Considering your position statement in discussion # 1 – if you had all possible resources (cost and personnel, etc. were not barriers), how would you explain this problem, and possible solutions, to your community?  Create a one-page handout that you could use to educate your community about the problem, and what they can do to avoid the problem or poor outcomes from the problem.

In your response to your classmates, share with them what you felt was effective and any other suggestions for improvement.

Post your initial response by Wednesday at 11:59 PM EST. Respond to two students by Saturday at 11:59 PM EST. The initial discussion post and discussion responses occur on three different calendar days of each electronic week. All responses should be a minimum of 300 words, scholarly written, APA formatted (with some exceptions due to limitations in the D2L editor), and referenced.  A minimum of 2 references are required (other than the course textbook). These are not the complete guidelines for participating in discussions. Please refer to the Grading Rubric for Online Discussion found in the Course Resources module. 

Child Poverty

As the child poverty data differs from county to state, trends show that in the United States, the child poverty level is at 16%, while in Northampton County, there is 10% of child poverty (2023).  While there are many questions about what may cause poverty, the answer is that there are many different factors or circumstances.  For example, cases may include parental job loss, longtime unemployment, and poor infrastructure (Pac et al., 2017).  While poverty is prevalent in many areas of the United States, it is also reported that between one and five children live in poverty in the United States (Schickedanz et al., 2021). 

                                                                             Effects of Child Poverty

 In addition, not only does poverty affect the child, but it also affects the entire family unit.  In focusing on the child, it should be recognized that poverty can be linked to possible poor child outcomes, such as being born with low birth weight and a decline in one’s physical health (Duncan, 2021).  The child could also develop a respiratory illness, such as asthma, due to any allergens that may put the child at risk (Francis et al., 2018).  It is also essential to recognize that children and families who experience poverty may experience depression and difficulty developing peer relationships.  In this case, it is necessary to help the child and family with any counseling or assistance they may need.  Reports show a greater likelihood of the child getting into delinquency or criminal behavior as they enter adolescence (Duncan, 2021).   

                                                                              Where to Go for Help

            In seeking assistance, it is always important to remember there is help.  Furthermore, I would suggest to families who may be experiencing poverty that there are resources available that they can utilize.  I would also offer home medical visits to those in need; for example, if the family and child suffer from chronic medical conditions requiring medications or need a physical exam, they can be seen on the van.  Likewise, I would also educate the family that there are local food banks in the area if they do not have food or the necessary funds to pay for food.  In addition, I would also explain to persons in need that they may qualify for a benefit offered by the United States Department of Agriculture, known as the Supplemental Nutritional Assistance Program, also referred to as SNAP.  Furthermore, this program can provide families with quality food if needed (Francis et al., 2018).  In closing, community members are also told to contact the local county office and other agencies if needed and that we are here to help them in any way we can.

                                                                                        References

Duncan, G. J. (2021).  A roadmap to reducing child poverty. Academic Pediatrics, 21(8), S97–S101. https://doi-org.wilkes.idm.oclc.org/10.1016/j.acap.2021.04.028

Francis, L., DePriest, K., Wilson, M., & Gross, D. (2018).  Child poverty, toxic stress, and social determinants of health: Screening and care coordination. Online journal of issues in nursing, 23(3), 2. https://doi.org/10.3912/OJIN.Vol23No03Man02

Northampton, Pennsylvania (2023).  County Health Rankings & Roadmaps.  (2023.).  Retrieved February 23, 2023, from https://www.countyhealthrankings.org/explore-health-rankings/pennsylvania/northampton?year=2022

Pac, J., Nam, J., Waldfogel, J., & Wimer, C. (2017). Young child poverty in the United States: Analyzing trends in poverty and the role of anti-poverty programs using the supplemental poverty measure. Children and youth services review, 74, 35–49.  https://doi.org/10.1016/j.childyouth.2017.01.022

Schickedanz, A., Szilagyi, P. G., & Dreyer, B. (2021). Child Poverty and Health in the United States: Introduction and executive summary. Academic Pediatrics, 21(8), S81–S85. https://doi-org.wilkes.idm.oclc.org/10.1016/j.acap.2021.09.003

Charles County is facing an increase in cases of sexually transmitted infections (STIs). My solution to alleviate the epidemic of STIs is to prioritize screening by creating clinics in all of  the cities in Charles County. One of the primary goals of these clinics would be to encourage individuals to come in for regular screenings, which can help identify and before they have a chance to spread. To make the clinics more accessible and attractive to patients, I would also offer additional incentives. For example, I could set up a drive-thru where individuals could receive a free coat, clothes, bread, or other simple items in exchange for getting screened. This would help to reduce any barriers to entry that might prevent individuals from seeking out healthcare services.

In addition to the clinics, I would also establish mobile screening units that could travel to each high school in the area. The focus would be on providing free screenings to students, as this demographic is particularly vulnerable to STIs. To encourage participation, I would offer incentives such as Amazon or food gift cards, which could help motivate students to get screened. Overall, my approach would be to make STI screenings as accessible and convenient as possible. By removing barriers to entry and providing incentives for participation, I believe we can encourage more individuals to get screened and ultimately help to reduce the spread of STIs. To make STI screening even more accessible, telehealth services will be implemented at all libraries in the county. Providers will be available to take consultations remotely. Additionally, an STI-specific application could be created for anyone to access via their mobile phone. This application would provide consultation and guidance for STIs.

According to research, telehealth programs for STIs must be developed with consideration of the specific needs and circumstances of the affected communities, like how traditional healthcare services are designed (Valentine et al., 2022). Some STI-related applications have been launched, and research has shown that interest in these apps was particularly high among young males. This indicates the potential for STI-related apps in preventing and identifying sexually transmitted diseases in this group. However, further research is necessary to validate these findings in other populations (Jakob et al., 2022). Overall, providing STI screening and telehealth services in libraries, and creating an STI-specific application would provide easy access to STI screening for a wide range of individuals. This would help to identify and treat STIs before they spread, ultimately reducing the overall spread of sexually transmitted infections.

References

Jakob, L., Steeb, T., Fiocco, Z., Pumnea, T., Jakob, S. N., Wessely, A., Rothenberger, C. C., Brinker, T. J., French, L. E., Berking, C., & Heppt, M. V. (2020). Patient perception of mobile phone apps for the care and prevention of sexually transmitted diseases: Cross-sectional study. JMIR MHealth and UHealth, 8(11). https://doi.org/10.2196/16517

Valentine, J. A., Mena, L., & Millett, G. (2022). Telehealth services: Implications for enhancing sexually transmitted infection prevention. Sexually Transmitted Diseases, 49(11S). https://doi.org/10.1097/olq.0000000000001699

Sexually transmitted diseases (STDs) are caused by bacteria, viruses, and parasites transmitted during vaginal, anal, and oral sex. There are more than 20 types of STDs, including chlamydia, genital herpes, gonorrhea, HIV, HPV, and syphilis. One challenge with STDs is that they do not always show symptoms, or symptoms may be mild. Although STDs affect both women and men, women often experience more severe health consequences because of an STD infection. Pregnant women can even pass an STD infection to their unborn babies. STDs are diagnosed through a physical exam, examination of a sore, swabbed fluid from the vagina, penis, or anus, or blood tests. Once there was a range of antibiotics to treat gonorrhea, but now there is only one treatment, which in some countries, gonorrhea strains have shown resistance. People may believe that leaving gonorrhea untreated is okay because it is not life-threatening. The idea that gonorrhea is not life-threatening is not so. Left untreated, it may cause infertility, blindness, epididymitis, and pelvic inflammatory disease; however, untreated gonorrhea can spread to the joints and blood, which can be life-threatening. Another reason to be concerned about gonorrhea infection is it puts people at an increased risk for HIV infection (Mayo Clinic, 2021).

In the Bronx, STDs are at the highest they have been since 2007. STDs in the Bronx (1,289.0) are over the double state (640.6) and national rates (555.1, [County Health Rankings, 2023]. Any disease with rates this high deserves immediate action to reduce its prevalence. Another problem is the stigma and shame surrounding STDs that keep people from being tested and discussing them. It is about time to stop allowing fear to dictate health when it comes down to STDs. Let’s talk about STDs. Let’s plan. Let’s take action. We must get people in the Bronx to make safe sex as necessary as wearing masks during the pandemic.

References

County Health Rankings. (2023). New York Data and Resources. https://www.countyhealth    rankings.org/explore-health-rankings/new-york/data-and-resources

Mayo Clinic. (2021, October 5). Gonorrhea. https://www.mayoclinic.org/diseases-  conditions/gonorrhea/symptoms-causes/syc-20351774

As we know, chlamydia is one of the most common transmitted sexually transmitted infections (STI). Transmission and re-infections of chlamydia are a common problem. Untreated infections can result in serious health consequences to the infected patient and pose a great risk to the public due to ongoing transmission. The Centers for Disease Control and Prevention (CDC) recommends that the partner and partners of the infected patient be treated for the same infection despite the presence of symptoms (Florida Department of Health, 2019). However, the ultimate recommendation is testing, although this is not always feasible. Expedited partner therapy (EPT) legislation was put into place in 2006 by the CDC (Centers for Disease Control and Prevention, 2021). EPT allows the treating healthcare practitioner to treat the partner or partners of their patient who has been diagnosed with Chlamydia. EPT is permissible in 46 states including the state of Florida. EPT is only recommended to be used in heterosexual relationships, this is secondary to increased risk of other co-occurring sexually transmitted infections that could be overlooked if only chlamydia was treated. Examples of other illness that could be overlooked are syphilis or human immunodeficiency virus (HIV), particularly in men who have sex with men populations. While EPT is an option it is often underutilized and therefore leaving many patients untreated allowing for the continued spread of the infection (Jamison et al., 2018).

While EPT is an option, many healthcare practitioners are not offering or utilizing EPT without an examination or laboratory result from the partner or partners of the infected patient. Several reasons have been citied as possible explanations. Studies have shown that providers are concerned about the legality of providing a prescription to a patient that has not expressively provided consent to be treated. Additional concern has been expressed around the need to send prescriptions electronically and that patient not being in the electronic medical record with appropriate demographic and allergy information available (Nanhoe et al., 2018).

Studies have shown that when providers rely solely on patients to report to their partner the infection and require the partner to seek out treatment, only 36% of male partners in heterosexual relationships actual follow through with care (Jamison et al., 2019). Therefore, as a medical community we must take action to improve EPT for chlamydia. Improving access and implementation will aid in the reduction of chlamydia cases by reducing transmission. One way this can be accomplished is by creating a subset in electronic prescription programs that allow for indication of  EPT treatment. In the state of Florida, there is no specific rule or designation of how these treatments should be delivered to the patient and pharmacies (Florida Department of Health, 2019). Indication of EPT treatment will alert the pharmacist to know this is a patient that the physician has not examined and therefore will prompt questioning about allergies and even financial resources at the time the patient picks up the medication. EPT indications will also allow for additional tracking of treatment executions for partners that can contribute to further research.

References

Centers for Disease Control and Prevention. (2021). Legal status of expedited partner therapy. https://doi.org/https://www.cdc.gov/std/ept/legal/default.htm

Florida Department of Health. (2019). Chlamydia (2019 Chlamydia Rates) [Report]. https://doi.org/https://www.flhealthcharts.gov/ChartsDashboards/rdPage.aspx?rdReport=STD.DataViewer&cid=0145

Jamison, C. D., Chang, T., & Mmeje, O. (2018). Expedited partner therapy: Combating record high sexually transmitted infection rates. American Journal of Public Health, 108(10), 1325–1327. https://doi.org/10.2105/ajph.2018.304570

Jamison, C. D., Coleman, J. S., & Mmeje, O. (2019). Improving women’s health and combatting sexually transmitted infections through expedited partner therapy. Obstetrics & Gynecology, 133(3), 416–422. https://doi.org/10.1097/aog.0000000000003088

Nanhoe, A. C., Visser, M., Omlo, J. J., Watzeels, A. M., van den Broek, I. V., & Götz, H. M. (2018). A pill for the partner via the chlamydia patient? results from a mixed method study among sexual health care providers in the netherlands. BMC Infectious Diseases, 18(1). https://doi.org/10.1186/s12879-018-3139-0