The paper’s requirements include a specific population focus, detailing social determinants of health, and cultural and ethnic diversity. The paper should d
Ten page paper not including the cover and reference pages that includes the Introduction, Community Needs, Social Determinates of Health, and Role of the FNP sections of their capstone presentation project based on the community needs and Healthy People 2030 objectives for the community.
Original instructions: The paper’s requirements include a specific population focus, detailing social determinants of health, and cultural and ethnic diversity. The paper should detail primary and secondary prevention, disease process (pathophysiology), epidemiology (specific to the US population), diagnostic measures (including pertinent lab tests), diagnosis (including three pertinent differential diagnoses with rational), FNP evaluation and management (including pharmacology), interprofessional collaboration or referral to another specialist, patient education, and the specific role of the nurse practitioner in the management of this patient utilizing the Shuler framework as a foundation. The paper must be in APA format (current 7th edition) with all the references and in-text citations in the correct format. The paper must be at least ten pages long, excluding the abstract and references. See the scholarly paper grading rubric.
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CapstonePreviewPaper.pdf
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SampleSynopsisMigraine.docx
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2MigraineManagementFNPApproach.docx
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Increasing COVID-19 vaccination rates in the Latino community of Tenderloin, San Francisco.
Sample Student Name
Course Name and Course Number
Instructor Name and Title
Sample University Name
Date Submitted
2 Introduction
The Coronavirus Disease 2019 (COVID-19) pandemic has taken an alarming impact on
San Francisco’s Latino which makes up 15% of San Francisco’s city population (United States
Census Bureau, 2020) and accounts for roughly 41% of the city’s COVID-19 infections
(DataSF, 2021). It is estimated that Latino individuals are four times higher for COVID-19
exposure and infection due to a range of disparities, barriers, and social determinants of health
(Clay et al., 2021). The COVID-19 vaccine is intended to provide immunity against the effects
of a respiratory infection (Graham, 2020). The Latino population in the city of San Francisco
has shown to be at a higher risk for COVID infection. Implementing an educational and
delivery plan about the COVID vaccine for the Tenderloin Latino community will decrease
vaccination hesitancy and promote knowledge about vaccine benefits and help meet Healthy
People 2023 objective IID-DO3: Increase the proportion of adults age 19 years or older who
get recommended vaccines.
Vaccinating communities with the highest prevalence of COVID-19 is an effective
measure to decrease the propagation of this disease (San Francisco Department of Public Health
& COVID Command Center, 2021). Since COVID-19 prevalence across Latino communities
within the city is 1.3x higher than non-Hispanic communities, concentrating vaccination efforts
in these communities will significantly bend the disease curve, while also saving lives (San
Francisco Department of Public Health & COVID Command Center, 2021).
The Latino communities of San Francisco’s Mission District are the most impacted by
COVID when comparing cases and deaths of COVID-19 in the city. The Latino population data
reported 41.4% infection rates with COVID compared to 18% in the Asian community and,
21.5% in the white community (DataSF, 2021).
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According to Salgado de Snyder et al., (2020), the reason Latinos decline vaccination are
(1) insufficient information, (2) lack of trust, and (3) a lack of interest or motivation. Salgado de
Snyder (2020) suggests that adult Latino men will not get the COVID vaccine due to limited
information, cost, and not knowing where to get the vaccine. The limited information provided
during the study was not sufficient, although they understood the need for vaccinations, there
was not a proper educational plan to inform them about the COVID-19 vaccine. Not being
properly informed can create healthcare difficulties. According to Salgado de Snyder (2020),
these barriers include language barriers and a lack of trust in the healthcare system.
Understanding the necessity for vaccination is important. Without the proper
understanding, the patients will have fears about the safety of the vaccine (Fisher et al., 2020).
One of the gaps identified was the need to increase vaccination campaigns to provide
supplemental immunization educational activities to the communities to increase vaccination
rates and provide the necessary services (Fisher et al., 2020; Guzman-Holst et al., 2020;
Olorunsaiye et al., 2020).
Social Determinants of Health
VERY IMPORTANT NOTE REGARDING THE SOCIAL DETERMINANTS OF HEALTH SECTION OF YOUR CAPSTONE DEVELOPMENT PAPER !!
1. Summarize what is meant by the term “ Social determinants of Health(SDOH)”.
2. Discuss how each of the SDOHs ( health , political social, and economic) affect /impact
the health outcomes of the patients in your capstone project community including your
interventions
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Interventions
VERY IMPORTANT NOTE REGARDING YOUR INVERVENTION SECTION !!
YOUR SECTION MUST BE MORE DETAILED AND SPECIFIC FOR YOUR COMMUNITY AND INTERVENTIONS
The focus of this capstone project is to help promote awareness about the benefits of the
COVID- vaccine in the Latino population of the Tenderloin community of San Francisco,
California.by developing a COVID-19 vaccine educational community outreach educational
program that will offer the Covid -19 vaccine as well as other support services such as seminars on
the importance of having a primary care provider . Partnerships will be developed with school, faith-
based, childcare, business communities, and trusted community-based organizations .
Review of Literature
A comprehensive database search was conducted to evaluate how an educational plan
provides a positive impact on the vaccination rates in Latino communities. The following
databases were used in the search: the Cumulative Index to Nursing and Allied Health Literature
(CINAHL), Cochrane, ScienceDirect, and PubMed. The search was limited to literature in
English or Spanish, research articles, and practice guidelines. Other inclusion criteria were
articles involving adults and adolescents (12 and above), journals, and peer review articles. The
search terms “vaccination,” COVID-19 vaccine,” “hesitance” and “acceptance.” The articles
selected examined the benefits of implementing an educational plan, particularly in Latino
communities. The themes identified were as follows: (a) efficiency of an educational plan in the
Latino community, (b) vaccination hesitancy, and (c) infection reduction. The articles were
leveled between I to V with a rating of “B” or “C.” The John Hopkins Nursing Evidence-Based
Practice Appraisal Tools were used to level and rate these articles (Dang and Dearholt, 2018, p.
237).
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The following articles reviewed are fundamental to the establishment of this
improvement project and highlight the potential benefits related to the educational plan
effectiveness and education management for Latinx patients. Salgado de Snyder et al., (2020)
described reasons for not getting vaccinated among adult Latino males. The study’s findings
implied that the limited knowledge about the benefits of vaccines was a great predictor of not
getting vaccinated, despite knowing that vaccines are important.
In Guzman-Holst’s (2019) systematic review the most frequent barriers to vaccinations
were group influences, followed by socioeconomic factors, low levels of education, lack of
awareness and religious and cultural beliefs.
Similarly, Salgado de Snyder (2020) showed the lack of knowledge about a disease and
its vaccines are major barriers to vaccination in the Latino population. This determines a gap in
understanding as well as a lack of education for the prevention of COVID-19 disease.
A cross-sectional survey completed by Fisher et al., (2020) demonstrated that the main
factors for vaccine hesitancy included low levels of education attainment, vaccine concerns, and
not enough information about the COVID-19 vaccine as well as lack of trust in the healthcare
system. Living in rural areas also had a strong correlation with not getting vaccinated. A
systematic review completed by Olorunsaiye et al., (2020) also found that starting a vaccination
campaign and additional immunization activities can help increase the vaccination rate in low
and middle-income communities.
According to Fisher et al., (2020) and Olorunsaiye et el., (2020), the best approach for
preventing vaccine hesitancy and achieving herd immunity is to implement an educational
approach that addresses the COVID-19 vaccine in a way that people from all educational levels
can understand. Implementing an educational plan consists of expanding the most up-to-date
information to patients to address any vaccination concerns and expand immunization services.
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Rivera (2013) describes that cultural competence, trust, and acceptance are fundamental
concepts for the development of intervention of change, particularly in the Latino population. In
addition to trust and acceptance. A culturally appropriate educational approach has become
important, especially by distributing information, connecting community members with
appropriate resources, messaging, and providing emotional support to help community members
implement positive health practices. (Caceres et al., 2021; Rivera, 2013; Messias et al., 2021).
Role of the FNP
VERY IMPORTANT NOTE REGARDING YOUR ROLE OF THE FNP SECTION OF YOUR CAPSTONE DEVELOPMENT PAPER!
IN THIS SECTION , DISCUSS HOW YOU WILL UTILIZE EACH OF THE FOLLOWING ROLES
OF THE FNP TO DEVELOP AND IMPLEMENT YOUR CAPSTONE PROJECT:
1. PROVIDER
2. EDUCATOR
3. RESEARCHER
4. ADVOCATE Conclusion
VERY IMPORTANT NOTE REGARDING THE CONCLUSION OF YOUR CAPSTONE
DEVELOPMENT PAPER !
The conclusion of your paper conclusion must end with the following statement or similar statement:
Continued development and refinement of this capstone project will be completed
in Nurs 8949/8950 including the development of the PICOT statement and culminate in a
final capstone project paper and posterboard that will be presented at the on-campus
FNP capstone project presentation session in the Fall 2024.
The Latino population is at higher risk for COVID-19 exposure. This exposure reveals
the need for understanding vaccination efforts. Immunization helps stops the spread of COVID-
19 infections. The focus is to immunize and educate the Latino population about the benefits of
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the COVID vaccine. In doing so, the occurrence of COVID-19 infections will decrease. With the
integration of an educational plan in the Latino community, addressing vaccine hesitancy has the
potential to increase vaccination rates, and herd immunity and promote protection against the
COVID-19 disease. Vaccine hesitancy is a complex issue, and no single strategy will be able to
address it. This project can help inform future approaches when designing campaigns to increase
trust and confidence and ultimately improved vaccination rates for communities with health
disparities. Continued development and refinement of this capstone project will be
completed in Nurs 8949/8950 including the development of the PICOT statement and
culminate in a final capstone project paper and posterboard that will be presented at the
on-campus FNP capstone project presentation session in the Fall 2024.
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References
Alligood, M. R. (2014). Nursing Theorists and Their Work. 8th ed. St. Louis, Mo.: Mosby
Clay S.L., Woodson, M., Mazurek, K., & Antonia, B (2021). Racial disparities and
COVID-19: Exploring the relationship between race/ethnicity, personal factors, health
access/affordability, and conditions associated with increased severity of COVID
19. Race Social Problems, 1-13. https://doi.org/10.1007/s12552-021-09320-9 Carrico, G. (2022). Increasing vaccination rates in the Latinx communities through a public health initiative for increasing education and vaccination. University of San Francisco.*
Dang, D., & Dearholt, S. L. (2018). John Hopkins Nursing evidence-based practice: Model and
guidelines (3rd ed.). Sigma Theta Tau International.
Data SF (2021, March 19). Covid-19 data and report.
https://data.sfgov.org/stories/s/9cs7-wy53
Centers for Disease Control and Prevention (2021, May 14). Provisional death counts for
coronavirus disease 2019.
https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm
Fiedler M., Song, Z.(2020). Estimating potential spending on COVID-19 care. Brookings.
https://www.brookings.edu/research/estimating-potential-spending-on-covid-19-care/
Fisher, K. A., Bloomstone, S., Walder, BA., & Crawford, S. (2020). Attitudes toward a
potential SARS-CoV-2 vaccine: A survey of U.S. adults. Annals of internal
medicine, 173(12), 964–973. https://doi.org/10.7326/M20-3569
Glanz, K., Rimer, B. K., & Viswanath, K. (2015). Health behavior: Theory, research, and
practice (5th ed., pp. 149-150). Wiley.
Graham B. (2020). Rapid COVID-19 vaccine development. Science, 368(6494), 945–946.
https://doi.org/10.1126/science.abb8923
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Guzman-Holst, A., DeAntonio, R., Prado-Cohrs, D., & Juliao, P. (2020). Barriers to
vaccination in Latin America: A systematic literature review. Vaccine, 38(3), 470–
481. https://doi.org/10.1016/j.vaccine.2019.10.088
King, C. R., Gerard, S. O., & Rapp, C. G. (2019). Essential knowledge for CNL and APRN
nurse leaders. Springer Publishing Company.
Linke, S. E., Robinson, C. J., & Pekmezi, D. (2014). Applying psychological theories to promote
healthy lifestyles. American Journal of Lifestyle Medicine, 8(1), 4-14.
https://doi.org/10.1177/1559827613487496
Melnick, G., Maerki, S. (2020, June 3). The Financial impact of COVID-19 on California
hospitals. California Health Care Foundation.
https://www.chcf.org/publication/financial-impact-covid-19-california-hospitals/
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing &
healthcare: A guide to best practice. Lippincott Williams & Wilkins.
Olorunsaiye, C. Z., Yusuf, K. K., Reinhart, K., & Salihu, H. M. (2020). COVID-19 and Child
vaccination: A systematic approach to closing the immunization gap. International
journal of Maternal Child Health and AIDS, 9(3), 381–385.
https://doi.org/10.21106/ijma.401
San Francisco Department of Public Health & COVID Command Center (2021). San
Francisco COVID-19 Vaccination Plan. Retrieve from
https://sf.gov/outreach-toolkit-coronavirus-covid-19
Salgado de Snyder, V. N. S. de, Garcia, D., Pineda, R., Calderon, J., Diaz, D., Morales, A., &
Perez, B. (2020). Exploring why adult Mexican males do not get vaccinated: Implications
for COVID-19 preventive actions. Hispanic Journal of Behavioral Sciences, 42(4), 515–
527. https://doi.org/10.1177/0739986320956913
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San Francisco Department of Public Health & COVID Command Center (2021). San
Francisco COVID-19 Vaccination Plan. Retrieve from https://sf.gov/outreach-toolkit-
coronavirus-covid-19
United States Census Bureau (2020, April 1). San Francisco city California.
https://www.census.gov/quickfacts/fact/table/sanfranciscocitycalifornia,sanfranciscocoun
tycalifornia/POP010210#POP010210 U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion
Healthy People 2030 Increase the proportion of adults age 19 years or older who get
recommended vaccines.
https://health.gov/healthypeople/objectives-and-data/browse-objectives/vaccination/increase-
proportion-adults-age-19-years-or-older-who-get-recommended-vaccines-iid-d03
*sample paper adapted from this source
,
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Synopsis of Migraine Management FNP Approach Paper
The Introduction
Migraine is a complex condition that affects the central nervous system, and among Black women in the United States, the condition disproportionately affects women between 18 and 50 years. Biological, cultural, and social determinants of health in a place like Plainfield, Illinois, worsen the health disparities because migraines go unnoticed and untreated. Systemic inequalities like racism, health care distrust, lack of access to specialists, and the lack of cultural competence among medical workers also aggravate such inequalities. FNP is the only profession to annul these gaps because the profession promotes patient-centric diligence that encompasses evidence-based procedures and culturally competent interventions. In this paper, pathophysiology, epidemiology, diagnosis, prevention, pharmacological treatment, patient education, and interprofessional collaboration are discussed as the mechanisms required to facilitate equal migraine care. It will emphasize the importance of FNPs in addressing the healthcare outcomes in Black women with migraine conditions and the importance of incorporating culturally sensitive treatment methods in order to limit health disparities.
The PICO Statement
The following PICO statement outlines the focus of the paper:
· Population (P): Black women between the ages of 18 and 50 years living in the locality of Plainfield, Illinois, with a disadvantaged and underserved population with contributive factors of systemic disparities and social determinants of health, who are experiencing migraines.
· Intervention (I): A holistic and culturally competent process of migraine management robust through Family Nurse Practitioners (FNPs), including the biology, psychology, social, and spiritual domains using prevention, pharmacologic treatments, educational training, and interprofessional collaboration practices based on the Shuler Nurse Practitioner Practice Model.
· Comparison (C): The typical care of migraine without the inclusion of patient-centeredness and cultural competence, as well as integration of the Shuler Model.
· Outcome (O): Improved migraine control, healthcare disparity, better quality of life, and more adherence to treatment among the people
Literature Review
Evidence has underscored sizeable disparities between the diagnosis and treatment of migraine among Black women, which is catalyzed primarily by institutionalized racism, implicit bias, and socioeconomic disparities. Such reasons lead to low diagnosis and inadequate treatment, and cultural stigma, health system mistrust, and lack of access to exceptional care are the specific challenges of Black women (Burch et al., 2021; Kiarashi et al., 2021; VanderPluym et al., 2022). Such health disparities might be decreased through structural modification, (Kiarashi et al. 2021), and cultural competence and medical professional education that improve access to care and its quality (VanderPluym et al., 2022).
Migraine can be discussed in terms of the pathophysiology of the disease, which relates it to the aspects of cortical spreading depression, trigeminovascular activation, and the liberation of such neuropeptides as CGRP, substance P, and neurokinin A that all are factors that add to the experiencing of the pain and neurological effects of migraine (Ailani et al., 2021; Khan et al., 2021; Puledda et al., 2023). Migraines can also be triggered by genetic predispositions combined with stress factors, hormonal changes, days with sleep disturbance, etc., and those with familial hemiplegic migraines have some ion channel mutations that reduce the threshold at which migraines occur (Khan et al., 2021).
Epidemiologically, the number of people with migraine is estimated to be 39 million in America, with more women than men prone to migraine. This situation is even worse among Black women, where the number of those with chronic migraines has been more evident, as well as a high divide in the treatment among African Americans and their white counterparts (Dong et al., 2025; Burch et al., 2021). Cultural stigma and a low level of services provided with cultural competence contribute to the insufficient diagnosis of the underlying migraines in the group, which is why building an early screening and placing culturally competent care in the discussion of interactions with patients is critical to said problem (Kiarashi et al., 2021).
The medications used in efficient treatment are triptans and CGRP medications, with non-pharmacologic ones like lifestyle changes, stress management, and food changes (Ailani et al., 2021; Callen et al., 2024). FNPs also play a critical role in the promotion of pharmacological interventions and non-pharmacological interventions, and addressing these disparities through the use of patient education and interprofessional collaboration (Cook et al., 2025).
Conclusion
To summarize, there are severe gaps in the healthcare delivery of migraines among Black women because of structural and cultural influences of the problem. The information indicates that it is necessary to introduce culturally competent and patient-centered care in order to achieve better results. The Shuler Nurse Practitioner Model provides a well-developed model in dealing with the mentioned challenges based on the needs of patients, which can be split into biological, psychological, social, and spiritual. As challenging health disparities or issues demand, FNPs are in the best position to initiate successful attempts to improve the way of handling migraines by diagnosing them at an early stage, through evidence-based interventions, and through interprofessional relationships. The quality of care provided to Black women with migraines would improve by ensuring future research and training of providers on cultural competence in order to reduce such health disparities.
References
Ailani, J., Burch, R. C., Robbins, M. S., & Board of Directors of the American Headache Society. (2021). The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache: The Journal of Head and Face Pain, 61(7), 1021–1039. https://doi.org/10.1111/head.14153
Burch, R., Rizzoli, P., & Loder, E. (2021). The prevalence and impact of migraine and severe headache in the United States: updated age, sex, and socioeconomic‐specific estimates from government health surveys. Headache: The Journal of Head and Face Pain, 61(1), 60-68. https://doi.org/10.1111/head.14024
Callen, E., Clay, T., Alai, J., Crawford, P., Visconti, A., Nederveld, A., … & Jabbarpour, Y. (2024). Migraine care practices in primary care: results from a national US survey. Family Practice, 41(3), 277–282. https://medicine.uky.edu/sites/default/files/2024-05/Migraine%20Care%20Practices%20in%20Primary%20Care.pdf
Cook, C., Leppke, A., & Abiri, A. (2025, April). Utilizing Competency-Based Curriculum to Enhance Family Nurse Practitioner Students’ Knowledge and Skills in the Diagnosis and Treatment of Migraine (P5-5.020). In Neurology (Vol. 104, No. 7_Supplement_1, p. 3081). Hagerstown, MD: Lippincott Williams & Wilkins. https://doi.org/10.1212/WNL.0000000000210781
Dong, L., Dong, W., Jin, Y., Jiang, Y., Li, Z., & Yu, D. (2025). The global burden of migraine: A 30-Year trend review and future projections by age, sex, country, and region. Pain and Therapy, 14(1), 297-315. https://doi.org/10.1007/s40122-024-00690-7
Khan, J., Al Asoom, L. I., Al Sunni, A., Rafique, N., Latif, R., Al Saif, S., … & Borgio, J. F. (2021). Genetics, pathophysiology, diagnosis, treatment, management, and prevention of migraine. Biomedicine & pharmacotherapy, 139, 111557. https://doi.org/10.1016/j.biopha.2021.111557
Kiarashi, J., VanderPluym, J., Szperka, C. L., Turner, S., Minen, M. T., Broner, S., … & Charleston IV, L. (2021). Factors associated with, and mitigation strategies for, health care disparities faced by patients with headache disorders. Neur
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