400210 Health Promotion And The Nurse

400210 Health Promotion And The Nurse

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400210 Health Promotion And The Nurse

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400210 Health Promotion And The Nurse

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Course Code: 400210
University: Western Sydney University

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Country: Australia

Question:

Identify andrationalise the health issue requiring change (supported by current literature)
Identify the health promotion activity – describe each strategy including the long andshort-term objectives
Plan to implement the project (action plan or a teaching plan or both)
Identify the resources (not onlyfinancial resources) required to implement the plan 
Develop and discuss a proposed evaluation plan (supported by current literature)

Answer:

Background
Australia is a land of diverse cultures. Since the time of early colonization in Australia, alcohol is being consumed as a beverage all over the country. Over the last few decades the alcohol consumption in this continent has increased with time. The Aboriginal population and the Torres Strait Islanders staying in Tasmania has always been centre of research for the past few decades due to their linguistically and culturally different background. Statistical data says that the consumption of alcohol among the aboriginal population residing in Tasmania has increased with time. The rate of alcohol consumption had been greater in the young generation aboriginals than that of the elderly ones (Howard et al., 2014). Although alcohol consumption can be considered as a no0rm among the aboriginals but the customs often pose serious effect on the health status of these aboriginal young generations.
As per the reports, the New South Wales Police force had mentioned alcohol to be one of the important causes of the mortality in patients. Reports suggest that alcohol may bring about avoidable complications like self harm, lack of consciousness, depression and may hamper the professional life (Lumley et al., 1985).  It has been reported that although alcohol is viewed as an essential part of socialization, a lot more is consumed in ways that pose ill effects on health. The report places forward with a possible health strategy to mitigate the disastrous effect of consumption of alcohol among the aboriginal youths. Te report further sheds light in to different long term and the short term objective. The objectives should be incorporated in the implementation plan.
The report further focuses on an evaluation plan that should be helpful for assessing the success of the proposal. Finally, a teaching plan, an evaluation strategy, campaign posters to direct the children will be found in the appendix section of the paper.
Prevalence of alcohol consumption among the aboriginal youths in Tasmania
As per the statistical data, in 2010-11, the national consumption of pure alcohol was about 9.99 litres per day per person. As per the reports atleast 62% of the total volume of alcohol consumed by the Australian population are at risks of acute harms and about 44% of the alcohol per volume consumed bears risks of chronic diseases (Australian Drug Foundation, 2016).
As per the data produced by the department of Police and Emergency Management, Tasmania has not been immune to harm related to alcohol. Nearly 1,194 families and 514 victims were affected by alcohol, 1219 public assaults. There had been 2607 notices of liquor infringement and 1232 cases of liquor confiscations (Australian Drug Foundation, 2016). As per the fact sheets of the Tasmanian Alcohol Trends 2016, produced by the Department of Health and human Services, Since 1995, the proportion of drinking at minimum risk levels among the Tasmanian aboriginal youths has increased from 4.2% to 7.9% on the other hand the high risk levels have risen from 2.7 to 4.7% (National Health Survey: First Results, 2014-15. 2017). Studies say that Tasmania has got the highest rate of alcohol consumption among the youths.
                                   
Figure1: Prevalence of alcohol consumption in Tasmania. Indigenous Vs Non-indigenous
(National Health Survey: First Results, 2014-15. (2017). Abs.gov.au)
Program development and planning
There are numerous reasons that prompted the development of the health proposal. Problematic alcohol has become a serious public issue in Tasmania as it can put people at the risk of injury, crime, poisoning, family breakdown, long term health issues and self destruction (Calabria et al., 2013). It has been reported that Tasmania has received $5 million from the Government of Australia for implementing plans for the controlling of alcohols among the aboriginal resident of the state. Despite of all the measures taken, the alcohol use amongst the aboriginal teenagers is still visible in the state of Tasmania.  According to (National Health Survey: First Results, 2014-15″, 2017). The aboriginal youths of the Tasmania are becoming susceptible to different health issues due to the excessive consumption of alcohol such as cardiovascular diseases, self harm, alcohol related accidents and many more. Another factor that acts as a driving factor for the health proposal is that, disparity in treatment is found amongst the aboriginals due to many factors such as racism and their non reliance on the western modes of treatment (Chikritzhs & Pascal, 2004). This is not only hampering the professional life of the aboriginals but also jeopardizing with their cognitive development. In order to mitigate this, it is necessary to take some extensive health strategies. The primary target audience for this initiative will be aboriginal younger adults between the age 15-28, residing in the aboriginal areas of Tasmania (Chikritzhs & Pascal, 2004). We have also included the parents of these participants and the other elderly people of the population as the secondary audience, which will help to evaluate the success of the assessment.
Engagement of the stake holders
As per the author (Adegbija, Hoy & Wang, 2015). In order to implement a successful health strategy, a dedicated work force is required that would be able to invest ample time for this project, set achievable goals and implementation of those goals. Initially the South East Tasmanian Aboriginal health Corporation (SETAC) would provide with education, workforce, early intervention, case management, counseling and prevention of the relapse (Chikritzhs & Pascal, 2004). The whole regimen has to be done in collaboration with the families of the participants. Organizations such as The Drug Education Network (DEN) will work in collaboration with the Tasmanian Aboriginal Corporation for delivering safe and appropriate education and training regarding alcohol treatment – (National Health Survey: First Results, 2014-15″, 2017).
Time frame
A good action plan should have a proper time frame for achieving the goals and assessing the outcomes of the success. The goals and the objectives of the ‘Aboriginal alcohol strategy in Tasmania’ should be done in a time frame of one year (Chikritzhs & Pascal, 2004). The planning sessions should not take more than a month and the implementation sessions would commence from the next month and should get completed within a year, depending upon the availability of the resources.
Objectives of the program
Long term objectives

To decrease the rate of alcohol consumptions among the aboriginal youths in Tasmania.
To decrease the risks like health risks, alcohol related injuries and self harm.
To decrease the disparity among the aboriginals and the non aboriginals and the non aboriginals in terms of health, education and profession, that would help to decrease the stress and anxiety among the aboriginal youths.

Short term objectives
In order to achieve the long term objectives in the near future it is essential to work on a set of short term goals. The objectives can be listed below as:-

Creating awareness among the youths of the Aboriginal population regarding the ill effects of alcohol on their health and social life (Gilligan et al ., 2012).
Creating awareness regarding the risks of penalties for supplying alcohol to the aboriginal youths in Tasmania.  
Imparting education to the secondary audiences that is the parents regarding the ill effects of alcohol consumption (Gilligan et al., 2012).
Imparting educationto the other persons of the aboriginal community of different age groups for creating a mass awareness.
Providing rehabilitation to the already addicted aboriginal youths.

Strategies
It should be noted that it is no possible to remove all the sources that triggers alcohol consumption among the aboriginal youths in Tasmania, but simple interventions can be adopted to improve their way of living (Treeby & Bruno, 2012). The different strategies that can be taken up are as follows:-

Promotion of programs and events in Tasmania that are alcohol free.
Underage license for business in liquors should be discouraged and license should not be permitted. In order to accomplish this it is necessary to reinforce the proof of age.
There should be sports and recreation for the youths (Peacock et al., 2013).
The young aboriginals should be impart with the knowledge regarding the detrimental effects of alcohol on their health on their, social, personal and professional life.
It is necessary to impart education to the whole aboriginal community, as it is from them that most of the children imitate.
Setting up rehabilitation clinic for providing shelter to the already victimized youths and provide them with appropriate holistic care (Peacock et al., 2013).
To close the gaps between the health care facilities received by the indigenous and the non indigenous population of Tasmania. Mobile dispensaries can be there to provide health support to those who cannot get access to the healthcare due to the remote locations.
Setting up alcohol awareness campaign throughout Tasmania.
Involving the government organization and the federal government to strengthen the chalked out plan.

Program implementation
The next step to this project is the preparation of a proper action plan or teaching plan for exploring on the topics about the ill effects of alcohol, the key strategies to reduce the rate of alcohol consumption, the strategies, the use of appropriate resources and time frame (Gilligan et al ., 2012). Action plan is a plan which normally contains the list of tasks that are required to be done to achieve the goals within a stipulated time period. This portion of the paper will be discussing about the action plan that is required to fulfill the strategy and achieve the goals. The action plan will enlist the goals and the strategies that have to be taken up supported by a valid time frame. As per the guide lines provided by the World health organization (WHO), strategies can be considered as approaches that can be used to attain objectives or goals of a health proposal. The strategies taken up will be able to minimize the harm inflicted by the excessive use of alcohol. There should be extensive and sound strategies in order to achieve the goals taken in the action plan.
Action plan

STRATEGY

ACTION/RESOURCES

STAKE HOLDERS

TIMEFRAME

· Goal 1 :  Restricting the availability and the use of alcohol in the society

· Promotion of programs and events in Tasmania that are alcohol free.
 
 
· Taxation and pricing, Regulating  the physical availability of alcohol, counter measures for drunk driving, restriction on advertising

Exposing the youths of the aboriginal population to social media, posting the sign board with ‘ `no alcohol’  in front of the event venue.
 
Increasing taxation on alcohol, the availability of alcohol can be controlled by reducing the hours of sale. Advertisement regarding the use of any addictive item shall be prohibited. Drink- driving measures may include random breath testing, mass media campaigns, lessening the Legal blood alcohol limit (BAC) for driving.
.
 
 
 

 
Tasmania
 
 
 
 
 
Tasmania
 
 
 

 
every event
 
 
 
 
 
December 2017
 
 

Goal 2: Discouraging the aboriginal youths of Tasmania from drinking alcoholic drinks and  Imparting education to the aboriginal youths and the aboriginal population regarding the detrimental effects of alcohol consumption

 
 
· Alcohol awareness in the aboriginal schools
 
 
 
· Campaign for  Community education
 
 
 
 
· Promotion of Sports and other means of recreation for the aboriginal youth (Gilligan et al ., 2012).
 

 
 
Campaigns , workshops , showing of documentaries in the aboriginal schools imparting education regarding the ill effects of alcohol.
 
Mobile camps and campaigns to disseminate the information regarding the ill effects of alcohol usage. Imparting education to the families of the teenagers.
 
Encouraging the youths to practice sports and get engaged in constructive tasks to improve their health and future professional career.

 
School Administrators
 
 
 
 
Department of Education
 
 
 
 
 
 
Local councils of Tasmania
 

 
 
 
 
Immediately
 
 
 
 
 
 
Immediately
 
 
 
 

Goal 3: Improvement in the current funding system of the Government or achieving the goal of reducing alcohol consumption.

· Advocating a proper policy and legislative framework
 
 
 
· Decreasing the racism faced by the aboriginal youths in schools, Universities and in workplaces to improve their mental  and physical well being

Making an appeal to the state and federal governments with the help of legislative actions by presenting valid facts and statistical data regarding the concerned issue.
 
 
Presence of strict vigilance against any act of discrimination

Government of Tasmania
Federal Government
 
 
 
The government and the head of different concerned organizations.

Immediately
 
 
 
 
 
 
As soon as possible

Evaluation
After the implementation of any action plan it is important to evaluate whether all the objectives have been met or not. There should be a sound evaluation plan for the assessment of the implementation plans.  The evaluation plans should include appropriate data collection methods, resources, risk register tools, interviews (Yates, 2013). In order to accomplish a proper evaluation plan it is necessary to prepare a set of questionnaire for the interviews.
Evaluation plan

Engaging the stakeholder

The primary step for the development of an evaluation plan is selection of the population, which would involve all the participants of the survey and other stakeholders related to the project including the community and the head of the organization (Gilligan et al., 2012).

Objectives and questions

All the questions should be related to alcohol consumption, which would focus on the reasons behind the alcohol consumption. It would also obtain feedback from the aboriginal population regarding the effectiveness of the measures taken.

Methods adopted in data collection

There will be properly structured question answer round which will be used for the field survey. According to (Department of Planning and Community Development, 2014) interviews involving question answer techniques can be used to useful to receive feedback from the culturally diverse population like the aboriginals (White & Hingson, 2013).

Time frame

It is necessary to set up the evaluation programs urgently for incorporating further improvement in the strategies in time. Therefore it is necessary to maintain the time frame and the data should be collected properly after the completion of the action plan (Wutzke et al., 2012).

Analysis

According to (Department of Planning and Community Development, 2014) it is necessary to evaluate and analyze the outcomes of the feedback report. The collected data should be analyzed thoroughly in order to understand the necessary findings for the draw conclusions. Analysis of the data should be done to estimate the funding and the budget plans. Data analysis can be done by using graphs, pictograms, charts and posters.
References:
Adegbija, O., Hoy, W., & Wang, Z. (2015). Prediction of cardiovascular disease risk using waist circumference among Aboriginals in a remote Australian community. BMC public health, 15(1), 57. https://doi.org/10.1186/s12889-015-1406-1
Australian Drug Foundation. (2016). Statistics – Drug Prevention & Alcohol Facts – DrugInfo. Druginfo.adf.org.au. Retrieved 8 October 2016, from https://www.druginfo.adf.org.au/topics/quick-statistics
Calabria, B., Clifford, A., Shakeshaft, A., Allan, J., Bliss, D., & Doran, C. (2013). The acceptability to Aboriginal Australians of a family?based intervention to reduce alcohol?related harms. Drug and alcohol review, 32(3), 328-332. DOI: 10.1111/j.1465-3362.2012.00525.x
Chikritzhs, T., & Pascal, R. (2004). Trends in youth alcohol consumption and related harms in Australian jurisdictions, 1990-2002. https://doi.org/10.1016/j.socscimed.2011.06.058
Department of Planning and Community Development. (2014). Evaluation step by stepguide. Retrieved 12 October 2016, from https://www.dhs.vic.gov
Gilligan, C., Kypri, K., Johnson, N., Lynagh, M., & Love, S. (2012). Parental supply of alcohol and adolescent risky drinking. Drug and alcohol review, 31(6), 754-762. DOI: 10.1111/j.1465-3362.2012.00418.x
Howard, S. J., Gordon, R., & Jones, S. C. (2014). Australian alcohol policy 2001–2013 and implications for public health. BMC public health, 14(1), 848. https://doi.org/10.1186/1471-2458-14-848
Kwan, M., Bobko, S., Faulkner, G., Donnelly, P., &Cairney, J. (2014). Sport participation and alcohol and illicit drug use in adolescents and young adults: A systematic review of longitudinal studies. Addictive Behaviors, 39(3), 497-506. https://dx.doi.org/10.1016/j.addbeh.2013.11.006
Lumley, J., Correy, J. F., Newman, N. M., & Curran, J. T. (1985). Cigarette smoking, alcohol consumption and fetal outcome in Tasmania 1981–82. Australian and New Zealand Journal of Obstetrics and Gynaecology, 25(1), 33-40. DOI: 10.1111/j.1479-828X.1985.tb00599.x
 National Health Survey: First Results, 2014-15. (2017). Abs.gov.au. Retrieved 23 October 2017, from https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.001~2014-15~Main%20Features~Tasmania~10007
Peacock, A., Bruno, R., Martin, F. H., & Carr, A. (2013). The impact of alcohol and energy drink consumption on intoxication and risk?taking behavior. Alcoholism: Clinical and experimental research, 37(7), 1234-1242. DOI: 10.1111/acer.12086
 Retrieved 23 October 2017, from https://www.dhhs.tas.gov.au/__data/assets/pdf_file/0011/138359/FINALTasmanianAlcoholReport20132.pdf
Roche, A. M., Steenson, T., & Andrew, R. (2013). Alcohol and young people: What the legislation says about access and secondary supply. Drug and alcohol review, 32(2), 124-132. DOI: 10.1111/dar.12017
Ryan, L. (2012). Tasmanian Aborigines: a history since 1803.  
Shipman, D., Roa, M., Hooten, J., & Wang, Z. J. (2012). Using the analytic rubric as an evaluation tool in nursing education: the positive and the negative. Nurse Education Today, 32(3), 246-249. https://doi.org/10.1016/j.nedt.2011.04.007
Treeby, M., & Bruno, R. (2012). Shame and guilt-proneness: Divergent implications for problematic alcohol use and drinking to cope with anxiety and depression symptomatology. Personality and Individual Differences, 53(5), 613-617. https://doi.org/10.1016/j.paid.2012.05.011
White, A., & Hingson, R. (2013). The burden of alcohol use: excessive alcohol consumption and related consequences among college students. Alcohol research: current reviews.
World Health Organization. (2016). Defining Objectives and preparing an Action Plan. Retrieved 10 October 2016, from https://www.who.int/hac/
Wutzke, S. E., Shiell, A., Gomel, M. K., & Conigrave, K. M. (2001). Cost effectiveness of brief interventions for reducing alcohol consumption. Social science & medicine, 52(6), 863-870. https://doi.org/10.1016/S0277-9536(00)00189-1
Yates, C. (2013). Evidence-Based Practice: The Components, History, and Process. Counseling Outcome Research And Evaluation, 4(1), 41-54.
Ziersch, A. M., Gallaher, G., Baum, F., & Bentley, M. (2011). Responding to racism: Insights on how racism can damage health from an urban study of Australian Aboriginal people. Social Science & Medicine, 73(7), 1045-1053. https://doi.org/10.1016/j.socscimed.2011.06.058

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400210 Health Promotion And The Nurse

400210 Health Promotion And The Nurse

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400210 Health Promotion And The Nurse

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400210 Health Promotion And The Nurse

0 Download14 Pages / 3,385 Words

Course Code: 400210
University: Western Sydney University

MyAssignmentHelp.com is not sponsored or endorsed by this college or university

Country: Australia

Question:

You are required to choose a health promotion initiative which is relevant to your area of clinical practice and analyse it in relation to social determinants of health.

Answer:

Topic: Health Promotion Proposal for Tobacco Smoking among Indigenous Australians

Introduction
The indigenous community is an indigenous community found within Australia. Despite that fact that Australia is regarded as one of the countries in the world with a working tobacco control, the tobacco smoking prevalence among the indigenous people of the country continues to be high. The community continues to suffer high mortality and morbidity rates arising from the abuse of tobacco. Indeed tobacco is to blame for the greatest percentage of preventable deaths among the indigenous people in Australia. This paper has identified tobacco smoking as a health concern among the indigenous community of Australia. It therefore presents a health promotion proposal targeted to curb the epidemic in the community. Explored in the paper is a needs analysis which provides the rationale and justification for the health promotion initiative. Subsequent to this, the paper presents the objectives of the health promotion initiative both in the short term and in the long run. Subsequently, the paper then explores the implementation plan for the health promotion proposal-herein; both the action plan and the funding or budget for the plan is discussed. At the end, an evaluation plan is discussed. This presents a strategy to assess the effectiveness and efficiency of the health promotion plan in reducing the prevalence of tobacco smoking among the indigenous people of Australia.
Needs Analysis
This section of the paper presents an update on the situation of tobacco use among the Aboriginal community and the Torres Strait Islander community. It takes a look at the prevalence of tobacco smoking among the indigenous community by age, gender and indigenous status. The morbidity and mortality rates arising from tobacco use among the community is also discussed. The segment then discusses the current initiatives working on the prevention and reduction of tobacco smoking in the community and their successes this far. This then provides the basis for new/more initiatives to add to these efforts.
Prevalence of Tobacco Smoking Among Indigenous Australians
As is the case with most other indigenous community’s world over, the tobacco smoking rates among Aboriginal and Torres Strait Islanders has been a lot higher than in the rest of the country. From available literature, tobacco smoking has been a problem for this community for a long time. In 1994, a study reported that 54% of Aboriginal people (men) were smokers of tobacco (Magnus et al. 2011). The prevalence among women according to the same study was 46%. In comparison, the average national rates for tobacco smoking was at 20% indicating that the prevalence of tobacco smoking among indigenous people was more than twice higher. In 2004/5, according to the national survey the prevalence of tobacco smoking had slightly declined to 52.1% among Aboriginals and Torres Strait Islanders.
More recently according to another study for 2012-2013, the prevalence of tobacco smoking among young indigenous Australians between ages 15 and 17 was 21.3%. The prevalence among indigenous young people in the age bracket 18-24 was 48.3%. Comparatively the national prevalence rates for tobacco using in the said age brackets were 4.1% and 17.3% respectively (Butler et al. 2010). This indicates that the rate of tobacco smoking among the indigenous youth was still several times higher than the national average. In the year 2014/15, the prevalence of smoking among the indigenous males and females had come down to 43.6%. Most recently in 2017, the prevalence of tobacco smoking among the Aboriginal and Torres Strait Islander has been estimated at 41.4%.
Figure 1: Trends in tobacco smoking between 1996 and 2014 (adopted from Thomas & Stevens, 2014)

Despite the fact that this is a decline from the previous years, the figure is still much higher than the national average for Australia which is just 14%.
Tobacco Smoking Prevalence by Age, Gender and Indigenous Status
According to a national survey conducted in 2014/15, the prevalence of tobacco smoking among indigenous Australians was higher than the national average in all age groups and in both gender. The prevalence among the Aboriginal community (39%) is slightly higher than the Torres Strait Islanders by 4% (Thomas & Stevens 2014). The prevalence among all age groups seems to be at the same level among all age groups except for 15-24 and 45-55, which indicate that men are more affected than their female counterparts.
Figure 2: Variations in tobacco smoking trends by age, gender and indigenous status (Thomas & Stevens, 2014).

Morbidity and Mortality Attributable to Smoking
The burden of disease that is attributable to tobacco smoking among the indigenous people of Australia is immense. As an indicator of severity of tobacco smoking, the prevalence of lung cancer has been found to be higher among the Aboriginal and Torres Strait Islanders (Martin et al. 2017).  Lung cancer is also found to appear among persons of younger ages among the indigenous communities as compared to non-indigenous Australians. This is attributable to exposure to tobacco intake at a tender age as already explored in the preceding paragraphs. The burden of premature deaths in the Aboriginal community is also high.
The Aboriginals and Torres Strait Islanders have a markedly lower life expectancy compared to the non-indigenous Australians. The 15 year difference is attributable to among other causes, high tobacco intake. Thomas et al. (2017) submits that if tobacco related deaths among the indigenous people of Australia were eliminated, the life expectancy would increase for both men and women (from 58.5 to 61 for men and from 65.3 to 67 for women). The prevalence of tobacco related illnesses namely, cervical cancer, pneumonia, cardiovascular disease and ear infections are higher than the national average. An indigenous Australian is 2 or 3 times more likely to be hospitalized with respiratory diseases related to tobacco smoking as compared to non-indigenous Australians (Shepherd & Zubrick 2012). This information is testament to the fact that there is need for more initiatives to deal with the problem
Plan Objectives
The following section identifies the objectives that are to be met by end of the session for the intervention plan for tobacco control:

Sustained media campaign to create awareness on dangers of smoking.
By the end of the intervention process at least 75 % of all adult persons in the Aboriginal population who are tobacco smokers should be signed up for a cessation plan.
Pharmacological methods for nicotine replacement.
A minimum of 50 % of Aboriginal adult smokers should report a 50% reduction in their smoking rates.
At least one support center (cessation support center) to be established within every locality to provide support for person willing to quit.

Strategies for Achieving Objectives
This segment of the paper addresses the strategies that will be employed achieving the intended objectives of the health promotion proposal. It gives a summary of the strategies that will be employed in achieving both the short term as well as long-term objectives of the plan. In the short term the health promotion initiative targets the following specific objectives:

Awareness creation-borrowing fromPender (2015), the program intends to produce salient messages to be disseminated in both mainstream and social media outlets with information discouraging the use of tobacco among the indigenous people of Australia. The messages will address the current morbidity and mortality burden attributable to tobacco smoking and highlight the potential benefits of cessation of tobacco smoking on health.
Cessation and Rehabilitation-the program objectifies the provision of opportunities for all affected persons to access pharmacological alternatives for smoking. This will be achieved by encouraging them to join cessation programs alongside providing support for cessation and rehabilitation. As contained inVictorian Health Promotion Foundation (2014) the program will provide alternatives for tobacco use such as nicotine replacement therapy, varenicline, nicotine gum, nicotine lozenges, nortriptyline and sustained release bupropion.
Support structures-The program idealizes the creation of necessary support structures within the family, workplace, schools and the general community to create the enabling environment for persons willing to quit to follow through the cessation process.
Training-the initiative will also seek to train and equip personnel who will be involved in the program. This is necessary in order to sensitize workers (including health workers, community health volunteers, social workers, police and local administrative agents) on how to offer help to the affected persons and more importantly, how to handle them through the cessation process in a manner that support them(Kegler, Rigler & Honeycutt 2011).

In the long term the initiative targets the following broad range objectives:

Behavior/ culture change

In the long-term, the initiative targets to impact on the behavior pattern of the indigenous people. The Aboriginal people of Australia have for a long time been known to chew dry leaves of tobacco even before they had contact with non-indigenous Australians and continue to use dry leaves of native tobacco even to date. In the history of the aboriginal people, tobacco was used as a form of currency in the ancient colonial times (Pruss-Ustun et al., 2016). In this region, Macassan pipes used to smoke tobacco are especially widespread during their traditional ceremonies. This is testament to the fact that in this community, the use of tobacco is deeply engrained in the culture. In fact, some of them still believe that chronic diseases such as respiratory and cardiovascular diseases (which are tobacco related) are caused by sorcery, conflict between persons or non-observance of taboos. As a consequence a long term objective must address the cultural belief in the smoking of tobacco and seek to influence the culture to move away from the tradition.

Providing access to culturally healthy materials

As already stated the use of tobacco among the Aboriginal and the Torres Strait Islanders is intricately engrossed and enabled by the culture and history of the communities. In the long term the initiative targets a behavior and culture shift from these traditions. However, this can only be successful if the initiative offers the community some meaningful culturally healthy options.

Addressing broader social disadvantages

The program recognizes that any initiative to prevent or reduce tobacco smoking has to seek redress for underlying factors that contribute to tobacco smoking among the Aboriginal people. Broader social disparities have been identified as a major causal pathway for tobacco smoking behavior (World Health Organization 2015). Use of tobacco is associated with low income, poor housing, low literacy levels and unemployment. The long term objective would be to seek redress for the said issues in order to deal with enabling factors for smoking

Long term community investments

The initiative being fully cognizant of the enabling factors for smoking of tobacco among Aboriginals, further having taken sufficient step towards effecting behavioral change and culture shift notes that another long term objective would be to invest in the community, in order to cushion against a reversal of the gains made. As posited by Sokol et al. (2017) this is aimed at creating opportunities for the community to engage in income generation and shun the negative behavior of tobacco smoking.
Action Plan
This segment of the report provides an outline for the implementation of the health promotion proposal and details the resources (both human and material) that would be needed in the implementation of the project. The need of funding is also discussed in the same section.
For a health promotion to be effective in curbing the high prevalence of tobacco smoking among the indigenous community the action plan must take a particular shape and form; firstly the strategies must adopt whole-of-community approach (Pruss-Ustun et al. 2016). The activities of the initiative should be integrated within the existing healthcare provision and should bring on board a variety of sectors in the society. Finally and most importantly the initiative must be multi component, with each component addressing the various facets of tobacco smoking in the community. The following are strategies of the action plan;
A cross-sector approach
Actors from any one sector cannot deliver the implementation of the initiative if it is to succeed. According to Victorian Health Promotion Foundation (2014), if the menace of tobacco smoking among the Aboriginals and the Torres Strait Islanders is to be recognized as a societal problem, any approaches to handle it must be multi-sectorial. Owing to this, the implementation will bring on board persons drawn from different sectors of the society. These will include the healthcare practitioners (nurses and clinical officers as primary stakeholders). Apart from the health care practitioners, government agencies such as the National Health Service, non-governmental organization offering health related services, community health volunteers, social workers, police and local administration officials will also be involved. This kind of approach ensures that all skills set required to deal with the problem are brought on board.
Whole-of Community Approach
Successful implementation of a health promotion initiative can only be realized if the plan is one that includes the whole community. When individuals are signed up to the cessation programs the initiatives must put in place mechanisms to ensure that the necessary supportive structures in which successful cessation can occur are also put in place(Shepherd & Zubrick 2012). This means that persons around the home, workplace, the neighborhood and the community in general have to be sensitized in order to create capacity in them to help addicts to recover from tobacco smoking. The strategies must also be integrated within the health care provision services in the state. This makes it easy to coordinate efforts between the healthcare providers and the health promotion initiative.
Multi-Component Approach
For a health promotion program to be effective in bringing down the prevalence it ought to be multi component; i.e. it should have several fronts that aim at finding redress for the various facets and underlying causal pathways for tobacco use (Pender 2015). High prevalence of tobacco smoking is directly associated with low income levels, poor housing conditions and unemployment. Addressing the health component of tobacco use is only the starting point. The social disadvantages that enable the behavior must be addressed if the prevalence is to be brought down. This partly explains the need for bringing on board the multi sectorial team including government agencies so as to help find solutions for the wider societal problems that enable smoking. As a vital component, the use of tobacco as a stress reliever must also be tackled, although it all comes down to the sources of stress which takes the plan back to the identified socio-economic disadvantages.
Funding
The funding of the health promotion initiative will be drawn from a number of sources. Just like many other tobacco control programs the initiative will partner with many other like-minded organizations and entities as already discussed. These include the National Health Services, non-governmental organization, local administration, social services and the police. The program will seek funding and logistical support from the partnering entities mentioned. According to Victorian Health Promotion Foundation (2014) health promotion initiatives cannot achieve their objectives without support from state and commonwealth governments. Most importantly the initiative will petition the state government to allocate some substantial amount of resources towards the same in its fiscal year’s budget.
Evaluation Plan
This section of the plan develops an evaluation plan that would be used to evaluate the effectiveness of the health promotion initiative. The evaluation plan is commenced by a clear identification of the purpose of the evaluation. Four main purposes are identified for the evaluation plan as adopted from Sokol et al. (2017).

To assess the impacts of the project activities on the community on the Aboriginals and the Torres Strait Islander community in terms of meeting the objectives and document the findings.
To evaluate the extent to which the activities of the initiative have been executed and their impacts.

To contribute to providing support to higher standards of evaluation planning in the furtherance of good practice and creation of evidence based practice in community initiatives for health promotion.

To create capacity in the Aboriginal and Torres Islander communities  to participate in the implementation of tobacco smoking control initiatives

Figure 3:  Summary of the evaluation questions that the evaluation plan will address (Sokol et al. (2017)

Process Evaluation
The main aspects of the evaluation plan will study the program documents in determining the length and breadth to which the program activities have been implemented.  As submitted by World Health Organization (2015) there will also be data collection by the program persons to assess the program reach. Reach here is used to refer to the number of tobacco users in the Aboriginal and Torres Strait Islander community that have been impacted by the program. Specific aspects of program reach such as program attendance will be weighed as an indicator of the performance of the initiative.
Data will be sourced from entities such as the project advisory committees, the National Health Services, program person’s action plans as well as the health services key performance indictor policy papers. Additionally, if need be, qualitative research methods will be used in the evaluation. According to Kegler, Rigler & Honeycutt (2011) this will involve methods such as interviews, questionnaires and open ended surveys to collect the assessment of key stakeholders on the progress of the initiative.
Figure 4: Major outcomes and indicators of the program reach that will be employed in the evaluation plan for the Health Promotion Initiative (Sokol et al., 2017)

The second part of the table shows the evaluation plan for the assessment of program reach of the Health Promotion Initiative

Conclusion
As presented in the paper, tobacco smoking is an issue of public health concern among the Aboriginal and Torres Strait Islanders. As evidenced from the prevalence rates of the tobacco smoking it is a matter that warrants the development of a health promotion initiative. The proposal plan has presented a need analysis as is evidenced by the high rates of tobacco smoking in the last several years. The objectives of the health promotion initiative would be to influence a culture/behavioral change in the attitudes of the indigenous peoples of Australia so they shift from the use of tobacco. A successful initiative will have to include a multi sectorial, and a multi-component approach that ensures all pertinent issues linked to tobacco use among the indigenous people are addressed. The evaluation plan has clearly documented a pathway for the monitoring and evaluation of the success of the initiative too.
References
Butler, R., Chapman, S., Thomas, D. P., & Torzillo, P. (2010). Low daily smoking estimates derived from sales monitored tobacco use in six remote predominantly Aboriginal communities. Australian & New Zealand Journal of Public Health, 34, S71–S75. https://doi.org/10.1111/j.1753-6405.2010.00557.x
Kegler, M. C., Rigler, J., & Honeycutt, S. (2011). The Role of community context in planning and implementing community-based health promotion projects. Evaluation & Program Planning, 34(3), 246–253. https://doi.org/10.1016/j.evalprogplan.2011.03.004
Magnus, A., Cadilhac, D., Sheppard, L., Cumming, T., Pearce, D., & Carter, R. (2011). Economic Benefits of Achieving Realistic Smoking Cessation Targets in Australia. American Journal of Public Health, 101(2), 321–327. https://doi.org/10.2105/AJPH.2009.191056
Martin, K., Dono, J., Rigney, N., Rayner, J., Sparrow, A., Miller, C., … Bowden, J. (2017). Barriers and facilitators for health professionals referring Aboriginal and Torres Strait Islander tobacco smokers to the Quitline. Australian & New Zealand Journal of Public Health, 41(6), 631–634. https://doi.org/10.1111/1753-6405.12727
Pender, N. (2015). The Health Promotion Model Manual. Available https://hdl.handle.net/2027.42/8535043
Pruss-Ustun, A., Wolf, J., Corvalan, C., Bos, R. & Neira, M. (2016).Preventing disease through healthy environments: A global assessment of the burden of disease from environmental risks. Geneva, Switzerland: World Health Organisation 37(6), 1072–1081. https://doi.org/10.1111/risa.12544
Shepherd, C. C. J., Li, J., & Zubrick, S. R. (2012). Social Gradients in the Health of Indigenous Australians. American Journal of Public Health, 102(1), 107–117. https://doi.org/10.2105/AJPH.2011.300354
Sokol, R., Moracco, B., Nelson, S., Rushing, J., Singletary, T., Stanley, K., & Stein, A. (2017). How local health departments work towards health equity. Evaluation & Program Planning, 65, 117–123. http s://doi.org/10.1016/j.evalprogplan.2017.08.002
Thomas, D. P., & Stevens, M. (2014). Aboriginal and Torres Strait Islander smoke-free homes, 2002 to 2008. Australian & New Zealand Journal of Public Health, 38(2), 147–153. https://doi.org/10.1111/1753-6405.12202
Thomas, D. P., Panaretto, K. S., Davey, M., Briggs, V., & Borland, R. (2017). The social determinants and starting and sustaining quit attempts in a national sample of Aboriginal and Torres Strait Islander smokers. Australian & New Zealand Journal of Public Health, 41(3), 230–236. https://doi.org/10.1111/1753-6405.12626
Victorian Health Promotion Foundation ‘A’ŸVicHealth’. (2014). Physical activity, sport and
walking: VicHealth’s Investment Plan (2014-2018). Available: https://www.vichealth.vic.gov. au/~/media/resourcecentre/publicationsandresources/physical%20activity/physactivity-investmentplan-2014-18.pdf?la=en 45
World Health Organization. (2015). WHO recommendations on health promotion interventions for maternal and newborn health. Geneva, Switzerland, WHO 37(6), 1096–1107. https://doi.org/10.1111/risa.12669

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400210 Health Promotion And The Nurse

400210 Health Promotion And The Nurse

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400210 Health Promotion And The Nurse

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You are required to choose a health promotion initiative which is relevant to your area of clinical practice and analyse it in relation to social determinants of health.

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Topic: Health Promotion Proposal for Tobacco Smoking among Indigenous Australians

Introduction
The indigenous community is an indigenous community found within Australia. Despite that fact that Australia is regarded as one of the countries in the world with a working tobacco control, the tobacco smoking prevalence among the indigenous people of the country continues to be high. The community continues to suffer high mortality and morbidity rates arising from the abuse of tobacco. Indeed tobacco is to blame for the greatest percentage of preventable deaths among the indigenous people in Australia. This paper has identified tobacco smoking as a health concern among the indigenous community of Australia. It therefore presents a health promotion proposal targeted to curb the epidemic in the community. Explored in the paper is a needs analysis which provides the rationale and justification for the health promotion initiative. Subsequent to this, the paper presents the objectives of the health promotion initiative both in the short term and in the long run. Subsequently, the paper then explores the implementation plan for the health promotion proposal-herein; both the action plan and the funding or budget for the plan is discussed. At the end, an evaluation plan is discussed. This presents a strategy to assess the effectiveness and efficiency of the health promotion plan in reducing the prevalence of tobacco smoking among the indigenous people of Australia.
Needs Analysis
This section of the paper presents an update on the situation of tobacco use among the Aboriginal community and the Torres Strait Islander community. It takes a look at the prevalence of tobacco smoking among the indigenous community by age, gender and indigenous status. The morbidity and mortality rates arising from tobacco use among the community is also discussed. The segment then discusses the current initiatives working on the prevention and reduction of tobacco smoking in the community and their successes this far. This then provides the basis for new/more initiatives to add to these efforts.
Prevalence of Tobacco Smoking Among Indigenous Australians
As is the case with most other indigenous community’s world over, the tobacco smoking rates among Aboriginal and Torres Strait Islanders has been a lot higher than in the rest of the country. From available literature, tobacco smoking has been a problem for this community for a long time. In 1994, a study reported that 54% of Aboriginal people (men) were smokers of tobacco (Magnus et al. 2011). The prevalence among women according to the same study was 46%. In comparison, the average national rates for tobacco smoking was at 20% indicating that the prevalence of tobacco smoking among indigenous people was more than twice higher. In 2004/5, according to the national survey the prevalence of tobacco smoking had slightly declined to 52.1% among Aboriginals and Torres Strait Islanders.
More recently according to another study for 2012-2013, the prevalence of tobacco smoking among young indigenous Australians between ages 15 and 17 was 21.3%. The prevalence among indigenous young people in the age bracket 18-24 was 48.3%. Comparatively the national prevalence rates for tobacco using in the said age brackets were 4.1% and 17.3% respectively (Butler et al. 2010). This indicates that the rate of tobacco smoking among the indigenous youth was still several times higher than the national average. In the year 2014/15, the prevalence of smoking among the indigenous males and females had come down to 43.6%. Most recently in 2017, the prevalence of tobacco smoking among the Aboriginal and Torres Strait Islander has been estimated at 41.4%.
Figure 1: Trends in tobacco smoking between 1996 and 2014 (adopted from Thomas & Stevens, 2014)

Despite the fact that this is a decline from the previous years, the figure is still much higher than the national average for Australia which is just 14%.
Tobacco Smoking Prevalence by Age, Gender and Indigenous Status
According to a national survey conducted in 2014/15, the prevalence of tobacco smoking among indigenous Australians was higher than the national average in all age groups and in both gender. The prevalence among the Aboriginal community (39%) is slightly higher than the Torres Strait Islanders by 4% (Thomas & Stevens 2014). The prevalence among all age groups seems to be at the same level among all age groups except for 15-24 and 45-55, which indicate that men are more affected than their female counterparts.
Figure 2: Variations in tobacco smoking trends by age, gender and indigenous status (Thomas & Stevens, 2014).

Morbidity and Mortality Attributable to Smoking
The burden of disease that is attributable to tobacco smoking among the indigenous people of Australia is immense. As an indicator of severity of tobacco smoking, the prevalence of lung cancer has been found to be higher among the Aboriginal and Torres Strait Islanders (Martin et al. 2017).  Lung cancer is also found to appear among persons of younger ages among the indigenous communities as compared to non-indigenous Australians. This is attributable to exposure to tobacco intake at a tender age as already explored in the preceding paragraphs. The burden of premature deaths in the Aboriginal community is also high.
The Aboriginals and Torres Strait Islanders have a markedly lower life expectancy compared to the non-indigenous Australians. The 15 year difference is attributable to among other causes, high tobacco intake. Thomas et al. (2017) submits that if tobacco related deaths among the indigenous people of Australia were eliminated, the life expectancy would increase for both men and women (from 58.5 to 61 for men and from 65.3 to 67 for women). The prevalence of tobacco related illnesses namely, cervical cancer, pneumonia, cardiovascular disease and ear infections are higher than the national average. An indigenous Australian is 2 or 3 times more likely to be hospitalized with respiratory diseases related to tobacco smoking as compared to non-indigenous Australians (Shepherd & Zubrick 2012). This information is testament to the fact that there is need for more initiatives to deal with the problem
Plan Objectives
The following section identifies the objectives that are to be met by end of the session for the intervention plan for tobacco control:

Sustained media campaign to create awareness on dangers of smoking.
By the end of the intervention process at least 75 % of all adult persons in the Aboriginal population who are tobacco smokers should be signed up for a cessation plan.
Pharmacological methods for nicotine replacement.
A minimum of 50 % of Aboriginal adult smokers should report a 50% reduction in their smoking rates.
At least one support center (cessation support center) to be established within every locality to provide support for person willing to quit.

Strategies for Achieving Objectives
This segment of the paper addresses the strategies that will be employed achieving the intended objectives of the health promotion proposal. It gives a summary of the strategies that will be employed in achieving both the short term as well as long-term objectives of the plan. In the short term the health promotion initiative targets the following specific objectives:

Awareness creation-borrowing fromPender (2015), the program intends to produce salient messages to be disseminated in both mainstream and social media outlets with information discouraging the use of tobacco among the indigenous people of Australia. The messages will address the current morbidity and mortality burden attributable to tobacco smoking and highlight the potential benefits of cessation of tobacco smoking on health.
Cessation and Rehabilitation-the program objectifies the provision of opportunities for all affected persons to access pharmacological alternatives for smoking. This will be achieved by encouraging them to join cessation programs alongside providing support for cessation and rehabilitation. As contained inVictorian Health Promotion Foundation (2014) the program will provide alternatives for tobacco use such as nicotine replacement therapy, varenicline, nicotine gum, nicotine lozenges, nortriptyline and sustained release bupropion.
Support structures-The program idealizes the creation of necessary support structures within the family, workplace, schools and the general community to create the enabling environment for persons willing to quit to follow through the cessation process.
Training-the initiative will also seek to train and equip personnel who will be involved in the program. This is necessary in order to sensitize workers (including health workers, community health volunteers, social workers, police and local administrative agents) on how to offer help to the affected persons and more importantly, how to handle them through the cessation process in a manner that support them(Kegler, Rigler & Honeycutt 2011).

In the long term the initiative targets the following broad range objectives:

Behavior/ culture change

In the long-term, the initiative targets to impact on the behavior pattern of the indigenous people. The Aboriginal people of Australia have for a long time been known to chew dry leaves of tobacco even before they had contact with non-indigenous Australians and continue to use dry leaves of native tobacco even to date. In the history of the aboriginal people, tobacco was used as a form of currency in the ancient colonial times (Pruss-Ustun et al., 2016). In this region, Macassan pipes used to smoke tobacco are especially widespread during their traditional ceremonies. This is testament to the fact that in this community, the use of tobacco is deeply engrained in the culture. In fact, some of them still believe that chronic diseases such as respiratory and cardiovascular diseases (which are tobacco related) are caused by sorcery, conflict between persons or non-observance of taboos. As a consequence a long term objective must address the cultural belief in the smoking of tobacco and seek to influence the culture to move away from the tradition.

Providing access to culturally healthy materials

As already stated the use of tobacco among the Aboriginal and the Torres Strait Islanders is intricately engrossed and enabled by the culture and history of the communities. In the long term the initiative targets a behavior and culture shift from these traditions. However, this can only be successful if the initiative offers the community some meaningful culturally healthy options.

Addressing broader social disadvantages

The program recognizes that any initiative to prevent or reduce tobacco smoking has to seek redress for underlying factors that contribute to tobacco smoking among the Aboriginal people. Broader social disparities have been identified as a major causal pathway for tobacco smoking behavior (World Health Organization 2015). Use of tobacco is associated with low income, poor housing, low literacy levels and unemployment. The long term objective would be to seek redress for the said issues in order to deal with enabling factors for smoking

Long term community investments

The initiative being fully cognizant of the enabling factors for smoking of tobacco among Aboriginals, further having taken sufficient step towards effecting behavioral change and culture shift notes that another long term objective would be to invest in the community, in order to cushion against a reversal of the gains made. As posited by Sokol et al. (2017) this is aimed at creating opportunities for the community to engage in income generation and shun the negative behavior of tobacco smoking.
Action Plan
This segment of the report provides an outline for the implementation of the health promotion proposal and details the resources (both human and material) that would be needed in the implementation of the project. The need of funding is also discussed in the same section.
For a health promotion to be effective in curbing the high prevalence of tobacco smoking among the indigenous community the action plan must take a particular shape and form; firstly the strategies must adopt whole-of-community approach (Pruss-Ustun et al. 2016). The activities of the initiative should be integrated within the existing healthcare provision and should bring on board a variety of sectors in the society. Finally and most importantly the initiative must be multi component, with each component addressing the various facets of tobacco smoking in the community. The following are strategies of the action plan;
A cross-sector approach
Actors from any one sector cannot deliver the implementation of the initiative if it is to succeed. According to Victorian Health Promotion Foundation (2014), if the menace of tobacco smoking among the Aboriginals and the Torres Strait Islanders is to be recognized as a societal problem, any approaches to handle it must be multi-sectorial. Owing to this, the implementation will bring on board persons drawn from different sectors of the society. These will include the healthcare practitioners (nurses and clinical officers as primary stakeholders). Apart from the health care practitioners, government agencies such as the National Health Service, non-governmental organization offering health related services, community health volunteers, social workers, police and local administration officials will also be involved. This kind of approach ensures that all skills set required to deal with the problem are brought on board.
Whole-of Community Approach
Successful implementation of a health promotion initiative can only be realized if the plan is one that includes the whole community. When individuals are signed up to the cessation programs the initiatives must put in place mechanisms to ensure that the necessary supportive structures in which successful cessation can occur are also put in place(Shepherd & Zubrick 2012). This means that persons around the home, workplace, the neighborhood and the community in general have to be sensitized in order to create capacity in them to help addicts to recover from tobacco smoking. The strategies must also be integrated within the health care provision services in the state. This makes it easy to coordinate efforts between the healthcare providers and the health promotion initiative.
Multi-Component Approach
For a health promotion program to be effective in bringing down the prevalence it ought to be multi component; i.e. it should have several fronts that aim at finding redress for the various facets and underlying causal pathways for tobacco use (Pender 2015). High prevalence of tobacco smoking is directly associated with low income levels, poor housing conditions and unemployment. Addressing the health component of tobacco use is only the starting point. The social disadvantages that enable the behavior must be addressed if the prevalence is to be brought down. This partly explains the need for bringing on board the multi sectorial team including government agencies so as to help find solutions for the wider societal problems that enable smoking. As a vital component, the use of tobacco as a stress reliever must also be tackled, although it all comes down to the sources of stress which takes the plan back to the identified socio-economic disadvantages.
Funding
The funding of the health promotion initiative will be drawn from a number of sources. Just like many other tobacco control programs the initiative will partner with many other like-minded organizations and entities as already discussed. These include the National Health Services, non-governmental organization, local administration, social services and the police. The program will seek funding and logistical support from the partnering entities mentioned. According to Victorian Health Promotion Foundation (2014) health promotion initiatives cannot achieve their objectives without support from state and commonwealth governments. Most importantly the initiative will petition the state government to allocate some substantial amount of resources towards the same in its fiscal year’s budget.
Evaluation Plan
This section of the plan develops an evaluation plan that would be used to evaluate the effectiveness of the health promotion initiative. The evaluation plan is commenced by a clear identification of the purpose of the evaluation. Four main purposes are identified for the evaluation plan as adopted from Sokol et al. (2017).

To assess the impacts of the project activities on the community on the Aboriginals and the Torres Strait Islander community in terms of meeting the objectives and document the findings.
To evaluate the extent to which the activities of the initiative have been executed and their impacts.

To contribute to providing support to higher standards of evaluation planning in the furtherance of good practice and creation of evidence based practice in community initiatives for health promotion.

To create capacity in the Aboriginal and Torres Islander communities  to participate in the implementation of tobacco smoking control initiatives

Figure 3:  Summary of the evaluation questions that the evaluation plan will address (Sokol et al. (2017)

Process Evaluation
The main aspects of the evaluation plan will study the program documents in determining the length and breadth to which the program activities have been implemented.  As submitted by World Health Organization (2015) there will also be data collection by the program persons to assess the program reach. Reach here is used to refer to the number of tobacco users in the Aboriginal and Torres Strait Islander community that have been impacted by the program. Specific aspects of program reach such as program attendance will be weighed as an indicator of the performance of the initiative.
Data will be sourced from entities such as the project advisory committees, the National Health Services, program person’s action plans as well as the health services key performance indictor policy papers. Additionally, if need be, qualitative research methods will be used in the evaluation. According to Kegler, Rigler & Honeycutt (2011) this will involve methods such as interviews, questionnaires and open ended surveys to collect the assessment of key stakeholders on the progress of the initiative.
Figure 4: Major outcomes and indicators of the program reach that will be employed in the evaluation plan for the Health Promotion Initiative (Sokol et al., 2017)

The second part of the table shows the evaluation plan for the assessment of program reach of the Health Promotion Initiative

Conclusion
As presented in the paper, tobacco smoking is an issue of public health concern among the Aboriginal and Torres Strait Islanders. As evidenced from the prevalence rates of the tobacco smoking it is a matter that warrants the development of a health promotion initiative. The proposal plan has presented a need analysis as is evidenced by the high rates of tobacco smoking in the last several years. The objectives of the health promotion initiative would be to influence a culture/behavioral change in the attitudes of the indigenous peoples of Australia so they shift from the use of tobacco. A successful initiative will have to include a multi sectorial, and a multi-component approach that ensures all pertinent issues linked to tobacco use among the indigenous people are addressed. The evaluation plan has clearly documented a pathway for the monitoring and evaluation of the success of the initiative too.
References
Butler, R., Chapman, S., Thomas, D. P., & Torzillo, P. (2010). Low daily smoking estimates derived from sales monitored tobacco use in six remote predominantly Aboriginal communities. Australian & New Zealand Journal of Public Health, 34, S71–S75. https://doi.org/10.1111/j.1753-6405.2010.00557.x
Kegler, M. C., Rigler, J., & Honeycutt, S. (2011). The Role of community context in planning and implementing community-based health promotion projects. Evaluation & Program Planning, 34(3), 246–253. https://doi.org/10.1016/j.evalprogplan.2011.03.004
Magnus, A., Cadilhac, D., Sheppard, L., Cumming, T., Pearce, D., & Carter, R. (2011). Economic Benefits of Achieving Realistic Smoking Cessation Targets in Australia. American Journal of Public Health, 101(2), 321–327. https://doi.org/10.2105/AJPH.2009.191056
Martin, K., Dono, J., Rigney, N., Rayner, J., Sparrow, A., Miller, C., … Bowden, J. (2017). Barriers and facilitators for health professionals referring Aboriginal and Torres Strait Islander tobacco smokers to the Quitline. Australian & New Zealand Journal of Public Health, 41(6), 631–634. https://doi.org/10.1111/1753-6405.12727
Pender, N. (2015). The Health Promotion Model Manual. Available https://hdl.handle.net/2027.42/8535043
Pruss-Ustun, A., Wolf, J., Corvalan, C., Bos, R. & Neira, M. (2016).Preventing disease through healthy environments: A global assessment of the burden of disease from environmental risks. Geneva, Switzerland: World Health Organisation 37(6), 1072–1081. https://doi.org/10.1111/risa.12544
Shepherd, C. C. J., Li, J., & Zubrick, S. R. (2012). Social Gradients in the Health of Indigenous Australians. American Journal of Public Health, 102(1), 107–117. https://doi.org/10.2105/AJPH.2011.300354
Sokol, R., Moracco, B., Nelson, S., Rushing, J., Singletary, T., Stanley, K., & Stein, A. (2017). How local health departments work towards health equity. Evaluation & Program Planning, 65, 117–123. http s://doi.org/10.1016/j.evalprogplan.2017.08.002
Thomas, D. P., & Stevens, M. (2014). Aboriginal and Torres Strait Islander smoke-free homes, 2002 to 2008. Australian & New Zealand Journal of Public Health, 38(2), 147–153. https://doi.org/10.1111/1753-6405.12202
Thomas, D. P., Panaretto, K. S., Davey, M., Briggs, V., & Borland, R. (2017). The social determinants and starting and sustaining quit attempts in a national sample of Aboriginal and Torres Strait Islander smokers. Australian & New Zealand Journal of Public Health, 41(3), 230–236. https://doi.org/10.1111/1753-6405.12626
Victorian Health Promotion Foundation ‘A’ŸVicHealth’. (2014). Physical activity, sport and
walking: VicHealth’s Investment Plan (2014-2018). Available: https://www.vichealth.vic.gov. au/~/media/resourcecentre/publicationsandresources/physical%20activity/physactivity-investmentplan-2014-18.pdf?la=en 45
World Health Organization. (2015). WHO recommendations on health promotion interventions for maternal and newborn health. Geneva, Switzerland, WHO 37(6), 1096–1107. https://doi.org/10.1111/risa.12669

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