Running head: BREVARD COUNTY- COMMUNITY BASED INTERVENTIONS ON

Brevard County- Community Based Interventions on STDs

Ashley Kavumkal
University of South Florida

November 22, 2015

BREVARD COUNTY- COMMUNITY BASED INTERVENTIONS ON

Brevard County- Community Based Interventions on STDs

The purpose of this study is to describe evidence based community interventions on a
selected population. This study selected Brevard County which is one of the 67 counties in
Florida. According to City-Data (2015), Brevard County has a land area of 1,018 square miles as
of 2012 with 95 % of the population being urban and five percent rural. The county total
population is estimated to be 545,667 as of 2013. As of 2014, the school board of Brevard is the
topmost among the major employers of the county with 8,222 employees, the united space
alliance with 6,400 employees being the second, and Health First hospital with approximately
5,958 employees being the third in line. Among the many healthcare systems in Brevard County,
Health First is one of the topmost with hospitals, specialty services, affiliated centers and
community partners. As of 2013, 15% of the residents in Brevard County live below the poverty
level compared to the rate of the state of Florida which is 17%. According to the County Health
Rankings of 2015, Brevard County has approximately 85% of people who are 25 years or older
with a high school degree compared to the Florida rate of 75%. As of 2013, 3.2% of people in the
county who are greater than the age of five do not speak English compared to 11.7% in Florida.
This study identifies statistical evidence and evaluates the health needs and risks of Brevard
County so as to find out what interventions could be implemented to support the needs of this
county.
Analysis of strengths and weaknesses based on health indicators of Brevard County
Strength one: Access to food is one of the strengths among the health indicators of
Brevard County which is one of the most important and basic factors that indicate good health.
promotes healthy body and clear cognitive thinking. According to the county health ranking,
Brevard county rating is at 6.7% in terms of access to food compared to 7.0% of the state of

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Florida (2015). In addition, the government also supports the countys facilities with nutritional
food programs for the needy at low or no cost.
Strength two: Free family planning programs are made available by the countys health
department for all women. Such services also maintain high confidentiality to safeguard the
privacy of the women. Educational sessions, laboratory tests, physical examinations and
teachings are the main services provided along with counseling and birth control methods. . The
main intention or goal is to educate women about preventing unexpected pregnancy. The
counseling sessions not only teach about healthy family planning but also talks about how to deal
with any treatable disease. As of the 2013 National Center for Health statistic, unexpected
pregnancy could be distressful for the individual as well as the society.
Strength three: Another strength is that Brevard County highly promotes prevention of
diseases. The health department makes sure that vaccinations are available through various
healthcare centers and clinics. According to the 2014 statistics provided by the Florida health
department, the immunization coverage rate for children of age up to 2 years is 96% which is
above the goal of state of Florida which is 95%.
Weakness one: One of the weaknesses is that the county has a rate of 29% for adult
obesity which out numbers the rate of adult obesity in the state of Florida which is 26% (Florida
County Health Ranking, 2015). Obesity has become a major health issue mainly because it leads
to many other serious health problems like hypertension, diabetes, cardiac diseases, vascular
diseases etc. Even though Brevard County has numerous fitness centers and other opportunities
for physical activity such as parks, not a lot of people are utilizing it well enough.
Weakness two: Another weakness is that the rate of smoking in Brevard County is higher
than the state rate. According to the Florida County Health Rating of 2015, Brevard County has
an estimate of 22% adult smokers compared to the Florida state rate of 18%. Smoking is another

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health issue that can lead to severe killer diseases such as lung cancer. Another drawback of
smoking is that it affects not only the smoker but also the people around him/her which is called
second hand smoke.
Weakness three: Another weakness is the rate of Sexually Transmitted Diseases (STDs)
in Brevard County. According to the 2015 county health ranking, 321 per 100,000 people in
Brevard County has reported sexually transmitted diseases compared to 402 per 100,000 people
for the state of Florida. Even though the number is less than the state rate this is a serious issue
that needs to be brought to attention as STDs spread very quickly due to unhealthy sexual
practices and lack of proper awareness.
Priority Health Issue-Among the three weaknesses mentioned above, this paper will
focus on STDs and HIV among the adolescent/ young population of Brevard County. This is an
important focus as the priority of health because of its very nature of spreading quickly. Being an
attraction for tourists Brevard County has numerous opportunities for entertainment such as night
clubs, pubs, beaches etc. which are also accessed by the young population. As mentioned
previously, the rate of STDs in Brevard county this year was 321 per 100,000 people and the
trend shows that the rate is increasing tremendously (Florida County Health Ranking, 2015).
Appropriate interventions and proper teaching must be applied among the young generation to
create awareness since they are the most vulnerable population.
Discussion of Community Health Model
Determinants of the Health Model
Healthy people 2020, is a huge government project that focuses on examining and
addressing correlation of elements such as genetic, biological, physical, individual behavior,
social environment, health services and its outcomes (2015). The health model will help the

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nurse to compare and assess the health outcomes of a community on an individual basis as well
as the community as a whole. In addition, this model will also serve as an outline upon which the
care can be coordinated in terms of planning, assessing, implementing, evaluating etc.
Population Diagnosis
The population diagnosis for the youngsters in Brevard County is the increasing rate of
STDs. In the case of Brevard County, the factors that contribute to STDs/HIV among young
population are environment, lifestyle and human biology. Environment and lifestyle factors
include the use of alcohol, drugs and smoking which contributes greatly to the occurrence of
STDs as it elevates sexual desires among the users by impairing their cognitive ability at the time
of use. Majority of the students live away from their parents and engage in illogical activities due
to peer pressure and lack of adult supervision. Thompson- a reporter from The Atlantic mentions
that spring breaks are the time when there is a surge in social behavior disorder along with an
increase in the rate of unsafe sexual activities (2013). Even though numerous health resources
are available for help, most youngsters hesitate to make use of it because of the fear of stigma.
According to CDC (2013), biological factor is a major contributor to STDs in that most STDs go
unnoticed due to the absence of symptoms or late symptoms which delays identification and
proper treatment at the right time. A study done by Henderhot et al in 2010 shows that one of the
topmost contributing factors of STDs are from the use of Marijuana on an average adolescent
age of 16.7.
Population-based intervention
According to the 2015 data by Florida charts Brevard County is at huge risk being in the
95th percentile based on the new cases of STDs reported. 19 million new cases are reported each
year in the united states. Due to the increasing number of reported cases of STDs in Brevard
County, this study will be focusing on young population of the county who is at risk for STDs.

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Primary level: Just like any other health issue, the initial or primary step is the
prevention of STDs by bringing the issue to the attention of those who are not affected yet and
are at high risk. For this, the main intervention is to educate the young population about unsafe
sexual practices that contributes to STDs. There is no disease at this state and for the community
nurse, the main concern is to educate adolescent about those behaviors that are unsafe and can
lead to STDs. CDC offers a great STD awareness campaign called Get Yourself Tested, focusing
on the young people to educate them about prevention of STDs (2015). This program also links
students to local testing services and promotes a friendly atmosphere for students to openly
communicate their concerns to healthcare providers. This is a great resource that can be used in
Brevard County which will help to get hold of the public officials and legislators in order to
bring regulations for contributing factors of STDs/ HIV such as alcohol, drugs etc. Church
communities or group for youth would be another stakeholder to be approached as they can
hugely influence the youngsters by creating awareness on a spiritual basis.
Secondary level: At this level the interventions should be aimed on the population that is
already affected. The recipients at this level will be the affected individuals and their families.
The intervention will be geared towards the healthcare providers and Funding sources because at
this level the focus will be on screening, diagnosis and treatment of the affected individual which
requires support from the healthcare providers and financial backup. The school board and public
officials must also be involved to ensure proper reporting of cases by maintaining confidentiality.
The goal of the community nurse at this level is to assist the individual during screening and
treatment and help them achieve good health if possible and to ensure recurrence does not occur.
As recommended by Mayo Clinic (2015), all individuals at risk including people with new,
multiple or same sex partners must be screened for STDs/HIV.

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Tertiary level: At this level, the intervention should be aimed on individuals who are
affected severely by STD/HIV for whom returning to the normal health level is impossible. In
this case community nurse should focus on providing palliative care and emotional support for
the individuals and their family and relatives (recipients) to ensure good quality care even in
such a situation. The nursing interventions include helping the individual to adhere to the
medication regimen which will help to reduce the viral load in case of HIV and to monitor for
any progression to AIDs (Mayo Clinic, 2015). The nurse could also educate the individual and
caretakers/family to anticipate and avoid any environmental factors that can further deteriorate
the immune system of the immunocompromised patient. The stakeholders at this level could be
the community members who can provide a positive and supportive environment to the patient
and family, public officials/agency which can arrange a financial plan for the affected and the
healthcare providers who can ensure full medical support throughout the situation.
Health Policy Proposal
The purpose of the health policies is to create a positive impact on the population of focus
based on the health issues. This is aimed for the benefit of the society on an individual as well as
community basis in a safe and practical way in terms of their health needs. STDs being a serious
health concern in Brevard County, a desired goal of the health policy would be to decrease the
incidence of STDs among the young population in this county by ensuring active participation of
the community members especially youngsters. The main intervention of focus is the primary
level intervention which is prevention by educating and creating awareness among youngsters
regarding safe sex practices to avoid STDs. The desired outcome expected from this intervention
is a decrease in the rate of STDs among youngsters in Brevard County. The stakeholders will be
the community members including the affected, their families, individuals at risk, school and
college board, healthcare facilities and providers, public officials and funding resources who all

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can contribute their little to create awareness to prevent/ minimize this issue. Media being a huge
influence among youngsters, television channels and celebrities can be approached for support
and promotion and to create a large-scale impact. Other support can come from the government
by allowing sexual education speeches at schools and colleges. Oppositions could be from
parents or conservatives whose values could be conflicting to the idea of teaching students about
the topic of sex.
The focus of the action plan will be safety in sexual practices. The first step to put the
policy into action will be at the school level to arrange a board meeting which includes parents
and student representatives to discuss the safety aspect of sexual practices among students and
making sure that resources (such as free condoms) and support will be made available by the
authorities to the affected/at risk population in such a way that is easily accessible to the students
without any bias. Thus, this will be a good start for the health policy being beneficial for Brevard
County on an individual as well as community basis.
Conclusion
The focus of this study is the increasing rate of STDs among the young generation in
Brevard County due to factors such as environment and lifestyle of this population. The role of
the community nurse in this issue is to create awareness among the community regarding the
need of prevention/ reduction of the incidence of STDs and to ensure that proper resources are
available for the affected/ at risk population to allow proper screening and treatment and to avoid
recurrence of the same. Active participation and contribution of the community and the
stakeholders is required to reach the goal of reduction of the rate of STDs in Brevard County.

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