Healthcare in the United States continues to strive to meet the goal of early detection of disease and illness. The purpose for early detection through any screening program is to detect diseases and identify risk factors connected with the disease, with the end result focusing on preventive care. The method of preventative screening for disease has demonstrated the ability to save lives, as well as decrease the costs of healthcare (Backer, Geske, McIlvain, Dodendorf, & Minier, 2005). A population health issue of concern is the contracting and spreading of the Human Papillomavirus, also known as HPV.
HPV is a virus that is contracted sexually through skin to skin contact and is known for its role in being a causative agent in cervical cancer among women of all ages (CDC, 2013). The concern with HPV is that the disease does not focus on one particular age group, however, the prevention of the disease is focused on teenagers both male and female between ages 11-12. According to the CDC, HPV infects roughly 20 million people in the U. S. with approximately 6. 2 million new cases each year (CDC, 2013). In order for a population health concern to be improved, there should first be programs that focus on the health concern.
Two advocacy programs focused on the teaching and prevention of HPV are the 3 For Me program and the National Cervical Cancer Coalition (NCCC). The 3 For Me program focuses on the teenage population and is a free and confidential program. This program centers on the series of three vaccinations needed in the prevention of HPV. What assists in making this program effective is the ease of scheduling an appointment, no cost, and total confidentiality, including parents. Many teenagers do not feel comfortable talking to their parents regarding sexual issues for the fear of getting in trouble or embarrassment.
This program allows young teens to prove responsibility and safety at the same time (3 For Me, n. d. ). The National Cervical Cancer Coalition is a non-profit organization committed to serving woman who have cervical cancer or at risk for cervical cancer due to HPV. (National Cervical Cancer Coalition, n. d. ). What makes this program effective is that it is a national wide program. The focus is not in one particular region or state, but the population as a whole. The sole drive of this organization is to educate and raise awareness of HPV throughout communities and for citizens across the nation.
When considering the development of an advocacy program, there is a great amount of planning that needs to be put into it the program for a result of successfulness. Power is in numbers, therefore, it is important to have the support of powerful individuals and other organizations to assist in making a change. Without the assistance from others, reaching the desired goal may be difficult due to lack financial resources. Each of the two organizations described above have aspects that could be modified in order to accomplish the goals that have been set forth. For example, the 3 For Me program only treats adolescents ages ranging 13-18.
Problems arise when there are teens who are sexually active prior to age 13, and who are unable to confidentially receive the HPV vaccination. This puts those teens at risk for acquiring the virus and spreading it to their partners. Another issue that is of concern with the 3 For Me program is that it is only available in a secluded area. It is not nationwide, so there is a limited number of teenagers that are being reached through this program (3 For Me, n. d. ). An issue with the National Cervical Cancer Coalition is this program focuses strictly on cancer in women caused from the Human Papilloma Virus, and only identifies cervical cancer.
Throat cancer, as well as anal cancer can be initiated from HPV, but this program does not identify these cancers, nor cancers in men caused from HPV. Because of the limitations, there are restrictions placed upon both sexes when relating HPV to available assistance. Legal Considerations The HPV vaccine is a great topic of debate when bearing in mind the legality issues that are considered. Given that HPV is the most common sexually transmitted disease in the United States, along with the cervical cancer rates and the success rates of the vaccinations, legal questions arise when deciding to mandate the vaccination for both boys and girls. Chen, 2012, p. 289). As with any vaccination, parents state there are concerns as to side effects and potential health issues that can occur for these young adults from receiving the vaccination. Other concerns of parents is that giving their child this vaccination implies approval from the parents for these young adults to have sexual activity (Chen, 2012, p. 290). Because of these concerns with the vaccination, many states remain in a debate over making the vaccination mandatory, however, in 2012, the Texas Governor Rick Perry was one of the first to mandate the vaccination for girls (Chen, 2102, p. 90). One forgotten issue among the debate is the fact that the male gender are largely responsible for spreading the majority of HPV infections to both women and other men. This becomes a concern because in the states where the vaccine is mandated, it is only mandated for girls (Chen, 2102, p. 291). Mandating the vaccination for females does decrease the chance of the female population acquiring HPV but deems to be an ineffective measure since more than half of men in the United States will acquire HPV at some point in their lives.
This is concerning because cancers in men caused by HPV include penile and anal cancer and is at a rate of 30 percent (Chen, 2012, p. 291). There is a violation of the equal protection guarantee when states exclude the male population from the mandating of the HPV vaccine. There is a stereotype that is gender biased and based on assumptions that only the female population are responsible for preventing or eliminating the Human Papillomavirus. To present HPV in a mode that is equal to both sexes, while attempting to keep the spreading of the virus at bay, the mandating of the vaccine for both sexes in all 50 states would be most beneficial.
When developing an advocacy plan for the teaching and prevention of HPV, existing regulations that may impact the advocacy efforts need to be taken into consideration. At this point in time, regulations regarding the HPV vaccination and mandating is individual to each state. A plan that would be advantageous to depleting HPV is to develop regulations that would state that both male and female pre-teens are required to receive the vaccination prior to entering the sixth grade. Sixth grade seems to be an appropriate age since it marks the start of middle school.
Usually prior to middle school, the adolescents are educated about menstrual cycles, sexual activity and safe sex. This education provides the opportunity to inform the students about the dangers of HPV, primary prevention, the importance of the HPV vaccination, and why it is administered. Without a doubt, many obstacles would arise if the HPV vaccine was mandated for boy and girls of adolescent age. Parents would most likely express that administration of the vaccination as a violation of freedom in the aspect of the parent’s ability to decide what is needed for their child.
Because of this particular obstacle, a great deal of information would need to be provided to the parents in regards to the statistics of cancer that is caused from HPV. Since a large portion of parents have their children vaccinated throughout their lives for the child’s protection against illnesses that are virtually eradicated, it would be necessary to put the HPV vaccine in the same perspective for the parents. Another possible obstacle that may arise is the concerns of safety and side effects of the vaccination (Ohlheiser, 2013).
According to Ohlheiser, a study that was performed demonstrated that safety concerns and side effects were the main decision making factor for parents against the HPV vaccine. This leads the healthcare providers to understand that there is a definite need for teaching about the HPV vaccine. Application The American Nurses Association (ANA) has set provisions or requirements relating to a specific code of ethics directed to nurses in relation to advocacy for population health. The first provision to review is number seven.
This provision states that in the profession of nursing, nurses are to demonstrate the attributes of leadership and practicality of their profession. The advancement of the profession of nursing should be obtained from mentoring and having strong roles within the community they work. Each entity of nursing has duties within their scope of practice, and should demonstrate a professionalism that is conducive to assisting those in need. This provision directly relates to developing an advocacy program that is beneficial to a population of health concerns and improving upon the issues of concern (ANA).
The second provision to review is number 8. This provision states that it is in the profession of nursing to be dedicated to the promotion of health, welfare and safety of each individual. Each nurse should be aware of specific health needs but to also be aware of health concerns on a broader spectrum. This include issues seen on an international level, not just the region the nurse resides. When applying this provision to the healthcare population, the focus is on change that is possible throughout the world and how this goal can be accomplished.
The nurse should be knowledgeable of healthcare concerns and play a very large part as being a fixative agent to the healthcare concerns. Any nurse promoting advocacy for a healthcare concern should not demonstrate prejudice against a culture or diverse group. There should be a level of human dignity and respect for the standards of a particular region (ANA). The final provision for review is number nine. This provision conveys the assertion of values. The organization of advocacy interconnects the values of nursing and social change that will improve health of the population.
Nurses continue to create ways to shed light upon specific needs and continue to develop methods for evaluating the effectiveness of the actions provided by the nurse. Nurse have the ability to work with individuals or groups, while bringing about changes to a population in need (ANA). When applying the provisions to the development of an advocacy program, it is imperative to fully understand the provisions and to apply them to every aspect of the development of an advocacy campaign.
While looking at the HPV vaccination and the documented provisions, ethical issues will certainly arise. Religious and philosophical beliefs may conflict with the adolescent receiving the vaccination. When this occurs, strict teaching should be imposed upon the patient as well as the parents. This should also be the equivalent for those who are unable to take the vaccine due to existing medical conditions to which the vaccination is contraindicated (Chen, 2012). Conclusion Throughout the world, there is a large need for promoting positive health behaviors.
Nurses have the ability and knowledge to identify these needs and take action, offering education and positive outcomes. Even with ethical and legal issues as a threat, the ultimate goal is to improve a population health concern. Without nurses pushing towards an ultimate goal of improving health outcomes, diseases and illnesses would certainly take over the population. Every day, nurses take steps to improve upon health concerns, knowing they can make a difference even if it is a small step at a time.