The primary motivation behind this consolidation

Assignment 2: Required Assignment 2—PSA Submission: Letter and PowerPoint

In this assignment, you review all your work and, using instructor feedback, finalize and submit your PSA for your selected public health problem.

Here are the components you need to include:

In M1: Assignment 3 , you selected a public health problem to examine throughout your course project.

M2: Assignment 1 , you explored funding sources for your PSA.

M2: Assignment 2 , you defined and described the extent of the public health problem and contributing factors.

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M3: Required Assignment 1 , you created a MAPP model for the public health problem. The primary motivation behind this consolidation 

M4: Assignment 2 , you explained your plan for designing a culturally competent PSA.

M5: Required Assignment 2 , you submit your PSA.

Scenario: 
Your county board of supervisors is considering a proposal to consolidate the county health department into a regional public health entity that would be formed by merging the health department with those of three other contiguous counties of similar size (each has a population in the 50,000–75,000 range).

The primary motivation behind this consolidation proposal is that a regional public health entity would assure better coordination of emergency preparedness and response activities within the region. You agree with this premise, but also fear that some public health activities may actually suffer in such a consolidation. You decide to write a letter to the editor of the newspaper serving your county in order to influence public opinion as the county board considers this matter.

Directions: 
For this assignment, you are to complete a:

Letter (approximately 2–3 pages) to the editor of an appropriate publication of your choice that clearly states your position and includes your rationale and relevant evidence. Include adequate research on the risks and benefits of regionalizing public health. Identify the publication for which you will write the letter. Be sure to research constraints the publication has for letters to the editor. The primary motivation behind this consolidation 

PowerPoint (PPT) presentation (approximately 5–7 slides) to deliver to the board to gather support for your previously created letter. The PPT presentation should explain what you feel are the advantages and disadvantages of the consolidation. Include detailed speaker notes to explain each slide.

Your final product will be in a PowerPoint slide show and be approximately 5–7 slides in length, and utilize at least 5 scholarly sources in research (beyond the textbook). In addition, a 2–3–page written letter to the editor of an appropriate publication of your choice should be developed. Your slide show should be formatted following current APA standards; written in a clear, concise, and organized manner; demonstrate ethical scholarship in accurate representation and attribution of sources; and display accurate spelling, grammar, and punctuation.View less » The primary motivation behind this consolidation 

Critique its alignment with public health principles

Use contemporary food standards for analysis:
Health claims
Review the information pertaining to this standard and provide an assessment of the following issues:
1. Document the policy statement that informs the standard.
2. Discuss the history/development of the standard
3. Describe the key players / submitters / commentators and their position in relation to standard
4. Situate the standard within relevant global policy/standards
5. Critique its alignment with public health principles
Conclude your analysis by summarizing the changes you would recommend to enable achievement of improved public health impacts Critique its alignment with public health principles 
Length:2000 words

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NOTE: the following criteria must be address strictly while addressing main question
This assessment relates to Module 3.4: food regulation and key regulatory issues. You may find it helpful to listen to the related online lectures and associated readings and links in this Module.
I also suggest that you use the individual task points for this assessment as subheadings in your report, as well as an introduction and conclusion.
You may find the following points helpful:
If you were to chooseHealth claims,for example, the policy statement that relates to that is Standard 1.2.7.
You are required to

• Document the policy statement that informs the standard ie give a summary overview of Standard 1.2.7, with some detail about the different levels of health claims
• Discuss the history/development of Standard 1.2.7 – from its development to the present day
• Describe the key players / submitters / commentators and their position in relation to standard – you will find it helpful to refer to the submissions that were made to the consultation paper of March 2009 – there is a link on Module 3.4 of Moodle that I copied and past in next page
• Situate the standard within relevant global policy/standards – how does Standard 1.2.7 compare with other countries’ food standards/legislation and with Codex Alimentarius?
• Critique its alignment with public health principles – I think this is straight forward and will be up to your individual judgement
• Given your review what else to you think could be done to improve public health impacts?? Critique its alignment with public health principles 

2000 words
Following note and link will be needed for assignment
http://www.foodstandards.gov.au/consumer/labelling/nutrition/Pages/default.aspx main link 
Foodand nutrition laws have been in place for decades. Traditionally in Australia, theirfocus has beenon safeguarding the purity and safety of thefood supply, andensuring that foodproviders were being honest about foodcontents. Ultimately, theaim was to prevent acute food safety concerns. Historically, there has been less focusonregulations to maintain and optimise the nutrition status of individuals or populations (i.e. health promotion objectives). However, two of the food regulatory issues that we will discuss as part of this sub-module relate to the broader Public Health agenda for not only protecting public safety, but also promoting good health – i.e. food labelling and food fortification.
USE THESE LINK FOR assignment
MOODLE 3.4
Further information onkey regulatory bodies can be found here:Food Standards Australia New Zealand (FSANZ);NSW Food Authority;Australia and New Zealand Ministerial Forum on Food Regulation; and theFood Regulation Standing Committee.The Food Standards Code can be foundhere. (You should, at the very least, click through to all of these links to see how toaccess information on these organisations/bodies).
Since the review of Review of Food Labelling Law and Policyin 2009, a large number ofconsultation and policy documentshave been developed on the issue, with subsequent changes to the Food Standards code related toNutrition, Health and Related Claims. There has also been avoluntary front-of-pack labelling schemethat has been endorsed by the Australia and New Zealand Ministerial Forum on Food Regulation.
· Have you seen food products displaying the Health Star Rating System? This system will be rolled outover the next five years, from June 2014. Note, however, that this isvoluntaryand so we cannot expect the same uptake as would be seen by a mandatory system (this is due to it’s implementation being a negotiation between Government, industry, and public health and consumer groups. So it’s not an ideal outcome but a step in the right direction!
In relation to Nutrition, Health and Related Claims, outcomes from this standard have been met with mixed views from the public health community. According to the standard, for manufacturers to be able to make a general or high-level health claim, the product must meet certain nutritional criteria for the product overall (theNutrient Profiling Scoring Criteria). Unfortunately, the same restrictions do not apply to nutrient content claims, nor for health-relatedingredient claims(e.g. ‘Contains fruit and vegetables’ or ‘whole grains’). Therefore, there is a potential for unhealthy products to carry nutrient content claims or to promote certain ingredients. Seeherefor amedia article describing this issue Critique its alignment with public health principles 

Healthcare Costs Increase Example

5 pages essay. Follow the instruction please.
Look at the bold sections in this sample paper:
https://www.irsc.edu/uploadedFiles/Students/AcademicSupportCenter/APA-Format-Manual.pdf (Links to an external site.)
 
In your outline start to map out the main sections that will be in your final paper. 
 
See below a detailed outline from walden university
http://writingcenter.waldenu.edu/318.htm (Links to an external site.)
 
The following outline is for a 5-7 page paper discussing the link between educational attainment and health. Review the other sections of this page for more detailed information about each component of this outline! Healthcare Costs Increase Example

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I. Introduction

 A. Current Problem: Educational attainment rates are decreasing in the United States while healthcare costs are increasing.
B. Population/Area of Focus: Unskilled or low-skilled adult workers
C. Key Terms:  healthy, well-educated
Thesis Statement: Because of their income deficit (cite sources) and general susceptibility to depression (cite sources), students who drop out of high school before graduation maintain a higher risk for physical and mental health problems later in life.

II. Background

 A. Historical Employment Overview: Unskilled laborers in the past were frequently unionized and adequately compensated for their work (cite sources).
B. Historical Healthcare Overview: Unskilled laborers in the past were often provided adequate healthcare and benefits (cite sources).
C. Current Link between Education and Employment Type: Increasingly, uneducated workers work in unskilled or low-skilled jobs (cite sources).
D. Gaps in the Research: Little information exists exploring the health implications of the current conditions in low-skilled jobs.

III. Major Point 1:  Conditions of employment affect workers’ physical health. 

 A. Minor Point 1: Unskilled work environments are correlated highly with worker injury (cite sources).
B. Minor Point 2: Unskilled work environments rarely provide healthcare or adequate injury recovery time (cite sources).

IV. Major Point 2: Conditions of employment affect workers’ mental health

 A. Minor Point 1: Employment in a low-skilled position is highly correlated with dangerous levels of stress (cite sources).
B. Minor Point 2: Stress is highly correlated with mental health issues (cite sources). Healthcare Costs Increase Example

V. Major Point 3: Physical  health and mental health correlate directly with one another.

 A. Minor Point 1: Mental health problems and physical health problems are highly correlated (cite sources).
B. Minor Point 2: Stress manifests itself in physical form (cite sources)

VI. Major Point 4: People with more financial worries have more stress and worse physical health.

 A. Minor Point 1: Many high-school dropouts face financial problems (cite sources).
B. Minor Point 2: Financial problems are often correlated with unhealthy lifestyle choices such unhealthy food choices, overconsumption/abuse of alcohol, chain smoking, abusive relationships, etc. (cite sources).

VII. Conclusion

 A. Restatement of Thesis:  Students who drop out of high school are at a higher risk for both mental and physical health problems throughout their lives.
B. Next Steps:  Society needs educational advocates; educators need to be aware of this situation and strive for student retention in order to promote healthy lifestyles and warn students of the risks associated with dropping out of school.

– See more at: http://writingcenter.waldenu.edu/318.htm#sthash.npL9P45P.dpuf Healthcare Costs Increase Example

social conditions on issue and proposed solutions

Five Questions”:

ü You will write responses to five (5) questions provided by the instructor, each response

approximately 350-500 words long.

ü These questions will help you identify and evaluate:

• §  theroleofthegoverningbodythatyouaretargetingwithyourproposal;
• §  thetwoopposingpolicypositionsandtheirclaimsmakers(i.e.thosewhoaresupporting social conditions on issue and proposed solutions

each position and their investment in that stance); and,

• §  your integration of conceptual material from weekly readings and class discussions

through midterm, including:

·         ·  types of moral perspectives;

·         ·  political alliances and relative political power of policy proposals;

·         ·  impact of social factors/social conditions on issue and proposed solutions;

·         ·  current and projected disparities in healthcare use and outcomes.

It is expected that you will be building on these writings as you proceed through the term.

list of the topic

Sources must include course readings as well as research from peer-reviewed academic social conditions on issue and proposed solutions

journals. 

Final write-up of the paper is due at 7 p.m. on Wednesday of Finals Week and emailed to the instructor.

Choose one of the following for your policy analysis paper.

1.      Public Health and Rights to Privacy: Should medical providers be bound by Public Health policies? Recently, a nurse who was exposed to the Ebola virus refused quarantine rules imposed by the legislature and health department of New Jersey. What were the arguments on both sides? What roles did science, cultural values and norms, and political posturing play in policymaking? What other factors were involved? What are implications for other issues in which private and public health sectors must collaborate?

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2.      Is unregulated economic growth good for our health? Scientists argue that diminishing biodiversity in our ecosystems world-wide, much of it due to unrestricted development and other human activity, will affect our health in the future. Are there ways we can grow an economy and maintain diversity in the environment?

3.      Health care digitization and other new technologies in your doctor’s office: Physicians and their staffs are facing increased pressures to digitize medical records, and recruit and maintain a remote client base through telemedicine practices, i.e., incorporate new technologies into their practices. Are these new practices changing the doctor-patient relationship? What do both doctors and patients think about the changes? And, what roles are medical industries, healthcare corporations, and governments playing in effecting certain changes?

4.      Making the rules regarding women’s contraceptive choices: One of most controversial (and litigated) provision of the PPACA is the obligation of employer plans to cover contraceptive services under prevention. Businesses that oppose coverage have challenged the law and won concessions. What are the origins of this debate, both in the construction of the law and in the history of women’s contraceptive choices in America? What implications does this have for women’s health care and for future policymaking? Should private businesses be able to block access to health care for women?

5.      What should government do in response to the problem of access to health care?: The Obama administration developed a health care policy that addressed the tens of millions of Americans who in 2010 were uninsured (and millions more who were underinsured). What provisions of the PPACA attempt to create a more inclusive system? What are the values and politics behind them? What are the arguments opposed? Did the PPACA go far enough, as others contend the U.S. should transition to a federally-funded “Medicare for Everybody” universal health insurance system?social conditions on issue and proposed solutions

6.      What role should medical professionals have in military anti-terrorism practices?: Since the exposure of abuse of detainees at Abu Gharib in Iraq in 2003, critics have questioned the role of psychiatrists in the justification of torture practices by military interrogators. Should physicians and psychiatrists provide information that helps determine how much and what kind of mistreatment could be delivered to detainees of the military during interrogations? Is there a point where a doctor’s obligation to “do no harm” is suspended during times of war?

MPPA 582-01, Healthcare Policy, Winter 2017_rev 30Dec2016 mg Page 12

7.      Immigrants and health care laws: In 1994 Californians passed an initiative, subsequently ruled unconstitutional, that included a provision requiring medical personnel to refuse care to undocumented immigrants. More recently, the Obama administration has ruled that while young undocumented immigrants may be allowed to be “lawfully present” in the U.S. (for schooling or work), they would not be eligible for health benefits under the new health care law. What are the obligations of a society to those within its borders? Is health care different from other kinds of “benefits”? How have other countries addressed this issue?

8.      Are there limits to the uses of medical technology?: Should genetic screening be used in hiring and contracting by employers, insurers, and governments? Is genetic enhancement an acceptable use of technology? These and other questions can be explored in determining at what point the costs of technologies (in terms of harm to persons or communities) outweigh the benefits.

9.      Technology and doctor/patient interaction: How are new medical technologies changing the doctor- patient encounter, as well as doctors’ approaches to clinical care? Is the use (or overuse of testing) improving diagnostic accuracy, or is this more myth than fact? What evidence speaks to what the balance should be between subjective observation and laboratory data in a doctor’s deliberations? Does the new health care law have something to say about the use of technologies in patient care?

10.  Off-label marketing of drugs: A common practice by physicians, and heavily promoted by drug companies, off-label use of drugs was given a boost by an appeals court decision in New York supporting marketing of drugs for uses not approved by the FDA. What are the pros and cons of this decision for doctors and patients? What should be the responsibilities of drug manufacturers, and what would be an appropriate governmental policy on this issue? social conditions on issue and proposed solutions

11.  Should medical providers be allowed to deny medications on grounds of conscience?: First pharmacists, and then, with the new provisions in the 2010 health care law, hospitals are exercising moral or religious grounds to gain exception to the mandate to provide birth control medications. Should exceptions be allowed? How should religious claims be weighed against individual rights?

12.  Should state legislatures or U.S. Congress regulate fracking? We are immersed in a new era of oil booms in North Dakota, Pennsylvania, and, more recently, Central California. Water infused with “various chemicals” (unidentified, to date) is blasted deep underground – below farms, close to water tables, handled by workers. Are these chemicals and processes harming workers or the environment? What responsibility do these companies have, not only to the environment which they are changing, but to workers and residents who may be affected by their practices?

13.  What’s the future for employer-based health care coverage?: At one time, employers willingly offered health care benefits as they competed with each other for workers. With outsourcing in the global labor market, high health care costs in the U.S., and a troubled economy, employers have implemented strategies for reducing their costs. What are some pre-2010 business strategies and current trends, and how does the ACA address them?

14.  Drug shortages, high-priced generics, and American health: Drug shortages have

MPPA 582-01, Healthcare Policy, Winter 2017_rev 30Dec2016 mg Page 13

increased dramatically in the last decade, nearly tripling. In especially short supply is a generic version of an important cancer drug. What is the threat to public health? What’s wrong with the drug production and distribution system? What have Congress and the FDA done in response? How can private enterprise and government agencies address this problem?

15. Health Care and the poor: Community health providers who treat the poor find they cycle in and out of care due to periods of homelessness, jail time, and other barriers, disrupting medical regimens. What are implications for individual health and public health? What provisions of the ACA can help address these issues?

Proposing an Alternative Topic

If you prefer to work on a topic not listed above, you must submit a proposal (typewritten, single-spaced, due no later than our first class meeting) addressing each of these points and arguing why your topic is relevant to health care policymaking as well as recent health care reforms:

15.  (1)  state your key policy question (examples provided above);

16.  (2)  state what level of governance is involved at which a policy decision should be made

(local, state, federal; specific agency), and provide the rationale for why that governmental

entity is critical for this issue;

17.  (3)  identify 2 key positions on this issue, including how each identifies the problem and what

each proposes for a solution; for example, using a topic above, DTC advertising of pharmaceuticals is argued by some as improving patient choice and by others as inventing demand – what is each side identifying as a problem, and what do they suggest be done about it?

18.  (4)  outline sources of evidence each position puts forth in its claims; and,

19.  (5)  finally, looking at the topic areas for each week of this course, consider which you expect to

be most relevant for your topic and why; for example, DTC advertising of prescription drugs is relevant to the study of the patient empowerment movement as well as the study of medical industries and the role of profit-making in health-related fields.View less » social conditions on issue and proposed solutions

Depression Research Sample Essay

Stage One: Develop an Issue Statement
Depression can strike anyone regardless of age, ethnic background, socioeconomic background, or gender (NIMH, 2011). An estimated 7 million of the nation’s 39 million adults aged 65 years and older are stricken by depression, which is a persistent sad, anxious, or empty feeling, or a feeling of hopelessness and pessimism (Aldrich, 2010). When the elderly population experiences depression, it may be overlooked because seniors, like children and adolescents may experience different and less obvious symptoms and signs of depression and may be unable or unwilling to acknowledge feelings of sadness or grief (NIMH, 2011). Depression Research Sample Essay
It is important to note that depression is not a normal part of aging. While older adults may face widowhood, loss of function, or loss of independence, persistent bereavement or serious depression is not normal and should be treated (Aldrich, 2010). Living with untreated depression presents a serious public health problem (Aldrich, 2010; CDC, 2010; NIMH, 2011). Depression complicates chronic conditions such as heart disease, diabetes, and stroke; increases health care costs; and often accompanies functional impairment and disability (Aldrich, 2010; CDC, 2010; CDC & NACDD, ND). Depression is also linked to higher health care costs and tied to higher mortality from suicide and cardiac disease (Aldrich, 2010; MHA, 2012). Depression in older adults is often not recognized or treated and yet, it is fairly easy to detect, highly treatable, and a candidate for prevention efforts—making it an excellent focus for public health activities (NIMH, 2011). Because depression is a highly treatable but currently undertreated condition among community-based older adults, all disease prevention programs for older adults should include a depression treatment component (CDC & NACDD, ND).
Stage Two: Use Data to Describe the Issue
Depression is the leading cause of disability as measured by Years Lived with Disability (YLDs) and the 4th leading contributor to the global burden of disease in 2000 (WHO, 2012). By the year 2020, depression is projected to reach 2nd place of the ranking of Disability Adjusted Life Years (DALYs) calculated for all ages, both sexes (WHO, 2012). Using the Behavioral Risk Factor Surveillance System (BFSS), the CDC found that lifetime indicators for depression in California for ages 50-64 are up to 17% and for those ages 65 and up, almost at 10% (CDC, 2006). Risk factors for late-onset depression included widowhood, physical illness, low educational attainment (less than high school), impaired functional status, and heavy alcohol consumption (CDC, 2006). Depression Research Sample Essay
Depression is a significant predictor of suicide in elderly Americans. Comprising only 13% of the U.S. population, individuals aged 65 and older account for 20% of all suicide deaths, with white males being particularly vulnerable (MHA, 2012). Suicide among white males aged 85 and older (65.3 deaths per 100,000 persons) is nearly six times the suicide rate (10.8 per 100,000) in the United States (MHA, 2012).
In regards to treatment, more than 55% of older persons treated for mental health services received care from primary care physicians and less than 3% aged 65 and older received treatment from mental health professional (MHA, 2012). Primary care physicians accurately recognize less than one half of patients with depression, resulting in potentially decreased function and increased length of hospitalization (MHA, 2012).
Stage Three: Search and Organize Information
Over the last decade, depression and other mental health problems have gained increased attention from the public health community. Mental health, including treatment of depression, is one of the Healthy People 2020 Leading Health Indicators requiring action (U.S. Department of Health and Human Services, 2012). The World Health Organization has launched an initiative focused on depression in public health (WHO, 2012). The Guide to Community Preventive Services (The Community Guide), developed by the non-federal Task Force on Community Preventive Services, has given the rating of “Recommended” to interventions involving collaborative care for treatment of adults 18 years of age or older who have major depression, as well as to home- and clinic-based depression care management interventions for older adults (Community Guide, 2011).
Using one of the leading EBPH resources, The Community Guide, as a tool for intervention recommendations, this resource recommends several strategies to manage depressive disorders. Each recommendation is based on evidence from a systematic review of the published scientific literature examining the effectiveness of the strategy (The Community Guide, 2011). The Community Guide’s evidence table on the recommendation of depression care management for older adults can be found in Appendix 1.
Stage Four: Prioritize Options
Collaborative care for the management of depressive disorders, also referred to as Depression Care Management (DCM) is a multicomponent, healthcare system-level intervention that uses case managers to link primary care providers, patients, and mental health specialists (The Community Guide, 2011). It is designed to: (1) improve the routine screening and diagnosis of depressive disorders; (2) increase provider use of evidence-based protocols for the proactive management of diagnosed depressive disorders; and (3) improve clinical and community support for active patient engagement in treatment goal setting and self-management (The Community Guide, 2011). This is a multi-component, healthcare system-level intervention that uses case managers to link primary care providers, patients, and mental health specialists and this type of intervention improves depression outcomes and is applicable to adult populations in most settings (The Community Guide, 2011).
The Task Force on Community Preventive Services “recommends collaborative care for the management of depressive disorders based on strong evidence of effectiveness in improving depression symptoms, adherence to treatment, response to treatment, and remission and recovery from depression” (The Community Guide, 2011). The Task Force also “finds that collaborative care models provide good economic value based on the weight of evidence from studies that assessed both costs and benefits” (The Community Guide, 2011). Depression Research Sample Essay
Stage Five: Develop and Implement an Intervention
The DCM model is a systematic team approach to treating depression in older adults, which is based on the model for treating chronic diseases (Aldrich, 2010; The Community Guide, 2011). Common elements of DCM include diagnosing depression through a validated screening instrument and providing psychotherapy or antidepressants according to evidence-based guidelines (Snowden, Steinman, & Frederick, 2008). Treatment is reexamined periodically through a validated severity measurement to determine how well patients are responding and to adjust treatment as needed (Snowden, Steinman, & Frederick, 2008). A trained social worker, nurse, or other practitioner (sometimes called a “depression care manager” or “care manager”) educates patients, tracks outcomes, assists with psychotherapy, and monitors anti-depressants prescribed by a primary care provider (Aldrich, 2010; Snowden, Steinman, & Frederick, 2008). The care manager works in consultation with a psychiatrist who supervises care, but typically does not see the patients (The Community Guide, 2011). The goal is to improve rates of faithfulness to treatment and to improve recognition and treatment for patients not responsive to their initial treatment (Snowden, Steinman, & Frederick, 2008).
In clinics, the depression care manager works with the patient’s primary care provider, a consulting psychiatrist, and other health care personnel to deliver the intervention (The Community Guide, 2011). Managing depression in primary care clinics is effective: elderly people already visit these facilities regularly, and one study of depressed older adults found that DCM was delivered at a mean cost of $580 per patient, compared with total health care cost per patient of about $8000 (Snowden, Steinman, & Frederick, 2008). In the home-based intervention, the depression care manager makes home visits and coordinates with other members of the collaborative care team outside of the participant’s home (Aldrich, 2010; Snowden, Steinman, & Frederick, 2008). One study of home-based management of depression found that costs averaged $630 per patient for an average of six visits (Snowden, Steinman, & Frederick, 2008).
Stage Six: Evaluate the Program
One program that follows the DCM model is the Program to Encourage Active and Rewarding Lives for Seniors (PEARLS) (Aldrich, 2010). PEARLS is a brief, time-limited, and participant-driven program that teaches depression management techniques to older adults with depression (Aldrich, 2010; Snowden, Steinman, & Frederick, 2008; University of Washington School of Public Health, 2009). It is offered to people who are receiving home-based services from community services agencies and the program consists of in-home counseling sessions followed by a series of maintenance session contacts conducted over the telephone (University of Washington School of Public Health, 2009). The PEARLS intervention is comprised of eight 50-minute sessions with a trained social service worker over a 19-week period including 3-6 subsequent telephone contacts (University of Washington School of Public Health, 2009).

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The objectives of the PEARLS program include: (1) empowering participants and helping them develop the skills to define and solve their problems, (2) enabling participants to become more socially and physically active, and to experience more pleasant activities, and (3) to decrease participants’ symptoms of depression and improve their health-related quality-of-life and emotional well-being (Aldrich, 2010).
The PEARLS counselor is the individual who works directly with clients to implement the program. In most settings, the counselor will be responsible for some or most of the recruiting of clients for PEARLS (University of Washington School of Public Health, 2009). Many PEARLS counselors will also be case managers; however, it is recommended that a counselor does not deliver PEARLS to the same client(s) he or she case manages (University of Washington School of Public Health, 2009).
The three basic components of the PEARLS Program include:
• Problem-Solving Treatment–A seven-step, participant-driven approach in which the individual is supported by a counselor to identify and solve problems that the participant wants to address (University of Washington School of Public Health, 2009).
• Social and Physical Activation–Counselors work with participants to increase their engagement in social, physical and recreational activities, in both their homes and in their community (University of Washington School of Public Health, 2009).
• Pleasant Activity Scheduling–Participants are encouraged to select an activity they would enjoy doing on their own or in the company of others (a pleasant activity they can do as “homework”); over 200 diverse activities are offered in the PEARLS Toolkit as possible options for participants to consider (University of Washington School of Public Health, 2009).
Within the 19 week PEARLS program, at least 40% of participants in the program will have a reduction or elimination of depressive symptoms, greater reported health-related quality of life, and improvements in functional and emotional well-being. The participants depression will be diagnosed through the Patient Health Questionnaire (PHQ-9) (a nine-item, validated instrument for screening and diagnosing depression) (Appendix 2), a score of 10.9 indicates an intermediate level of depression (Snowden, Steinman, & Frederick, 2008; University of Washington School of Public Health, 2009). The PHQ-9 is completed early in each PEARLS session. In addition, this set of questions sets the context for identifying a problem. According to Snowden et al., after using the PEARLS treatment in a study, the average PHQ-9 score had decreased to 4.8 and 30 (87%) of the 35 participants were in remission (Snowden, Steinman, & Frederick, 2008).
Outcome data in the PEARLS toolkit from the University of Washington School of Public Health include the following:
• PHQ-9 scores (from the PEARLS Tracking Chart, Baseline and Final Questionnaires)
• General Health (from the Baseline and Final Questionnaires)
• Social Activity (from the Baseline and Final Questionnaires)
• Physical Activity (from the Baseline and Final Questionnaires)
• Pleasant Activity (from the Baseline and Final Questionnaires)
References
Aldrich, N. (2010). CDC promotes public health approach to address depression among older adults. Retrieved from http://www.cdc.gov/aging/pdf/CIB_mental_health.pdf.
Centers for Disease Control and Prevention (CDC). (2010). Mental health and aging. Retrieved from http://www.cdc.gov/aging/mentalhealth/depression.htm.
Centers for Disease Control and Prevention (CDC). (2006). Indicator: Lifetime diagnosis of depression. Retrieved from http://apps.nccd.cdc.gov/MAHA/IndicatorDetails.aspx?IndId=23.
Centers for Disease Control and Prevention (CDC) and National Association for Chronic Disease Directors (NACDD). (ND). The state of mental health and aging in America. Retrieved from
http://www.cdc.gov/aging/pdf/mental_health_brief_2.pdf.
The Guide to Community Preventive Services. (2011). Interventions to reduce depression among older adults. Retrieved from http://www.thecommunityguide.org/mentalhealth/depression-home.html.
Mental Health America (MHA). (2012). Depression in older adults. Retrieved from
http://www.mentalhealthamerica.net/index.cfm?objectid=C7DF94FF-1372-4D20-C8E34FC0813A5FF9.
National Institute for Mental Health. (2011). Mental Health Topics. Retrieved from
http://www.nimh.nih.gov/index.shtml.
Snowden, M., Steinman, L., & Frederick, J. (2007). Treating depression in older adults: Challenges to implementing the recommendations of an expert panel. Prevention of Chronic Disease. 5 (1): 26.
University of Washington School of Public Health. (2009). Depression care management: Evidence-based programs, PEARLS. Retrieved from http://www.prc-han.org/docs/PEARLS_feb09.pdf.
U.S. Department of Health and Human Services. (2012). Mental health and mental disorders. Retrieved from http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=28.
World Health Organization (WHO). (2012). Disorders Management. Retrieved from
http://www.who.int/mental_health/management/depression/definition/en/.
World Health Organization (WHO). (2012). WHO initiative on depression in public health.
Retrieved from http://www.who.int/mental_health/management/depression/depressioninph/en/. Depression Research Sample Essay