REPLY POSTS:Reply separately to two of your classmates posts (See attached classmates posts, post#1 and post#2). When replying to your peers, think about the ethical considerations related to research

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of your classmates posts (See attached classmates posts, post#1 and post#2).

When replying to your peers, think about the ethical considerations related to research or working with a vulnerable population. Although the vulnerable share characteristics making them susceptible to health concerns, they remain unique.

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In the initial post (see attachment, mine was about “combat veterans”), everyone discussed both strengths and weaknesses inherent to a specific vulnerable population.

What steps would you recommend to ensure that your peer’s vulnerable group is ethically protected throughout the research as well as the participation element of a community-based participatory research project; that is, shelter services, food banks, case management, support groups, etc.?

– Use at least two scholarly references per peer post. In your reply posts, include how the information you learned from your peer’s post will help you to provide care to a patient as a Nurse Practitioner.


: The expectation is not that you “agree” or “disagree” with your peers but that you develop a conversation with information that is validated via citations to encourage learning and to bring your own perspective to the conversation.

Please, send me the two documents separately, for example one is the reply to my peers Post #1, and the other one is the reply to my other peer Post #2.

Please, keep in mind these are replies.



: My background for you to have as a reference: I am currently enrolled in the Psych Mental Health Practitioner Program, I am a Registered Nurse, I work at a Psychiatric Hospital, where I also work with this vulnerable population.

REPLY POSTS:Reply separately to two of your classmates posts (See attached classmates posts, post#1 and post#2). When replying to your peers, think about the ethical considerations related to research
Running head: HEALTH PROMOTION 0 Community-Based Participatory Care to Combat Veterans Student’s name Institution affiliation Combat veterans are a vulnerable group that serves the military in combat zones. This kind of group experiences a lot of challenges when serving, including mental health issues. Even after their services and after returning to their homes, they experience a lot of problems, such as struggling to meet their needs (Westphal& Convoy, 2015). When in service, it means that you are separated from family members, which is often stressful. Mental health problems such as post-traumatic stress disorder (PTSD) is caused by stress. Community-Based Participatory Research (CBPR) is an approach used to conduct research involving members of the community. The CBPR project can help identify some of the problems faced by this group. This paper discusses the cons and pros of implementing a Community-Based Participatory Research health promotion project with combat veterans. Through the implementation of the Community-Based Participatory Research health promotion project, the veteran group can primarily benefit because most healthcare practitioners are willing to collaborate. Nurses who initiate and implement health promotion plans try to work within the cultural context with the involved vulnerable group (Johnson &Koocher, 2017). The practitioners try much to develop and work out plans to engage the combat veterans. Though most of these veterans may seem uninterested, healthcare personnel can understand, recognize, and assess this vulnerable group’s importance, thus instigating health promotion plans and services also aimed to support military family wellbeing. The CBPR health project is aimed at collecting research to improve the lives of different vulnerable groups. An advantage of this research project includes exploring perceptions as well as overall knowledge from the combat veterans. CBPR joins with the community to make a comprehensive research of a vulnerable group, to minimize disparities. As stated above, this group is exposed to a lot of health problems that need attention. With the American generation influenced and defined by military war, more combat veterans qualify for VHA, but fewer are enrolled (Johnson &Koocher, 2017). Healthcare practitioners have no straight impact on combat veterans’ maintenance and care. The purpose of the health promotion plan is to address the needs of this vulnerable group because it’s a fact that half of their lives are usually at risk. Flexibility and awareness are some of the cons of implementing CBPR. As their health lives include more downs than ups, it’s better to know the limits of combat veterans and self-awareness. Some of the things that are likely to make a combat veteran not wanting to participate in this kind of project are the fact that many of them suffer from physical disabilities, like being on a wheelchair due to war injuries, while others are experiencing brain injuries, sprains and strains and so on (Westphal& Convoy, 2015). Ethical issues can serve as barriers, or cons of implementing the CBPR project. Reason being that combat veterans are mindful of ethical implications. Confidentiality is a factor that this group doesn’t want to endanger, so they stay tight and hold up information. Combat veterans’ ethical practices (personal and professional) are liable on actual submission of private and cultural scruples as well as professional rules (Oster et al. 2019). They are not allowed to share any information outside their job areas, so implementing the health promotion plan to people who often and hardly share information based on their workplaces is hard. Culture can also serve as a con because not every person or combat veteran exhibits cultural beliefs and behavior characteristics. References Johnson, W. B., &Koocher, G. P. (2017). Ethical issues in the treatment of suicidal military personnel and veterans. Retrieved from Oster, C., Lawn, S., & Waddell, E. (2019). Delivering services to the families of Veterans of current conflicts: a rapid review of outcomes for Veterans. Journal of Military, Veteran and Family Health, 5(2), 159-175. Retrieved from Westphal, R., & Convoy, S. (2015). Military culture implications for mental health and nursing care. OJIN: The Online Journal of Issues in Nursing, 20(1), 47-54. Retrieved from
REPLY POSTS:Reply separately to two of your classmates posts (See attached classmates posts, post#1 and post#2). When replying to your peers, think about the ethical considerations related to research
POST #1 JENIFER The purpose of this discussion is to weigh the pros and cons of the implementation of a Community-Based Participatory Research (CBPR) health promotion project with the homeless adolescent and young adult vulnerable population. Also, this discussion will consider the benefits of the actions of this vulnerable population in a CBPR health promotion project and how their active role is important. Lastly, this discussion post will examine this vulnerable population’s health disparities and health inequities on the ability of a program to be successful.       Homeless adolescents and young adults depend on shelters, food banks, and community clinics as their health assets to optimize their health. Schooling, which includes nurses, free meals, shelter, and education, can increase this vulnerable population’s health promotion. This vulnerable population’s health problems start with the lack of basic needs such as food, shelter, and health education. This sets this population up to fail at health promotion. Unfortunately, as Podschun (1993) and Woan et al. (2013) discuss in their studies, this population’s health problems also stem from risky behaviors such as drug use, needle sharing, decreased condom use, and increased number of sexual partners. The risky behaviors accompanied by limited available access to health care leaves this population at risk for disease, illness, and unhealthy habits. This population can not access health care due to cost, feeling judged, having a lack of trust with providers, and not having time off from work to seek care (Woan et al., 2013). Podschun (1993) reviewed multiple studies that confirmed this vulnerable population engaged in risky behaviors that set themselves up for health problems such as HIV. However, even with lack of education, lack of healthcare and increased risks of developing diseases, homeless adolescents and young adults are resilient. They learn to live with minimum resources, become empowered to heal with the least amount of resources, and learn from other teen homeless role models on how to live their best health promoting life. Teen outreach programs provide a means to improve the homeless adolescent and young adult’s lives. These programs provide resources, education, and interventions to increase this vulnerable population’s health promotion and disease prevention.       The CBPR is one way to promote and increase health promotion in this vulnerable population’s community. This research method includes participants from this vulnerable community to have a voice in the needed social changes in their community. The goal of these changes is to increase health promotion, empower, and increase knowledge in this vulnerable population. As Pender et al., (2015) states, CBPR will only be successful if through community analysis, the community must be thoroughly involved. This type of research will fail if it does not include the community’s input. Wallerstein and Duran (2010) discuss that CBPR will be most successful if the community members decide on the intervention, the community members are valued, the community’s cultural values and beliefs are respected, and there is a concrete plan when grant funding ends.      As we consider the implementation of a Community-Based Participatory Research health promotion project with the homeless adolescents and young adults, as future Advanced Practice Registered Nurses (APRNs), we must examine the pros and cons. The homeless adolescents and young adults have shown empowerment, motivation, and continued support through teen outreach programs. The “Teen Peer Outreach-Street Work Project” is one intervention that could be from a Community Based Participatory Research health promotion project. This vulnerable population might consider this intervention as a means to increase their health promotion. The program is based on teen homeless participants becoming educators for other young adolescents and young adults. This provides a sense of cultural respect. The students and the educators share a common culture and the educators know how the students feel (Podschun, 1993). Due to a high rate of low literacy skills, the program used HIV learning materials with “high-impact coloration, photographs, and symbols” (Podschun, 1993). The pros to this health promotion project is that the vulnerable population decided on the intervention. This group decided that homeless teens would become more empowered and more eager to learn if fellow homeless teens taught them. The group was valued and the program is based on homeless teens teaching other homeless teens. The program incorporated this population’s language and made teaching materials based on their literacy level. As a result of the community population being involved, respected, listened to and valued, this study determined they could educate 1,000 homeless teens in one year (Podschun, 1993).       The cons of CBPR health promotion projects must be considered when assessing how long programs can maintain productivity. These teen programs need continued participants to be active in their roles as educators. This requires younger homeless children stepping up and being the next teen educator or teens that were students to become educators. If this cycle stops, this program will lack valuable educators. Another con comes from grant funding. If these teen programs are based on grant funding, will the community educators continue these programs without funding?  This program might face the challenge of sustainability. As Wallerstein and Duran (2010) discuss, there needs to be attention placed on the program and resources or a barrier to sustain the intervention will surface. A back up plan must be in place for these crucial programs to stay open. Also, the teens must trust the researchers in these teen outreach programs. If not, they will not return for education, support or to show the researcher what they have learned, or how their health promotion has improved (Wallerstein & Duran, 2010).       The homeless adolescent and young adult’s health disparities and inequities can both hinder and benefit the success of CBPR health promotion projects. There are many different areas that can be researched on the homeless adolescent and young adult population. From poverty to lack of healthcare to lack of health literacy to risky health behaviors, researchers have an array of areas to choose. Researchers might have gratification from their research projects if improvements in health promotion were achieved through their projects. However, this vulnerable population might not have the qualifications for research funding or the means to be researched. For example, per Pender et al. (2015), when setting up screenings for certain populations, the specific population must be taken into consideration. Some populations have an increased or decreased attendance to participate in screenings (Pender et al., 2010). Another reason CBPR health promotion projects might not benefit from researching this population is due to inability to participate. If transportation is necessary to be interviewed, assessed or to go to the project setting, then this population might not be able to participate. This population might be able to do what the researcher wants them to do. They might not have the healthy food choices, ability to exercise, or ability to sleep as directed from the researcher. Also, researchers take on an extra layer of work when researching these vulnerable populations. Vulnerable populations bear watching from different ethical organizations to ensure they are being treated properly and not taken advantage of.        Implementation of a CBPR health promotion project with the homeless adolescent and young adult vulnerable population could improve this population’s health promotion. Continuing the motivation and empowerment from this population and maintaining an active role of its participants would bring more success to adolescent and young adult programs. Due to this vulnerable population’s health disparities and inequities, there are many areas to increase this population’s health promotion and disease prevention. Funding, trust, and continued community involvement will increase the success of these CBPR’s health promotion projects.                                                                                     Reference Pender, N., Murdaugh, C., Parsons, M.,(2015).Health Promotion and Nursing Practice (7th edition). Pearson Education Podschun, G. (1993). Teen Peer Outreach-Street Work Project: HIV prevention education for runaway and homeless youth. Retrieved May 17, 2020, from Wallerstein, N., & Duran, B. (2010). Community-Based Participatory Research Contributions to Intervention Research: The Intersection of Science and Practice to Improve Health Equity. American Journal of Public Health, 100(S1). doi:10.2105/ajph.2009.184036 Woan, J., Lin, J., & Auerswald, C. (2013). The Health Status of Street Children and Youth in Low- and Middle-Income Countries: A Systematic Review of the Literature. Journal of Adolescent Health, 53(3). doi:10.1016/j.jadohealth.2013.03.013 1358 words
REPLY POSTS:Reply separately to two of your classmates posts (See attached classmates posts, post#1 and post#2). When replying to your peers, think about the ethical considerations related to research
POST #2 OKEKE Patient-centered care and effective communication is key in developing a collaborative relationship with patients and is especially important in the care of vulnerable patients. Homeless people are a vulnerable population that is underserved, medically disadvantaged, and poverty-stricken, making them increasingly susceptible to health problems and worse health outcomes. Homelessness remains a prevalent, pervasive public health issue in the United States despite years of legal and policy interventions offering short- and long-term solutions (Hodge Jr., DiPietro, & Horton-Newell, 2017). Many homeless individuals lack resources to enhance their ability to maintain and sustain health and well-being. Therefore, homeless people have high rates of chronic disease and acute illnesses, often associated with, or exacerbated by, their living situations (Morrison,2009). A considerable amount of published research on the health status and conditions of homeless persons also shows that they have a broad range of mental health and substance use needs (SAMHSA, 2011). They lack healthy lifestyles and are distrustful of the health system and health care providers, thus resulting in late-stage seeking to treat for chronic conditions.According to a study conducted by Whitney (2013), most homeless people have a very strong aversion to medical care. This is often based on previous failed or disparaging encounters in the health system, including misdiagnosis, iatrogenesis, and discrimination, leading to both fear and loathing of professional health care. Increased exposure to violence, malnutrition, extreme weather, and criminal charges are additional risk factors for homeless persons, contributing to poor health outcomes and premature death. Services critical to homeless persons, including adult dental care, case management, and housing support are needed. Additionally communities need to increase mental health and substance abuse treatment capacity, change laws that criminalize mental illness and addiction, and prioritize permanent and supportive housing over emergency shelters to help improve their quality of life (Hodge Jr., DiPietro, & Horton-Newell, 2017).Community- Based Participatory Research (CBPR) is known to be an effective research process when conducting research with members of vulnerable populations. This approach is beneficial because the vulnerable populations being researched are working alongside researchers. CBPR allows vulnerable populations to be empowered. Homeless persons can advocate for increase access to health care, housing, and support for mental health and substance abuse concerns. Voicing their concerns, ideas for change and sharing their personal experiences can help further elicit change in their community. Health disparities and inequities in the homeless population can benefit the project’s success because many of them may be motivated for change because they want consistent food and housing security, access to health care, and improved quality of life. However, the project’s success can be hindered by the distrusting mindset of the homeless population. They may have lost hope or are unmotivated because of their past negative experiences with medical professionals. Disadvantages of CBPR also include increased time to develop trusting relationships with community members, or exclusion of a vast amount of members of the vulnerable population, to adequately represent the population. Therefore results may not be inclusive of the majority of the vulnerable population. Although the vulnerable share characteristics making them vulnerable to health concerns, they remain unique. Researchers should be mindful of this when conducting community-based participatory research. Nonetheless, CBPR is crucial in addressing health disparities in socially disadvantaged population groups and an ideal way to fight for health equity.                                                                       References D.S. Morrison. (2009). “Homelessness as an Independent Risk Factor for Mortality: Results from a Retrospective Cohort Study,” International Journal of Epidemiology 28, no.3. 877-883.Hodge Jr., J. G., DiPietro, B., & Horton-Newell, A. E. (2017). Homelessness and the Public’s Health: Legal Responses. Journal of Law, Medicine & Ethics, 45, 28–32. Department of Substance Abuse and Mental Health Services Administration (SAMHSA) (2011).Whitley, R. (2013). Fear and loathing in New England: examining the health-care perspectives of homeless people in rural areas. Anthropology & Medicine, 20(3), 232–243.

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