Running head: WAYNE COUNTY ASSESSMENT

WAYNE COUNTY ASSESSMENT 9

Project and Wayne County Assessment

The Need for the Intervention

Several health-related issues arise from the Wayne County Assessment 1999-2004. First, approximately 10 percent of the population lacks health insurance, a majority of whom are seasonal workers employed on a part-time basis. Worryingly, 22 percent of the countys payroll employees are either uninsured or underinsured. To some extent, the large populations of uninsured persons is as a result of structural factors such as low income and restrictive insurance plans that limit access to migrants who have lived in the county for less than two years. However, low education levels also play a significant role as most uninsured residents lack knowledge about affordable health coverage plans such as Value Med. Data on educational attainment shows that only 63 percent of the population completed high school and only 14 percent were college graduates. It is likely, therefore, that most residents do not, in fact, understand the value of having health insurance.

Secondly, access to preventive healthcare services is limited. The lack of health insurance and low-income levels limit residents ability to seek out care. For instance, 8.3 percent of the population lives below the poverty line, including 23.9 percent of the elderly aged above 65, and who bear the greater burden of chronic illness. Further, most residents are employed on a part-time basis and depend on a daily wage, which makes it difficult to take time off work during weekdays to seek healthcare services. Such residents would be available during weekends, when most physicians are unavailable. With the low education levels, it is likely that most residents do not understand the value of preventive care services. The lack of access to healthcare results in negative health behaviors evident in the high prevalence of sexually-transmitted diseases and the high mortality from chronic illnesses. These factors indicate a need for intervention.

The Proposed Intervention

The proposed intervention is geared at increasing i) health insurance coverage and ii) access to preventive care. It is based primarily on the theory of planned behavior (TPB). However, Wayne County residents are at different stages for instance,...

In this regard, the theory of planned behavior will be integrated with the trans-theoretical model to identify the most plausible strategies for persons at different stages of change.

Specific Intervention Strategies

The TPB argues that intention is the driving factor behind behavioral change. The greater the intention; the higher the likelihood of behavioral change. However, intention is a function of the individuals attitude towards the current and proposed behavior, the subjective norm (social pressure to change or not change behavior), and perceived behavioral control (the extent to which one believes they can change behavior) (Glanz, Rimer & Viswanath, 2015). An individual is more likely to change their health-seeking behavior if they harbor positive attitudes towards health insurance and preventive care, face sufficient social pressure to change, and if they believe that they can manage the change successfully. Specific strategies need to focus on realizing these outcomes.

Influencing Residents Attitudes

Studies have shown that establishing the right attitudes towards tobacco control among middle school students significantly reduced their smoking rate (Tapera et al., 2020). As such, there is a need to influence residents attitudes towards health insurance and preventive care. One way to do this is by educating Wayne County residents on the benefits that they stand to derive from health insurance coverage and how accessing preventive care could help improve their quality of life and reduce mortality from chronic illness. The youth...

…such, behavioral control strategies would be used on individuals at the preparation, action and maintenance stages, who understand the value of preventive care and are either already on an insurance plan or are ready to take action in the next 30 days (Glanz et al., 2015). The aim is to encourage them to hold on or stick to the course towards behavioral change and strategies are thus more personalized to specific individuals.

Sources contend that it would be prudent that interventions for behavioral control are tailored to eliminate noise and give the same personal relevance to enable implementers to pay attention the most important details (Morrison, 2015). One potential strategy is to schedule appointments and offer appointment reminder cards to ensure that participants are kept continually motivated and encouraged through motivational interviewing (Morrison, 2015). Appointments also provide invaluable opportunities for participants to discuss the challenges they face and expectations with the implementers of the intervention, and receive the relevant support on how to address the same (Morrison, 2015). A second strategy is to develop personalized cues that reinforce intervention messages, lead participants through action planning, and providing new content (Morrison, 2015). Further, program implementers could organize one-on-one teach back calls where participants are prompted to explain key concepts learnt about insurance and preventive care services. Any wrong perceptions could then be corrected before they escalate and affect the gains made. Nudging would also be effective at this level of intervention (Vlaev, 2016). It involves nudging peoples health choices by making healthy options easier (Vlaev, 2016). This could be done by working together with local healthcare facilities to increase the flexibility of physician schedules so that more physicians are available during weekends to cater for residents who may be unavailable on weekdays. The aim of behavioral control is to keep participants encouraged and…