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Advocacy Action Plan (1500 words)Based on my Needs Assessment and Literature review (which i have provided for you below),write a six -page paper describing the action plan that follows and addresses the following.●Identify the problem and sub-problem(s)●Provide data and evidence that support that the problem exists so that the reader understands the severity of the problem●Identify stakeholders and their role in solving the problem●Identify of the actions that need to be taken●Identify the intended outcomes if action is takenpaper needs to be in APA format, at least 5 references, i have provided 2 of my papers over the semester to help you conduct this paper. Also a sample paper of what my professor is expecting and to help you. Also have a template, which is what she will be grading off of.needs five references only from online, book, more than 20% plagerissm




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Assignment due: May 13th by 5pm via Turnitin in Canvas
Word limit: 1500 words
1. Cover page
Ø Title of the Assignment: Advocacy Action plan
Ø Name of the student
Ø Student ID
Ø Submission date
Ø Submitted to
Ø Word limit
2. Introduction- One paragraph
Ø Mention the statement of the problem.
Ø Write few lines about the problem you have chosen for the topic in the
Ø Then write the lead or link to the next paragraph.
3. Burden of the problem with the evidence
4. Stakeholders involved in decision making role
5. Interventions/ Strategies need to be taken for the problem you identified
6. Intended outcomes of the problem if the action is already taken
7. Conclusion
8. References: Minimum of 5 references adhering with APA style guidelines. It can be
either books or journals, Govt websites. Ref shouldn’t more than 5yrs old.
9. Similarity Index should not go beyond 20%
10. Word limit accepted + or – 10% of 1500 words
Asthma Advocacy Action Plan
Submission Date: May 15, 2018
Submitted To: Dr. Sujatha Shanmugasundaram
Word Limit: 1675
Asthma Advocacy Action Plan
The statement of the problem is to assess the impacts of asthma among children under 18
years old in the Hispanic population in Fresno. Asthma is a huge issue in the community due to
air pollution, smoking, inaccessible health care, and low socioeconomic status that can increase
lung and health problems. It is significant to address this problem because the Hispanic children
mortality rate has increased over the years and it could be difficult to control in the population if
prevention methods are not implemented. Also, it is crucial to involve important stakeholders
related to the asthma problem since they can create intervention programs and raise public
awareness. The next paragraph will discuss about the burdens of asthma in Fresno, such as air
pollution, smoking, limited healthcare services, and low socioeconomic status that affects the
Hispanic community.
Burden of the Problem
Fresno, California has the highest rate of air pollution in the entire country and it affects
majority of the community with asthma. The main population that are affected by asthma is
Hispanic children under 18 years old. It was researched that they have the highest mortality rate
because as reported by the U.S. Department of Health and Human Services, Hispanic children are
two times more likely to die from asthma (OMH, 2017). As the asthma rate for Hispanic children
increases each year, it is crucial to address this issue in order for the mortality rate to decrease. The
main risk factors that should be focused on are air pollution, smoking, lack of health services, and
low socioeconomic status. By researching about these risk factors, it can prevent Hispanic children
from developing asthma and result in low morbidity and mortality rates in Fresno.
The air quality and the environment in Fresno was ranked the lowest compared to other
cities in the United States due to tremendous emission of dangerous chemicals. This problem poses
as a hazard to mainly children because their immune system are not fully develop to fight off
harmful chemicals emitted from road traffic and agricultural processes. As reported as by the
National Institute of Environmental Health Sciences, high levels of nitrogen dioxide is one of the
main toxic gases that is released from vehicles and affects children’s lungs (NIEHS, 2018).
Consequently, this can increase Hispanic children’s risk of developing asthma since their main
form of transportation are cars. Another risk factor is the exposure to pesticides used in agricultural
processes. A study was conducted by UC Berkeley about how elemental sulfur, the mostly used
pesticide, affected children’s respiratory system and discovered that it reduces their lung function
and causes asthma development (Berkeley, 2017). From this research, elemental sulfur affects
Hispanic children the greatest since they mostly live near agricultural environments where their
families worked in farmlands. Therefore, they have the highest rate of developing asthma since
they are constantly exposed to a toxic pesticide that weakens their lungs and breathing.
Smoking is another impact on the Hispanic community since children are directly exposed
to the toxins from a smoked cigarette. For example, carcinogenic particles found in one cigarette
like carbon dioxide, nitrogen oxide, and hydrogen cyanide are asthma triggers that causes
inflammation of the lungs and constrict the airways (Kalyva, Eiser, & Papathanasiou, 2016). This
can potentially worsen the asthma in children and cause complications to their health such as
developing pneumonia or chronic obstructive pulmonary disease. It was reported from the Centers
for Disease Control and Prevention that about 10% of Hispanic adults are current smokers (CDC,
2018). For this reason, the mortality rate of Hispanic children has increased because they mostly
live in poor environments where either there are high level of smokers or they are exposed to
smoking by their parents. All in all, this indicates that there is a need for programs to prohibit
smoking so it can prevent asthma emerging in Hispanic children.
The majority of the Hispanic population mainly lives in poor communities where it contain
asthma triggers such as pollen, mold, dust, and debris. The reasons why they reside in this type of
area are due to their low socioeconomic status and lack of education. Language barriers is one of
the main thing that makes it difficult for Hispanic families to understand what asthma is and why
it is important to prevent. Without the proper education and the lack of understanding English,
parents may misdiagnose their children’s asthma with some other health problems and treat their
children with the incorrect medication. Another issue that low income Hispanic families confront
is the limited healthcare services available to them. From the California Health Report, it discussed
about the high asthma rates in the Central Valley and how Medi-Cal does not cover further
assessments of people’s asthma or the environment of their home (Childers, 2017). This is a huge
negative impact to the Hispanic community because it is important that their children receive
regular checkups in case their asthma returns. As well, assessing family homes is crucial because
asthma triggers need to be removed from their homes to prevent any further development. When
these risk factor of asthma are addressed, the Hispanic children mortality rate can be reduce.
There are many stakeholders in California that develops or are a part of a program that help
create prevention methods for asthma. From the Central California Asthma Collaborative, the
program coordinator named Stephani Pineda wanted to develop a program to reduce asthma
triggers indoors. She discovered that since children spent about 70%-90% of their time inside, they
are mainly exposed to indoor pollutants that are directly emitted within the house (Childers, 2017).
Another important stakeholder from the California Department of Public Health is the health
educator known as Debbie Shrem. The main goal of her intervention program is to protect students
and staffs from asthma in California schools by developing proper hygienic procedures (SEHAC,
2015). As well, more asthma prevention methods are created by the Environmental Defense Fund’s
campaign manager named Lucia Oliva Hennelly and she promotes the importance of decreasing
asthma hazards (Hennelly, 2014). From these three stakeholders, they all aim to prevent asthma in
the community with different types of methods and programs.
The main program that Stephani Pineda developed was called the Asthma Impact Model
and its focus were to educate low-income families in the Central Valley about asthma prevention
from indoor pollutants and to reduce the amount of visits to the emergency room (Childers, 2017).
Her program was funded by grants provided by the California Endowment, Social Impact Bond,
and Social Finance. It helped families paid for a health outreach worker to perform a home
assessment and to educate them how to eliminate asthma triggers. For example, they would
educate families that when removing mold it is safer to use natural products than using bleach
because it contains harsh chemicals that can cause asthma (Childers, 2017). As for Debbie Shrem,
she is a part of the California Work-Related Asthma Prevention Program that created educational
videos and fact sheets to teach students and train staffs the appropriate cleaning techniques
(SEHAC, 2015). The main reason of her plan is to raise awareness and to decrease asthma
developments so that schools can improve its health quality. On the other hand, Lucia Hennelly
approached asthma prevention by reinforcing the federal laws of chemical and air pollution
regulations so that asthma hazards can be diminish. Another method in her plan is to strive for a
chemical free air by limiting the amount of pollutants being released (Hennelly, 2014). With the
establishment of different intervention plans, they all focus to decrease asthma in children.
Intended Outcomes of the Problem
The interventions implemented by these stakeholders has either created a huge or small
impact within the Hispanic community. For the Asthma Impact Model, it tremendously assisted
many low-income Hispanic families in the Central Valley and made their homes free of indoor
pollutants. Also, Pineda’s program decreased majority of the asthma in children and many were
able to return to school healthy (Childers, 2017). For the Work-Related Asthma Prevention
Program, many school staffs were trained for asthma management and children learned the proper
cleaning methods. As for the outcome, many California schools maintained the use of Shrem’s
asthma plans because it was evident that the number of asthma development in children had
extremely decreased (SEHAC, 2015). Moreover, seeing that her intervention plan was a success
and how it increased awareness, many other states has started to consider using some policies in
their plan. However, Hennelly’s plan only increased awareness about asthma preventions since
her goal to strengthen chemical and air pollution regulations are still in progress (Hennelly, 2014).
For this reason, the proposal may have been put on hold since reinforcing federal laws requires
many processes that it has to go through. Even though some strategies achieved huge successes
and some made slight impacts, they all still raised awareness about asthma and the importance of
preventing it.
Overall, the research assignment about asthma prevention in the Hispanic community was
interesting and informative. It was astonishing to find that many people in Fresno are unaware
about the challenges that Hispanic children experience with asthma. For that reason, developing
asthma preventions and promoting it in the community is critical because it can decrease the
amount of children contracting it and reduce their mortality rate. In order to achieve these goals,
people need to be aware that language barriers and limited healthcare access are reoccurring
problems for them. Although people may least expect these issues, it occurs in the Hispanic
population on a daily basis where children are affected by multiple risk factors of asthma. For
example, learning that smoking can cause children to develop asthma was shocking because the
harsh chemicals from the cigarette can affect them even though they are not the ones smoking.
Therefore, creating intervention programs to prevent asthma can help improve their health since
many stakeholders had successes with their plans. All in all, it is important that the more educated
and assistance the Hispanic community have with asthma, the less issues their children will have
to deal with.
Berkeley, U. (2017). Heavily Used Pesticide Linked to Breathing Problems in Farmworkers’
Children. Laboratory Equipment, p. Laboratory Equipment, Aug 16, 2017.
Centers for Disease Control and Prevention (CDC). (2018). Tips From Former Smokers ®.
Retrieved from
Childers, L. (2017). Driven By High Asthma Rates, Central Valley Tries to Improve Indoor Air
Quality. Retrieved from
Hennelly, L. O. (2014). Why Latinos are disproportionately affected by asthma, and what we can
do. Retrieved April 17, 2018, from
Kalyva, E., Eiser, C., & Papathanasiou, A. (2016). Health-Related Quality of Life of Children
with Asthma: Self and Parental Perceptions. International Journal of Behavioral
Medicine, 23(6), 730-737.
National Institute of Environmental Health Sciences (NIEHS). (2018). Asthma. Retrieved from
Office of Minority Health (OMH). (2017). Asthma and Hispanic Americans. Retrieved May 15,
2018, from
School Environmental Health and Asthma Collaborative (SEHAC). (2015). Work-Related
Asthma Prevention Program. Retrieved from
Alzheimer’s Literature Review
Cheyenne Marmolejo
April 11, 2019
Submitted to: Dr. Suja
Word Limit: 1500
Alzheimer’s is a disease that affects the brain and leads to a loss of the functionality and
structure of the neurons that form building blocks. As a result, the disease leads to memory loss
among a majority of those it affects. The other symptoms associated with the condition include
problems with communicating coherently and in a meaningful way, quick shifts in the
temperament, loss of personal and social conduct appreciation and withdrawal. The disease over a
period physically depreciates the affected body and leads to death as main organs are wasted away
(Elio, Schelterns & Feldman, 2011). On average, most individuals succumb to the disease 3 to 9
years after diagnosis.
The causes of the disease are poorly understood but it is generally accepted that genetics
have the largest role to play in determining who gets affected by the disease. Other factors that are
believed to cause the condition are many forms of depression, or injuries to the brain. As earlier
stated, the disease begins by wasting away neurons found in the brain. Degeneration also occurs
in other parts like the frontal cortex and leads to the general shrinking of the brain. This paper
seeks into Alzheimer’s as a disease that affects a sizeable portion of the population more so the
elderly, and evaluate its effects on the society at large (Jeffrey et al, 2018).
The Burden of the Problem
Alzheimer’s is a growing social phenomenon because of the demographic changes that
have occurred from the beginning of the boomer generation. The condition mostly affects the
elderly and is equivalent to dementia. The demographic change that has been occurring in the last
few decades has seen two effects. Firstly, a larger section of the population is living longer and
increasing the number of people at risk of getting the disease. An aging population also translates
to a larger percentage of the population is at risk of getting afflicted by the disease. As a result, the
disease has become a large social burden to the community, the health sector and the government
because of the increased costs. The social cost of the disease in the United States is estimated to
be $100 billion annually (Jeffrey et al, 2018).
Such huge amounts of money that other sectors of the national budget or health budget are
transferred to cater for the rising costs of the condition. Additionally, individuals suffering from
the disease are not able to contribute to the national economy as a result of their condition,
essentially hurting the employment economy. The largest portion of the costs involved with
Alzheimer’s is care that the affected have to give over a long period. This means the construction
and expanding of institutions that cater to the patients. The in-patient’s model of the care system
represents a costly affair for the state and family involved given that it is also labor intensive. For
those who choose to have home care, the cost of lost earnings can be a big detriment to the family
finances (Jeffrey et al, 2018).
The financial burden increases the disease takes its toll and the patient can no longer
communicate or interact or remember recent happenings. Loss of memory leads to social
discomforts and may tear apart at families. The costs and time taken to care for patients of the
disease are not fully catered for or covered by these programs. However, the cost already paid at
the initial stages stretch any national health fund and may mean that the fund does not cover other
areas of interest. In the United States, the disease is ranked as the sixth leading cause of death
among the general population. When the figures are narrowed down to reflect its effects on the
elderly, the disease becomes the third leading cause of death among that age group (Leon, et al,
Currently, the disease has no known cure and patients are only given the at most care in a
bid to make their lives as comfortable as possible. However, early diagnosis gives the individual
and family time to try out options that are on clinical trial. Thus, the disease requires the best
medical attendance to prevent more harm (Jeffrey et al, 2018).
Treatment and Prevention
The disease is not very well understood concerning its causes or why it only afflicts the
older people in society. However, studies have shown the development of the disease with the
gradual wasting away of the brain with the aim of better understanding the condition. Through
these studies, scientists have been able to link the disease with how the brain changes as one gets
older. As earlier stated, the main cause of the disease is thought to be genetics with the likelihood
of it affecting people of the same family higher than those of another family without a relative who
was once diagnosed with the disease (Leon, et al, 2013). The genetic link between the disease and
individuals suffering from it means that it is much harder to treat in the future because it is a genetic
disorder. However, it may also mean that it is easier to identify people as a larger risk of conducting
the disease.
Research and trials have shown that meditation methods alongside other techniques can
progressively help lead to a memory recovery process. Other forms of interventions such as
constant brain simulation and repetitiveness can lead to a slowing down of the worst ravages of
memory loss. Early diagnosis of the disease leads to treatment that preserves the mental state but
only for a short period (Elio, Schelterns & Feldman, 2011). It is important to note that the worst
ravages of the disease cannot be stopped. Individuals can, however, join clinical trials to help
scientists to understand the condition better and come up with treatment for the condition.
Currently, the National Institute of Aging leads the research in finding the answers to the most
pertinent questions about the disease.
Funding Issues
Alzheimer’s is currently the only condition/disease that scientists do not have a way of
either …
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