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  • [Solved] create a draft with the information attached 5 pages. NO AI use. No plagiarism. References from 2020-2026. follow the template

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    Executive Solution Overview

    **files (3)** – ## PICOTsofar.docx – ## Week4Template.modified.docx – ## AssignmentRubricmoedified.docx **## PICOTsofar.docx** PICOT so far: In nurse practitioners and physicians managing adult patients (≥18 years) with lumbar radiculopathy at Miami Wellness Pain Relief Center (P), how does the impl…

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    Assignment Prompt & Instructions

    **files (3)**

    – ## PICOTsofar.docx

    – ## Week4Template.modified.docx

    – ## AssignmentRubricmoedified.docx

    **## PICOTsofar.docx**

    PICOT so far:

    In nurse practitioners and physicians managing adult patients (≥18 years) with lumbar radiculopathy at Miami Wellness Pain Relief Center (P), how does the implementation of an evidence-based antineuropathic prescribing protocol combined with a structured educational program (I), compared to current opioid-based prescribing practices (C), affect patient functional outcomes (ODI), provider adherence to prescribing guidelines, and patient participation in physical therapy (O) over an eight-week period (T)?

    **## Week4Template.modified.docx**

    **Week 4: Theoretical Framework & Change Model**

    This section needs to be 2-4 pages and it should include the theoretical framework to support your project. Identify the theory to serve as the foundation for your project. This may be a nursing theory or a theory from another discipline if pertinent and applicable. As you introduce the theory, identify its primary premises (include in-text citations when sharing content from outside sources).

    In the following paragraphs operationalize each of the primary premises from your chosen theoretical framework as they apply specifically to your project. Doing this demonstrates you have not only identified a theory, but you have also been able to conceptualize its use as your project’s framework.

    **Change Model (2-4 pages)**

    Begin with a description of your selected change model and why it was selected as the model for this specific change. You should learn about the model from a primary source (i.e., do not cite a textbook). The model you select should be appropriate to the change that you are recommending (i.e., individual change or organizational change. Use the model to describe the practice change that you recommend even if that is reinforcement and education regarding the status quo. Your change process should be specific to your setting.

    **Step 1: Name of Step from the Change Model**

    You may make each step of the model a level 2 heading (title case and flush left, as demonstrated above) and then describe how you would implement the step of the change in your selected setting. Your change process must be specific to your question and the answer that you found through your literature review and your setting. It should be a well-thought-out process using the model as a guide

    **References**

    **## AssignmentRubricmoedified.docx**

    | |
    | — |
    | |

    ![](https://www.sweetstudy.com/questions/create-a-draft-with-the-information-attached-5-pages-no-ai-use-no-plagiarism-references-from-2020-2026-follow-the-template)_DNP 7700 DNP Project I_

    | |
    | — |
    | |

    _Doctor of Nursing Program_

    | |
    | — |
    | |

    ![](https://www.sweetstudy.com/questions/create-a-draft-with-the-information-attached-5-pages-no-ai-use-no-plagiarism-references-from-2020-2026-follow-the-template)_Identify your problems, but give your_

    _power and energy to solutions. – Tony Robbins_

    _PURPOSE_

    The purpose of this paper is to write the theoretical framework & Change Model portion of your DNP practice change thesis proposal.

    _COURSE OUTCOMES_

    This assignment provides documentation of student ability to meet the following course outcomes. Ã Craft a high impact problem statement of importance to specialty practice.

    Ã Synthesize biophysical, psychosocial, organizational and public health literature to define a clinical issue of concern.

    Ã Evaluate the scope, complexity, and impact of the problem on patients, providers and systems using global, national and local data.

    Analyze existing models of care delivery and evidence based practice to improve healthcare outcomes.

    Ã Synthesize scientific knowledge and practice expertise to support a change in practice-relevant evidence-based practice.

    Ã Integrate theory with scientific knowledge and practice expertise for informed practice.

    Ã Uses project management processes to assess and plan the DNP Project.

    Ã Design an evidence-based practice-change project to address a practice issue at the appropriate system's level.

    Ã Develop a care delivery initiative that addresses health care disparities.

    Ã Generate effective communication and collaboration skills interprofessional and interprofessional teams.

    ## Program Outcomes

    Ã I-Integrate Scientific Underpinnings into Practice

    Ã II-Develop Organizational and Systems Leadership for Quality Improvement and Systems Thinking

    Ã III-Apply Clinical Scholarship and Analytical Methods for Evidence-Based Practice

    Ã IV-Use Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care

    Ã V-Influence Health Care Policy for Advocacy in Health Care

    Ã VI-Employ Interprofessional Collaboration for Improving Patient and Population Health Outcomes

    Ã VII-Synthesize Clinical Prevention and Population Health concepts for Improving the Nation’s Health

    Ã VIII-Demonstrate advanced levels of clinical judgment, systems thinking, and accountability in designing, delivering, and evaluating evidence-based care to improve patient outcome

    ## Nurse Executive Role-Specific Competency

    Ã Knowledge of Healthcare

    Ã Communication

    Ã Leadership

    Ã Professionalism

    _DUE DATE_ **:** Submit to the Moodle by Saturday of the end Week 4 at 11:59 p.m. ET.

    _POINTS:_ This assignment is worth a total of 100 points.

    _REQUIREMENTS_

    Ã To complete this application, you will need to access to the Miami Regional College virtual library database. following databases: CINAHL Complete Database, MEDLINE Complete Database, LIRN, and so forth. Our Librarian is available to help on campus from Monday to Friday 7:30 am to 9:00 pm & Saturday 8:00 am to 3:00 pm. Additionally, the virtual Ask a Librarian feature is available in Moodle as well as the writing tutor software Tutor.com available 24/7.

    Ã Furthermore, please read the proposed articles in the week #1 & #2 #3 #4 in Moodle. Please use the template provided for this assignment in Moodle week #4 folder. You must work in collaboration with your preceptor, DNP Practicum project Thesis Mentor, and DNP Mentor. Should you have any questions, feel free to reach out to your professor, DNP mentor, or post your question in the Q/A forum on Moodle. We are here to help. J

    Ã You will receive feedback on your submission and are expected to make the necessary changes and resubmit the corrected portion of this paper for final grading in week #5 assignment folder of revised week #4 section.

    Ã This assignment is worth 100 points and will be graded on the required components as summarized in the directions and grading criteria/rubric. This assignment will be graded on quality of information, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria and rubric.

    Ã To complete this assignment, you will need to review the grading rubric carefully and consider how to incorporate each required criterion into the final paper. This final paper is an extension of the project proposal that you completed in DNP7700.

    Ã The length of the final paper is to be no greater than 50 pages excluding title page, abstract, reference pages, and appendices. The following are estimates for length of each section for this week.

    · Theoretical Framework (2-4 pages)

    · Change Model (2-4 pages)

    Ã APA format and effective writing is required for the paper. Use your APA manual or Purdue Owl to check and correct your formatting. Use Grammarly, Tutor Source, and the grammar and spelling check on your Word Processor and criteria for effective writing to assure that your paper well written. APA format is required, with both a title page and reference page.

    Ã Create your manuscript using the version of Microsoft Word. You can tell that the document is saved as a MS Word document because it will end in “.docx”.

    Ã
    **Follow the directions and grading criteria closely**. Any questions about this paper may be posted under the Q & A Forum.

    Ã This paper will be submitted through Turnitin, a Turnitin similarity score of 20% or less is expected.

    Ã
    **A minimum of 8 current scholarly references that are 5 years old or less for this section.**

    _PREPARING THE PROJECT REPORT_

    | | | | | | |
    | — | — | — | — | — | — |
    | **Category** | **Description** |
    | Writing Organization/Structure | See Rubric – Week #2 – |
    | Writing Mechanics/Usage | See Rubric – Week #2 – |
    | APA | See Rubric – Week #2 – |
    | Abstract | See APA template for Final Paper and Rubric |
    | Introduction (1 – 2 paragraphs) | See APA template and Rubric – Week #2 – |
    | Problem Statement ( 1-2 paragraphs) | See APA template and Rubric – Week #2 – |
    | Objectives and Aims (1 page) | See APA template and Rubric – Week #2 – |
    | Significance of the Practice Problem (1-3 pages) | See APA template and Rubric – Week #2 – |
    | PICOT Question | See APA template and Rubric |
    | | Theoretical Framework (2-4 pages) | | | See APA template and Rubric – Week #4 – | |
    | | Model of Change (2-4 pages) | | | See APA template and Rubric – Week #4 – | |
    | Synthesis of the Literature (5-10 pages) | See APA template and Rubric – Week #3 – |
    | Practice Recommendation (1-2 pages) | See APA template and Rubric – Week #3 – |
    | EBP: Verification of Chosen Option (1 paragraph) | See APA template and Rubric – Week #3 – |
    | Project Setting | See APA template and Rubric |
    | Project Vision, Mission, Objectives | See APA template and Rubric |
    | Project Description | See APA template and Rubric |
    | Project Evaluation and Data Analysis | See APA template and Rubric |
    | Implications for Nursing and Healthcare | See APA template and Rubric |
    | Dissemination | See APA template and Rubric |
    | Conclusion | See APA template and Rubric |
    | References | See APA template and Rubric |
    | Appendices | See APA template and Rubric |
    | **Total 100 points** | **A quality essay will meet or exceed all of the above requirements as described on the APA Template for the Final Paper and the following grading rubric.** |

    _DIRECTIONS AND GRADING CRITERIA_

    ## GRADING RUBRIC

    | | | |
    | — | — | — |
    | **PART I: WRITING AND APA CRITERION** | **Approved** | **Not Approved** |
    | **Organization/Structure – 5 points –**<br>There is logical sequencing of ideas through well-developed paragraphs. Transitions are used to enhance organization. There is a logical progression of thoughts and ideas. Concepts are clearly presented with doctoral level vocabulary. The paper is well organized from introduction to conclusion. | | |
    | **Mechanics/Usage — 5 points –**<br>There are few errors in punctuation, capitalization, spelling, sentence structure, or word usage. | | |
    | **APA — 10 points –**<br>There is consistent adherence to APA criteria in title page, running head, headings, citations, and/or reference page. Font, layout, and/or margins adhere to APA format. | | |
    | **Part II: Content** | **Approved** | **Not Approved** |
    | **Theoretical Framework** **–40 points –**<br>Inclusion of the theoretical framework to support the project. The theory serving as the foundation of the project is identified. This may be a nursing theory or a theory from another discipline if pertinent and applicable. Introduction of the theory, identification of its primary premises. Operationalize each of the primary premises from the chosen theoretical framework as they apply | | |
    | specifically to the project. Doing this demonstrates that the student has not only identified a theory, but also was able to conceptualize its use as the project’s framework. | | |
    | **Change Model — 40 points—**<br>Description of selected change model and why it was selected as the model for this specific change. The model selected should be appropriate to the change recommended (i.e., individual change or organizational change). Used the model to describe the practice change recommended even if that is reinforcement and education regarding the status quo. The change process should be specific to the practicum setting. Description provided of every steps of the Change Model. | | |
    | **Total Points = 100 points**<br>**This assignment is graded as an all or none; all criteria must be acceptable to earn the 100 points.** |

    | |
    | — |
    | 2 |

    _DNP 7770 Practicum Project I– Week #4_

    DNP7700 -Contributors: Dr. Anny Dionne, Dr. Karen Perez, Dr. Amarilys Gonzalez, Dr. Trabanco, Dr. De Varona, Dr. Itzel Vega Crespo, Effective Date: 10/26/24

    ![](https://www.sweetstudy.com/questions/create-a-draft-with-the-information-attached-5-pages-no-ai-use-no-plagiarism-references-from-2020-2026-follow-the-template) Dr. Angel Garcia
    ![](https://www.sweetstudy.com/questions/create-a-draft-with-the-information-attached-5-pages-no-ai-use-no-plagiarism-references-from-2020-2026-follow-the-template).

    | |
    | — |
    | 2 |

    ## image1.jpg

    ## image2.jpg

    ## image3.png

    **## AssignmentRubricmoedified.docx**

    | |
    | — |
    | |

    ![](https://www.sweetstudy.com/questions/create-a-draft-with-the-information-attached-5-pages-no-ai-use-no-plagiarism-references-from-2020-2026-follow-the-template)_DNP 7700 DNP Project I_

    | |
    | — |
    | |

    _Doctor of Nursing Program_

    | |
    | — |
    | |

    ![](https://www.sweetstudy.com/questions/create-a-draft-with-the-information-attached-5-pages-no-ai-use-no-plagiarism-references-from-2020-2026-follow-the-template)_Identify your problems, but give your_

    _power and energy to solutions. – Tony Robbins_

    _PURPOSE_

    The purpose of this paper is to write the theoretical framework & Change Model portion of your DNP practice change thesis proposal.

    _COURSE OUTCOMES_

    This assignment provides documentation of student ability to meet the following course outcomes. Ã Craft a high impact problem statement of importance to specialty practice.

    Ã Synthesize biophysical, psychosocial, organizational and public health literature to define a clinical issue of concern.

    Ã Evaluate the scope, complexity, and impact of the problem on patients, providers and systems using global, national and local data.

    Analyze existing models of care delivery and evidence based practice to improve healthcare outcomes.

    Ã Synthesize scientific knowledge and practice expertise to support a change in practice-relevant evidence-based practice.

    Ã Integrate theory with scientific knowledge and practice expertise for informed practice.

    Ã Uses project management processes to assess and plan the DNP Project.

    Ã Design an evidence-based practice-change project to address a practice issue at the appropriate system's level.

    Ã Develop a care delivery initiative that addresses health care disparities.

    Ã Generate effective communication and collaboration skills interprofessional and interprofessional teams.

    ## Program Outcomes

    Ã I-Integrate Scientific Underpinnings into Practice

    Ã II-Develop Organizational and Systems Leadership for Quality Improvement and Systems Thinking

    Ã III-Apply Clinical Scholarship and Analytical Methods for Evidence-Based Practice

    Ã IV-Use Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care

    Ã V-Influence Health Care Policy for Advocacy in Health Care

    Ã VI-Employ Interprofessional Collaboration for Improving Patient and Population Health Outcomes

    Ã VII-Synthesize Clinical Prevention and Population Health concepts for Improving the Nation’s Health

    Ã VIII-Demonstrate advanced levels of clinical judgment, systems thinking, and accountability in designing, delivering, and evaluating evidence-based care to improve patient outcome

    ## Nurse Executive Role-Specific Competency

    Ã Knowledge of Healthcare

    Ã Communication

    Ã Leadership

    Ã Professionalism

    _DUE DATE_ **:** Submit to the Moodle by Saturday of the end Week 4 at 11:59 p.m. ET.

    _POINTS:_ This assignment is worth a total of 100 points.

    _REQUIREMENTS_

    Ã To complete this application, you will need to access to the Miami Regional College virtual library database. following databases: CINAHL Complete Database, MEDLINE Complete Database, LIRN, and so forth. Our Librarian is available to help on campus from Monday to Friday 7:30 am to 9:00 pm & Saturday 8:00 am to 3:00 pm. Additionally, the virtual Ask a Librarian feature is available in Moodle as well as the writing tutor software Tutor.com available 24/7.

    Ã Furthermore, please read the proposed articles in the week #1 & #2 #3 #4 in Moodle. Please use the template provided for this assignment in Moodle week #4 folder. You must work in collaboration with your preceptor, DNP Practicum project Thesis Mentor, and DNP Mentor. Should you have any questions, feel free to reach out to your professor, DNP mentor, or post your question in the Q/A forum on Moodle. We are here to help. J

    Ã You will receive feedback on your submission and are expected to make the necessary changes and resubmit the corrected portion of this paper for final grading in week #5 assignment folder of revised week #4 section.

    Ã This assignment is worth 100 points and will be graded on the required components as summarized in the directions and grading criteria/rubric. This assignment will be graded on quality of information, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria and rubric.

    Ã To complete this assignment, you will need to review the grading rubric carefully and consider how to incorporate each required criterion into the final paper. This final paper is an extension of the project proposal that you completed in DNP7700.

    Ã The length of the final paper is to be no greater than 50 pages excluding title page, abstract, reference pages, and appendices. The following are estimates for length of each section for this week.

    · Theoretical Framework (2-4 pages)

    · Change Model (2-4 pages)

    Ã APA format and effective writing is required for the paper. Use your APA manual or Purdue Owl to check and correct your formatting. Use Grammarly, Tutor Source, and the grammar and spelling check on your Word Processor and criteria for effective writing to assure that your paper well written. APA format is required, with both a title page and reference page.

    Ã Create your manuscript using the version of Microsoft Word. You can tell that the document is saved as a MS Word document because it will end in “.docx”.

    Ã
    **Follow the directions and grading criteria closely**. Any questions about this paper may be posted under the Q & A Forum.

    Ã This paper will be submitted through Turnitin, a Turnitin similarity score of 20% or less is expected.

    Ã
    **A minimum of 8 current scholarly references that are 5 years old or less for this section.**

    _PREPARING THE PROJECT REPORT_

    | | | | | | |
    | — | — | — | — | — | — |
    | **Category** | **Description** |
    | Writing Organization/Structure | See Rubric – Week #2 – |
    | Writing Mechanics/Usage | See Rubric – Week #2 – |
    | APA | See Rubric – Week #2 – |
    | Abstract | See APA template for Final Paper and Rubric |
    | Introduction (1 – 2 paragraphs) | See APA template and Rubric – Week #2 – |
    | Problem Statement ( 1-2 paragraphs) | See APA template and Rubric – Week #2 – |
    | Objectives and Aims (1 page) | See APA template and Rubric – Week #2 – |
    | Significance of the Practice Problem (1-3 pages) | See APA template and Rubric – Week #2 – |
    | PICOT Question | See APA template and Rubric |
    | | Theoretical Framework (2-4 pages) | | | See APA template and Rubric – Week #4 – | |
    | | Model of Change (2-4 pages) | | | See APA template and Rubric – Week #4 – | |
    | Synthesis of the Literature (5-10 pages) | See APA template and Rubric – Week #3 – |
    | Practice Recommendation (1-2 pages) | See APA template and Rubric – Week #3 – |
    | EBP: Verification of Chosen Option (1 paragraph) | See APA template and Rubric – Week #3 – |
    | Project Setting | See APA template and Rubric |
    | Project Vision, Mission, Objectives | See APA template and Rubric |
    | Project Description | See APA template and Rubric |
    | Project Evaluation and Data Analysis | See APA template and Rubric |
    | Implications for Nursing and Healthcare | See APA template and Rubric |
    | Dissemination | See APA template and Rubric |
    | Conclusion | See APA template and Rubric |
    | References | See APA template and Rubric |
    | Appendices | See APA template and Rubric |
    | **Total 100 points** | **A quality essay will meet or exceed all of the above requirements as described on the APA Template for the Final Paper and the following grading rubric.** |

    _DIRECTIONS AND GRADING CRITERIA_

    ## GRADING RUBRIC

    | | | |
    | — | — | — |
    | **PART I: WRITING AND APA CRITERION** | **Approved** | **Not Approved** |
    | **Organization/Structure – 5 points –**<br>There is logical sequencing of ideas through well-developed paragraphs. Transitions are used to enhance organization. There is a logical progression of thoughts and ideas. Concepts are clearly presented with doctoral level vocabulary. The paper is well organized from introduction to conclusion. | | |
    | **Mechanics/Usage — 5 points –**<br>There are few errors in punctuation, capitalization, spelling, sentence structure, or word usage. | | |
    | **APA — 10 points –**<br>There is consistent adherence to APA criteria in title page, running head, headings, citations, and/or reference page. Font, layout, and/or margins adhere to APA format. | | |
    | **Part II: Content** | **Approved** | **Not Approved** |
    | **Theoretical Framework** **–40 points –**<br>Inclusion of the theoretical framework to support the project. The theory serving as the foundation of the project is identified. This may be a nursing theory or a theory from another discipline if pertinent and applicable. Introduction of the theory, identification of its primary premises. Operationalize each of the primary premises from the chosen theoretical framework as they apply | | |
    | specifically to the project. Doing this demonstrates that the student has not only identified a theory, but also was able to conceptualize its use as the project’s framework. | | |
    | **Change Model — 40 points—**<br>Description of selected change model and why it was selected as the model for this specific change. The model selected should be appropriate to the change recommended (i.e., individual change or organizational change). Used the model to describe the practice change recommended even if that is reinforcement and education regarding the status quo. The change process should be specific to the practicum setting. Description provided of every steps of the Change Model. | | |
    | **Total Points = 100 points**<br>**This assignment is graded as an all or none; all criteria must be acceptable to earn the 100 points.** |

    | |
    | — |
    | 2 |

    _DNP 7770 Practicum Project I– Week #4_

    DNP7700 -Contributors: Dr. Anny Dionne, Dr. Karen Perez, Dr. Amarilys Gonzalez, Dr. Trabanco, Dr. De Varona, Dr. Itzel Vega Crespo, Effective Date: 10/26/24

    ![](https://www.sweetstudy.com/questions/create-a-draft-with-the-information-attached-5-pages-no-ai-use-no-plagiarism-references-from-2020-2026-follow-the-template) Dr. Angel Garcia
    ![](https://www.sweetstudy.com/questions/create-a-draft-with-the-information-attached-5-pages-no-ai-use-no-plagiarism-references-from-2020-2026-follow-the-template).

    | |
    | — |
    | 2 |

    ## image1.jpg

    ## image2.jpg

    ## image3.png

    **## PICOTsofar.docx**

    PICOT so far:

    In nurse practitioners and physicians managing adult patients (≥18 years) with lumbar radiculopathy at Miami Wellness Pain Relief Center (P), how does the implementation of an evidence-based antineuropathic prescribing protocol combined with a structured educational program (I), compared to current opioid-based prescribing practices (C), affect patient functional outcomes (ODI), provider adherence to prescribing guidelines, and patient participation in physical therapy (O) over an eight-week period (T)?

    **## Week4Template.modified.docx**

    **Week 4: Theoretical Framework & Change Model**

    This section needs to be 2-4 pages and it should include the theoretical framework to support your project. Identify the theory to serve as the foundation for your project. This may be a nursing theory or a theory from another discipline if pertinent and applicable. As you introduce the theory, identify its primary premises (include in-text citations when sharing content from outside sources).

    In the following paragraphs operationalize each of the primary premises from your chosen theoretical framework as they apply specifically to your project. Doing this demonstrates you have not only identified a theory, but you have also been able to conceptualize its use as your project’s framework.

    **Change Model (2-4 pages)**

    Begin with a description of your selected change model and why it was selected as the model for this specific change. You should learn about the model from a primary source (i.e., do not cite a textbook). The model you select should be appropriate to the change that you are recommending (i.e., individual change or organizational change. Use the model to describe the practice change that you recommend even if that is reinforcement and education regarding the status quo. Your change process should be specific to your setting.

    **Step 1: Name of Step from the Change Model**

    You may make each step of the model a level 2 heading (title case and flush left, as demonstrated above) and then describe how you would implement the step of the change in your selected setting. Your change process must be specific to your question and the answer that you found through your literature review and your setting. It should be a well-thought-out process using the model as a guide

    **References**

    **## AssignmentRubricmoedified.docx**

    | |
    | — |
    | |

    ![](https://www.sweetstudy.com/questions/create-a-draft-with-the-information-attached-5-pages-no-ai-use-no-plagiarism-references-from-2020-2026-follow-the-template)_DNP 7700 DNP Project I_

    | |
    | — |
    | |

    _Doctor of Nursing Program_

    | |
    | — |
    | |

    ![](https://www.sweetstudy.com/questions/create-a-draft-with-the-information-attached-5-pages-no-ai-use-no-plagiarism-references-from-2020-2026-follow-the-template)_Identify your problems, but give your_

    _power and energy to solutions. – Tony Robbins_

    _PURPOSE_

    The purpose of this paper is to write the theoretical framework & Change Model portion of your DNP practice change thesis proposal.

    _COURSE OUTCOMES_

    This assignment provides documentation of student ability to meet the following course outcomes. Ã Craft a high impact problem statement of importance to specialty practice.

    Ã Synthesize biophysical, psychosocial, organizational and public health literature to define a clinical issue of concern.

    Ã Evaluate the scope, complexity, and impact of the problem on patients, providers and systems using global, national and local data.

    Analyze existing models of care delivery and evidence based practice to improve healthcare outcomes.

    Ã Synthesize scientific knowledge and practice expertise to support a change in practice-relevant evidence-based practice.

    Ã Integrate theory with scientific knowledge and practice expertise for informed practice.

    Ã Uses project management processes to assess and plan the DNP Project.

    Ã Design an evidence-based practice-change project to address a practice issue at the appropriate system's level.

    Ã Develop a care delivery initiative that addresses health care disparities.

    Ã Generate effective communication and collaboration skills interprofessional and interprofessional teams.

    ## Program Outcomes

    Ã I-Integrate Scientific Underpinnings into Practice

    Ã II-Develop Organizational and Systems Leadership for Quality Improvement and Systems Thinking

    Ã III-Apply Clinical Scholarship and Analytical Methods for Evidence-Based Practice

    Ã IV-Use Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care

    Ã V-Influence Health Care Policy for Advocacy in Health Care

    Ã VI-Employ Interprofessional Collaboration for Improving Patient and Population Health Outcomes

    Ã VII-Synthesize Clinical Prevention and Population Health concepts for Improving the Nation’s Health

    Ã VIII-Demonstrate advanced levels of clinical judgment, systems thinking, and accountability in designing, delivering, and evaluating evidence-based care to improve patient outcome

    ## Nurse Executive Role-Specific Competency

    Ã Knowledge of Healthcare

    Ã Communication

    Ã Leadership

    Ã Professionalism

    _DUE DATE_ **:** Submit to the Moodle by Saturday of the end Week 4 at 11:59 p.m. ET.

    _POINTS:_ This assignment is worth a total of 100 points.

    _REQUIREMENTS_

    Ã To complete this application, you will need to access to the Miami Regional College virtual library database. following databases: CINAHL Complete Database, MEDLINE Complete Database, LIRN, and so forth. Our Librarian is available to help on campus from Monday to Friday 7:30 am to 9:00 pm & Saturday 8:00 am to 3:00 pm. Additionally, the virtual Ask a Librarian feature is available in Moodle as well as the writing tutor software Tutor.com available 24/7.

    Ã Furthermore, please read the proposed articles in the week #1 & #2 #3 #4 in Moodle. Please use the template provided for this assignment in Moodle week #4 folder. You must work in collaboration with your preceptor, DNP Practicum project Thesis Mentor, and DNP Mentor. Should you have any questions, feel free to reach out to your professor, DNP mentor, or post your question in the Q/A forum on Moodle. We are here to help. J

    Ã You will receive feedback on your submission and are expected to make the necessary changes and resubmit the corrected portion of this paper for final grading in week #5 assignment folder of revised week #4 section.

    Ã This assignment is worth 100 points and will be graded on the required components as summarized in the directions and grading criteria/rubric. This assignment will be graded on quality of information, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria and rubric.

    Ã To complete this assignment, you will need to review the grading rubric carefully and consider how to incorporate each required criterion into the final paper. This final paper is an extension of the project proposal that you completed in DNP7700.

    Ã The length of the final paper is to be no greater than 50 pages excluding title page, abstract, reference pages, and appendices. The following are estimates for length of each section for this week.

    · Theoretical Framework (2-4 pages)

    · Change Model (2-4 pages)

    Ã APA format and effective writing is required for the paper. Use your APA manual or Purdue Owl to check and correct your formatting. Use Grammarly, Tutor Source, and the grammar and spelling check on your Word Processor and criteria for effective writing to assure that your paper well written. APA format is required, with both a title page and reference page.

    Ã Create your manuscript using the version of Microsoft Word. You can tell that the document is saved as a MS Word document because it will end in “.docx”.

    Ã
    **Follow the directions and grading criteria closely**. Any questions about this paper may be posted under the Q & A Forum.

    Ã This paper will be submitted through Turnitin, a Turnitin similarity score of 20% or less is expected.

    Ã
    **A minimum of 8 current scholarly references that are 5 years old or less for this section.**

    _PREPARING THE PROJECT REPORT_

    | | | | | | |
    | — | — | — | — | — | — |
    | **Category** | **Description** |
    | Writing Organization/Structure | See Rubric – Week #2 – |
    | Writing Mechanics/Usage | See Rubric – Week #2 – |
    | APA | See Rubric – Week #2 – |
    | Abstract | See APA template for Final Paper and Rubric |
    | Introduction (1 – 2 paragraphs) | See APA template and Rubric – Week #2 – |
    | Problem Statement ( 1-2 paragraphs) | See APA template and Rubric – Week #2 – |
    | Objectives and Aims (1 page) | See APA template and Rubric – Week #2 – |
    | Significance of the Practice Problem (1-3 pages) | See APA template and Rubric – Week #2 – |
    | PICOT Question | See APA template and Rubric |
    | | Theoretical Framework (2-4 pages) | | | See APA template and Rubric – Week #4 – | |
    | | Model of Change (2-4 pages) | | | See APA template and Rubric – Week #4 – | |
    | Synthesis of the Literature (5-10 pages) | See APA template and Rubric – Week #3 – |
    | Practice Recommendation (1-2 pages) | See APA template and Rubric – Week #3 – |
    | EBP: Verification of Chosen Option (1 paragraph) | See APA template and Rubric – Week #3 – |
    | Project Setting | See APA template and Rubric |
    | Project Vision, Mission, Objectives | See APA template and Rubric |
    | Project Description | See APA template and Rubric |
    | Project Evaluation and Data Analysis | See APA template and Rubric |
    | Implications for Nursing and Healthcare | See APA template and Rubric |
    | Dissemination | See APA template and Rubric |
    | Conclusion | See APA template and Rubric |
    | References | See APA template and Rubric |
    | Appendices | See APA template and Rubric |
    | **Total 100 points** | **A quality essay will meet or exceed all of the above requirements as described on the APA Template for the Final Paper and the following grading rubric.** |

    _DIRECTIONS AND GRADING CRITERIA_

    ## GRADING RUBRIC

    | | | |
    | — | — | — |
    | **PART I: WRITING AND APA CRITERION** | **Approved** | **Not Approved** |
    | **Organization/Structure – 5 points –**<br>There is logical sequencing of ideas through well-developed paragraphs. Transitions are used to enhance organization. There is a logical progression of thoughts and ideas. Concepts are clearly presented with doctoral level vocabulary. The paper is well organized from introduction to conclusion. | | |
    | **Mechanics/Usage — 5 points –**<br>There are few errors in punctuation, capitalization, spelling, sentence structure, or word usage. | | |
    | **APA — 10 points –**<br>There is consistent adherence to APA criteria in title page, running head, headings, citations, and/or reference page. Font, layout, and/or margins adhere to APA format. | | |
    | **Part II: Content** | **Approved** | **Not Approved** |
    | **Theoretical Framework** **–40 points –**<br>Inclusion of the theoretical framework to support the project. The theory serving as the foundation of the project is identified. This may be a nursing theory or a theory from another discipline if pertinent and applicable. Introduction of the theory, identification of its primary premises. Operationalize each of the primary premises from the chosen theoretical framework as they apply | | |
    | specifically to the project. Doing this demonstrates that the student has not only identified a theory, but also was able to conceptualize its use as the project’s framework. | | |
    | **Change Model — 40 points—**<br>Description of selected change model and why it was selected as the model for this specific change. The model selected should be appropriate to the change recommended (i.e., individual change or organizational change). Used the model to describe the practice change recommended even if that is reinforcement and education regarding the status quo. The change process should be specific to the practicum setting. Description provided of every steps of the Change Model. | | |
    | **Total Points = 100 points**<br>**This assignment is graded as an all or none; all criteria must be acceptable to earn the 100 points.** |

    | |
    | — |
    | 2 |

    _DNP 7770 Practicum Project I– Week #4_

    DNP7700 -Contributors: Dr. Anny Dionne, Dr. Karen Perez, Dr. Amarilys Gonzalez, Dr. Trabanco, Dr. De Varona, Dr. Itzel Vega Crespo, Effective Date: 10/26/24

    ![](https://www.sweetstudy.com/questions/create-a-draft-with-the-information-attached-5-pages-no-ai-use-no-plagiarism-references-from-2020-2026-follow-the-template) Dr. Angel Garcia
    ![](https://www.sweetstudy.com/questions/create-a-draft-with-the-information-attached-5-pages-no-ai-use-no-plagiarism-references-from-2020-2026-follow-the-template).

    | |
    | — |
    | 2 |

    ## image1.jpg

    ## image2.jpg

    ## image3.png

    **## PICOTsofar.docx**

    PICOT so far:

    In nurse practitioners and physicians managing adult patients (≥18 years) with lumbar radiculopathy at Miami Wellness Pain Relief Center (P), how does the implementation of an evidence-based antineuropathic prescribing protocol combined with a structured educational program (I), compared to current opioid-based prescribing practices (C), affect patient functional outcomes (ODI), provider adherence to prescribing guidelines, and patient participation in physical therapy (O) over an eight-week period (T)?

    **## Week4Template.modified.docx**

    **Week 4: Theoretical Framework & Change Model**

    This section needs to be 2-4 pages and it should include the theoretical framework to support your project. Identify the theory to serve as the foundation for your project. This may be a nursing theory or a theory from another discipline if pertinent and applicable. As you introduce the theory, identify its primary premises (include in-text citations when sharing content from outside sources).

    In the following paragraphs operationalize each of the primary premises from your chosen theoretical framework as they apply specifically to your project. Doing this demonstrates you have not only identified a theory, but you have also been able to conceptualize its use as your project’s framework.

    **Change Model (2-4 pages)**

    Begin with a description of your selected change model and why it was selected as the model for this specific change. You should learn about the model from a primary source (i.e., do not cite a textbook). The model you select should be appropriate to the change that you are recommending (i.e., individual change or organizational change. Use the model to describe the practice change that you recommend even if that is reinforcement and education regarding the status quo. Your change process should be specific to your setting.

    **Step 1: Name of Step from the Change Model**

    You may make each step of the model a level 2 heading (title case and flush left, as demonstrated above) and then describe how you would implement the step of the change in your selected setting. Your change process must be specific to your question and the answer that you found through your literature review and your setting. It should be a well-thought-out process using the model as a guide

    **References**

    **## AssignmentRubricmoedified.docx**

    | |
    | — |
    | |

    ![](https://www.sweetstudy.com/questions/create-a-draft-with-the-information-attached-5-pages-no-ai-use-no-plagiarism-references-from-2020-2026-follow-the-template)_DNP 7700 DNP Project I_

    | |
    | — |
    | |

    _Doctor of Nursing Program_

    | |
    | — |
    | |

    ![](https://www.sweetstudy.com/questions/create-a-draft-with-the-information-attached-5-pages-no-ai-use-no-plagiarism-references-from-2020-2026-follow-the-template)_Identify your problems, but give your_

    _power and energy to solutions. – Tony Robbins_

    _PURPOSE_

    The purpose of this paper is to write the theoretical framework & Change Model portion of your DNP practice change thesis proposal.

    _COURSE OUTCOMES_

    This assignment provides documentation of student ability to meet the following course outcomes. Ã Craft a high impact problem statement of importance to specialty practice.

    Ã Synthesize biophysical, psychosocial, organizational and public health literature to define a clinical issue of concern.

    Ã Evaluate the scope, complexity, and impact of the problem on patients, providers and systems using global, national and local data.

    Analyze existing models of care delivery and evidence based practice to improve healthcare outcomes.

    Ã Synthesize scientific knowledge and practice expertise to support a change in practice-relevant evidence-based practice.

    Ã Integrate theory with scientific knowledge and practice expertise for informed practice.

    Ã Uses project management processes to assess and plan the DNP Project.

    Ã Design an evidence-based practice-change project to address a practice issue at the appropriate system's level.

    Ã Develop a care delivery initiative that addresses health care disparities.

    Ã Generate effective communication and collaboration skills interprofessional and interprofessional teams.

    ## Program Outcomes

    Ã I-Integrate Scientific Underpinnings into Practice

    Ã II-Develop Organizational and Systems Leadership for Quality Improvement and Systems Thinking

    Ã III-Apply Clinical Scholarship and Analytical Methods for Evidence-Based Practice

    Ã IV-Use Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care

    Ã V-Influence Health Care Policy for Advocacy in Health Care

    Ã VI-Employ Interprofessional Collaboration for Improving Patient and Population Health Outcomes

    Ã VII-Synthesize Clinical Prevention and Population Health concepts for Improving the Nation’s Health

    Ã VIII-Demonstrate advanced levels of clinical judgment, systems thinking, and accountability in designing, delivering, and evaluating evidence-based care to improve patient outcome

    ## Nurse Executive Role-Specific Competency

    Ã Knowledge of Healthcare

    Ã Communication

    Ã Leadership

    Ã Professionalism

    _DUE DATE_ **:** Submit to the Moodle by Saturday of the end Week 4 at 11:59 p.m. ET.

    _POINTS:_ This assignment is worth a total of 100 points.

    _REQUIREMENTS_

    Ã To complete this application, you will need to access to the Miami Regional College virtual library database. following databases: CINAHL Complete Database, MEDLINE Complete Database, LIRN, and so forth. Our Librarian is available to help on campus from Monday to Friday 7:30 am to 9:00 pm & Saturday 8:00 am to 3:00 pm. Additionally, the virtual Ask a Librarian feature is available in Moodle as well as the writing tutor software Tutor.com available 24/7.

    Ã Furthermore, please read the proposed articles in the week #1 & #2 #3 #4 in Moodle. Please use the template provided for this assignment in Moodle week #4 folder. You must work in collaboration with your preceptor, DNP Practicum project Thesis Mentor, and DNP Mentor. Should you have any questions, feel free to reach out to your professor, DNP mentor, or post your question in the Q/A forum on Moodle. We are here to help. J

    Ã You will receive feedback on your submission and are expected to make the necessary changes and resubmit the corrected portion of this paper for final grading in week #5 assignment folder of revised week #4 section.

    Ã This assignment is worth 100 points and will be graded on the required components as summarized in the directions and grading criteria/rubric. This assignment will be graded on quality of information, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria and rubric.

    Ã To complete this assignment, you will need to review the grading rubric carefully and consider how to incorporate each required criterion into the final paper. This final paper is an extension of the project proposal that you completed in DNP7700.

    Ã The length of the final paper is to be no greater than 50 pages excluding title page, abstract, reference pages, and appendices. The following are estimates for length of each section for this week.

    · Theoretical Framework (2-4 pages)

    · Change Model (2-4 pages)

    Ã APA format and effective writing is required for the paper. Use your APA manual or Purdue Owl to check and correct your formatting. Use Grammarly, Tutor Source, and the grammar and spelling check on your Word Processor and criteria for effective writing to assure that your paper well written. APA format is required, with both a title page and reference page.

    Ã Create your manuscript using the version of Microsoft Word. You can tell that the document is saved as a MS Word document because it will end in “.docx”.

    Ã
    **Follow the directions and grading criteria closely**. Any questions about this paper may be posted under the Q & A Forum.

    Ã This paper will be submitted through Turnitin, a Turnitin similarity score of 20% or less is expected.

    Ã
    **A minimum of 8 current scholarly references that are 5 years old or less for this section.**

    _PREPARING THE PROJECT REPORT_

    | | | | | | |
    | — | — | — | — | — | — |
    | **Category** | **Description** |
    | Writing Organization/Structure | See Rubric – Week #2 – |
    | Writing Mechanics/Usage | See Rubric – Week #2 – |
    | APA | See Rubric – Week #2 – |
    | Abstract | See APA template for Final Paper and Rubric |
    | Introduction (1 – 2 paragraphs) | See APA template and Rubric – Week #2 – |
    | Problem Statement ( 1-2 paragraphs) | See APA template and Rubric – Week #2 – |
    | Objectives and Aims (1 page) | See APA template and Rubric – Week #2 – |
    | Significance of the Practice Problem (1-3 pages) | See APA template and Rubric – Week #2 – |
    | PICOT Question | See APA template and Rubric |
    | | Theoretical Framework (2-4 pages) | | | See APA template and Rubric – Week #4 – | |
    | | Model of Change (2-4 pages) | | | See APA template and Rubric – Week #4 – | |
    | Synthesis of the Literature (5-10 pages) | See APA template and Rubric – Week #3 – |
    | Practice Recommendation (1-2 pages) | See APA template and Rubric – Week #3 – |
    | EBP: Verification of Chosen Option (1 paragraph) | See APA template and Rubric – Week #3 – |
    | Project Setting | See APA template and Rubric |
    | Project Vision, Mission, Objectives | See APA template and Rubric |
    | Project Description | See APA template and Rubric |
    | Project Evaluation and Data Analysis | See APA template and Rubric |
    | Implications for Nursing and Healthcare | See APA template and Rubric |
    | Dissemination | See APA template and Rubric |
    | Conclusion | See APA template and Rubric |
    | References | See APA template and Rubric |
    | Appendices | See APA template and Rubric |
    | **Total 100 points** | **A quality essay will meet or exceed all of the above requirements as described on the APA Template for the Final Paper and the following grading rubric.** |

    _DIRECTIONS AND GRADING CRITERIA_

    ## GRADING RUBRIC

    | | | |
    | — | — | — |
    | **PART I: WRITING AND APA CRITERION** | **Approved** | **Not Approved** |
    | **Organization/Structure – 5 points –**<br>There is logical sequencing of ideas through well-developed paragraphs. Transitions are used to enhance organization. There is a logical progression of thoughts and ideas. Concepts are clearly presented with doctoral level vocabulary. The paper is well organized from introduction to conclusion. | | |
    | **Mechanics/Usage — 5 points –**<br>There are few errors in punctuation, capitalization, spelling, sentence structure, or word usage. | | |
    | **APA — 10 points –**<br>There is consistent adherence to APA criteria in title page, running head, headings, citations, and/or reference page. Font, layout, and/or margins adhere to APA format. | | |
    | **Part II: Content** | **Approved** | **Not Approved** |
    | **Theoretical Framework** **–40 points –**<br>Inclusion of the theoretical framework to support the project. The theory serving as the foundation of the project is identified. This may be a nursing theory or a theory from another discipline if pertinent and applicable. Introduction of the theory, identification of its primary premises. Operationalize each of the primary premises from the chosen theoretical framework as they apply | | |
    | specifically to the project. Doing this demonstrates that the student has not only identified a theory, but also was able to conceptualize its use as the project’s framework. | | |
    | **Change Model — 40 points—**<br>Description of selected change model and why it was selected as the model for this specific change. The model selected should be appropriate to the change recommended (i.e., individual change or organizational change). Used the model to describe the practice change recommended even if that is reinforcement and education regarding the status quo. The change process should be specific to the practicum setting. Description provided of every steps of the Change Model. | | |
    | **Total Points = 100 points**<br>**This assignment is graded as an all or none; all criteria must be acceptable to earn the 100 points.** |

    | |
    | — |
    | 2 |

    _DNP 7770 Practicum Project I– Week #4_

    DNP7700 -Contributors: Dr. Anny Dionne, Dr. Karen Perez, Dr. Amarilys Gonzalez, Dr. Trabanco, Dr. De Varona, Dr. Itzel Vega Crespo, Effective Date: 10/26/24

    ![](https://www.sweetstudy.com/questions/create-a-draft-with-the-information-attached-5-pages-no-ai-use-no-plagiarism-references-from-2020-2026-follow-the-template) Dr. Angel Garcia
    ![](https://www.sweetstudy.com/questions/create-a-draft-with-the-information-attached-5-pages-no-ai-use-no-plagiarism-references-from-2020-2026-follow-the-template).

    | |
    | — |
    | 2 |

    ## image1.jpg

    ## image2.jpg

    ## image3.png

  • [Solved] developing an evidence based plan

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    I need help developing an implementation plan using the Iowa Model of Evidence-Based Practice model while identifying key stakeholders, a timeline, and implications for practice

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    Assignment Prompt & Instructions

    I need help developing an implementation plan using the Iowa Model of Evidence-Based Practice model while identifying key stakeholders, a timeline, and implications for practice

  • [Solved] Assigment .Apa seven . All instructions attached.

    ✓ Verified Academic Solution Available

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    **files (1)** – ## TelehealthAccessandRemoteMonitoringinYourCommunity.docx **## TelehealthAccessandRemoteMonitoringinYourCommunity.docx** Nursing Leadership and Management-DBX-DL01 Nora Hernandez-Pupo Writing Assignment Week 4: Telehealth Access and Remote Monitoring in Your Community **Telehealth A…

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    Assignment Prompt & Instructions

    **files (1)**

    – ## TelehealthAccessandRemoteMonitoringinYourCommunity.docx

    **## TelehealthAccessandRemoteMonitoringinYourCommunity.docx**

    Nursing Leadership and Management-DBX-DL01 Nora Hernandez-Pupo

    Writing Assignment Week 4: Telehealth Access and Remote Monitoring in Your Community

    **Telehealth Access and Remote Monitoring in Your Community** _(Examine how healthcare services in_
    _**your specific ZIP code** are providing telehealth and remote monitoring options and whether these services benefit the patient population.)_

    **Assignment Overview**

    **In this essay, you will evaluate the extent to which healthcare services in your specific geographic area (use your ZIP code for specificity- NAME YOUR actual CITY where you live) are offering telehealth and remote monitoring options. You will analyze the impact of these services on patient care and outcomes. Your submission must include at least three examples that you uncovered through research in your neighborhood.**

    **Requirements**

    **Essay Format and Length:**

    · The assignment must be written as a formal essay.

    · It must include an introduction, graduate-level discussion questions and responses, and a conclusion that synthesizes your key points.

    ·
    **The paper should be a minimum of 3 pages in length, excluding the cover page and reference list.**

    **Content Specifics:**

    ·
    **Introduction:**

    · Introduce the topic with background information on telehealth and remote monitoring.

    · Clearly state the purpose of your essay.

    · Provide your ZIP code to contextualize the geographic focus of your study.

    ·
    **Graduate-Level Questions & Analysis:**

    · Develop and answer at least two or three in-depth, graduate-level questions related to:

    · How telehealth and remote monitoring options are integrated into local healthcare services.

    · The benefits (or perceived benefits) these options offer to the patient population.

    · Potential challenges or limitations associated with these technological advances.

    · Make sure to substantiate your analysis with evidence-based practice (EBP). This should include referencing scholarly articles, government or institutional reports, and credible online sources.

    · Include at least three concrete examples from your research in your local neighborhood that illustrate how these services are implemented. Explain how each example supports your discussion.

    ·
    **Conclusion:**

    · Summarize your findings.

    · Synthesize the key points discussed in your paper.

    · Reflect on the overall impact of telehealth and remote monitoring services on patient care in your area.

    **APA Format:**

    · Your essay must strictly adhere to APA 7th Edition guidelines.

    · Ensure correct use of APA formatting for the title page, headings/levels, in-text citations, and the reference list.

    · Double-check that all references are accurately cited within your text and that your reference list is complete.

    **Evidence-Based Practice (EBP):**

    · Develop your answers and support your analysis with evidence-based research.

    · Incorporate data, statistics, and findings from peer-reviewed literature and reputable sources to lend credibility to your discussion.

    · 4 current sources must be used and are peer-review journal articles or scholarly books. Sources include both general background sources and specialized sources.  All REFERENCES must have DOI Numbers for me to look them up

    **Rubric Review:**

    · Before submission, review the assignment rubric provided by your instructor. Make sure your essay addresses all the required components and meets the expected quality criteria.

    **Submission Guidelines**

    ·
    **File Format:** Submit your assignment as a Word document or PDF via the designated course submission portal.

    ·
    **Cover Page and References:** A cover page and a separate references page are required. These pages are not included in the minimum page count.

    ·
    **Deadline:** Submit the final version of your essay by the due date specified in your course calendar.

    ·
    **Proofreading:** Check for clarity, coherence, grammar, and APA formatting before submission. A well-organized and carefully proofread paper will reflect your understanding and attention to detail.

    By following these instructions, you will create a comprehensive, well-structured, and evidence-based analysis of how telehealth and remote monitoring options are utilized within your local healthcare services. This assignment not only highlights your ability to connect academic research with real-world healthcare practices but also demonstrates your capacity for critical thinking and graduate-level writing.

    Feel free to reach out if you have any questions or need further clarification. Good luck with your research and writing!

    Remember, your analysis should be both reflective and analytical, providing a robust discussion on how telehealth solutions are impacting patient care in your own neighborhood. Use your findings to contribute meaningful insights into the ongoing evolution of healthcare services.

    **REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**

    **Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)

    **Details & Information**

    **## TelehealthAccessandRemoteMonitoringinYourCommunity.docx**

    Nursing Leadership and Management-DBX-DL01 Nora Hernandez-Pupo

    Writing Assignment Week 4: Telehealth Access and Remote Monitoring in Your Community

    **Telehealth Access and Remote Monitoring in Your Community** _(Examine how healthcare services in_
    _**your specific ZIP code** are providing telehealth and remote monitoring options and whether these services benefit the patient population.)_

    **Assignment Overview**

    **In this essay, you will evaluate the extent to which healthcare services in your specific geographic area (use your ZIP code for specificity- NAME YOUR actual CITY where you live) are offering telehealth and remote monitoring options. You will analyze the impact of these services on patient care and outcomes. Your submission must include at least three examples that you uncovered through research in your neighborhood.**

    **Requirements**

    **Essay Format and Length:**

    · The assignment must be written as a formal essay.

    · It must include an introduction, graduate-level discussion questions and responses, and a conclusion that synthesizes your key points.

    ·
    **The paper should be a minimum of 3 pages in length, excluding the cover page and reference list.**

    **Content Specifics:**

    ·
    **Introduction:**

    · Introduce the topic with background information on telehealth and remote monitoring.

    · Clearly state the purpose of your essay.

    · Provide your ZIP code to contextualize the geographic focus of your study.

    ·
    **Graduate-Level Questions & Analysis:**

    · Develop and answer at least two or three in-depth, graduate-level questions related to:

    · How telehealth and remote monitoring options are integrated into local healthcare services.

    · The benefits (or perceived benefits) these options offer to the patient population.

    · Potential challenges or limitations associated with these technological advances.

    · Make sure to substantiate your analysis with evidence-based practice (EBP). This should include referencing scholarly articles, government or institutional reports, and credible online sources.

    · Include at least three concrete examples from your research in your local neighborhood that illustrate how these services are implemented. Explain how each example supports your discussion.

    ·
    **Conclusion:**

    · Summarize your findings.

    · Synthesize the key points discussed in your paper.

    · Reflect on the overall impact of telehealth and remote monitoring services on patient care in your area.

    **APA Format:**

    · Your essay must strictly adhere to APA 7th Edition guidelines.

    · Ensure correct use of APA formatting for the title page, headings/levels, in-text citations, and the reference list.

    · Double-check that all references are accurately cited within your text and that your reference list is complete.

    **Evidence-Based Practice (EBP):**

    · Develop your answers and support your analysis with evidence-based research.

    · Incorporate data, statistics, and findings from peer-reviewed literature and reputable sources to lend credibility to your discussion.

    · 4 current sources must be used and are peer-review journal articles or scholarly books. Sources include both general background sources and specialized sources.  All REFERENCES must have DOI Numbers for me to look them up

    **Rubric Review:**

    · Before submission, review the assignment rubric provided by your instructor. Make sure your essay addresses all the required components and meets the expected quality criteria.

    **Submission Guidelines**

    ·
    **File Format:** Submit your assignment as a Word document or PDF via the designated course submission portal.

    ·
    **Cover Page and References:** A cover page and a separate references page are required. These pages are not included in the minimum page count.

    ·
    **Deadline:** Submit the final version of your essay by the due date specified in your course calendar.

    ·
    **Proofreading:** Check for clarity, coherence, grammar, and APA formatting before submission. A well-organized and carefully proofread paper will reflect your understanding and attention to detail.

    By following these instructions, you will create a comprehensive, well-structured, and evidence-based analysis of how telehealth and remote monitoring options are utilized within your local healthcare services. This assignment not only highlights your ability to connect academic research with real-world healthcare practices but also demonstrates your capacity for critical thinking and graduate-level writing.

    Feel free to reach out if you have any questions or need further clarification. Good luck with your research and writing!

    Remember, your analysis should be both reflective and analytical, providing a robust discussion on how telehealth solutions are impacting patient care in your own neighborhood. Use your findings to contribute meaningful insights into the ongoing evolution of healthcare services.

    **REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**

    **Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)

    **Details & Information**

  • [Solved] Assigment .Apa seven . All instructions attached.

    ✓ Verified Academic Solution Available

    Executive Solution Overview

    **files (3)** – ## Attemptfeedback.docx – ## HealthPromotio1.docx – ## Maternal_Mental_Health_Proposal.docx **## Attemptfeedback.docx** Attempt feedback Category 3, Number 15: Maternal Mental Health During the First Postpartum Year Your paper demonstrates alignment good with the assignment instru…

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    Assignment Prompt & Instructions

    **files (3)**

    – ## Attemptfeedback.docx

    – ## HealthPromotio1.docx

    – ## Maternal_Mental_Health_Proposal.docx

    **## Attemptfeedback.docx**

    Attempt feedback

    Category 3, Number 15: Maternal Mental Health During the First Postpartum Year

    Your paper demonstrates alignment good  with the assignment instructions and follows the required organization, including an introduction, global, national, local, and concluding section. The introduction clearly identifies maternal mental health during the first postpartum year as a significant public health concern and effectively explains its impact on mothers, infants, families, and communities. The discussion establishes a strong foundation for the need for health promotion interventions.

    Your paper, needs to incorporate  more synthesis of the literature by comparing findings across studies rather than presenting each study individually. This would further demonstrate graduate-level critical thinking and strengthen the justification for your proposed health promotion strategies.

    Although your local section is good, consider adding county-level postpartum mental health statistics in addition to the shelter-based study to provide a broader representation of maternal mental health across Miami-Dade County.

    From a writing perspective, only minor revisions are recommended. There are several lengthy sentences that could be divided to improve readability. Additionally, review grammatical issues such as unnecessary spaces before punctuation (e.g., "Southern Africa ,") and occasional awkward phrasing (e.g., "The load may occur at different time points" could be revised to "The burden may occur at different time points.") These small refinements will further improve the scholarly flow of the paper.

    **## HealthPromotio1.docx**

    Health Promotion & Role Development in Adv. Nursing Practice-DBX-DL01 Nora Hernandez-Pupo

    Health Promotion Proposal, Part 1

    **Health Promotion Proposal, Part 1-this is the SAME TOPIC that was Approved in WEEK 2.**

    **Description**

    Over the duration of this course,
    **you will submit a scholarly PowerPoint “Health Promotion Program Proposal,” addressing existing nursing knowledge related to health promotion and a written proposal.**

    In the written proposal, you will also develop a health promotion program to meet the health needs of a vulnerable population in your potential concentration area or community. The PowerPoint portion is your presentation of that proposal.

    The proposal must demonstrate graduate school-level writing and critical analysis. The final version of

    your proposal is due in week 8.

    For this assignment you will submit
    **Part One** of your proposal, detailing a health problem that is

    prevalent within
    **your selected group** and demonstrating your
    **research of health promotion strategies for addressing this specific health problem**. At this point, you already developed in your discussions the core ideas of the topic contained in this assignment-
    **this is the SAME TOPIC that was Approved in WEEK 2.** You will use the same information, but it won’t be a copy-and-paste exercise. The purpose is that you enhance your ideas with the comments and outcomes of the weekly discussions and previous evaluations.

    Directions

    1. Introduction. Describe the health problem. Don't type "Introduction".  (1 paragraph at least).

    Using data and statistics, support your claim that the issue you selected is a problem.

    What specifically will you address in your proposed health promotion program?

    Be sure your proposed outcome is realistic and measurable.

    2. Describe the vulnerable population.  (1-3 paragraphs).

    What are the risk factors that make this a vulnerable population?

    Use evidence to support the risk factors you have identified.

    3. Provide a review of literature from scholarly journals (at least 2) of evidence-based interventions that address the problem. (2 paragraphs, one for each article).

    After completing a literature search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and weaknesses of all the sources you have found. (2-3 paragraphs).

    4. Select and present an appropriate health promotion/disease prevention theoretical or conceptual model that best serves as the guiding framework for the proposal.  (2-3 paragraphs).

    For this assignment, a conclusion paragraph is not required.

    Writing Assignment Requirements

    **Three to five pages in length MAXIMUM – do not exceed page limit- be concise (excluding title page, references, and appendices)**

    **Follow APA format**

    **Cite a minimum of 6 references**

    **Please review the rubric prior to submission.**

    Sample APA paper for your reference:

    **APA 7 – Professional Sample Paper – 2020.pdf**

    **REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**

    **Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)

    **Submission**

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    Press Alt + F10 to access toolbar options

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    **## Maternal_Mental_Health_Proposal.docx**

    1

    **Category 3, Number 15: Maternal Mental Health During the First Postpartum Year**

    Ana Hernandez

    Florida National University

    Health Promotion & Role Development in Advanced Nursing Practice

    Nora Hernandez-Pupo

    July 11, 2026

    **Category 3, Number 15: Maternal Mental Health During the First Postpartum Year**

    Maternal mental health in the first postpartum year is a critical issue for women’s health, newborn development and family stability. The most common illness to be assessed is postpartum depression, but postpartum anxiety, trauma-related symptoms, obsessive thoughts, and severe mood disorders can also develop or persist after childbirth. Persistent symptoms may impair sleep, self-care, maternal-infant bonding, nursing, relationships, and access to routine health services. Maternal mental health cannot be addressed by individual responsibility alone, because risk is shaped by biological changes, poverty, violence, lack of social support, housing instability, language obstacles and fragmented care. This idea is congruent with a multilevel health-promotion model that includes recurrent screening in the first year postpartum, culturally sensitive education, timely referral, peer and family support, and integrated community services.

    The scale and uneven distribution of the problem highlight the global significance of postpartum mental health. A synthesis of 565 research from 80 countries or regions that included over 1.2 million women was conducted by Wang et al. (2021), who calculated a global prevalence of postpartum depression of 17.22%. The same analysis revealed significant variation by geography, with a prevalence of 39.96% in Southern Africa , and pointed to national development and income as crucial drivers to interregional variances . Prevalence differences were also connected with social support, partner engagement, aggression, financial difficulties, stressful life events, pregnancy intention and living conditions. The results of this study demonstrate that postpartum depression is not a rare condition and is tightly linked with the social and economic contexts in which mothers recover and care for their infants.

    Disparities are considerably more pronounced in resource-limited contexts. Roddy Mitchell et al. (2023) looked at 589 studies that included 616,708 women from 51 low- and middle-income countries and reported a pooled prevalence of prenatal depression of 24.7%, or about one in four women. The prevalence was 31.5% in Middle East and North Africa and was notably high among women exposed to intimate partner abuse (38.9%), women living with HIV (35.1%) and women affected by natural disasters (34.8%). Such figures imply that measures for health promotion should not be limited to teaching on symptoms. Successful programs globally should build capacity for primary care and maternal-child health providers, include mental health screening as part of prenatal and postpartum services, build functional referral systems in low-resource settings, and leverage community health workers or peer support when access to specialty care is limited.

    Postpartum depression is frequent in the United States, and the load may occur at different time points within the first year. Robbins et al. (2023) reported that 7.2% of moms had depression symptoms at 9 to 10 months postpartum, using data from the Pregnancy Risk Assessment Monitoring System connected to a follow-up survey of 1,954 mothers (Robbins et al., 2023). Importantly, 57.4% of the moms having symptoms at this later assessment did not report depressed symptoms at 2 to 6 months. Strong associations were found between postpartum Medicaid coverage, a history of depression, and current postpartum anxiety with symptoms at 9 to 10 months. These findings highlight the inadequacy of a single screening at the usual postpartum visit and support screening at several touch points including obstetric follow-up, primary care visits, home visits, and pediatric well-child visits.

    National evidence also shows increasing diagnosis and significant racial and ethnic discrepancies. In a varied health-system cohort of 442,308 births, diagnosed postpartum depression increased from 9.4% in 2010 to 19.0% in 2021, reported Khadka et al. (2024). Over the same period of time, the rates grew from 8.9% to 18.8% among Hispanic patients and from 9.2% to 22.0% among non-Hispanic Black patients. A separate nationwide analysis of PRAMS data indicated that 54% of mothers who reported postpartum depressive symptoms lived at or below the federal poverty limit, and that psychosocial stress during pregnancy was related with more than three times the odds of symptoms (O’Connor & Su, 2023). Collectively, these findings support programs that combine validated screening with tangible aid for food insecurity, insurance continuity, intimate partner violence, transportation, childcare, and access to linguistically appropriate behavioral health services.

    The local relevance of the topic is apparent in Miami, especially among moms experiencing housing and financial insecurity. Curzon et al. (2025) examined 182 mothers with infants age seven months or younger receiving services in a women’s shelter in Miami. At baseline, 15.3% had clinically high self-reported postpartum depression symptoms. This study represents a highly vulnerable local group and should not be generalized to the prevalence for all mothers in Miami-Dade County, but it provides direct evidence that postpartum mental health needs exist within local community settings where traditional office-based care may be difficult to access. The findings also underscore the necessity of implementing screening into trusted spaces for postpartum families, including shelters, home-visiting services, community centers, food-assistance programs, and others.

    The Miami study also shows that relationship-based community intervention can lead to better results. Following 16 weeks of child-parent psychotherapy, the percentage of mothers with clinically high symptoms reduced from 15.3% to 6.7%, treatment satisfaction was 94%, and participants reported reductions in parenting stress and depressive symptom intensity (Curzon et al., 2025). These findings could inform a local health promotion program that includes bilingual English Spanish education, repeated screening with a validated instrument, same-day suicide risk assessment, when necessary, warm referrals to therapy or psychiatric care, peer support groups, partner and family education, navigation to housing, nutrition, insurance, and childcare resources. Advanced practice nurses can spearhead this paradigm by training community partners, doing clinical assessments, coordinating interdisciplinary referrals, assessing medication and breastfeeding issues, and following up to ensure women actually receive follow-up care.

    Evidence supports promoting mother mental health globally, nationally, and locally throughout the first postpartum year. Statistics from worldwide and U.S. data suggest a significant burden, and late-onset symptoms demonstrate that moms who screen negative initially may nevertheless develop depression months after birth (Robbins et al., 2023; Wang et al., 2021). Local Miami data also demonstrate that relationship-based, community-integrated care can alleviate symptoms among moms enduring substantial social adversity (Curzon et al., 2025). Thus, a good program should not be restricted to the distribution of educational materials or to one screening. It should provide a continuous system of culturally relevant identification, connection to treatment, support and follow-up, and address the socioeconomic circumstances that promote risk. Advanced practice nurses can contribute to safeguarding mother functioning, improving early parent-child connections, and reducing preventable mental health inequities through leadership, advocacy, clinical competence, and partnering with community organizations.

    **References**

    Curzon, M. M., Graziano, P. A., Arcia, E., Cox, S. K., Ayala, M., Carnero, N. A., O'Mara, N., & Sundari Foundation (2025). Initial promise of child-parent psychotherapy in reducing stress and postpartum depression among mothers experiencing homelessness: a feasibility and pilot study.
    _Archives of women's mental health_,
    _28_(2), 385–394.
    [https://doi.org/10.1007/s00737-024-01492-8](https://doi.org/10.1007/s00737-024-01492-8)

    Khadka, N., Fassett, M. J., Oyelese, Y., Mensah, N. A., Chiu, V. Y., Yeh, M., Peltier, M. R., & Getahun, D. (2024). Trends in Postpartum Depression by Race, Ethnicity, and Prepregnancy Body Mass Index.
    _JAMA network open_,
    _7_(11), e2446486.
    [https://doi.org/10.1001/jamanetworkopen.2024.46486](https://doi.org/10.1001/jamanetworkopen.2024.46486)

    Roddy Mitchell, A., Gordon, H., Lindquist, A., Walker, S. P., Homer, C. S. E., Middleton, A., Cluver, C. A., Tong, S., & Hastie, R. (2023). Prevalence of Perinatal Depression in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis.
    _JAMA psychiatry_,
    _80_(5), 425–431. https://doi.org/10.1001/jamapsychiatry.2023.0069

    O'Connor, S., & Su, L. J. (2023). Postpartum Depressive Symptoms: An Analysis of Social Determinants Using the Pregnancy Risk Assessment Monitoring System.
    _Women's health reports (New Rochelle, N.Y.)_,
    _4_(1), 584–593. https://doi.org/10.1089/whr.2023.0050

    Robbins, C. L., Ko, J. Y., D'Angelo, D. V., Salvesen von Essen, B., Bish, C. L., Kroelinger, C. D., Tevendale, H. D., Warner, L., & Barfield, W. (2023). Timing of Postpartum Depressive Symptoms.
    _Preventing chronic disease_,
    _20_, E103. https://doi.org/10.5888/pcd20.230107

    Wang, Z., Liu, J., Shuai, H., Cai, Z., Fu, X., Liu, Y., Xiao, X., Zhang, W., Krabbendam, E., Liu, S., Liu, Z., Li, Z., & Yang, B. X. (2021). Mapping global prevalence of depression among postpartum women.
    _Translational psychiatry_,
    _11_(1), 543. https://doi.org/10.1038/s41398-021-01663-6

    **## Maternal_Mental_Health_Proposal.docx**

    1

    **Category 3, Number 15: Maternal Mental Health During the First Postpartum Year**

    Ana Hernandez

    Florida National University

    Health Promotion & Role Development in Advanced Nursing Practice

    Nora Hernandez-Pupo

    July 11, 2026

    **Category 3, Number 15: Maternal Mental Health During the First Postpartum Year**

    Maternal mental health in the first postpartum year is a critical issue for women’s health, newborn development and family stability. The most common illness to be assessed is postpartum depression, but postpartum anxiety, trauma-related symptoms, obsessive thoughts, and severe mood disorders can also develop or persist after childbirth. Persistent symptoms may impair sleep, self-care, maternal-infant bonding, nursing, relationships, and access to routine health services. Maternal mental health cannot be addressed by individual responsibility alone, because risk is shaped by biological changes, poverty, violence, lack of social support, housing instability, language obstacles and fragmented care. This idea is congruent with a multilevel health-promotion model that includes recurrent screening in the first year postpartum, culturally sensitive education, timely referral, peer and family support, and integrated community services.

    The scale and uneven distribution of the problem highlight the global significance of postpartum mental health. A synthesis of 565 research from 80 countries or regions that included over 1.2 million women was conducted by Wang et al. (2021), who calculated a global prevalence of postpartum depression of 17.22%. The same analysis revealed significant variation by geography, with a prevalence of 39.96% in Southern Africa , and pointed to national development and income as crucial drivers to interregional variances . Prevalence differences were also connected with social support, partner engagement, aggression, financial difficulties, stressful life events, pregnancy intention and living conditions. The results of this study demonstrate that postpartum depression is not a rare condition and is tightly linked with the social and economic contexts in which mothers recover and care for their infants.

    Disparities are considerably more pronounced in resource-limited contexts. Roddy Mitchell et al. (2023) looked at 589 studies that included 616,708 women from 51 low- and middle-income countries and reported a pooled prevalence of prenatal depression of 24.7%, or about one in four women. The prevalence was 31.5% in Middle East and North Africa and was notably high among women exposed to intimate partner abuse (38.9%), women living with HIV (35.1%) and women affected by natural disasters (34.8%). Such figures imply that measures for health promotion should not be limited to teaching on symptoms. Successful programs globally should build capacity for primary care and maternal-child health providers, include mental health screening as part of prenatal and postpartum services, build functional referral systems in low-resource settings, and leverage community health workers or peer support when access to specialty care is limited.

    Postpartum depression is frequent in the United States, and the load may occur at different time points within the first year. Robbins et al. (2023) reported that 7.2% of moms had depression symptoms at 9 to 10 months postpartum, using data from the Pregnancy Risk Assessment Monitoring System connected to a follow-up survey of 1,954 mothers (Robbins et al., 2023). Importantly, 57.4% of the moms having symptoms at this later assessment did not report depressed symptoms at 2 to 6 months. Strong associations were found between postpartum Medicaid coverage, a history of depression, and current postpartum anxiety with symptoms at 9 to 10 months. These findings highlight the inadequacy of a single screening at the usual postpartum visit and support screening at several touch points including obstetric follow-up, primary care visits, home visits, and pediatric well-child visits.

    National evidence also shows increasing diagnosis and significant racial and ethnic discrepancies. In a varied health-system cohort of 442,308 births, diagnosed postpartum depression increased from 9.4% in 2010 to 19.0% in 2021, reported Khadka et al. (2024). Over the same period of time, the rates grew from 8.9% to 18.8% among Hispanic patients and from 9.2% to 22.0% among non-Hispanic Black patients. A separate nationwide analysis of PRAMS data indicated that 54% of mothers who reported postpartum depressive symptoms lived at or below the federal poverty limit, and that psychosocial stress during pregnancy was related with more than three times the odds of symptoms (O’Connor & Su, 2023). Collectively, these findings support programs that combine validated screening with tangible aid for food insecurity, insurance continuity, intimate partner violence, transportation, childcare, and access to linguistically appropriate behavioral health services.

    The local relevance of the topic is apparent in Miami, especially among moms experiencing housing and financial insecurity. Curzon et al. (2025) examined 182 mothers with infants age seven months or younger receiving services in a women’s shelter in Miami. At baseline, 15.3% had clinically high self-reported postpartum depression symptoms. This study represents a highly vulnerable local group and should not be generalized to the prevalence for all mothers in Miami-Dade County, but it provides direct evidence that postpartum mental health needs exist within local community settings where traditional office-based care may be difficult to access. The findings also underscore the necessity of implementing screening into trusted spaces for postpartum families, including shelters, home-visiting services, community centers, food-assistance programs, and others.

    The Miami study also shows that relationship-based community intervention can lead to better results. Following 16 weeks of child-parent psychotherapy, the percentage of mothers with clinically high symptoms reduced from 15.3% to 6.7%, treatment satisfaction was 94%, and participants reported reductions in parenting stress and depressive symptom intensity (Curzon et al., 2025). These findings could inform a local health promotion program that includes bilingual English Spanish education, repeated screening with a validated instrument, same-day suicide risk assessment, when necessary, warm referrals to therapy or psychiatric care, peer support groups, partner and family education, navigation to housing, nutrition, insurance, and childcare resources. Advanced practice nurses can spearhead this paradigm by training community partners, doing clinical assessments, coordinating interdisciplinary referrals, assessing medication and breastfeeding issues, and following up to ensure women actually receive follow-up care.

    Evidence supports promoting mother mental health globally, nationally, and locally throughout the first postpartum year. Statistics from worldwide and U.S. data suggest a significant burden, and late-onset symptoms demonstrate that moms who screen negative initially may nevertheless develop depression months after birth (Robbins et al., 2023; Wang et al., 2021). Local Miami data also demonstrate that relationship-based, community-integrated care can alleviate symptoms among moms enduring substantial social adversity (Curzon et al., 2025). Thus, a good program should not be restricted to the distribution of educational materials or to one screening. It should provide a continuous system of culturally relevant identification, connection to treatment, support and follow-up, and address the socioeconomic circumstances that promote risk. Advanced practice nurses can contribute to safeguarding mother functioning, improving early parent-child connections, and reducing preventable mental health inequities through leadership, advocacy, clinical competence, and partnering with community organizations.

    **References**

    Curzon, M. M., Graziano, P. A., Arcia, E., Cox, S. K., Ayala, M., Carnero, N. A., O'Mara, N., & Sundari Foundation (2025). Initial promise of child-parent psychotherapy in reducing stress and postpartum depression among mothers experiencing homelessness: a feasibility and pilot study.
    _Archives of women's mental health_,
    _28_(2), 385–394.
    [https://doi.org/10.1007/s00737-024-01492-8](https://doi.org/10.1007/s00737-024-01492-8)

    Khadka, N., Fassett, M. J., Oyelese, Y., Mensah, N. A., Chiu, V. Y., Yeh, M., Peltier, M. R., & Getahun, D. (2024). Trends in Postpartum Depression by Race, Ethnicity, and Prepregnancy Body Mass Index.
    _JAMA network open_,
    _7_(11), e2446486.
    [https://doi.org/10.1001/jamanetworkopen.2024.46486](https://doi.org/10.1001/jamanetworkopen.2024.46486)

    Roddy Mitchell, A., Gordon, H., Lindquist, A., Walker, S. P., Homer, C. S. E., Middleton, A., Cluver, C. A., Tong, S., & Hastie, R. (2023). Prevalence of Perinatal Depression in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis.
    _JAMA psychiatry_,
    _80_(5), 425–431. https://doi.org/10.1001/jamapsychiatry.2023.0069

    O'Connor, S., & Su, L. J. (2023). Postpartum Depressive Symptoms: An Analysis of Social Determinants Using the Pregnancy Risk Assessment Monitoring System.
    _Women's health reports (New Rochelle, N.Y.)_,
    _4_(1), 584–593. https://doi.org/10.1089/whr.2023.0050

    Robbins, C. L., Ko, J. Y., D'Angelo, D. V., Salvesen von Essen, B., Bish, C. L., Kroelinger, C. D., Tevendale, H. D., Warner, L., & Barfield, W. (2023). Timing of Postpartum Depressive Symptoms.
    _Preventing chronic disease_,
    _20_, E103. https://doi.org/10.5888/pcd20.230107

    Wang, Z., Liu, J., Shuai, H., Cai, Z., Fu, X., Liu, Y., Xiao, X., Zhang, W., Krabbendam, E., Liu, S., Liu, Z., Li, Z., & Yang, B. X. (2021). Mapping global prevalence of depression among postpartum women.
    _Translational psychiatry_,
    _11_(1), 543. https://doi.org/10.1038/s41398-021-01663-6

    **## Attemptfeedback.docx**

    Attempt feedback

    Category 3, Number 15: Maternal Mental Health During the First Postpartum Year

    Your paper demonstrates alignment good  with the assignment instructions and follows the required organization, including an introduction, global, national, local, and concluding section. The introduction clearly identifies maternal mental health during the first postpartum year as a significant public health concern and effectively explains its impact on mothers, infants, families, and communities. The discussion establishes a strong foundation for the need for health promotion interventions.

    Your paper, needs to incorporate  more synthesis of the literature by comparing findings across studies rather than presenting each study individually. This would further demonstrate graduate-level critical thinking and strengthen the justification for your proposed health promotion strategies.

    Although your local section is good, consider adding county-level postpartum mental health statistics in addition to the shelter-based study to provide a broader representation of maternal mental health across Miami-Dade County.

    From a writing perspective, only minor revisions are recommended. There are several lengthy sentences that could be divided to improve readability. Additionally, review grammatical issues such as unnecessary spaces before punctuation (e.g., "Southern Africa ,") and occasional awkward phrasing (e.g., "The load may occur at different time points" could be revised to "The burden may occur at different time points.") These small refinements will further improve the scholarly flow of the paper.

    **## HealthPromotio1.docx**

    Health Promotion & Role Development in Adv. Nursing Practice-DBX-DL01 Nora Hernandez-Pupo

    Health Promotion Proposal, Part 1

    **Health Promotion Proposal, Part 1-this is the SAME TOPIC that was Approved in WEEK 2.**

    **Description**

    Over the duration of this course,
    **you will submit a scholarly PowerPoint “Health Promotion Program Proposal,” addressing existing nursing knowledge related to health promotion and a written proposal.**

    In the written proposal, you will also develop a health promotion program to meet the health needs of a vulnerable population in your potential concentration area or community. The PowerPoint portion is your presentation of that proposal.

    The proposal must demonstrate graduate school-level writing and critical analysis. The final version of

    your proposal is due in week 8.

    For this assignment you will submit
    **Part One** of your proposal, detailing a health problem that is

    prevalent within
    **your selected group** and demonstrating your
    **research of health promotion strategies for addressing this specific health problem**. At this point, you already developed in your discussions the core ideas of the topic contained in this assignment-
    **this is the SAME TOPIC that was Approved in WEEK 2.** You will use the same information, but it won’t be a copy-and-paste exercise. The purpose is that you enhance your ideas with the comments and outcomes of the weekly discussions and previous evaluations.

    Directions

    1. Introduction. Describe the health problem. Don't type "Introduction".  (1 paragraph at least).

    Using data and statistics, support your claim that the issue you selected is a problem.

    What specifically will you address in your proposed health promotion program?

    Be sure your proposed outcome is realistic and measurable.

    2. Describe the vulnerable population.  (1-3 paragraphs).

    What are the risk factors that make this a vulnerable population?

    Use evidence to support the risk factors you have identified.

    3. Provide a review of literature from scholarly journals (at least 2) of evidence-based interventions that address the problem. (2 paragraphs, one for each article).

    After completing a literature search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and weaknesses of all the sources you have found. (2-3 paragraphs).

    4. Select and present an appropriate health promotion/disease prevention theoretical or conceptual model that best serves as the guiding framework for the proposal.  (2-3 paragraphs).

    For this assignment, a conclusion paragraph is not required.

    Writing Assignment Requirements

    **Three to five pages in length MAXIMUM – do not exceed page limit- be concise (excluding title page, references, and appendices)**

    **Follow APA format**

    **Cite a minimum of 6 references**

    **Please review the rubric prior to submission.**

    Sample APA paper for your reference:

    **APA 7 – Professional Sample Paper – 2020.pdf**

    **REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**

    **Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)

    **Submission**

    Text Editor

    Press Alt + F10 to access toolbar options

    _Word count: 0_

    **Drag files here**

    Maximum size: 512 MB

    **or**

    **Details & Information**

    **## Maternal_Mental_Health_Proposal.docx**

    1

    **Category 3, Number 15: Maternal Mental Health During the First Postpartum Year**

    Ana Hernandez

    Florida National University

    Health Promotion & Role Development in Advanced Nursing Practice

    Nora Hernandez-Pupo

    July 11, 2026

    **Category 3, Number 15: Maternal Mental Health During the First Postpartum Year**

    Maternal mental health in the first postpartum year is a critical issue for women’s health, newborn development and family stability. The most common illness to be assessed is postpartum depression, but postpartum anxiety, trauma-related symptoms, obsessive thoughts, and severe mood disorders can also develop or persist after childbirth. Persistent symptoms may impair sleep, self-care, maternal-infant bonding, nursing, relationships, and access to routine health services. Maternal mental health cannot be addressed by individual responsibility alone, because risk is shaped by biological changes, poverty, violence, lack of social support, housing instability, language obstacles and fragmented care. This idea is congruent with a multilevel health-promotion model that includes recurrent screening in the first year postpartum, culturally sensitive education, timely referral, peer and family support, and integrated community services.

    The scale and uneven distribution of the problem highlight the global significance of postpartum mental health. A synthesis of 565 research from 80 countries or regions that included over 1.2 million women was conducted by Wang et al. (2021), who calculated a global prevalence of postpartum depression of 17.22%. The same analysis revealed significant variation by geography, with a prevalence of 39.96% in Southern Africa , and pointed to national development and income as crucial drivers to interregional variances . Prevalence differences were also connected with social support, partner engagement, aggression, financial difficulties, stressful life events, pregnancy intention and living conditions. The results of this study demonstrate that postpartum depression is not a rare condition and is tightly linked with the social and economic contexts in which mothers recover and care for their infants.

    Disparities are considerably more pronounced in resource-limited contexts. Roddy Mitchell et al. (2023) looked at 589 studies that included 616,708 women from 51 low- and middle-income countries and reported a pooled prevalence of prenatal depression of 24.7%, or about one in four women. The prevalence was 31.5% in Middle East and North Africa and was notably high among women exposed to intimate partner abuse (38.9%), women living with HIV (35.1%) and women affected by natural disasters (34.8%). Such figures imply that measures for health promotion should not be limited to teaching on symptoms. Successful programs globally should build capacity for primary care and maternal-child health providers, include mental health screening as part of prenatal and postpartum services, build functional referral systems in low-resource settings, and leverage community health workers or peer support when access to specialty care is limited.

    Postpartum depression is frequent in the United States, and the load may occur at different time points within the first year. Robbins et al. (2023) reported that 7.2% of moms had depression symptoms at 9 to 10 months postpartum, using data from the Pregnancy Risk Assessment Monitoring System connected to a follow-up survey of 1,954 mothers (Robbins et al., 2023). Importantly, 57.4% of the moms having symptoms at this later assessment did not report depressed symptoms at 2 to 6 months. Strong associations were found between postpartum Medicaid coverage, a history of depression, and current postpartum anxiety with symptoms at 9 to 10 months. These findings highlight the inadequacy of a single screening at the usual postpartum visit and support screening at several touch points including obstetric follow-up, primary care visits, home visits, and pediatric well-child visits.

    National evidence also shows increasing diagnosis and significant racial and ethnic discrepancies. In a varied health-system cohort of 442,308 births, diagnosed postpartum depression increased from 9.4% in 2010 to 19.0% in 2021, reported Khadka et al. (2024). Over the same period of time, the rates grew from 8.9% to 18.8% among Hispanic patients and from 9.2% to 22.0% among non-Hispanic Black patients. A separate nationwide analysis of PRAMS data indicated that 54% of mothers who reported postpartum depressive symptoms lived at or below the federal poverty limit, and that psychosocial stress during pregnancy was related with more than three times the odds of symptoms (O’Connor & Su, 2023). Collectively, these findings support programs that combine validated screening with tangible aid for food insecurity, insurance continuity, intimate partner violence, transportation, childcare, and access to linguistically appropriate behavioral health services.

    The local relevance of the topic is apparent in Miami, especially among moms experiencing housing and financial insecurity. Curzon et al. (2025) examined 182 mothers with infants age seven months or younger receiving services in a women’s shelter in Miami. At baseline, 15.3% had clinically high self-reported postpartum depression symptoms. This study represents a highly vulnerable local group and should not be generalized to the prevalence for all mothers in Miami-Dade County, but it provides direct evidence that postpartum mental health needs exist within local community settings where traditional office-based care may be difficult to access. The findings also underscore the necessity of implementing screening into trusted spaces for postpartum families, including shelters, home-visiting services, community centers, food-assistance programs, and others.

    The Miami study also shows that relationship-based community intervention can lead to better results. Following 16 weeks of child-parent psychotherapy, the percentage of mothers with clinically high symptoms reduced from 15.3% to 6.7%, treatment satisfaction was 94%, and participants reported reductions in parenting stress and depressive symptom intensity (Curzon et al., 2025). These findings could inform a local health promotion program that includes bilingual English Spanish education, repeated screening with a validated instrument, same-day suicide risk assessment, when necessary, warm referrals to therapy or psychiatric care, peer support groups, partner and family education, navigation to housing, nutrition, insurance, and childcare resources. Advanced practice nurses can spearhead this paradigm by training community partners, doing clinical assessments, coordinating interdisciplinary referrals, assessing medication and breastfeeding issues, and following up to ensure women actually receive follow-up care.

    Evidence supports promoting mother mental health globally, nationally, and locally throughout the first postpartum year. Statistics from worldwide and U.S. data suggest a significant burden, and late-onset symptoms demonstrate that moms who screen negative initially may nevertheless develop depression months after birth (Robbins et al., 2023; Wang et al., 2021). Local Miami data also demonstrate that relationship-based, community-integrated care can alleviate symptoms among moms enduring substantial social adversity (Curzon et al., 2025). Thus, a good program should not be restricted to the distribution of educational materials or to one screening. It should provide a continuous system of culturally relevant identification, connection to treatment, support and follow-up, and address the socioeconomic circumstances that promote risk. Advanced practice nurses can contribute to safeguarding mother functioning, improving early parent-child connections, and reducing preventable mental health inequities through leadership, advocacy, clinical competence, and partnering with community organizations.

    **References**

    Curzon, M. M., Graziano, P. A., Arcia, E., Cox, S. K., Ayala, M., Carnero, N. A., O'Mara, N., & Sundari Foundation (2025). Initial promise of child-parent psychotherapy in reducing stress and postpartum depression among mothers experiencing homelessness: a feasibility and pilot study.
    _Archives of women's mental health_,
    _28_(2), 385–394.
    [https://doi.org/10.1007/s00737-024-01492-8](https://doi.org/10.1007/s00737-024-01492-8)

    Khadka, N., Fassett, M. J., Oyelese, Y., Mensah, N. A., Chiu, V. Y., Yeh, M., Peltier, M. R., & Getahun, D. (2024). Trends in Postpartum Depression by Race, Ethnicity, and Prepregnancy Body Mass Index.
    _JAMA network open_,
    _7_(11), e2446486.
    [https://doi.org/10.1001/jamanetworkopen.2024.46486](https://doi.org/10.1001/jamanetworkopen.2024.46486)

    Roddy Mitchell, A., Gordon, H., Lindquist, A., Walker, S. P., Homer, C. S. E., Middleton, A., Cluver, C. A., Tong, S., & Hastie, R. (2023). Prevalence of Perinatal Depression in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis.
    _JAMA psychiatry_,
    _80_(5), 425–431. https://doi.org/10.1001/jamapsychiatry.2023.0069

    O'Connor, S., & Su, L. J. (2023). Postpartum Depressive Symptoms: An Analysis of Social Determinants Using the Pregnancy Risk Assessment Monitoring System.
    _Women's health reports (New Rochelle, N.Y.)_,
    _4_(1), 584–593. https://doi.org/10.1089/whr.2023.0050

    Robbins, C. L., Ko, J. Y., D'Angelo, D. V., Salvesen von Essen, B., Bish, C. L., Kroelinger, C. D., Tevendale, H. D., Warner, L., & Barfield, W. (2023). Timing of Postpartum Depressive Symptoms.
    _Preventing chronic disease_,
    _20_, E103. https://doi.org/10.5888/pcd20.230107

    Wang, Z., Liu, J., Shuai, H., Cai, Z., Fu, X., Liu, Y., Xiao, X., Zhang, W., Krabbendam, E., Liu, S., Liu, Z., Li, Z., & Yang, B. X. (2021). Mapping global prevalence of depression among postpartum women.
    _Translational psychiatry_,
    _11_(1), 543. https://doi.org/10.1038/s41398-021-01663-6

    **## Attemptfeedback.docx**

    Attempt feedback

    Category 3, Number 15: Maternal Mental Health During the First Postpartum Year

    Your paper demonstrates alignment good  with the assignment instructions and follows the required organization, including an introduction, global, national, local, and concluding section. The introduction clearly identifies maternal mental health during the first postpartum year as a significant public health concern and effectively explains its impact on mothers, infants, families, and communities. The discussion establishes a strong foundation for the need for health promotion interventions.

    Your paper, needs to incorporate  more synthesis of the literature by comparing findings across studies rather than presenting each study individually. This would further demonstrate graduate-level critical thinking and strengthen the justification for your proposed health promotion strategies.

    Although your local section is good, consider adding county-level postpartum mental health statistics in addition to the shelter-based study to provide a broader representation of maternal mental health across Miami-Dade County.

    From a writing perspective, only minor revisions are recommended. There are several lengthy sentences that could be divided to improve readability. Additionally, review grammatical issues such as unnecessary spaces before punctuation (e.g., "Southern Africa ,") and occasional awkward phrasing (e.g., "The load may occur at different time points" could be revised to "The burden may occur at different time points.") These small refinements will further improve the scholarly flow of the paper.

    **## HealthPromotio1.docx**

    Health Promotion & Role Development in Adv. Nursing Practice-DBX-DL01 Nora Hernandez-Pupo

    Health Promotion Proposal, Part 1

    **Health Promotion Proposal, Part 1-this is the SAME TOPIC that was Approved in WEEK 2.**

    **Description**

    Over the duration of this course,
    **you will submit a scholarly PowerPoint “Health Promotion Program Proposal,” addressing existing nursing knowledge related to health promotion and a written proposal.**

    In the written proposal, you will also develop a health promotion program to meet the health needs of a vulnerable population in your potential concentration area or community. The PowerPoint portion is your presentation of that proposal.

    The proposal must demonstrate graduate school-level writing and critical analysis. The final version of

    your proposal is due in week 8.

    For this assignment you will submit
    **Part One** of your proposal, detailing a health problem that is

    prevalent within
    **your selected group** and demonstrating your
    **research of health promotion strategies for addressing this specific health problem**. At this point, you already developed in your discussions the core ideas of the topic contained in this assignment-
    **this is the SAME TOPIC that was Approved in WEEK 2.** You will use the same information, but it won’t be a copy-and-paste exercise. The purpose is that you enhance your ideas with the comments and outcomes of the weekly discussions and previous evaluations.

    Directions

    1. Introduction. Describe the health problem. Don't type "Introduction".  (1 paragraph at least).

    Using data and statistics, support your claim that the issue you selected is a problem.

    What specifically will you address in your proposed health promotion program?

    Be sure your proposed outcome is realistic and measurable.

    2. Describe the vulnerable population.  (1-3 paragraphs).

    What are the risk factors that make this a vulnerable population?

    Use evidence to support the risk factors you have identified.

    3. Provide a review of literature from scholarly journals (at least 2) of evidence-based interventions that address the problem. (2 paragraphs, one for each article).

    After completing a literature search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and weaknesses of all the sources you have found. (2-3 paragraphs).

    4. Select and present an appropriate health promotion/disease prevention theoretical or conceptual model that best serves as the guiding framework for the proposal.  (2-3 paragraphs).

    For this assignment, a conclusion paragraph is not required.

    Writing Assignment Requirements

    **Three to five pages in length MAXIMUM – do not exceed page limit- be concise (excluding title page, references, and appendices)**

    **Follow APA format**

    **Cite a minimum of 6 references**

    **Please review the rubric prior to submission.**

    Sample APA paper for your reference:

    **APA 7 – Professional Sample Paper – 2020.pdf**

    **REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**

    **Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)

    **Submission**

    Text Editor

    Press Alt + F10 to access toolbar options

    _Word count: 0_

    **Drag files here**

    Maximum size: 512 MB

    **or**

    **Details & Information**

    **## Maternal_Mental_Health_Proposal.docx**

    1

    **Category 3, Number 15: Maternal Mental Health During the First Postpartum Year**

    Ana Hernandez

    Florida National University

    Health Promotion & Role Development in Advanced Nursing Practice

    Nora Hernandez-Pupo

    July 11, 2026

    **Category 3, Number 15: Maternal Mental Health During the First Postpartum Year**

    Maternal mental health in the first postpartum year is a critical issue for women’s health, newborn development and family stability. The most common illness to be assessed is postpartum depression, but postpartum anxiety, trauma-related symptoms, obsessive thoughts, and severe mood disorders can also develop or persist after childbirth. Persistent symptoms may impair sleep, self-care, maternal-infant bonding, nursing, relationships, and access to routine health services. Maternal mental health cannot be addressed by individual responsibility alone, because risk is shaped by biological changes, poverty, violence, lack of social support, housing instability, language obstacles and fragmented care. This idea is congruent with a multilevel health-promotion model that includes recurrent screening in the first year postpartum, culturally sensitive education, timely referral, peer and family support, and integrated community services.

    The scale and uneven distribution of the problem highlight the global significance of postpartum mental health. A synthesis of 565 research from 80 countries or regions that included over 1.2 million women was conducted by Wang et al. (2021), who calculated a global prevalence of postpartum depression of 17.22%. The same analysis revealed significant variation by geography, with a prevalence of 39.96% in Southern Africa , and pointed to national development and income as crucial drivers to interregional variances . Prevalence differences were also connected with social support, partner engagement, aggression, financial difficulties, stressful life events, pregnancy intention and living conditions. The results of this study demonstrate that postpartum depression is not a rare condition and is tightly linked with the social and economic contexts in which mothers recover and care for their infants.

    Disparities are considerably more pronounced in resource-limited contexts. Roddy Mitchell et al. (2023) looked at 589 studies that included 616,708 women from 51 low- and middle-income countries and reported a pooled prevalence of prenatal depression of 24.7%, or about one in four women. The prevalence was 31.5% in Middle East and North Africa and was notably high among women exposed to intimate partner abuse (38.9%), women living with HIV (35.1%) and women affected by natural disasters (34.8%). Such figures imply that measures for health promotion should not be limited to teaching on symptoms. Successful programs globally should build capacity for primary care and maternal-child health providers, include mental health screening as part of prenatal and postpartum services, build functional referral systems in low-resource settings, and leverage community health workers or peer support when access to specialty care is limited.

    Postpartum depression is frequent in the United States, and the load may occur at different time points within the first year. Robbins et al. (2023) reported that 7.2% of moms had depression symptoms at 9 to 10 months postpartum, using data from the Pregnancy Risk Assessment Monitoring System connected to a follow-up survey of 1,954 mothers (Robbins et al., 2023). Importantly, 57.4% of the moms having symptoms at this later assessment did not report depressed symptoms at 2 to 6 months. Strong associations were found between postpartum Medicaid coverage, a history of depression, and current postpartum anxiety with symptoms at 9 to 10 months. These findings highlight the inadequacy of a single screening at the usual postpartum visit and support screening at several touch points including obstetric follow-up, primary care visits, home visits, and pediatric well-child visits.

    National evidence also shows increasing diagnosis and significant racial and ethnic discrepancies. In a varied health-system cohort of 442,308 births, diagnosed postpartum depression increased from 9.4% in 2010 to 19.0% in 2021, reported Khadka et al. (2024). Over the same period of time, the rates grew from 8.9% to 18.8% among Hispanic patients and from 9.2% to 22.0% among non-Hispanic Black patients. A separate nationwide analysis of PRAMS data indicated that 54% of mothers who reported postpartum depressive symptoms lived at or below the federal poverty limit, and that psychosocial stress during pregnancy was related with more than three times the odds of symptoms (O’Connor & Su, 2023). Collectively, these findings support programs that combine validated screening with tangible aid for food insecurity, insurance continuity, intimate partner violence, transportation, childcare, and access to linguistically appropriate behavioral health services.

    The local relevance of the topic is apparent in Miami, especially among moms experiencing housing and financial insecurity. Curzon et al. (2025) examined 182 mothers with infants age seven months or younger receiving services in a women’s shelter in Miami. At baseline, 15.3% had clinically high self-reported postpartum depression symptoms. This study represents a highly vulnerable local group and should not be generalized to the prevalence for all mothers in Miami-Dade County, but it provides direct evidence that postpartum mental health needs exist within local community settings where traditional office-based care may be difficult to access. The findings also underscore the necessity of implementing screening into trusted spaces for postpartum families, including shelters, home-visiting services, community centers, food-assistance programs, and others.

    The Miami study also shows that relationship-based community intervention can lead to better results. Following 16 weeks of child-parent psychotherapy, the percentage of mothers with clinically high symptoms reduced from 15.3% to 6.7%, treatment satisfaction was 94%, and participants reported reductions in parenting stress and depressive symptom intensity (Curzon et al., 2025). These findings could inform a local health promotion program that includes bilingual English Spanish education, repeated screening with a validated instrument, same-day suicide risk assessment, when necessary, warm referrals to therapy or psychiatric care, peer support groups, partner and family education, navigation to housing, nutrition, insurance, and childcare resources. Advanced practice nurses can spearhead this paradigm by training community partners, doing clinical assessments, coordinating interdisciplinary referrals, assessing medication and breastfeeding issues, and following up to ensure women actually receive follow-up care.

    Evidence supports promoting mother mental health globally, nationally, and locally throughout the first postpartum year. Statistics from worldwide and U.S. data suggest a significant burden, and late-onset symptoms demonstrate that moms who screen negative initially may nevertheless develop depression months after birth (Robbins et al., 2023; Wang et al., 2021). Local Miami data also demonstrate that relationship-based, community-integrated care can alleviate symptoms among moms enduring substantial social adversity (Curzon et al., 2025). Thus, a good program should not be restricted to the distribution of educational materials or to one screening. It should provide a continuous system of culturally relevant identification, connection to treatment, support and follow-up, and address the socioeconomic circumstances that promote risk. Advanced practice nurses can contribute to safeguarding mother functioning, improving early parent-child connections, and reducing preventable mental health inequities through leadership, advocacy, clinical competence, and partnering with community organizations.

    **References**

    Curzon, M. M., Graziano, P. A., Arcia, E., Cox, S. K., Ayala, M., Carnero, N. A., O'Mara, N., & Sundari Foundation (2025). Initial promise of child-parent psychotherapy in reducing stress and postpartum depression among mothers experiencing homelessness: a feasibility and pilot study.
    _Archives of women's mental health_,
    _28_(2), 385–394.
    [https://doi.org/10.1007/s00737-024-01492-8](https://doi.org/10.1007/s00737-024-01492-8)

    Khadka, N., Fassett, M. J., Oyelese, Y., Mensah, N. A., Chiu, V. Y., Yeh, M., Peltier, M. R., & Getahun, D. (2024). Trends in Postpartum Depression by Race, Ethnicity, and Prepregnancy Body Mass Index.
    _JAMA network open_,
    _7_(11), e2446486.
    [https://doi.org/10.1001/jamanetworkopen.2024.46486](https://doi.org/10.1001/jamanetworkopen.2024.46486)

    Roddy Mitchell, A., Gordon, H., Lindquist, A., Walker, S. P., Homer, C. S. E., Middleton, A., Cluver, C. A., Tong, S., & Hastie, R. (2023). Prevalence of Perinatal Depression in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis.
    _JAMA psychiatry_,
    _80_(5), 425–431. https://doi.org/10.1001/jamapsychiatry.2023.0069

    O'Connor, S., & Su, L. J. (2023). Postpartum Depressive Symptoms: An Analysis of Social Determinants Using the Pregnancy Risk Assessment Monitoring System.
    _Women's health reports (New Rochelle, N.Y.)_,
    _4_(1), 584–593. https://doi.org/10.1089/whr.2023.0050

    Robbins, C. L., Ko, J. Y., D'Angelo, D. V., Salvesen von Essen, B., Bish, C. L., Kroelinger, C. D., Tevendale, H. D., Warner, L., & Barfield, W. (2023). Timing of Postpartum Depressive Symptoms.
    _Preventing chronic disease_,
    _20_, E103. https://doi.org/10.5888/pcd20.230107

    Wang, Z., Liu, J., Shuai, H., Cai, Z., Fu, X., Liu, Y., Xiao, X., Zhang, W., Krabbendam, E., Liu, S., Liu, Z., Li, Z., & Yang, B. X. (2021). Mapping global prevalence of depression among postpartum women.
    _Translational psychiatry_,
    _11_(1), 543. https://doi.org/10.1038/s41398-021-01663-6

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    **files (2)** – ## HealthPromotio1.docx – ## Community-Based_Programs_Metabolic_Syndrome_Corrected.docx **## HealthPromotio1.docx** Health Promotion & Role Development in Adv. Nursing Practice-DBX-DL01 Nora Hernandez-Pupo Health Promotion Proposal, Part 1 **Health Promotion Proposal, Part 1-this…

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    **files (2)**

    – ## HealthPromotio1.docx

    – ## Community-Based_Programs_Metabolic_Syndrome_Corrected.docx

    **## HealthPromotio1.docx**

    Health Promotion & Role Development in Adv. Nursing Practice-DBX-DL01 Nora Hernandez-Pupo

    Health Promotion Proposal, Part 1

    **Health Promotion Proposal, Part 1-this is the SAME TOPIC that was Approved in WEEK 2.**

    **Description**

    Over the duration of this course,
    **you will submit a scholarly PowerPoint “Health Promotion Program Proposal,” addressing existing nursing knowledge related to health promotion and a written proposal.**

    In the written proposal, you will also develop a health promotion program to meet the health needs of a vulnerable population in your potential concentration area or community. The PowerPoint portion is your presentation of that proposal.

    The proposal must demonstrate graduate school-level writing and critical analysis. The final version of

    your proposal is due in week 8.

    For this assignment you will submit
    **Part One** of your proposal, detailing a health problem that is

    prevalent within
    **your selected group** and demonstrating your
    **research of health promotion strategies for addressing this specific health problem**. At this point, you already developed in your discussions the core ideas of the topic contained in this assignment-
    **this is the SAME TOPIC that was Approved in WEEK 2.** You will use the same information, but it won’t be a copy-and-paste exercise. The purpose is that you enhance your ideas with the comments and outcomes of the weekly discussions and previous evaluations.

    Directions

    1. Introduction. Describe the health problem. Don't type "Introduction".  (1 paragraph at least).

    Using data and statistics, support your claim that the issue you selected is a problem.

    What specifically will you address in your proposed health promotion program?

    Be sure your proposed outcome is realistic and measurable.

    2. Describe the vulnerable population.  (1-3 paragraphs).

    What are the risk factors that make this a vulnerable population?

    Use evidence to support the risk factors you have identified.

    3. Provide a review of literature from scholarly journals (at least 2) of evidence-based interventions that address the problem. (2 paragraphs, one for each article).

    After completing a literature search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and weaknesses of all the sources you have found. (2-3 paragraphs).

    4. Select and present an appropriate health promotion/disease prevention theoretical or conceptual model that best serves as the guiding framework for the proposal.  (2-3 paragraphs).

    For this assignment, a conclusion paragraph is not required.

    Writing Assignment Requirements

    **Three to five pages in length MAXIMUM – do not exceed page limit- be concise (excluding title page, references, and appendices)**

    **Follow APA format**

    **Cite a minimum of 6 references**

    **Please review the rubric prior to submission.**

    Sample APA paper for your reference:

    **APA 7 – Professional Sample Paper – 2020.pdf**

    **REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**

    **Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)

    **Submission**

    Text Editor

    Press Alt + F10 to access toolbar options

    _Word count: 0_

    **Drag files here**

    Maximum size: 512 MB

    **or**

    **Details & Information**

    **## Community-Based_Programs_Metabolic_Syndrome_Corrected.docx**

    **Community-Based Programs to Prevent Metabolic Syndrome**

    Anthony Pisani

    Florida National University

    Health Promotion & Role Development in Advanced Nursing Practice

    Dr. Nora Hernandez-Pupo

    July 11, 2026

    **Community-Based Programs to Prevent Metabolic Syndrome**

    ## Introduction

    Metabolic syndrome is a major health-promotion concern because it represents a cluster of interrelated and preventable cardiometabolic abnormalities, including abdominal obesity, elevated blood pressure, impaired glucose regulation, high triglyceride levels, and reduced high-density lipoprotein cholesterol. When these conditions occur together, the risk of type 2 diabetes, cardiovascular disease, stroke, chronic kidney disease, and premature mortality increases. Although individual behavior contributes to metabolic risk, community conditions also shape food choices, physical activity, access to screening, health literacy, and continuity of care. Therefore, prevention cannot rely exclusively on personal responsibility. This paper proposes a culturally responsive, nurse-led community program that combines bilingual education, cardiometabolic screening, nutrition counseling, structured physical activity, community health worker follow-up, and referrals to primary care for adults at increased risk in Miami-Dade County.

    ## Global and National Significance of Metabolic Syndrome

    The global rise in obesity and diabetes demonstrates the urgency of preventing metabolic syndrome before irreversible complications develop. In 2022, approximately 2.5 billion adults worldwide were overweight, including more than 890 million adults living with obesity (World Health Organization [WHO], 2025). A pooled analysis of 3,663 population-representative studies further demonstrated that obesity increased in most countries between 1990 and 2022, indicating that the problem reflects broad changes in food environments, physical activity, and social conditions rather than isolated individual choices (NCD Risk Factor Collaboration [NCD-RisC], 2024). Similarly, the GBD 2021 Diabetes Collaborators (2023) estimated that 529 million people were living with diabetes in 2021 and projected that the number could exceed 1.31 billion by 2050.

    In the United States, the same risk trajectory is evident. National surveillance data show that diabetes, prediabetes, obesity, and hypertension affect large proportions of the adult population. These statistics establish the need for prevention; however, surveillance alone does not identify which interventions are most effective. Graduate-level analysis requires connecting epidemiologic need with intervention research. Current evidence indicates that programs are more successful when they combine dietary change, physical activity, repeated behavioral support, and follow-up rather than relying on a single educational encounter.

    ## Evidence Supporting Community-Based Interventions

    Recent intervention studies provide stronger support for a multidimensional community strategy. Mbugua et al. (2022) conducted a randomized controlled trial involving 352 adults with metabolic syndrome who were followed for 15 months. Participants receiving community-based lifestyle education demonstrated significant improvements in blood pressure, blood glucose, cholesterol, central obesity, diet, and physical activity compared with those receiving routine hospital-based advice. Importantly, approximately one in three participants experienced improvement in physiologic, anthropometric, and clinical markers. These findings suggest that repeated community engagement can produce clinically meaningful change beyond general counseling delivered during routine care.

    A systematic review and meta-analysis by Park et al. (2024) reached a similar conclusion. Across seven studies, comprehensive lifestyle interventions that combined diet and exercise improved health behaviors and produced reductions in fasting glucose and systolic blood pressure, particularly when programs lasted approximately six months. This synthesis is important because it demonstrates that no single strategy is likely to be sufficient. Nutrition education may improve knowledge, but participants also need structured opportunities for exercise, goal setting, self-monitoring, and reinforcement.

    Technology may strengthen, but should not replace, interpersonal support. Wong et al. (2023) compared a mobile application with booklet-based education among adults with metabolic syndrome. The mobile-supported intervention improved several outcomes, including physical activity, body weight, waist circumference, body mass index, and systolic blood pressure. Nevertheless, digital interventions may be less accessible to residents with limited digital literacy, unstable internet access, or language barriers. For Miami-Dade County, a hybrid model is therefore preferable: bilingual face-to-face sessions should remain central, while text messages or a simple mobile platform can provide reminders, activity tracking, and follow-up.

    Taken together, the evidence supports a layered intervention rather than a one-time health fair. Mbugua et al. (2022) demonstrated the effectiveness of sustained community education, Park et al. (2024) showed that combined diet-and-exercise programs are more effective than isolated components, and Wong et al. (2023) demonstrated the added value of technology-supported follow-up. The convergence of these findings supports a culturally tailored program that integrates screening, behavioral coaching, structured activity, and continuing contact.

    ## Metabolic Risk in Miami-Dade County

    Miami-Dade County is an appropriate location for this program because local demographic and health conditions may intensify metabolic risk and create barriers to prevention. The county had an estimated population of approximately 2.8 million in 2025; 70.6% of residents identified as Hispanic or Latino, 54.5% were foreign-born, and 75.3% spoke a language other than English at home (U.S. Census Bureau, 2025). In addition, 14.8% of residents younger than 65 years were uninsured and 14.2% lived in poverty. These conditions support the need for low-cost, bilingual services delivered in trusted community settings.

    Health-specific data strengthen the local justification. County Health Rankings & Roadmaps reported an adult obesity prevalence of approximately 30% in Miami-Dade County, while local neighborhood estimates show substantially higher obesity levels in several communities, including Florida City, Brownsville, Opa-locka, and Miami Gardens (County Health Rankings & Roadmaps, 2026). These geographic differences indicate that a countywide average can conceal pockets of greater risk. The Florida Department of Health in Miami-Dade County also identifies chronic disease prevention and healthy weight, physical activity, and nutrition as community health priorities for 2025–2030 (Florida Department of Health in Miami-Dade County, 2026). Therefore, the proposed program should prioritize neighborhoods with high obesity burden, lower income, limited insurance coverage, and reduced access to preventive care.

    ## Proposed Community-Based Prevention Program

    The proposed program would enroll adults aged 18 years or older who have obesity, prediabetes, hypertension, dyslipidemia, a large waist circumference, or another documented metabolic risk factor. Recruitment could occur through federally qualified health centers, churches, libraries, community centers, food-distribution sites, and local health fairs. The 12-week program would be delivered in English and Spanish, with Haitian Creole support when available.

    At baseline, nurses would measure blood pressure, weight, body mass index, and waist circumference and would arrange point-of-care glucose or hemoglobin A1c screening when permitted by organizational policy. Participants with abnormal findings would receive a referral to primary care rather than being treated solely within the community program. Weekly sessions would address affordable meal planning, label reading, portion control, sugar-sweetened beverages, culturally familiar food substitutions, stress management, sleep, and safe physical activity. Structured walking groups would meet at least twice weekly, and participants would develop individualized activity goals.

    Community health workers would conduct brief follow-up contacts between sessions, reinforce goals, identify barriers, and connect participants with food, transportation, insurance, and primary care resources. Text messages could be used for reminders and self-monitoring, but paper materials and telephone follow-up would remain available to avoid excluding people with limited technology access. This design reflects the evidence that sustained, multicomponent support is more effective than isolated education.

    ## Role of the Advanced Practice Nurse

    The advanced practice registered nurse would provide clinical and organizational leadership for the program. Responsibilities would include developing evidence-based educational materials, training staff and community health workers, establishing screening and referral criteria, reviewing abnormal results, coordinating with primary care providers, and ensuring culturally and linguistically appropriate communication. The nurse would also evaluate whether participants experience barriers related to medication access, food insecurity, transportation, health insurance, or health literacy. By integrating clinical assessment with community partnerships, the advanced practice nurse can help translate population-level evidence into practical prevention services.

    ## Evaluation of Program Outcomes

    Program effectiveness should be evaluated at baseline, 12 weeks, and, when feasible, three to six months after completion. Primary outcomes would include changes in systolic and diastolic blood pressure, body weight, waist circumference, physical activity, and self-reported intake of fruits, vegetables, and sugar-sweetened beverages. Secondary outcomes would include attendance, completion rate, referrals completed, participant satisfaction, and confidence in managing cardiometabolic risk. Because a 12-week program may be too brief to produce large laboratory changes, results should be interpreted cautiously. The expected outcome is not immediate elimination of metabolic syndrome, but measurable improvement in modifiable risk factors and stronger connection to continuing preventive care.

    ## Conclusion

    Metabolic syndrome is a preventable pathway to diabetes, cardiovascular disease, kidney disease, and premature mortality. Global and national statistics establish the magnitude of the problem, while Miami-Dade County data demonstrate the need for local, culturally responsive prevention. Current research shows that community programs are most effective when they combine nutrition, physical activity, behavioral support, repeated follow-up, and accessible technology. A bilingual, nurse-led program delivered through trusted community organizations could improve early detection, reduce modifiable risk factors, and connect high-risk adults with primary care. The strongest expected impact would come from sustained engagement rather than one-time education. Through structured evaluation and community partnerships, the proposed intervention could provide a practical and evidence-informed approach to reducing metabolic risk in vulnerable Miami-Dade communities.

    ## References

    County Health Rankings & Roadmaps. (2026). Adult obesity: Miami-Dade County, Florida. University of Wisconsin Population Health Institute. https://www.countyhealthrankings.org/health-data

    Florida Department of Health in Miami-Dade County. (2026). Community health planning. https://miamidade.floridahealth.gov/programs-and-services/community-health-planning-and-statistics/community-health-planning/

    GBD 2021 Diabetes Collaborators. (2023). Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: A systematic analysis for the Global Burden of Disease Study 2021. The Lancet, 402(10397), 203–234. https://doi.org/10.1016/S0140-6736(23)01301-6

    Mbugua, S. M., Kimani, S. T., & Munyoki, G. (2022). Community-based lifestyle intervention improves metabolic syndrome and related markers among Kenyan adults. Journal of Diabetes & Metabolic Disorders, 21, 545–555. https://doi.org/10.1007/s40200-022-01023-1

    NCD Risk Factor Collaboration (NCD-RisC). (2024). Worldwide trends in underweight and obesity from 1990 to 2022: A pooled analysis of 3,663 population-representative studies with 222 million children, adolescents, and adults. The Lancet, 403(10431), 1027–1050. https://doi.org/10.1016/S0140-6736(23)02750-2

    Park, S., Lee, J., Seok, J. W., Park, C. G., & Jun, J. (2024). Comprehensive lifestyle modification interventions for metabolic syndrome: A systematic review and meta-analysis. Journal of Nursing Scholarship, 56(2), 249–259. https://doi.org/10.1111/jnu.12946

    U.S. Census Bureau. (2025). QuickFacts: Miami-Dade County, Florida. https://www.census.gov/quickfacts/fact/table/miamidadecountyflorida/PST045225

    Wong, E. M. L., Leung, D. Y. P., Wang, Q., Leung, A. Y. M., & Cheung, A. S. P. (2023). The effect of a lifestyle intervention program using a mobile application versus the effect of a program using a booklet for adults with metabolic syndrome: A three-arm randomized controlled trial. Journal of Nursing Scholarship, 55(4), 936–948. https://doi.org/10.1111/jnu.12883

    World Health Organization. (2025, May 7). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

    1

    **## Community-Based_Programs_Metabolic_Syndrome_Corrected.docx**

    **Community-Based Programs to Prevent Metabolic Syndrome**

    Anthony Pisani

    Florida National University

    Health Promotion & Role Development in Advanced Nursing Practice

    Dr. Nora Hernandez-Pupo

    July 11, 2026

    **Community-Based Programs to Prevent Metabolic Syndrome**

    ## Introduction

    Metabolic syndrome is a major health-promotion concern because it represents a cluster of interrelated and preventable cardiometabolic abnormalities, including abdominal obesity, elevated blood pressure, impaired glucose regulation, high triglyceride levels, and reduced high-density lipoprotein cholesterol. When these conditions occur together, the risk of type 2 diabetes, cardiovascular disease, stroke, chronic kidney disease, and premature mortality increases. Although individual behavior contributes to metabolic risk, community conditions also shape food choices, physical activity, access to screening, health literacy, and continuity of care. Therefore, prevention cannot rely exclusively on personal responsibility. This paper proposes a culturally responsive, nurse-led community program that combines bilingual education, cardiometabolic screening, nutrition counseling, structured physical activity, community health worker follow-up, and referrals to primary care for adults at increased risk in Miami-Dade County.

    ## Global and National Significance of Metabolic Syndrome

    The global rise in obesity and diabetes demonstrates the urgency of preventing metabolic syndrome before irreversible complications develop. In 2022, approximately 2.5 billion adults worldwide were overweight, including more than 890 million adults living with obesity (World Health Organization [WHO], 2025). A pooled analysis of 3,663 population-representative studies further demonstrated that obesity increased in most countries between 1990 and 2022, indicating that the problem reflects broad changes in food environments, physical activity, and social conditions rather than isolated individual choices (NCD Risk Factor Collaboration [NCD-RisC], 2024). Similarly, the GBD 2021 Diabetes Collaborators (2023) estimated that 529 million people were living with diabetes in 2021 and projected that the number could exceed 1.31 billion by 2050.

    In the United States, the same risk trajectory is evident. National surveillance data show that diabetes, prediabetes, obesity, and hypertension affect large proportions of the adult population. These statistics establish the need for prevention; however, surveillance alone does not identify which interventions are most effective. Graduate-level analysis requires connecting epidemiologic need with intervention research. Current evidence indicates that programs are more successful when they combine dietary change, physical activity, repeated behavioral support, and follow-up rather than relying on a single educational encounter.

    ## Evidence Supporting Community-Based Interventions

    Recent intervention studies provide stronger support for a multidimensional community strategy. Mbugua et al. (2022) conducted a randomized controlled trial involving 352 adults with metabolic syndrome who were followed for 15 months. Participants receiving community-based lifestyle education demonstrated significant improvements in blood pressure, blood glucose, cholesterol, central obesity, diet, and physical activity compared with those receiving routine hospital-based advice. Importantly, approximately one in three participants experienced improvement in physiologic, anthropometric, and clinical markers. These findings suggest that repeated community engagement can produce clinically meaningful change beyond general counseling delivered during routine care.

    A systematic review and meta-analysis by Park et al. (2024) reached a similar conclusion. Across seven studies, comprehensive lifestyle interventions that combined diet and exercise improved health behaviors and produced reductions in fasting glucose and systolic blood pressure, particularly when programs lasted approximately six months. This synthesis is important because it demonstrates that no single strategy is likely to be sufficient. Nutrition education may improve knowledge, but participants also need structured opportunities for exercise, goal setting, self-monitoring, and reinforcement.

    Technology may strengthen, but should not replace, interpersonal support. Wong et al. (2023) compared a mobile application with booklet-based education among adults with metabolic syndrome. The mobile-supported intervention improved several outcomes, including physical activity, body weight, waist circumference, body mass index, and systolic blood pressure. Nevertheless, digital interventions may be less accessible to residents with limited digital literacy, unstable internet access, or language barriers. For Miami-Dade County, a hybrid model is therefore preferable: bilingual face-to-face sessions should remain central, while text messages or a simple mobile platform can provide reminders, activity tracking, and follow-up.

    Taken together, the evidence supports a layered intervention rather than a one-time health fair. Mbugua et al. (2022) demonstrated the effectiveness of sustained community education, Park et al. (2024) showed that combined diet-and-exercise programs are more effective than isolated components, and Wong et al. (2023) demonstrated the added value of technology-supported follow-up. The convergence of these findings supports a culturally tailored program that integrates screening, behavioral coaching, structured activity, and continuing contact.

    ## Metabolic Risk in Miami-Dade County

    Miami-Dade County is an appropriate location for this program because local demographic and health conditions may intensify metabolic risk and create barriers to prevention. The county had an estimated population of approximately 2.8 million in 2025; 70.6% of residents identified as Hispanic or Latino, 54.5% were foreign-born, and 75.3% spoke a language other than English at home (U.S. Census Bureau, 2025). In addition, 14.8% of residents younger than 65 years were uninsured and 14.2% lived in poverty. These conditions support the need for low-cost, bilingual services delivered in trusted community settings.

    Health-specific data strengthen the local justification. County Health Rankings & Roadmaps reported an adult obesity prevalence of approximately 30% in Miami-Dade County, while local neighborhood estimates show substantially higher obesity levels in several communities, including Florida City, Brownsville, Opa-locka, and Miami Gardens (County Health Rankings & Roadmaps, 2026). These geographic differences indicate that a countywide average can conceal pockets of greater risk. The Florida Department of Health in Miami-Dade County also identifies chronic disease prevention and healthy weight, physical activity, and nutrition as community health priorities for 2025–2030 (Florida Department of Health in Miami-Dade County, 2026). Therefore, the proposed program should prioritize neighborhoods with high obesity burden, lower income, limited insurance coverage, and reduced access to preventive care.

    ## Proposed Community-Based Prevention Program

    The proposed program would enroll adults aged 18 years or older who have obesity, prediabetes, hypertension, dyslipidemia, a large waist circumference, or another documented metabolic risk factor. Recruitment could occur through federally qualified health centers, churches, libraries, community centers, food-distribution sites, and local health fairs. The 12-week program would be delivered in English and Spanish, with Haitian Creole support when available.

    At baseline, nurses would measure blood pressure, weight, body mass index, and waist circumference and would arrange point-of-care glucose or hemoglobin A1c screening when permitted by organizational policy. Participants with abnormal findings would receive a referral to primary care rather than being treated solely within the community program. Weekly sessions would address affordable meal planning, label reading, portion control, sugar-sweetened beverages, culturally familiar food substitutions, stress management, sleep, and safe physical activity. Structured walking groups would meet at least twice weekly, and participants would develop individualized activity goals.

    Community health workers would conduct brief follow-up contacts between sessions, reinforce goals, identify barriers, and connect participants with food, transportation, insurance, and primary care resources. Text messages could be used for reminders and self-monitoring, but paper materials and telephone follow-up would remain available to avoid excluding people with limited technology access. This design reflects the evidence that sustained, multicomponent support is more effective than isolated education.

    ## Role of the Advanced Practice Nurse

    The advanced practice registered nurse would provide clinical and organizational leadership for the program. Responsibilities would include developing evidence-based educational materials, training staff and community health workers, establishing screening and referral criteria, reviewing abnormal results, coordinating with primary care providers, and ensuring culturally and linguistically appropriate communication. The nurse would also evaluate whether participants experience barriers related to medication access, food insecurity, transportation, health insurance, or health literacy. By integrating clinical assessment with community partnerships, the advanced practice nurse can help translate population-level evidence into practical prevention services.

    ## Evaluation of Program Outcomes

    Program effectiveness should be evaluated at baseline, 12 weeks, and, when feasible, three to six months after completion. Primary outcomes would include changes in systolic and diastolic blood pressure, body weight, waist circumference, physical activity, and self-reported intake of fruits, vegetables, and sugar-sweetened beverages. Secondary outcomes would include attendance, completion rate, referrals completed, participant satisfaction, and confidence in managing cardiometabolic risk. Because a 12-week program may be too brief to produce large laboratory changes, results should be interpreted cautiously. The expected outcome is not immediate elimination of metabolic syndrome, but measurable improvement in modifiable risk factors and stronger connection to continuing preventive care.

    ## Conclusion

    Metabolic syndrome is a preventable pathway to diabetes, cardiovascular disease, kidney disease, and premature mortality. Global and national statistics establish the magnitude of the problem, while Miami-Dade County data demonstrate the need for local, culturally responsive prevention. Current research shows that community programs are most effective when they combine nutrition, physical activity, behavioral support, repeated follow-up, and accessible technology. A bilingual, nurse-led program delivered through trusted community organizations could improve early detection, reduce modifiable risk factors, and connect high-risk adults with primary care. The strongest expected impact would come from sustained engagement rather than one-time education. Through structured evaluation and community partnerships, the proposed intervention could provide a practical and evidence-informed approach to reducing metabolic risk in vulnerable Miami-Dade communities.

    ## References

    County Health Rankings & Roadmaps. (2026). Adult obesity: Miami-Dade County, Florida. University of Wisconsin Population Health Institute. https://www.countyhealthrankings.org/health-data

    Florida Department of Health in Miami-Dade County. (2026). Community health planning. https://miamidade.floridahealth.gov/programs-and-services/community-health-planning-and-statistics/community-health-planning/

    GBD 2021 Diabetes Collaborators. (2023). Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: A systematic analysis for the Global Burden of Disease Study 2021. The Lancet, 402(10397), 203–234. https://doi.org/10.1016/S0140-6736(23)01301-6

    Mbugua, S. M., Kimani, S. T., & Munyoki, G. (2022). Community-based lifestyle intervention improves metabolic syndrome and related markers among Kenyan adults. Journal of Diabetes & Metabolic Disorders, 21, 545–555. https://doi.org/10.1007/s40200-022-01023-1

    NCD Risk Factor Collaboration (NCD-RisC). (2024). Worldwide trends in underweight and obesity from 1990 to 2022: A pooled analysis of 3,663 population-representative studies with 222 million children, adolescents, and adults. The Lancet, 403(10431), 1027–1050. https://doi.org/10.1016/S0140-6736(23)02750-2

    Park, S., Lee, J., Seok, J. W., Park, C. G., & Jun, J. (2024). Comprehensive lifestyle modification interventions for metabolic syndrome: A systematic review and meta-analysis. Journal of Nursing Scholarship, 56(2), 249–259. https://doi.org/10.1111/jnu.12946

    U.S. Census Bureau. (2025). QuickFacts: Miami-Dade County, Florida. https://www.census.gov/quickfacts/fact/table/miamidadecountyflorida/PST045225

    Wong, E. M. L., Leung, D. Y. P., Wang, Q., Leung, A. Y. M., & Cheung, A. S. P. (2023). The effect of a lifestyle intervention program using a mobile application versus the effect of a program using a booklet for adults with metabolic syndrome: A three-arm randomized controlled trial. Journal of Nursing Scholarship, 55(4), 936–948. https://doi.org/10.1111/jnu.12883

    World Health Organization. (2025, May 7). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

    1

    **## HealthPromotio1.docx**

    Health Promotion & Role Development in Adv. Nursing Practice-DBX-DL01 Nora Hernandez-Pupo

    Health Promotion Proposal, Part 1

    **Health Promotion Proposal, Part 1-this is the SAME TOPIC that was Approved in WEEK 2.**

    **Description**

    Over the duration of this course,
    **you will submit a scholarly PowerPoint “Health Promotion Program Proposal,” addressing existing nursing knowledge related to health promotion and a written proposal.**

    In the written proposal, you will also develop a health promotion program to meet the health needs of a vulnerable population in your potential concentration area or community. The PowerPoint portion is your presentation of that proposal.

    The proposal must demonstrate graduate school-level writing and critical analysis. The final version of

    your proposal is due in week 8.

    For this assignment you will submit
    **Part One** of your proposal, detailing a health problem that is

    prevalent within
    **your selected group** and demonstrating your
    **research of health promotion strategies for addressing this specific health problem**. At this point, you already developed in your discussions the core ideas of the topic contained in this assignment-
    **this is the SAME TOPIC that was Approved in WEEK 2.** You will use the same information, but it won’t be a copy-and-paste exercise. The purpose is that you enhance your ideas with the comments and outcomes of the weekly discussions and previous evaluations.

    Directions

    1. Introduction. Describe the health problem. Don't type "Introduction".  (1 paragraph at least).

    Using data and statistics, support your claim that the issue you selected is a problem.

    What specifically will you address in your proposed health promotion program?

    Be sure your proposed outcome is realistic and measurable.

    2. Describe the vulnerable population.  (1-3 paragraphs).

    What are the risk factors that make this a vulnerable population?

    Use evidence to support the risk factors you have identified.

    3. Provide a review of literature from scholarly journals (at least 2) of evidence-based interventions that address the problem. (2 paragraphs, one for each article).

    After completing a literature search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and weaknesses of all the sources you have found. (2-3 paragraphs).

    4. Select and present an appropriate health promotion/disease prevention theoretical or conceptual model that best serves as the guiding framework for the proposal.  (2-3 paragraphs).

    For this assignment, a conclusion paragraph is not required.

    Writing Assignment Requirements

    **Three to five pages in length MAXIMUM – do not exceed page limit- be concise (excluding title page, references, and appendices)**

    **Follow APA format**

    **Cite a minimum of 6 references**

    **Please review the rubric prior to submission.**

    Sample APA paper for your reference:

    **APA 7 – Professional Sample Paper – 2020.pdf**

    **REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**

    **Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)

    **Submission**

    Text Editor

    Press Alt + F10 to access toolbar options

    _Word count: 0_

    **Drag files here**

    Maximum size: 512 MB

    **or**

    **Details & Information**

    **## Community-Based_Programs_Metabolic_Syndrome_Corrected.docx**

    **Community-Based Programs to Prevent Metabolic Syndrome**

    Anthony Pisani

    Florida National University

    Health Promotion & Role Development in Advanced Nursing Practice

    Dr. Nora Hernandez-Pupo

    July 11, 2026

    **Community-Based Programs to Prevent Metabolic Syndrome**

    ## Introduction

    Metabolic syndrome is a major health-promotion concern because it represents a cluster of interrelated and preventable cardiometabolic abnormalities, including abdominal obesity, elevated blood pressure, impaired glucose regulation, high triglyceride levels, and reduced high-density lipoprotein cholesterol. When these conditions occur together, the risk of type 2 diabetes, cardiovascular disease, stroke, chronic kidney disease, and premature mortality increases. Although individual behavior contributes to metabolic risk, community conditions also shape food choices, physical activity, access to screening, health literacy, and continuity of care. Therefore, prevention cannot rely exclusively on personal responsibility. This paper proposes a culturally responsive, nurse-led community program that combines bilingual education, cardiometabolic screening, nutrition counseling, structured physical activity, community health worker follow-up, and referrals to primary care for adults at increased risk in Miami-Dade County.

    ## Global and National Significance of Metabolic Syndrome

    The global rise in obesity and diabetes demonstrates the urgency of preventing metabolic syndrome before irreversible complications develop. In 2022, approximately 2.5 billion adults worldwide were overweight, including more than 890 million adults living with obesity (World Health Organization [WHO], 2025). A pooled analysis of 3,663 population-representative studies further demonstrated that obesity increased in most countries between 1990 and 2022, indicating that the problem reflects broad changes in food environments, physical activity, and social conditions rather than isolated individual choices (NCD Risk Factor Collaboration [NCD-RisC], 2024). Similarly, the GBD 2021 Diabetes Collaborators (2023) estimated that 529 million people were living with diabetes in 2021 and projected that the number could exceed 1.31 billion by 2050.

    In the United States, the same risk trajectory is evident. National surveillance data show that diabetes, prediabetes, obesity, and hypertension affect large proportions of the adult population. These statistics establish the need for prevention; however, surveillance alone does not identify which interventions are most effective. Graduate-level analysis requires connecting epidemiologic need with intervention research. Current evidence indicates that programs are more successful when they combine dietary change, physical activity, repeated behavioral support, and follow-up rather than relying on a single educational encounter.

    ## Evidence Supporting Community-Based Interventions

    Recent intervention studies provide stronger support for a multidimensional community strategy. Mbugua et al. (2022) conducted a randomized controlled trial involving 352 adults with metabolic syndrome who were followed for 15 months. Participants receiving community-based lifestyle education demonstrated significant improvements in blood pressure, blood glucose, cholesterol, central obesity, diet, and physical activity compared with those receiving routine hospital-based advice. Importantly, approximately one in three participants experienced improvement in physiologic, anthropometric, and clinical markers. These findings suggest that repeated community engagement can produce clinically meaningful change beyond general counseling delivered during routine care.

    A systematic review and meta-analysis by Park et al. (2024) reached a similar conclusion. Across seven studies, comprehensive lifestyle interventions that combined diet and exercise improved health behaviors and produced reductions in fasting glucose and systolic blood pressure, particularly when programs lasted approximately six months. This synthesis is important because it demonstrates that no single strategy is likely to be sufficient. Nutrition education may improve knowledge, but participants also need structured opportunities for exercise, goal setting, self-monitoring, and reinforcement.

    Technology may strengthen, but should not replace, interpersonal support. Wong et al. (2023) compared a mobile application with booklet-based education among adults with metabolic syndrome. The mobile-supported intervention improved several outcomes, including physical activity, body weight, waist circumference, body mass index, and systolic blood pressure. Nevertheless, digital interventions may be less accessible to residents with limited digital literacy, unstable internet access, or language barriers. For Miami-Dade County, a hybrid model is therefore preferable: bilingual face-to-face sessions should remain central, while text messages or a simple mobile platform can provide reminders, activity tracking, and follow-up.

    Taken together, the evidence supports a layered intervention rather than a one-time health fair. Mbugua et al. (2022) demonstrated the effectiveness of sustained community education, Park et al. (2024) showed that combined diet-and-exercise programs are more effective than isolated components, and Wong et al. (2023) demonstrated the added value of technology-supported follow-up. The convergence of these findings supports a culturally tailored program that integrates screening, behavioral coaching, structured activity, and continuing contact.

    ## Metabolic Risk in Miami-Dade County

    Miami-Dade County is an appropriate location for this program because local demographic and health conditions may intensify metabolic risk and create barriers to prevention. The county had an estimated population of approximately 2.8 million in 2025; 70.6% of residents identified as Hispanic or Latino, 54.5% were foreign-born, and 75.3% spoke a language other than English at home (U.S. Census Bureau, 2025). In addition, 14.8% of residents younger than 65 years were uninsured and 14.2% lived in poverty. These conditions support the need for low-cost, bilingual services delivered in trusted community settings.

    Health-specific data strengthen the local justification. County Health Rankings & Roadmaps reported an adult obesity prevalence of approximately 30% in Miami-Dade County, while local neighborhood estimates show substantially higher obesity levels in several communities, including Florida City, Brownsville, Opa-locka, and Miami Gardens (County Health Rankings & Roadmaps, 2026). These geographic differences indicate that a countywide average can conceal pockets of greater risk. The Florida Department of Health in Miami-Dade County also identifies chronic disease prevention and healthy weight, physical activity, and nutrition as community health priorities for 2025–2030 (Florida Department of Health in Miami-Dade County, 2026). Therefore, the proposed program should prioritize neighborhoods with high obesity burden, lower income, limited insurance coverage, and reduced access to preventive care.

    ## Proposed Community-Based Prevention Program

    The proposed program would enroll adults aged 18 years or older who have obesity, prediabetes, hypertension, dyslipidemia, a large waist circumference, or another documented metabolic risk factor. Recruitment could occur through federally qualified health centers, churches, libraries, community centers, food-distribution sites, and local health fairs. The 12-week program would be delivered in English and Spanish, with Haitian Creole support when available.

    At baseline, nurses would measure blood pressure, weight, body mass index, and waist circumference and would arrange point-of-care glucose or hemoglobin A1c screening when permitted by organizational policy. Participants with abnormal findings would receive a referral to primary care rather than being treated solely within the community program. Weekly sessions would address affordable meal planning, label reading, portion control, sugar-sweetened beverages, culturally familiar food substitutions, stress management, sleep, and safe physical activity. Structured walking groups would meet at least twice weekly, and participants would develop individualized activity goals.

    Community health workers would conduct brief follow-up contacts between sessions, reinforce goals, identify barriers, and connect participants with food, transportation, insurance, and primary care resources. Text messages could be used for reminders and self-monitoring, but paper materials and telephone follow-up would remain available to avoid excluding people with limited technology access. This design reflects the evidence that sustained, multicomponent support is more effective than isolated education.

    ## Role of the Advanced Practice Nurse

    The advanced practice registered nurse would provide clinical and organizational leadership for the program. Responsibilities would include developing evidence-based educational materials, training staff and community health workers, establishing screening and referral criteria, reviewing abnormal results, coordinating with primary care providers, and ensuring culturally and linguistically appropriate communication. The nurse would also evaluate whether participants experience barriers related to medication access, food insecurity, transportation, health insurance, or health literacy. By integrating clinical assessment with community partnerships, the advanced practice nurse can help translate population-level evidence into practical prevention services.

    ## Evaluation of Program Outcomes

    Program effectiveness should be evaluated at baseline, 12 weeks, and, when feasible, three to six months after completion. Primary outcomes would include changes in systolic and diastolic blood pressure, body weight, waist circumference, physical activity, and self-reported intake of fruits, vegetables, and sugar-sweetened beverages. Secondary outcomes would include attendance, completion rate, referrals completed, participant satisfaction, and confidence in managing cardiometabolic risk. Because a 12-week program may be too brief to produce large laboratory changes, results should be interpreted cautiously. The expected outcome is not immediate elimination of metabolic syndrome, but measurable improvement in modifiable risk factors and stronger connection to continuing preventive care.

    ## Conclusion

    Metabolic syndrome is a preventable pathway to diabetes, cardiovascular disease, kidney disease, and premature mortality. Global and national statistics establish the magnitude of the problem, while Miami-Dade County data demonstrate the need for local, culturally responsive prevention. Current research shows that community programs are most effective when they combine nutrition, physical activity, behavioral support, repeated follow-up, and accessible technology. A bilingual, nurse-led program delivered through trusted community organizations could improve early detection, reduce modifiable risk factors, and connect high-risk adults with primary care. The strongest expected impact would come from sustained engagement rather than one-time education. Through structured evaluation and community partnerships, the proposed intervention could provide a practical and evidence-informed approach to reducing metabolic risk in vulnerable Miami-Dade communities.

    ## References

    County Health Rankings & Roadmaps. (2026). Adult obesity: Miami-Dade County, Florida. University of Wisconsin Population Health Institute. https://www.countyhealthrankings.org/health-data

    Florida Department of Health in Miami-Dade County. (2026). Community health planning. https://miamidade.floridahealth.gov/programs-and-services/community-health-planning-and-statistics/community-health-planning/

    GBD 2021 Diabetes Collaborators. (2023). Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: A systematic analysis for the Global Burden of Disease Study 2021. The Lancet, 402(10397), 203–234. https://doi.org/10.1016/S0140-6736(23)01301-6

    Mbugua, S. M., Kimani, S. T., & Munyoki, G. (2022). Community-based lifestyle intervention improves metabolic syndrome and related markers among Kenyan adults. Journal of Diabetes & Metabolic Disorders, 21, 545–555. https://doi.org/10.1007/s40200-022-01023-1

    NCD Risk Factor Collaboration (NCD-RisC). (2024). Worldwide trends in underweight and obesity from 1990 to 2022: A pooled analysis of 3,663 population-representative studies with 222 million children, adolescents, and adults. The Lancet, 403(10431), 1027–1050. https://doi.org/10.1016/S0140-6736(23)02750-2

    Park, S., Lee, J., Seok, J. W., Park, C. G., & Jun, J. (2024). Comprehensive lifestyle modification interventions for metabolic syndrome: A systematic review and meta-analysis. Journal of Nursing Scholarship, 56(2), 249–259. https://doi.org/10.1111/jnu.12946

    U.S. Census Bureau. (2025). QuickFacts: Miami-Dade County, Florida. https://www.census.gov/quickfacts/fact/table/miamidadecountyflorida/PST045225

    Wong, E. M. L., Leung, D. Y. P., Wang, Q., Leung, A. Y. M., & Cheung, A. S. P. (2023). The effect of a lifestyle intervention program using a mobile application versus the effect of a program using a booklet for adults with metabolic syndrome: A three-arm randomized controlled trial. Journal of Nursing Scholarship, 55(4), 936–948. https://doi.org/10.1111/jnu.12883

    World Health Organization. (2025, May 7). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

    1

    **## HealthPromotio1.docx**

    Health Promotion & Role Development in Adv. Nursing Practice-DBX-DL01 Nora Hernandez-Pupo

    Health Promotion Proposal, Part 1

    **Health Promotion Proposal, Part 1-this is the SAME TOPIC that was Approved in WEEK 2.**

    **Description**

    Over the duration of this course,
    **you will submit a scholarly PowerPoint “Health Promotion Program Proposal,” addressing existing nursing knowledge related to health promotion and a written proposal.**

    In the written proposal, you will also develop a health promotion program to meet the health needs of a vulnerable population in your potential concentration area or community. The PowerPoint portion is your presentation of that proposal.

    The proposal must demonstrate graduate school-level writing and critical analysis. The final version of

    your proposal is due in week 8.

    For this assignment you will submit
    **Part One** of your proposal, detailing a health problem that is

    prevalent within
    **your selected group** and demonstrating your
    **research of health promotion strategies for addressing this specific health problem**. At this point, you already developed in your discussions the core ideas of the topic contained in this assignment-
    **this is the SAME TOPIC that was Approved in WEEK 2.** You will use the same information, but it won’t be a copy-and-paste exercise. The purpose is that you enhance your ideas with the comments and outcomes of the weekly discussions and previous evaluations.

    Directions

    1. Introduction. Describe the health problem. Don't type "Introduction".  (1 paragraph at least).

    Using data and statistics, support your claim that the issue you selected is a problem.

    What specifically will you address in your proposed health promotion program?

    Be sure your proposed outcome is realistic and measurable.

    2. Describe the vulnerable population.  (1-3 paragraphs).

    What are the risk factors that make this a vulnerable population?

    Use evidence to support the risk factors you have identified.

    3. Provide a review of literature from scholarly journals (at least 2) of evidence-based interventions that address the problem. (2 paragraphs, one for each article).

    After completing a literature search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and weaknesses of all the sources you have found. (2-3 paragraphs).

    4. Select and present an appropriate health promotion/disease prevention theoretical or conceptual model that best serves as the guiding framework for the proposal.  (2-3 paragraphs).

    For this assignment, a conclusion paragraph is not required.

    Writing Assignment Requirements

    **Three to five pages in length MAXIMUM – do not exceed page limit- be concise (excluding title page, references, and appendices)**

    **Follow APA format**

    **Cite a minimum of 6 references**

    **Please review the rubric prior to submission.**

    Sample APA paper for your reference:

    **APA 7 – Professional Sample Paper – 2020.pdf**

    **REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**

    **Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)

    **Submission**

    Text Editor

    Press Alt + F10 to access toolbar options

    _Word count: 0_

    **Drag files here**

    Maximum size: 512 MB

    **or**

    **Details & Information**

    **## Community-Based_Programs_Metabolic_Syndrome_Corrected.docx**

    **Community-Based Programs to Prevent Metabolic Syndrome**

    Anthony Pisani

    Florida National University

    Health Promotion & Role Development in Advanced Nursing Practice

    Dr. Nora Hernandez-Pupo

    July 11, 2026

    **Community-Based Programs to Prevent Metabolic Syndrome**

    ## Introduction

    Metabolic syndrome is a major health-promotion concern because it represents a cluster of interrelated and preventable cardiometabolic abnormalities, including abdominal obesity, elevated blood pressure, impaired glucose regulation, high triglyceride levels, and reduced high-density lipoprotein cholesterol. When these conditions occur together, the risk of type 2 diabetes, cardiovascular disease, stroke, chronic kidney disease, and premature mortality increases. Although individual behavior contributes to metabolic risk, community conditions also shape food choices, physical activity, access to screening, health literacy, and continuity of care. Therefore, prevention cannot rely exclusively on personal responsibility. This paper proposes a culturally responsive, nurse-led community program that combines bilingual education, cardiometabolic screening, nutrition counseling, structured physical activity, community health worker follow-up, and referrals to primary care for adults at increased risk in Miami-Dade County.

    ## Global and National Significance of Metabolic Syndrome

    The global rise in obesity and diabetes demonstrates the urgency of preventing metabolic syndrome before irreversible complications develop. In 2022, approximately 2.5 billion adults worldwide were overweight, including more than 890 million adults living with obesity (World Health Organization [WHO], 2025). A pooled analysis of 3,663 population-representative studies further demonstrated that obesity increased in most countries between 1990 and 2022, indicating that the problem reflects broad changes in food environments, physical activity, and social conditions rather than isolated individual choices (NCD Risk Factor Collaboration [NCD-RisC], 2024). Similarly, the GBD 2021 Diabetes Collaborators (2023) estimated that 529 million people were living with diabetes in 2021 and projected that the number could exceed 1.31 billion by 2050.

    In the United States, the same risk trajectory is evident. National surveillance data show that diabetes, prediabetes, obesity, and hypertension affect large proportions of the adult population. These statistics establish the need for prevention; however, surveillance alone does not identify which interventions are most effective. Graduate-level analysis requires connecting epidemiologic need with intervention research. Current evidence indicates that programs are more successful when they combine dietary change, physical activity, repeated behavioral support, and follow-up rather than relying on a single educational encounter.

    ## Evidence Supporting Community-Based Interventions

    Recent intervention studies provide stronger support for a multidimensional community strategy. Mbugua et al. (2022) conducted a randomized controlled trial involving 352 adults with metabolic syndrome who were followed for 15 months. Participants receiving community-based lifestyle education demonstrated significant improvements in blood pressure, blood glucose, cholesterol, central obesity, diet, and physical activity compared with those receiving routine hospital-based advice. Importantly, approximately one in three participants experienced improvement in physiologic, anthropometric, and clinical markers. These findings suggest that repeated community engagement can produce clinically meaningful change beyond general counseling delivered during routine care.

    A systematic review and meta-analysis by Park et al. (2024) reached a similar conclusion. Across seven studies, comprehensive lifestyle interventions that combined diet and exercise improved health behaviors and produced reductions in fasting glucose and systolic blood pressure, particularly when programs lasted approximately six months. This synthesis is important because it demonstrates that no single strategy is likely to be sufficient. Nutrition education may improve knowledge, but participants also need structured opportunities for exercise, goal setting, self-monitoring, and reinforcement.

    Technology may strengthen, but should not replace, interpersonal support. Wong et al. (2023) compared a mobile application with booklet-based education among adults with metabolic syndrome. The mobile-supported intervention improved several outcomes, including physical activity, body weight, waist circumference, body mass index, and systolic blood pressure. Nevertheless, digital interventions may be less accessible to residents with limited digital literacy, unstable internet access, or language barriers. For Miami-Dade County, a hybrid model is therefore preferable: bilingual face-to-face sessions should remain central, while text messages or a simple mobile platform can provide reminders, activity tracking, and follow-up.

    Taken together, the evidence supports a layered intervention rather than a one-time health fair. Mbugua et al. (2022) demonstrated the effectiveness of sustained community education, Park et al. (2024) showed that combined diet-and-exercise programs are more effective than isolated components, and Wong et al. (2023) demonstrated the added value of technology-supported follow-up. The convergence of these findings supports a culturally tailored program that integrates screening, behavioral coaching, structured activity, and continuing contact.

    ## Metabolic Risk in Miami-Dade County

    Miami-Dade County is an appropriate location for this program because local demographic and health conditions may intensify metabolic risk and create barriers to prevention. The county had an estimated population of approximately 2.8 million in 2025; 70.6% of residents identified as Hispanic or Latino, 54.5% were foreign-born, and 75.3% spoke a language other than English at home (U.S. Census Bureau, 2025). In addition, 14.8% of residents younger than 65 years were uninsured and 14.2% lived in poverty. These conditions support the need for low-cost, bilingual services delivered in trusted community settings.

    Health-specific data strengthen the local justification. County Health Rankings & Roadmaps reported an adult obesity prevalence of approximately 30% in Miami-Dade County, while local neighborhood estimates show substantially higher obesity levels in several communities, including Florida City, Brownsville, Opa-locka, and Miami Gardens (County Health Rankings & Roadmaps, 2026). These geographic differences indicate that a countywide average can conceal pockets of greater risk. The Florida Department of Health in Miami-Dade County also identifies chronic disease prevention and healthy weight, physical activity, and nutrition as community health priorities for 2025–2030 (Florida Department of Health in Miami-Dade County, 2026). Therefore, the proposed program should prioritize neighborhoods with high obesity burden, lower income, limited insurance coverage, and reduced access to preventive care.

    ## Proposed Community-Based Prevention Program

    The proposed program would enroll adults aged 18 years or older who have obesity, prediabetes, hypertension, dyslipidemia, a large waist circumference, or another documented metabolic risk factor. Recruitment could occur through federally qualified health centers, churches, libraries, community centers, food-distribution sites, and local health fairs. The 12-week program would be delivered in English and Spanish, with Haitian Creole support when available.

    At baseline, nurses would measure blood pressure, weight, body mass index, and waist circumference and would arrange point-of-care glucose or hemoglobin A1c screening when permitted by organizational policy. Participants with abnormal findings would receive a referral to primary care rather than being treated solely within the community program. Weekly sessions would address affordable meal planning, label reading, portion control, sugar-sweetened beverages, culturally familiar food substitutions, stress management, sleep, and safe physical activity. Structured walking groups would meet at least twice weekly, and participants would develop individualized activity goals.

    Community health workers would conduct brief follow-up contacts between sessions, reinforce goals, identify barriers, and connect participants with food, transportation, insurance, and primary care resources. Text messages could be used for reminders and self-monitoring, but paper materials and telephone follow-up would remain available to avoid excluding people with limited technology access. This design reflects the evidence that sustained, multicomponent support is more effective than isolated education.

    ## Role of the Advanced Practice Nurse

    The advanced practice registered nurse would provide clinical and organizational leadership for the program. Responsibilities would include developing evidence-based educational materials, training staff and community health workers, establishing screening and referral criteria, reviewing abnormal results, coordinating with primary care providers, and ensuring culturally and linguistically appropriate communication. The nurse would also evaluate whether participants experience barriers related to medication access, food insecurity, transportation, health insurance, or health literacy. By integrating clinical assessment with community partnerships, the advanced practice nurse can help translate population-level evidence into practical prevention services.

    ## Evaluation of Program Outcomes

    Program effectiveness should be evaluated at baseline, 12 weeks, and, when feasible, three to six months after completion. Primary outcomes would include changes in systolic and diastolic blood pressure, body weight, waist circumference, physical activity, and self-reported intake of fruits, vegetables, and sugar-sweetened beverages. Secondary outcomes would include attendance, completion rate, referrals completed, participant satisfaction, and confidence in managing cardiometabolic risk. Because a 12-week program may be too brief to produce large laboratory changes, results should be interpreted cautiously. The expected outcome is not immediate elimination of metabolic syndrome, but measurable improvement in modifiable risk factors and stronger connection to continuing preventive care.

    ## Conclusion

    Metabolic syndrome is a preventable pathway to diabetes, cardiovascular disease, kidney disease, and premature mortality. Global and national statistics establish the magnitude of the problem, while Miami-Dade County data demonstrate the need for local, culturally responsive prevention. Current research shows that community programs are most effective when they combine nutrition, physical activity, behavioral support, repeated follow-up, and accessible technology. A bilingual, nurse-led program delivered through trusted community organizations could improve early detection, reduce modifiable risk factors, and connect high-risk adults with primary care. The strongest expected impact would come from sustained engagement rather than one-time education. Through structured evaluation and community partnerships, the proposed intervention could provide a practical and evidence-informed approach to reducing metabolic risk in vulnerable Miami-Dade communities.

    ## References

    County Health Rankings & Roadmaps. (2026). Adult obesity: Miami-Dade County, Florida. University of Wisconsin Population Health Institute. https://www.countyhealthrankings.org/health-data

    Florida Department of Health in Miami-Dade County. (2026). Community health planning. https://miamidade.floridahealth.gov/programs-and-services/community-health-planning-and-statistics/community-health-planning/

    GBD 2021 Diabetes Collaborators. (2023). Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: A systematic analysis for the Global Burden of Disease Study 2021. The Lancet, 402(10397), 203–234. https://doi.org/10.1016/S0140-6736(23)01301-6

    Mbugua, S. M., Kimani, S. T., & Munyoki, G. (2022). Community-based lifestyle intervention improves metabolic syndrome and related markers among Kenyan adults. Journal of Diabetes & Metabolic Disorders, 21, 545–555. https://doi.org/10.1007/s40200-022-01023-1

    NCD Risk Factor Collaboration (NCD-RisC). (2024). Worldwide trends in underweight and obesity from 1990 to 2022: A pooled analysis of 3,663 population-representative studies with 222 million children, adolescents, and adults. The Lancet, 403(10431), 1027–1050. https://doi.org/10.1016/S0140-6736(23)02750-2

    Park, S., Lee, J., Seok, J. W., Park, C. G., & Jun, J. (2024). Comprehensive lifestyle modification interventions for metabolic syndrome: A systematic review and meta-analysis. Journal of Nursing Scholarship, 56(2), 249–259. https://doi.org/10.1111/jnu.12946

    U.S. Census Bureau. (2025). QuickFacts: Miami-Dade County, Florida. https://www.census.gov/quickfacts/fact/table/miamidadecountyflorida/PST045225

    Wong, E. M. L., Leung, D. Y. P., Wang, Q., Leung, A. Y. M., & Cheung, A. S. P. (2023). The effect of a lifestyle intervention program using a mobile application versus the effect of a program using a booklet for adults with metabolic syndrome: A three-arm randomized controlled trial. Journal of Nursing Scholarship, 55(4), 936–948. https://doi.org/10.1111/jnu.12883

    World Health Organization. (2025, May 7). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

    1

  • [Solved] Assigment .Apa seven . All instructions attached.

    ✓ Verified Academic Solution Available

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    **files (1)** – ## casestudy2.docx **## casestudy2.docx** Advanced Primary Care of Family I-HBN-HY01 Luis Serrano 🩺 CASE STUDY 2 – Chest Pain and Dyspnea: Diagnostic Reasoning in Primary Care 5 pages **CASE STUDY 2 – Chest Pain and Dyspnea: Diagnostic Reasoning in Primary Care** **Case Scenario** Ms…

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    **files (1)**

    – ## casestudy2.docx

    **## casestudy2.docx**

    Advanced Primary Care of Family I-HBN-HY01 Luis Serrano

    🩺 CASE STUDY 2 – Chest Pain and Dyspnea: Diagnostic Reasoning in Primary Care 5 pages

    **CASE STUDY 2 – Chest Pain and Dyspnea: Diagnostic Reasoning in Primary Care**

    **Case Scenario**

    Ms. L.T. is a
    **61-year-old female** presenting with intermittent chest tightness and exertional dyspnea for 3 weeks.

    **History:**

    · PMH: Hypertension, tobacco use (30 pack-years), anxiety

    · Medications: Amlodipine 5 mg daily

    · Symptoms: Chest discomfort radiating to jaw, relieved by rest

    **Vitals:**

    · BP: 156/88 mmHg

    · HR: 96 bpm

    **Initial Findings:**

    · EKG: Nonspecific ST-T changes

    · SpO₂: 95% on room air

    **Student Assignment Requirements**

    **1. Pathophysiology (25%)**

    · Compare and contrast ischemic vs non-ischemic chest pain mechanisms

    · Explain cardiopulmonary causes of dyspnea

    · Address anxiety overlap

    **2. Assessment & Differential Diagnosis (35%)**

    · Focused cardiac and pulmonary exam

    · Prioritized differential diagnosis

    · Identification of
    **life-threatening conditions**

    · Decision-making for ED referral vs outpatient management

    **3. Pharmacology & Initial Management (30%)**

    · Acute and chronic pharmacologic considerations

    · Antihypertensive optimization

    · Risk reduction strategies

    · Follow-up testing and referrals

    **4. APA & Evidence Integration (10%)**

    **RUBRIC – CASE STUDY 2 – Chest Pain and Dyspnea Diagnostic Reasoning (100 Points)**

    **1. Pathophysiology of Symptoms (25 points)**

    | | |
    | — | — |
    | **Level** | **Description** |
    | **Excellent (23–25)** | Clearly differentiates ischemic and non-ischemic mechanisms of chest pain and dyspnea, accurately linking physiology to patient presentation. |
    | **Satisfactory (18–22)** | Correct explanation of major mechanisms with limited depth or integration. |
    | **Unsatisfactory (13–17)** | Partial or unclear explanation of pathophysiology. |
    | **Poor (1–12)** | Incorrect or superficial explanation of mechanisms. |
    | **Not Submitted (0)** | Section not submitted or missing. |

    **2. Assessment & Differential Diagnosis (35 points)**

    | | |
    | — | — |
    | **Level** | **Description** |
    | **Excellent (33–35)** | Thorough, prioritized differential diagnosis with clear identification of life-threatening conditions and appropriate disposition decisions. |
    | **Satisfactory (26–32)** | Appropriate differential but limited prioritization or incomplete reasoning. |
    | **Unsatisfactory (18–25)** | Incomplete or poorly prioritized differential diagnosis. |
    | **Poor (1–17)** | Unsafe or inaccurate diagnostic reasoning. |
    | **Not Submitted (0)** | Section not submitted or missing. |

    **3. Pharmacology & Initial Management Plan (30 points)**

    | | |
    | — | — |
    | **Level** | **Description** |
    | **Excellent (28–30)** | Evidence-based management addressing acute and chronic needs with clear rationale and follow-up. |
    | **Satisfactory (22–27)** | Management plan is appropriate but lacks detail or optimization. |
    | **Unsatisfactory (16–21)** | Partial or unsupported management decisions. |
    | **Poor (1–15)** | Unsafe or inappropriate treatment plan. |
    | **Not Submitted (0)** | Section not submitted or missing. |

    **## casestudy2.docx**

    Advanced Primary Care of Family I-HBN-HY01 Luis Serrano

    🩺 CASE STUDY 2 – Chest Pain and Dyspnea: Diagnostic Reasoning in Primary Care 5 pages

    **CASE STUDY 2 – Chest Pain and Dyspnea: Diagnostic Reasoning in Primary Care**

    **Case Scenario**

    Ms. L.T. is a
    **61-year-old female** presenting with intermittent chest tightness and exertional dyspnea for 3 weeks.

    **History:**

    · PMH: Hypertension, tobacco use (30 pack-years), anxiety

    · Medications: Amlodipine 5 mg daily

    · Symptoms: Chest discomfort radiating to jaw, relieved by rest

    **Vitals:**

    · BP: 156/88 mmHg

    · HR: 96 bpm

    **Initial Findings:**

    · EKG: Nonspecific ST-T changes

    · SpO₂: 95% on room air

    **Student Assignment Requirements**

    **1. Pathophysiology (25%)**

    · Compare and contrast ischemic vs non-ischemic chest pain mechanisms

    · Explain cardiopulmonary causes of dyspnea

    · Address anxiety overlap

    **2. Assessment & Differential Diagnosis (35%)**

    · Focused cardiac and pulmonary exam

    · Prioritized differential diagnosis

    · Identification of
    **life-threatening conditions**

    · Decision-making for ED referral vs outpatient management

    **3. Pharmacology & Initial Management (30%)**

    · Acute and chronic pharmacologic considerations

    · Antihypertensive optimization

    · Risk reduction strategies

    · Follow-up testing and referrals

    **4. APA & Evidence Integration (10%)**

    **RUBRIC – CASE STUDY 2 – Chest Pain and Dyspnea Diagnostic Reasoning (100 Points)**

    **1. Pathophysiology of Symptoms (25 points)**

    | | |
    | — | — |
    | **Level** | **Description** |
    | **Excellent (23–25)** | Clearly differentiates ischemic and non-ischemic mechanisms of chest pain and dyspnea, accurately linking physiology to patient presentation. |
    | **Satisfactory (18–22)** | Correct explanation of major mechanisms with limited depth or integration. |
    | **Unsatisfactory (13–17)** | Partial or unclear explanation of pathophysiology. |
    | **Poor (1–12)** | Incorrect or superficial explanation of mechanisms. |
    | **Not Submitted (0)** | Section not submitted or missing. |

    **2. Assessment & Differential Diagnosis (35 points)**

    | | |
    | — | — |
    | **Level** | **Description** |
    | **Excellent (33–35)** | Thorough, prioritized differential diagnosis with clear identification of life-threatening conditions and appropriate disposition decisions. |
    | **Satisfactory (26–32)** | Appropriate differential but limited prioritization or incomplete reasoning. |
    | **Unsatisfactory (18–25)** | Incomplete or poorly prioritized differential diagnosis. |
    | **Poor (1–17)** | Unsafe or inaccurate diagnostic reasoning. |
    | **Not Submitted (0)** | Section not submitted or missing. |

    **3. Pharmacology & Initial Management Plan (30 points)**

    | | |
    | — | — |
    | **Level** | **Description** |
    | **Excellent (28–30)** | Evidence-based management addressing acute and chronic needs with clear rationale and follow-up. |
    | **Satisfactory (22–27)** | Management plan is appropriate but lacks detail or optimization. |
    | **Unsatisfactory (16–21)** | Partial or unsupported management decisions. |
    | **Poor (1–15)** | Unsafe or inappropriate treatment plan. |
    | **Not Submitted (0)** | Section not submitted or missing. |

  • [Solved] Assigment .Apa seven . All instructions attached.

    ✓ Verified Academic Solution Available

    Executive Solution Overview

    **files (2)** – ## PreliminaryReferenceList1.docx – ## ScholarlyPaperUPLOADHERE.docx **## PreliminaryReferenceList1.docx** 2 **Preliminary Reference List** **Merle Mishel's Uncertainty in Illness Theory** Vianka Concepcion Florida National University Nursing Theory-DBX-DL01 Dr.Nora Hernandez-Pupo Ju…

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    Assignment Prompt & Instructions

    **files (2)**

    – ## PreliminaryReferenceList1.docx

    – ## ScholarlyPaperUPLOADHERE.docx

    **## PreliminaryReferenceList1.docx**

    2

    **Preliminary Reference List**

    **Merle Mishel's Uncertainty in Illness Theory**

    Vianka Concepcion

    Florida National University

    Nursing Theory-DBX-DL01

    Dr.Nora Hernandez-Pupo

    July 17, 2026

    **Preliminary Reference List**

    Andrade, C. R. A. G., Costa, L. de M. C., Lúcio, I. M. L., Pereira, J. F., Lima, H. N., & Nascimento, R. L. (2024). Uncertainties experienced by nursing professionals who contracted Covid-19: A priori, everyone is human.
    _Revista Brasileira de Enfermagem_,
    _77_(suppl 1). https://doi.org/10.1590/0034-7167-2023-0142

    Bao, Y., Yang, L., Zhao, J., Wang, Z., Fu, L., Fang, M., & Jin’e Lin. (2026). The association between chronic disease resource utilization and illness uncertainty in COPD patients: A latent profile analysis.
    _PeerJ_,
    _14_, e20674. https://doi.org/10.7717/peerj.20674

    Grant, J. B., & Johnson-Koenke, R. (2024). Navigating chronic uncertainty: A theory synthesis for nursing communication in life-limiting illness.
    _BMC Nursing_,
    _23_(1). https://doi.org/10.1186/s12912-024-02328-7

    Guan, T., Chapman, M. V., Lisa, Zimmer, C., Carrie Jo Braden, Cynthia Fraga Rizo, Northouse, L., & Song, L. (2023). Illness uncertainty and quality of life in patients with advanced cancer and their family caregivers: An actor‐partner interdependence model analysis.
    _Psycho-Oncology_,
    _32_(11), 1744–1751. https://doi.org/10.1002/pon.6228

    Li, M., Li, J., Liu, H., Pan, Z., Zhang, B., Zhang, W., Li, J., Yang, K., Yu, Y., Yang, T., Dongsen Lv, Zhang, N., Li, S., Li, Q., Song, R., Liu, J., Li, H., & Wei, J. (2025). The assessment of caregiver burden and associated factors on the primary family caregivers for patients with moyamoya disease: A cross-sectional study [Review of
    _The assessment of caregiver burden and associated factors on the primary family caregivers for patients with moyamoya disease: A cross-sectional study_].
    _Frontiers in Psychiatry_,
    _16_, 1688617–1688617. https://doi.org/10.3389/fpsyt.2025.1688617

    Li, Q., Luo, C., Ye, J., Bian, Z., Sun, W., Zhou, M., & Rong, M. (2024). Relationship Between Illness Uncertainty and Family Resilience Among Caregivers of Stroke Patients in Chinese Nuclear Families: The Mediating Role of Perceived Stress.
    _Patient Preference and Adherence_,
    _Volume 18_, 1095–1105. https://doi.org/10.2147/ppa.s463562

    Zhang, W., Pan, Z., Zhu, Y., Dongsen Lv, Zhang, H., Li, S., Liu, C., Xiong, X., Li, Q., Yao, G., Yang, S., Song, R., Yan, S., Wang, D., Li, M., & Liu, H. (2024). Illness uncertainty, resilience, and perceived social support among patients with moyamoya disease: A cross-sectional study [Review of
    _Illness uncertainty, resilience, and perceived social support among patients with moyamoya disease: A cross-sectional study_].
    _Frontiers in Psychiatry_,
    _15_. https://doi.org/10.3389/fpsyt.2024.1405594

    **## ScholarlyPaperUPLOADHERE.docx**

    Nursing Theory-DBX-DL01 Nora Hernandez-Pupo

    Scholarly Paper UPLOAD HERE Due Saturday @ 2359

    **SCHOLARLY PAPER INSTRUCTIONS**

    **DUE DATE: WEEK 4 Saturday at 2359**

    **Assignment Overview**

    **Due Date:**

    ·
    **Week 4, Saturday at 11:59 PM** Submissions must be received by the deadline. Late assignments will not be accepted.

    **Paper Topic:**

    · Select and analyze a nursing theory of your choice.

    **Paper Length and Formatting Requirements:**

    · Your formal paper should be
    **5-6 pages in length**, not including the title page and reference pages.

    · Use the following formatting settings:

    ·
    **Double-spaced text**

    ·
    **12-point font** (preferably Times New Roman)

    ·
    **1-inch margins** on all sides

    · Follow APA 7th Edition guidelines for:

    · Title (cover) page

    · Headers and pagination

    · In-text citations and reference list

    **Content and Structure**

    Your paper must be organized into the following sections. Each section should be clearly labeled and addressed in your final submission.

    **Introduction**

    ·
    **Purpose:** Begin your paper by introducing the nursing theory you have chosen.

    ·
    **Content Requirements:**

    · Provide a brief background of the theorist—include information about their education, career, and any contributions that are relevant to the development of the theory.

    · Explain why the theorist is significant in the world of nursing.

    ·
    **Tips:** Keep this section concise, yet informative enough for the reader to understand the origin of the theory.

    **Basic Concept Analysis**

    ·
    **Purpose:** Clearly outline the core components of the nursing theory.

    ·
    **Content Requirements:**

    · Identify and briefly explain the major concepts that form the basis of the theory.

    · Discuss how these core concepts work together to define the theory.

    · Use clear definitions and simple examples if appropriate to illustrate each concept.

    ·
    **Tips:** Focus on the essential ideas that make the theory unique and applicable to nursing practice.

    **Relevance**

    ·
    **Purpose:** Demonstrate how the nursing theory is connected to broader healthcare practices and current research.

    ·
    **Content Requirements:**

    · Explain how the theorist’s work connects to the theory, and in turn, how the theory influences healthcare practices.

    · Discuss the application of the theory in today’s clinical settings.

    · Reference current research or clinical practice studies that apply the theory.

    ·
    **Scholarly Sources:**

    · Incorporate at least
    **two peer-reviewed or research articles** that detail how the theory is being utilized in clinical practice or research.

    · Summarize the key findings of each article including the results of the study and the implications they have for future practice.

    ·
    **Tips:** Be analytical and use evidence-based practice (EBP) to support your relevance discussion.

    **Summary**

    ·
    **Purpose:** Your summary should provide a critical reflection on the theory.

    ·
    **Content Requirements:**

    · Summarize the strengths and limitations of the nursing theory.

    · Reflect on how well the theory bridges theoretical frameworks with practical application.

    ·
    **Tips:** Offer a balanced perspective that recognizes both the benefits and potential shortcomings of the theory in advancing nursing practice.

    **Additional Guidelines**

    ·
    **APA Formatting:**

    · Ensure that your cover sheet, headers, pagination, and reference pages adhere to APA 7th Edition standards.

    · All in-text citations must match your reference list.

    ·
    **Assignment Quality:**

    · The writing should be formal, well-organized, and clearly written at a graduate level.

    · Each section should logically flow into the next, maintaining coherence throughout your paper.

    ·
    **Review the Rubric:**

    · Refer to the grading rubric provided (if available) to ensure that you have met all the criteria required for a high-quality submission.

    ·
    **Proofread Your Paper:**

    · Before submission, check for grammatical errors and clarity. Make sure your arguments are well-supported by evidence from your scholarly sources.

    **REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**

    **Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)

    **Final Submission Reminder**

    ·
    **Deadline:** Submit your final paper by
    **Week 4 Saturday at 11:59 PM**.

    ·
    **Submission Process:** Upload your paper in the designated submission portal. Ensure that your attachment is correctly named with your name and assignment title.

    By following these expanded instructions, you are well equipped to produce a comprehensive, well-structured, and evidence-based paper on your selected nursing theory. Taking the time to address each section thoroughly will enhance your chance for success and contribute thoughtfully to your field of study. Happy writing!

    Please refer to the grading rubric in the assignment drop box.

    **Submission**

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    Rubric Details

    **Maximum Score**

    100 points

    **Exemplary Work**

    The paper presents a thorough and insightful analysis of the chosen nursing theory. All key concepts are clearly articulated, relevant to the theory, and expertly linked to contemporary nursing practices. Evidence from multiple scholarly sources enhances the discussion.

    **40**

    **Proficient Work**

    The analysis of the nursing theory is clear and relevant, addressing the core concepts and making appropriate connections to current nursing practice. Some scholarly sources are incorporated effectively.

    **30**

    **Needs Improvement**

    The discussion of the nursing theory is somewhat unclear or lacks depth. Some key concepts may not be adequately explained. Connections to current practice are weak or underdeveloped.

    **20**

    **Unsatisfactory Work**

    The analysis of the nursing theory is minimal or missing. Key concepts are poorly defined, and there are little to no connections made to current nursing practice.

    **10**

    **Exemplary Work**

    The paper is exceptionally well-organized with clear section headings and a logical flow of ideas. Each section seamlessly transitions to the next.

    **30**

    **Proficient Work**

    The organization of the paper is good, with clear headings. There is some coherent flow between sections, though a few transitions may be abrupt.

    **22.5**

    **Needs Improvement**

    The paper lacks a clear organizational structure. Section headings may be present, but the flow of ideas is unclear or confusing.

    **15**

    **Unsatisfactory Work**

    The paper is poorly organized. There are no clear section headings, and ideas are presented in a haphazard manner.

    **7.5**

    **Exemplary Work**

    The paper includes multiple peer-reviewed articles that are highly relevant and current. Each source is well-integrated into the discussion and supports key arguments effectively. At least 2 sources are used to develop the paper.

    **15**

    **Proficient Work**

    The paper uses at least 2 relevant peer-reviewed sources, though the integration could be improved. Lacks synthesis and support. Most sources are appropriate and contribute to the key arguments.

    **11.25**

    **Needs Improvement**

    Less than 2 sources are used in the paper. The analysis lacks support from scholarly literature, which weakens key arguments.

    **7.5**

    **Unsatisfactory Work**

    The paper uses 1 peer-reviewed sources or relies on non-scholarly sources, lacks scholarly synthesis and connections. Key claims lack credible support.

    **3.75**

    **Exemplary Work**

    All REFERENCES have DOI Numbers for me to look them up.

    **10**

    **Proficient Work**

    All REFERENCES have DOI Numbers for me to look them up- but not all are working.

    **7.5**

    **Needs Improvement**

    Not all REFERENCE have a DOI Number for me to look them up.

    **5**

    **Unsatisfactory Work**

    More than 2 REFERENCES do not have DOI Numbers for me to look them up.

    **2.5**

    **Exemplary Work**

    The paper strictly follows APA 7th Edition guidelines throughout, including formatting, in text citations. The writing is clear, formal, and free of grammatical errors.

    **5**

    **Proficient Work**

    The paper mostly adheres to APA 7th Edition guidelines, with only minor formatting errors. The writing is generally clear with few grammatical issues.

    **3.75**

    **Needs Improvement**

    The paper shows irregularities in APA formatting and numerous grammatical errors that distract from the overall clarity of the writing.

    **2.5**

    **Unsatisfactory Work**

    The paper does not follow APA 7th Edition guidelines. There are significant problems in writing quality, including many grammatical errors that obstruct understanding.

    **## ScholarlyPaperUPLOADHERE.docx**

    Nursing Theory-DBX-DL01 Nora Hernandez-Pupo

    Scholarly Paper UPLOAD HERE Due Saturday @ 2359

    **SCHOLARLY PAPER INSTRUCTIONS**

    **DUE DATE: WEEK 4 Saturday at 2359**

    **Assignment Overview**

    **Due Date:**

    ·
    **Week 4, Saturday at 11:59 PM** Submissions must be received by the deadline. Late assignments will not be accepted.

    **Paper Topic:**

    · Select and analyze a nursing theory of your choice.

    **Paper Length and Formatting Requirements:**

    · Your formal paper should be
    **5-6 pages in length**, not including the title page and reference pages.

    · Use the following formatting settings:

    ·
    **Double-spaced text**

    ·
    **12-point font** (preferably Times New Roman)

    ·
    **1-inch margins** on all sides

    · Follow APA 7th Edition guidelines for:

    · Title (cover) page

    · Headers and pagination

    · In-text citations and reference list

    **Content and Structure**

    Your paper must be organized into the following sections. Each section should be clearly labeled and addressed in your final submission.

    **Introduction**

    ·
    **Purpose:** Begin your paper by introducing the nursing theory you have chosen.

    ·
    **Content Requirements:**

    · Provide a brief background of the theorist—include information about their education, career, and any contributions that are relevant to the development of the theory.

    · Explain why the theorist is significant in the world of nursing.

    ·
    **Tips:** Keep this section concise, yet informative enough for the reader to understand the origin of the theory.

    **Basic Concept Analysis**

    ·
    **Purpose:** Clearly outline the core components of the nursing theory.

    ·
    **Content Requirements:**

    · Identify and briefly explain the major concepts that form the basis of the theory.

    · Discuss how these core concepts work together to define the theory.

    · Use clear definitions and simple examples if appropriate to illustrate each concept.

    ·
    **Tips:** Focus on the essential ideas that make the theory unique and applicable to nursing practice.

    **Relevance**

    ·
    **Purpose:** Demonstrate how the nursing theory is connected to broader healthcare practices and current research.

    ·
    **Content Requirements:**

    · Explain how the theorist’s work connects to the theory, and in turn, how the theory influences healthcare practices.

    · Discuss the application of the theory in today’s clinical settings.

    · Reference current research or clinical practice studies that apply the theory.

    ·
    **Scholarly Sources:**

    · Incorporate at least
    **two peer-reviewed or research articles** that detail how the theory is being utilized in clinical practice or research.

    · Summarize the key findings of each article including the results of the study and the implications they have for future practice.

    ·
    **Tips:** Be analytical and use evidence-based practice (EBP) to support your relevance discussion.

    **Summary**

    ·
    **Purpose:** Your summary should provide a critical reflection on the theory.

    ·
    **Content Requirements:**

    · Summarize the strengths and limitations of the nursing theory.

    · Reflect on how well the theory bridges theoretical frameworks with practical application.

    ·
    **Tips:** Offer a balanced perspective that recognizes both the benefits and potential shortcomings of the theory in advancing nursing practice.

    **Additional Guidelines**

    ·
    **APA Formatting:**

    · Ensure that your cover sheet, headers, pagination, and reference pages adhere to APA 7th Edition standards.

    · All in-text citations must match your reference list.

    ·
    **Assignment Quality:**

    · The writing should be formal, well-organized, and clearly written at a graduate level.

    · Each section should logically flow into the next, maintaining coherence throughout your paper.

    ·
    **Review the Rubric:**

    · Refer to the grading rubric provided (if available) to ensure that you have met all the criteria required for a high-quality submission.

    ·
    **Proofread Your Paper:**

    · Before submission, check for grammatical errors and clarity. Make sure your arguments are well-supported by evidence from your scholarly sources.

    **REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**

    **Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)

    **Final Submission Reminder**

    ·
    **Deadline:** Submit your final paper by
    **Week 4 Saturday at 11:59 PM**.

    ·
    **Submission Process:** Upload your paper in the designated submission portal. Ensure that your attachment is correctly named with your name and assignment title.

    By following these expanded instructions, you are well equipped to produce a comprehensive, well-structured, and evidence-based paper on your selected nursing theory. Taking the time to address each section thoroughly will enhance your chance for success and contribute thoughtfully to your field of study. Happy writing!

    Please refer to the grading rubric in the assignment drop box.

    **Submission**

    Text Editor

    Press Alt + F10 to access toolbar options

    _Word count: 0_

    **Drag files here**

    Maximum size: 512 MB

    **or**

    **Details & Information**

    Rubric Details

    **Maximum Score**

    100 points

    **Exemplary Work**

    The paper presents a thorough and insightful analysis of the chosen nursing theory. All key concepts are clearly articulated, relevant to the theory, and expertly linked to contemporary nursing practices. Evidence from multiple scholarly sources enhances the discussion.

    **40**

    **Proficient Work**

    The analysis of the nursing theory is clear and relevant, addressing the core concepts and making appropriate connections to current nursing practice. Some scholarly sources are incorporated effectively.

    **30**

    **Needs Improvement**

    The discussion of the nursing theory is somewhat unclear or lacks depth. Some key concepts may not be adequately explained. Connections to current practice are weak or underdeveloped.

    **20**

    **Unsatisfactory Work**

    The analysis of the nursing theory is minimal or missing. Key concepts are poorly defined, and there are little to no connections made to current nursing practice.

    **10**

    **Exemplary Work**

    The paper is exceptionally well-organized with clear section headings and a logical flow of ideas. Each section seamlessly transitions to the next.

    **30**

    **Proficient Work**

    The organization of the paper is good, with clear headings. There is some coherent flow between sections, though a few transitions may be abrupt.

    **22.5**

    **Needs Improvement**

    The paper lacks a clear organizational structure. Section headings may be present, but the flow of ideas is unclear or confusing.

    **15**

    **Unsatisfactory Work**

    The paper is poorly organized. There are no clear section headings, and ideas are presented in a haphazard manner.

    **7.5**

    **Exemplary Work**

    The paper includes multiple peer-reviewed articles that are highly relevant and current. Each source is well-integrated into the discussion and supports key arguments effectively. At least 2 sources are used to develop the paper.

    **15**

    **Proficient Work**

    The paper uses at least 2 relevant peer-reviewed sources, though the integration could be improved. Lacks synthesis and support. Most sources are appropriate and contribute to the key arguments.

    **11.25**

    **Needs Improvement**

    Less than 2 sources are used in the paper. The analysis lacks support from scholarly literature, which weakens key arguments.

    **7.5**

    **Unsatisfactory Work**

    The paper uses 1 peer-reviewed sources or relies on non-scholarly sources, lacks scholarly synthesis and connections. Key claims lack credible support.

    **3.75**

    **Exemplary Work**

    All REFERENCES have DOI Numbers for me to look them up.

    **10**

    **Proficient Work**

    All REFERENCES have DOI Numbers for me to look them up- but not all are working.

    **7.5**

    **Needs Improvement**

    Not all REFERENCE have a DOI Number for me to look them up.

    **5**

    **Unsatisfactory Work**

    More than 2 REFERENCES do not have DOI Numbers for me to look them up.

    **2.5**

    **Exemplary Work**

    The paper strictly follows APA 7th Edition guidelines throughout, including formatting, in text citations. The writing is clear, formal, and free of grammatical errors.

    **5**

    **Proficient Work**

    The paper mostly adheres to APA 7th Edition guidelines, with only minor formatting errors. The writing is generally clear with few grammatical issues.

    **3.75**

    **Needs Improvement**

    The paper shows irregularities in APA formatting and numerous grammatical errors that distract from the overall clarity of the writing.

    **2.5**

    **Unsatisfactory Work**

    The paper does not follow APA 7th Edition guidelines. There are significant problems in writing quality, including many grammatical errors that obstruct understanding.

    **## PreliminaryReferenceList1.docx**

    2

    **Preliminary Reference List**

    **Merle Mishel's Uncertainty in Illness Theory**

    Vianka Concepcion

    Florida National University

    Nursing Theory-DBX-DL01

    Dr.Nora Hernandez-Pupo

    July 17, 2026

    **Preliminary Reference List**

    Andrade, C. R. A. G., Costa, L. de M. C., Lúcio, I. M. L., Pereira, J. F., Lima, H. N., & Nascimento, R. L. (2024). Uncertainties experienced by nursing professionals who contracted Covid-19: A priori, everyone is human.
    _Revista Brasileira de Enfermagem_,
    _77_(suppl 1). https://doi.org/10.1590/0034-7167-2023-0142

    Bao, Y., Yang, L., Zhao, J., Wang, Z., Fu, L., Fang, M., & Jin’e Lin. (2026). The association between chronic disease resource utilization and illness uncertainty in COPD patients: A latent profile analysis.
    _PeerJ_,
    _14_, e20674. https://doi.org/10.7717/peerj.20674

    Grant, J. B., & Johnson-Koenke, R. (2024). Navigating chronic uncertainty: A theory synthesis for nursing communication in life-limiting illness.
    _BMC Nursing_,
    _23_(1). https://doi.org/10.1186/s12912-024-02328-7

    Guan, T., Chapman, M. V., Lisa, Zimmer, C., Carrie Jo Braden, Cynthia Fraga Rizo, Northouse, L., & Song, L. (2023). Illness uncertainty and quality of life in patients with advanced cancer and their family caregivers: An actor‐partner interdependence model analysis.
    _Psycho-Oncology_,
    _32_(11), 1744–1751. https://doi.org/10.1002/pon.6228

    Li, M., Li, J., Liu, H., Pan, Z., Zhang, B., Zhang, W., Li, J., Yang, K., Yu, Y., Yang, T., Dongsen Lv, Zhang, N., Li, S., Li, Q., Song, R., Liu, J., Li, H., & Wei, J. (2025). The assessment of caregiver burden and associated factors on the primary family caregivers for patients with moyamoya disease: A cross-sectional study [Review of
    _The assessment of caregiver burden and associated factors on the primary family caregivers for patients with moyamoya disease: A cross-sectional study_].
    _Frontiers in Psychiatry_,
    _16_, 1688617–1688617. https://doi.org/10.3389/fpsyt.2025.1688617

    Li, Q., Luo, C., Ye, J., Bian, Z., Sun, W., Zhou, M., & Rong, M. (2024). Relationship Between Illness Uncertainty and Family Resilience Among Caregivers of Stroke Patients in Chinese Nuclear Families: The Mediating Role of Perceived Stress.
    _Patient Preference and Adherence_,
    _Volume 18_, 1095–1105. https://doi.org/10.2147/ppa.s463562

    Zhang, W., Pan, Z., Zhu, Y., Dongsen Lv, Zhang, H., Li, S., Liu, C., Xiong, X., Li, Q., Yao, G., Yang, S., Song, R., Yan, S., Wang, D., Li, M., & Liu, H. (2024). Illness uncertainty, resilience, and perceived social support among patients with moyamoya disease: A cross-sectional study [Review of
    _Illness uncertainty, resilience, and perceived social support among patients with moyamoya disease: A cross-sectional study_].
    _Frontiers in Psychiatry_,
    _15_. https://doi.org/10.3389/fpsyt.2024.1405594

    **## ScholarlyPaperUPLOADHERE.docx**

    Nursing Theory-DBX-DL01 Nora Hernandez-Pupo

    Scholarly Paper UPLOAD HERE Due Saturday @ 2359

    **SCHOLARLY PAPER INSTRUCTIONS**

    **DUE DATE: WEEK 4 Saturday at 2359**

    **Assignment Overview**

    **Due Date:**

    ·
    **Week 4, Saturday at 11:59 PM** Submissions must be received by the deadline. Late assignments will not be accepted.

    **Paper Topic:**

    · Select and analyze a nursing theory of your choice.

    **Paper Length and Formatting Requirements:**

    · Your formal paper should be
    **5-6 pages in length**, not including the title page and reference pages.

    · Use the following formatting settings:

    ·
    **Double-spaced text**

    ·
    **12-point font** (preferably Times New Roman)

    ·
    **1-inch margins** on all sides

    · Follow APA 7th Edition guidelines for:

    · Title (cover) page

    · Headers and pagination

    · In-text citations and reference list

    **Content and Structure**

    Your paper must be organized into the following sections. Each section should be clearly labeled and addressed in your final submission.

    **Introduction**

    ·
    **Purpose:** Begin your paper by introducing the nursing theory you have chosen.

    ·
    **Content Requirements:**

    · Provide a brief background of the theorist—include information about their education, career, and any contributions that are relevant to the development of the theory.

    · Explain why the theorist is significant in the world of nursing.

    ·
    **Tips:** Keep this section concise, yet informative enough for the reader to understand the origin of the theory.

    **Basic Concept Analysis**

    ·
    **Purpose:** Clearly outline the core components of the nursing theory.

    ·
    **Content Requirements:**

    · Identify and briefly explain the major concepts that form the basis of the theory.

    · Discuss how these core concepts work together to define the theory.

    · Use clear definitions and simple examples if appropriate to illustrate each concept.

    ·
    **Tips:** Focus on the essential ideas that make the theory unique and applicable to nursing practice.

    **Relevance**

    ·
    **Purpose:** Demonstrate how the nursing theory is connected to broader healthcare practices and current research.

    ·
    **Content Requirements:**

    · Explain how the theorist’s work connects to the theory, and in turn, how the theory influences healthcare practices.

    · Discuss the application of the theory in today’s clinical settings.

    · Reference current research or clinical practice studies that apply the theory.

    ·
    **Scholarly Sources:**

    · Incorporate at least
    **two peer-reviewed or research articles** that detail how the theory is being utilized in clinical practice or research.

    · Summarize the key findings of each article including the results of the study and the implications they have for future practice.

    ·
    **Tips:** Be analytical and use evidence-based practice (EBP) to support your relevance discussion.

    **Summary**

    ·
    **Purpose:** Your summary should provide a critical reflection on the theory.

    ·
    **Content Requirements:**

    · Summarize the strengths and limitations of the nursing theory.

    · Reflect on how well the theory bridges theoretical frameworks with practical application.

    ·
    **Tips:** Offer a balanced perspective that recognizes both the benefits and potential shortcomings of the theory in advancing nursing practice.

    **Additional Guidelines**

    ·
    **APA Formatting:**

    · Ensure that your cover sheet, headers, pagination, and reference pages adhere to APA 7th Edition standards.

    · All in-text citations must match your reference list.

    ·
    **Assignment Quality:**

    · The writing should be formal, well-organized, and clearly written at a graduate level.

    · Each section should logically flow into the next, maintaining coherence throughout your paper.

    ·
    **Review the Rubric:**

    · Refer to the grading rubric provided (if available) to ensure that you have met all the criteria required for a high-quality submission.

    ·
    **Proofread Your Paper:**

    · Before submission, check for grammatical errors and clarity. Make sure your arguments are well-supported by evidence from your scholarly sources.

    **REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**

    **Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)

    **Final Submission Reminder**

    ·
    **Deadline:** Submit your final paper by
    **Week 4 Saturday at 11:59 PM**.

    ·
    **Submission Process:** Upload your paper in the designated submission portal. Ensure that your attachment is correctly named with your name and assignment title.

    By following these expanded instructions, you are well equipped to produce a comprehensive, well-structured, and evidence-based paper on your selected nursing theory. Taking the time to address each section thoroughly will enhance your chance for success and contribute thoughtfully to your field of study. Happy writing!

    Please refer to the grading rubric in the assignment drop box.

    **Submission**

    Text Editor

    Press Alt + F10 to access toolbar options

    _Word count: 0_

    **Drag files here**

    Maximum size: 512 MB

    **or**

    **Details & Information**

    Rubric Details

    **Maximum Score**

    100 points

    **Exemplary Work**

    The paper presents a thorough and insightful analysis of the chosen nursing theory. All key concepts are clearly articulated, relevant to the theory, and expertly linked to contemporary nursing practices. Evidence from multiple scholarly sources enhances the discussion.

    **40**

    **Proficient Work**

    The analysis of the nursing theory is clear and relevant, addressing the core concepts and making appropriate connections to current nursing practice. Some scholarly sources are incorporated effectively.

    **30**

    **Needs Improvement**

    The discussion of the nursing theory is somewhat unclear or lacks depth. Some key concepts may not be adequately explained. Connections to current practice are weak or underdeveloped.

    **20**

    **Unsatisfactory Work**

    The analysis of the nursing theory is minimal or missing. Key concepts are poorly defined, and there are little to no connections made to current nursing practice.

    **10**

    **Exemplary Work**

    The paper is exceptionally well-organized with clear section headings and a logical flow of ideas. Each section seamlessly transitions to the next.

    **30**

    **Proficient Work**

    The organization of the paper is good, with clear headings. There is some coherent flow between sections, though a few transitions may be abrupt.

    **22.5**

    **Needs Improvement**

    The paper lacks a clear organizational structure. Section headings may be present, but the flow of ideas is unclear or confusing.

    **15**

    **Unsatisfactory Work**

    The paper is poorly organized. There are no clear section headings, and ideas are presented in a haphazard manner.

    **7.5**

    **Exemplary Work**

    The paper includes multiple peer-reviewed articles that are highly relevant and current. Each source is well-integrated into the discussion and supports key arguments effectively. At least 2 sources are used to develop the paper.

    **15**

    **Proficient Work**

    The paper uses at least 2 relevant peer-reviewed sources, though the integration could be improved. Lacks synthesis and support. Most sources are appropriate and contribute to the key arguments.

    **11.25**

    **Needs Improvement**

    Less than 2 sources are used in the paper. The analysis lacks support from scholarly literature, which weakens key arguments.

    **7.5**

    **Unsatisfactory Work**

    The paper uses 1 peer-reviewed sources or relies on non-scholarly sources, lacks scholarly synthesis and connections. Key claims lack credible support.

    **3.75**

    **Exemplary Work**

    All REFERENCES have DOI Numbers for me to look them up.

    **10**

    **Proficient Work**

    All REFERENCES have DOI Numbers for me to look them up- but not all are working.

    **7.5**

    **Needs Improvement**

    Not all REFERENCE have a DOI Number for me to look them up.

    **5**

    **Unsatisfactory Work**

    More than 2 REFERENCES do not have DOI Numbers for me to look them up.

    **2.5**

    **Exemplary Work**

    The paper strictly follows APA 7th Edition guidelines throughout, including formatting, in text citations. The writing is clear, formal, and free of grammatical errors.

    **5**

    **Proficient Work**

    The paper mostly adheres to APA 7th Edition guidelines, with only minor formatting errors. The writing is generally clear with few grammatical issues.

    **3.75**

    **Needs Improvement**

    The paper shows irregularities in APA formatting and numerous grammatical errors that distract from the overall clarity of the writing.

    **2.5**

    **Unsatisfactory Work**

    The paper does not follow APA 7th Edition guidelines. There are significant problems in writing quality, including many grammatical errors that obstruct understanding.

    **## PreliminaryReferenceList1.docx**

    2

    **Preliminary Reference List**

    **Merle Mishel's Uncertainty in Illness Theory**

    Vianka Concepcion

    Florida National University

    Nursing Theory-DBX-DL01

    Dr.Nora Hernandez-Pupo

    July 17, 2026

    **Preliminary Reference List**

    Andrade, C. R. A. G., Costa, L. de M. C., Lúcio, I. M. L., Pereira, J. F., Lima, H. N., & Nascimento, R. L. (2024). Uncertainties experienced by nursing professionals who contracted Covid-19: A priori, everyone is human.
    _Revista Brasileira de Enfermagem_,
    _77_(suppl 1). https://doi.org/10.1590/0034-7167-2023-0142

    Bao, Y., Yang, L., Zhao, J., Wang, Z., Fu, L., Fang, M., & Jin’e Lin. (2026). The association between chronic disease resource utilization and illness uncertainty in COPD patients: A latent profile analysis.
    _PeerJ_,
    _14_, e20674. https://doi.org/10.7717/peerj.20674

    Grant, J. B., & Johnson-Koenke, R. (2024). Navigating chronic uncertainty: A theory synthesis for nursing communication in life-limiting illness.
    _BMC Nursing_,
    _23_(1). https://doi.org/10.1186/s12912-024-02328-7

    Guan, T., Chapman, M. V., Lisa, Zimmer, C., Carrie Jo Braden, Cynthia Fraga Rizo, Northouse, L., & Song, L. (2023). Illness uncertainty and quality of life in patients with advanced cancer and their family caregivers: An actor‐partner interdependence model analysis.
    _Psycho-Oncology_,
    _32_(11), 1744–1751. https://doi.org/10.1002/pon.6228

    Li, M., Li, J., Liu, H., Pan, Z., Zhang, B., Zhang, W., Li, J., Yang, K., Yu, Y., Yang, T., Dongsen Lv, Zhang, N., Li, S., Li, Q., Song, R., Liu, J., Li, H., & Wei, J. (2025). The assessment of caregiver burden and associated factors on the primary family caregivers for patients with moyamoya disease: A cross-sectional study [Review of
    _The assessment of caregiver burden and associated factors on the primary family caregivers for patients with moyamoya disease: A cross-sectional study_].
    _Frontiers in Psychiatry_,
    _16_, 1688617–1688617. https://doi.org/10.3389/fpsyt.2025.1688617

    Li, Q., Luo, C., Ye, J., Bian, Z., Sun, W., Zhou, M., & Rong, M. (2024). Relationship Between Illness Uncertainty and Family Resilience Among Caregivers of Stroke Patients in Chinese Nuclear Families: The Mediating Role of Perceived Stress.
    _Patient Preference and Adherence_,
    _Volume 18_, 1095–1105. https://doi.org/10.2147/ppa.s463562

    Zhang, W., Pan, Z., Zhu, Y., Dongsen Lv, Zhang, H., Li, S., Liu, C., Xiong, X., Li, Q., Yao, G., Yang, S., Song, R., Yan, S., Wang, D., Li, M., & Liu, H. (2024). Illness uncertainty, resilience, and perceived social support among patients with moyamoya disease: A cross-sectional study [Review of
    _Illness uncertainty, resilience, and perceived social support among patients with moyamoya disease: A cross-sectional study_].
    _Frontiers in Psychiatry_,
    _15_. https://doi.org/10.3389/fpsyt.2024.1405594

    **## ScholarlyPaperUPLOADHERE.docx**

    Nursing Theory-DBX-DL01 Nora Hernandez-Pupo

    Scholarly Paper UPLOAD HERE Due Saturday @ 2359

    **SCHOLARLY PAPER INSTRUCTIONS**

    **DUE DATE: WEEK 4 Saturday at 2359**

    **Assignment Overview**

    **Due Date:**

    ·
    **Week 4, Saturday at 11:59 PM** Submissions must be received by the deadline. Late assignments will not be accepted.

    **Paper Topic:**

    · Select and analyze a nursing theory of your choice.

    **Paper Length and Formatting Requirements:**

    · Your formal paper should be
    **5-6 pages in length**, not including the title page and reference pages.

    · Use the following formatting settings:

    ·
    **Double-spaced text**

    ·
    **12-point font** (preferably Times New Roman)

    ·
    **1-inch margins** on all sides

    · Follow APA 7th Edition guidelines for:

    · Title (cover) page

    · Headers and pagination

    · In-text citations and reference list

    **Content and Structure**

    Your paper must be organized into the following sections. Each section should be clearly labeled and addressed in your final submission.

    **Introduction**

    ·
    **Purpose:** Begin your paper by introducing the nursing theory you have chosen.

    ·
    **Content Requirements:**

    · Provide a brief background of the theorist—include information about their education, career, and any contributions that are relevant to the development of the theory.

    · Explain why the theorist is significant in the world of nursing.

    ·
    **Tips:** Keep this section concise, yet informative enough for the reader to understand the origin of the theory.

    **Basic Concept Analysis**

    ·
    **Purpose:** Clearly outline the core components of the nursing theory.

    ·
    **Content Requirements:**

    · Identify and briefly explain the major concepts that form the basis of the theory.

    · Discuss how these core concepts work together to define the theory.

    · Use clear definitions and simple examples if appropriate to illustrate each concept.

    ·
    **Tips:** Focus on the essential ideas that make the theory unique and applicable to nursing practice.

    **Relevance**

    ·
    **Purpose:** Demonstrate how the nursing theory is connected to broader healthcare practices and current research.

    ·
    **Content Requirements:**

    · Explain how the theorist’s work connects to the theory, and in turn, how the theory influences healthcare practices.

    · Discuss the application of the theory in today’s clinical settings.

    · Reference current research or clinical practice studies that apply the theory.

    ·
    **Scholarly Sources:**

    · Incorporate at least
    **two peer-reviewed or research articles** that detail how the theory is being utilized in clinical practice or research.

    · Summarize the key findings of each article including the results of the study and the implications they have for future practice.

    ·
    **Tips:** Be analytical and use evidence-based practice (EBP) to support your relevance discussion.

    **Summary**

    ·
    **Purpose:** Your summary should provide a critical reflection on the theory.

    ·
    **Content Requirements:**

    · Summarize the strengths and limitations of the nursing theory.

    · Reflect on how well the theory bridges theoretical frameworks with practical application.

    ·
    **Tips:** Offer a balanced perspective that recognizes both the benefits and potential shortcomings of the theory in advancing nursing practice.

    **Additional Guidelines**

    ·
    **APA Formatting:**

    · Ensure that your cover sheet, headers, pagination, and reference pages adhere to APA 7th Edition standards.

    · All in-text citations must match your reference list.

    ·
    **Assignment Quality:**

    · The writing should be formal, well-organized, and clearly written at a graduate level.

    · Each section should logically flow into the next, maintaining coherence throughout your paper.

    ·
    **Review the Rubric:**

    · Refer to the grading rubric provided (if available) to ensure that you have met all the criteria required for a high-quality submission.

    ·
    **Proofread Your Paper:**

    · Before submission, check for grammatical errors and clarity. Make sure your arguments are well-supported by evidence from your scholarly sources.

    **REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**

    **Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)

    **Final Submission Reminder**

    ·
    **Deadline:** Submit your final paper by
    **Week 4 Saturday at 11:59 PM**.

    ·
    **Submission Process:** Upload your paper in the designated submission portal. Ensure that your attachment is correctly named with your name and assignment title.

    By following these expanded instructions, you are well equipped to produce a comprehensive, well-structured, and evidence-based paper on your selected nursing theory. Taking the time to address each section thoroughly will enhance your chance for success and contribute thoughtfully to your field of study. Happy writing!

    Please refer to the grading rubric in the assignment drop box.

    **Submission**

    Text Editor

    Press Alt + F10 to access toolbar options

    _Word count: 0_

    **Drag files here**

    Maximum size: 512 MB

    **or**

    **Details & Information**

    Rubric Details

    **Maximum Score**

    100 points

    **Exemplary Work**

    The paper presents a thorough and insightful analysis of the chosen nursing theory. All key concepts are clearly articulated, relevant to the theory, and expertly linked to contemporary nursing practices. Evidence from multiple scholarly sources enhances the discussion.

    **40**

    **Proficient Work**

    The analysis of the nursing theory is clear and relevant, addressing the core concepts and making appropriate connections to current nursing practice. Some scholarly sources are incorporated effectively.

    **30**

    **Needs Improvement**

    The discussion of the nursing theory is somewhat unclear or lacks depth. Some key concepts may not be adequately explained. Connections to current practice are weak or underdeveloped.

    **20**

    **Unsatisfactory Work**

    The analysis of the nursing theory is minimal or missing. Key concepts are poorly defined, and there are little to no connections made to current nursing practice.

    **10**

    **Exemplary Work**

    The paper is exceptionally well-organized with clear section headings and a logical flow of ideas. Each section seamlessly transitions to the next.

    **30**

    **Proficient Work**

    The organization of the paper is good, with clear headings. There is some coherent flow between sections, though a few transitions may be abrupt.

    **22.5**

    **Needs Improvement**

    The paper lacks a clear organizational structure. Section headings may be present, but the flow of ideas is unclear or confusing.

    **15**

    **Unsatisfactory Work**

    The paper is poorly organized. There are no clear section headings, and ideas are presented in a haphazard manner.

    **7.5**

    **Exemplary Work**

    The paper includes multiple peer-reviewed articles that are highly relevant and current. Each source is well-integrated into the discussion and supports key arguments effectively. At least 2 sources are used to develop the paper.

    **15**

    **Proficient Work**

    The paper uses at least 2 relevant peer-reviewed sources, though the integration could be improved. Lacks synthesis and support. Most sources are appropriate and contribute to the key arguments.

    **11.25**

    **Needs Improvement**

    Less than 2 sources are used in the paper. The analysis lacks support from scholarly literature, which weakens key arguments.

    **7.5**

    **Unsatisfactory Work**

    The paper uses 1 peer-reviewed sources or relies on non-scholarly sources, lacks scholarly synthesis and connections. Key claims lack credible support.

    **3.75**

    **Exemplary Work**

    All REFERENCES have DOI Numbers for me to look them up.

    **10**

    **Proficient Work**

    All REFERENCES have DOI Numbers for me to look them up- but not all are working.

    **7.5**

    **Needs Improvement**

    Not all REFERENCE have a DOI Number for me to look them up.

    **5**

    **Unsatisfactory Work**

    More than 2 REFERENCES do not have DOI Numbers for me to look them up.

    **2.5**

    **Exemplary Work**

    The paper strictly follows APA 7th Edition guidelines throughout, including formatting, in text citations. The writing is clear, formal, and free of grammatical errors.

    **5**

    **Proficient Work**

    The paper mostly adheres to APA 7th Edition guidelines, with only minor formatting errors. The writing is generally clear with few grammatical issues.

    **3.75**

    **Needs Improvement**

    The paper shows irregularities in APA formatting and numerous grammatical errors that distract from the overall clarity of the writing.

    **2.5**

    **Unsatisfactory Work**

    The paper does not follow APA 7th Edition guidelines. There are significant problems in writing quality, including many grammatical errors that obstruct understanding.

  • [Solved] Assigment .Apa seven . All instructions attached.

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    **files (2)** – ## AdvancedWritingandResearch.docx – ## Research_Paper_1_Rough_Draft.docx **## AdvancedWritingandResearch.docx** Advanced Writing and Research-DBX-DL01 Yvette De la Vega Research Paper #1:Final Draft For the final draft of Research Paper #1, ensure to follow the instructions prov…

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    **files (2)**

    – ## AdvancedWritingandResearch.docx

    – ## Research_Paper_1_Rough_Draft.docx

    **## AdvancedWritingandResearch.docx**

    Advanced Writing and Research-DBX-DL01 Yvette De la Vega

    Research Paper #1:Final Draft

    For the final draft of Research Paper #1, ensure to follow the instructions provided below. Failure to follow instructions accurately will impact your grade negatively.

    1. Type of essay: Informative

    2. Topic: Write an Informative Research Paper about:

    **A current advancement or issue in your field. (This may be a new form of technology, device, cure, medication, software, or practice).**

    3. The specific topic of your paper must be approved; otherwise, it will result in a zero (0) as your grade for this assignment.

    4. This paper must be 4 pages long (not including the Works Cited page).

    5. Format: MLA

    6. The Thesis Statement must be clear, underlined, and at the end of the introductory paragraph. It must contain the three (3) points that will be developed in the body paragraphs.

    Example:

    High levels of alcohol consumption have detrimental effects on your personal health, such as weight gain (point 1), heart disease (point 2), and liver complications (point 3).

    7. Documentation: You must use at least six (6) sources from within the last 5-10 years. They must be from reliable databases; ProQuest Central is highly recommended.

    8. There must be at least 1 in-text citations in each of the body paragraphs.

    *Do NOT use Wikipedia, Infoplease, Answers.com, WebMd, Psychology Today as a source.

    10. Similarity (Originality Report): Up to 20% of similarity will be accepted with no penalty.

    \*\*\*\* Papers assisted by any Artificial Intelligence software will not be accepted, and it will be considered an act of academic dishonesty.

    **LATE SUBMISSIONS WILL RECEIVE A ZERO.**

    **Submission**

    Text Editor

    Press Alt + F10 to access toolbar options

    _Word count: 0_

    **Drag files here**

    Maximum size: 512 MB

    ## **or** Rubric Details

    **Maximum Score**

    100 points

    **Excellent**

    very engaging hook that captures the reader's attention, provides a great deal of background information,

    **10**

    **Satisfactory**

    engaging hook that captures the reader's attention, provides sufficient background information

    **7.5**

    **Unsatisfactory**

    somewhat engaging hook , provides a some background information,

    **5**

    **Poor**

    No hook/ is not interesting or captures the reader's attention, provides minimal background information,

    **2.5**

    **Excellent**

    thesis is clearly stated at the end of the introduction and previews the structure of the essay with 3 subpoints

    **15**

    **Satisfactory**

    thesis is stated at the end of the introduction and previews the structure of the essay with 3 subpoints

    **11.25**

    **Unsatisfactory**

    thesis is unclearly stated and previews the structure of the essay with 3 or less subpoints

    **7.5**

    **Poor**

    thesis is unclear and and does not preview the organization of the essay with subpoints

    **3.75**

    **Excellent**

    very organized, great use of transitions, topic sentences, great deal of details provided to support thesis. Writer integrates all aspects of the pattern of development

    **45**

    **Satisfactory**

    organized, good use of transitions, topic sentences, great deal of details provided to support thesis Writer integrates most aspects of the pattern of development

    **33.75**

    **Unsatisfactory**

    somewhat organized, some transitions and topic sentences are used, minimal details provided to support thesis Writer somewhat integrates aspects of the pattern of development

    **22.5**

    **Poor**

    not organized, doesn’t include topic sentences transitions details are irrelevant and do not support thesis Writer barely integrates aspects of the pattern of development

    **11.25**

    **Excellent**

    comes to a very adequate close, restates thesis, provides broader implications

    **5**

    **Satisfactory**

    comes to an adequate close, restates thesis, hints to broader implications

    **3.75**

    **Unsatisfactory**

    comes to a somewhat adequate close, restates thesis, hints to broader implications

    **2.5**

    **Poor**

    abrupt close, barely restates thesis, doesn’t hint to broader implications

    **1.25**

    **Excellent**

    Writer makes 1-2 errors in grammar or mechanics that distract the reader from the content.

    **10**

    **Satisfactory**

    Writer makes 3-4 errors in grammar or mechanics that distract the reader from the content.

    **7.5**

    **Unsatisfactory**

    Writer makes more than 4 errors in grammar or mechanics that distract the reader from the content.

    **5**

    **Poor**

    Writer makes more than 5 errors in grammar or mechanics that distract the reader from the content.

    **2.5**

    **Excellent**

    The paper greatly adheres to all MLA guidelines for citations, font, style, line spacing, and headings. All sources are accurately listed on works cited page and are scholarly/credible

    **15**

    **Satisfactory**

    The paper adheres to most MLA guidelines for citations, font, style, line spacing, and headings. Most sources are accurately listed on works cited page and are scholarly/credible

    **11.25**

    **Unsatisfactory**

    The paper adheres to some MLA guidelines for citations, font, style, line spacing, and headings. Sources listed on works cited are not all credible/scholarly

    **7.5**

    **Poor**

    The paper lacks adherence to MLA guidelines for citations, font, style, line spacing, and headings. Sources are not fully listed on works cited page and are not credible

    **Details & Information**

    **Assessment due date**

    7/26/26, 11:59 PM (EDT)

    **Attempts**

    2 attempts left

    **Evaluation rubric** [This item is evaluated with a rubric](https://fnu.blackboard.com/ultra/grades/assessment/_5071832_1/overview/attempt/create/rubric-view?columnId=_1233862_1&courseId=_54520_1)

    **## Research_Paper_1_Rough_Draft.docx**

    Pino 1

    Eniusky Pino

    Florida National University

    Professor Yvette De la Vega

    Advanced Writing and Research-DBX-DL01

    19 July 2026

    **Continuous Glucose Monitoring in Type 2 Diabetes Care**

    For many adults with type 2 diabetes, glucose monitoring typically involves stopping several times a day to prick a finger and jotting down a single number. Continuous glucose monitoring (CGM) modifies that experience by employing a small sensor worn on the body to measure glucose in the fluid under the skin all day and all night. The sensor delivers information to a receiver or smartphone, allowing patients and clinicians to observe patterns, trends and alerts rather than isolated measurements. CGM was first used mostly by people with type 1 diabetes or those on intensive insulin therapy, but emerging data has broadened its relevance in general care for adults with type 2 diabetes, including some who use basal insulin exclusively or noninsulin medicines. This is especially important for family nurse practitioners, as managing diabetes includes appropriate medication adjustments, patient education, lifestyle counseling, and prevention of complications.
    Continuous glucose monitoring is reshaping type 2 diabetes care by improving glycemic control, strengthening patient self-management and primary care collaboration, and offering long-term economic value despite ongoing barriers involving cost, training, insurance coverage, and equitable access.

    First, CGM can enhance control of blood sugar because it gives a fuller view of glucose variations than occasional finger-stick tests. A standard meter tells you what your glucose level is at a single point in time, whereas CGM shows you the direction and speed of change, time spent in range, bouts of hyperglycemia and probable hypoglycemia. The MOBILE randomized clinical trial included people with poorly controlled type 2 diabetes receiving basal insulin therapy in primary care settings. Investigators found that CGM was associated with “significantly lower HbA1c levels at 8 months” compared to blood glucose meter monitoring (Martens et al. ). This finding is noteworthy because even a moderate drop in HbA1c may assist clinicians determine whether medication, nutrition or activity strategies are working. The wider research backs up the trial findings. In 2024 a comprehensive review and meta-analysis of twelve randomized trials indicated that CGM lowered HbA1c by an average of 0.31 percentage points and increased time in range by more than six percentage points. The authors concluded that “CGM use compared with SMBG is associated with improvements in glycaemic control” (Jancev et al. . The device also picks up overnight and post-meal patterns that patients may not see with planned testing. For the family nurse practitioner, these trends can help to make safer drug modifications and more targeted counseling. CGM data should not replace a clinical assessment. Sensor accuracy, symptoms, medications and the individual’s treatment plan still need to be addressed.

    CGM can also enhance self-management and promote collaboration between patients and primary care teams. With diabetes, people have to make daily decisions regarding food, exercise, medicine, sleep and stress, but many patients cannot clearly relate these actions to subsequent glucose results. They get instant feedback and can see how a meal, an exercise or a missing medication alters the glucose curve.” In the DISCO GM randomized crossover study, people with complex type 2 diabetes reported improvement in self-management scores, quality of life, HbA1c and time in range. The researchers found that “the introduction of CGM can significantly improve diabetes self-management behaviour” (Parsons et al.). This instructional impact can make an abstract guideline, like limiting refined carbs, visible and personal. CGM also can increase the efficiency of office visits since the practitioner, and the patient can study the same data and establish specific goals. A 2025 pilot project trained primary care doctors to read CGMs using pharmacists and diabetes educators to help with sensor implantation, teaching and follow-up. Increased time in range significantly and average HbA1c fell from 9.68% to 7.31%. The authors concluded that using CGM in primary care was “feasible and effective using a multidisciplinary approach” (Zadel et al.). These data show that effective implementation is a function not just of acquiring the device, but also of educating patients how to respond to the information and preparing doctors to read the standardized reports . Without education, too many alarms or strange graphs might produce confusion instead of confidence.

    Finally, the long-term benefits of CGM should be weighed against the practical and ethical constraints of the device. There is an ongoing cost for sensors and transmitters, and coverage regulations may range depending on insurance plan, prescription regimen and documentation needed. Furthermore, patients may not own a compatible smartphone, have dependable internet access, computer literacy, or the ability to update sensors accurately. But economic research implies that higher monitoring expenses may be compensated by better control and fewer issues. A 2024 U.S. microsimulation of persons with type 2 diabetes on basal insulin found CGM “offered more QALYs … at a lower cost” over 10 years than finger-stick monitoring (Frank et al.). The model estimated savings from decreased severe hypoglycemia events, diabetic ketoacidosis episodes, and long-term cardiovascular and renal consequences. This was a simulation and not a clinical experiment, thus the conclusions are based on the assumptions that were built into the model and should be read with caution. Another concern is access. A evaluation in 2026 found “ongoing inequities by age, race and ethnicity, insurance coverage and care setting” (Villanueva et al.). These disparities may deny people with the greatest illness burden access to technology. Primary care organizations consequently need clear eligibility processes, staff training, appropriate language education, technical support, privacy measures and plans for patients who cannot afford sensors on an ongoing basis. CGM can be a high-value improvement, but without healthcare systems addressing pricing and digital access its advantages will be unequal.

    To conclude, continuous glucose monitoring represents an important improvement in the management of type 2 diabetes. Research demonstrates it can enhance HbA1c and time in range, assist patients understand how their daily actions impact glucose, and encourage more focused engagement with family nurse practitioners and interdisciplinary primary care teams. Economic models also imply that avoiding acute events and long-term problems may offset some of the expense of the technology. At the same time, CGM is not necessarily helpful for every patient. Insurance limits, device costs, data interpretation, alarm fatigue, and inequitable access may limit its utility. The most appropriate method is therefore to combine the device with tailored education, clinical follow-up and equal coverage policies. As CGMs become more popular in primary care, family nurse practitioners will be key in identifying who may benefit, training patients how to utilize the information securely, and ensuring that technology improves treatment rather than widens existing gaps.

    Works Cited

    Frank, Jerry, et al. “Continuous Glucose Monitoring for Self-Management of Diabetes in People Living with Type 2 Diabetes Mellitus on Basal Insulin Therapy: A Microsimulation Model and Cost-Effectiveness Analysis from a US Perspective with Relevance to Medicaid.” Journal of Managed Care & Specialty Pharmacy, vol. 30, no. 9, 2024, pp. 917–928. https://doi.org/10.18553/jmcp.2024.24025.

    Jancev, Milena, et al. “Continuous Glucose Monitoring in Adults with Type 2 Diabetes: A Systematic Review and Meta-Analysis.” Diabetologia, vol. 67, no. 5, 2024, pp. 798–810. https://doi.org/10.1007/s00125-024-06107-6.

    Martens, Thomas W., et al. “Effect of Continuous Glucose Monitoring on Glycemic Control in Patients with Type 2 Diabetes Treated with Basal Insulin: A Randomized Clinical Trial.” JAMA, vol. 325, no. 22, 2021, pp. 2262–2272. https://doi.org/10.1001/jama.2021.7444.

    Parsons, Sharon N., et al. “Does the Short-Term Use of Continuous Glucose Monitoring Enhance Diabetes Self-Management Behaviour in Type 2 Diabetes? The DISCO GM Study: A Randomised, Controlled Cross-Over Study.” Diabetes & Metabolic Syndrome: Clinical Research & Reviews, vol. 19, no. 7, 2025, article 103283. https://doi.org/10.1016/j.dsx.2025.103283.

    Villanueva, Giuliana Perini, et al. “Continuous Glucose Monitoring in Type 2 Diabetes: Clinical Outcomes, Disparities in Access, and Cost-Effectiveness.” Current Diabetes Reports, vol. 26, no. 1, 2026, article 19. https://doi.org/10.1007/s11892-026-01631-8.

    Zadel, Alyssa H., et al. “Continuous Glucose Monitoring in Primary Care: Multidisciplinary Pilot Implementation Study.” JMIR Diabetes, vol. 10, 2025, e69061. https://doi.org/10.2196/69061.

    **## Research_Paper_1_Rough_Draft.docx**

    Pino 1

    Eniusky Pino

    Florida National University

    Professor Yvette De la Vega

    Advanced Writing and Research-DBX-DL01

    19 July 2026

    **Continuous Glucose Monitoring in Type 2 Diabetes Care**

    For many adults with type 2 diabetes, glucose monitoring typically involves stopping several times a day to prick a finger and jotting down a single number. Continuous glucose monitoring (CGM) modifies that experience by employing a small sensor worn on the body to measure glucose in the fluid under the skin all day and all night. The sensor delivers information to a receiver or smartphone, allowing patients and clinicians to observe patterns, trends and alerts rather than isolated measurements. CGM was first used mostly by people with type 1 diabetes or those on intensive insulin therapy, but emerging data has broadened its relevance in general care for adults with type 2 diabetes, including some who use basal insulin exclusively or noninsulin medicines. This is especially important for family nurse practitioners, as managing diabetes includes appropriate medication adjustments, patient education, lifestyle counseling, and prevention of complications.
    Continuous glucose monitoring is reshaping type 2 diabetes care by improving glycemic control, strengthening patient self-management and primary care collaboration, and offering long-term economic value despite ongoing barriers involving cost, training, insurance coverage, and equitable access.

    First, CGM can enhance control of blood sugar because it gives a fuller view of glucose variations than occasional finger-stick tests. A standard meter tells you what your glucose level is at a single point in time, whereas CGM shows you the direction and speed of change, time spent in range, bouts of hyperglycemia and probable hypoglycemia. The MOBILE randomized clinical trial included people with poorly controlled type 2 diabetes receiving basal insulin therapy in primary care settings. Investigators found that CGM was associated with “significantly lower HbA1c levels at 8 months” compared to blood glucose meter monitoring (Martens et al. ). This finding is noteworthy because even a moderate drop in HbA1c may assist clinicians determine whether medication, nutrition or activity strategies are working. The wider research backs up the trial findings. In 2024 a comprehensive review and meta-analysis of twelve randomized trials indicated that CGM lowered HbA1c by an average of 0.31 percentage points and increased time in range by more than six percentage points. The authors concluded that “CGM use compared with SMBG is associated with improvements in glycaemic control” (Jancev et al. . The device also picks up overnight and post-meal patterns that patients may not see with planned testing. For the family nurse practitioner, these trends can help to make safer drug modifications and more targeted counseling. CGM data should not replace a clinical assessment. Sensor accuracy, symptoms, medications and the individual’s treatment plan still need to be addressed.

    CGM can also enhance self-management and promote collaboration between patients and primary care teams. With diabetes, people have to make daily decisions regarding food, exercise, medicine, sleep and stress, but many patients cannot clearly relate these actions to subsequent glucose results. They get instant feedback and can see how a meal, an exercise or a missing medication alters the glucose curve.” In the DISCO GM randomized crossover study, people with complex type 2 diabetes reported improvement in self-management scores, quality of life, HbA1c and time in range. The researchers found that “the introduction of CGM can significantly improve diabetes self-management behaviour” (Parsons et al.). This instructional impact can make an abstract guideline, like limiting refined carbs, visible and personal. CGM also can increase the efficiency of office visits since the practitioner, and the patient can study the same data and establish specific goals. A 2025 pilot project trained primary care doctors to read CGMs using pharmacists and diabetes educators to help with sensor implantation, teaching and follow-up. Increased time in range significantly and average HbA1c fell from 9.68% to 7.31%. The authors concluded that using CGM in primary care was “feasible and effective using a multidisciplinary approach” (Zadel et al.). These data show that effective implementation is a function not just of acquiring the device, but also of educating patients how to respond to the information and preparing doctors to read the standardized reports . Without education, too many alarms or strange graphs might produce confusion instead of confidence.

    Finally, the long-term benefits of CGM should be weighed against the practical and ethical constraints of the device. There is an ongoing cost for sensors and transmitters, and coverage regulations may range depending on insurance plan, prescription regimen and documentation needed. Furthermore, patients may not own a compatible smartphone, have dependable internet access, computer literacy, or the ability to update sensors accurately. But economic research implies that higher monitoring expenses may be compensated by better control and fewer issues. A 2024 U.S. microsimulation of persons with type 2 diabetes on basal insulin found CGM “offered more QALYs … at a lower cost” over 10 years than finger-stick monitoring (Frank et al.). The model estimated savings from decreased severe hypoglycemia events, diabetic ketoacidosis episodes, and long-term cardiovascular and renal consequences. This was a simulation and not a clinical experiment, thus the conclusions are based on the assumptions that were built into the model and should be read with caution. Another concern is access. A evaluation in 2026 found “ongoing inequities by age, race and ethnicity, insurance coverage and care setting” (Villanueva et al.). These disparities may deny people with the greatest illness burden access to technology. Primary care organizations consequently need clear eligibility processes, staff training, appropriate language education, technical support, privacy measures and plans for patients who cannot afford sensors on an ongoing basis. CGM can be a high-value improvement, but without healthcare systems addressing pricing and digital access its advantages will be unequal.

    To conclude, continuous glucose monitoring represents an important improvement in the management of type 2 diabetes. Research demonstrates it can enhance HbA1c and time in range, assist patients understand how their daily actions impact glucose, and encourage more focused engagement with family nurse practitioners and interdisciplinary primary care teams. Economic models also imply that avoiding acute events and long-term problems may offset some of the expense of the technology. At the same time, CGM is not necessarily helpful for every patient. Insurance limits, device costs, data interpretation, alarm fatigue, and inequitable access may limit its utility. The most appropriate method is therefore to combine the device with tailored education, clinical follow-up and equal coverage policies. As CGMs become more popular in primary care, family nurse practitioners will be key in identifying who may benefit, training patients how to utilize the information securely, and ensuring that technology improves treatment rather than widens existing gaps.

    Works Cited

    Frank, Jerry, et al. “Continuous Glucose Monitoring for Self-Management of Diabetes in People Living with Type 2 Diabetes Mellitus on Basal Insulin Therapy: A Microsimulation Model and Cost-Effectiveness Analysis from a US Perspective with Relevance to Medicaid.” Journal of Managed Care & Specialty Pharmacy, vol. 30, no. 9, 2024, pp. 917–928. https://doi.org/10.18553/jmcp.2024.24025.

    Jancev, Milena, et al. “Continuous Glucose Monitoring in Adults with Type 2 Diabetes: A Systematic Review and Meta-Analysis.” Diabetologia, vol. 67, no. 5, 2024, pp. 798–810. https://doi.org/10.1007/s00125-024-06107-6.

    Martens, Thomas W., et al. “Effect of Continuous Glucose Monitoring on Glycemic Control in Patients with Type 2 Diabetes Treated with Basal Insulin: A Randomized Clinical Trial.” JAMA, vol. 325, no. 22, 2021, pp. 2262–2272. https://doi.org/10.1001/jama.2021.7444.

    Parsons, Sharon N., et al. “Does the Short-Term Use of Continuous Glucose Monitoring Enhance Diabetes Self-Management Behaviour in Type 2 Diabetes? The DISCO GM Study: A Randomised, Controlled Cross-Over Study.” Diabetes & Metabolic Syndrome: Clinical Research & Reviews, vol. 19, no. 7, 2025, article 103283. https://doi.org/10.1016/j.dsx.2025.103283.

    Villanueva, Giuliana Perini, et al. “Continuous Glucose Monitoring in Type 2 Diabetes: Clinical Outcomes, Disparities in Access, and Cost-Effectiveness.” Current Diabetes Reports, vol. 26, no. 1, 2026, article 19. https://doi.org/10.1007/s11892-026-01631-8.

    Zadel, Alyssa H., et al. “Continuous Glucose Monitoring in Primary Care: Multidisciplinary Pilot Implementation Study.” JMIR Diabetes, vol. 10, 2025, e69061. https://doi.org/10.2196/69061.

    **## AdvancedWritingandResearch.docx**

    Advanced Writing and Research-DBX-DL01 Yvette De la Vega

    Research Paper #1:Final Draft

    For the final draft of Research Paper #1, ensure to follow the instructions provided below. Failure to follow instructions accurately will impact your grade negatively.

    1. Type of essay: Informative

    2. Topic: Write an Informative Research Paper about:

    **A current advancement or issue in your field. (This may be a new form of technology, device, cure, medication, software, or practice).**

    3. The specific topic of your paper must be approved; otherwise, it will result in a zero (0) as your grade for this assignment.

    4. This paper must be 4 pages long (not including the Works Cited page).

    5. Format: MLA

    6. The Thesis Statement must be clear, underlined, and at the end of the introductory paragraph. It must contain the three (3) points that will be developed in the body paragraphs.

    Example:

    High levels of alcohol consumption have detrimental effects on your personal health, such as weight gain (point 1), heart disease (point 2), and liver complications (point 3).

    7. Documentation: You must use at least six (6) sources from within the last 5-10 years. They must be from reliable databases; ProQuest Central is highly recommended.

    8. There must be at least 1 in-text citations in each of the body paragraphs.

    *Do NOT use Wikipedia, Infoplease, Answers.com, WebMd, Psychology Today as a source.

    10. Similarity (Originality Report): Up to 20% of similarity will be accepted with no penalty.

    \*\*\*\* Papers assisted by any Artificial Intelligence software will not be accepted, and it will be considered an act of academic dishonesty.

    **LATE SUBMISSIONS WILL RECEIVE A ZERO.**

    **Submission**

    Text Editor

    Press Alt + F10 to access toolbar options

    _Word count: 0_

    **Drag files here**

    Maximum size: 512 MB

    ## **or** Rubric Details

    **Maximum Score**

    100 points

    **Excellent**

    very engaging hook that captures the reader's attention, provides a great deal of background information,

    **10**

    **Satisfactory**

    engaging hook that captures the reader's attention, provides sufficient background information

    **7.5**

    **Unsatisfactory**

    somewhat engaging hook , provides a some background information,

    **5**

    **Poor**

    No hook/ is not interesting or captures the reader's attention, provides minimal background information,

    **2.5**

    **Excellent**

    thesis is clearly stated at the end of the introduction and previews the structure of the essay with 3 subpoints

    **15**

    **Satisfactory**

    thesis is stated at the end of the introduction and previews the structure of the essay with 3 subpoints

    **11.25**

    **Unsatisfactory**

    thesis is unclearly stated and previews the structure of the essay with 3 or less subpoints

    **7.5**

    **Poor**

    thesis is unclear and and does not preview the organization of the essay with subpoints

    **3.75**

    **Excellent**

    very organized, great use of transitions, topic sentences, great deal of details provided to support thesis. Writer integrates all aspects of the pattern of development

    **45**

    **Satisfactory**

    organized, good use of transitions, topic sentences, great deal of details provided to support thesis Writer integrates most aspects of the pattern of development

    **33.75**

    **Unsatisfactory**

    somewhat organized, some transitions and topic sentences are used, minimal details provided to support thesis Writer somewhat integrates aspects of the pattern of development

    **22.5**

    **Poor**

    not organized, doesn’t include topic sentences transitions details are irrelevant and do not support thesis Writer barely integrates aspects of the pattern of development

    **11.25**

    **Excellent**

    comes to a very adequate close, restates thesis, provides broader implications

    **5**

    **Satisfactory**

    comes to an adequate close, restates thesis, hints to broader implications

    **3.75**

    **Unsatisfactory**

    comes to a somewhat adequate close, restates thesis, hints to broader implications

    **2.5**

    **Poor**

    abrupt close, barely restates thesis, doesn’t hint to broader implications

    **1.25**

    **Excellent**

    Writer makes 1-2 errors in grammar or mechanics that distract the reader from the content.

    **10**

    **Satisfactory**

    Writer makes 3-4 errors in grammar or mechanics that distract the reader from the content.

    **7.5**

    **Unsatisfactory**

    Writer makes more than 4 errors in grammar or mechanics that distract the reader from the content.

    **5**

    **Poor**

    Writer makes more than 5 errors in grammar or mechanics that distract the reader from the content.

    **2.5**

    **Excellent**

    The paper greatly adheres to all MLA guidelines for citations, font, style, line spacing, and headings. All sources are accurately listed on works cited page and are scholarly/credible

    **15**

    **Satisfactory**

    The paper adheres to most MLA guidelines for citations, font, style, line spacing, and headings. Most sources are accurately listed on works cited page and are scholarly/credible

    **11.25**

    **Unsatisfactory**

    The paper adheres to some MLA guidelines for citations, font, style, line spacing, and headings. Sources listed on works cited are not all credible/scholarly

    **7.5**

    **Poor**

    The paper lacks adherence to MLA guidelines for citations, font, style, line spacing, and headings. Sources are not fully listed on works cited page and are not credible

    **Details & Information**

    **Assessment due date**

    7/26/26, 11:59 PM (EDT)

    **Attempts**

    2 attempts left

    **Evaluation rubric** [This item is evaluated with a rubric](https://fnu.blackboard.com/ultra/grades/assessment/_5071832_1/overview/attempt/create/rubric-view?columnId=_1233862_1&courseId=_54520_1)

    **## Research_Paper_1_Rough_Draft.docx**

    Pino 1

    Eniusky Pino

    Florida National University

    Professor Yvette De la Vega

    Advanced Writing and Research-DBX-DL01

    19 July 2026

    **Continuous Glucose Monitoring in Type 2 Diabetes Care**

    For many adults with type 2 diabetes, glucose monitoring typically involves stopping several times a day to prick a finger and jotting down a single number. Continuous glucose monitoring (CGM) modifies that experience by employing a small sensor worn on the body to measure glucose in the fluid under the skin all day and all night. The sensor delivers information to a receiver or smartphone, allowing patients and clinicians to observe patterns, trends and alerts rather than isolated measurements. CGM was first used mostly by people with type 1 diabetes or those on intensive insulin therapy, but emerging data has broadened its relevance in general care for adults with type 2 diabetes, including some who use basal insulin exclusively or noninsulin medicines. This is especially important for family nurse practitioners, as managing diabetes includes appropriate medication adjustments, patient education, lifestyle counseling, and prevention of complications.
    Continuous glucose monitoring is reshaping type 2 diabetes care by improving glycemic control, strengthening patient self-management and primary care collaboration, and offering long-term economic value despite ongoing barriers involving cost, training, insurance coverage, and equitable access.

    First, CGM can enhance control of blood sugar because it gives a fuller view of glucose variations than occasional finger-stick tests. A standard meter tells you what your glucose level is at a single point in time, whereas CGM shows you the direction and speed of change, time spent in range, bouts of hyperglycemia and probable hypoglycemia. The MOBILE randomized clinical trial included people with poorly controlled type 2 diabetes receiving basal insulin therapy in primary care settings. Investigators found that CGM was associated with “significantly lower HbA1c levels at 8 months” compared to blood glucose meter monitoring (Martens et al. ). This finding is noteworthy because even a moderate drop in HbA1c may assist clinicians determine whether medication, nutrition or activity strategies are working. The wider research backs up the trial findings. In 2024 a comprehensive review and meta-analysis of twelve randomized trials indicated that CGM lowered HbA1c by an average of 0.31 percentage points and increased time in range by more than six percentage points. The authors concluded that “CGM use compared with SMBG is associated with improvements in glycaemic control” (Jancev et al. . The device also picks up overnight and post-meal patterns that patients may not see with planned testing. For the family nurse practitioner, these trends can help to make safer drug modifications and more targeted counseling. CGM data should not replace a clinical assessment. Sensor accuracy, symptoms, medications and the individual’s treatment plan still need to be addressed.

    CGM can also enhance self-management and promote collaboration between patients and primary care teams. With diabetes, people have to make daily decisions regarding food, exercise, medicine, sleep and stress, but many patients cannot clearly relate these actions to subsequent glucose results. They get instant feedback and can see how a meal, an exercise or a missing medication alters the glucose curve.” In the DISCO GM randomized crossover study, people with complex type 2 diabetes reported improvement in self-management scores, quality of life, HbA1c and time in range. The researchers found that “the introduction of CGM can significantly improve diabetes self-management behaviour” (Parsons et al.). This instructional impact can make an abstract guideline, like limiting refined carbs, visible and personal. CGM also can increase the efficiency of office visits since the practitioner, and the patient can study the same data and establish specific goals. A 2025 pilot project trained primary care doctors to read CGMs using pharmacists and diabetes educators to help with sensor implantation, teaching and follow-up. Increased time in range significantly and average HbA1c fell from 9.68% to 7.31%. The authors concluded that using CGM in primary care was “feasible and effective using a multidisciplinary approach” (Zadel et al.). These data show that effective implementation is a function not just of acquiring the device, but also of educating patients how to respond to the information and preparing doctors to read the standardized reports . Without education, too many alarms or strange graphs might produce confusion instead of confidence.

    Finally, the long-term benefits of CGM should be weighed against the practical and ethical constraints of the device. There is an ongoing cost for sensors and transmitters, and coverage regulations may range depending on insurance plan, prescription regimen and documentation needed. Furthermore, patients may not own a compatible smartphone, have dependable internet access, computer literacy, or the ability to update sensors accurately. But economic research implies that higher monitoring expenses may be compensated by better control and fewer issues. A 2024 U.S. microsimulation of persons with type 2 diabetes on basal insulin found CGM “offered more QALYs … at a lower cost” over 10 years than finger-stick monitoring (Frank et al.). The model estimated savings from decreased severe hypoglycemia events, diabetic ketoacidosis episodes, and long-term cardiovascular and renal consequences. This was a simulation and not a clinical experiment, thus the conclusions are based on the assumptions that were built into the model and should be read with caution. Another concern is access. A evaluation in 2026 found “ongoing inequities by age, race and ethnicity, insurance coverage and care setting” (Villanueva et al.). These disparities may deny people with the greatest illness burden access to technology. Primary care organizations consequently need clear eligibility processes, staff training, appropriate language education, technical support, privacy measures and plans for patients who cannot afford sensors on an ongoing basis. CGM can be a high-value improvement, but without healthcare systems addressing pricing and digital access its advantages will be unequal.

    To conclude, continuous glucose monitoring represents an important improvement in the management of type 2 diabetes. Research demonstrates it can enhance HbA1c and time in range, assist patients understand how their daily actions impact glucose, and encourage more focused engagement with family nurse practitioners and interdisciplinary primary care teams. Economic models also imply that avoiding acute events and long-term problems may offset some of the expense of the technology. At the same time, CGM is not necessarily helpful for every patient. Insurance limits, device costs, data interpretation, alarm fatigue, and inequitable access may limit its utility. The most appropriate method is therefore to combine the device with tailored education, clinical follow-up and equal coverage policies. As CGMs become more popular in primary care, family nurse practitioners will be key in identifying who may benefit, training patients how to utilize the information securely, and ensuring that technology improves treatment rather than widens existing gaps.

    Works Cited

    Frank, Jerry, et al. “Continuous Glucose Monitoring for Self-Management of Diabetes in People Living with Type 2 Diabetes Mellitus on Basal Insulin Therapy: A Microsimulation Model and Cost-Effectiveness Analysis from a US Perspective with Relevance to Medicaid.” Journal of Managed Care & Specialty Pharmacy, vol. 30, no. 9, 2024, pp. 917–928. https://doi.org/10.18553/jmcp.2024.24025.

    Jancev, Milena, et al. “Continuous Glucose Monitoring in Adults with Type 2 Diabetes: A Systematic Review and Meta-Analysis.” Diabetologia, vol. 67, no. 5, 2024, pp. 798–810. https://doi.org/10.1007/s00125-024-06107-6.

    Martens, Thomas W., et al. “Effect of Continuous Glucose Monitoring on Glycemic Control in Patients with Type 2 Diabetes Treated with Basal Insulin: A Randomized Clinical Trial.” JAMA, vol. 325, no. 22, 2021, pp. 2262–2272. https://doi.org/10.1001/jama.2021.7444.

    Parsons, Sharon N., et al. “Does the Short-Term Use of Continuous Glucose Monitoring Enhance Diabetes Self-Management Behaviour in Type 2 Diabetes? The DISCO GM Study: A Randomised, Controlled Cross-Over Study.” Diabetes & Metabolic Syndrome: Clinical Research & Reviews, vol. 19, no. 7, 2025, article 103283. https://doi.org/10.1016/j.dsx.2025.103283.

    Villanueva, Giuliana Perini, et al. “Continuous Glucose Monitoring in Type 2 Diabetes: Clinical Outcomes, Disparities in Access, and Cost-Effectiveness.” Current Diabetes Reports, vol. 26, no. 1, 2026, article 19. https://doi.org/10.1007/s11892-026-01631-8.

    Zadel, Alyssa H., et al. “Continuous Glucose Monitoring in Primary Care: Multidisciplinary Pilot Implementation Study.” JMIR Diabetes, vol. 10, 2025, e69061. https://doi.org/10.2196/69061.

    **## AdvancedWritingandResearch.docx**

    Advanced Writing and Research-DBX-DL01 Yvette De la Vega

    Research Paper #1:Final Draft

    For the final draft of Research Paper #1, ensure to follow the instructions provided below. Failure to follow instructions accurately will impact your grade negatively.

    1. Type of essay: Informative

    2. Topic: Write an Informative Research Paper about:

    **A current advancement or issue in your field. (This may be a new form of technology, device, cure, medication, software, or practice).**

    3. The specific topic of your paper must be approved; otherwise, it will result in a zero (0) as your grade for this assignment.

    4. This paper must be 4 pages long (not including the Works Cited page).

    5. Format: MLA

    6. The Thesis Statement must be clear, underlined, and at the end of the introductory paragraph. It must contain the three (3) points that will be developed in the body paragraphs.

    Example:

    High levels of alcohol consumption have detrimental effects on your personal health, such as weight gain (point 1), heart disease (point 2), and liver complications (point 3).

    7. Documentation: You must use at least six (6) sources from within the last 5-10 years. They must be from reliable databases; ProQuest Central is highly recommended.

    8. There must be at least 1 in-text citations in each of the body paragraphs.

    *Do NOT use Wikipedia, Infoplease, Answers.com, WebMd, Psychology Today as a source.

    10. Similarity (Originality Report): Up to 20% of similarity will be accepted with no penalty.

    \*\*\*\* Papers assisted by any Artificial Intelligence software will not be accepted, and it will be considered an act of academic dishonesty.

    **LATE SUBMISSIONS WILL RECEIVE A ZERO.**

    **Submission**

    Text Editor

    Press Alt + F10 to access toolbar options

    _Word count: 0_

    **Drag files here**

    Maximum size: 512 MB

    ## **or** Rubric Details

    **Maximum Score**

    100 points

    **Excellent**

    very engaging hook that captures the reader's attention, provides a great deal of background information,

    **10**

    **Satisfactory**

    engaging hook that captures the reader's attention, provides sufficient background information

    **7.5**

    **Unsatisfactory**

    somewhat engaging hook , provides a some background information,

    **5**

    **Poor**

    No hook/ is not interesting or captures the reader's attention, provides minimal background information,

    **2.5**

    **Excellent**

    thesis is clearly stated at the end of the introduction and previews the structure of the essay with 3 subpoints

    **15**

    **Satisfactory**

    thesis is stated at the end of the introduction and previews the structure of the essay with 3 subpoints

    **11.25**

    **Unsatisfactory**

    thesis is unclearly stated and previews the structure of the essay with 3 or less subpoints

    **7.5**

    **Poor**

    thesis is unclear and and does not preview the organization of the essay with subpoints

    **3.75**

    **Excellent**

    very organized, great use of transitions, topic sentences, great deal of details provided to support thesis. Writer integrates all aspects of the pattern of development

    **45**

    **Satisfactory**

    organized, good use of transitions, topic sentences, great deal of details provided to support thesis Writer integrates most aspects of the pattern of development

    **33.75**

    **Unsatisfactory**

    somewhat organized, some transitions and topic sentences are used, minimal details provided to support thesis Writer somewhat integrates aspects of the pattern of development

    **22.5**

    **Poor**

    not organized, doesn’t include topic sentences transitions details are irrelevant and do not support thesis Writer barely integrates aspects of the pattern of development

    **11.25**

    **Excellent**

    comes to a very adequate close, restates thesis, provides broader implications

    **5**

    **Satisfactory**

    comes to an adequate close, restates thesis, hints to broader implications

    **3.75**

    **Unsatisfactory**

    comes to a somewhat adequate close, restates thesis, hints to broader implications

    **2.5**

    **Poor**

    abrupt close, barely restates thesis, doesn’t hint to broader implications

    **1.25**

    **Excellent**

    Writer makes 1-2 errors in grammar or mechanics that distract the reader from the content.

    **10**

    **Satisfactory**

    Writer makes 3-4 errors in grammar or mechanics that distract the reader from the content.

    **7.5**

    **Unsatisfactory**

    Writer makes more than 4 errors in grammar or mechanics that distract the reader from the content.

    **5**

    **Poor**

    Writer makes more than 5 errors in grammar or mechanics that distract the reader from the content.

    **2.5**

    **Excellent**

    The paper greatly adheres to all MLA guidelines for citations, font, style, line spacing, and headings. All sources are accurately listed on works cited page and are scholarly/credible

    **15**

    **Satisfactory**

    The paper adheres to most MLA guidelines for citations, font, style, line spacing, and headings. Most sources are accurately listed on works cited page and are scholarly/credible

    **11.25**

    **Unsatisfactory**

    The paper adheres to some MLA guidelines for citations, font, style, line spacing, and headings. Sources listed on works cited are not all credible/scholarly

    **7.5**

    **Poor**

    The paper lacks adherence to MLA guidelines for citations, font, style, line spacing, and headings. Sources are not fully listed on works cited page and are not credible

    **Details & Information**

    **Assessment due date**

    7/26/26, 11:59 PM (EDT)

    **Attempts**

    2 attempts left

    **Evaluation rubric** [This item is evaluated with a rubric](https://fnu.blackboard.com/ultra/grades/assessment/_5071832_1/overview/attempt/create/rubric-view?columnId=_1233862_1&courseId=_54520_1)

    **## Research_Paper_1_Rough_Draft.docx**

    Pino 1

    Eniusky Pino

    Florida National University

    Professor Yvette De la Vega

    Advanced Writing and Research-DBX-DL01

    19 July 2026

    **Continuous Glucose Monitoring in Type 2 Diabetes Care**

    For many adults with type 2 diabetes, glucose monitoring typically involves stopping several times a day to prick a finger and jotting down a single number. Continuous glucose monitoring (CGM) modifies that experience by employing a small sensor worn on the body to measure glucose in the fluid under the skin all day and all night. The sensor delivers information to a receiver or smartphone, allowing patients and clinicians to observe patterns, trends and alerts rather than isolated measurements. CGM was first used mostly by people with type 1 diabetes or those on intensive insulin therapy, but emerging data has broadened its relevance in general care for adults with type 2 diabetes, including some who use basal insulin exclusively or noninsulin medicines. This is especially important for family nurse practitioners, as managing diabetes includes appropriate medication adjustments, patient education, lifestyle counseling, and prevention of complications.
    Continuous glucose monitoring is reshaping type 2 diabetes care by improving glycemic control, strengthening patient self-management and primary care collaboration, and offering long-term economic value despite ongoing barriers involving cost, training, insurance coverage, and equitable access.

    First, CGM can enhance control of blood sugar because it gives a fuller view of glucose variations than occasional finger-stick tests. A standard meter tells you what your glucose level is at a single point in time, whereas CGM shows you the direction and speed of change, time spent in range, bouts of hyperglycemia and probable hypoglycemia. The MOBILE randomized clinical trial included people with poorly controlled type 2 diabetes receiving basal insulin therapy in primary care settings. Investigators found that CGM was associated with “significantly lower HbA1c levels at 8 months” compared to blood glucose meter monitoring (Martens et al. ). This finding is noteworthy because even a moderate drop in HbA1c may assist clinicians determine whether medication, nutrition or activity strategies are working. The wider research backs up the trial findings. In 2024 a comprehensive review and meta-analysis of twelve randomized trials indicated that CGM lowered HbA1c by an average of 0.31 percentage points and increased time in range by more than six percentage points. The authors concluded that “CGM use compared with SMBG is associated with improvements in glycaemic control” (Jancev et al. . The device also picks up overnight and post-meal patterns that patients may not see with planned testing. For the family nurse practitioner, these trends can help to make safer drug modifications and more targeted counseling. CGM data should not replace a clinical assessment. Sensor accuracy, symptoms, medications and the individual’s treatment plan still need to be addressed.

    CGM can also enhance self-management and promote collaboration between patients and primary care teams. With diabetes, people have to make daily decisions regarding food, exercise, medicine, sleep and stress, but many patients cannot clearly relate these actions to subsequent glucose results. They get instant feedback and can see how a meal, an exercise or a missing medication alters the glucose curve.” In the DISCO GM randomized crossover study, people with complex type 2 diabetes reported improvement in self-management scores, quality of life, HbA1c and time in range. The researchers found that “the introduction of CGM can significantly improve diabetes self-management behaviour” (Parsons et al.). This instructional impact can make an abstract guideline, like limiting refined carbs, visible and personal. CGM also can increase the efficiency of office visits since the practitioner, and the patient can study the same data and establish specific goals. A 2025 pilot project trained primary care doctors to read CGMs using pharmacists and diabetes educators to help with sensor implantation, teaching and follow-up. Increased time in range significantly and average HbA1c fell from 9.68% to 7.31%. The authors concluded that using CGM in primary care was “feasible and effective using a multidisciplinary approach” (Zadel et al.). These data show that effective implementation is a function not just of acquiring the device, but also of educating patients how to respond to the information and preparing doctors to read the standardized reports . Without education, too many alarms or strange graphs might produce confusion instead of confidence.

    Finally, the long-term benefits of CGM should be weighed against the practical and ethical constraints of the device. There is an ongoing cost for sensors and transmitters, and coverage regulations may range depending on insurance plan, prescription regimen and documentation needed. Furthermore, patients may not own a compatible smartphone, have dependable internet access, computer literacy, or the ability to update sensors accurately. But economic research implies that higher monitoring expenses may be compensated by better control and fewer issues. A 2024 U.S. microsimulation of persons with type 2 diabetes on basal insulin found CGM “offered more QALYs … at a lower cost” over 10 years than finger-stick monitoring (Frank et al.). The model estimated savings from decreased severe hypoglycemia events, diabetic ketoacidosis episodes, and long-term cardiovascular and renal consequences. This was a simulation and not a clinical experiment, thus the conclusions are based on the assumptions that were built into the model and should be read with caution. Another concern is access. A evaluation in 2026 found “ongoing inequities by age, race and ethnicity, insurance coverage and care setting” (Villanueva et al.). These disparities may deny people with the greatest illness burden access to technology. Primary care organizations consequently need clear eligibility processes, staff training, appropriate language education, technical support, privacy measures and plans for patients who cannot afford sensors on an ongoing basis. CGM can be a high-value improvement, but without healthcare systems addressing pricing and digital access its advantages will be unequal.

    To conclude, continuous glucose monitoring represents an important improvement in the management of type 2 diabetes. Research demonstrates it can enhance HbA1c and time in range, assist patients understand how their daily actions impact glucose, and encourage more focused engagement with family nurse practitioners and interdisciplinary primary care teams. Economic models also imply that avoiding acute events and long-term problems may offset some of the expense of the technology. At the same time, CGM is not necessarily helpful for every patient. Insurance limits, device costs, data interpretation, alarm fatigue, and inequitable access may limit its utility. The most appropriate method is therefore to combine the device with tailored education, clinical follow-up and equal coverage policies. As CGMs become more popular in primary care, family nurse practitioners will be key in identifying who may benefit, training patients how to utilize the information securely, and ensuring that technology improves treatment rather than widens existing gaps.

    Works Cited

    Frank, Jerry, et al. “Continuous Glucose Monitoring for Self-Management of Diabetes in People Living with Type 2 Diabetes Mellitus on Basal Insulin Therapy: A Microsimulation Model and Cost-Effectiveness Analysis from a US Perspective with Relevance to Medicaid.” Journal of Managed Care & Specialty Pharmacy, vol. 30, no. 9, 2024, pp. 917–928. https://doi.org/10.18553/jmcp.2024.24025.

    Jancev, Milena, et al. “Continuous Glucose Monitoring in Adults with Type 2 Diabetes: A Systematic Review and Meta-Analysis.” Diabetologia, vol. 67, no. 5, 2024, pp. 798–810. https://doi.org/10.1007/s00125-024-06107-6.

    Martens, Thomas W., et al. “Effect of Continuous Glucose Monitoring on Glycemic Control in Patients with Type 2 Diabetes Treated with Basal Insulin: A Randomized Clinical Trial.” JAMA, vol. 325, no. 22, 2021, pp. 2262–2272. https://doi.org/10.1001/jama.2021.7444.

    Parsons, Sharon N., et al. “Does the Short-Term Use of Continuous Glucose Monitoring Enhance Diabetes Self-Management Behaviour in Type 2 Diabetes? The DISCO GM Study: A Randomised, Controlled Cross-Over Study.” Diabetes & Metabolic Syndrome: Clinical Research & Reviews, vol. 19, no. 7, 2025, article 103283. https://doi.org/10.1016/j.dsx.2025.103283.

    Villanueva, Giuliana Perini, et al. “Continuous Glucose Monitoring in Type 2 Diabetes: Clinical Outcomes, Disparities in Access, and Cost-Effectiveness.” Current Diabetes Reports, vol. 26, no. 1, 2026, article 19. https://doi.org/10.1007/s11892-026-01631-8.

    Zadel, Alyssa H., et al. “Continuous Glucose Monitoring in Primary Care: Multidisciplinary Pilot Implementation Study.” JMIR Diabetes, vol. 10, 2025, e69061. https://doi.org/10.2196/69061.

  • [Solved] Assigment .Apa seven . All instructions attached.

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    **files (2)** – ## Preliminary_Reference_List_Mishel.docx – ## ScholarlyPaperUPLOADHERE.docx **## Preliminary_Reference_List_Mishel.docx** 2 **Preliminary Reference List: Merle Mishel's Uncertainty in Illness Theory** Dianabel Blanco Florida National University Nursing Theory-DBX-DL01 Dr.Nora …

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    **files (2)**

    – ## Preliminary_Reference_List_Mishel.docx

    – ## ScholarlyPaperUPLOADHERE.docx

    **## Preliminary_Reference_List_Mishel.docx**

    2

    **Preliminary Reference List: Merle Mishel's Uncertainty in Illness Theory**

    Dianabel Blanco

    Florida National University

    Nursing Theory-DBX-DL01

    Dr.Nora Hernandez-Pupo

    July 17, 2026

    **Preliminary Reference List: Merle Mishel's Uncertainty in Illness Theory**

    This preliminary reference list is used in conjunction with a Theorist Paper which explores Merle Mishel's Uncertainty in Illness Theory (UIT) and its extended reconceptualization (RUIT) in terms of the lived experience of adults with chronic illness. Mishel's original theory focuses on the meaning of uncertainty in relation to the occurrence of illness events, whereas the reconceptualized theory focuses on the unresolved chronic uncertainty that occurs in chronic/recurrent illness as opposed to a single acute illness. In this reformulation, uncertainty is not necessarily a negative condition that must be resolved; rather, through the process over time, patients may come to value uncertainty as an opportunity, bringing about a change in the way they think about uncertainty and a change in the way they think about themselves.

    The following sources were chosen to reflect the use of the theory in diverse populations with chronic diseases such as chronic obstructive pulmonary disease, chronic liver disease, oncology, and professional care taking settings, as well as new theoretical development of the theory. There are also a number of sources that discuss the psychological and behavioral consequences of unmanaged uncertainty, including decreased self-efficacy, psychological difficulties adjusting, and anticipatory grief, as these all relate to assessment and planning for nursing interventions. All sources are peer-reviewed journal articles published since 2021 (which reflects the current standards for evidence-based graduate-level research writing), or books published since 2021, and have been independently verified before use. These references set the theoretical context for UIT/RUIT and the current empirical evidence, and serve as a foundation for the entire Theorist Paper to explore how uncertainty will be created, appraised, and managed throughout the illness journey, and how nursing interventions based on the theory can enhance patient coping, psychological adjustment, and quality of life.

    To ensure that authorship, journal, volume, page numbers and digital object identifier information are accurate, a direct database or publisher search was used to locate all nine sources. As per the guidelines for the submission there are no annotations, the citations below are only given as a working reference list for the continued development of the full Theorist Paper.

    **References**

    Andrade, C. R. A. G., Costa, L. M. C., Lúcio, I. M. L., Pereira, J. F., Lima, H. N., & Nascimento, R. L. (2024). Uncertainties experienced by nursing professionals who contracted Covid-19: A priori, everyone is human. Revista Brasileira de Enfermagem, 77(3), e20230142. https://doi.org/10.1590/0034-7167-2023-0142

    Bao, Y., Yang, L., Zhao, J., Wang, Z., Fu, L., Fang, M., & Lin, J. (2026). The association between chronic disease resource utilization and illness uncertainty in COPD patients: A latent profile analysis. PeerJ, 14, Article e20674. https://doi.org/10.7717/peerj.20674

    Eppel-Meichlinger, J., Kobleder, A., & Mayer, H. (2024). Refining Mishel's reconceptualized uncertainty in illness theory: Explaining the development of uncertainty in chronic illness. Research and Theory for Nursing Practice, 38(2), 171–192. https://doi.org/10.1891/RTNP-2023-0068

    Farooqui, H. A., Zafar, M. H., Haider, A., Samad, A., Qureshi, S. U. R., Shahid, M. A., Shazib, A., Farooq, A., Naz, N., Saeed, Z. B., & Maaz, M. (2025). Prospective association between illness uncertainty and self-management self-efficacy in patients with early-stage chronic liver disease over a six-month follow-up. Cureus, 17(9), Article e92787. https://doi.org/10.7759/cureus.92787

    Grant, J. B., & Johnson-Koenke, R. (2024). Navigating chronic uncertainty: A theory synthesis for nursing communication in life-limiting illness. BMC Nursing, 23, Article 653. https://doi.org/10.1186/s12912-024-02328-7

    Guan, T., Qan'ir, Y., & Song, L. (2021). Systematic review of illness uncertainty management interventions for cancer patients and their family caregivers. Supportive Care in Cancer, 29(8), 4623–4640. https://doi.org/10.1007/s00520-020-05931-x

    Reinken, D. N., & Reed, S. M. (2023). Mishel's uncertainty in illness theory: Informing nursing diagnoses and care planning. International Journal of Nursing Knowledge, 34(4), 316–324. https://doi.org/10.1111/2047-3095.12406

    Skojec, T. A., Davidson, T. M., & Kelechi, T. J. (2025). The relationship between uncertainty in illness and psychological adjustment to chronic illness. Journal of Health Psychology, 30(4), 622–637. https://doi.org/10.1177/13591053241249861

    Zhang, N., Li, H., Kang, H., Wang, Y., & Zuo, Z. (2023). Relationship between self-disclosure and anticipatory grief in patients with advanced lung cancer: The mediation role of illness uncertainty. Frontiers in Psychology, 14, Article 1266818. https://doi.org/10.3389/fpsyg.2023.1266818

    **## ScholarlyPaperUPLOADHERE.docx**

    Nursing Theory-DBX-DL01 Nora Hernandez-Pupo

    Scholarly Paper UPLOAD HERE Due Saturday @ 2359

    **SCHOLARLY PAPER INSTRUCTIONS**

    **DUE DATE: WEEK 4 Saturday at 2359**

    **Assignment Overview**

    **Due Date:**

    ·
    **Week 4, Saturday at 11:59 PM** Submissions must be received by the deadline. Late assignments will not be accepted.

    **Paper Topic:**

    · Select and analyze a nursing theory of your choice.

    **Paper Length and Formatting Requirements:**

    · Your formal paper should be
    **5-6 pages in length**, not including the title page and reference pages.

    · Use the following formatting settings:

    ·
    **Double-spaced text**

    ·
    **12-point font** (preferably Times New Roman)

    ·
    **1-inch margins** on all sides

    · Follow APA 7th Edition guidelines for:

    · Title (cover) page

    · Headers and pagination

    · In-text citations and reference list

    **Content and Structure**

    Your paper must be organized into the following sections. Each section should be clearly labeled and addressed in your final submission.

    **Introduction**

    ·
    **Purpose:** Begin your paper by introducing the nursing theory you have chosen.

    ·
    **Content Requirements:**

    · Provide a brief background of the theorist—include information about their education, career, and any contributions that are relevant to the development of the theory.

    · Explain why the theorist is significant in the world of nursing.

    ·
    **Tips:** Keep this section concise, yet informative enough for the reader to understand the origin of the theory.

    **Basic Concept Analysis**

    ·
    **Purpose:** Clearly outline the core components of the nursing theory.

    ·
    **Content Requirements:**

    · Identify and briefly explain the major concepts that form the basis of the theory.

    · Discuss how these core concepts work together to define the theory.

    · Use clear definitions and simple examples if appropriate to illustrate each concept.

    ·
    **Tips:** Focus on the essential ideas that make the theory unique and applicable to nursing practice.

    **Relevance**

    ·
    **Purpose:** Demonstrate how the nursing theory is connected to broader healthcare practices and current research.

    ·
    **Content Requirements:**

    · Explain how the theorist’s work connects to the theory, and in turn, how the theory influences healthcare practices.

    · Discuss the application of the theory in today’s clinical settings.

    · Reference current research or clinical practice studies that apply the theory.

    ·
    **Scholarly Sources:**

    · Incorporate at least
    **two peer-reviewed or research articles** that detail how the theory is being utilized in clinical practice or research.

    · Summarize the key findings of each article including the results of the study and the implications they have for future practice.

    ·
    **Tips:** Be analytical and use evidence-based practice (EBP) to support your relevance discussion.

    **Summary**

    ·
    **Purpose:** Your summary should provide a critical reflection on the theory.

    ·
    **Content Requirements:**

    · Summarize the strengths and limitations of the nursing theory.

    · Reflect on how well the theory bridges theoretical frameworks with practical application.

    ·
    **Tips:** Offer a balanced perspective that recognizes both the benefits and potential shortcomings of the theory in advancing nursing practice.

    **Additional Guidelines**

    ·
    **APA Formatting:**

    · Ensure that your cover sheet, headers, pagination, and reference pages adhere to APA 7th Edition standards.

    · All in-text citations must match your reference list.

    ·
    **Assignment Quality:**

    · The writing should be formal, well-organized, and clearly written at a graduate level.

    · Each section should logically flow into the next, maintaining coherence throughout your paper.

    ·
    **Review the Rubric:**

    · Refer to the grading rubric provided (if available) to ensure that you have met all the criteria required for a high-quality submission.

    ·
    **Proofread Your Paper:**

    · Before submission, check for grammatical errors and clarity. Make sure your arguments are well-supported by evidence from your scholarly sources.

    **REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**

    **Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)

    **Final Submission Reminder**

    ·
    **Deadline:** Submit your final paper by
    **Week 4 Saturday at 11:59 PM**.

    ·
    **Submission Process:** Upload your paper in the designated submission portal. Ensure that your attachment is correctly named with your name and assignment title.

    By following these expanded instructions, you are well equipped to produce a comprehensive, well-structured, and evidence-based paper on your selected nursing theory. Taking the time to address each section thoroughly will enhance your chance for success and contribute thoughtfully to your field of study. Happy writing!

    Please refer to the grading rubric in the assignment drop box.

    **Submission**

    Text Editor

    Press Alt + F10 to access toolbar options

    _Word count: 0_

    **Drag files here**

    Maximum size: 512 MB

    **or**

    **Details & Information**

    Rubric Details

    **Maximum Score**

    100 points

    **Exemplary Work**

    The paper presents a thorough and insightful analysis of the chosen nursing theory. All key concepts are clearly articulated, relevant to the theory, and expertly linked to contemporary nursing practices. Evidence from multiple scholarly sources enhances the discussion.

    **40**

    **Proficient Work**

    The analysis of the nursing theory is clear and relevant, addressing the core concepts and making appropriate connections to current nursing practice. Some scholarly sources are incorporated effectively.

    **30**

    **Needs Improvement**

    The discussion of the nursing theory is somewhat unclear or lacks depth. Some key concepts may not be adequately explained. Connections to current practice are weak or underdeveloped.

    **20**

    **Unsatisfactory Work**

    The analysis of the nursing theory is minimal or missing. Key concepts are poorly defined, and there are little to no connections made to current nursing practice.

    **10**

    **Exemplary Work**

    The paper is exceptionally well-organized with clear section headings and a logical flow of ideas. Each section seamlessly transitions to the next.

    **30**

    **Proficient Work**

    The organization of the paper is good, with clear headings. There is some coherent flow between sections, though a few transitions may be abrupt.

    **22.5**

    **Needs Improvement**

    The paper lacks a clear organizational structure. Section headings may be present, but the flow of ideas is unclear or confusing.

    **15**

    **Unsatisfactory Work**

    The paper is poorly organized. There are no clear section headings, and ideas are presented in a haphazard manner.

    **7.5**

    **Exemplary Work**

    The paper includes multiple peer-reviewed articles that are highly relevant and current. Each source is well-integrated into the discussion and supports key arguments effectively. At least 2 sources are used to develop the paper.

    **15**

    **Proficient Work**

    The paper uses at least 2 relevant peer-reviewed sources, though the integration could be improved. Lacks synthesis and support. Most sources are appropriate and contribute to the key arguments.

    **11.25**

    **Needs Improvement**

    Less than 2 sources are used in the paper. The analysis lacks support from scholarly literature, which weakens key arguments.

    **7.5**

    **Unsatisfactory Work**

    The paper uses 1 peer-reviewed sources or relies on non-scholarly sources, lacks scholarly synthesis and connections. Key claims lack credible support.

    **3.75**

    **Exemplary Work**

    All REFERENCES have DOI Numbers for me to look them up.

    **10**

    **Proficient Work**

    All REFERENCES have DOI Numbers for me to look them up- but not all are working.

    **7.5**

    **Needs Improvement**

    Not all REFERENCE have a DOI Number for me to look them up.

    **5**

    **Unsatisfactory Work**

    More than 2 REFERENCES do not have DOI Numbers for me to look them up.

    **2.5**

    **Exemplary Work**

    The paper strictly follows APA 7th Edition guidelines throughout, including formatting, in text citations. The writing is clear, formal, and free of grammatical errors.

    **5**

    **Proficient Work**

    The paper mostly adheres to APA 7th Edition guidelines, with only minor formatting errors. The writing is generally clear with few grammatical issues.

    **3.75**

    **Needs Improvement**

    The paper shows irregularities in APA formatting and numerous grammatical errors that distract from the overall clarity of the writing.

    **2.5**

    **Unsatisfactory Work**

    The paper does not follow APA 7th Edition guidelines. There are significant problems in writing quality, including many grammatical errors that obstruct understanding.

    **## ScholarlyPaperUPLOADHERE.docx**

    Nursing Theory-DBX-DL01 Nora Hernandez-Pupo

    Scholarly Paper UPLOAD HERE Due Saturday @ 2359

    **SCHOLARLY PAPER INSTRUCTIONS**

    **DUE DATE: WEEK 4 Saturday at 2359**

    **Assignment Overview**

    **Due Date:**

    ·
    **Week 4, Saturday at 11:59 PM** Submissions must be received by the deadline. Late assignments will not be accepted.

    **Paper Topic:**

    · Select and analyze a nursing theory of your choice.

    **Paper Length and Formatting Requirements:**

    · Your formal paper should be
    **5-6 pages in length**, not including the title page and reference pages.

    · Use the following formatting settings:

    ·
    **Double-spaced text**

    ·
    **12-point font** (preferably Times New Roman)

    ·
    **1-inch margins** on all sides

    · Follow APA 7th Edition guidelines for:

    · Title (cover) page

    · Headers and pagination

    · In-text citations and reference list

    **Content and Structure**

    Your paper must be organized into the following sections. Each section should be clearly labeled and addressed in your final submission.

    **Introduction**

    ·
    **Purpose:** Begin your paper by introducing the nursing theory you have chosen.

    ·
    **Content Requirements:**

    · Provide a brief background of the theorist—include information about their education, career, and any contributions that are relevant to the development of the theory.

    · Explain why the theorist is significant in the world of nursing.

    ·
    **Tips:** Keep this section concise, yet informative enough for the reader to understand the origin of the theory.

    **Basic Concept Analysis**

    ·
    **Purpose:** Clearly outline the core components of the nursing theory.

    ·
    **Content Requirements:**

    · Identify and briefly explain the major concepts that form the basis of the theory.

    · Discuss how these core concepts work together to define the theory.

    · Use clear definitions and simple examples if appropriate to illustrate each concept.

    ·
    **Tips:** Focus on the essential ideas that make the theory unique and applicable to nursing practice.

    **Relevance**

    ·
    **Purpose:** Demonstrate how the nursing theory is connected to broader healthcare practices and current research.

    ·
    **Content Requirements:**

    · Explain how the theorist’s work connects to the theory, and in turn, how the theory influences healthcare practices.

    · Discuss the application of the theory in today’s clinical settings.

    · Reference current research or clinical practice studies that apply the theory.

    ·
    **Scholarly Sources:**

    · Incorporate at least
    **two peer-reviewed or research articles** that detail how the theory is being utilized in clinical practice or research.

    · Summarize the key findings of each article including the results of the study and the implications they have for future practice.

    ·
    **Tips:** Be analytical and use evidence-based practice (EBP) to support your relevance discussion.

    **Summary**

    ·
    **Purpose:** Your summary should provide a critical reflection on the theory.

    ·
    **Content Requirements:**

    · Summarize the strengths and limitations of the nursing theory.

    · Reflect on how well the theory bridges theoretical frameworks with practical application.

    ·
    **Tips:** Offer a balanced perspective that recognizes both the benefits and potential shortcomings of the theory in advancing nursing practice.

    **Additional Guidelines**

    ·
    **APA Formatting:**

    · Ensure that your cover sheet, headers, pagination, and reference pages adhere to APA 7th Edition standards.

    · All in-text citations must match your reference list.

    ·
    **Assignment Quality:**

    · The writing should be formal, well-organized, and clearly written at a graduate level.

    · Each section should logically flow into the next, maintaining coherence throughout your paper.

    ·
    **Review the Rubric:**

    · Refer to the grading rubric provided (if available) to ensure that you have met all the criteria required for a high-quality submission.

    ·
    **Proofread Your Paper:**

    · Before submission, check for grammatical errors and clarity. Make sure your arguments are well-supported by evidence from your scholarly sources.

    **REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**

    **Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)

    **Final Submission Reminder**

    ·
    **Deadline:** Submit your final paper by
    **Week 4 Saturday at 11:59 PM**.

    ·
    **Submission Process:** Upload your paper in the designated submission portal. Ensure that your attachment is correctly named with your name and assignment title.

    By following these expanded instructions, you are well equipped to produce a comprehensive, well-structured, and evidence-based paper on your selected nursing theory. Taking the time to address each section thoroughly will enhance your chance for success and contribute thoughtfully to your field of study. Happy writing!

    Please refer to the grading rubric in the assignment drop box.

    **Submission**

    Text Editor

    Press Alt + F10 to access toolbar options

    _Word count: 0_

    **Drag files here**

    Maximum size: 512 MB

    **or**

    **Details & Information**

    Rubric Details

    **Maximum Score**

    100 points

    **Exemplary Work**

    The paper presents a thorough and insightful analysis of the chosen nursing theory. All key concepts are clearly articulated, relevant to the theory, and expertly linked to contemporary nursing practices. Evidence from multiple scholarly sources enhances the discussion.

    **40**

    **Proficient Work**

    The analysis of the nursing theory is clear and relevant, addressing the core concepts and making appropriate connections to current nursing practice. Some scholarly sources are incorporated effectively.

    **30**

    **Needs Improvement**

    The discussion of the nursing theory is somewhat unclear or lacks depth. Some key concepts may not be adequately explained. Connections to current practice are weak or underdeveloped.

    **20**

    **Unsatisfactory Work**

    The analysis of the nursing theory is minimal or missing. Key concepts are poorly defined, and there are little to no connections made to current nursing practice.

    **10**

    **Exemplary Work**

    The paper is exceptionally well-organized with clear section headings and a logical flow of ideas. Each section seamlessly transitions to the next.

    **30**

    **Proficient Work**

    The organization of the paper is good, with clear headings. There is some coherent flow between sections, though a few transitions may be abrupt.

    **22.5**

    **Needs Improvement**

    The paper lacks a clear organizational structure. Section headings may be present, but the flow of ideas is unclear or confusing.

    **15**

    **Unsatisfactory Work**

    The paper is poorly organized. There are no clear section headings, and ideas are presented in a haphazard manner.

    **7.5**

    **Exemplary Work**

    The paper includes multiple peer-reviewed articles that are highly relevant and current. Each source is well-integrated into the discussion and supports key arguments effectively. At least 2 sources are used to develop the paper.

    **15**

    **Proficient Work**

    The paper uses at least 2 relevant peer-reviewed sources, though the integration could be improved. Lacks synthesis and support. Most sources are appropriate and contribute to the key arguments.

    **11.25**

    **Needs Improvement**

    Less than 2 sources are used in the paper. The analysis lacks support from scholarly literature, which weakens key arguments.

    **7.5**

    **Unsatisfactory Work**

    The paper uses 1 peer-reviewed sources or relies on non-scholarly sources, lacks scholarly synthesis and connections. Key claims lack credible support.

    **3.75**

    **Exemplary Work**

    All REFERENCES have DOI Numbers for me to look them up.

    **10**

    **Proficient Work**

    All REFERENCES have DOI Numbers for me to look them up- but not all are working.

    **7.5**

    **Needs Improvement**

    Not all REFERENCE have a DOI Number for me to look them up.

    **5**

    **Unsatisfactory Work**

    More than 2 REFERENCES do not have DOI Numbers for me to look them up.

    **2.5**

    **Exemplary Work**

    The paper strictly follows APA 7th Edition guidelines throughout, including formatting, in text citations. The writing is clear, formal, and free of grammatical errors.

    **5**

    **Proficient Work**

    The paper mostly adheres to APA 7th Edition guidelines, with only minor formatting errors. The writing is generally clear with few grammatical issues.

    **3.75**

    **Needs Improvement**

    The paper shows irregularities in APA formatting and numerous grammatical errors that distract from the overall clarity of the writing.

    **2.5**

    **Unsatisfactory Work**

    The paper does not follow APA 7th Edition guidelines. There are significant problems in writing quality, including many grammatical errors that obstruct understanding.

    **## Preliminary_Reference_List_Mishel.docx**

    2

    **Preliminary Reference List: Merle Mishel's Uncertainty in Illness Theory**

    Dianabel Blanco

    Florida National University

    Nursing Theory-DBX-DL01

    Dr.Nora Hernandez-Pupo

    July 17, 2026

    **Preliminary Reference List: Merle Mishel's Uncertainty in Illness Theory**

    This preliminary reference list is used in conjunction with a Theorist Paper which explores Merle Mishel's Uncertainty in Illness Theory (UIT) and its extended reconceptualization (RUIT) in terms of the lived experience of adults with chronic illness. Mishel's original theory focuses on the meaning of uncertainty in relation to the occurrence of illness events, whereas the reconceptualized theory focuses on the unresolved chronic uncertainty that occurs in chronic/recurrent illness as opposed to a single acute illness. In this reformulation, uncertainty is not necessarily a negative condition that must be resolved; rather, through the process over time, patients may come to value uncertainty as an opportunity, bringing about a change in the way they think about uncertainty and a change in the way they think about themselves.

    The following sources were chosen to reflect the use of the theory in diverse populations with chronic diseases such as chronic obstructive pulmonary disease, chronic liver disease, oncology, and professional care taking settings, as well as new theoretical development of the theory. There are also a number of sources that discuss the psychological and behavioral consequences of unmanaged uncertainty, including decreased self-efficacy, psychological difficulties adjusting, and anticipatory grief, as these all relate to assessment and planning for nursing interventions. All sources are peer-reviewed journal articles published since 2021 (which reflects the current standards for evidence-based graduate-level research writing), or books published since 2021, and have been independently verified before use. These references set the theoretical context for UIT/RUIT and the current empirical evidence, and serve as a foundation for the entire Theorist Paper to explore how uncertainty will be created, appraised, and managed throughout the illness journey, and how nursing interventions based on the theory can enhance patient coping, psychological adjustment, and quality of life.

    To ensure that authorship, journal, volume, page numbers and digital object identifier information are accurate, a direct database or publisher search was used to locate all nine sources. As per the guidelines for the submission there are no annotations, the citations below are only given as a working reference list for the continued development of the full Theorist Paper.

    **References**

    Andrade, C. R. A. G., Costa, L. M. C., Lúcio, I. M. L., Pereira, J. F., Lima, H. N., & Nascimento, R. L. (2024). Uncertainties experienced by nursing professionals who contracted Covid-19: A priori, everyone is human. Revista Brasileira de Enfermagem, 77(3), e20230142. https://doi.org/10.1590/0034-7167-2023-0142

    Bao, Y., Yang, L., Zhao, J., Wang, Z., Fu, L., Fang, M., & Lin, J. (2026). The association between chronic disease resource utilization and illness uncertainty in COPD patients: A latent profile analysis. PeerJ, 14, Article e20674. https://doi.org/10.7717/peerj.20674

    Eppel-Meichlinger, J., Kobleder, A., & Mayer, H. (2024). Refining Mishel's reconceptualized uncertainty in illness theory: Explaining the development of uncertainty in chronic illness. Research and Theory for Nursing Practice, 38(2), 171–192. https://doi.org/10.1891/RTNP-2023-0068

    Farooqui, H. A., Zafar, M. H., Haider, A., Samad, A., Qureshi, S. U. R., Shahid, M. A., Shazib, A., Farooq, A., Naz, N., Saeed, Z. B., & Maaz, M. (2025). Prospective association between illness uncertainty and self-management self-efficacy in patients with early-stage chronic liver disease over a six-month follow-up. Cureus, 17(9), Article e92787. https://doi.org/10.7759/cureus.92787

    Grant, J. B., & Johnson-Koenke, R. (2024). Navigating chronic uncertainty: A theory synthesis for nursing communication in life-limiting illness. BMC Nursing, 23, Article 653. https://doi.org/10.1186/s12912-024-02328-7

    Guan, T., Qan'ir, Y., & Song, L. (2021). Systematic review of illness uncertainty management interventions for cancer patients and their family caregivers. Supportive Care in Cancer, 29(8), 4623–4640. https://doi.org/10.1007/s00520-020-05931-x

    Reinken, D. N., & Reed, S. M. (2023). Mishel's uncertainty in illness theory: Informing nursing diagnoses and care planning. International Journal of Nursing Knowledge, 34(4), 316–324. https://doi.org/10.1111/2047-3095.12406

    Skojec, T. A., Davidson, T. M., & Kelechi, T. J. (2025). The relationship between uncertainty in illness and psychological adjustment to chronic illness. Journal of Health Psychology, 30(4), 622–637. https://doi.org/10.1177/13591053241249861

    Zhang, N., Li, H., Kang, H., Wang, Y., & Zuo, Z. (2023). Relationship between self-disclosure and anticipatory grief in patients with advanced lung cancer: The mediation role of illness uncertainty. Frontiers in Psychology, 14, Article 1266818. https://doi.org/10.3389/fpsyg.2023.1266818

    **## ScholarlyPaperUPLOADHERE.docx**

    Nursing Theory-DBX-DL01 Nora Hernandez-Pupo

    Scholarly Paper UPLOAD HERE Due Saturday @ 2359

    **SCHOLARLY PAPER INSTRUCTIONS**

    **DUE DATE: WEEK 4 Saturday at 2359**

    **Assignment Overview**

    **Due Date:**

    ·
    **Week 4, Saturday at 11:59 PM** Submissions must be received by the deadline. Late assignments will not be accepted.

    **Paper Topic:**

    · Select and analyze a nursing theory of your choice.

    **Paper Length and Formatting Requirements:**

    · Your formal paper should be
    **5-6 pages in length**, not including the title page and reference pages.

    · Use the following formatting settings:

    ·
    **Double-spaced text**

    ·
    **12-point font** (preferably Times New Roman)

    ·
    **1-inch margins** on all sides

    · Follow APA 7th Edition guidelines for:

    · Title (cover) page

    · Headers and pagination

    · In-text citations and reference list

    **Content and Structure**

    Your paper must be organized into the following sections. Each section should be clearly labeled and addressed in your final submission.

    **Introduction**

    ·
    **Purpose:** Begin your paper by introducing the nursing theory you have chosen.

    ·
    **Content Requirements:**

    · Provide a brief background of the theorist—include information about their education, career, and any contributions that are relevant to the development of the theory.

    · Explain why the theorist is significant in the world of nursing.

    ·
    **Tips:** Keep this section concise, yet informative enough for the reader to understand the origin of the theory.

    **Basic Concept Analysis**

    ·
    **Purpose:** Clearly outline the core components of the nursing theory.

    ·
    **Content Requirements:**

    · Identify and briefly explain the major concepts that form the basis of the theory.

    · Discuss how these core concepts work together to define the theory.

    · Use clear definitions and simple examples if appropriate to illustrate each concept.

    ·
    **Tips:** Focus on the essential ideas that make the theory unique and applicable to nursing practice.

    **Relevance**

    ·
    **Purpose:** Demonstrate how the nursing theory is connected to broader healthcare practices and current research.

    ·
    **Content Requirements:**

    · Explain how the theorist’s work connects to the theory, and in turn, how the theory influences healthcare practices.

    · Discuss the application of the theory in today’s clinical settings.

    · Reference current research or clinical practice studies that apply the theory.

    ·
    **Scholarly Sources:**

    · Incorporate at least
    **two peer-reviewed or research articles** that detail how the theory is being utilized in clinical practice or research.

    · Summarize the key findings of each article including the results of the study and the implications they have for future practice.

    ·
    **Tips:** Be analytical and use evidence-based practice (EBP) to support your relevance discussion.

    **Summary**

    ·
    **Purpose:** Your summary should provide a critical reflection on the theory.

    ·
    **Content Requirements:**

    · Summarize the strengths and limitations of the nursing theory.

    · Reflect on how well the theory bridges theoretical frameworks with practical application.

    ·
    **Tips:** Offer a balanced perspective that recognizes both the benefits and potential shortcomings of the theory in advancing nursing practice.

    **Additional Guidelines**

    ·
    **APA Formatting:**

    · Ensure that your cover sheet, headers, pagination, and reference pages adhere to APA 7th Edition standards.

    · All in-text citations must match your reference list.

    ·
    **Assignment Quality:**

    · The writing should be formal, well-organized, and clearly written at a graduate level.

    · Each section should logically flow into the next, maintaining coherence throughout your paper.

    ·
    **Review the Rubric:**

    · Refer to the grading rubric provided (if available) to ensure that you have met all the criteria required for a high-quality submission.

    ·
    **Proofread Your Paper:**

    · Before submission, check for grammatical errors and clarity. Make sure your arguments are well-supported by evidence from your scholarly sources.

    **REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**

    **Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)

    **Final Submission Reminder**

    ·
    **Deadline:** Submit your final paper by
    **Week 4 Saturday at 11:59 PM**.

    ·
    **Submission Process:** Upload your paper in the designated submission portal. Ensure that your attachment is correctly named with your name and assignment title.

    By following these expanded instructions, you are well equipped to produce a comprehensive, well-structured, and evidence-based paper on your selected nursing theory. Taking the time to address each section thoroughly will enhance your chance for success and contribute thoughtfully to your field of study. Happy writing!

    Please refer to the grading rubric in the assignment drop box.

    **Submission**

    Text Editor

    Press Alt + F10 to access toolbar options

    _Word count: 0_

    **Drag files here**

    Maximum size: 512 MB

    **or**

    **Details & Information**

    Rubric Details

    **Maximum Score**

    100 points

    **Exemplary Work**

    The paper presents a thorough and insightful analysis of the chosen nursing theory. All key concepts are clearly articulated, relevant to the theory, and expertly linked to contemporary nursing practices. Evidence from multiple scholarly sources enhances the discussion.

    **40**

    **Proficient Work**

    The analysis of the nursing theory is clear and relevant, addressing the core concepts and making appropriate connections to current nursing practice. Some scholarly sources are incorporated effectively.

    **30**

    **Needs Improvement**

    The discussion of the nursing theory is somewhat unclear or lacks depth. Some key concepts may not be adequately explained. Connections to current practice are weak or underdeveloped.

    **20**

    **Unsatisfactory Work**

    The analysis of the nursing theory is minimal or missing. Key concepts are poorly defined, and there are little to no connections made to current nursing practice.

    **10**

    **Exemplary Work**

    The paper is exceptionally well-organized with clear section headings and a logical flow of ideas. Each section seamlessly transitions to the next.

    **30**

    **Proficient Work**

    The organization of the paper is good, with clear headings. There is some coherent flow between sections, though a few transitions may be abrupt.

    **22.5**

    **Needs Improvement**

    The paper lacks a clear organizational structure. Section headings may be present, but the flow of ideas is unclear or confusing.

    **15**

    **Unsatisfactory Work**

    The paper is poorly organized. There are no clear section headings, and ideas are presented in a haphazard manner.

    **7.5**

    **Exemplary Work**

    The paper includes multiple peer-reviewed articles that are highly relevant and current. Each source is well-integrated into the discussion and supports key arguments effectively. At least 2 sources are used to develop the paper.

    **15**

    **Proficient Work**

    The paper uses at least 2 relevant peer-reviewed sources, though the integration could be improved. Lacks synthesis and support. Most sources are appropriate and contribute to the key arguments.

    **11.25**

    **Needs Improvement**

    Less than 2 sources are used in the paper. The analysis lacks support from scholarly literature, which weakens key arguments.

    **7.5**

    **Unsatisfactory Work**

    The paper uses 1 peer-reviewed sources or relies on non-scholarly sources, lacks scholarly synthesis and connections. Key claims lack credible support.

    **3.75**

    **Exemplary Work**

    All REFERENCES have DOI Numbers for me to look them up.

    **10**

    **Proficient Work**

    All REFERENCES have DOI Numbers for me to look them up- but not all are working.

    **7.5**

    **Needs Improvement**

    Not all REFERENCE have a DOI Number for me to look them up.

    **5**

    **Unsatisfactory Work**

    More than 2 REFERENCES do not have DOI Numbers for me to look them up.

    **2.5**

    **Exemplary Work**

    The paper strictly follows APA 7th Edition guidelines throughout, including formatting, in text citations. The writing is clear, formal, and free of grammatical errors.

    **5**

    **Proficient Work**

    The paper mostly adheres to APA 7th Edition guidelines, with only minor formatting errors. The writing is generally clear with few grammatical issues.

    **3.75**

    **Needs Improvement**

    The paper shows irregularities in APA formatting and numerous grammatical errors that distract from the overall clarity of the writing.

    **2.5**

    **Unsatisfactory Work**

    The paper does not follow APA 7th Edition guidelines. There are significant problems in writing quality, including many grammatical errors that obstruct understanding.

    **## Preliminary_Reference_List_Mishel.docx**

    2

    **Preliminary Reference List: Merle Mishel's Uncertainty in Illness Theory**

    Dianabel Blanco

    Florida National University

    Nursing Theory-DBX-DL01

    Dr.Nora Hernandez-Pupo

    July 17, 2026

    **Preliminary Reference List: Merle Mishel's Uncertainty in Illness Theory**

    This preliminary reference list is used in conjunction with a Theorist Paper which explores Merle Mishel's Uncertainty in Illness Theory (UIT) and its extended reconceptualization (RUIT) in terms of the lived experience of adults with chronic illness. Mishel's original theory focuses on the meaning of uncertainty in relation to the occurrence of illness events, whereas the reconceptualized theory focuses on the unresolved chronic uncertainty that occurs in chronic/recurrent illness as opposed to a single acute illness. In this reformulation, uncertainty is not necessarily a negative condition that must be resolved; rather, through the process over time, patients may come to value uncertainty as an opportunity, bringing about a change in the way they think about uncertainty and a change in the way they think about themselves.

    The following sources were chosen to reflect the use of the theory in diverse populations with chronic diseases such as chronic obstructive pulmonary disease, chronic liver disease, oncology, and professional care taking settings, as well as new theoretical development of the theory. There are also a number of sources that discuss the psychological and behavioral consequences of unmanaged uncertainty, including decreased self-efficacy, psychological difficulties adjusting, and anticipatory grief, as these all relate to assessment and planning for nursing interventions. All sources are peer-reviewed journal articles published since 2021 (which reflects the current standards for evidence-based graduate-level research writing), or books published since 2021, and have been independently verified before use. These references set the theoretical context for UIT/RUIT and the current empirical evidence, and serve as a foundation for the entire Theorist Paper to explore how uncertainty will be created, appraised, and managed throughout the illness journey, and how nursing interventions based on the theory can enhance patient coping, psychological adjustment, and quality of life.

    To ensure that authorship, journal, volume, page numbers and digital object identifier information are accurate, a direct database or publisher search was used to locate all nine sources. As per the guidelines for the submission there are no annotations, the citations below are only given as a working reference list for the continued development of the full Theorist Paper.

    **References**

    Andrade, C. R. A. G., Costa, L. M. C., Lúcio, I. M. L., Pereira, J. F., Lima, H. N., & Nascimento, R. L. (2024). Uncertainties experienced by nursing professionals who contracted Covid-19: A priori, everyone is human. Revista Brasileira de Enfermagem, 77(3), e20230142. https://doi.org/10.1590/0034-7167-2023-0142

    Bao, Y., Yang, L., Zhao, J., Wang, Z., Fu, L., Fang, M., & Lin, J. (2026). The association between chronic disease resource utilization and illness uncertainty in COPD patients: A latent profile analysis. PeerJ, 14, Article e20674. https://doi.org/10.7717/peerj.20674

    Eppel-Meichlinger, J., Kobleder, A., & Mayer, H. (2024). Refining Mishel's reconceptualized uncertainty in illness theory: Explaining the development of uncertainty in chronic illness. Research and Theory for Nursing Practice, 38(2), 171–192. https://doi.org/10.1891/RTNP-2023-0068

    Farooqui, H. A., Zafar, M. H., Haider, A., Samad, A., Qureshi, S. U. R., Shahid, M. A., Shazib, A., Farooq, A., Naz, N., Saeed, Z. B., & Maaz, M. (2025). Prospective association between illness uncertainty and self-management self-efficacy in patients with early-stage chronic liver disease over a six-month follow-up. Cureus, 17(9), Article e92787. https://doi.org/10.7759/cureus.92787

    Grant, J. B., & Johnson-Koenke, R. (2024). Navigating chronic uncertainty: A theory synthesis for nursing communication in life-limiting illness. BMC Nursing, 23, Article 653. https://doi.org/10.1186/s12912-024-02328-7

    Guan, T., Qan'ir, Y., & Song, L. (2021). Systematic review of illness uncertainty management interventions for cancer patients and their family caregivers. Supportive Care in Cancer, 29(8), 4623–4640. https://doi.org/10.1007/s00520-020-05931-x

    Reinken, D. N., & Reed, S. M. (2023). Mishel's uncertainty in illness theory: Informing nursing diagnoses and care planning. International Journal of Nursing Knowledge, 34(4), 316–324. https://doi.org/10.1111/2047-3095.12406

    Skojec, T. A., Davidson, T. M., & Kelechi, T. J. (2025). The relationship between uncertainty in illness and psychological adjustment to chronic illness. Journal of Health Psychology, 30(4), 622–637. https://doi.org/10.1177/13591053241249861

    Zhang, N., Li, H., Kang, H., Wang, Y., & Zuo, Z. (2023). Relationship between self-disclosure and anticipatory grief in patients with advanced lung cancer: The mediation role of illness uncertainty. Frontiers in Psychology, 14, Article 1266818. https://doi.org/10.3389/fpsyg.2023.1266818

    **## ScholarlyPaperUPLOADHERE.docx**

    Nursing Theory-DBX-DL01 Nora Hernandez-Pupo

    Scholarly Paper UPLOAD HERE Due Saturday @ 2359

    **SCHOLARLY PAPER INSTRUCTIONS**

    **DUE DATE: WEEK 4 Saturday at 2359**

    **Assignment Overview**

    **Due Date:**

    ·
    **Week 4, Saturday at 11:59 PM** Submissions must be received by the deadline. Late assignments will not be accepted.

    **Paper Topic:**

    · Select and analyze a nursing theory of your choice.

    **Paper Length and Formatting Requirements:**

    · Your formal paper should be
    **5-6 pages in length**, not including the title page and reference pages.

    · Use the following formatting settings:

    ·
    **Double-spaced text**

    ·
    **12-point font** (preferably Times New Roman)

    ·
    **1-inch margins** on all sides

    · Follow APA 7th Edition guidelines for:

    · Title (cover) page

    · Headers and pagination

    · In-text citations and reference list

    **Content and Structure**

    Your paper must be organized into the following sections. Each section should be clearly labeled and addressed in your final submission.

    **Introduction**

    ·
    **Purpose:** Begin your paper by introducing the nursing theory you have chosen.

    ·
    **Content Requirements:**

    · Provide a brief background of the theorist—include information about their education, career, and any contributions that are relevant to the development of the theory.

    · Explain why the theorist is significant in the world of nursing.

    ·
    **Tips:** Keep this section concise, yet informative enough for the reader to understand the origin of the theory.

    **Basic Concept Analysis**

    ·
    **Purpose:** Clearly outline the core components of the nursing theory.

    ·
    **Content Requirements:**

    · Identify and briefly explain the major concepts that form the basis of the theory.

    · Discuss how these core concepts work together to define the theory.

    · Use clear definitions and simple examples if appropriate to illustrate each concept.

    ·
    **Tips:** Focus on the essential ideas that make the theory unique and applicable to nursing practice.

    **Relevance**

    ·
    **Purpose:** Demonstrate how the nursing theory is connected to broader healthcare practices and current research.

    ·
    **Content Requirements:**

    · Explain how the theorist’s work connects to the theory, and in turn, how the theory influences healthcare practices.

    · Discuss the application of the theory in today’s clinical settings.

    · Reference current research or clinical practice studies that apply the theory.

    ·
    **Scholarly Sources:**

    · Incorporate at least
    **two peer-reviewed or research articles** that detail how the theory is being utilized in clinical practice or research.

    · Summarize the key findings of each article including the results of the study and the implications they have for future practice.

    ·
    **Tips:** Be analytical and use evidence-based practice (EBP) to support your relevance discussion.

    **Summary**

    ·
    **Purpose:** Your summary should provide a critical reflection on the theory.

    ·
    **Content Requirements:**

    · Summarize the strengths and limitations of the nursing theory.

    · Reflect on how well the theory bridges theoretical frameworks with practical application.

    ·
    **Tips:** Offer a balanced perspective that recognizes both the benefits and potential shortcomings of the theory in advancing nursing practice.

    **Additional Guidelines**

    ·
    **APA Formatting:**

    · Ensure that your cover sheet, headers, pagination, and reference pages adhere to APA 7th Edition standards.

    · All in-text citations must match your reference list.

    ·
    **Assignment Quality:**

    · The writing should be formal, well-organized, and clearly written at a graduate level.

    · Each section should logically flow into the next, maintaining coherence throughout your paper.

    ·
    **Review the Rubric:**

    · Refer to the grading rubric provided (if available) to ensure that you have met all the criteria required for a high-quality submission.

    ·
    **Proofread Your Paper:**

    · Before submission, check for grammatical errors and clarity. Make sure your arguments are well-supported by evidence from your scholarly sources.

    **REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**

    **Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)

    **Final Submission Reminder**

    ·
    **Deadline:** Submit your final paper by
    **Week 4 Saturday at 11:59 PM**.

    ·
    **Submission Process:** Upload your paper in the designated submission portal. Ensure that your attachment is correctly named with your name and assignment title.

    By following these expanded instructions, you are well equipped to produce a comprehensive, well-structured, and evidence-based paper on your selected nursing theory. Taking the time to address each section thoroughly will enhance your chance for success and contribute thoughtfully to your field of study. Happy writing!

    Please refer to the grading rubric in the assignment drop box.

    **Submission**

    Text Editor

    Press Alt + F10 to access toolbar options

    _Word count: 0_

    **Drag files here**

    Maximum size: 512 MB

    **or**

    **Details & Information**

    Rubric Details

    **Maximum Score**

    100 points

    **Exemplary Work**

    The paper presents a thorough and insightful analysis of the chosen nursing theory. All key concepts are clearly articulated, relevant to the theory, and expertly linked to contemporary nursing practices. Evidence from multiple scholarly sources enhances the discussion.

    **40**

    **Proficient Work**

    The analysis of the nursing theory is clear and relevant, addressing the core concepts and making appropriate connections to current nursing practice. Some scholarly sources are incorporated effectively.

    **30**

    **Needs Improvement**

    The discussion of the nursing theory is somewhat unclear or lacks depth. Some key concepts may not be adequately explained. Connections to current practice are weak or underdeveloped.

    **20**

    **Unsatisfactory Work**

    The analysis of the nursing theory is minimal or missing. Key concepts are poorly defined, and there are little to no connections made to current nursing practice.

    **10**

    **Exemplary Work**

    The paper is exceptionally well-organized with clear section headings and a logical flow of ideas. Each section seamlessly transitions to the next.

    **30**

    **Proficient Work**

    The organization of the paper is good, with clear headings. There is some coherent flow between sections, though a few transitions may be abrupt.

    **22.5**

    **Needs Improvement**

    The paper lacks a clear organizational structure. Section headings may be present, but the flow of ideas is unclear or confusing.

    **15**

    **Unsatisfactory Work**

    The paper is poorly organized. There are no clear section headings, and ideas are presented in a haphazard manner.

    **7.5**

    **Exemplary Work**

    The paper includes multiple peer-reviewed articles that are highly relevant and current. Each source is well-integrated into the discussion and supports key arguments effectively. At least 2 sources are used to develop the paper.

    **15**

    **Proficient Work**

    The paper uses at least 2 relevant peer-reviewed sources, though the integration could be improved. Lacks synthesis and support. Most sources are appropriate and contribute to the key arguments.

    **11.25**

    **Needs Improvement**

    Less than 2 sources are used in the paper. The analysis lacks support from scholarly literature, which weakens key arguments.

    **7.5**

    **Unsatisfactory Work**

    The paper uses 1 peer-reviewed sources or relies on non-scholarly sources, lacks scholarly synthesis and connections. Key claims lack credible support.

    **3.75**

    **Exemplary Work**

    All REFERENCES have DOI Numbers for me to look them up.

    **10**

    **Proficient Work**

    All REFERENCES have DOI Numbers for me to look them up- but not all are working.

    **7.5**

    **Needs Improvement**

    Not all REFERENCE have a DOI Number for me to look them up.

    **5**

    **Unsatisfactory Work**

    More than 2 REFERENCES do not have DOI Numbers for me to look them up.

    **2.5**

    **Exemplary Work**

    The paper strictly follows APA 7th Edition guidelines throughout, including formatting, in text citations. The writing is clear, formal, and free of grammatical errors.

    **5**

    **Proficient Work**

    The paper mostly adheres to APA 7th Edition guidelines, with only minor formatting errors. The writing is generally clear with few grammatical issues.

    **3.75**

    **Needs Improvement**

    The paper shows irregularities in APA formatting and numerous grammatical errors that distract from the overall clarity of the writing.

    **2.5**

    **Unsatisfactory Work**

    The paper does not follow APA 7th Edition guidelines. There are significant problems in writing quality, including many grammatical errors that obstruct understanding.

  • [Solved] Wk 9 papr

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    Executive Solution Overview

    **Succinctly, in 1–2 pages, address the following:** – Briefly explain the neurobiological basis for PTSD illness. – Discuss the _DSM-5-TR_ diagnostic criteria for PTSD and relate these criteria to the symptomology presented in the case study. Does the video case presentation provide sufficient info…

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    Assignment Prompt & Instructions

    **Succinctly, in 1–2 pages, address the following:**

    – Briefly explain the neurobiological basis for PTSD illness.
    – Discuss the _DSM-5-TR_ diagnostic criteria for PTSD and relate these criteria to the symptomology presented in the case study. Does the video case presentation provide sufficient information to derive a PTSD diagnosis? Justify your reasoning. Do you agree with the other diagnoses in the case presentation? Why or why not?
    – Discuss one other psychotherapy treatment option for the client in this case study. Explain whether your treatment option is considered a “gold standard treatment” from a clinical practice guideline perspective, and why using gold standard, evidence-based treatments from clinical practice guidelines is important for psychiatric-mental health nurse practitioners.

    Support your Assignment with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.