Health Promotion Project on Rising Rate of Colorectal Cancer in Hong Kong

Health Promotion
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Institutional Affiliation
Health Promotion
There are consistently increasing public health issues globally. Such health challenges have triggered emphasis on the need to implement more health promotion projects. Health promotion programs emphasize keeping individuals healthy by empowering communities and individuals who are susceptible to some health concerns to make changes in their lives and choose behaviors that limit their risks to some health conditions. Through health promotion initiatives, individuals are encouraged to master more control over their own health with limited inputs from other stakeholders in healthcare. Health promotion programs focus on social, economic, or environmental factors that contribute to the health quality or wellness among individuals within specified geographic regions. Stakeholders in health promotion understand their mandate to ensure healthy living and wellness by addressing the root causes of illnesses and not focusing primarily on curing or treating individuals. An ideal health promotion program must consist of three primary tenets, including communication in which the program raises awareness about some health concerns and healthy behaviors that can aid in minimizing the concerns. Health promotion also constitutes education in which stakeholders encourage behavioral changes by instilling actions and knowledge to support the behavioral transition from unhealthy to healthy. Ultimately, health promotion constitutes persuasion of policies, systems, and the environment in an attempt to develop a structure of health and wellness whose benefits can last for generations. This report focuses on developing a health promotion planning framework for a specific health issue, which is to address the rising rate of colorectal cancer in Hong Kong. The framework development is based on the Precede Proceed Model (PPM), social cognitive theory, and the Health Action Model (HAM) to guide the project toward achieving its set objectives. A properly structured health promotion program should be grounded on objectives that can be evaluated at the completion of the project.
Rising Rate of Colorectal Cancer in Hong Kong
Colorectal cancer in Hong Kong is an increasingly concerning public health issue. In 2020, there were 34,325 cases of deaths and discharges linked to malignant neoplasm of the anus, rectum, and colon, which is commonly referred to as colorectal cancer (Fahmi, Fitrina, & Supriyati, 2020). Through such numbers, colorectal cancer constituted 13.7% of all hospitalizations related to cancer treatment. Colorectal cancer has advanced to be the second commonest cancer in Hong Kong. The condition is spread across different demographic factions. In 2019, it was established that there were 2320 cases among females and 3236 among males. According to Fahmi, Fitrina, and Supriyati (2020), the ratio at the time halted at 1: 1.4. The incidence rates among males in 2019 stood at 94.5 per 100,000 standard population against 56.8 for females. The age-standardized incidence stood at 47.8 for males against 29.2 for females in the 100,000 standard population. Between 2983 and 019, the age-standardized incidence of colorectal cancer in Hong Kong has stayed on a positive trajectory for both sexes. That is, the number of cases annually has kept increasing since 1983. With the current healthcare policies barely focused on addressing the issue of colorectal cancer conclusively, the chances are high that more people will contract the illness in the near future. In mortality analysis, colorectal cancer is the second leading cause of cancer-related deaths in Hong Kong. There were 2287 cases of colorectal cancer deaths in 2020. That number accounted for 15.4% of all cancer-related deaths. Males still lead in the mortality rates by 38.5% against 23.9% for females. Age is still a serious contributing factor to the cases of colorectal cancer in Hong Kong. The current data indicates that 90% of the recorded cases constitute 50 years or older individuals, while younger generations aged between 49 and 20 years constitute 10%. However, new trends are emerging that indicate an increasing prevalence of colorectal cancer among individuals between 20 and 40 years. An increased prevalence across the younger age groups should steer more concerns in the already challenging number.
National Policies and Programs
The government of Hong Kong has been implementing new policies to help curb colorectal cancer prevalence. One such policy is the colorectal cancer screening program that focuses on subsidizing the costs for colorectal cancer screening services among residents of Hong Kong aged between 50 and 75 years (Syakurah et al., 2018). Having noted the inadequacies in the public health facilities, the new program subsidizes screening in private healthcare facilities. The program is motivated to prevent colorectal cancer incidences before they occur. Upon visiting the facilities, the eligible individuals are supposed to take a fecal occult blood test (FOBT) to help in detecting blood in the stool (Haghi et al., 2021). The test is sophisticated enough to detect even microscopic amounts of blood in the stool. The analyses are poised to help in removing polyps before they develop into cancer.
Hong Kong also has an effective infrastructure that it uses to address the challenge of cancer it faces presently. In 2019, the government developed the cancer action program to address the key deficiencies in the fight against cancer (Sabooteh et al., 2021). The plan aims at advancing cancer management initiatives through prevention, diagnosis, treatment, surveillance, and support care services. Different organizations have since emerged to help in the fight against cancer, as outlined by the government (Wylie-Wai et al., 2013). The Food and Health Bureau (FHB) is the host of institutions that oversees the formulation of policies and allocation of resources aimed at managing the spread of cancer (Haghi et al., 2021). The FHB operates in conjunction with the cancer coordinating committee (CCC) that advises the ministry on every progress made in the fight against cancer. Hong Kong Cancer Registry (HKCaR) is another government-recognized agency tasked with executing surveillance and data collection to sustain a population-based cancer registry for the entire nation (Sabooteh et al., 2021). With readily available data on cancer, it becomes easier to categorize populations and project resources depending on the noted needs. The other institutions and government-based partnerships leading the fight against cancer in Hong Kong include the DH, a government advisor on health policy, the research office (RO), and the HA. Hong Kong is motivating every initiative aimed at addressing the challenging growth in cancer.
Target Group
The project targets individuals aged 50 years or above. The prevalent data on cancer currently indicates that people aged 50 years or above constitute at least 90% of the confirmed colorectal cancer cases in Hong Kong (Syakurah et al., 2018). Age is a risk factor when it comes to colorectal factors, with the risk increasing as individuals grow older (Haghi et al., 2021). Exposure to other chronic illnesses, changing health priorities and treatment goals as people grow older, emotional and social health, and a history of falls are noted as some of the reasons why colorectal cancer prevalence is higher in older individuals (Sabooteh et al., 2021). The other factors that have been assessed include the challenges of cognitive abilities in such age brackets, loneliness, and dietary behaviors that make colorectal cancer commonplace among older generations (Wylie-Wai et al., 2013). The reason why the older generations are important to this study is that they are faced with unique challenges in the fight against colorectal cancer. Primarily, such individuals are not privy to most health-based data, which make them at risk of contracting the illnesses (Haghi et al., 2021). Having little knowledge about particular illnesses eases the possibility of contracting such illnesses because individuals cannot understand the preventive measures. Additionally, older individuals are faced with multiple challenges while undergoing different treatment regimens for colorectal cancer (Haghi et al., 2021). For instance, systemic therapies are commonly used to treat or manage colorectal cancer. Both younger and older individuals are prone to risks when exposed to systemic therapy. However, the older an individual gets, the higher the risks associated with systemic therapies. The same high-risk outcomes can be witnessed with the adoption of other treatment strategies, including radiotherapy, bone marrow transplantation, and surgeries (Wylie-Wai et al., 2013). Such challenges make older individuals the ideal audience for health promotion programs aimed at addressing colorectal cancer.
Health Promotion Planning Framework
There are many models for consideration in developing a health promotion planning initiative. For instance, the health belief model can be employed to guide a health promotion initiative. The health belief model can help to predict individual changes through a series of health behaviors (Wylie-Wai et al., 2013). The belief model is anchored in an individual behavioral system, emphasizing aspects such as perceived susceptibility to health issues, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy (Sabooteh et al., 2021). While the health belief theory is sophisticated enough to efficiently guide a health promotion program, this program will focus on PPM. PPM is a health promotion framework that has been used extensively to address a range of public health issues. The popularity of this model stems from how it streamlines the process of health promotion into specific stages to ease understanding and input (Sze-Chuen et al., 2013). PPM is also insightful in encompassing a needs assessment strategy through its guidelines to ease the program coordinators to complete their initiatives without ignoring any vital elements of an ideal health promotion program. Besides addressing the needs assessment, the PPM framework also offers insights into the nine phases of a health promotion program divided into the PRECEDE (the first 5 phases) and PROCEED (the last 4 phases). Each of the phases bears significant relevance to the completion of the programs.
Health Needs Assessment
The first four phases of PPM assist in prioritizing and assessing the health needs and concerns of secondary stakeholders in the community. When putting together efficient management of colorectal cancer projects for older adults, there are four essential requirements that must be addressed (Habibzadeh et al., 2021). In health needs assessments, effective communication across multidisciplinary teams is critical, so key stakeholders (social workers and family members) will be involved in this project to ensure that the issue of colorectal cancer among the elderly is defined by the local community rather than by outside parties.
The Major Needs
There are four main needs that healthcare professionals should understand as they partake in health promotion programs. The first category of needs is the normative needs which are defined by professionals based on long-standing standards or norms (Sze-Chuen et al., 2013). Norms are prospects like poor dietary behaviors can cause obesity and other illnesses (Sze-Chuen et al., 2013). Through normative needs assessment, healthcare professionals explore the violated standards that could trigger various illnesses. The second category of needs is felt. Felt needs are perceived by individuals who know what they want (Sabooteh et al., 2021). For instance, one can distribute self-administered questionnaires among participants to understand their perceptions of colorectal cancer. The third category of needs is the expressed needs that showcase transition and progression into demands. That can constitute the demand for health policies to subsidize screening for colorectal cancer (Sabooteh et al., 2021). The final category in needs assessment is comparative needs, in which communities are compared in terms of their susceptibility to various health concerns. With a comparative needs assessment, policymakers can determine variations in health concerns through different population groups. Before commencing the program, it will be important to conduct a needs assessment to ascertain the position of the participants in different aspects of the assessed health promotion initiative. The first stage of needs assessment is conducting engaging interviews in which the program managers seek information on how the projected participants understand the health issue illuminated (Karim & Tangpong, 2018). The program also focuses on social assessment in which information is gathered on the social issues linked with the prevalence of colorectal cancer among the aging populations. The other areas of needs assessment that will be necessary for the study include epidemiological assessment, behavior and environmental assessment, and educational and ecological assessment.
PPM Phases
Phase 1: Social Assessment
The first stage in conducting an effective health promotion program is through the implementation of social assessment. The social assessment focuses on identifying the social indicators such as welfare, employment status, housing, poverty level, and education and their impact on the targeted populations (Phoenix-Kit et al., 2014). Different sources of data exist in understanding the social structures that surround the increasing cases of colorectal cancer. As noted in the efforts that the government is putting to address the issue, the Hong Kong government has put in place agencies that collect data pertaining to colorectal cancer trends in the nation (Karim & Tangpong, 2018). There are also hospitals and non-governmental organizations that engage actively in collecting social data linked to the prevalence of colorectal cancer (Haghi et al., 2021). With social assessment completed, it becomes easy to understand the availability, or lack thereof, of social structures specifically linked to the healthcare concern.
Phase 2: Epidemiological Assessment
The epidemiological assessment explores the extent to which the colorectal cancer issue affects the Hong Kong community. Epidemiological data can be sought through both qualitative and quantitative research approaches (Stephenson & Stephenson, 2011). The local community, healthcare professionals, and non-governmental organizations harbor data on the epidemiology of colorectal cancer in various demographic segments within Hong Kong. The data can be employed to classify participants in terms of areas with a high prevalence of individuals who are more susceptible to a health c...