Student Name Walden University NURS 6050 – Policy and Advocacy for Improving Population Health Prof. Name Date Reassessment of Global Health Issue: Obesity Description of the Issue Obesity has become one of the most pressing global health challenges of our time, affecting millions across all continents. According to the World Health Organization (WHO, 2021), nearly 1.9 billion people worldwide were classified as overweight in 2016, reflecting a significant rise in obesity rates over recent decades. Defined as an excessive accumulation of body fat detrimental to health, obesity contributes not only to increased individual morbidity and mortality but also exerts substantial pressure on healthcare systems and national economies globally. Particularly alarming is its disproportionate effect on low- and middle-income countries, which face the dual burden of undernutrition and overnutrition, complicating public health responses (Caballero, 2019). Addressing obesity demands urgent and coordinated international interventions tailored to diverse social, economic, and cultural contexts. Country-Specific Policies on Obesity How have different countries addressed obesity through policies? Various countries have developed distinct strategies to tackle obesity, focusing on prevention, regulation, and public awareness. Below is a summary of policies implemented in the United States and Canada, highlighting their strengths and limitations: Country Policy Description Strengths Weaknesses United States The U.S. has initiated multiple programs targeting childhood obesity. The “Let’s Move!” campaign, launched by Michelle Obama in 2010, promotes physical activity and healthy eating. Additionally, the “Healthy, Hunger-Free Kids Act of 2010” establishes nutritional standards for school meals, monitored by the USDA. The CDC also funds community interventions, such as the Childhood Obesity Research Demonstration (CORD) project (Bradwisch et al., 2020). A comprehensive approach focusing on nutrition and physical activity; strong support for community programs Many policies are voluntary; inconsistent implementation across states and regions limits overall effectiveness Canada Canada targets obesity through a range of policies, including the “Sugary Drink Tax,” regulations on fast-food outlets through the “Fast Food Restaurant Act,” and the “Marketing of Unhealthy Foods to Children Act” to curb unhealthy consumption (Kao et al., 2020). Uses economic incentives to reduce unhealthy behaviors; regulates fast-food density and advertising to children Taxation policies may disproportionately burden lower-income populations; assessing overall policy impact remains challenging How Do Social Determinants of Health Affect Obesity Rates? Social determinants—such as education, income, and socioeconomic inequalities—are pivotal factors influencing obesity prevalence. Both in the U.S. and Canada, lower levels of education and higher income disparities correlate strongly with increased obesity risks (Golden, 2021; CDC, 2023). These disparities highlight the necessity for obesity prevention strategies that go beyond individual behavior changes and incorporate structural solutions aimed at reducing social inequities. Without addressing these root causes, efforts to reduce obesity may be ineffective or exacerbate existing health disparities. What Is the Impact of Obesity on Local Health Organizations and Policies? The widespread consequences of obesity compel local health organizations to adapt their resources and strategic priorities. In the U.S., efforts largely emphasize primary prevention and health education, yet these programs often face funding limitations and uneven implementation across communities (Feng & Martin, 2020). In contrast, Canadian health services pursue more integrated models that combine prevention with accessible treatment options, reflecting the country’s universal healthcare system and broader public health focus (Lytvyak et al., 2022). These contrasting approaches illustrate how health system structures and policy environments shape the capacity to manage obesity at the local level. How Do Obesity Policies Affect the Global Population? Canada’s policy measures targeting obesity—such as taxing sugary beverages and regulating food marketing—have implications far beyond its borders. These strategies serve as successful examples for other nations seeking to curb obesity rates through evidence-based interventions. Global health initiatives benefit from knowledge-sharing and collaborative efforts that adapt effective national policies into culturally and economically appropriate frameworks worldwide (Ríos-Reyna et al., 2022). Consequently, coordinated international policy exchange plays a critical role in advancing global obesity prevention and control. What Is the Role of Nurses as Advocates in Addressing Obesity? Nurses hold a crucial position in obesity advocacy, acting as frontline agents in promoting healthful behaviors and influencing public health policy. In the U.S., nurses focus on educating individuals and communities about nutrition and physical activity, supporting lifestyle modifications to prevent obesity (Chang et al., 2021). Canadian nurses extend this role by actively participating in systemic advocacy, promoting public health measures and policy changes that address obesity’s broader social determinants. This expanded scope underscores nurses’ essential contribution to multi-level strategies aimed at reducing obesity prevalence. Conclusion Effectively combating the global obesity epidemic requires multifaceted approaches that consider social determinants of health and adapt to diverse national contexts. Both the United States and Canada provide insightful examples of policy interventions, each with distinctive strengths and challenges shaped by their health systems and socio-political landscapes. Continued international collaboration, rigorous evaluation of policy outcomes, and dissemination of best practices are vital to mitigating obesity’s worldwide burden and fostering healthier populations. References Berry, E. M. (2020). The Obesity Pandemic-Whose Responsibility? No Blame, No Shame, Not More of the Same. Frontiers in Nutrition, 7, 2. https://doi.org/10.3389/fnut.2020.00002 Bradwisch, S. A., Smith, E. M., Mooney, C., & Scaccia, D. (2020). Obesity in children and adolescents: An overview. Nursing, 50(11), 60–66. https://doi.org/10.1097/01.NURSE.0000718908.20119.01 Caballero, B. (2019). Humans against Obesity: Who Will Win? Advances in Nutrition, 10(suppl_1), S4–S9. https://doi.org/10.1093/advances/nmy055 Centers for Disease Control and Prevention. (2019). Policy Resources. https://www.cdc.gov/nccdphp/dnpao/divisioninformation/policy/index.htm Chang, W. P., Wang, C. H., & Lin, Y. K. (2021). Influence of Obesity on Heart Rate Variability in Nurses with Age and Shift Type as Moderators. BioMed Research International, 2021, 8119929. https://doi.org/10.1155/2021/8119929 Feng, W., & Martin, E. G. (2020). Fighting obesity at the local level? An analysis of predictors of local health departments’ policy involvement. Preventive Medicine, 133, 106006. https://doi.org/10.1016/j.ypmed.2020.106006 Golden, A. (2021). Obesity’s Impact. The Nursing Clinics of North America, 56(4), xiii–xiv. https://doi.org/10.1016/j.cnur.2021.08.004 Kao, K. E., Jones, A. C., Ohinmaa, A., & Paulden, M. (2020). The health and financial impacts of a sugary drink tax across different income groups in Canada. Economics & Human Biology, 38, 100869. https://www.sciencedirect.com/science/article/pii/S1570677X19302746 Lytvyak, E., Straube, S., Modi, R., & Lee, K. K. (2022). Trends in obesity across Canada from 2005 to 2018: a consecutive cross-sectional population-based study. CMAJ Open,

Student Name Walden University NURS 6050 – Policy and Advocacy for Improving Population Health Prof. Name Date Healthcare Program/Policy Evaluation: Falls and Incident/Accident Reporting at Crestpark Nursing Home, LLC, Spring of 2021 Description Falls and unexpected incidents remain among the most pressing safety concerns in long-term care facilities. Within settings such as Crestpark Nursing Home, LLC, these events can significantly affect residents’ quality of life, often resulting in injuries, loss of independence, hospital transfers, and psychological distress. During the spring of 2021, Crestpark implemented a structured fall-prevention program combined with a standardized incident/accident reporting policy aimed at strengthening resident safety practices. This evaluation explores how effectively those measures were executed, the quality of the reporting process, and how well the program aligned with broader patient-safety goals. Emphasis was placed not only on identifying trends in fall occurrences but also on understanding how the interdisciplinary team collaborated to mitigate risks and enhance preventive strategies. What Are the Healthcare Program/Policy Outcomes? The intended outcomes of Crestpark’s fall-prevention and reporting policies centered on two major goals: (1) lowering the frequency of resident falls and (2) minimizing the severity of injuries when falls occurred. Given that long-term care residents often experience gait instability, cognitive decline, and chronic health conditions, falls are a common clinical concern. To achieve these desired outcomes, each fall event underwent a structured evaluation by an interdisciplinary team—including nurses, rehabilitation specialists, and administrative personnel. The team assessed environmental, medical, and functional factors contributing to each incident. From these assessments, individualized, evidence-based care plans were developed to better protect residents and prevent recurrence. The policy aimed not only to reduce immediate harm but also to create long-term safety cultures within the facility. How Is the Success of the Healthcare Program/Policy Measured? Success was measured through continuous performance-monitoring methods embedded in Crestpark’s Quality Improvement (QI) structure. Quarterly QI meetings served as dedicated forums where trends, case reviews, and staff concerns were examined. In these meetings, the interdisciplinary team reviewed: Additionally, qualitative feedback from families, residents, and staff members offered insight into perceived safety improvements and operational shortcomings. A successful evaluation was indicated by a clear reduction in fall rates, improved documentation practices, and enhanced staff responsiveness to safety issues. Who Are the People Reached by This Evaluation? This evaluation directly and indirectly influenced approximately 300 individuals, including residents, nursing and support staff, administrative leadership, and family members. Residents benefited from safer environments and more proactive monitoring. Staff benefited from updated training expectations and clearer reporting guidelines, which in turn supported more coordinated care. Family members were also included, recognizing that they contribute important perspectives about residents’ functional changes, preferences, and safety needs. When Was the Evaluation Conducted? At Crestpark Nursing Home, LLC, evaluations occur routinely on a quarterly basis. However, the March 2021 evaluation carried unique significance because it marked the first comprehensive QI review following a nearly seven-month gap created by COVID-19 disruptions. The pandemic had altered staffing patterns, visitation procedures, and care workflows, making this evaluation critical in reassessing resident safety post-disruption. Additional assessments were conducted as needed when adverse events occurred or when staff identified emerging safety concerns. What Data Sources Were Used? A wide range of data sources informed the evaluation to ensure rigor and accuracy. These included: By triangulating clinical and administrative data, the evaluation provided a comprehensive understanding of the factors contributing to falls and allowed the team to identify recurring patterns, such as medication interactions, environmental hazards, or mobility impairments. What Are the Potential Benefits and Unintended Consequences of the Evaluation? Benefits:One of the major benefits identified was the requirement for immediate fall notification, which facilitated quick response times and ensured that residents received prompt assessments. Newly licensed nurses especially benefited from structured protocols, enabling them to gain confidence while ensuring patient safety. The evaluation also increased transparency and accountability among team members by encouraging consistent reporting practices. Unintended Consequences:Despite these benefits, the policy produced some unintended emotional and professional tensions. Experienced nurses expressed feelings of being overly scrutinized when falls occurred under their care. This sentiment occasionally led to reduced morale. To address this, leadership used the evaluation period to emphasize collaborative problem-solving rather than individual blame. Team-based discussions helped reframe fall events as system-level issues rather than personal shortcomings. Who Are the Stakeholders Involved in the Evaluation? The evaluation process included a broad array of stakeholders: Each stakeholder category played a distinct role in shaping policy implementation and providing feedback used to refine safety practices. How Successful Was the Evaluation? Based on the results reviewed during the spring 2021 QI meeting, the evaluation demonstrated meaningful improvements, including a reduction in the total number of falls and enhanced resident mobility due to increased therapy engagement and individualized interventions. Additionally, incident reporting rates became more accurate and comprehensive. The evaluation confirmed that the policies in place were contributing positively to long-term safety outcomes and fostering a more proactive patient-safety culture. What Recommendations Were Made Regarding the Policy? The evaluation supported the continuation of the existing policies due to their positive impact on safety outcomes. Recommendations included: These recommendations aimed to reinforce safety culture while ensuring that policies evolve in response to resident needs and clinical best practices. PA005 Healthcare Program/Policy Evaluation How Could Nurses Be Involved in Future Evaluations? Nurses will continue to play a central role in future evaluations, especially as frontline observers of resident behavior and environmental safety. Expanding nurse involvement can be achieved through: These efforts would ensure that nurses’ firsthand knowledge informs ongoing policy refinement, strengthening both safety outcomes and interdisciplinary collaboration. Summary Table: Evaluation Overview Aspect Details Program/Policy Focus Fall prevention and incident/accident reporting at Crestpark Nursing Home Evaluation Period Spring 2021 (major review in March following COVID-19-related gap) Number of People Reached ~300 residents, staff members, and family participants Data Sources Incident reports, medical charts, hospital transfer records, imaging, rehabilitation data Stakeholders Residents, families, nursing staff, administration, therapists, social workers Outcomes Lower fall rates; improved mobility; enhanced reporting accuracy Success Measurement Quarterly QI meetings, trend reviews, stakeholder feedback Benefits Faster fall response, stronger

Student Name Walden University NURS 6050 – Policy and Advocacy for Improving Population Health Prof. Name Date PA004 Design and Implementation Healthcare Program Summary Hospital-acquired infection (HAI) prevention programs are structured initiatives designed to reduce the incidence of infections that patients acquire during the course of receiving medical treatment for other conditions. HAIs remain a persistent public health challenge, affecting not only hospitals but also ambulatory surgical centers, rehabilitation facilities, and long-term care organizations. These infections contribute substantially to patient morbidity, mortality, and unnecessary resource utilization. According to recent estimates, more than half a million patients in the United States experience HAIs every year, highlighting the need for robust, evidence-based prevention strategies (Haque et al., 2020). The program aims to mitigate several priority infections, including central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), surgical site infections (SSIs), ventilator-associated pneumonia (VAP), Clostridioides difficile (C. difficile) infections, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and tuberculosis (TB). The estimated annual cost to sustain this initiative is approximately $1,500, primarily allocated toward employing an infection prevention nurse responsible for protocol development, education, and staff competency assessments. Additional expenditures include staff training sessions, procurement of personal protective equipment (PPE), environmental sanitation supplies, and patient education materials. Overall, the program intends to decrease infection rates, elevate staff and patient awareness, reduce antibiotic resistance, minimize complications, and lower avoidable healthcare expenditures. By fostering a culture of safety, the program ultimately enhances patient outcomes and strengthens quality of care. Target Population The program’s primary beneficiaries are individuals receiving care in any healthcare setting. However, certain patient groups are recognized as particularly vulnerable and thus remain the focus of intensified monitoring. These high-risk populations include individuals undergoing surgical procedures, patients with indwelling medical devices such as urinary catheters or central lines, those receiving broad-spectrum antibiotics, and individuals with suppressed immune function. Although these groups face heightened susceptibility, the program acknowledges that HAIs can affect any patient, reinforcing the need for universal prevention strategies. Nurse’s Role in Program Design Nurses serve as foundational contributors to the creation and refinement of infection control initiatives. Because they maintain continuous patient contact, they collect essential clinical data, identify emerging infection trends, and report findings to interdisciplinary teams. Their insight from frontline experience allows the program to address real-world clinical challenges rather than theoretical assumptions. In addition, nurses are crucial educators who convey prevention strategies to patients, families, and healthcare personnel, ensuring that communication is clear and understandable (Flaubert et al., 2021). Their involvement in protocol development ensures that policies are practical, feasible, and aligned with evidence-based standards. Nurse Advocacy for the Target Population Nursing advocacy plays a central role in safeguarding patients from preventable infections. Nurses routinely evaluate antimicrobial use, identify inappropriate prescribing patterns, and collaborate with prescribers to promote judicious antibiotic therapy. Through consistent monitoring of PPE use, adherence to isolation precautions, and reinforcement of hand hygiene standards, nurses protect both patients and healthcare workers. Their advocacy extends to addressing institutional barriers—such as inadequate supplies or outdated policies—that may compromise infection prevention efforts (Lee et al., 2021). How Does Advocacy Influence Program Design? Advocacy directly shapes program design by ensuring that patient needs, safety priorities, and ethical considerations are incorporated into prevention strategies. Through data-driven insights and patient-centered recommendations, nurses guide the development of interventions that reduce infection rates while supporting staff workflow. For example, advocating for enhanced hand hygiene training or improved PPE accessibility may lead to updates in program protocols. By emphasizing antimicrobial stewardship, nurses support strategies that address antibiotic resistance, an increasingly critical global concern. Recommended Evaluation Tools Infection Control Assessment and Response (ICAR) Tool The CDC ICAR tool is a comprehensive resource that healthcare facilities can use to assess current infection prevention practices, identify performance gaps, and support continuous quality improvement (CDC, 2019). The tool evaluates domains such as: This tool provides actionable recommendations and promotes alignment with national infection prevention standards. Healthcare Team Members Required Key Personnel and Roles The effectiveness of an HAI prevention program depends on a coordinated, multidisciplinary team. Each member contributes specialized expertise that supports the overall success of the initiative. Team Member Role Infection Control Nurses Lead program development, perform audits, provide staff training Physicians Offer clinical guidance and oversee infection management Pharmacists Monitor medication use and support antibiotic stewardship Environmental Services Staff Maintain cleaning, disinfection, and sanitation practices Administration Ensure resources, staffing, and policy support Occupational Health Personnel Monitor employee health and ensure PPE compliance Nurse’s Role in Program Implementation During implementation, nurses operationalize infection control policies by integrating them into daily practice. Responsibilities include delivering direct patient care based on infection control standards, educating patients and their families on preventive practices, monitoring compliance with hand hygiene and PPE guidelines, assisting in surveillance efforts, and documenting outcomes for ongoing evaluation. Nurses also provide real-time feedback to leadership teams, helping refine program components based on observed challenges. Comparison of Nurse’s Role: Design vs. Implementation Aspect Role in Program Design Role in Program Implementation Focus Planning, assessment, and strategic development Applying protocols and providing hands-on patient care Activities Developing guidelines, analyzing data, recommending resources Teaching patients/staff, monitoring compliance, reporting outcomes Contribution Advocating for evidence-based interventions Ensuring interventions are effectively executed References Centers for Disease Control and Prevention. (2019). Infection control assessment tools. https://www.cdc.gov/hai/prevent/infection-control-assessment-tools.html Centers for Disease Control and Prevention. (n.d.). Nursing home COVID-19 infection control assessment and response (ICAR) tool facilitator guide. Retrieved February 21, 2024, from https://www.cdc.gov/infectioncontrol/pdf/icar/nursing-home-icar-facilitator-guide.pdf Flaubert, J. L., Menestrel, S. L., Williams, D. R., & Wakefield, M. K. (2021). The role of nurses in improving health care access and quality. National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK573910/ PA004 Design and Implementation Haque, M., McKimm, J., Sartelli, M., Dhingra, S., Labricciosa, F. M., Islam, S., Jahan, D., Nusrat, T., Chowdhury, T. S., Coccolini, F., Iskandar, K., Catena, F., & Charan, J. (2020). Strategies to prevent healthcare-associated infections: A narrative overview. Risk Management and Healthcare Policy, 13(1), 1765–1780. https://doi.org/10.2147/RMHP.S269315 Lee, Y., Salahuddin, M., Gibson‐Young, L., & Oliver, G. D. (2021). Assessing personal protective equipment needs for healthcare workers. Health Science Reports, 4(3). https://doi.org/10.1002/hsr2.370

Student Name Walden University NURS 6050 – Policy and Advocacy for Improving Population Health Prof. Name Date Differences Between a Board of Nursing and Professional Nurse Associations A Board of Nursing (BON) serves as a state-mandated regulatory body responsible for overseeing and enforcing the legal standards that govern nursing practice. Established through state legislation—most commonly the Nurse Practice Act—the BON ensures that public safety remains the central priority in all nursing activities. This authority grants BONs the power to evaluate nursing education programs, issue and revoke licenses, investigate allegations of misconduct, and impose disciplinary actions when necessary. By performing these functions, BONs create a regulatory environment that safeguards the public and ensures that nurses practice in an ethical, competent, and accountable manner (Short & Loversidge, 2019; National Council of State Boards of Nursing, 2022). Professional Nurse Associations vs. Board of Nursing In contrast to the governmental and regulatory purpose of BONs, professional nurse associations exist as independent, member-supported organizations dedicated to advancing the profession rather than regulating it. These associations—such as the American Nurses Association (ANA) or specialty groups like the American Association of Critical-Care Nurses—focus on professional development, policy advocacy, continuing education, leadership building, and advancing evidence-based practice (American Nurses Association, 2021). Membership is voluntary, and participation in these organizations offers nurses opportunities to expand their expertise, influence healthcare policies, and engage with a community of peers. State boards of nursing, however, maintain a structure that reflects their statutory responsibilities. For example, the Florida Board of Nursing (FBON) is composed of appointed members, including licensed nurses, consumer representatives, and at least one member aged 60 or older. This balance ensures that decisions reflect both professional standards and the interests of the general public (Toney-Butler & Martin, 2021). Table 1 Comparison of Boards of Nursing and Professional Nurse Associations Feature Board of Nursing (BON) Professional Nurse Associations Primary Function Regulates nursing practice and protects public safety Advocates for nurses, supports professional development Authority Established by state law; empowered through Nurse Practice Act Functions as a private or non-profit entity Membership Automatic for licensed nurses; not optional Voluntary enrollment; dues or fees required Focus Areas Licensure, discipline, scope-of-practice rules, education program oversight Continuing education, leadership, networking, policy advocacy Beneficiaries Public consumers of healthcare Nursing professionals Examples State Boards of Nursing (e.g., FBON) ANA, specialty nursing associations Medical Necessity: A Federal Regulation of Healthcare Medical necessity is a federally guided principle used primarily by Medicare and other insurers to determine whether specific medical services are reasonable, appropriate, and eligible for reimbursement. Medicare defines medically necessary services as those essential for diagnosing, treating, or managing a medical condition, including restoring or improving bodily function (CMS, 2021; Verhovshek, 2019). This regulatory requirement plays a crucial role in shaping clinical decision-making, influencing the services patients can access, the timing of care delivery, and the level of financial coverage available. While medical necessity criteria promote consistency and help reduce misuse or unnecessary healthcare spending, they can also introduce barriers. Healthcare providers may face delays due to prior authorizations, extensive documentation requests, or rigid criteria that must be met before approval. These processes ensure evidence-based practice but may inadvertently contribute to treatment delays, administrative burden, and patient frustration. Nonetheless, adherence remains essential to ensure equitable, accountable, and high-quality care across federal healthcare programs. Regulation of Registered Nurses and Advanced Practice Nurse Practitioners in Florida The practice of Registered Nurses (RNs) and Advanced Practice Registered Nurses (APRNs) in Florida is governed by the Florida Nurse Practice Act, which outlines expectations for safe, ethical, and competent care. RNs must complete an approved nursing education program and pass the NCLEX-RN to demonstrate fundamental clinical competency. Their licensure must be renewed biennially, accompanied by mandatory continuing education requirements aimed at maintaining up-to-date knowledge and professional accountability (Florida Board of Nursing, 2022). APRNs undergo a more advanced regulatory pathway due to their expanded clinical roles. They must first hold an RN license, then obtain a graduate degree—typically a master’s or doctoral degree—from an accredited program. Additionally, APRNs must earn national board certification in their specialty area. Florida law requires APRNs who wish to practice independently to complete 3,000 hours of supervised clinical experience under a collaborative practice agreement before being eligible for autonomous practice status (Florida Board of Nursing, 2022). These layered regulatory requirements ensure that APRNs possess the advanced clinical reasoning, diagnostic skills, and specialized competencies necessary for independent and safe practice. Impact of Advanced Practice Nurse Practitioners on Healthcare Delivery, Costs, and Access Advanced Practice Registered Nurses (APRNs) are instrumental in improving healthcare accessibility, particularly in states such as Florida where growth in the older adult population and physician shortages heighten the need for expanded care models. APRNs deliver comprehensive care—diagnosing conditions, prescribing medications, and managing chronic diseases—thereby addressing gaps in primary care and meeting the needs of underserved and rural populations (Cleveland et al., 2019). APRNs also contribute significantly to cost-effective healthcare delivery. Research indicates that care provided by APRNs is of comparable quality to that provided by physicians, often at a lower overall cost. Their involvement helps reduce unnecessary emergency department visits, shorten wait times, and increase preventive care uptake. These advantages are particularly important in Florida, where chronic disease prevalence and long-term care needs continue to escalate. By maximizing APRN autonomy and integrating them fully into healthcare teams, states can enhance service efficiency, reduce system-wide costs, and ensure sustained high-quality outcomes for diverse patient populations. References American Nurses Association. (2021). American Nurses Association. https://www.nursingworld.org/ana/ Cleveland, K., Motter, T., & Smith, Y. (2019). Affordable care: Harnessing the power of nurses. OJIN: The Online Journal of Issues in Nursing, 24(2). https://doi.org/10.3912/ojin.vol24no02man02 Centers for Medicare & Medicaid Services. (2021). CMS. https://www.cms.gov/ Florida Board of Nursing. (2022). Licensing and registration. https://floridasnursing.gov/licensing/ National Council of State Boards of Nursing. (2022). Nursing regulation. https://www.ncsbn.org/boards.htm PA003 Regulation Short, N. M., & Loversidge, J. M. (2019). Government response: Regulation. In Health policy and politics: A nurse’s guide (6th ed., pp. 56–84). Jones & Bartlett Learning. Toney-Butler, T. J., & Martin, R. L. (2021). Florida Nurse Practice Act laws and rules. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK532859/ Verhovshek, J. V.

Student Name Walden University NURS 6050 – Policy and Advocacy for Improving Population Health Prof. Name Date Legislation Grid Template Health-Related Bill Name/Bill # Human Life Protection Act, HB 314 Description The Human Life Protection Act (HB 314) is a state-level legislative measure enacted in Alabama with the intent to prohibit nearly all abortion procedures within the state. The bill establishes strict parameters around reproductive healthcare by classifying the performance or attempted performance of an abortion as a felony offense. Its scope includes all stages of pregnancy, thereby making Alabama one of the states with the most restrictive abortion laws in the nation. Despite its comprehensive restrictions, HB 314 outlines limited medical exceptions. These include circumstances in which the pregnant individual faces significant risks to life or major bodily functions, as well as conditions such as ectopic pregnancies or nonviable fetal diagnoses. The goal, according to legislative sponsors, is to prevent elective abortion while preserving access to life-saving medical interventions. To better organize the essential aspects of the legislation, the following table provides a detailed summary. Table 1 Key Elements of the Human Life Protection Act (HB 314)** Category Details Bill Number/Name Human Life Protection Act, HB 314 Primary Focus Establishes a near-total abortion ban in Alabama, including attempted abortions Criminal Penalties Performing an abortion is considered a felony; penalties differ based on involvement and professional role Exceptions Included Life-threatening maternal conditions, nonviable pregnancies, ectopic pregnancies, miscarriages requiring medical intervention, severe psychiatric crises posing imminent risk Jurisdiction State of Alabama Current Status Enacted in 2019; enforcement suspended pending judicial review Federal or State? State legislation applicable only within Alabama Federal or State? State of AlabamaHB 314 is exclusively a state law passed by the Alabama Legislature and signed by the governor. Its authority extends solely within Alabama’s borders and does not apply at the federal level. Enforcement is dependent on state judicial processes and ongoing federal constitutional considerations. Legislative Intent The legislative intent behind HB 314 is framed around the belief that human life begins at conception and therefore warrants full legal protection. The law explicitly states that unborn children should be recognized as legal persons, aligning fetal rights closely with established protections afforded to born individuals (HB 314, 2019). To further reinforce this stance, the bill imposes significant criminal penalties on providers to deter elective abortion procedures. Supporters emphasize that HB 314 is designed to challenge previous federal rulings on abortion rights by creating a legal environment conducive to judicial reconsideration. The bill’s limited exceptions—restricted to emergencies threatening the woman’s life, nonviable conditions such as lethal fetal anomalies, and medically urgent situations—reflect the legislature’s intent to differentiate between elective procedures and medically essential care. The overarching purpose is to redefine the legal and moral framework for reproductive rights within Alabama, signaling a shift toward prioritizing fetal personhood in legislative decisions. Proponents/Opponents Proponents of HB 314 consist primarily of conservative policymakers and advocacy groups who view the law as a moral imperative to protect unborn life. Key supporters include Representative Terri Collins, who sponsored the bill in the House, and Senator Clyde Chambliss, who advanced it in the Senate. Governor Kay Ivey also endorsed the legislation upon signing it, emphasizing alignment with the state’s longstanding cultural and religious values related to life and family. Opponents, however, include Democratic legislators, reproductive-rights organizations, medical associations, and civil liberties groups. These critics argue that the law imposes extreme barriers to healthcare access, disproportionately impacts women of color and low-income individuals, and undermines medical decision-making. Several health professionals have raised concerns about potential ethical dilemmas, particularly the chilling effect on clinical care when providers fear legal consequences. Legal challenges from groups such as the American Civil Liberties Union (ACLU) and Planned Parenthood continue to assert that HB 314 violates constitutional protections and established reproductive rights precedents. Target Population HB 314 directly affects two primary groups: Indirectly, the legislation also influences families, support networks, social services, and healthcare institutions that must navigate altered reproductive healthcare landscapes. Communities with limited healthcare resources and individuals facing socioeconomic barriers may experience disproportionate impacts due to constrained access to safe reproductive options. Status of the Bill Although HB 314 was signed into law on May 15, 2019, its implementation remains suspended because of a federal injunction issued by U.S. District Judge Myron Thompson. This injunction prevents the state from enforcing the law while ongoing litigation evaluates its compatibility with constitutional standards. The bill continues to be a central point of discussion in national debates on reproductive rights, especially following shifts in federal judicial interpretations regarding abortion. As of the most recent updates, HB 314 remains unenforced but symbolically influential. It has shaped legislative momentum across multiple states considering similar restrictions and remains pivotal in shaping public discourse around reproductive health, bodily autonomy, and the boundaries of state authority in healthcare. General Notes/Comments HB 314 is widely recognized as one of the most restrictive abortion laws in the country. Even though it is not currently in effect, the legislation reflects broader national efforts aimed at redefining reproductive rights through state-level policymaking. The bill has contributed to significant legal, ethical, and social debates, prompting increased scrutiny of the balance between individual autonomy and state interest. Medical professionals, policymakers, and advocacy groups continue to monitor court developments, as the law’s future implications extend beyond Alabama and could influence the direction of reproductive legislation across the United States. References Bill HB 314. (2019). Human Life Protection Act, Alabama Regular Session. PA002 Legislation Laureate Education Inc. (2019). Legislation Grid Template.

Student Name Walden University NURS 6050 – Policy and Advocacy for Improving Population Health Prof. Name Date Introduction The objective of this theory application paper is to explore how agenda-setting theory helps explain the influence of political television networks—including CNN News, BBC News, Al Jazeera, NBC News, and MSNBC—on adolescent viewers. Originally proposed by McCombs and Shaw, agenda-setting theory posits that the media shape public priorities by emphasizing particular topics, ultimately guiding audiences toward viewing those topics as most important (Griffin, Ledbetter, & Sparks, 2019). Within this theoretical lens, adolescents who consume political news frequently may adopt the media’s hierarchy of concerns, such as immigration, terrorism, governmental accountability, human rights issues, and political corruption. While such exposure can enhance awareness of global political environments, it may also expose adolescents to complex subjects they are not yet developmentally equipped to interpret. This early engagement may give rise to narrow viewpoints, overgeneralizations, or polarized attitudes rooted in political identity, ethnicity, or nationality. Background Television remains one of the most widely accessed sources of political information, particularly for young audiences who spend several hours interacting with digital media daily. Political television programming often blends factual reporting with dramatic narratives, repetitive imagery, and emotionally charged commentary. As adolescents encounter these portrayals, they may begin to accept media-selected issues as the most urgent societal concerns, even when they lack contextual understanding or exposure to competing perspectives. Prior scholarship reveals that political news tends to emphasize conflict, crises, and emotionally provocative themes, which can heighten stress, fear, and confusion among younger viewers (Holbert et al., 2007). Moreover, adolescents may internalize simplified portrayals of complex topics such as terrorism, international relations, or immigration. Sensationalized stories can unintentionally reinforce stereotypes or contribute to distorted beliefs about minority communities and foreign nations (Kruikemeier & Shehata, 2017). To illustrate these effects, Table 1 summarizes the common content priorities of political TV news and how adolescents may interpret them. Table 1 Common Political TV Themes and Potential Adolescent Interpretations Political TV Focus Area Typical Media Message Possible Adolescent Interpretation Terrorism/Conflict Emphasis on global threats, violence, and instability Increased fear, mistrust, or generalizations about certain cultures or religious groups Immigration Immigrants portrayed as economic burdens or security risks Development of negative assumptions about foreigners or minority groups Corruption Focus on scandals, misconduct, and unethical behavior Growing cynicism or loss of trust in political institutions Elections Candidate drama, competition, and “horse-race” dynamics Viewing politics as entertainment rather than democratic participation Theoretical Framework Agenda-setting theory argues that while media outlets may not instruct audiences on how to think, they strongly influence what audiences think about. News organizations filter information through decisions about which stories receive attention, how frequently they appear, and how prominently they are positioned. Such decisions serve as cognitive cues that shape the mental frameworks individuals use to understand political and social realities (Griffin et al., 2019). Television editors and journalists act as gatekeepers who elevate specific topics and downplay others, thereby steering political conversations, shaping public opinion, and influencing civic behaviors. These agenda-setting choices are especially impactful for adolescents because they are still developing critical thinking skills and may rely heavily on media portrayals when forming political worldviews. Levels of Agenda Setting Level Description Relevance to Adolescents First-Level Agenda Setting Determines which issues receive the most attention (issue salience). Adolescents may adopt these highlighted issues as central priorities in society. Second-Level Agenda Setting (Attribute Framing) Shapes how an issue is described or framed in coverage. Adolescents may develop biased opinions based on framed portrayals and labels. Literature Review Agenda-setting research consistently demonstrates that political television news strongly influences young viewers’ perceptions of societal issues. Political news channels often direct attention toward topics such as economic instability, scandals, national security concerns, or debates over minority rights. Historical events—including the media focus on the Clinton-Lewinsky scandal or televised narratives during the Iraq War—reflect the capacity of televised framing to shape public discourse, including that of adolescents still forming political identities (Yioutas & Segvic, 2003). Political framing further intensifies its effects by shaping how adolescents evaluate political leaders. Repeated portrayals of certain politicians as heroic, deceitful, radical, or incompetent can lead adolescents to internalize these labels without assessing the evidence behind them (Caulk, 2016). High exposure to politically charged content is also associated with increased emotional vulnerability, heightened partisan attitudes, and reduced willingness to consider alternative viewpoints. Research Questions The analysis is guided by the following questions: How can parents prevent their children from being influenced by political TV news? How do political TV news channels contribute to bias among politicians? Case Study A clear example of agenda-setting’s influence emerges from media coverage of the 2016 U.S. Presidential Election. Different news networks highlighted particular narratives—such as the email controversy surrounding Hillary Clinton, immigration policies debated by candidates, or concerns regarding temperament and leadership style. These messaging patterns significantly shaped voter perceptions, ultimately intensifying ideological divisions among the public (Faris et al., 2017). Gender bias also plays a persistent role in political television coverage. Female political candidates frequently receive attention not only for their platforms but also for their appearance, personality, and emotional expressiveness. Such portrayals reinforce gendered stereotypes and shape young viewers’ perceptions of who is considered a “typical” or “credible” leader (Kaklamanidou & Tally, 2016). Consequently, adolescents exposed to gendered political coverage may internalize narrow assumptions about leadership roles and gender expectations. Analysis Political television news wields significant influence over adolescents by shaping their perceptions of political issues, governmental structures, and civic responsibilities. Because adolescence is a formative period in cognitive and social development, repeated exposure to emotionally charged or sensationalized political content can foster anxiety, fear, or political disengagement. Additionally, adolescents may have limited media literacy, making it difficult for them to distinguish between objective reporting and biased framing. How can parents prevent their children from being influenced by political TV news? Parents play a crucial role in moderating and contextualizing political media exposure. Strategies include: How do political TV news channels contribute to bias among politicians? Political news channels often employ framing techniques that dramatize