Community Health Nursing Diagnosis: Social Isolation of the COVID-19 suspects and patients: Increased risk of infection among the population of Black Hawk County of Iowa related to lack of social distancing due to the current pandemic as demonstrated by an increased number of patients and casualties. Among many possible solutions, social media might be an effective way to increase awareness about diseases and their causes and symptoms. The use of social media might be especially effective for many economically disadvantageous segments of Black Hawk County of Iowa. It has been observed during the field and online research that the government and private sectors have initiated a plethora of online activities. However, there is still room for accelerating the social media campaign because not all the people observed during the study were aware of the complexities of COVID-19, its causes, and its effects. It is expected that as the authorities and private sector increase interactive activities like quizzes, tests, riddles, and other programs, many people might spend more time on their cell phones and computers instead of meeting others physically. Thus the effective use of social media, as recommended in the next sections of this write-up, might go a long way in reducing the number of possible infections from coronavirus in Black Hawk County of Iowa.
(B1) Health Inequity/Disparity
As with other states and counties in the country, Black Hawk County has economic and health disparities. According to experts, “health disparity” refers to “a lack of equality and similarity, especially in a way that is not fair” (Carter-Pokras & Baquet, 2002). Before presenting the data collected, it seems appropriate to take a bird’s eye view of the universal problem. Worldwide, almost a billion people have no access to basic medical care. More than 15 million people die each year from curable diseases such as diarrhea, malaria, and tuberculosis, around five million of them from lack of access to clean drinking water. Almost without exception, this affects people with low incomes in developing countries. Similar problems also exist in the Black Hawk County area under observation. During the data collection exercise, it was observed that many society segments were indeed poor, with little knowledge of the causes, impacts, and precautions of COVID-19. It was also observed that those who have resources were better cognizant of this deadly disease.
On the contrary, in the county’s relatively poor areas, many people were not following the SOPs for social distancing. Especially, the people above sixty years of age and teenagers were seen not complying with maintaining a distance of six feet. I felt that community nursing might be very helpful for them in giving guidance about infectious diseases. Such ailments as malaria, diarrhea, and particularly COVID-19 have characteristics in transmission, course, and treatment that make the poor, particularly at risk. I have realized through this exercise that poverty and illness are often mutually reinforcing. Households with low incomes, for example, tend to have to forego quality education, especially for their children, when they fall ill. As a possible consequence, poverty is “passed on” to the next generation. Health is also an important factor for the productivity of a household and thus for its economic development. The field exercise reinforced my belief that income and health are interdependent in many cases. Trying to breaking this “vicious circle” is of central importance to health care and prevention. The government should collaborate with the private sector to improve health awareness and provide medical services that would benefit even after COVID-19.
The field study provided some interesting information about the health services in the area. Amongst the various segments, the education level of the Black population was on the lower side. The next on the list were people of Asian origin. Interestingly these two segments were also economically disadvantageous, proving that financial resources and educational achievements are somewhat related. Approximately thirty percent of Black people have not completed their high school, and most of them were not aware of the health services provided at Federal, state, and county levels. Therefore, a small fraction of such people were not covered by health insurance. Hispanic were better educated, and almost all of them were covered by health insurance. They were observing social distancing in a better way as compared to others. The survey revealed that poverty is related to unhealthy habits. According to experts, the following are the four determinants of economic instability (Social Determinants of Health, 2014):
- Food Insecurity
- Housing Instability
The same was established in the field research. Unfortunately, the economically poor segments were not taking the coronavirus seriously. Informal interviews with some Black people revealed that they were in the habit of drinking. The highly educated White people were aware of alcohol’s dangers; therefore, they were not drinking regularly. The experts also recommend avoiding wine due to its side effects, especially for the liver (Thomas, 2020). It was also established that social media’s use might prove effective to promote health consciousness amongst all segments. It is also important to mention that a strong immune system might play an effective role in the war against COVID-19.
Lastly, it is important to present some data about the incidence of COVID-19 in the area. The details are pictorially represented in figure 1(Black Hawk County, Iowa COVID-19 Response, 2020).
Figure 1- COVID-19 Response(Black Hawk County, Iowa COVID-19 Response, 2020).
(B1a) Primary Community and Prevention Resources
The present and past governments of Black Hawk County, Iowa, have been allocating resources for the residents’ health, as evidenced by the county’s public sector medical infrastructure. Apart from this, a considerable number of private-sector clinics and hospitals were also there. On the doors of clinics and hospitals, health professionals have placed messages about the social distancing and the usage of masks and sanitizers. I visited over a dozen clinics and hospitals in the county, and the staff was observing corona virus-related SOPs. However, it was unfortunate to report that many patients and their attendants were not observing social distancing and the usage of masks and sanitizers. It might be one reason why there was a surge in COVID-19 cases in the county in recent days. According to the official data, there are 675 beds available in hospitals in the county. Moreover, there are 29 emergency beds (Black Hawk County, Iowa COVID-19 Response, 2020). With limited time and resources, I could not visit all the hospitals; however, I found that some hospitals are working to their full capacity, which denotes the situation’s gravity.
As far as the prevention efforts are concerned, the public and private entities have initiated many awareness programs online and offline. The state government has launched dedicated social media pages to upload prevention-related content. The general public is also spreading awareness about the pandemic; however, I noticed that many rumors and unsupported stories are also spread on social media, which is not conducive to the county and state population’s health and wellness.
(B1b) Underlying Causes
I have selected COVID-19 because it is currently one of the most important health concerns not only for the county and the state but also for the whole world. I think that the major cause of the relatively high rate of infection of coronavirus in the county is a non-observance of COVID-19 SOPs by the public in the county. When the pandemic started, there were reports that the doctors and the medical staff lacked the personal protective equipment (PPE); however, lately, the government supplied the required materials. For this purpose, they have imported a considerable quantity from China and other nations. I noticed a fall in infection rate after the initial rise; however, the situation has recently gone worse once again. As I have noticed in the visits, many underprivileged people were not fully cognizant of this deadly disease’s dangers.
(B2) Evidence-Based Practice
The government has established an “Immunization and Infectious Diseases Workgroup (IID)” to achieve national health objectives. I think that IID’s recommendations might be considerably helpful in the prevention of COVID-19 since it is also an infectious disease. According to this workgroup, many of such ailments are “vaccine-preventable” (Healthy People 2030, 2020). The best preventive approach would be using the coronavirus vaccine, which would be publicly available in the USA very soon. But until that time, the evidence and research might be helpful, suggesting that social distancing might prevent this pandemic. According to research, infectious droplets do not travel more than six feet (McIntosh, Hirsch, & Bloom, 2020). In the light of historical evidence, “individuals should avoid crowds and close contact with ill individuals” (McIntosh, Hirsch, & Bloom, 2020). Mass awareness might be an effective tool to prevent the spread of this pandemic.
(B2a) Identification of Data.
The fieldwork findings are similar to the data already available in the media and scholarly circles. The total population of Black Hawk County, Iowa, is 133,956 (Black Hawk County, Iowa COVID-19 Response, 2020). As the case at the national level, the Black community is economically suppressed in the areas visited. Their educational attainment is lower than other segments of the society, and they were found frequently violating the COVID-19 SOPs. The field trip revealed that in recent weeks coronavirus infection cases are on the rise. The detailed data is given in figure 1.
(C1) Social Media Campaign Objective
The proposed social media campaign would increase the mass awareness by twenty percent about the COVID-19 precautions amongst the economically disadvantageous population of Black Hawk County, Iowa. This goal would be achieved in one month. This objective is immensely important to reduce the rate of the county’s deadly disease. Moreover, it is expected that the spillover impacts of the social media campaign would be positive for other segments of society as people tend to share the content they like and find advantageous.
(C2) Social Marketing Interventions
In the first social media intervention, economically disadvantageous segments of Black Hawk County, Iowa, would be targeted through social media about the importance of precautionary measures to remain safe from COVID-19. This type of intervention is important because they say, “prevention is better than cure.” As mentioned in the preceding sections, certain portions of the society in Black Hawk County, Iowa, are not properly following recommended procedures, including social distancing and a mask covering.
In the second social media intervention, the county’s poor segments would be targeted through social media about the dangers of COVID-19. This type of intervention is significant because when masses are aware of an ailment’s dangers, they might be more conscious to avoid it.
(C3) Description of Social Media Platform
The following platform would be used:
The use of a multichannel platform would result in wider access and reach. Some people prefer audio, video, and images. The cost consideration would be important, which varies from platform to platform.
(C3a) Benefits of Social Media Platforms
- Facebook: It is very popular amongst youngsters, and it might help spread preventive messages.
- Twitter: The people who use short messages prefer this platform.
- YouTube: It would be used because the majority of people prefer to view videos.
- Blogs: It would be used because blogs offer a wide range of text and images, which might help spread preventive messages.
- Snapchat: With time, it has lost its popularity, but some people still use it.
- Instagram: People who use images and pictures prefer to use this platform.
(C4) Benefit to Target Population
To achieve the target of increasing awareness about COVID-19 by twenty percent, comprehensive social media has been devised. Interesting and captivating social media content would be created with the help of qualified health professionals. The target population would have many benefits in the following ways:
- The targeted segments would receive preventive tips in the form of a time-effective manner.
- The popularity of mobiles would also benefit the target population as all the planned platforms are accessible through cell phones.
- It is expected that the creation and dissemination of quality content would play its role in the wider spread of content.
(D) Best Practices for Social Media
COVID-19 is indeed a serious emergency; therefore, international best practices would be observed. The following points would be taken care off:
- Demographics of audiences
- Language preferences
- Educational level
- The authenticity of the content
- Selection of platforms
- Timing of communication
- Interactive communication
- Creative content
- Respectful content
- Appropriate language
- Right tone
- Discrimination free
- Responsive communication
- No over posting
- Use of images
- Use of videos
- Appropriate tools
- Measuring results
- Modifications in strategy if required
(E1) Stakeholder Roles and Responsibilities
In the planned social media campaign, creators and users are two main stakes holders. It is the creators of the content’s responsibility to abide by national and local laws and create content that follows social and ethical values. From the community’s perspective, they are a major contributor to the social cause to prevent the spread of COVID-19. The second important stakeholders are the ultimate users of the content. It is the responsibility of the users to follow the precautionary measures mentioned in the shared content. Apart from this, they might serve society by forwarding messages to others.
(E2) Potential Public and Private Partnerships
The public and private sector organizations might be indeed helpful in the social media campaign. The local government of the county might provide accurate information about the population and vulnerable segments. The private sector entities might be helpful in the creation of content and its dissemination.
In the first-week social media account would be created, and some basic planning about the content development would be done. In the second week, content would be developed and spread through various platforms. It would take another four weeks before the evaluation might be made about the impact of the campaign.
The evaluation would be done through two short surveys done through survey monkey, an easily available tool. If the proposed campaign increases the target segment’s awareness level by 20 percent, the campaign might be declared successful. In the case of negative variance, the strategy might be revisited.
(E5) Cost of Implementing the Campaign
It is estimated that fifteen thousand dollars might be needed to complete the campaign.
(F) Reflection on Social Media Marketing
The community health nurse can use social media to promote awareness about promoting preventive measures about COVID-19. The general public might be safe from the pandemic, and in this way, community health would improve. The resources saved might be used to establish hospitals in the county, bringing job opportunities for nurses.
(F1) Reflection on Future Nursing Practice
In my career as a community nurse, I can use social media to create awareness about the latest research about health and wellness. Generally, people do not prefer to read lengthy research papers, so I would read them and share usable information in easy-to-understand language to the masses. In this way, I would play a positive role in community wellbeing.
Black Hawk County, Iowa COVID-19 Response. (2020). Coronavirus Response. Blackhawkcovid19-Bhcengineer.Hub.Arcgis.com; Black Hawk County, Iowa COVID-19 Response. https://blackhawkcovid19-bhcengineer.hub.arcgis.com/
Carter-Pokras, O., & Baquet, C. (2002). What is a” health disparity”? Public Health Reports, 117(5), 426.
Healthy People 2030. (2020). Immunization and Infectious Diseases Workgroup – Healthy People 2030 | health.gov. Health.Gov. https://health.gov/healthypeople/about/workgroups/immunization-and-infectious-diseases-workgroup#cit1
McIntosh, K., Hirsch, M. S., & Bloom, A. (2020). Coronavirus disease, 2019 (COVID-19): Epidemiology, virology, and prevention. Lancet. Infect. Dis, 1, 2019-2020. https://library.fitnessformulary.com/wp-content/uploads/Coronavirus-disease-2019-COVID-19_-Epidemiology-virology-and-prevention-UpToDate.pdf
Social determinants of health. (2014). Social determinants of health. Healthypeople.Gov; Office of Disease Prevention and Health Promotion. https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health
Thomas, L. (2020, May 22). Why wine is damaging our body more than we thought. News-Medical. https://www.news-medical.net/health/Why-Wine-is-Damaging-Our-Body-More-Than-We-Thought.aspx