The implementation of the project was faced with a number of ethical issues. The most predominant was assigning personal blame to some of the participants who had been adversely affected by alcohol and substance abuse. The ethical dilemma in this instance was that the health status of many of these individuals was caused by personal choices, for instance the choice to engage in alcohol and substance abuse (Nies & McEwen, 2013). There is a belief that individuals should be blamed personally for illnesses that result from their personal choices (Hernandez, 2011). However, previous discussions have highlighted the influence of some mitigating circumstances in the health of an individual.
For instance, the social environment, a big influence on those individuals who turn to alcohol and substance abuse, may predispose young people to these poor health habits. The resolution of this ethical issue was important to the success of the program. Irrespective of the personal choices that the participants, and the role that these choices played towards their current health status, the program was going to be sensitive towards them. The objectives of the program was to enhance behavior change. The design of the program was not to suit the population that does not have alcohol dependence. On the contrary, it was designed to inspire behavior change in the general population.
Another ethical issues that the program faced was the relative ignorance of the participants of the Indian descent. This is because the children were the first generation in the United States of America, and as such, had not been exposed to the different social environment. The ethical dilemma was whether to inform the participants on the effects of the social environment, especially its influence towards alcohol and substance abuse (Masse & Williams-Jones, 2012). This ethical issue was addressed by consulting the parents to offer informed consent for their children to be taught on the contents of the program. It was necessary to seek consent from the parents in case they preferred handling the issue otherwise.
During the implementation of the program, I encountered various barriers. It was important to overcome these barriers to the success of the program. One of the barriers encountered was lack of proficiency in English. Communication is very important in health education programs. It is important to articulate the issues in a way that the target population can comprehend. The lack of proficiency in English because of the diverse cultural backgrounds of the participants was a barrier. This was even more significant when using teaching aids because some of the participants experienced difficulties in reading. In overcoming this barrier, I employed the use of group discussions where the issues were articulated by peers, at times in ethnic dialects (Singleton & Krause, 2009).
Another barrier faded in the program was the cultural barrier (Timmerman, 2007). Different cultures have different perceptions of the importance of alcohol and substance abuse. For instance, participants from the Caribbean region had difficulties why the program listed Marijuana as one of the substances that were often abused, and had adverse health effects. These culturally-inspired opinions can have a detrimental effect on the success of the program, especially when they are held by people with influence and are not countered sufficiently. In overcoming this barrier, I adduced statistics on the health effects of substance abuse. This helped bring to perspective the negative effects of this drug (Singleton & Krause, 2009).
The third barrier that with which the program was faced was low health literacy (Singleton & Krause, 2009). Heath literacy is important for health education and promotion programs. They build on existing knowledge in the population. Low literacy levels in a population pose barriers for health education programs, especially when such programs are designed to last for a considerable short period. In overcoming this barrier, I gave handouts with general information for the participants to read before the following classes. I would review the material so as to make any clarifications that the participants might want. I also made recommendations to the local health department for widespread health education activities and programs in order to raise the literacy levels of the population.
Hernandez, B. (2011). Foundation concepts of global community health promotion and education. Sudbury, MA: Jones & Bartlett Learning.
Masse, R. & Williams-Jones, W. (2012). Ethical dilemmas in health promotion practice. Retrieved from> http://genethics.ca/personal/papers/Masse-WJ.pdf
Nies, M. & McEwen, M. (2013). Community/Public health nursing: Promoting the health of populations. St. Louis. Elsevier Saunders.
Singleton, K. & Krause, E. (2009). Understanding cultural and linguistic barriers to healtsh literacy. The online journal of issues in nursing, 14 (3): Manuscript 4.
Timmerman, G. (2007). Addressing barriers to health promotion in underserved women, Family & community health, 30 (1): 34-42