NURS FPX 6011 Evidence-Based Population Health Improvement Plan Example

NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement PlanNURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan

NURS FPX 6011 Evidence-Based Population Health Improvement Plan Assignment Brief

Course: NURS FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health

Assignment Title: Assessment 2 Evidence-Based Population Health Improvement Plan

Assignment Overview:

In this assignment, you will develop an evidence-based population health improvement plan aimed at addressing a prevalent health issue within a specific community. Your task involves analyzing data, identifying community health concerns, evaluating environmental factors, and proposing targeted interventions grounded in ethical principles and cultural sensitivity.

Understanding Assignment Objectives:

The primary objective of this assignment is to apply evidence-based practice principles to develop a comprehensive population health improvement plan tailored to the unique needs of a specific community. You will critically analyze data on health prevalence, environmental factors, and community determinants to formulate effective interventions aimed at reducing health disparities and improving health outcomes.

The Student’s Role:

As a student, your role is to act as a healthcare practitioner tasked with developing a population health improvement plan aligned with the needs and circumstances of a specific community. You will utilize your knowledge of evidence-based practice, cultural competence, and ethical principles to propose interventions that promote health equity, community empowerment, and cultural relevance. Through research and critical analysis, you will identify key health concerns, environmental factors, and barriers to healthcare access within the target population, and develop targeted strategies to address these challenges.

NURS FPX 6011 Evidence-Based Population Health Improvement Plan Example

Data Evaluation

Identifying Community Health Concerns

In analyzing the data on diabetes within the American Indian (AI) community, it’s evident that this population faces a significant health challenge. More than 90% of diabetic cases in the U.S. are diagnosed as type 2 diabetes mellitus (T2DM), with American Indians being particularly affected. Research from the Centers for Disease Control and Prevention (CDC) indicates that approximately one in two American Indians suffers from diabetes, a rate significantly higher than that of white non-Hispanic populations. This prevalence of T2DM among AI individuals is concerning, especially considering that they have twice the likelihood of developing T2DM and experiencing related mortality compared to their white counterparts.

Furthermore, the data highlights the interconnectedness of diabetes with other health issues within the AI community. Conditions such as obesity and cardiovascular diseases often coexist with T2DM, contributing to the overall health burden among American Indians. Despite some improvements in diabetes rates since 2013, it remains a leading cause of illness and mortality among AI populations. Additionally, the incidence of diabetes varies across tribal groups, with certain communities, like the Pima tribe, experiencing higher rates.

Overall, the data underscores the urgent need for targeted interventions to address T2DM and its associated health concerns within the American Indian community. By understanding the unique challenges and disparities faced by this population, healthcare practitioners can develop more effective strategies for prevention, management, and treatment of diabetes and its complications.

Community Data Evaluation: Environmental Factors

Environmental factors significantly contribute to the prevalence of type 2 diabetes mellitus (T2DM) within the American Indian (AI) community (Lucero & Roubideaux, 2022). Traumatic events, such as forced migration and lifestyle modifications enforced by government policies like the Indian Removal Act, have created severe hardships for AIs. These experiences have led to societal insults and forced lifestyle adjustments, exacerbating health inequalities. Historically, AIs were displaced from their traditional lands, disrupting their way of life and forcing reliance on government aid. Destruction of traditional irrigation methods further compounded the situation, leading to dependence on government subsidies.

Moreover, disparities in healthcare facilities and access contribute to the health burden experienced by AIs. Limited availability of resources, coupled with environmental factors such as the consumption of fat-rich foods, increases the risk of obesity and subsequently, diabetes among AIs. This underscores the importance of addressing environmental factors in population health improvement initiatives aimed at mitigating the prevalence of T2DM within the AI community.

Relevance and Validity of the Resources

The information gathered from credible sources provides valuable insights into the environmental risk factors contributing to T2DM prevalence among AIs (Lucero & Roubideaux, 2022). Reports from reputable databases such as the Centers for Disease Control and Prevention (CDC) and Indian Health Service (IHS) serve as reliable sources of information on AI health issues. By relying on evidence-based data, healthcare professionals can better understand the environmental determinants of health disparities within the AI community, thus informing targeted interventions aimed at improving population health outcomes.

Meeting Community Needs: Population Health Improvement Plan

To effectively address the population health concern of type 2 diabetes mellitus (T2DM) within the American Indian (AI) community, a comprehensive health improvement plan is proposed, grounded in ethical principles and tailored to meet community needs (Hailes et al., 2020). The plan encompasses five ethical principles: equity, empowerment, openness, respect, and participation, which serve as guiding values in the development and implementation of interventions. These principles aim to empower community members while honoring their cultural values and promoting health equity.

The proposed strategies include providing budgetary support and training to community members to facilitate sustainable health practices. By equipping individuals with the necessary resources and skills, the plan seeks to promote self-efficacy and community ownership of health initiatives. Additionally, culturally relevant cooking classes will be offered to promote healthy dietary choices tailored to the preferences and traditions of the AI community. These classes will not only impart practical cooking skills but also raise awareness about the importance of nutrition in diabetes prevention and management.

Recognizing potential barriers to health improvement, such as limited access to healthy food options and cultural preferences for traditional meals, the plan incorporates targeted solutions to address these challenges (Zamora-Kapoor et al., 2019). Strategies include facilitating access to low-fat and low-carb dietary options through community partnerships and education initiatives. Furthermore, the plan respects cultural food traditions while promoting healthier alternatives through culturally sensitive education and engagement efforts. By fostering understanding and acceptance of dietary modifications, the plan aims to overcome resistance to change and promote long-term health outcomes.

Measuring Outcomes

To evaluate the effectiveness of the health improvement plan, several measurable criteria are proposed (Domingo et al., 2021). Firstly, increased preference for healthy food options among community members will be assessed through surveys and dietary assessments. Changes in dietary habits and adherence to recommended guidelines will serve as indicators of the plan’s impact on promoting healthier lifestyles and reducing the incidence of T2DM and related complications. Additionally, the plan aims to enhance trust and communication between healthcare providers and the AI community. Qualitative feedback and patient satisfaction surveys will be utilized to gauge improvements in trust and communication, thereby ensuring that healthcare services are culturally competent and responsive to community needs.

Communication Strategy

To effectively communicate and implement the population health improvement plan within the American Indian (AI) community, it is crucial to engage community leaders and members in the decision-making process (Gillson et al., 2022). Research has shown that historical injustices and marginalization have led to a lack of trust in medical treatments and healthcare institutions among AIs, highlighting the importance of building trust and rapport. By involving community leaders in the development of the healthcare plan, healthcare professionals can demonstrate respect for AI customs and traditions, thereby fostering trust and cooperation.

Understanding the culture and traditions of the AI community is essential for healthcare providers to effectively interact and communicate with community members (Gillson et al., 2022). By gaining insights into cultural norms and spiritual beliefs, healthcare professionals can tailor communication strategies to be more culturally sensitive and relevant. This understanding also enables clinicians to provide care that respects and honors the cultural background of AI individuals, bridging the trust gap and promoting better health outcomes.

Moreover, actively involving community members in decision-making processes can further enhance trust and accountability (Magkos et al., 2020). By inviting community members to participate in discussions and decision-making related to their healthcare, healthcare providers can empower individuals to take ownership of their health and well-being. This participatory approach fosters a sense of community ownership and ensures that interventions are culturally appropriate and responsive to community needs.

To promote adherence to medical treatments and lifestyle interventions, it is essential to integrate western healthcare practices with traditional cultural and spiritual beliefs (Magkos et al., 2020). This can be achieved by organizing community events and workshops that combine western medical knowledge with AI customs and traditions. By involving community elders and other respected members, healthcare providers can overcome linguistic and cultural barriers, facilitating effective communication and engagement.

Value & Relevance of Evidence

The evidence supporting the population health improvement plan underscores its significance and potential impact on addressing community health concerns. According to Carter et al. (2011), understanding the five fundamental facets of ethics is crucial for guiding the ethical framework of the health improvement strategy. This research emphasizes the importance of incorporating ethical considerations into health promotion efforts, especially when addressing cultural and traditional values within a community. By providing insights into epidemiological and community statistics, evidence assists healthcare professionals in making informed decisions about patient care.

Moreover, Lucero and Roubideaux (2022) shed light on the environmental factors influencing food choices among American Indians (AIs), offering valuable insights into the socio-economic determinants that drive unhealthy dietary habits. Their research emphasizes the importance of addressing these factors through targeted interventions, such as financial management training and cooking classes, to promote healthier food choices while considering economic constraints.

Furthermore, VanderWeele et al. (2019) identify cultural obstacles that contribute to the prevalence of diabetes among AIs, highlighting the need for culturally tailored interventions to improve health outcomes. Understanding these barriers enables healthcare professionals to develop effective health improvement initiatives that resonate with the cultural values and beliefs of the AI community.


In conclusion, the evidence-based population health improvement plan outlined in this paper addresses the significant health challenge of type 2 diabetes mellitus (T2DM) within the American Indian (AI) community. By analyzing data on diabetes prevalence and its associated health concerns, it is evident that AIs face disparities in health outcomes compared to other populations. Environmental factors, historical injustices, and cultural barriers contribute to the higher prevalence of T2DM among AIs, highlighting the need for targeted interventions tailored to their unique needs and circumstances.

The proposed health improvement plan integrates ethical principles, community engagement strategies, and evidence-based interventions to address T2DM and its related complications. By empowering community members, promoting culturally relevant interventions, and fostering trust and communication, the plan aims to mitigate the impact of T2DM and improve overall health outcomes within the AI community.

Moving forward, it is essential to implement and evaluate the effectiveness of the proposed interventions, measuring outcomes such as changes in dietary habits, adherence to treatment guidelines, and improvements in trust and communication between healthcare providers and the AI community. By prioritizing community needs and leveraging evidence-based strategies, healthcare practitioners can work collaboratively with AI communities to achieve better health outcomes and reduce health disparities.


Centers for Disease Control and Prevention. (2021, December 16). Type 2 Diabetes. Retrieved from

Carter, S. M., Rychetnik, L., Lloyd, B., Kerridge, I. H., Baur, L., Bauman, A., Hooker, C., & Zask, A. (2011). Evidence, ethics, and values: A framework for health promotion. American Journal of Public Health, 101(3), 465–472.

Domingo, A., Charles, K.-A., Jacobs, M., Brooker, D., & Hanning, R. M. (2021). Indigenous community perspectives of food security, sustainable food systems and strategies to enhance access to local and traditional healthy food for partnering Williams treaties First Nations (Ontario, Canada). International Journal of Environmental Research and Public Health, 18(9), 4404.

Gillson, S. L., Hautala, D., Sittner, K. J., & Walls, M. (2022). Historical trauma and oppression: Associations with internalizing outcomes among American Indian adults with type 2 diabetes. Transcultural Psychiatry.

Hailes, H. P., Ceccolini, C. J., Gutowski, E., & Liang, B. (2020). Ethical guidelines for social justice in psychology. Professional Psychology: Research and Practice.

Lucero, J. E., & Roubideaux, Y. (2022). Unpublished manuscript.

Magkos, F., Hjorth, M. F., & Astrup, A. (2020). Diet and exercise in the prevention and treatment of type 2 diabetes mellitus. Nature Reviews Endocrinology, 16.

Magkos, F., Hjorth, M. F., & Astrup, A. (2020). Diet and exercise in the prevention and treatment of type 2 diabetes mellitus. Nature Reviews Endocrinology, 16.

VanderWeele, T. J., McNeely, E., & Koh, H. K. (2019). Reimagining Health—Flourishing. JAMA, 321(17), 1667.

Zamora-Kapoor, A., Sinclair, K., Nelson, L., Lee, H., & Buchwald, D. (2019). Obesity risk factors in American Indians and Alaska Natives: A systematic review. Public Health, 174, 85–96.

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