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a.                       Section 1

  1. Introduction

i. WHO’s Definition of Health

Who defines health as “the highest possible standard of complete physical, mental, and social wellness” (WHO, 2020). Moreover, it recognizes that health could have different meanings for different people depending on the circumstances they face.Therefore, it does not only view health as a lack of or absence of a disease or infirmity but as total wellness even when one is not in pain.

ii.  Concepts of Health, Health Promotion, and Behavior Change Options

What health means for a person in her 80s may be different from what it means for a 16 or 2-year-old. Promotion of health refers to taking proactive measures to improve one’s health status and preventing and/or reducing the risk of getting some prevalent disease which could be prevented through behavioral and lifestyle change (RHIhub, 2020). Healthcare organization should focus on health promotion which involves implementing programs to educate, inform, and influence people within the communities and societies they operate to embrace behavior change by choosing healthy lifestyles like exercising, eating healthy, avoiding smoking, washing hands, embracing hygiene and other precautionary measures to reduce their probability of getting certain diseases (Achterberg et al., 2014)

iii.  Vulnerable Individuals and Populations

Vulnerable individuals and populations refer to individuals and groups that are disadvantaged and marginalized in one way or another thus making them not achieve equal access and affordability of some or all human fundamental rights like other people in the society (Mechanic & Tanner, 2007). They are economically, racially, socially, linguistically, culturally, and ethically disadvantaged which negatively impacts their capacity to access fundamental services like education, health, safety, security, and other basic needs (Tangcharoensathien et al., 2018)

  1. Historical Perspectives of Health

Health has always been an important concept to people and societies across the world even before the 18th century and beyond and has undergone significant changes and development. Today, the healthcare industry enjoys some of the best and most innovative facilities and resources that the world has ever witnessed. However, health demands have continued to change and increase hence forcing the developments in terms of tools and technology to meet the increasing and changing healthcare demands, needs, and trends. The perspective of health in the 21st century has shifted from curative to preventive measures characterized by health promotion and behavioral change approaches by people, providers, payers, and governments (Berridge, 2018).

  1. Healthy People Initiative – Overall Summary of the Initiative

The Healthy People Initiative aims at attaining “high-quality, longer lives that are free from preventable diseases by engaging in proactive and practical health promotion initiatives” (Healthy People, 2020). It also aims at preventing disabilities, physical and mental injuries, and premature deaths caused by preventable accidents and diseases and promoting health equality, eliminating health disparities, and improving the general health and wellbeing of all people and groups at all levels and ages (Healthy People, 2020).

  1. Levels of Prevention
  2. Primordial- It involves taking precautionary actions and measures to prevent health risks by reducing or eliminating the adverse effects of behavioral, ecological,  behavioral, economic, cultural and social patterns of living (In Porta & International Epidemiological Association, 2014).
  3. Primary-It aims to prevent a disease or an injury from occurring by eliminating exposures to hazards or altering and changing unhealthy and unsafe behavioral patterns that could lead to the occurrence of a disease or injury (Bencko, 2020).
  4. Secondary-It aims at intervening and ending disease before it fully develops. Involves reducing new infections cases or severe cases (Bencko, 2020).
  5. Tertiary- It aims at preventing severe symptoms and the progress of a disease or injury once it affects an individual. Involves improving quality of life, reducing and preventing disability and adverse symptoms (In Porta & International Epidemiological Association, 2014).
  6. Quaternary- It aims at preventing the risk of over-medicalization and protecting patients from new medical invasions by promoting ethically acceptable treatment methods and approaches (Bencko, 2020).
  7. The Role of Nursing, Specifically APRNs, in Health Promotion, and Disease Prevention

APRNs interact with patients and community members every day in their day to day operations and thus they are at a better position to train, educate and discuss healthy and safe behavior that can help people to improve their health and prevent getting certain diseases which can be prevented by choosing or stopping certain behavioral patterns of living (Achterberg et al., 2014).



1.     Section 2

a.     Vulnerability as a Concept

Vulnerability refers to the state of certain groups or individuals in a society, community, or country being disadvantaged compared to other people. Vulnerability means that an individual or group faces challenges of affordability and accessibility of certain fundamental human rights such as education, health, shelter, security, safety, and other basic needs (Mechanic & Tanner, 2007).

b.     Health Disparities

It refers to inequality of health access and affordability by certain groups or individuals compared to others in the same society. Health disparity occurs as a result of the comparison of health outcomes, condition, and status where some groups or populations are advantaged as compared to others. Health disparity occurs as a result of vulnerability where some groups and populations are disadvantaged racially, socially, ethnically, economically, physically, and mentally to achieve equal health care levels as other groups (Mechanic & Tanner, 2007).

c.      Cultural Competency as a Provider

Health practitioners and organizations operate in a setting where they offer services to people from diverse backgrounds economically, socially, linguistically, racially, and ethnically.  Hence, healthcare providers need to enhance cultural competency to be able to effectively offer quality healthcare services that meet the economic, social, cultural, and linguistic needs of their patients and clients (Beach et al, 2015).

Vulnerability exposes marginalized and disadvantaged groups to the risk of harm and adversity. Resilience is the capacity to cope or overcome an adversity. Vulnerable individuals and populations learn to develop resilience for them to survive in the disadvantaged and marginalized environments and also overcome tough situations in life (Mechanic & Tanner, 2007). Therefore the concept of vulnerability and resilience exists together.

Healthcare providers or professionals such as APRNs play the role of advocacy by advising patients and their families on the best treatment options that can improve their recovery and wellbeing. APRNs should act in the best interest of their patients and act as the link between them and the healthcare system. They assess the patient’s needs and advise the patient and the physicians on the progress and best intervention measures (Davoodvand, Abbaszadeh & Ahmadi, 2016).

According to Mechanic and Tanner (2007) vulnerable populations and individuals are disadvantaged economically, socially, and environmentally and this limits their ability and capacity to achieve basic needs such as food, education, shelter, safety, health, and social and institutional support. Vulnerable groups, people, and populations face stereotypes, discrimination, and lack of support from the society and institutions where they are supposed to receive help. Hence, they live as victims, struggling, and competing against the advantaged members of society for limited resources (Mechanic & Tanner, 2007).

2.     Section 3

My vulnerable population is individuals with Traumatic Brain Injury (TBI).  These are the people with brain dysfunction as a result of an outside force or violent blow on the head due to severe sports injuries or car accidents (Galgano et al., 2017). This vulnerable population includes adults and infants who are victims of severe and traumatizing accidents thus leaving them with the physical and traumatic brain injury which impacts their normal living patterns.

TBI requires costly treatment, surgeries, and therapy for the patients to recover or achieve a stable and manageable health status (Galgano et al., 2017). Sometimes these people may not have medical insurance by the time to get involved in accidents result in TBI. Hence, they depend on their families, loved ones, and government to provide them with treatment and medical interventions necessary to reverse their condition or prevent further detriment to their mental health. Therefore, they require social and institutional justice. Social justice refers to the support they may receive from their families, friends, loved ones, colleagues and community-based organizations while institutional justice refers to access and affordability of quality healthcare services within the healthcare setting to improve their health, recovery, outcome, and physical and mental wellbeing (Galgano et al., 2017).

TBI like many other mental illnesses and disorders faces low literacy among members of society. Many people do not possess the right kind of information on the treatment, therapies, and management interventions and approaches of TBI (Kutcher, Wei, & Coniglio, 2016). Therefore, individuals with TBI may fail to seek medical attention to have their conditions diagnosed correctly, treated, and managed as they should. Low TBI literacy among people has also affected the quality of life of individuals with TBI especially small children who cannot express themselves well except through crying and show signs of head injury, discomfort, and impaired physical balance.

d.     Evaluation of My Vulnerable Population In Relation to Current Healthy People Initiative Guidelines.

Individuals with TBI are a primary focus for healthy people initiative which aims at improving quality of life by promoting longer lives free from physical and mental injury. Individuals with TBI are already past this goal or aim of healthy people initiative, and therefore, what is critical for them is to get appropriate healthcare services to treat and manage their condition, and thus improve their health, quality of life and lead to longer, healthier lives as per the intentions and goals of healthy people in initiative 2020.

e.      One Primary Health Concern For My Population and The Preventive Guideline Related to This Concern and How I Might Motivate this Group to Make Behavioral Changes.

One primary concern for individuals with TBI is getting further physical and mental injury as a result of their condition. One preventive guideline is for this vulnerable population to seek therapeutic services for their health condition to prevent further detriment on their mental health (Galgano et al., 2017). I can motivate this vulnerable population to embrace healthy and safe lifestyles to ensure they do not get other diseases, illnesses, and injuries that may lead to the further detriment of their health status and condition.

f.      Use of Community Based Participatory Research (CBPR) With My Vulnerable Population and How Community-Level Plans/Interventions can Influence Individual and Family Health.

According to Tapp, White, Steuerwald, and Dulin (2013), CBPR programs involving vulnerable populations such as individuals with TBI help to focus on issues that are specific to that group. As a result, the CBPR programs lead to the discovery of solutions and intervention strategies that are practical and applicable to the particular group and their implementation directly benefits the vulnerable group in terms of improving their health and living conditions. However, researchers and experts engaging in CBPRs involving the participation of individuals with TBI must do so ethically and responsibly, thus promoting human rights and dignity of the people together with their families. The findings of such CBPR programs should also result in community-level plans and interventions that influence individuals and family health by educating, training, and supporting behavioral change and health promotion for individuals with TBI.

g.     The Resources Available within My Community for My Specific Population and Vulnerable Populations in General.

My community has Community-Based Institutions and Programs that help in educating the members of society about various mental healthcare conditions and disorders including TBI. These programs educate and provide information to society thus enabling them to identify mental illnesses and traumas and to help the victims or patients to seek medical attention (Kutcher, Wei, & Coniglio, 2016). Besides, these institutions together with psychological centers within public healthcare organizations provide therapeutic interventions for people with mental illnesses and conditions such as TBI.

3.     Section 4

a.     The conclusion

Individuals with TBI experience brain dysfunction because of severe sports, cars or any other type of accidents. The conditions affect their brain functionality and therefore they have to seek costly treatment, surgeries, and therapies. Sometimes they may not have medical insurance and thus depend on family, friends, and government for medical interventions to help improve their health. Hence, this population is vulnerable due to their mental, physical, and economic status that hinder their access and affordability of healthcare.

b.     An Approach for Improving Health Literacy within My Population

Training and educational programs executed by healthcare professionals such as APRNs and other healthcare practitioners can help individuals with TBI to understand their condition and learn how best to manage it and improve their general health. These training sessions could also involve their families who are the primary caregivers at home. This approach can increase the society’s as well as family’s literacy on TBI thus benefiting individuals with TBI who depend on their families and society’s moral support and finances to pay for therapy for them to recover, get appropriate treatment and achieve improved health status (Kutcher, Wei, & Coniglio, 2016).

c.      How, As An APRN, I Can Impact Vulnerable Individuals In My Community.

I plan to continue educating vulnerable individuals in my community about health promotion and disease prevention. I will implement this initiative by talking to members of my community within and outside clinical settings on healthy and safe lifestyles that they can embrace and the unhealthy and unsafe behaviors that they can change to reduce their risk of getting prevalent preventable diseases. I will also use my social media platforms to educate and positively impact vulnerable populations in my community.

d.     Conclusion and a Summary of How We as a Nation are doing with Health Promotion and Disease Prevention.

Our nation is doing well in terms of health promotion and disease prevention in the current decade as compared to a few decades ago. Healthcare organizations and practitioners are keeners on health promotion through influencing people to embrace safer and healthier behaviors and environmental protection to prevent them or other members of society from getting preventable diseases. Health promotion is critical as it will improve the overall wellbeing of the society thus reduce ng pressure on the healthcare system, providers, and practitioners.







Achterberg, T., Huisman-de Waal, G. G., Ketelaar, N. A., Oostendorp, R. A., Jacobs, J. E., & Wollersheim, H. C. (2014). How to promote healthy behaviors in patients? An overview of evidence for behavior change techniques. Health promotion international26(2), 148–162.

Beach, M. C., Price, E. G., Gary, T. L., Robinson, K. A., Gozu, A., Palacio, A., Smarth, C., Jenckes, M. W., Feuerstein, C., Bass, E. B., Powe, N. R., & Cooper, L. A. (2015). Cultural competence: A systematic review of health care provider educational interventions. Medical care43(4), 356–373.

Bencko, V. (2020). Hygiene and epidemiology: Prague: Charles University in Prague, Karolinum Press

Berridge V. (2018). A historical perspective. London journal of primary care1(1), 35–37.

Davoodvand, S., Abbaszadeh, A., & Ahmadi, F. (2016). Patient advocacy from the clinical nurses’ viewpoint: a qualitative study. Journal of medical ethics and the history of medicine9, 5.

Galgano, M., Toshkezi, G., Qiu, X., Russell, T., Chin, L., & Zhao, L. R. (2017). Traumatic Brain Injury: Current treatment strategies and future endeavors. Cell transplantation26(7), 1118–1130.

Healthy People 2020. (2020). Healthy people 2020 initiative goals. Retrieved from,

Kutcher, S., Wei, Y., & Coniglio, C. (2016). Mental health literacy: Past, present, and future. Canadian journal of psychiatry. Revue Canadienne de Psychiatrie61(3), 154–158.

Mechanic, D. & Tanner, J. (2007). Caring for the vulnerable: Vulnerable People, Groups, And Populations: Societal View. Health Affair. Vol. 26. (5).

Rural Health Information Hub (RHIhub). (2020). Defining health promotion and disease prevention. Retrieved from,

Tangcharoensathien, V., Mills, A., Das, M. B., Patcharanarumol, W., Buntan, M., & Johns, J. (2018). Addressing the health of vulnerable populations: social inclusion and universal health coverage. Journal of global health8(2), 020304.

Tapp, H., White, L., Steuerwald, M., & Dulin, M. (2013). Use of community-based participatory research in primary care to improve healthcare outcomes and disparities in care. Journal of comparative effectiveness research2(4), 405–419.

WHO. (2020). Frequently Asked Questions (FAQs): What is the who definition of health? Retrieved from,

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