NURS 6720 Week 4 intervention selection paper example

Reminders First, Then a Knock on the Door: Selecting Registry Recall by Bilingual Community Health Workers With Public Health Nurse Home Visits

Student Name

College of Nursing, Walden University

NURS 6720: Population-Based Public Health Nursing Interventions

Instructor Name

Month Day, Year

Reminders First, Then a Knock on the Door: Selecting Registry Recall by Bilingual Community Health Workers With Public Health Nurse Home Visits

The Decision

This paper selects one intervention for resettled children under 12 in the composite city whose catch-up vaccination series remain open: registry-based reminder and recall delivered by bilingual community health workers, with public health nurse home visits for families the calls do not reach. The components run as a sequence. Each quarter, the registry analyst produces a list of children in the aggregate with open series, after duplicate records have been reviewed. Community health workers who share the families' main languages contact each family by phone, and in person at the resettlement agency office or a partner clinic, to explain which catch-up doses the records show as outstanding and to help arrange an appointment at a time the parents can attend. Families who cannot be reached after three attempts, or who are reached but do not attend within six weeks, are referred to the public health nurse, who visits the home with an interpreter where needed, reviews any vaccination records the family holds, including records carried from overseas, and arranges the next step. The evidence review judged both components transferable to this aggregate, the first with adaptation (Kempe et al., 2013; Rodewald et al., 1999).

Why an Enabling Problem Calls for This Intervention

The PRECEDE-PROCEED model sorts the influences on a health behavior into three groups: predisposing factors, such as knowledge, attitudes and beliefs that motivate action; enabling factors, such as access, skills and resources that make action possible; and reinforcing factors, such as feedback and support that sustain it (Green et al., 2022). Placing the aggregate's barriers into these groups shows where the gap lies.

The evidence points mostly to enabling factors. Families in the aggregate began the catch-up series at screening, which suggests they were willing to vaccinate. The profile found barriers of access instead: clinic hours that overlap parents' shift work, thin bus service after dark and on Saturdays, contact details that change after the first months, and registry records that may split one child into two. Predisposing factors may matter for some families, such as uncertainty about why doses given overseas are being repeated, but they do not explain most of the open series. Reinforcing factors, such as someone following up after a missed appointment, are largely absent. An intervention that finds families, speaks their language and makes an appointment possible addresses the enabling gap directly, and follow-up by the same workers adds reinforcement.

Intervention Types and Levels

The Minnesota Public Health Intervention Wheel names population-based interventions by type and level (Keller et al., 2004). This intervention combines three types. Case finding locates individuals and families with identified risk factors and connects them with resources, which describes identifying children with open series from the registry. Outreach locates populations of interest and provides information about the nature of the concern and how to obtain services, which describes the community health workers' contact in families' languages. Referral and follow-up assists families to obtain needed resources, which describes the nurse's home visits and the arranged appointment. All three act at the individual and family level. A fourth element acts at the systems level: working with the registry to resolve duplicate records and to enter overseas records, so that the list the program works from reflects which children actually need doses.

Why a Media Campaign Was Rejected

A media campaign about catch-up vaccination was considered and rejected. Campaigns work mainly on predisposing factors, such as awareness and attitudes, and the aggregate's gap lies mostly elsewhere. A campaign would also have to run in several languages, some with no local media, and it would reach the whole city rather than the 171 children identified in the profile. It would not make a single appointment easier to reach. Messages about the value of vaccination could still have a place within the program, delivered by the community health workers in conversation, where a parent's question about repeated doses can be answered directly rather than broadcast to everyone. That keeps attention to predisposing factors inside a design built around the enabling gap, instead of spending the budget on a campaign aimed at a problem most families do not have.

Why a Weekend Clinic Was Rejected

A weekend catch-up clinic addresses an enabling factor, clinic hours, and was the strongest alternative. It was rejected as a standalone program because it waits for families to come. Without someone finding families with open series, explaining what is due and helping them plan the trip, a weekend clinic would mainly serve families who were already likely to finish. Weekend and evening appointment times are therefore included within the selected intervention, as places the community health workers can book, rather than as a separate program.

Why School-Entry Enforcement Was Rejected

School-entry vaccination requirements are common and effective in many settings, and enforcing them more strictly for this aggregate was considered. It was rejected because enforcement acts at the point of exclusion, removing a child from school when records are incomplete. For families who already value vaccination and are held back by access, exclusion adds a burden without solving the enabling problem, and it would remove children from the place where the school nurse could help. It would also fall hardest on the children whose records are duplicated or whose overseas doses have not been entered, penalizing a records problem the family did not create.

What the Selection Commits To

Selecting this intervention commits the program to three things later weeks must deliver: a clean registry list before any calls begin, community health workers who speak the aggregate's main languages with interpreter support for the rest, and nurse time for home visits. The Task Force's recommendations for client reminder and recall and for home visits support the combination (Briss et al., 2000), but the program's success will depend on whether those three conditions are met in this city. If any one of them fails, the design fails with it, and the implementation plan is where each condition gets a named person, a schedule and a cost.

References

Briss, P. A., Rodewald, L. E., Hinman, A. R., Shefer, A. M., Strikas, R. A., Bernier, R. R., Carande-Kulis, V. G., Yusuf, H. R., Ndiaye, S. M., & Williams, S. M. (2000). Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults. American Journal of Preventive Medicine, 18(1, Suppl.), 97-140. https://doi.org/10.1016/S0749-3797(99)00118-X

Green, L. W., Gielen, A. C., Ottoson, J. M., Peterson, D. V., & Kreuter, M. W. (2022). Health program planning, implementation, and evaluation: Creating behavioral, environmental, and policy change. Johns Hopkins University Press. https://doi.org/10.1353/book.100161

Keller, L. O., Strohschein, S., Lia-Hoagberg, B., & Schaffer, M. A. (2004). Population-based public health interventions: Practice-based and evidence-supported. Part I. Public Health Nursing, 21(5), 453-468. https://doi.org/10.1111/j.0737-1209.2004.21509.x

Kempe, A., Saville, A., Dickinson, L. M., Eisert, S., Reynolds, J., Herrero, D., Beaty, B., Albright, K., Dibert, E., Koehler, V., Lockhart, S., & Calonge, N. (2013). Population-based versus practice-based recall for childhood immunizations: A randomized controlled comparative effectiveness trial. American Journal of Public Health, 103(6), 1116-1123. https://doi.org/10.2105/AJPH.2012.301035

Rodewald, L. E., Szilagyi, P. G., Humiston, S. G., Barth, R., Kraus, R., & Raubertas, R. F. (1999). A randomized study of tracking with outreach and provider prompting to improve immunization coverage and primary care. Pediatrics, 103(1), 31-38. https://doi.org/10.1542/peds.103.1.31