Community Prevention Project of Arthritis

Abstract

Arthritis is a chronic, progressive disease that wears joint synovial and affects other body organs and vasculature. Although there are some myths about arthritis that it affects only the elderly, this disease is multigenerational. It affects people of all sexes, races, and ages. While current programs, designed to address the impact of arthritis on joints, have been shown to be of benefit, the incapacitating and developing nature of the disease continues to affect many community members. Currently, there are several organizations addressing the challenges posed by arthritis in the community. These organizations help in the alleviation of suffering among arthritis patients. Some of these organizations are Arthritis Foundation, National Arthritis Action Plan, and Center for Disease Prevention and Control.

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One in every five Americans is affected by arthritis. Nearly two-thirds of people with arthritis are under the age of 65. With the aging of the baby boomer population, the prevalence of arthritis is expected to rise by 40 % by the year 2030. This means that it will affect approximately 67 million people. This proposal is thus aiming at raising awareness and reducing the impact of this serious, unacceptable, and painful disease in the community. Much of the researches done on arthritis indicate that enhancing understanding is essential. Knowledge about arthritis should also be publicized through education. Such activities will help in reducing the suffering associated with arthritis. Additionally, providing knowledge on the prevention and control of arthritis will ensure that new discoveries are handled appropriately.

This proposal presents a community prevention program dedicated to patients suffering from arthritis and their family members who suffer indirectly. To implement this project successfully, the contribution of various stakeholders is paramount. All stakeholders involved in this project will play various roles in the implementation process. To monitor any success in this project proposal, the Department of Public Health will access any achievement attained. Any findings made will be disseminated to all stakeholders involved or any other stakeholders who may be interested in this project.

Keywords: arthritis, a community prevention program, non-profit health organizations

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Problem Description

Arthritis is a disease comprising of approximately a hundred conditions. It mainly affects connective tissues, joints, and surrounding tissues. Currently, arthritis affects approximately 46 million Americans. This makes arthritis a public health concern or problem. What is more worrying, the number of patients suffering from this condition is expected to rise. The number of adults with doctor-diagnosed arthritis is expected or projected to increase to 67 million by the year 2030. A third of these new patients will have limited activity as a result of this condition. Recent studies indicate that the lifetime risk of developing knee osteoarthritis has risen by 45 %. This risk increases to 57 % among people with a past knee injury. Lifetime risk and inability to move for knee osteoarthritis also go up to with increased weight and three in five people who are obese.

It is a common chronic disease, and it affects one out of every three citizens in most countries. This disease causes disability and limits daily activities of over 7 million people in the country. It causes swelling and stiffness around the bones, muscles, ligaments, tendons, and some internal organs. The most common types of arthritis are rheumatoid, and osteoarthritis; each of these conditions affects 2.1 million and 16 million Americans respectively. Although there are some myths about arthritis that it affects only the elderly, this disease is multigenerational. It affects people of all sexes, races, and ages. Patients suffering from arthritis can have a wide range of symptoms depending on the type of arthritis one is suffering. In most forms of the disease, joints of the knees, wrists, fingers, ankles, hips, or elbows become stiff, painful, tender, and swollen.

However, one of the most significant symptoms is that a patient will experience a lot of pain in or around the connective tissues, joints, and surrounding tissues in the body. The patient will experience fatigue as the day progresses. In juvenile rheumatoid arthritis, rash, fever, and anemia will occur in most cases. Eventually, arthritis may spread to other parts of the body or remain concentrated in certain joints.

Arthritis symptoms can be cyclical, and a patient may experience active phases of worsening or reappearance process called a flare. Since arthritis is a multigenerational disease and not a disease for the old only, all people stand the risk of getting arthritis. Currently, it is determined that genetic factors, lifestyle behaviors play a significant role in arthritis. Certain types of arthritis are more prevalent among women such as rheumatoid arthritis. Other forms of arthritis are more common among men such as gout. The elderly in the community may get arthritis because of wear and tear or joints not necessarily because of lifestyle behaviors. The disease eventually causes disability, and patients can no longer move with ease or become completely immobile. Additionally, it affects those taking care of the patients or the caregivers financially.

A lot of money or resources are used in taking care of patients. Approximately, $ 86 million is used every year in the country for treatment services. Besides the fact that arthritis is affecting people economically and socially, the challenge it is posing in the community is ensuring the delivery of underutilized and effective interventions. Although there are quite many public programs, campaigns sensitizing people about arthritis, more needs to be done. Today, there is inadequate or insufficient dissemination of information aimed at addressing the needs of patients suffering from arthritis. Nowadays, there are several organizations addressing the challenges posed by arthritis in the community.

These organizations help in the alleviation of suffering among arthritis patients. Some of these organizations are Arthritis Foundation, National Arthritis Action Plan, and Center for Disease Prevention and Control. There is increased importance to continue educating the community about the health and care concerning arthritis. This is because this disease condition is affecting and infecting many people every down because of a lack of information.

Solution Description

Many researches have been conducted on arthritis prevention or intervention program. Goeppinger and Lorig (2009) conducted a study on the arthritis intervention program. The authors initiated and nurtured a nationwide program that increased knowledge and promoted information about arthritis, its causes, prevention, early diagnosis, appropriate management, and pain management (Goeppinger & Lorig, 2009). Enhancing understanding and developing knowledge of arthritis by publicizing educational resources and information on services provided, and research results can greatly reduce the suffering associated with arthritis. Additionally, providing knowledge on the control and prevention of arthritis through research, epidemiology, and surveillance ensures new discoveries on the disease are handled appropriately (Yelin & Callahan, 2005).

According to Brady, Jernick, Hootman, and Sniezek (2009), arthritis is a serious chronic disease in America. Its management should involve states, policymakers, health providers and professionals, and all citizens. All these are stakeholders in the coordination and implementation of local and state services and programs to lessen the arthritis burden on health public (Brady, Jernick, Hootman & Sniezek, 2009). In their research, Do, Hootman, Helmick, and Brady (2011) proved that cooperation within the national voluntary and governmental offices of health organizations.

Proposal for Community Prevention Project

Several researchers have applied various theories of chronic disease prevention projects. Health education theory, TMC theory, Alexander technique theory, and the theory of Reasoned Action (RTA) are among the successful theories in arthritis prevention projects (Neuberger, Smith & Hassanein, 2012). The RTA proved to be the most effective as it helps the community adapt and work towards arthritis prevention. Fishbein and Ajzen formulated the theory of reasoned action in 1980. The TRA resulted from behavior research from expectancy-value models. Fishbein and Ajzen formulated the TRA theory after trying to approximate the discrepancy between behavior and attitude.

Planned Behavior theory is related to deliberate and controlled behavior. Afterward, the behavior seemed not to be quite under control and on a voluntary basis. There was the addition of apparent behavioral control in voluntary behavior. With this addition, TRA theory was also referred to as the theory of planned behavior, abbreviated as (TPB). Therefore, the theory may predict the behavior since it can be planned and deliberative.

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The theory of Planned Behavior/Reasoned Action proposes that an individual’s behavior is governed by a purpose to perform a certain behavior. In turn, this purpose serves as a function for an individual’s attitude as well as his or her subjective norm. Hence, the best forward planner of behavior is to have a purpose or intention. In this case, intention becomes the cognitive symbol of a person’s readiness to carry out a given behavior. The intention is considered to be the immediate precursor of behavior. According to the TRA theory, there are three things that determine the intention: attitude towards the behavior, alleged behavioral control, and subjective norms (Notani, 1998).

The theory of Reasoned Action suggests that only exact attitudes regarding the concerning behavior can be anticipated to forecast that behavior. Apart from measuring attitudes concerning the behavior, it is necessary to measure the individual norms of people. Additionally, it is essential to consider their beliefs concerning the individuals they care about as they consider the behavior in question (Read, 1999). Lastly, alleged behavioral control inspires purposes. Perceived behavioral control means people’s opinions of their capability to carry out a given behavior. The predictors show the way to intention. Therefore, the more positive the subjective norm and attitude is the better the perceived control is, and the individual’s intention to carry out the certain behavior is stronger.

The theory of Reasoned Action provides useful information that can be applied in the proposal for community prevention projects: Arthritis Prevention, Cure, and Control. The theory can be used in disease prevention behavior and consumption prediction. The theory helps in the research of what the patients should do and what they should not do to reduce the causes of arthritis or sometimes, at the early stages, even prevent it. Besides, the theory is useful in the management, and pain management of arthritis (Taylor & Todd, 1995).

Strengths and Limitations of the Project

There are available resources from the government to fund arthritis prevention projects in most states in America since the government understands the economic and social benefits associated with the projects. Unfortunately, there is inadequate personnel to perform the planned activities. Additionally, both arthritis patients and healthcare professionals lack knowledge concerning the benefits and existence of these programs (Boult & Altmann, 2011).

Research Outcomes

According to Goeppinger and Lorig, (2009), arthritis prevention and intervention project conducted in 2009 managed to provide permanent developments in the provision of healthcare for patients with arthritis. There was public awareness that raised knowledge and public awareness of arthritis (Goeppinger & Lorig, 2009). The intervention project improved and increased community-based amenities available to patients with arthritis, as well as their family members (Yelin & Callahan, 2005). The projects also classified and used proof-based arthritis systems and obtain interconnected services and materials from companies with having appropriate knowledge and expertise of arthritis. The projects base their performance on the most contemporary scientific findings and information (Neuberger, Smith & Hassanein, 2012).

Additionally, the best way to diagnose arthritis is by being aware of one’s body and knowing the above-discussed symptoms. Several criteria determine various forms of arthritis and only a doctor can be able to verify if a patient has more than one condition of arthritis. The most important, getting an early and accurate diagnosis is significant in combating arthritis. Presently, there is no cure for arthritis, but there are several options available in hospitals to aid in the relief of symptoms. The two major groups of medications available are first-line non-steroidal anti-inflammatory drugs and second-line drugs.

Implementation Plan

The project proposed in this report is a community prevention process in the form of a project dedicated to patients suffering from arthritis and their family members. The project’s aim is to initiate and nurture a nationwide program that will increase knowledge and promote information about arthritis, its causes, prevention, early diagnosis, appropriate management, and pain management. Two mainly required supports for the proposal are human as well as financial resources. The fact is that it requires two hundred thousand dollars in one year in order to function properly.

Writers of the account have disintegrated their objectives for the need of recognizing functions required to accomplish aims. The goals are encircled using the S.M.A.R.T standard in assisting to determine objectives. The appraisal procedure is measured for entire functions using outcomes and outputs. Aims of the account are to establish four departments, which include marketing, CSR, financial, and operational departments as elaborated in the logic prototype.

The Department of Public Health will establish, maintain and promote an Arthritis Control, Cure, and Prevention Project to educate consumers, raise public awareness, and educate service providers, teachers, and health professionals (Brady, Jernick, Hootman & Sniezek, 2009). The program will have the following elements;

First of all, it requires assessment. Assessment will be conducted to recognize the following:

  • epidemiological researches conducted in the nation;
  • accessible educational programs and materials and technical assistance nationwide;
  • arthritis public and professional awareness.

Advisory Association on Arthritis: this council will offer a non-governmental contribution concerning the Arthritis Cure, Control and Prevention Program (Boult & Altmann, 2011).

Public awareness: this department will raise knowledge and public awareness of arthritis.

Technical assistance: this division will organize a pilot program that will fund the project in the following activities: physical activity, screenings, professional education, public education, awareness campaigns, and surveillance programs (Hirano, Laurent & Lorig, 2012).

The project is selected on the basis of the theory of Reasoned Action. The TRA suggests that only exact attitudes regarding the concerning behavior can be anticipated to forecast that behavior. It provides useful information that can be applied in the proposal for community prevention project – Arthritis Prevention, Cure, and Control. The theory can be used in disease prevention behavior and consumption prediction

Various stakeholders will be involved in the implementation process. They will include the project squad leader, operations manager, marketing manager, finance manager, project team members, human resource manager, volunteers, health professionals, their family sponsors, well-wishers, and members.

Project Program

Writers of the account have recognized numerous tasks, which are essential regarding the carnivals' achievement. The writers have recognized the department or personnel answerable to accomplish the work within its limits. Various errands are associated together with the rest of the errands. This forms critical steps since all managers, as well as stakeholders, can utilize documents to analyze and criticize the entire procedure regarding corporate social responsibility.

Resources

Human resources. The human resources department entails an important role in project success. The author entrusts that human resources have three tasks. The human resources department forms the oil that maintains the carnival engine running appropriately.

Physical resources. To add to this, the project will need a set of objective resources to make sure that it has set forth. In the chart below, the author provides a set of necessities of equipment required whether it is leased, purchased, or rented.

Purpose of the Project

  1. To initiate and nurture a nationwide program that will increase knowledge and promote information about arthritis, its causes, prevention, early diagnosis, appropriate management, and pain management.
  2. To enhance understanding and develop knowledge of arthritis by publicizing educational resources and information on services provided and research results.
  3. To provide knowledge on the control and prevention of arthritis through research, epidemiology, and surveillance.
  4. To use training and educational services and resources developed by experts.
  5. To assess the importance of improving the accessibility and quality of community-based services for patients with arthritis.
  6. To intensify awareness concerning causes, prevention, diagnosis, treatment, and management of arthritis among states, policymakers, health providers, and professionals, and all citizens.
  7. To coordinate and implement local and state services and programs to lessen the arthritis burden on health public.
  8. To fund the arthritis prevention program on a national level.
  9. To provide permanent developments in the provision of healthcare for patients with arthritis.
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Evaluation Plan

The Department of Public Health will establish, maintain and promote an Arthritis Control, Cure, and Prevention Project to educate consumers, raise public awareness, and educate service providers, teachers, and health professionals (Brady, Jernick, Hootman & Sniezek, 2009). For successful and widespread dissemination of the program, solid evidence-based data to show its efficacy is needed. To attain such evidence-based data, a randomized controlled trial is conducted that measures short-term and long-term effects of the program on symptoms, function, physical activity, and a set of psychosocial measures. This study is not funded by the Arthritis Foundation, but by the Centers for Disease Control and Prevention through a grant from the Association of American Medical Colleges.

The program will have the elements indicated in the implementation section of the project previously

Methods Used to Evaluate the Effectiveness of Proposed Solution

In coordination with the selected grantees, the Department of Public Health will assess the achievement of the community health project and its consequences. The department will perform the following activities in the evaluation:

  1. Provide sufficient personnel to implement and manage the Arthritis Cure, Control, and Prevention Program.
  2. Provide suitable training for the personnel of the Arthritis Control, Cure, and Prevention Program.
  3. Distinguish suitable organizations to manage and carry out the program.
  4. Base the performance on the most contemporary scientific findings and information.
  5. Work to improve and increase community-based amenities available to patients with arthritis, as well as their family members (Yelin & Callahan, 2005).

Operate with national voluntary and governmental offices of health organizations, their local chapters, community organizations, business leaders, community and human services and healthcare providers to maximize and coordinate efforts of State properties in the areas of education, detection, prevention, treatment and pain management of arthritis (Boult & Altmann, 2011).

Classify and use proof-based arthritis systems and obtain interconnected services and materials from companies, which have appropriate knowledge and expertise in arthritis.

Variables

The participants that will appear at least at ten of sixteen classes are expected to indicate development in stiffness, fatigue, and pain in some leg and arm energy and the self-confidence, which they will accomplish their arthritis complication. Six months later, after completing the session, fatigue and pain will still healthier than at the baseline. However, self-efficacy and disability measures will not be considered. Nevertheless, the detachment of participants that sustained the exercise at home maintained developments in entire symptoms and weakened only in self-efficiency for physical functions that are demarcated as the information that one has the self-motivation and ability to employ.

The following participants are expected to have well-documented results:

People with Arthritis

  • Decreased depression
  • Increased functional capability
  • Decreased pain
  • Increased self-care behavior

Arthritis Self-Help Course

  • Decreased physician visits (43% of the decrease in 4 years)
  • Decreased depression
  • Increased Self-efficacy
  • Increased knowledge
  • Increased frequency of relaxation and exercise
  • Decreased Pain

Aquatics Program

  • Improved day-to-day function.

Tools Necessary to Educate Project Participants

Data collection will be done using public educational forums’ survey (early education), and participation in self-help and exercise programs (behavior modification programs, in which well-documented results have previously been recognized). Short-term outcomes will evaluate the success in training and recruiting 40 program leaders, organizing a sequence of early educational debates, and exceeding three hundred participants in self-help or exercise courses. Short-term outcomes will also be measured through the victory of the doctor’s initiative both in willingness and attendance by the health community to provide arthritis educational leaflets and refer people to the Community Arthritis Project (Boult & Altmann, 2011).

Assessment Tools

Expected outcomes of the Community Prevention Plan (Arthritis) Project will go beyond traditional outcomes’ measurements and incorporate the following:

  1. Before and after participant surveys in early/ awareness education, programs will manage to document not less than doubling of acquaintance and recall the significance of early treatment and diagnosis for arthritis, and an increased tendency to seek treatment and diagnostic services.
  2. 40 leader trainers will be certified and trained in the different highly proven treatment and self-help and effective programs that will be available to the area inhabitants (Neuberger, Smith & Hassanein, 2012).
  3. The success of the program will be verified by a sturdy increase in the number of people who attend preliminary knowledge/awareness programs. They record behavior change programs, where previously documented results include a decrease in the number of doctor visits.
  4. Many services and programs will be self-sustaining. A Regional Arthritis Council shall be formulated as a Capstone to the Arthritis Prevention Project.

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Assessment and Evaluation

About 346 people will take part in the project. These stakeholders will be organized into regulation and interference groups. Participants in this research will conduct their activities while standing up, instead of sitting. The Arthritis Prevention Program classes will be offered at a sturdy extent suitable to the people attending them. The activities will take part twice a week, for an hour lesson for 8 weeks. Participants will complete the program at the periphery. The evaluation will start after the eighth week.

The crowd will then receive the contribution to measure stiffness, pain, and fatigue using the illustration scale. In addition, physical performance will be evaluated with self-report and performance actions. Physical activities will be scored according to the type of activity, frequency, and duration, self-efficacy, depression, and helplessness that will be evaluated using several questionnaires (Goeppinger & Lorig, 2009).

Dissemination Plan

The authors will use the following strategy for disseminating the significance of project outcomes to the greater nursing community:

  • the authors of the project will promote the dissemination of the opinion leaders;
  • acclimatization of contingency administration for clinical practices;
  • the use of written materials, such as brochures, reports, newspapers and journals to disseminate information about recovery and treatment to the patients and their family members;
  • putting into operation a trauma-focused practice for patients;
  • dissemination via organizational change.

Expected Project Outcomes

The authors deduce that the Arthritis Prevention, Cure, and Control Program, initially known as the PACE, has modestly improved strength and symptoms, but does not upgrade the function, escalate exercise fortitude, or escalate physical function. In addition, extra substantial benefits, intensity, and frequency may require to be improved.

Literature Review

The Medical Origins of Arthritis

One of the most important contributions to the never-ending campaign against arthritis has been done by the study of professors Yelin and Callahan (2005). This article is of immense practical importance for the proposed research since it outlines the most common problems connected with arthritis treatment. The statistics deal with the situation in the UK. The findings of this paper have been substantially amplified by the co-joint of professors Wollenhaupt and Zeidler, who have identified particular origins of reactive and undifferentiated types of arthritis. This paper is focused on the empirical evaluation of 140 arthritis case studies encountered in the medical practice of the USA.

Further exploration of the medical roots of the problem has been conducted in the study of Hyrich, Watson, and Lunt (2011), which paid their attention to the analysis of biochemical origins of rheumatoid arthritis in the United Kingdom. The provided statistical data clearly endorses the assumptions of the study. One of the most profound researches upon the originative issues of the analyzed health disorder has been made in the work of Professor Michael Becker (2005). The paper is primarily focused on the analysis of biochemical factors that aggravate the disease development, and the findings of the academics have been corroborated by the statistical data aggregated worldwide.

Extant of the Existing Treatment Techniques

One of the most effective encapsulation over the subject at issue has been done by the team of professors Boult and Altmann (2011). The authors of the article laid specifically accentuated the importance of the contemporary diagnosing solutions, the opinion that has been endorsed by the subsequent studies of similar natures (Do, Hootman, Helmick, & Brady, 2011). Statistically, it has been empirically concluded that one of the basic aspects of effective treatment techniques is the timely detection of the disease. The role of timely diagnostics and issues connected with therapy techniques utilized to treat the ailment has been examined by van Dongen, van Aken (2006), and their associates.

With regard to the collected empirical evidence, it is necessary to highlight that this cross-sectional study analyzed 34 case studies internationally. The findings of these scholars immensely contributed to the composition of the working paper of Neuberger, Smith, and Hassaseim (2012), which effectively dispersed a popular scientific misperception that therapy is not sufficient to cure arthritis and surgical intervention may be required in individual cases. The study is basically longitudinal and speculates over 43 clinical cases in the USA.

Prevention Campaign

The objective of the analyzed project is primarily to organize an effective promotional campaign with the ultimate goal to raise public awareness upon arthritis prevention and treatment effective techniques. Although purely medical in its nature, these issues have been explored in the works of Smolen, Aletaha, Bijlsma, et al. (2010), which identified the core aspects the international community is to consider. Empirically, the practice of the European Union and the USA has been analyzed. Their findings and assumptions have been endorsed by the work of Hirano, Laurent, and Lorig (2008), who outlined the basic assumptions for the study, although lacking statistical data for their research.

A particular need for regular physical exercising has been recognized in the research study of Van der Heijde, Breedveld, and Kavanaugh (2010), who broadly speculated over the role of physical inertia in arthritis formation, referring to 91 clinical studies in the European Union. The role of obesity and overweight has been examined in the quantitative longitudinal study of Brady, Jernick, Hootman, and Sniezek (2009). Having proven that obesity can indirectly contribute to arthritis formation, the authors have made an immense statistical endorsement for this project, as well as subsequent proof of their findings made by the work of Yazici, Reed, and Klem (2011). Along with the obesity problems, this work meticulously analyzed the promotional activities that are recommended to be taken by the state healthcare authorities to achieve the public awareness objectives.

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