Phillip March 25, 2024 No Comments

PA006 Global Healthcare Issues

PA006 Global Healthcare Issues Name  University NURS 6050 Policy and Advocacy for Improving Population Health Prof. Name Date Global Healthcare Issue – Obesity Description The epidemic of obesity has escalated into a national health crisis with far-reaching global implications. According to the World Health Organization (WHO, 2021), as of 2016, approximately 1.9 billion individuals worldwide were overweight. Obesity, characterized by an excessive accumulation of fat, imposes a significant burden not only on individuals but also on healthcare systems, thus impacting global economic productivity. This burden is particularly pronounced in low- and middle-income countries, underscoring the imperative for comprehensive global solutions (Caballero, 2019). Country United States Policy Description In the United States, efforts to combat childhood obesity are channeled through targeted policies such as the “Let’s Move!” initiative, launched by Michelle Obama in 2010. This initiative advocates for healthier lifestyles with an emphasis on increased physical activity and improved nutrition (Bradwisch et al., 2020). Additionally, the “Healthy, Hunger-Free Kids Act of 2010” establishes nutritional standards for school meals administered by the USDA. The CDC’s “Childhood Obesity Research Demonstration (CORD)” project provides funding for community-based interventions (Bradwisch et al., 2020). Strengths and Weaknesses The strengths of US policies lie in their holistic approach to addressing childhood obesity, establishment of nutritional standards for school meals, and provision of funding for community-based interventions. However, weaknesses such as their voluntary nature and implementation challenges exist. Country Canada Policy Description Canada adopts a comprehensive approach spanning the lifespan to address obesity. Policies such as the “Sugary Drink Tax,” “Fast Food Restaurant Act,” and “Marketing of Unhealthy Foods to Children Act” aim to deter unhealthy consumption while promoting healthier alternatives (Kao et al., 2020). Strengths and Weaknesses Canadian policies leverage economic incentives to discourage unhealthy consumption and regulate the density and location of fast-food establishments. Nevertheless, weaknesses such as regressive taxation and difficulties in defining and monitoring effectiveness persist. Impact of Social Determinants of Health Social determinants of health significantly contribute to obesity rates in both countries. Factors such as educational attainment and income inequality increase the risk of obesity, underscoring the need for targeted interventions (Golden, 2021; CDC, 2023). Impact on Local Health Organizations and Policies Global health issues like obesity influence resource allocation and service delivery in local health organizations. While the US prioritizes primary prevention and grapples with resource constraints, Canada adopts a holistic approach emphasizing prevention and accessibility (Feng & Martin, 2020; Lytvyak et al., 2022). Impact on Global Population Policies addressing obesity in Canada have the potential to positively impact the global population. Successful strategies can serve as models for other nations, and sharing knowledge can contribute to global advancements in understanding and combating obesity (Ríos-Reyna et al., 2022). Impact on the Role of Nurses as Advocates Health policies directly shape the role of nurses as advocates. While US policies empower nurses to promote healthy behaviors, Canadian policies allow for advocacy for systemic interventions and public health initiatives (Chang et al., 2021). Conclusion Addressing obesity necessitates comprehensive strategies that account for social determinants of health and the unique contexts of each country. Collaborative efforts, knowledge sharing, and ongoing evaluation are vital for effectively addressing this global health issue. References Berry, E. M. (2020). The Obesity Pandemic-Whose Responsibility? No Blame, No Shame, Not More of the Same. Frontiers in nutrition, 7, 2. https://doi.org/10.3389/fnut.2020.00002 Bradwisch, S. A., Smith, E. M., Mooney, C., & Scaccia, D. (2020). Obesity in children and adolescents: An overview. Nursing, 50(11), 60–66. https://doi.org/10.1097/01.NURSE.0000718908.20119.01 Caballero, B. (2019). Humans against Obesity: Who Will Win? Advances in nutrition (Bethesda, Md.), 10(suppl_1), S4–S9. https://doi.org/10.1093/advances/nmy055 Centers for Disease Control and Prevention. (2019). Policy Resources. https://www.cdc.gov/nccdphp/dnpao/divisioninformation/policy/index.htm Chang, W. P., Wang, C. H., & Lin, Y. K. (2021). Influence of Obesity on Heart Rate Variability in Nurses with Age and Shift Type as Moderators. BioMed research international, 2021, 8119929. https://doi.org/10.1155/2021/8119929 Di Cesare, M., Sorić, M., Bovet, P., Miranda, J. J., Bhutta, Z., Stevens, G. A., Laxmaiah, A., Kengne, A. P., & Bentham, J. (2019). The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action. BMC medicine, 17(1), 212. https://doi.org/10.1186/s12916-019-1449-8 Feng, W., & Martin, E. G. (2020). Fighting obesity at the local level? An analysis of predictors of local health departments’ policy involvement. Preventive medicine, 133, 106006. Advance online publication. https://doi.org/10.1016/j.ypmed.2020.106006 NURS 6050 Assessment 6 PA006 Global Healthcare Issues Golden, A. (2021). Obesity’s Impact. The Nursing clinics of North America, 56(4), xiii–xiv. https://doi.org/10.1016/j.cnur.2021.08.004 Javed, Z., Valero-Elizondo, J., Maqsood, M. H., Mahajan, S., Taha, M. B., Patel, K. V., Sharma, G., Hagan, K., Blaha, M. J., Blankstein, R., Mossialos, E., Virani, S. S., CainzosAchirica, M., & Nasir, K. (2022). Social determinants of health and obesity: Findings from a national study of US adults. Obesity (Silver Spring, Md.), 30(2), 491–502. https://doi.org/10.1002/oby.23336 Kao, K. E., Jones, A. C., Ohinmaa, A., & Paulden, M. (2020). The health and financial impacts of a sugary drink tax across different income groups in Canada. Economics & Human Biology, 38, 100869. https://www.sciencedirect.com/science/article/pii/S1570677X19302746 Lytvyak, E., Straube, S., Modi, R., & Lee, K. K. (2022). Trends in obesity across Canada from 2005 to 2018: a consecutive cross-sectional population-based study. CMAJ open, 10(2), E439–E449. https://doi.org/10.9778/cmajo.20210205 Ríos-Reyna, C., Díaz-Ramírez, G., Castillo-Ruíz, O., Pardo-Buitimea, N. Y., & Alemán-Castillo, S. E. (2022). Políticas y estrategias para combatir la obesidad en Latinoamérica [Policies and strategies to combat obesity in Latin America]. Revista medica del Instituto Mexicano del Seguro Social, 60(6), 666–674. Safaei, M., Sundararajan, E. A., Driss, M., Boulila, W., & Shapi’i, A. (2021). A systematic literature review on obesity: Understanding the causes & consequences of obesity and reviewing various machine learning approaches used to predict obesity. Computers in biology and medicine, 136, 104754. https://doi.org/10.1016/j.compbiomed.2021.104754 NURS 6050 Assessment 6 PA006 Global Healthcare Issues

Phillip March 25, 2024 No Comments

PA005 Healthcare Program/Policy Evaluation

PA005 Healthcare Program/Policy Evaluation Name  University NURS 6050 Policy and Advocacy for Improving Population Health Prof. Name Date Healthcare Program/Policy Evaluation Falls and Incident/Accident Reporting at Crestpark Nursing Home, LLC, Spring of 2021 Description Falls and incidents are inevitable within nursing homes, necessitating vigilant protection of residents by healthcare professionals. This evaluation scrutinizes the efficacy of fall prevention and incident/accident reporting policies at Crestpark Nursing Home, LLC, with a focus on minimizing incidents and injuries associated with falls. Healthcare Program/Policy Outcomes The core objectives of our fall prevention and incident/accident policies are clear: to avert falls and consequent injuries. Despite the prevalence of falls in long-term care facilities due to age-related factors, our approach entails comprehensive assessment of each fall incident, identifying root causes, and formulating preventive strategies collaboratively. Success of the Healthcare Program/Policy Success metrics are gauged through scheduled Quality Improvement (QI) meetings engaging diverse healthcare professionals within our institution. By analyzing individual cases and overall trends alongside inputs from stakeholders, we pinpoint policy shortcomings. Success manifests as a significant decline or minimal rates of falls. Number of People Reached Approximately 300 individuals, including residents, staff, and families, were involved in the evaluation process. Policy adjustments are designed to elevate the quality of resident care while accommodating family perspectives. Timing of the Evaluation Quarterly evaluations/QI meetings are routine at Crestpark Nursing Home, LLC, supplemented by ad hoc assessments. The March 2021 evaluation marked the first meeting in nearly 7 months due to disruptions from the COVID-19 pandemic. NURS 6050 Assessment 5 PA005 Healthcare Program/Policy Evaluation Data Sources Incident/accident reports, resident charts, hospital records, and imaging reports served as primary data sources, ensuring a holistic understanding of each fall incident. Potential Benefits and Unintended Consequences Immediate notification of falls to designated personnel emerged as a beneficial outcome, aiding novice nurses and facilitating prompt resident assessment. Nonetheless, unintended consequences, such as feelings of inadequacy among experienced nurses, were mitigated through team deliberations. Stakeholders Involved Stakeholders encompass residents, families, nursing staff, administration, and the social worker. Resident safety and well-being remain the central focus of evaluation outcomes. Evaluation of Success The evaluation demonstrates success, evidenced by a decline in fall occurrences and enhanced resident mobility and independence. Ongoing policy assessments and adjustments are slated to bolster safety protocols. Recommendation for Continuation Continuation of the existing policy is advocated, given its favorable impact on resident safety and fall incident reduction. Policy refinements will be informed by continuous evaluations and stakeholder feedback. Involvement in Future Evaluations Future involvement in evaluations may entail soliciting feedback from residents’ families and spending more time on the floor to gain firsthand insights into policy implementation challenges and successes. NURS 6050 Assessment 5 PA005 Healthcare Program/Policy Evaluation

Phillip March 25, 2024 No Comments

PA004 Design and Implementation

PA004 Design and Implementation Name  University NURS 6050 Policy and Advocacy for Improving Population Health Prof. Name Date Healthcare Program Summary Hospital-acquired infection prevention measures are designed to reduce or eradicate healthcare-associated infections (HAIs), which are infections acquired by patients while receiving treatment for other conditions (Haque et al., 2020). These infections are often not limited to hospitals, but they can also occur in surgical centers, long-term care units, or any other healthcare setting. HAIs should be given appropriate priority because they lead to increased morbidity, mortality, and healthcare expenses. In the US, more than 500 thousand patients are affected by these bacterial infections annually. The key targeted infections include central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), surgical site infections (SSI), ventilator-associated pneumonia (VAP), Clostridioides difficile (C. difficile), tuberculosis (TB), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE). The direct expenditure on this prevention program amounts to approximately $1,500 annually, encompassing staffing an infection prevention nurse for designing and implementing standard protocols, conducting screening, and providing education for staff and personnel. NURS 6050 Assessment 4 PA004 Design and Implementation Other costs include training staff, providing appropriate personal protective equipment, cleaning supplies, and educating patients. The goals of these programs include decreasing infection rates, educating both patients and staff, and helping to reduce healthcare expenditures. One intended objective is to improve patient security and effectiveness by inhibiting antibiotic resistance and ensuring that patients do not develop other complications. Target Population The primary target population will be the patients at these healthcare centers. More specifically, subgroups of patients include surgical patients, those with urinary catheters or central lines, patients on antibiotics, and immunocompromised individuals. While these groups are at higher risk of acquiring healthcare-associated infections, other patients may also be affected. Nurse’s Role in Program Design Nurses play a crucial role in designing and implementing hospital-associated infection control programs (Flaubert et al., 2021). As the first point of contact for patients, nurses can gather valuable data and report infections, contributing to vital information for healthcare providers regarding infection prevalence and outbreak patterns. Nurses also play a pivotal role in patient education, ensuring that information is appropriate and easily understandable for patients and staff. Nurse Advocacy for Target Population Nurses serve as advocates for patients by conducting antimicrobial surveillance, assessing medication regimens, and ensuring proper antibiotic use. They oversee the implementation of infection control protocols, including the correct use of personal protective equipment (PPE), which is essential for both healthcare workers and patients (Lee et al., 2021). Advocate’s Influence on Program Design By advocating for patients, nurses can steer infection prevention programs towards addressing key issues observed in clinical practice. Through education and evidence-based practice, nurses can educate patients and healthcare workers on antimicrobial stewardship and other preventive measures. Recommended Evaluation Tools The “Infection Control Assessment and Response (ICAR) tool,” developed by the Centers for Disease Control and Prevention (CDC, 2019), is a critical instrument for guiding program development. This tool evaluates a facility’s infection prevention control measures comprehensively, focusing on quality improvement activities across various components, including training, hand hygiene, and antibiotic stewardship. Healthcare Team Members Needed Infection control professionals, often nurses, lead infection prevention programs and oversee their implementation. Other essential team members include physicians, pharmacists, environmental services staff, administration, and occupational health staff. Nurse’s Role in Program Implementation During program implementation, nurses fulfill various roles, including following guidelines, providing patient care, educating patients and communities, monitoring program progress, and collecting data to inform program planning. Nurse’s Role: Design vs. Implementation The nurse’s role is multifaceted during both program design and implementation. During design, nurses focus on planning, analysis, and resource allocation, drawing from their fieldwork experiences. During implementation, nurses adhere to program protocols, provide patient education, and suggest revisions to ensure program objectives are met. References CDC. (n.d.). NURSING HOME COVID-19 INFECTION CONTROL ASSESSMENT AND RESPONSE (ICAR) TOOL FACILITATOR GUIDE. Retrieved February 21, 2024, from https://www.cdc.gov/infectioncontrol/pdf/icar/nursing-home-icar-facilitator-guide.pdf CDC. (2019). Infection Control Assessment Tools. Centers for Disease Control and Prevention. https://www.cdc.gov/hai/prevent/infection-control-assessment-tools.html Flaubert, J. L., Menestrel, S. L., Williams, D. R., & Wakefield, M. K. (2021). The Role of Nurses in Improving Health Care Access and Quality. In www.ncbi.nlm.nih.gov. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK573910/ Haque, M., McKimm, J., Sartelli, M., Dhingra, S., Labricciosa, F. M., Islam, S., Jahan, D., Nusrat, T., Chowdhury, T. S., Coccolini, F., Iskandar, K., Catena, F., & Charan, J. (2020). Strategies to Prevent Healthcare-Associated Infections: A Narrative Overview. Risk Management and Healthcare Policy, 13(1), 1765–1780. https://doi.org/10.2147/RMHP.S269315 Lee, Y., Salahuddin, M., Gibson‐Young, L., & Oliver, G. D. (2021). Assessing personal protective equipment needs for healthcare workers. Health Science Reports, 4(3). https://doi.org/10.1002/hsr2.370 NURS 6050 Assessment 4 PA004 Design and Implementation

Phillip March 25, 2024 No Comments

PA003 Regulation

PA003 Regulation Name  University NURS 6050 Policy and Advocacy for Improving Population Health Prof. Name Date Differences Between a Board of Nursing and Professional Nurse Associations A Board of Nursing (BON) functions as an executive-branch state government agency vested with the authority to enforce extant laws and regulations governing nursing practice, aimed at safeguarding public welfare (Short & Loversidge, 2019; National Council State Board of Nursing, Inc., 2022). The primary objective of a Board of Nursing is to ensure public health and safety by ensuring that all nurses are duly licensed and capable of delivering safe and competent nursing care (Nursing regulation, 2022). Professional Nurse Associations vs. Board of Nursing Distinguished from Boards of Nursing, professional nursing associations are private organizations that require membership dues for access to benefits. For instance, the American Nurses Association operates as a professional nursing association advocating for nurses in the profession (American Nurses Association, 2021). The composition of a Board of Nursing, such as the Florida Board of Nursing (FBON), typically includes appointees by the Governor, with diverse representation, including registered nurses, licensed practical nurses, laypersons, and individuals over 60 years old (Toney-Butler & Martin, 2021). Medical Necessity: A Federal Regulation of Healthcare Medical necessity, as defined by Medicare, encompasses services or items deemed reasonable and necessary for the diagnosis or treatment of illnesses or injuries, or for improving the function of malformed body parts (CMS, 2021; Verhovshek, 2019). Compliance with medical necessity regulations can significantly impact healthcare delivery, potentially causing delays in treatment due to stringent diagnosis requirements and insurer pre-approval processes. Regulation of Registered Nurses and Advanced Practice Nurse Practitioners in Florida Registered Nurses (RNs) and Advanced Practice Nurse Practitioners (APRNs) in Florida are subject to the Nurses Practice Act, which governs nursing practice in the state (Florida Board of Nursing, 2022). RNs must graduate from a Florida-approved nursing school and pass the National Council Licensure Examination to obtain licensure, with renewal requiring completion of continuing education credits every two years (Florida Board of Nursing, 2022). APRNs, in addition to RN licensure, must obtain a Master’s of Nursing degree from an accredited Florida nursing school, pass a specialized certification exam, and accrue 3000 supervised hours before practicing independently (Florida Board of Nursing, 2022). Impact of Advanced Practice Nurse Practitioners on Healthcare Delivery, Costs, and Access In Florida, the increased involvement of APRNs, both independently and in collaboration with physicians, has facilitated enhanced healthcare access and reduced costs, particularly pertinent amid a growing elderly population (Cleveland et al., 2019). Utilizing APRNs more efficiently than physicians has the potential to generate significant cost savings for the state healthcare system, alleviating the strain posed by physician shortages and enhancing patient care efficiency. References American Nurses Association. (2021). American Nurses Association. ANA. Retrieved January 8, 2022, from https://www.nursingworld.org/ana/ Cleveland, K., Motter, T., & Smith, Y. (2019). Affordable care: Harnessing the power of Nurses. OJIN: The Online Journal of Issues in Nursing, 24(2). https://doi.org/10.3912/ojin.vol24no02man02 CMS. (2021). Home – Centers for Medicare & Medicaid Services. CMS. Retrieved January 8, 2022, from https://www.cms.gov/ Florida Board of Nursing. (2022). Licensing and registration. Florida Board of Nursing. Retrieved January 8, 2022, from https://floridasnursing.gov/licensing/ National Council State Board of Nursing, Inc. (2022). Nursing regulation. NCSBN. Retrieved January 8, 2022, from https://ncsbn.org/boards.htm Short, N. M., & Loversidge, J. M. (2019). Chapter 4 Government Response: Regulation. In Health policy and politics: A nurse’s guide (6th ed., pp. 56– 84). Jones & Bartlett Learning. NURS 6050 Assessment 3 PA003 Regulation Toney-Butler, T. J., & Martin, R. L. (2021). Florida Nurse Practice Act Laws and Rules. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532859/ Verhovshek, J. V. J. (2019, April 5). Medical necessity: Why it matters, ways to demonstrate it. AAPC Knowledge Center. Retrieved January 8, 2022, from https://www.aapc.com/blog/46500-medical-necessity-why-it-mattersways-to-demonstrate-I it/#:~:text=Medicare%20defines %20%E2%80%9Cmedical%20necessity %E2%80%9D%20as%20services %20or%20items,of%20treating%20a%2 0patient%20is%20reasonable %20and%20necessary. NURS 6050 Assessment 3 PA003 Regulation

Phillip March 25, 2024 No Comments

PA002 Legislation

PA002 Legislation Name  University NURS 6050 Policy and Advocacy for Improving Population Health Prof. Name Date Introduction Health-related Bill Name/Bill #: Human Life Protection Act, HB 314 Description The Human Life Protection Act, also known as Bill HB 314, mandates a comprehensive prohibition on abortions and attempted abortions throughout all stages of pregnancy within Alabama, constituting a felony offense upon violation. The bill delineates specific exemptions. Federal or State? State of Alabama Legislative Intent The primary legislative intent behind the Human Life Protection Act, Bill HB 314, is to protect all forms of life, including unborn children. Under HB 314, fetuses are legally recognized as persons (HB 314, 2019), with individuals who engage in or attempt abortions without exemption being subject to felony charges. Exceptions to this bill include situations where the continuation of the pregnancy poses health risks to the pregnant woman, cases of lethal fetal anomalies, instances where the pregnant woman is affected by a mental illness posing a lethal threat to either herself or the fetus, ectopic pregnancies, or miscarriages necessitating a procedure for fetal removal (HB 314, 2019). NURS 6050 Assessnent 2 PA002 Legislation Proponents/Opponents Advocates supporting this bill include a significant portion of the Republican party, Republican Governor Kay Ivey, House sponsor Terri Collins, and Senate Sponsor Clyde Chambliss. Conversely, the bill has faced strong opposition from Democratic politicians and a minority of Republican politicians. Target Population This legislation primarily targets pregnant women and medical practitioners involved in performing or attempting abortions. Status of the Bill The Human Life Protection Act was officially enacted into law on May 15, 2019; however, its implementation has been postponed due to a preliminary injunction contested by District Judge Myron Thompson (HB 314, 2019). The bill continues to receive significant media attention from opposing factions and is consistently challenged by activists. General Notes/Comments N/A References Bill HB 314, 2019, Alabama, Reg. Sess. (AL, 2019) NURS 6050 Assessnent 2 PA002 Legislation

Phillip March 25, 2024 No Comments

PA001 Agenda Setting

PA001 Agenda Setting Name  University NURS 6050 Policy and Advocacy for Improving Population Health Prof. Name Date Introduction The aim of this paper is to apply agenda-setting theory to examine the impact of various political television programs, such as CNN News, BBC News, Al Jazeera, NBC News, and MSNBC, on adolescents. Agenda-setting theory, developed by Maxwell McCombs and Donald Shaw, posits that the media significantly influences the public agenda (Griffin, Ledbetter & Sparks, 2019). This suggests that political TV shows may influence adolescents’ perceptions of the importance of certain topics on the public agenda, potentially leading to discussions on issues like terrorism, immigration, social injustices, and corruption. However, it is also possible that adolescents may discuss topics beyond their comprehension and develop divisive attitudes based on race and nationality. Background Television remains a primary source of information on current political issues for many individuals, including adolescents. Political TV programs often highlight societal issues to engage viewers in discussions. Adolescents, who spend considerable time watching TV, may perceive these highlighted issues as more significant, which could lead to biased perceptions and negative attitudes toward certain groups. Political TV news tends to emphasize negative content, which can impact adolescent mental health (Holbert et al., 2007). Moreover, news coverage influences adolescents’ perceptions of issues such as terrorism, often leading to distorted beliefs (Kruikemeier & Shehata, 2017). Theoretical Framework Agenda-setting theory suggests that the media filters and shapes reality for audiences by highlighting selected topics based on their perceived appeal. Editors serve as gatekeepers, determining which content reaches the public (Griffin, Ledbetter & Sparks, 2019). Media coverage influences public perceptions and policy agendas by highlighting certain issues while downplaying others. Agenda-setting is particularly crucial in politics, as it affects public opinion and policy decisions. Literature Review Research utilizing agenda-setting theory demonstrates how political TV news influences adolescents. These news stations shape discussions by often focusing on issues such as minority rights, elections, and political scandals. Coverage of events like the Clinton-Lewinsky scandal or the Iraq War impacts adolescent perceptions and behaviors (Yioutas & Segvic, 2003). Framing of political TV news can create biases and negative perceptions of politicians, which in turn influence adolescent attitudes and behaviors (Caulk, 2016). Research Questions How can parents prevent their children from being influenced by political TV news? How do political TV news channels contribute to bias among politicians? Case Study Political TV news channels play a significant role in shaping public perception, especially during elections. For example, coverage of the 2016 US Presidential election portrayed candidates in specific lights, influencing voter opinions and behaviors (Faris et al., 2017). Gender biases are also perpetuated, affecting adolescent views on gender roles and political participation (Kaklamanidou & Tally, 2016). Analysis Political TV news has a profound impact on adolescents’ perceptions, behaviors, and attitudes toward politicians and elections. Biased coverage and framing contribute to negative attitudes and behaviors among adolescents. Parents must monitor and guide adolescents’ media consumption to mitigate these influences. Conclusion Political TV news, through agenda-setting, shapes public perceptions and behaviors, including those of adolescents. Biased coverage and framing can lead to negative attitudes and behaviors among adolescents, underscoring the importance of parental guidance and media literacy education. References Caulk, N. (2016). Political news exposure and attitude polarization in adolescence. Journal of Adolescence, 47, 129-139. Faris, R., Roberts, H., Etling, B., Bourassa, N., Zuckerman, E., & Benkler, Y. (2017). Partisanship, propaganda, and disinformation: Online media and the 2016 U.S. presidential election. Harvard Kennedy School. Retrieved from https://cyber.harvard.edu/publications/2017/08/mediacloud Griffin, E., Ledbetter, A., & Sparks, G. (2019). A first look at communication theory (10th ed.). McGraw-Hill Education. Holbert, R. L., Kwak, N., Shah, D. V., & Yang, S. U. (2007). Environmental concern, patterns of television viewing, and pro-environmental behaviors: Integrating models of media consumption and effects. Journal of Broadcasting & Electronic Media, 51(4), 675-699. NURS 6050 Assessment 1 PA001 Agenda Setting Kaklamanidou, B., & Tally, M. (2016). From girl power to grrrls to queer girls: Gendered representations in Nickelodeon programming, 2001–2014. Popular Communication, 14(1), 1-18. Kruikemeier, S., & Shehata, A. (2017). Examining the impact of news media exposure on issue knowledge: The case of the refugee crisis. Mass Communication and Society, 20(6), 825-848. Yioutas, J., & Segvic, I. (2003). War and the changing agenda of presidential news conferences: A study of the Clinton presidency. Journalism & Mass Communication Quarterly, 80(4), 913-930. NURS 6050 Assessment 1 PA001 Agenda Setting

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