Student will develop a scholarly presentation using Microsoft PowerPoint to inform peers/colleagues about?a health problem that is prevalent within?your selected group?and dem

Health Promotion Proposal Part 1 1

Health Promotion Proposal Part 1

Lung Cancer

Health Promotion Proposal Part 1 2

Health Promotion Proposal- Lung Cancer

Lung cancer remains a severe health concern, with a high occurrence among the elderly,

particularly those who have previously smoked (Adams et al., 2023). This issue is becoming

increasingly concerning in Miami, Florida, due to demographic and lifestyle issues. This disease

is the top cause of cancer-related mortalities globally and also has a substantial health impact in

the United States. In 2020, approximately 228,820 new instances of lung cancer were reported in

the United States, with around 135,720 fatalities underscoring the severity of the disease

(Thandra et al., 2021). The elderly, particularly those over 65, are disproportionately afflicted,

with an average age at diagnosis of roughly 70 years (Thandra et al., 2021). This age group is

particularly vulnerable in Miami, which has a large elderly population. The high prevalence of

lung cancer in this population is primarily due to prolonged exposure to risk factors, particularly

smoking. In Florida, the age-adjusted lung cancer incidence rate is around 50.5 per 100,000

individuals which is higher than the national average (Florida Department of Health, 2024). This

percentage is significantly more concerning among the elderly, particularly those with a history

of smoking. The suggested health promotion program intends to address this serious issue by

emphasizing lung cancer prevention and early diagnosis among Miami's older smokers. The goal

is to reduce lung cancer incidence and mortality by 25% over the next five years by focused

interventions such as smoking cessation support, information campaigns regarding early signs

and symptoms, and promotion of regular screening among high-risk persons. The program's

success will be measured in terms of decreased smoking rates, increased participation in lung

cancer screening, and, ultimately, a drop in lung cancer incidence and mortality rates among this

group.

Health Promotion Proposal Part 1 3

Description of the Vulnerable Population

Older adults in Miami who have a history of smoking are a susceptible demographic for a

variety of reasons. First, age is a crucial risk factor for lung cancer; the majority of patients

diagnosed with the disease are 65 years or older (Adams et al., 2023). This age group's

physiological deterioration renders individuals more vulnerable to cancer and less capable of

recovery. Second, a history of smoking dramatically raises the risk. About 80% to 90% of lung

cancer occurrences are attributed to smoking, making it the most common cause of the disease

(Centers for Disease Control and Prevention, 2023). In Miami, where smoking has long been

considered culturally acceptable, elderly persons are more likely to have had prolonged exposure

to tobacco, thus increasing their risk. Also, socioeconomic factors such as access to healthcare

and educational inequality contribute to this susceptibility by influencing both the likelihood of

continued smoking and the capability for early cancer diagnosis.

Literature Review

A review of recent literature underscores the importance of targeted interventions. The

study by Krist et al. (2021) marks a significant advancement in lung cancer screening protocols.

It recommends annual “low-dose computed tomography” (LDCT) screenings for adults aged

50-80 who have a substantial smoking history. This suggestion emerged from a systematic

review and a modeling study highlighting the moderate net benefit of annual LDCT screening in

diminishing lung cancer mortality among high-risk groups.

Another significant study by Hawrysz et al. (2022) delves into lung cancer risk in men,

mainly focusing on compliance with the cancer preventive guidelines published in "2018 World

Health Promotion Proposal Part 1 4

Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR)”. This research

found that adherence to these recommendations, especially the aspect of limiting smoking, was

linked to a notably lower risk of lung cancer. The study's strength lies in its comprehensive

approach, considering lifestyle and dietary factors alongside smoking habits. However, it focuses

predominantly on male subjects, which may not wholly represent the diverse demographics of

elderly smokers, especially in a multicultural community like Miami.

The study by Krist et al. (2021) is commendable for its robust methodology and

impactful recommendations. The strength of this recommendation lies in its evidence-based

approach underpinned by comprehensive data analysis and modeling, thus providing a clear

guideline for lung cancer screening. However, the recommendation's applicability may be limited

by its dependency on patient adherence to annual screenings and the need for healthcare systems

to support the widespread implementation of LDCT screening programs.

The study by Hawrysz et al. (2022) provides a comprehensive view of prevention,

particularly highlighting the role of lifestyle changes. Its strength is demonstrating the tangible

benefits of adherence to cancer prevention guidelines. However, the study's limitation is its

potential over-reliance on self-reported data, which may introduce biases. Additionally, while it

establishes a clear link between lifestyle changes and reduced cancer risk, it does not address the

challenges of implementing these changes at a population level, particularly in diverse

communities like Miami, Florida.

Health Promotion Model

Health Promotion Proposal Part 1 5

The Transtheoretical Model (TTM) of Behavior Change is an ideal framework for this

health promotion proposal. TTM recognizes that behavior change, particularly smoking

cessation, is a process that involves several stages: pre-contemplation, contemplation,

preparation, action, and maintenance (Chang et al., 2024). The first step, "pre-contemplation,"

takes into account the fact that many older smokers may not want to quit at first. The first step is

to make older people more aware of the risks of continuing to smoke and the benefits of giving

up altogether. Then, precisely planned interventions can be made to deal with the problems and

drive behind each stage of change. For example, in the contemplation stage, people can be

encouraged to think about quitting by using educational materials and motivational interviews.

During the action and maintenance stages of the TTM, the program will offer tools like support

groups and ways to stop smoking. This method is essential for older people because it considers

their specific problems, like having solid habits and not wanting to change.

TTM also stresses how important it is to avoid relapse, which is especially important for

older people who may have long-standing smoking habits (Chang et al., 2024). Support groups,

therapy, and follow-up can be added to the program to help people in the maintenance stage,

which is essential for making sure that quitting smoking lasts. This plan is excellent for lowering

the risk of lung cancer in Miami's older smokers because it is flexible and focuses on each

person's readiness.

Health Promotion Proposal Part 1 6

References

Adams, S. J., Lee, P., Vliegenthart, R., Stone, E., Baldwin, D. R., & Fintelmann, F. J. (2023).

Screening for lung cancer. The Lancet, 390–408, 401(10374). 10.1016/

S0140-6736(22)01694-4 is the DOI.

The Centers for Disease Prevention and Control. (2023). What Are the Lung Cancer Risk

Factors?

Chang, Y.-H., Fu, C.-H., Hsu, M.-H., Okoli, C., & Guo, S.-E. (2024). The effectiveness of a

transtheoretical model-based smoking cessation intervention for rural smokers: A quasi-

experimental longitudinal study. Patient Education and Counseling. Advanced online

publication. https://doi.org/10.1016/j.pec.2024.108136

Chandra, K. C., Barsouk, A., Saginala, K., Aluru, J. S., & Barsouk, A. (2021). Epidemiology of

lung cancer. Contemporary Oncology (Poznan, Poland), 25(1), 45–52. https://doi.org/10.5114/

wo.2021.103829

Health Promotion Proposal Part 1 7

Florida Department of Health. (2024). Lung cancer incidence. Retrieved from https://

w w w . f l h e a l t h c h a r t s . g o v / C h a r t s D a s h b o a r d s / r d P a g e . a s p x ?

rdReport=NonVitalInd.Dataviewer&cid=446

Slowinska, M. A., Czerwinska, A., Wadolowska, L., Hawrysz, I., & Golota, J. J. (2022). Men's

Lung Cancer Risk and Adherence to the 2018 WCRF/AICR Cancer Prevention

Guideline. 4295 in Nutrients, 14(20)

US Preventive Services Task Force, together with Caughey, A. B., Cabana, M., Barry, M. J.,

Mangione, C. M., Davidson, K. W., and Krist, A. H. (2021). Lung cancer screening is

advised by the US Preventive Services Task Force. Jama; 325(10), 962-970.

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Health Promotion Program: Part 2

Lung Cancer

Health promotion program proposal- Lung Cancer

The high prevalence of lung cancer among older smokers in Miami, Florida, will be

addressed by implementing a comprehensive health promotion program centered on

interventions derived from the Transtheoretical Model (TTM) of Behavior Change. This process

2

involves several stages: pre-contemplation, contemplation, preparation, action, and maintenance

(Chang et al., 2024). This program will target the specific needs of the selected population,

focusing on smoking cessation, early detection, and lifestyle modification. The intervention will

incorporate education, counseling, support services, and community outreach initiatives. The

program is planned to take five years. The program will begin with a planning phase in Year 1. In

this phase, resources will be allocated, partnerships established, and intervention strategies

finalized. This phase will involve securing funding for educational materials, outreach

campaigns, and smoking cessation resources. It will also include collaboration with community

organizations, healthcare facilities, and local authorities to effectively reach and engage the target

population. In this phase, advanced practice nurses will lead and coordinate the program. They

will use their expertise to assess individual needs, provide personalized interventions, and

collaborate with interdisciplinary teams.

In years 2 to 4, the implementation phase will be executed. This phase will be done in

stages. It will begin with the pre-contemplation and contemplation stages. Here, the focus will be

on raising awareness among older smokers who may still need to consider quitting. Educational

campaigns will use community events, social media, and healthcare facilities to disseminate

information about the risks of smoking and the benefits of cessation. APNs and community

health workers will conduct outreach activities to engage individuals in discussions about their

smoking habits and motivations for change. Motivational interviewing techniques will explore

ambivalence and encourage contemplation of behavior change. These stages will be followed by

the preparation stage. In this stage, individuals will be provided with resources and support to

assist them in quitting smoking. Smoking cessation counseling sessions will be offered, during

3

which APNs will collaborate with individuals to develop personalized quit plans. In addition,

nicotine replacement therapy, prescription medications, and other pharmacotherapies will be

prescribed as appropriate. Educational materials and self-help resources will be distributed to

empower individuals to take steps toward quitting.

This stage will be followed by the action stage. In this stage, individuals will engage in

quitting smoking and implementing their quit plans. APNs will facilitate support groups to

provide peer support and encouragement. Behavioral therapy sessions will also be encouraged to

address coping strategies, stress management techniques, and relapse prevention strategies.

APNs will also closely monitor and follow up to ensure that individuals receive ongoing support

and assistance throughout their quitting journey. Pharmacotherapy will be adjusted as needed to

optimize cessation outcomes. This will be followed by the maintenance stage. This stage will

ensure sustained smoking cessation and prevent relapse. In this stage, APNs will continue to

provide ongoing support through individual counseling sessions, support group meetings, and

follow-up appointments. In addition, they will reinforce relapse prevention strategies and hone

coping skills to help individuals overcome challenges and triggers. APNs may also emphasize

long-term pharmacotherapy to support individuals in maintaining abstinence. Regular monitoring

and evaluation will assess progress and identify areas for further support or intervention.

Outcomes

The outcomes of the health promotion program are SMART. They include a reduction of

lung cancer incidence and mortality by 25% among older smokers in Miami within five years.

The program seeks to decrease smoking rates among older adults through comprehensive

4

smoking cessation support and resources and increase participation in lung cancer screening

programs by 20% annually. This will contribute to a 25% reduction in lung cancer incidence and

mortality rates within the target population. These outcomes are specific in targeting smoking

behavior and early detection, measurable through quantitative indicators such as smoking

prevalence and screening participation rates, achievable through evidence-based interventions

and community engagement, relevant to the program's overarching goal of reducing lung cancer

burden, and time-bound within a five-year timeframe to track progress and ensure accountability.

Evaluation of outcomes

In year 5, the health promotion program will be evaluated on its impacts on reducing lung

cancer burden among Miami's older smokers. This evaluation will involve assessing program

outcomes, including changes in smoking behavior, participation rates in lung cancer screening

programs, and trends in lung cancer incidence and mortality rates. To evaluate changes in

smoking behavior, surveys, and self-reported data will be analyzed to determine changes in

smoking prevalence and cessation rates among older smokers in Miami. Success in this

assessment will be demonstrated by a reduction in smoking prevalence among older smokers in

Miami compared to baseline data. Increased rates of successful smoking cessation and a shift in

attitudes towards smoking cessation, as evidenced by survey responses and self-reported data,

will also indicate success.

Furthermore, the participation rates in lung cancer screening programs will be evaluated

through various means, including data collection at healthcare facilities, surveys and interviews

to gauge awareness and attitudes, healthcare provider reporting, community outreach events, and

5

comparative analysis of participation rates over time and across different demographic groups.

The success of this outcome will be indicated by an increase in participation rates in lung cancer

screening programs among high-risk individuals. More individuals undergoing regular

screenings, especially those recommended by evidence-based guidelines, will suggest improved

awareness and engagement with preventive healthcare services. Lastly, lung cancer incidence

and mortality rates will be evaluated by analyzing epidemiological data from population-based

cancer registries and mortality databases. This analysis will involve comparing pre-program and

post-program rates, assessing trends over time, and comparing them to national averages.

Statistical methods such as regression analysis will determine the program's contribution to

changes in lung cancer incidence and mortality rates while controlling for confounding variables.

Success will be reflected in decreased lung cancer incidence and mortality rates among the target

population. A downward trend in both incidence and mortality rates throughout the program will

show the effectiveness of interventions in reducing lung cancer within the community.

Challenges

Implementing the program may need more access to healthcare resources among

vulnerable populations. This may be due to socioeconomic disparities and geographical barriers.

Socioeconomic disparities can result from differences in income, education, employment, and

health insurance, which influence the individuals' ability to afford and access healthcare services

(McMaughaN et al., 2020). Geographical barriers are the challenges related to the availability

and proximity of healthcare facilities in rural or underserved areas where healthcare

infrastructure may be limited. The program will address these by increasing outreach efforts to

6

underserved communities. It will use mobile clinics, community health centers, and telehealth

services to improve access to screening, counseling, and support services. Implementing the

program may also face the challenge of resistance to behavior change among older smokers with

entrenched habits, who may face psychological, social, and physiological barriers to quitting. To

address this, the program will offer incentives for participation, such as financial rewards or

access to cessation aids, and provide personalized counseling and support tailored to each

individual's readiness to change. Lastly, the program may face financial constraints. More

funding is needed to ensure the delivery of comprehensive services and interventions (Archer et

al., 2022). This barrier will be addressed by advocating for policy changes to allocate resources

towards lung cancer prevention initiatives, collaborate with public and private stakeholders to

secure additional funding sources, and explore cost-effective strategies such as leveraging

existing infrastructure and partnerships to maximize the impact of available resources.

Nevertheless, implementing evidence-based interventions and addressing barriers to

implementation will help the program achieve measurable improvements in smoking cessation

rates, participation in screening programs, and reductions in lung cancer incidence and mortality

rates among older adults in Miami. Through ongoing evaluation and adaptation, the program

seeks to contribute to the broader efforts in lung cancer prevention and control to improve the

health outcomes and well-being of older adults in Miami.

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References

Chang, Y.-H., Guo, S.-E., Okoli, C., Fu, C.-H., and Hsu, M.-H. (2024). A quasi-experimental

longitudinal study examined the efficacy of a transtheoretical model-based smoking

8

cessation intervention for smokers in rural areas. Counseling and Education for Patients.

Advanced publication on the internet. In this case, the doi: 10.1016/j.pec.2024.108136

Oloruntoba, O., McMaughan, D. J., & Smith, M. L. (2020). Access to healthcare and

socioeconomic level are linked factors that influence healthy aging. Public Health

Frontiers, p. 8. This article contains 10.3389/fpubh.2020.00231.

Robinson, L., Brown, T., & Archer, J. (2022). This scoping study protocol examines how

healthcare funding affects interprofessional collaboration and integrated primary and

allied care service delivery. 11(5) JMIR Research Protocols. This link points to

10.2196/36448.