REPLY POSTS:Reply separately to two of your classmates posts (See attached classmates posts, post#1 and post#2). When replying to your peers, think about the ethical considerations related to research
POST #1 JENIFER
The purpose of this discussion is to weigh the pros and cons of the implementation of a Community-Based Participatory Research (CBPR) health promotion project with the homeless adolescent and young adult vulnerable population. Also, this discussion will consider the benefits of the actions of this vulnerable population in a CBPR health promotion project and how their active role is important. Lastly, this discussion post will examine this vulnerable population’s health disparities and health inequities on the ability of a program to be successful.
Homeless adolescents and young adults depend on shelters, food banks, and community clinics as their health assets to optimize their health. Schooling, which includes nurses, free meals, shelter, and education, can increase this vulnerable population’s health promotion. This vulnerable population’s health problems start with the lack of basic needs such as food, shelter, and health education. This sets this population up to fail at health promotion. Unfortunately, as Podschun (1993) and Woan et al. (2013) discuss in their studies, this population’s health problems also stem from risky behaviors such as drug use, needle sharing, decreased condom use, and increased number of sexual partners. The risky behaviors accompanied by limited available access to health care leaves this population at risk for disease, illness, and unhealthy habits. This population can not access health care due to cost, feeling judged, having a lack of trust with providers, and not having time off from work to seek care (Woan et al., 2013). Podschun (1993) reviewed multiple studies that confirmed this vulnerable population engaged in risky behaviors that set themselves up for health problems such as HIV. However, even with lack of education, lack of healthcare and increased risks of developing diseases, homeless adolescents and young adults are resilient. They learn to live with minimum resources, become empowered to heal with the least amount of resources, and learn from other teen homeless role models on how to live their best health promoting life. Teen outreach programs provide a means to improve the homeless adolescent and young adult’s lives. These programs provide resources, education, and interventions to increase this vulnerable population’s health promotion and disease prevention.
The CBPR is one way to promote and increase health promotion in this vulnerable population’s community. This research method includes participants from this vulnerable community to have a voice in the needed social changes in their community. The goal of these changes is to increase health promotion, empower, and increase knowledge in this vulnerable population. As Pender et al., (2015) states, CBPR will only be successful if through community analysis, the community must be thoroughly involved. This type of research will fail if it does not include the community's input. Wallerstein and Duran (2010) discuss that CBPR will be most successful if the community members decide on the intervention, the community members are valued, the community’s cultural values and beliefs are respected, and there is a concrete plan when grant funding ends.
As we consider the implementation of a Community-Based Participatory Research health promotion project with the homeless adolescents and young adults, as future Advanced Practice Registered Nurses (APRNs), we must examine the pros and cons. The homeless adolescents and young adults have shown empowerment, motivation, and continued support through teen outreach programs. The “Teen Peer Outreach-Street Work Project” is one intervention that could be from a Community Based Participatory Research health promotion project. This vulnerable population might consider this intervention as a means to increase their health promotion. The program is based on teen homeless participants becoming educators for other young adolescents and young adults. This provides a sense of cultural respect. The students and the educators share a common culture and the educators know how the students feel (Podschun, 1993). Due to a high rate of low literacy skills, the program used HIV learning materials with “high-impact coloration, photographs, and symbols” (Podschun, 1993). The pros to this health promotion project is that the vulnerable population decided on the intervention. This group decided that homeless teens would become more empowered and more eager to learn if fellow homeless teens taught them. The group was valued and the program is based on homeless teens teaching other homeless teens. The program incorporated this population’s language and made teaching materials based on their literacy level. As a result of the community population being involved, respected, listened to and valued, this study determined they could educate 1,000 homeless teens in one year (Podschun, 1993).
The cons of CBPR health promotion projects must be considered when assessing how long programs can maintain productivity. These teen programs need continued participants to be active in their roles as educators. This requires younger homeless children stepping up and being the next teen educator or teens that were students to become educators. If this cycle stops, this program will lack valuable educators. Another con comes from grant funding. If these teen programs are based on grant funding, will the community educators continue these programs without funding? This program might face the challenge of sustainability. As Wallerstein and Duran (2010) discuss, there needs to be attention placed on the program and resources or a barrier to sustain the intervention will surface. A back up plan must be in place for these crucial programs to stay open. Also, the teens must trust the researchers in these teen outreach programs. If not, they will not return for education, support or to show the researcher what they have learned, or how their health promotion has improved (Wallerstein & Duran, 2010).
The homeless adolescent and young adult’s health disparities and inequities can both hinder and benefit the success of CBPR health promotion projects. There are many different areas that can be researched on the homeless adolescent and young adult population. From poverty to lack of healthcare to lack of health literacy to risky health behaviors, researchers have an array of areas to choose. Researchers might have gratification from their research projects if improvements in health promotion were achieved through their projects. However, this vulnerable population might not have the qualifications for research funding or the means to be researched. For example, per Pender et al. (2015), when setting up screenings for certain populations, the specific population must be taken into consideration. Some populations have an increased or decreased attendance to participate in screenings (Pender et al., 2010). Another reason CBPR health promotion projects might not benefit from researching this population is due to inability to participate. If transportation is necessary to be interviewed, assessed or to go to the project setting, then this population might not be able to participate. This population might be able to do what the researcher wants them to do. They might not have the healthy food choices, ability to exercise, or ability to sleep as directed from the researcher. Also, researchers take on an extra layer of work when researching these vulnerable populations. Vulnerable populations bear watching from different ethical organizations to ensure they are being treated properly and not taken advantage of.
Implementation of a CBPR health promotion project with the homeless adolescent and young adult vulnerable population could improve this population’s health promotion. Continuing the motivation and empowerment from this population and maintaining an active role of its participants would bring more success to adolescent and young adult programs. Due to this vulnerable population’s health disparities and inequities, there are many areas to increase this population’s health promotion and disease prevention. Funding, trust, and continued community involvement will increase the success of these CBPR’s health promotion projects.
Reference
Pender, N., Murdaugh, C., Parsons, M.,(2015).Health Promotion and Nursing Practice (7th edition). Pearson Education
Podschun, G. (1993). Teen Peer Outreach-Street Work Project: HIV prevention education for runaway and homeless youth. Retrieved May 17, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1403354/pdf/pubhealthrep00068-000
Wallerstein, N., & Duran, B. (2010). Community-Based Participatory Research Contributions to Intervention Research: The Intersection of Science and Practice to Improve Health Equity. American Journal of Public Health, 100(S1). doi:10.2105/ajph.2009.184036
Woan, J., Lin, J., & Auerswald, C. (2013). The Health Status of Street Children and Youth in Low- and Middle-Income Countries: A Systematic Review of the Literature. Journal of Adolescent Health, 53(3). doi:10.1016/j.jadohealth.2013.03.013
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