Running head: POLICY 1

Policy and Advocacy for Improving Population Health

Student’s Name:

Institutional Affiliation:

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Health Issue and the Population Affected

A stroke occurs when there is an interruption of the flow of blood to the brain, reduced

flow due to blockage, or a rupture in the blood vessels that supply blood to the brain which can

result to a hemorrhagic stroke or an ischemic stroke. According to the Centers for Disease

Control & Prevention (2017), there are more than 795,000 cases of stroke reported yearly in the

United States. Research in this area has revealed that a vast majority of these strokes can be

prevented (Calre, 2017). Even through stroke commonly occurs in elderly individuals, it can

occur in individuals of any age including unborn babies in the womb. Data from the Heart &

Stroke 2018 Stroke Report indicates that more women succumb to strokes than men, with

women who have stroke suffering from greater disabilities. The long-term outcomes following a

stroke vary significantly and partly depend on the type of stroke and the age of the affected

individual. Majority of stroke survivors are able to regain their functional independence, but

around 15-30% of affected individuals will suffer a permanent disability. Some people usually

experience a permanent decline in cognitive function and most survivors live in danger of a

recurrent stroke in the future.

Health Advocacy Campaigns

The type of advocacy campaigns that were investigated in the West Helena area includes

stroke education advocacy campaign and The Furthering Access to Stroke Telemedicine (FAST)

campaign. In this area, there is a local non-profit organization that offers stroke education to

residents in Philips County in Arkansas. The campaign provides education materials on stroke,

lectures on stroke, and takes part in health fairs and local events. The University of Arkansas

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Medical Science (UAMS) is used as a resource for education and patient placement. The main

aim of the organization is to educate the general public and offer stroke outreach through the use

of simplified terms. In addition, it enlightens residents on the resources that are available and

how they can utilize them. The main strength of stroke education advocacy campaign is

spreading the awareness of stroke at the grass root level. Easy language is used when delivering

information to the general public and the amount of information that is disseminated is not

overwhelming. Ordinary residents of the area are handed legible and clear material with

informative graphics that are pleasing to the eye. During community events, many members of

the community converge together and the presence of familiar faces makes it easier to exchange

and distribute information about stroke.

The Furthering Access to Stroke Telemedicine campaign has been implemented in this

area through the use of interactive video-conferencing in the delivery of care to stroke patients.

Modern advancements in technology such as mobile phones, tablets, and remote communication

have facilitated the adoption of telemedicine making healthcare providers more accessible across

the U.S. The primary objective of using telemedicine with stroke patients is to increase access to

quick assessment, diagnosis, and treatment of stroke which in turn improves the quality of life in

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the long-term. The technological world is continuously dynamic and new inventions are

developed every day. Telemedicine is used for stroke consults and stroke assessments with a

neurologist. They do give the clot buster medications and UAMS coordinator helps in to finding

placement for a stroke patient. The integration of telemedicine helps in increasing the access to

stroke care from any location in the U.S. The use of technological devices such as mobile phones

is relatively easier since they are available to most healthcare professionals and they serve as

tools for facilitating early diagnosis and treatment of stroke (West Helena, 2018).

Plan for a Health Advocacy Campaign

Among the leading causes of death in the U.S., stroke is ranked fifth and it is the leading

cause of disability in adults. This indicates that there is an urgent need to develop policy

solutions to promote the prevention and early treatment of stroke. One of the primary risk factors

of stroke is hypertension and 30% of hypertension cases may be attributable to obesity. In 2017,

the state of Arkansas had the third highest rate of hypertension in the United States at 41.3%

(The State of Obesity, 2018). Furthermore, it has a relatively high rate of obesity with 35.7% of

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adults and 33.9% of children aged between 10 and 17 being obese or overweight (Trust for

American Health, 2017).

The proposed policy advocates for changes in lifestyle and dietary habits to promote

healthy nutrition which can reduce risk factors associated with the incidence of stroke.

According to an estimate by the World Health Organization (2013), 80% of strokes can be

prevented through lifestyle behaviors, and this includes healthy eating. The science of nutrition is

constantly evolving and studies have shown that factors that have the most impact on health

include overall quality of an individual’s diet, type of food consumed and the quantity of food

consumed. The campaign advocates for a policy to promote proper nutrition for all residents to

prevent stroke and facilitate quick diagnosis and treatment.

Healthy food consumption depends on a number of factors including availability and

consumer choice. Food availability is determined by advertising, cultural preferences, health

education, geographic consideration and retail competition. The policy proposes to increase the

advertisement of healthy foods and limit the advertisement of unhealthy foods during peak

television hours. This might be beneficial in reducing the consumption of unhealthy food in this

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population. Some of the population-based dietary interventions that can be implemented to

reduce the risk of stroke include reduction in the salt in food, elimination of fats in diet, menu

labeling by food companies, cholesterol reduction, and avoidance of food desserts (Eckel et al.,

on is to enhance dietary behaviors in this 2014). The main objective of the proposed policy soluti

population by reducing the consumption of high-calorie, low-nutrient foods. In addition, it aims

at influencing the local government to ensure the consideration of the needs of stroke patients,

their families, caregivers, and to look to minimize the risk factors of stroke that are associated

with nutrition.

Healthy food consumption can save many individuals from stroke by promoting

consumption of healthy food choices and this might reduce the chances of a low quality of life

that may be experienced by the survivors. The process of formulating the proposed health

advocacy policy may improve the control of stroke and enable survivors to live a better life.

There is a need to come with a regulation structure that prohibits commercial marketing of

unhealthy foods and these regulations should set minimum standards, monitor compliance, and

enact penalties for those who fail to comply (Brambila-Macias et al., 2011). This policy can

create an environment that allows individuals to make healthy choices easier and create

opportunities to improve dietary behavior. A more effective regulation technique for marketing

and advertising can help to support efforts to promote healthy diet and minimize the incidence of

stroke.

Enactment of the Policy

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The proposed policy will require the creation of a new law. This policy proposes to

increase the advertisement of healthy foods and limit the advertisement of unhealthy foods

during peak TV hours. Most ongoing policy efforts to address the marketing of food in high

income countries focus on TV advertisements. The incidence of stroke can be reduced through

changes in dietary habits and lifestyle behavior to promote healthy nutrition. Proper nutrition can

be promoted through the use of television advertisements which would be recommended in the

food advertisement policy and can be enacted as a new law to help in reducing the risk factors

associated with the incidence of stroke.

The law would impose regulations on all public media channels and mandates them to

control the time when food advertisements are aired. Through this individuals will be able to

make informed choices about the meals they usually consumer and remove the obstacle of

lacking information on the right choice of food they should purchase. The advertisement law can

be useful in encouraging low calorie intake with research indicating that can lead to nutritional

improvements in many families by prompting them to rethink about their food choices (). The

food industry has a duty to pledge to limit TV adverts to residents to reduce the exposure and

power of marketing unhealthy foods.

The proposed policy relates to the risk behavioral factor with regards to the health of the

population. Currently, most of the food and beverage marketing on TV is for products which

have high contents of fat, sugar, and sodium. According to Kemps, Tiggemann, & Hollitt, (2014)

advertisements shape the beliefs, food preferences, purchase intentions and dietary intake of the

public. The current legislations in this population have some moderations with regards to stroke

prevention. Evidently, there is no elaborate plan to protect the public from the risk factors

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associated with stroke. Therefore, there is a need to come up with a law to regulate food

advertisement with an aim of promoting proper nutrition for stroke prevention in the population.

How Current Legislation Affects Advocacy Efforts

In the United States of America, issues of free commercial speech could present a major

barrier to enacting laws that limit food advertising. The current legislation might slow down

these advocacy efforts. This is primarily attributed to the fact that the existing regulations have

only mandated the ministry of health to conduct health campaigns and has also handed the power

to act on laws to the legislature (Conklin, Morris, & Nolte, 2015). This implies that private

citizens have limited power to develop or propose policies. Consequently, the only thing that

would be possible is lobbying with the policy-makers to come up with ways through which they

can enhance their policies and laws in order to improve the living standards of the general public.

Nonetheless, given that there is a provision for the public participation in the current law with

regard to the legislation, it might promote these advocacy efforts in making proposals to change

the marketing of food products (Kemps, Tiggemann, & Hollitt, 2014). As a result, the

suggestions will be based on the appropriate interventions which may be assumed in order to

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enact the required laws which will facilitate improved health for the population. This is essential

to ensure that members of this population are able to avoid risk factors that might expose them to

stroke.

Analysis of Methods to Influence Stroke Legislation

The three legs of lobbying are compared to the three legs of a stool implying that each

one of them is vital in ensuring that advocacy efforts remain steadfast (Milestead, 2016). The

three legs include the professional lobbyists, grassroots lobbyists, and obtaining financial

backing. Professional lobbying involves professionals who have the essential skills and

competencies with an aim of bringing the legislators to together to deliberate on the proposal and

resonate in the best way the proposed policy can improve the standards of living of the

population. It refers to participating in advocacy efforts from a professional capacity while at the

same time representing a particular group of interest. Therefore, it is important to be a member of

a professional association such as the American Nurses Association and be active for the

organization to assist in influencing legislators to accept the healthy food advertisements policy.

As a professional lobbyist, the legislators will view you as an expert who has and can provide

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should not be supported. For crucial information about a policy or issue and why it should and

this reason, it would be necessary to ensure that the interests of the general public are prioritized.

Grassroots lobbying involves rallying different stakeholders in the community to get

them on your side and it represents democracy in action (Milstead, 2016). It also consists of

efforts to bring experts and knowledgeable individuals on board who will help in influencing

legislators. Involved stakeholders can be rallied to the efforts for advocacy of the food

advertisements policy through the help of emails, written letters, phone calls, and face-to-face

visitations. There can also be a liaison with the public health department, the food industry, and

media corporations who can also play a role in convincing legislators.

Financial power is crucial in politics and we cannot ignore its massive influence as it

dictates who gets elected and which laws are passed by legislators. Health organizations,

insurance agencies, and pharmaceutical companies invest a lot of money in lobbying efforts.

Most of the funds that are used by healthcare professionals to conduct lobbying activities are

obtained from membership fees paid to professional health organizations (Singh, 2015).

Therefore, it would be of benefit to show support to fundraising efforts and endorsement

decisions of professional associations such as the American Nurse Association to obtain financial

backing to influence law makers for the healthy food advertisement policy.

Obstacles that Could Arise in the Legislative Process

There are a number of expected obstacles that might arise in the legislative process for

the advocacy of the healthy food advertisement policy. The main obstacle would be resistance to

change by some of the legislators who are rigid to change. In this regard, these legislators may

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cite a number of reasons as to why the proposed change might not be good for the food industry

and the general public. To overcome this obstacle, it would be important to involve all

stakeholders and legislators and explain to them the potential benefits that may arise from the

proposed policy in the long-term.

Another obstacle would be meeting or gaining access to legislators and policymakers

since one had to pass through several layers of staff to get to them. This hurdle can be overcome

through continuous persistence and patience as well as developing a relationship with the aides

of the legislator or policy maker through grassroots lobbying. Another potential hurdle is lack of

interest from stakeholders to rally behind the proposed policy. This challenge can be overcome

through the use of compelling and explicit information about the change and a show of the

beneficial elements of the policy (Conklin, Morris, & Nolte, 2015). Another obstacle that might

be experienced is insufficient funds when attempting to persuade individuals in power to support

the policy and it can be overcome by actively engaging in fundraising efforts led by professional

nursing organizations.

Ethical Dilemmas

A number of ethical dilemmas might arise during the process of implementing an

advocacy campaign to promote changes in lifestyle and dietary behaviors with an aim of

reducing the risk factors associated with the incidence of stroke. One ethical dilemma is

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establishing whether stroke should be considered as an epidemic and as to whether there was a

need to involve the government and media channels in the advocacy campaign to help reduce the

risk factors of stroke that are associated with nutrition. The author would need to decide whether

to consider the impact of influential groups during the advocacy campaign. These influential

groups include individuals who have stakes in the measure that the author seeks to advocate for

and propose a policy.

It is another dilemma trying to figure out whether onlookers should be concerned with

what other people are watching or what other people are eating. Some of the TV viewers may

tend to think that the health campaign will only be targeting them and the regulation of what is

being brought on the Television might be interpreted as a punishment. Others may tend to view

the act of addressing one of the risk factors of stroke as a one-sided way of addressing the risk

factors of stroke. Ethics and morals arise when an individual has to think of what is best for the

population as well as what can be done to resolve the health issue of stroke. As a nurse, I have a

role to promote proper nutrition as a measure to reduce the risk factor of stroke associated with

nutrition. This campaign will aim at educating parents, and small children on the risk of

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maladaptive dietary habits. The author will be required to make the entire population understand

that the dietary habits could have an influence on the incidence or recurrence of stroke.

An understanding of the American Nurses Association (ANA) Code of Ethics is essential

for nurses to help them in tackling ethical dilemmas. Provision seven of the code explains that

nurses have an ethical responsibility to stay updated and disseminate recent research findings to

promote evidence-based best practice, safeguard the rights of patients in research, participate in

the development of practice standards that support the nursing body of knowledge and ethical

practice, and meet their ethical obligations by taking part in global, national, state or local

initiates. This provision requires a nurse to always be informed on the best practices that can be

utilized in the care plan for a patient, educate the patient, family, and general public.

Applicable Ethics and Lobbying Laws

The primary concern of ethics and lobbying laws is setting ethical standards for the action

of federal representatives and those who intend to influence them. The ethics laws in Arkansas

safeguard individuals and communities from harm by making sure that the implementation of a

particular policy or the process of carrying out a particular campaign does not result to harm to

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the people who are involved. This advocacy campaign would need to observe the applicable

ethics and reporting requirements. Structured program assessments will also be necessary for

financial support.

In Arkansas, the lobby law imposes regulations on direct communication with members

of the legislative and executive branches of the state government to influence legislative action.

The law was drafted to control different forms of direct communication whereby communication

could be in the form of a letter, telephone, telegraph, or in person. The lobby laws must be

considered during the process of the advocacy campaign since the author will be communicating

directly to people to inform them on importance of addressing the nutritional risk factor of

stroke. According to Garraham (2014) information that is related to the alterations that might

arise during lobbying registration as well as the issues that will be lobbied during the reporting

period must be included in the reports.

Ethical Challenges

This advocacy campaign might face unique ethical challenges which are likely to be

experienced with this population such as the fear of embarrassment for the individuals who have

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maladaptive nutritional habits. Some individuals might fail to attend the advocacy campaign

meetings because they do not want to be viewed as an individual with limited knowledge on

on that the entire population of Arkansas will proper nutrition. Another challenge is the expectati

become aware of the importance of proper nutrition in averting the risk of stroke by improving

their dietary behaviors at the completion of the campaign.

Summary

This paper has tackled the issue of stroke and indicated the need to enhance proper

dietary behaviors while spreading awareness on the importance of a healthy diet. It also points to

the lack of awareness of one of the risk factors of stroke, preventative measures in the population

and the need to address it through a health advocacy campaign. Two advocacy campaigns that

have been used in educating this population on stroke were presented. It also indicated the

proposed TV advertisement regulation policy to improve nutrition of this population. It also

points out how the policy will be enacted as well as how the three legs of lobbying can be

utilized to impact legislators. In addition, it presents ethical concerns and challenges that might

arise during the campaign and how they can be resolved.

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References

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Nursing, Vol 31(No 1), 54-58. Retrieved from www.jcn.co.uk/.../community-

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Centers for Disease Control & Prevention (2017). Stroke facts. Retrieved from:

https://www.cdc.gov/stroke/facts.htm

Conklin, A., Morris, Z., & Nolte, E. (2015). What is the evidence base for public involvement in

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Eckel, R. H., Jakicic, J. M., Ard, J. D., De Jesus, J. M., Miller, N. H., Hubbard, V. S., ... &

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