1. Resources
1.1. Leadership
1.1.1. What do you bring to the table? what are your leadership skills and qualifications?
1.1.1.1. Responsibility
1.1.1.1.1. Perseverance
1.1.1.1.2. Responsibility theme forces you to take psychological ownership for anything you commit yourself to, and whether large or small, you feel emotionally bound to follow it through to completion (Rath, 2007, pp. 149)
1.1.1.2. Restorative
1.1.1.2.1. Enjoying the challenge of analyzing the symptoms, identifying what is wrong, and finding a solution (Rath, 2007, pp. 153)
1.1.1.3. Strategic
1.1.1.3.1. Strategic enables you to sort through the clutter and find the best route. It is a distinct way of thinking, as special perspective on the world a large (Rath, 2007, pp. 165).
1.1.1.4. Relator
1.1.1.4.1. Describes your attitude toward your relationships. In simpler terms, the Relator them pulls you toward people you already know (Rath, 2007, pp. 145).
1.1.1.5. Team work
1.1.1.5.1. Speaking Up
1.1.1.5.2. Collaboration
1.1.1.5.3. Experimentation
1.1.1.5.4. Reflection
1.1.1.6. Learner
1.1.1.6.1. Always be drawn to learn. It enables you to thrive in dynamic work environments (Rath, 2007, pp. 133).
1.2. Team members
1.2.1. What are the back ground and skill sets you will need on your team?
1.2.1.1. Education in Health Promotion
1.2.1.2. Communication skills
1.2.1.3. Community Health Education
1.2.1.4. Health Innovation
1.2.1.5. Organizer/Planning
1.2.1.6. Proposal writer and editor
1.3. Budget
1.3.1. What do you anticipate this change initiate will cost? what will you need to consider to calculate the cost?
1.3.1.1. I assume that a project like this would need to cover the cost of marketing, continuous nutrition education for health professionals, cost centers for employees assisting with the program, and vouchers for participants.
2. Communication Strategies
2.1. What is your communication plan to roll out this change initiative?
2.1.1. Social Media & Web communication
2.1.1.1. Remain in contact with stakeholders
2.1.1.2. Facebook
2.1.1.3. Instagram
2.1.1.4. Twitter
2.1.2. Flyers
2.1.2.1. Post flyers around the community and local hospital.
2.1.3. Radio Station
2.1.3.1. Broad cast program and event through radio station. Many elderly listen to the radio.
2.1.4. Provider to patient
2.1.4.1. Current Diagnosis
2.1.4.1.1. Unhealthy lifestyle/ eating habits
2.1.4.2. Referrals
2.1.4.2.1. Provider to Provider or Provider to Patient
2.1.4.3. Appointments
2.1.4.3.1. Follow Up appointments
2.1.5. Door to door
2.1.5.1. Home visits in community and rural locations.
3. Technology
3.1. Will new technology be used to make this change?
3.1.1. Radio
3.1.1.1. Delivering a message across the reservation may require broadcasting over the radio.
3.1.2. iPads
3.1.2.1. iPads may come in hand when out and about with the community. Showing the material and collecting contact information right then and there would be easier then using pen and paper.
3.2. Please explain how you will utilize new technology or develop technology platforms that do not exist.
3.2.1. Social Media
3.2.1.1. Many healthcare organizations use social media for public relations, but the tool has much more utility. Although relatively new as a marketing channel, social media represents an important promotional asset for any healthcare organization. Despite its novelty, social media firms have established themselves as permanent mainstream marketing channels. However, this newness means that healthcare organizations have yet to develop best practices for its use. Along with other tools, care providers use social media as a reliable channel to educate consumers. For instance, Facebook posts published by care providers can contain wellness information and provide consumers with helpful advice while helping organizations build community rapport. (How Health Communicators Use Social Media, n.d.)
4. Summary
5. Problem Statement
5.1. The Navajo Reservation is the largest reservation in the United States, with a population of 180,000 residents. The Prevalence for diabetes is 22%, a population living below the poverty line is 43%, an unemployment rate of 42%, and a life expectancy of 74 years old (Navajo Nation, 2009). Due to contributing factors of food scarcity and limited nutrition education, one in three individuals of the Navajo population are now diabetic or pre-diabetic. There are on going efforts to tackle the growing combat of health care issues on the Navajo reservation. Although, there are collaborations with local health departments, the Health Promotion and Diabetes Prevention program is one of the only programs to really emphasis diabetes prevention. By advancing nutrition programs on the Navajo reservation, we could increase efforts of educating health professionals and increasing more nutrition programs for communities. These programs could include education programs for health professionals, nutritional activities in the community, and nutrition referrals from provider to department, and Fresh fruit and vegetable vouchers to participants who participate in nutrition programs.
6. Innovative Process
6.1. What innovative strategies will you use to complete this health care change initiative?
6.1.1. Ideas
6.1.1.1. Reaching across boundaries
6.1.2. Planning
6.1.2.1. Framing for learning
6.1.3. Process
6.1.3.1. Learning from failures
6.1.4. Brain storm
6.1.4.1. actively generate as many ideas (Johansson, 2017, pp. 105)
6.1.5. Solutions
6.1.5.1. Allow time for evaluation
7. Possible Obstacles
7.1. Finance
7.1.1. How will you pay for this change initiative?
7.1.1.1. Indian Health Services (the main provider for health services on Indian reservations), is federally funded by the United States Government. I will look into grants and the budget offered for health promotions.
7.1.1.1.1. Submit Proposal
7.1.1.2. American Public Health Association (APHA)
7.1.1.2.1. Submit Proposal
7.1.1.3. Centers for Disease Control and Prevention (Tribal Support)
7.1.1.3.1. Submit Proposal
7.2. Policy
7.2.1. Are there policies impacting you ability to change? Federal, State, Organizational.
7.2.1.1. What are the steps to get this accomplisehd
7.2.1.1.1. Get contact information
7.2.1.2. United States Federal Policies
7.2.1.2.1. Research and review
7.2.1.3. Tribal Policies
7.3. Evidence Based Practice
7.3.1. Is there evidence to support your change? What is the evidence?
7.3.1.1. Through evidence-based medicine, it can be determined that lifestyle practices, including nutrition and physical activity, influence health and diseases in the United States (Kris-Etherton, Akabas, Bales, Bistrian, Braun, Edwards, Van Horn ,2014). The importance of including nutrition in training of health care professionals, along with continuing education, remains a low priority in health care. According to the American Journal of Clinical Nutrition, “There is a need for strategies to be developed and integrated into the education and training programs of health care professionals to attain a translational impact on disease prevention, treatment outcomes, and population health” (Kris-Etherton, Akabas, Bales, Bistrian, Braun, Edwards, Van Horn ,2014). By having common nutrition competencies across health care, we can achieve new standards for improving health care.
7.4. Stakeholders
7.4.1. How will you influence stakeholders to see that this change initiative is necessary to buy into your idea?
7.4.1.1. Are you sure you access to right stakeholders?
7.4.1.1.1. For now these would be the stakeholders I would reach out to for further planning of nutrition programs, with affiliation with Indian Health Services.
7.4.1.2. The Division of Planning, Evaluation, and Research (Indian Health Services)
7.4.1.2.1. Lucie Vogal (Planning)
7.4.1.2.2. Yvonne Davis (Evaluation)
7.4.1.3. Navajo Area IHS Office
7.4.1.3.1. Marie Nelson
7.4.1.4. Go Intersection Hunting (Johansson, 2017, pp. 84)
8. Overview
8.1. Idea and Motivation for choosing this change? What is your why?
8.1.1. This Change Initiative hits close to home, due to the reason that I am Native American and see first hand the affects of poor nutrition being a main affiliation for many health issues on the reservation. Not only am I an observer to the issue, but I experience the same challenges of not eating a well balanced diet. I am at risk for diabetes and heart conditions (as they run in my family, both maternal and paternal). After living off of the reservation, I see a difference in the education for nutrition from a n urban town to the reservation. This is the driving force to implement a change initiative for increased nutrition programs in health care on the Navajo reservation.
8.2. Outcomes
8.2.1. By increasing nutrition education and promotion, individuals will have known knowledge of the benefits of consuming a balanced nutritious intake. By increasing the education of health eating, the goal is to minimize the challenges of choosing health food items, over unhealthy food items. In a study performed by the SNAP Education and evaluation study, they "evaluated the impact of several nutrition education programs on fruit and vegetable consumption among low-income elementary school children and seniors. The study found that children participating in certain nutrition education programs increased their daily fruit and vegetable consumption at home by a quarter- to a third-cup, and were more likely to choose low-fat or fat-free milk. Participating seniors consumed about a half-cup more fruits and vegetables daily." (Study Shows Strong Nutrition, 2013).
8.2.2. What are you goals for this change?
8.2.2.1. Increase nutrition education and promotion on the Navajo reservation, using the health care systems, in efforts to increase awareness of proper food consumption and to make conscious food choices, if efforts to decrease health issues.
9. Systems
9.1. How do you think the system may change when the change initiative is implemented?
9.1.1. Departments included?
9.1.1.1. Marketing Efforts
9.1.1.2. Health Promotion/ Disease Prevention
9.1.1.2.1. Health Promotion and Public Health, would be departments to consider additional stakeholders for the program.
9.1.1.3. Budgeting Department
9.1.2. Departments excluded?