Community Health and Population Focused

The assignment is the outcome of the personal research on the health concerns in Sunset Park Brooklyn. The aim of the assignment is to develop a health promotion campaign using social media support. The target population for the field work involves children, adults and elderly. The rational for this attempt is the large number of people affected by the lack of insurance in the town. Lack of health insurance is recognised as rapidly increasing problem.

Running head: COMMUNITY HEATH AND POPULATION FOCUSED
Community heath and population focused
Name of the Student
Name of the University
Author note

1COMMUNITY HEATH AND POPULATION FOCUSED
Introduction
The assignment is the outcome of the personal research on the health concerns in Sunset
Park Brooklyn. As per the data obtained from research and fieldwork in the medical doctor
office, the health concern was lack of the insurance to cater for citizens’ in case of sickness.
Filed work included data collection through interview, to treat patients lacking health insurance.
The target population for the field work involves children, adults and elderly. The aim of the
assignment is to develop a health promotion campaign using social media support. The rational
for this attempt is the large number of people affected by the lack of insurance in the town. Lack
of health insurance is recognised as rapidly increasing problem. The same is depicted below in
statistics (Health.ny.gov, 2018). The campaign is expected to address the health concern of the
target population.
Fig 1: showing health insurance status
(source: Health.ny.gov, 2018)

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Problem description
The fieldwork was promoted in the town called Sunset Park Brooklyn. It is the south
western part of the, “New York Cityborough of Brooklyn.” Sunset Park is the 25 acre area is the
wonderful place for children, with sports clubs and active community centres. Brooklyn is the
most popular borough of New York. Sunset is the area between the 1st and 8th Avenues and 65th
Street and the Prospect Expressway. The Park expansions have developed 214 of the 324 total
acres. It makes the area most distinguished in the country system (Www1.nyc.gov, 2018).
Owing to the health concern in this area that is lack of health insurance, the primary
prevention involves social media campaign for health promotion. A lack of quality health care
services in Sunset Park increases rate of hospitalisations. The percentage of adults without the
health insurance is 27% in spite of the Affordable Care Act (BAO, 2013). This borough is
comprised of heterogeneous neighbourhoods and represents ethnic diversity. The demographic
data showed that the total population in this area is 120,441, 50.5% were male (11220 male ages
30-40 ) and 49.5% female. Among the total residents 73.2% were comprised of the adults above
18 years, and 9% were senior citizens, and 17.8% were children. In this borough, 29% of the
families were living below poverty line. Therefore, the target population affected by this
disparity are the children, adults and elderly, mainly belonging to socioeconomic disadvantaged
section of society (Www1.nyc.gov, 2018).
Researching about the physical and social environment it was found that the, bourough is
not very trendy. There are no luxury condominium developments. It is diverse community with
spanish. legal and illegal immigrants. The social life of people is poor due to high rate of
mortality and morbidity due to different chronic illnesses such as cancer, diabetes, obesity and
cardiovascular diseases (Cunningham, 2011). (Please refer Appendix for interview questionnaire

3COMMUNITY HEATH AND POPULATION FOCUSED
during fieldwork). The lack of health insurance is leading to the health disparity or inequity.
Both factors are dependent on individuals' different background and social groups. There is need
to address community gap in health care insurance facility.
(Www1.nyc.gov, 2018)
Linkage of health concern with health inequity/disparity within target population
The disparities simply arise from high, medium and low-income neighbourhoods.

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(Www1.nyc.gov, 2018)
As per the above statistics there low percentage of adults that is 42% completed high
school and only 29% adults have college degrees. According to Mirowsky (2017) higher levels
of education is associated with better health outcomes. In Sunset Park the 29% of residents are
below the federal poverty line Www1.nyc.gov, 2018). Due to lack of adequate income the target
population are not able to buy premiums of the insurances. Therefore, they have large waiting
times during visits and multiple visits discourage them to access health care on time. Some are
not aware of its benefits due to low educational attainments. On the other hand people with high
educational attainment receive on time health care. Thus, the poverty and lack of community
resources have adverse impact on the health well being due to health inequity (Health.ny.gov,
2018). High income families access the health care on time due to insurance facility, while the
low income families are deprived. This is attributed to the power imbalance between the
employed and unemployed, high and low income neighbourhood and high and low education
attainment Www1.nyc.gov, 2018).

5COMMUNITY HEATH AND POPULATION FOCUSED
Www1.nyc.gov, 2018)
There are community resources and programs which are put in place to address the
lack of health insurance affecting both adults, children and the elderly. They include;
 Community Outreach Agencies- There are approximately 32 organizations such as
community service organizations, care management agencies in Brooklyn to
conduct outreach services starting from mobile health vans to low-income
earners, older adults and immigrants.
 Religious service organizations- There are several religious service
organizations and faith-based institutions that provides resources and care for
resources and care people in Sunset Park
 Youth Development Programs- in Brooklyn includes 57 employment and
internship programs, 50 family support program and 402 after-school program.
 National Alliance on Mental Illness- is an organisation in Brooklyn offering
education programs, training, and family education to the people
 Peer, Support, Training, and Self- Advocacy Organization- There are 29 agencies
offering peer, family support and advocacy services and programs.

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 Foster Children Agencies- organise the family treatment and rehabilitation
services
 Local government social service programs- by 68 organisations support for food
and Medicaid needs (Department of Health, 2018; Homehealthcareagencies.com,
2018; Nyc.gov, 2018).
According to Ayo (2012), unemployment and poverty limits the health choices, as people
as they spent major part of the income on paying rents rather than health insurances. Children
are also the target population of the campaign because of the high rate of elementary school
absenteeism. Community well being is dependent on the health and education of children and
adolescents (Mirowsky, 2017).
Thus, the factors contributing to lack of medical insurance cover in the Sunset Park,
includes employment, education, and income. It is because of the high unemployment status,
median household income, unemployment status, below poverty lines individuals and families
(Www1.nyc.gov, 2018).
Evidence based practice associated with the selected primary prevention topic
Social media campaigns are evidence based option all over the world for health
promotion. There are large numbers of people using social media on a daily basis. Therefore, to
address the health concern of target people in Sunset Park, social media campaign strategy can
be employed. Many health care providers use social media such as blogs, social networking sites,
for promoting various health programs such as Breast cancer prevention Facebook page (Jabbour
& Yamout, 2012).

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Two of the evidences have been extracted from the literature review demonstrating the
efficacy of the social media campaign-
1. (Chung, 2015)- analysed audience response (both qualitative and quantitaive) to
the online videos on anti-smoking via You Tube. The results showed positive
response of the audience, with positive ratings being more prevalent. Pro-
campaign messages were predominant than negative ones
2. (Zhang et al., 2015)- assed the influence of social media message in improving
the physical activity when conducting the 13-week social media-based exercise.
The results showed increase in enrolment into exercise classes via promotional
message and media content
Community health nursing social media campaign strategy
The social media campaign objectives are as follows:
 Increase awareness about demanding the right to proper medical care/insurance
 Work with target population increased access to screening services
Population focused social marketing interventions for this case would include 1.
Education to create awareness of health insurances and premiums and 2. Monitoring the health
screening services facilities for target population
Two platforms for population focused social marketing interventions are Facebook and
Twitter. Both are the best social media platforms, as Facebook users exceeded one billion
worldwide and over 100 million people tweeting at Twitter. This makes them, the best social
platform to communicate with the targeted group (Oermann, 2007, p. 167).

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Appropriate staffing will be developed to create comment to allow regular posting of
content related to health insurance. The content plan for Facebook and Twitter will be developed
along with security needs. The approach to determine engagement with facebook fans will be
developed and the followers will be given the share, comment, like and upload options (Ventola,
2014).
There will be improved communication between patents and the health care providers
using the two platforms about health insurance. They can increasingly access the health related
content despite dwelling in remote areas. The patient can well communicate during crisis such as
latest outbreak of viral infection. Patient can learn about preventive actions and risk factors for
illness. The patients can get awareness of lifestyle changes for preventing overweight or obesity
or any chronic illnesses by updated health information on medication, recent research or
evidenced based options. It is easy to create awareness on health promotion campaigns (Ventola,
2014).
Benefits to the target population
 Awareness of health insurance disparity and health problems among
disadvantaged section
 Access to basic health care services and right medical care
 Access to premiums of insurances and decreased visit times
 Greater participation in screening services
 Decrease disparity and inequity
 Greater utilisation of Affordable care Act

9COMMUNITY HEATH AND POPULATION FOCUSED
Best practices for implementing social media tools for health marketing
The guidelines of CDC government will be used in creating content for social media as it
mentions the best practices for use of Facebook and Twitter.
It includes writing relevant content based on the time, geography, audience, and interests
of the target people. The content would be easy to understand and share. To make it interesting
the colourful pictures and videos will be used. Te verbs called “learn, watch or join” will be
used (CDC Social Media Best Practices, 2018). As per the guidelines, for clearance approval in
Facebook and Twitter, the new accounts will be cleared by the program’s HCSO office. The
OADC will be notified five days earlier and security approval will be taken from chief
information security officer. A privacy impact assessment will be completed and signed by
privacy officer.
Any controversial topics will be cleared immediately. Standard health messages will also
be passed through communication channel. Branding and logo making will follow the standard
guidelines of the CDC Brand Identity standards. The application section will mention the
commitment policy. Any message before deleting for violating the commitment policy will be
recorded and archived. The schedule and frequency of the posts will be defined for per week.
Single URL should be used as per best practices for all facebook posts. Custom images will post
and cross linked with Twitter. The guidelines are similar for Twitter health promotion plan
(Cdc.gov, 2018).
Using the above guidelines the three best practices for health promotion strategy using
social media are-
 Covert searchers to followers- by presenting patient friendly articles

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 Scale word of mouth – create shareable content for promotion of campaign
 Encourage engagement when the users are most active online- Example
encourage users to post on Facebook after getting access to premium health
insurance package with hash tag # or uploading the video of patient self
monitoring glucose
Social media campaign implementation plan
Data collection
The interview was done with adults aging 30-40. Our sample constituted a population of
11220. The interview was carried on the elderly adults and children who were not insured. It
was found that nonelderly adults, younger adults ranging between 19-34 are likely to be
uninsured than adults. Among children of age ranging 7-18 years are more likely to uninsured
thus uninsurance rate for these children is much less than those of adults of 19-34 of age. The
uninsured adults are more likely to report poor or fair health compared to their insured
counterpart. The information obtained that led to lack of medical insurance included;
 The high cost of obtaining insurance cover
 Lack of knowledge concerning insurance
 Lost eligibility for Medicaid
The stakeholders of the campaign are-
 The hospital mangers, physicians specialized in health education- they will assist
in designing, performing and revision of evaluation process
 The insurance workers- will assist in the evaluation of primary and secondary
outcomes through the validated questionnaire.

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 The managers from various counties who will supervise all scientific work taking
place in the intervention- that is insurance for immigrants and families with
children not having insurance
The potential partnerships includes Non- Governmental Organizations (NGO)
advocating for human rights will be involved in order to facilitate an implementation of this plan
and also to assist in funding the implementation where possible. Campaign will be implemented
within the time line of one year and may be further continued based on the outcomes.
Implementation of the plan will take a maximum of roughly 21 days to enable it to start
functioning starting from the time objectives are set up to the time retrospective is presented to
the team (Stanhope & Lancaster, 2013).
Timescale
2018 campaign timescale
Activity Timeline
Partnership engagements and recruitment staff May- July 2018
Planning project and meeting security
requirements, media content
July- September 2018
Development of protocols, surveys, training of
volunteers
Oct- Nov 2018
Baseline data analysis and reporting Nov- Dec 2018
Implementation plan Jan onwards
Evaluation June- July 2019

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Evaluation of social platform effectiveness will be done by Survey of the hospitals and
gather information concerning the demographics in order to make sure the target population was
being educated. Collect data on number of people screened. The increase in traffic to Facebook
and Twitter will be tracked. Number of clicks will be counted though Adobe SiteCatalyst and
set up report for automatically delivered metrics (Cdc.gov, 2018).
Objective Expected outcome Mode of measurement
Raise awareness about insurance
and its effects health
Increased number of adults
accepting the severity of situation
and seeking help fearlessly.
 Internal statistics of the
programs,
 followers of the
Facebook and twitter
page
 Visitors in hospitals
 Expert insurance
providers data
 Feedback and comments
on the Facebook about
premium insurance
packages
Encourage the patients to speak
about their diabetes management
complications
Awareness of screening services
Demonstration of skills to self
manage diabetes – such as glucose
monitoring, regular participation in
insulin therapy
Workshop and seminar
attendance,
community feedback (surveys),
Number of clicks and views of
videos and posters in Facebook

13COMMUNITY HEATH AND POPULATION FOCUSED
Awareness of psychological
support
Arrangement of proper counselling
session for improved mental health
Increased access to psychological
support programs
Greater awareness demonstrated
Survey from mental health
support centers on increase of
visitors
Record of active counselling
programs in Sunset program
Brooklyn
Number of clicks on Facebook
page on mental health videos
Need of budget
The social media platform campaign will ensure low cost budget. I would use $ 100 and
two free months of skillshare will be offered to our buffers customers. $ 40 will be allocated for
preparing videos, graphics and brochures, and posters for attract large number of people. For
advertisement $ 40 will be used. Social media management will take $ 10 includes planning,
scheduling of online posts, and management of brand accounts. $10 will be used in Analytics
such as Icon square which will assist to understand and enhance my Instagram marketing. Chart
beat will enable me to see the number of visitors on my site in real time (Potter et al., 2016).
Particulars Cost allocated in $
Advertisement 40
Graphics, Photos, and Videos 40
Analytics 10

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Social media management 10
Impact of social media marketing on the health promotion efforts
There was a positive impact of using the social media platform. Two tools that were used
were Facebook and Twitter (Thornicroft, 2011). It helped to communicate with large number of
people in a short span of time. The benefits of using these tools in health promotion effort
includes greater source of patient information and support. It was easy for the target population
to get information regarding health insurance. It enabled health care professionals to readily
share tailored information anytime they are in need of them. It greatly influences the policy
formulation as information is collect in an open forum that motivates policy makers to address
the concerns. These tools help in developing healthier population (Lim, 2016).
Future implications
Future implications of the social media health promotion for nurses include advancement
of personal and professional goals. Nurses can access information of workplace and share
knowledge of best practices or evidenced based care options with fellow nurses, for advancing
health through personal and professional means. Nurses can also get training online on resources
like Zika training resources. It will help overcome the issue of geographical isolation, by
building local support network and communities of practices. Using social media will help
nurses in transition periods such as change of practice areas. Nurses can help patient share their
illness stories and help them connect with providers (Ventola, 2014).

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Appendix
Questions to ask during interview at the time of field work –
Questions to physicians and care providers and target population (People who retired without
insurance, illegal immigrants lacking insurance)
 What are the current gaps/barriers in this health insurance system?
 What can be done to address those gaps?
 Have you ever used a social media campaign in your agency?
 What type of social media campaign do you feel would work in our community?
 How does the agency advertise their services?
 How would someone in the community find out about the resources they offer?
 Roles in getting insurance for admitted patients who have no insurance?
 Roles in getting insurance for admitted patients who have no insurance and lives with
grown children?

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