individuals by advocating, educating, and collaborating with health educators to prevent sexually transmitted infections and unwanted pregnancies. The target of the sexual health program will be to improve sexual health by implementing a strategic plan on how to protect against and prevent STDs. My program encourages safe sex to better the health of many by assisting people in accessing information and resources. I want to promote the positive aspect in young adults. As a young adult, the sexual experiences pressures them to try new things and new positions. They are experimenting with various sexual activities which allows them to become at risk for contracting sexually transmitted diseases. Sexually transmitted diseases is more prevalent in low socioeconomic status household due to lack of insured individuals. Young adults in this population do not often seek clinical facilities because of a financial strain, no transportation, and access to supply their needs.
The overall goal is to provide all people with knowledge, strategies and skills to promote the well-being of their sexual development as they encounter relationships, intimacy, and affection. My program provides sexual health services for all ages and gender. Advancing sexual health education in young adults is supported by providing high quality program that are affordable and accessible to improve the adolescent and young adult community. What is really going on in our society with young adults as it relates to sexual health? Are we finding more or less monogamous relationships in the young adult community? Today, as found in social media we are facing more and more temptation as it relates to sex. Many individuals are not in monogamous relationships anymore. Sexual health becomes important to young adults as they grow older and mature. It’s not about monogamous relationships, it’s about lets have sex and lets have fun as a means of recreational activity. As viewed in social media, sex has no feelings attached, others are doing it, people have inquisitive minds, and people are interested in engaging in various sexual activities whether its life threatening. Young adult’s views of sex relates to drinking and smoking marijuana, it is not as important.
- Process Objective: By August 2017, my sexual health program will provide Safer sex activities every Monday of the month.
- Impact Objective: After being educated on safe sex, many people will be aware of how to protect themselves when encountering sexual situations.
- Outcome Objective: By September 2017 there will be an increase of sexual health awareness and education in the city of Denton.
Sexual health education is effective at helping young adults make informed decisions about their health. My program focus on the intervention of sexually transmitted diseases in response to increased risk of STDs in young adults. Sexual health promotion seeks to empower students in taking responsibility to receive information and education which is important to overall health. In my program I will use more than one theory to address sexual health. There are different approaches in distinguishing elements that are vital to construct more effective sexual health education key concepts that will meet the needs of young adults. The theories I will be using are the social cognitive theory and the theory of planned behavior. Both theories will contribute to a decrease in negative sexual health long-term consequences.
In my program planning, I will also integrate the theories into practice by using the transtheoretical and IMB model. I chose the social cognitive theory to examine health promotion and disease prevention. This theory contributes to change in sexual health behaviors within experiences, influences, and interactions. The theory of planned behavior targets will assist targeting young adults in safe sex and preventing STD/HIV. The transtheoretical and IMB model will be information incorporated from both theories. The IMB model will display the planning process in promoting sexual health. This model help individuals become educated about the sexual health issue which motivates individuals to use their knowledge when engaging in risky behaviors regarding sexual activity. Lastly, the individual must construct the necessary skills to reduce negative sexual behaviors. Incorporating these theories/models into the planning process accounts for targeting well-known pathways to enhance sexual health.
The goals and objectives for my program aims to provide knowledge, and skills to promote overall sexual health. My planned intervention targets planning and implementing sexual health in relation to the goals and objectives and needs of the individual. The goals and objectives are strategies used to influence program objectives. The intervention phase of a sexual health education program is designed to increase the use of condoms among sexually active adolescents. This could fill knowledge gaps among the target group (Information), reinforce the group’s personal views about condom use and help them to personalize the risks of teen pregnancy and/or STI/ HIV (Motivation) and incorporate role playing exercises to help individuals learn how to negotiate condom use with sexual partners while also teaching them where to access free condoms (Behavioural skills) (Public Health Agency of Canada, 2008).
Understanding sexual health is a more effective method to utilize to pursue positive sexual behaviors. The level of prevention my program will target is primary and secondary prevention. Approaches to primary level of prevention in my program has made an attempt to attack the health issue before it worsens. Furthermore, secondary level of prevention aims to reflect strategies aimed at young adults who have previously been affected by STDs/HIV. My program intentions are to understand the risk, protective factors, and the prevalence of the disease. In my program, I use primary and secondary prevention to target the community at increased risk for sexually transmitted diseases and HIV. Community influence will be the focus of my program. Communities continue to provide the strongest efforts to prevent teen pregnancy and STDs in the United States (Challa, S., Manu, A., Morhe, E., Dalton, VK., Loll, D et al, 2017). Community influence has been effective in reducing STD rates and increasing the use of contraceptives among young adults. While some communities support abstinence-until-marriage education, other communities promote balanced, realistic education—abstinence plus contraceptive and safer sex education (Berne, Huberman, 1999).
Intervention strategies to maintain sexual health in young adults have produced a successful outcome. Clinics can implement interventions to improve screening and rescreening to reduce STD prevalence, reduce long-term sequelae, and meet federal requirements to demonstrate improvement in health outcomes (Taylor, Frasure-Williams, Burnett, Park, 2016). Clinics that provide screening for STDs contribute to successful interventions that are effective, however community based clinics should expand programs to improve the sexual health of men and women. Marketing campaigns, school based programs, and health promotion strategies have all been successful in addressing sexual health in young adults. Understanding priority population in intervention programs is the most important when addressing sexual health. Individuals in priority populations have limited access to health care clinics, however individuals living in this community are at a greater risk for STD/HIV. An intervention to promote sexual health for priority populations improves the overall sexual health of teens and young adults. The intervention scenery provides extensive access to the priority population who would benefit from sexual health education.
Intervention resources consist of condoms, STD/HIV testing, contraceptive choices which are the best practices for prevention. In order to implement the intervention strategies, our program must offer a great deal of adolescent needs so they can be prepared. Resources such as Planned Parenthood and center for disease control and prevention offers a variety of testing, treatment, and screening for those in need. The STD resources provide a quick snapshot of current STD trends and issues, highlighting the increasing concern about antibiotic-resistant gonorrhea, the need to address underlying contributors to health equity, and the worrying trends of increased STD rates in younger populations (Astho, 2017). The resources provided are helpful in reducing sexually transmitted diseases. Being that STDs are an important health concern, resources are needed to discuss and provide the best practices for decreasing sexually transmitted diseases. My program requires a multi-strategy intervention to make programs. A multi-strategy intervention are prepared to integrate multiple levels of intervention strategies at an individual and community level. Several population groups depend on the interaction of multiple protective and risk factors. The use of multiple strategies aims to promote adolescent sexual health and address various determining factors of sexual behavior.
Motivation and Retention
In my program, I focus on the interaction and attention related to the sexual health of young adults. Social media usage among young adults is at an all-time high. Young adults trust technology and rely on social media to seek information for themselves and others. Opportunities to better engage adolescents and young adults through social media exist in healthcare delivery, health education and health policy (Wong, Merchant, Moreno, 2014). Healthcare delivery through social media will motivate young adults to increase compliance with their health. Healthcare delivery through social media gives health educators a platform to get adolescent attention. Previous work suggests that teens are interested in receiving health information via social media, particularly for sensitive topics like sexual health. For this and other stigmatized topics that disproportionately affect adolescents and young adults, such as mental illness, young people may benefit from the anonymity of exploring these topics online through social media (Wong, Merchant, Moreno, 2014). Social media provides a range of opportunity to motivate and empower adolescents on to work on their behavior change.
Program Staff, Vendors, & Partners
Various factors influence health programs. Sexual health is influenced by both internal and external factors. The impact of internal and external resources encourage behavior change. My program uses both resources to support decision making. The internal factors used are knowledge, attitudes and cultural beliefs, healthy decision making and the external resources used are social media influences, environmental factors, parents, and engagement in sexual activity. Both resources are implications for promoting my sexual health program. Sexual health education is about developing long-term skills and knowledge to understand the importance of sexual health education through a variety of programs and interventions. The rationale for sexual health in young adults requires a positive approach to advancing sexual health in the adolescent community. The rationale for the use of programs and service is that it makes the most progress in targeting young people using innovative strategies for behavior change.
In both interviews, I obtained relevant information for assisting community members in addressing sexual health. I interviewed XXXX, a priority population potential participant she expressed her need for sexual health education. I asked Ms. XXXX questions pertaining to programs, interventions, what she knew about sexual health prior to the interview. I asked Roslyn has she been sexually active in the past 12 months and her answer was yes. I also asked her does her and her partners use protection and she responded sometimes. I also asked her if she was aware of the long-term consequences of having sex without a condom with someone who is affected by an STD/HIV, she was unaware and uneducated on sexual health. She was also asked if her or her partner have been diagnosed with an STD and her answer was no. XXXX mentioned that she would not know what to do if she was diagnosed with an STD. She says she would like to see more sexual health programs in her community to educate her and those around her. She also mentioned that she would participate in the programs and interventions if they were interactive and if they made her feel comfortable enough to ask questions. She believes sexual health is a subject that needs to be discussed because it’s happening. While it can be difficult getting the attention of more than half of the community, XXXX strategy may require marketing and assistance from other health education organizations to help other community members. I also interviewed XXXX2, a priority population potential member. She was asked the same questions as XXXX and she responds giving suggestion on what she would like to see as a potential participant. She has not had any sexual partners and she is not sexually active. She mentions that she is friends with other women who have been treated for an STD and they were uneducated on sexual health however they were eager to engage in sexual activity due to peer pressure. XXXX2 was certain that sexual health was an important issue that affects many however people are afraid to have this conversation with others without being judged. I plan to use multiple strategies to market sexual health education programs and getting youth to stay committed to the programs. I will market my programs by getting help from community members, involve other support networks, and make frequent contact with community members to stay in touch. Lastly, with the help of other health organizations I will obtain more information to see the program as meaningful.
Facilities, Instructional Resources, and Equipment & Supplies
Program supplies and equipment play a major role in the health care field, and it is necessary to make sure to consider all options when purchasing supplies for your medical facility. In the health care field, medical supplies are defined as items that need to be replaced on a routine basis, and medical equipment are items that can last a year or longer (ECHO, 2001). It is important to consider what the tools will be utilized for and the time span that you will be able to utilize them. As well, storage is an important component to consider for medical equipment and supplies in order to get most out of the equipment and supplies. (Add more to introduction)
The most common sexual supplies that you will find in today’s health care settings are condoms, birth control, and multiple other supplies that prevent pregnancy and sexual diseases. These items fall under supplies because they will be given out and replaced on a routine basis. Condoms have expiration dates and are only good for a certain of time before they need to be replaced. “Birth control should be stored in a dry, clean, cool, well-ventilated area and protected from sunlight (ECHO, 2001)”. As well considering the manufacturer that the sexual supplies are purchased from will determine how long that these supplies will last.
Medical equipment is important for a health care establishment, especially where one will be receiving a check-up. If the examination equipment is up-to-date it is easier for doctors to notice any sexually transmitted diseases or other problems that pertain to one’s reproductive health. Out of date material could cause an incorrect diagnosis or simply not catch an issue that could turn into a bigger problem if not treated within a specific time length.
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