PS370 Unit 9 Health Education Program Proposal Example

Settlement Day Health Check: A PS370 Unit 9 Health Education Program Proposal for a Fishing Port

[Student Name]

Purdue University Global

PS370: Health Psychology

Unit 9 Health Education Program Proposal

[Instructor Name]

[Date]

The program, the port partners and the figures are composite; the planning model, guidelines and studies cited are real.

Need

New Bedford is the highest-value commercial fishing port in the United States, landing mostly sea scallops. Fishing crews face a health risk profile unlike that of most workers. Injury rates are high, there is no paid sick leave, and a Massachusetts analysis of opioid-related overdose deaths found that farming, fishing and forestry workers had one of the highest death rates of any occupational group. Opioid use, including injection in some cases, raises the risk of hepatitis C and HIV. Smoking rates on boats are high, and crews spend ten to fourteen days at sea out of reach of routine care.

Paul, a 51-year-old scallop captain and the composite case followed through this course, illustrates the gap. He injected heroin for about a year before entering treatment in 2017. He learned he had hepatitis C only when his treatment program tested him, was cured with an eight-week course of antiviral pills in 2019 and has since lost two crew members to overdoses. He still smokes at sea after a heart attack.

Planning Model

PRECEDE-PROCEED has planners start from the quality-of-life and health outcomes a community wants and work backward to the behaviors, environments and predisposing, enabling and reinforcing factors that produce them, then to plan implementation and evaluation in matching steps (Green & Kreuter, 2005).

The outcomes this program targets are fewer overdose deaths, more hepatitis C infections found and cured, more HIV infections found and treated, and fewer smokers among crews. The behaviors are getting tested, carrying naloxone and making a supported quit attempt. Predisposing factors include beliefs that testing is only for people who inject now, that hepatitis C treatment is long and harsh and that naloxone encourages drug use. Enabling factors are the main barrier: crews are at sea when clinics are open and ashore when they want to rest. Reinforcing factors include captains' attitudes, since a crew member who is tested with his captain's support is likelier to follow through.

The program goes to the dock on settlement day because that is the one time every crew member is ashore, awake and in the same place.

Evidence for the Services

Since 2020 the CDC has advised a one-time hepatitis C test for every adult, repeated periodically while risks such as injecting drugs continue (Schillie et al., 2020). Current antiviral treatment cures most people in eight to twelve weeks, so finding infections is the main barrier to cure. A Cochrane review found that opioid substitution therapy was associated with roughly halving the chance of a new hepatitis C infection, with larger reductions when it was combined with high-coverage needle and syringe programs (Platt et al., 2017), so the program will also link people to treatment for opioid use disorder.

Overdose education and naloxone distribution has evidence from Massachusetts itself. Walley et al. (2013) compared communities across the state and found that those with high rates of naloxone program enrollment had substantially lower opioid overdose death rates than communities without programs, after accounting for other factors.

Program Design

The program will run on settlement day, when each boat's catch is sold and crews are paid at the dealer's office. A van with a nurse and a peer educator will park at three dealers on a rotating schedule, two days a week, from late morning until the last crew has been paid.

Each visit offers four services. First, rapid hepatitis C antibody and HIV tests with results in about twenty minutes, followed by confirmatory testing for positives. Second, a ten-minute naloxone training with a kit to keep on the boat. Third, a brief smoking-cessation conversation using the Ask, Advise, Refer approach, with enrollment in the state quitline and free nicotine replacement. Fourth, a direct referral to a local clinic that offers buprenorphine and hepatitis C treatment.

Paul will serve as the program's first peer educator. He will tell crews his own story of hepatitis C treatment and recovery, and his standing as a captain addresses the reinforcing factor the model identifies. Two more peer educators will be recruited from crews in the program's first quarter.

Objectives

Testing is the first target: 600 crew members offered a test and at least 300 tested in the first twelve months. At least 80 percent of people with a positive hepatitis C or HIV result will attend a treatment appointment within sixty days. The program will distribute at least 400 naloxone kits, one for every active scallop boat in the port and the rest to individual crew members. At least 120 smokers will enroll in the quitline.

Evaluation

Process evaluation will track visits held, people reached, tests given and kits distributed, and will survey crews each quarter about barriers. Outcome evaluation will track linkage to care and confirmed cures through the partner clinic, quitline enrollments and quit status at six months, and reports of naloxone use on boats. The program will also follow state overdose death data for the port, recognizing that one program cannot be credited with changes in those numbers.

Conclusion

Settlement Day Health Check brings testing, naloxone and smoking support to the one place and time crews can be reached. It is planned from the community's outcomes backward, built on evidence from the same state, and led by a peer whose own history shows each service working.

References

Green, L. W., & Kreuter, M. W. (2005). Health program planning: An educational and ecological approach (4th ed.). McGraw-Hill.

Platt, L., Minozzi, S., Reed, J., Vickerman, P., Hagan, H., French, C., Jordan, A., Degenhardt, L., Hope, V., Hutchinson, S., Maher, L., Palmateer, N., Taylor, A., Bruneau, J., & Hickman, M. (2017). Needle syringe programmes and opioid substitution therapy for preventing hepatitis C transmission in people who inject drugs. Cochrane Database of Systematic Reviews, 2017(9), Article CD012021. https://doi.org/10.1002/14651858.CD012021.pub2

Schillie, S., Wester, C., Osborne, M., Wesolowski, L., & Ryerson, A. B. (2020). CDC recommendations for hepatitis C screening among adults: United States, 2020. MMWR Recommendations and Reports, 69(2), 1-17. https://doi.org/10.15585/mmwr.rr6902a1

Walley, A. Y., Xuan, Z., Hackman, H. H., Quinn, E., Doe-Simkins, M., Sorensen-Alawad, A., Ruiz, S., & Ozonoff, A. (2013). Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: Interrupted time series analysis. BMJ, 346, Article f174. https://doi.org/10.1136/bmj.f174