Chronic Obstructive Pulmonary Disease (COPD) among Homeless Veteran Smokers in Florida

Intervention Program for Chronic Obstructive Pulmonary Disease among Homeless Veteran Smokers in Florida
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Intervention Program for Chronic Obstructive Pulmonary Disease among Homeless Veteran Smokers in Florida
PART ONE
Introduction
Chronic Obstructive Pulmonary Disease (COPD) refers to infections of the respiratory system, including chronic bronchitis and emphysema. The condition is characterized by breathing complications, coughing, and limitations in lung airflow. Tobacco smoking is the major cause of COPD and primary contributor to fatality cases associated with chronic lower respiratory infections. The proposed health intervention program targets homeless older persons diagnosed with Chronic Obstructive Pulmonary Disease (COPD) due to chronic smoking, and who have no access to healthcare services.
Rationale for Choosing Veteran Smokers diagnosed with COPD
This population is of interest because it represents a marginalized group of people who are unable to access basic needs such as shelter and healthcare insurance. It is characterized by poverty and poor living conditions, which exposes the population to many health risk factors. Research studies indicate that COPD is common in persons aged 40 years and above, and the condition worsens with increasing age. In this regard, veteran smokers are the most vulnerable group to smoking-related infections such as COPD. In fact, clinical studies show that although mild symptoms for smoking-related infection such as coughs may be present in the early years (which patients can easily tolerate and therefore ignore the condition), they become chronic and life-threatening at 67 years and over (Kenny, 2014).
At the same time, smoking is the leading cause of COPD, which puts veteran smokers at a higher risk. The combination of nicotine addiction and decreasing immunity makes older persons more vulnerable to COPD infections than the general population. In this regard, this project aims to implement an intervention plan that will not only improve the health conditions of veteran COPD patients by promoting access to healthcare services, but also promote healthy living by encourage cessation from smoking.
National Statistics
Chronic Obtrusive Pulmonary Disease is one of the major causes of death in the U.S. In 2008, COPD-related complications were identified as the third leading cause of death in the country (Kochanek, 2011). A 2011 survey by the Centers for Disease Control and Prevention found out that:
An average of 6% of the U.S. population has been diagnosed with COPD.
Over 70% of the population diagnosed with COPD is aged 55 years and above.
Majority of COPD patients earn less than $25,000
20.9% of those diagnosed with COPD were unable to work
7.8% of COPD patients are unemployed
7.6% of COPD patients are retired.
COP prevalence decreased with an increase in household income (CDC, 2012).
These statistics suggest that there is high level of prevalence of COPD among lower class veteran smokers. Their situation is worsened by being homeless, which, besides making it difficult to hold a regular job, prevents them from accessing better healthcare. This may partly be due to the fact that homeless smokers are concerned by more urgent problems related to their day-to-day survival, such as food and a place to sleep. Thus, health concerns are not a priority so long as they feel they are okay, i.e. they can tolerate COPD symptoms.
The implication of these findings is that age and economic status are the major factors in COPD prevalence. Whereas the severity of COPD symptoms increases with age, poverty prevents the affected individuals from accessing the necessary healthcare services to reverse the trend of tobacco addiction and inflammation of the respiratory system. The proposed study aims to address these factors by helping the target population seek healthcare at the earliest opportunity and maintain a healthy living style by reducing/quitting smoking.
PART TWO
Intervention Objectives
The general aim of the intervention program is to help veteran chronic smokers affected by COPD to access healthcare services and stop smoking to improve the quality and length of their lives. Specifically, the project is intended to achieve the following objectives:
Improve access to healthcare services by homeless chronic veteran smokers diagnosed with COPD
Promote healthy living among homeless veteran smokers by encourage cessation from cigarette smoking.
Create a platform through which chronic smokers may seek help to stop smoking.
COPD Statistics in Florida
The state of Florida is among the regions with high rates of COPD, having ranked second after California. With a population of 18, 328, 340 (2009 statistics) people, more than 2.4 million (about 11%) were affected by COPD related infections (American Lung Association, 2010). Adult asthma, chronic bronchitis and emphysema accounted for 1.8 million cases, representing 75% of infections. Generally, cigarette smoking, which is the major cause of COPD infections worldwide, accounts for 430, 000 deaths annually in the United States and 28, 700 in the state of Florida (Florida Department of Health, 2013). The statistics also indicate that COPD diseases are prevalent among the older and low income populations, given that over 950 000 COPD cases out of 1.8 million were associated with adult asthma. This is clear evidence that COPD is a serious health risk among the veteran population that needs to be addressed by using different interventions avenues.
Model Programs
The Sacred Heart Health System
The Sacred Heart Health System is based in Pensacola, Northwest Florida. It has branches in South Walton County and Gulf County, as well as runs outpatient centers in the coast of Florida Panhandle. The organization’s cancer prevention department supports a program for tobacco cessation within the local community that targets the youth and adults. The program offers six-week one-on-one counseling sessions conducted by a certified Tobacco Cessation Clinician. Patients are provided with information about nicotine addiction and how to deal with it. In addition, patients are put into support systems where they interact with fellow addicts who are in the process of quitting. Also included in the program are over-the-phone counseling services, pharmacotherapy recommendations and social support services, which are all aimed at helping individuals stop smoking, deal with withdrawal symptoms as well as secure social support to enhance day-to-day sustenance. The counseling program is three dimensional as it focuses on the patient’s psychological, physical, and habitual aspects of nicotine addiction. Beneficiaries of the program are referred by physician and healthcare providers as well as self-referrals.
The program reports a high success rate compared to the national average for quitting from tobacco use. The program’s achievement is based on the assessment that is carried out before treatment therapies are commenced, the one-on-one approach, the step-by-step teaching model on quitting strategies, and the regular follow up sessions.
The Scope and Context of the Proposed Intervention Program
Place where the Community Intervention Program will take place
Considering the age of the target group, most of whom would be physically handicapped, the program will be carried out at their places of residence. Owing to the fact that the targeted population will be homeless veterans, the program will seek them out in facilities that shelter homeless people and the elderly. This may also include abandoned buildings and public places like parks. For working persons, the program will include reaching them at their places of work and providing them with the information they need to reverse their smoking habits. In short, therefore, this is more of an outreach program that seeks to take the services to the target population wherever they may be found.
The first step in implementing an effective intervention program is identifying the risk factors of the target population. The profile of the target population is characterized by low income, lack of access to basic needs such as healthcare, poor physical health, lack of social support, poor social life, among other aspects associated with homeless older persons. With this hindsight, it is possible that smoking is one of the ways that the affected individuals deal with psychological stress. In this regard, the intended projects will attempt to ascertain and address the following risk factors as they pertain to the socio-economic conditions of the target group.
The level of social interaction that the group enjoys
Level of access to basic needs like food, shelter, healthcare, etc.
Family life; absence or presence of other family embers
Availability or absence of healthcare facilities within the localities
Access to social support relief programs like food stamps.
The aim of this approach is to identify the cause of the problem and formulate ways of minimizing or eliminating the risk factors. Accordingly, the initial step is to determine whether the factors stated above in one way or the other contributes to smoking, which in turn causes COPD infections. <...