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The application concepts seen in most population and health intervention programs aim at strengthening community health fundamentals of the respective populations they are handling. The running of these programs is elementally based upon the achievement of desired success levels, which is manifested by the number of people among the population practicing healthy habits in order to avoid developing certain illnesses or conditions associated with that particular population. The element of promoting health intervention pursuing psychosocial aspects of health has proven to an effective instrument in a bid to significantly establish the efficacy of such research programs in meeting population needs and the distinctly increasing the outcome of these programs in the long run. There is therefore an increasing need to target specific community needs by focusing on specific contextual matters associated with a population Research Programs
Academic Model for Prevention and Teaching HIV/AIDS (AMPATH) Program
The academic Model for Prevention and Teaching HIV/AIDS Program (AMPATH) is an academic model research program between two academic institutions located in the United States and Kenya, East Africa (O’Brien & McDonald, 2006). The institutions are Indiana University in the United States and Moi University in Kenya. The project specifically operates in the Rift Valley region of Kenya. The research program involves the use of teaching programs existing in both institutions focusing majorly on medical and other health related courses, for instance, environmental health. In this kind of research model students go on exchange programs in order to gain significant information exchange on HIV/AIDS trends (O’Brien & McDonald, 2006).Afterwards the students are deployed to the field where the programs are running to assist in carrying out interventions, disseminating relevant information and collecting relevant data. This data is then later on utilized in assessing the achievement of initially set program initiatives focusing on HIV/AIDS. The research project is located in Kenya, East Africa and handles over 3 million patients affected by HIV/AIDS, in this region who include children and adults (O’Brien & McDonald, 2006). In addition, the program has a nutrition and antiretroviral component included apart from the focus of psychological aspects of health affecting these HIV/AIDS victims.
Rwanda Zambia HIV Research Group (RZHRG)
The Rwanda Zambia HIV Research Group started off with an aim of establishing the prevalence and causative factors of HIV/AIDS among a chosen heterosexual population located in both localities. This research project has two sites located in Kigali, Rwanda and Lusaka, Zambia. These two sites form the largest cohorts existing in the modern day world of epidemiological studies. In 2007, the research project ended up developing a Couples Voluntary Counseling and Testing Curriculum (Emory University, 2005). This curriculum sought to strengthen education and institutional frameworks towards developing sustainability course units for improving knowledge on trends in HIV/AIDS. According to Emory University (2005) “This observation created an immediate need to equip community field sites around the world with tools for implementing couples voluntary counseling and testing (CVCT) interventions” (Emory University, 2005). The program of couple testing essentially aimed at improving the component of psychosocial health among affected couples since ordinarily this was a neglected part in many replicated programs worldwide. When this research project began it initially targeted 4000 women with a starting cohort of nearly 1458 HIV positive and negative women (Emory University, 2005). This number has consequently grown up significantly and currently both sites (located in Zambia and Rwanda) represent the first and second largest cohort groups in the world to ever have been implemented in an epidemiological research project.
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Research, identify, and describe two successful community based programs that help in meeting the needs of the population
Community Based HIV/AIDS Prevention, Care and Support Program (COPHIA)
In an evaluation exercise by MEASURE Evaluation team Pathfinder’s Community Based HIV/AIDS Prevention, Care and Support Program (COPHIA) was assessed in order to ascertain the success level of the program. The report indicated that this was one of the most successful of Pathfinder International’s programs. The activities under the program primarily involved targeting orphans and vulnerable children (OVC) coming from HIV/AIDS affected families in the pilot sites (Brown, L. et al, 2010). The program objective essentially involved an assessment of psychosocial domains of health with regard to the manifested effects in the lives of orphans and children coming from HIV/AIDS affected families. Community Based HIV/AIDS Prevention, Care and Support Program is funded by the U.S Agency for International Development (USAID) and the U.S President’s Emergency Plan for AIDS Relief alternatively called the Emergency Plan (Brown, L. et al, 2010). Since this was a community based program with majority of the costs coming from in the form of transportation and training allowances for Teacher of Teacher (TOT) supervisors and volunteers in the program.
The budget consisted of 2,500 Kenyan shillings (approximately U.S. $34) for CHW supervision, facilitation allowances for full day training of 2, 000 Kenyan Shillings (approximately U.S. $29), while training paralegals, VCT counselors , and child counselors received 400 Kenyan shillings (or U.S $5) in form of travel costs and lunch costs (Brown, L. et al, 2010). The program has been in operation for the last 8 years and is currently in its monitoring and evaluation phase. The psychosocial aspect of the program stated that, “Children affected by HIV/AIDS often live in households undergoing dramatic changes, including intensified poverty; increased responsibilities placed on young members of the family; poor parental health that may increase emotional or physical neglect, stigma and discrimination from friends, community members, or extended family; or parental death” (Brown, L. et al, 2010).
Integrated Community-Based Home Care (ICHC)
The Integrated Community-Based Home Care (ICHC) is a program targeting terminally ill patients who are suffering HIV/AIDS. The program is primarily based in the Garder Route, Western Cape Province in South Africa which has the highest prevalence of HIV/AIDS in the province (IMPUMELELO Innovations Award Trust, 2008). In addition, the project also serves areas of Sedgefield, Knysna, which is on the east of Harkville bordering Plettenberg Bay area (IMPUMELELO Innovations Award Trust, 2008). For a long time HIV/AIDS based programs have neglected the plight of terminally ill patients who essentially have a double tragedy by virtue of their dual medical conditions, a factor which contributes to major psychological related problems. The program offers care for 350 patients every month and on an annual basis the program provides 3217 beneficiaries food and clothing; 1489 children with play therapy and meals; conducts 599 doctor consultations; aids 303 beneficiaries with social grants; conducts 745 home nursing visits; and helps 245 beneficiaries during bereavement process (IMPUMELELO Innovations Award Trust, 2008). The community based program has registered significant success in tackling the constantly psychological health concerns in the South African. The program is very successful by virtue of that it has registered 40% growth in terms of patient loads and 537 new referrals (IMPUMELELO Innovations Award Trust, 2008).
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The project operates on a 3.2 million South African Rands budget (IMPUMELELO Innovations Award Trust, 2008). The funding partners are as follows: 12% of funds are acquired through the Department of Health and the European Union through the Western Cape provincial administration; 30% of funds are acquired through volunteer fundraising committees; 40% of funds are acquired from Corporate donors; and Non Governmental Organizations and local CBOs provide 18% of the total budget (IMPUMELELO Innovations Award Trust, 2008).
Identify and describe a minimum of two interventions that could be suggested to assist in minimizing the impact of the illness/condition.
In order to significantly minimize the complexities associated with psychological problems it is necessary to come up with long term strategies focusing on behavioral aspects.
It is necessary to incorporate strategies, which elementally focuses on changing individual lifestyles of the affected persons with an aim of influencing positive perceptions towards vocational and other social perspectives.
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It is also important to create an enabling environment that aims at changing negative impacts infused in culture in association with illness, which will consequently lead to individuals acquiring positive coping strategies in due consideration of economic and social dynamics.
Justify implementation of the two interventions you are recommending
The incorporation of strategies leading to lifestyle change with regard to individuals adopting positive vocational and social activities is an effective component of enhancing psychological health domain in tackling HIV/AIDS. According to Falvo (2005), “Individual perception or misperception of the reactions of others in social groups may determine the level of acceptance that they receive” (p.21). This is because this has a significant effect upon the achievement of a participatory effect in socioeconomic activities that can enable them to receive acceptance and sustenance. Falvo (2005) adds that, “At other times, certain work tasks, environmental conditions, or work schedules must be modified to accommodate the limitations imposed by the chronic illness or disability” (p.22). However, this should only be done for specific times when affected individuals are unable to integrate with the society. It is important to note that psychological variables may also affect the relative levels of functional capacity and in turn the entire rehabilitation process (Falvo, 2005).
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The creation of an enabling environment focused upon creating positive coping strategies is a positive element considering the dynamic factors influencing HIV/AIDS aspects. According to Martz and Livneh (2005), “Dispositional-based measures seek to address the respondent’s habitual (i.e. stylistic) use of coping, typically across different types of contexts and time periods” (p.18). The consideration given to context is a factor usually neglected in many community based programs. In a certain case study it was established that cognitive, motivational, content, and physiological variables affect the manner in which information will be processed paying particular focus on the interactive elements of personality, state anxiety, and individual traits (Martz, E. & Livneh, 2007). These factors have an overarching effect in strengthening coping strategies among individuals by taking into account the fact that they impact negatively upon psychological perspectives which in turn affects the program efficacy. In addition, it is important to note that social factors and cultural beliefs can lead the creation of a supportive or unsupportive environment (Belgrave, 1998). It is also important to note that coping strategies are also influenced by other factors which may be devoid of normally observed behavioral aspects. According to Belgrave (1998), “This may in part be due to socioeconomic factors, including lack of employment opportunities, limited access to social services and health agencies, and the presence of environmental stressors” (p.5). The further strengthens the need for stronger enabling environment.
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Several programs have been instituted in a bid to tackle the complex problems associated with psychological health impacts upon affected individuals suffering from HIV/AIDS. The research projects serve to indicate the manner in which there is need to implement integrated programs that are capable of addressing all the relevant centers in order to increase the efficacy of the outcome variables. In addition, it is critical to that the promotion of health intervention through psychosocial dimensions in health care is proving to be an effective instrument focusing on the relative variations in terms of efficacy desired. There is therefore an increasing need to target specific community needs by focusing on specific contextual matters associated with a population.
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