NR 506 Week 1 Assignment Formulating a Healthcare Policy Worksheet 1

Formulating a Healthcare Policy

Evidence suggests that artificial colors are a negative additive to foods that can affect a person’s health. Some snacks sold in the Miami-Dade County schools’ vending machines contain artificial colors (AC). Although evidence says that AC does not cause Attention Deficit/Hyperactivity Disorder (ADHD), it does say that it can worsen its symptoms and/or exacerbates allergies. My healthcare policy issue is that these types of snacks should be removed. This policy will be presented to the school board. Ms. Perla Tabares Hantman (Chair) and Dr. Dorothy Bendross-Mindigall (Vice-Chair).

Key points – Worksheet 1

Describe a public-health policy issue and its importance to you and nursing.

I am interested, familiar and passionate about removing AC from school snacks. Miami Dade County Schools has a Wellness Policy that promotes wellness and academic performance with 5 goals in mind: Nutrition, Physical education, Physical activity, Health and Nutrition literacy, and Preventive Healthcare. My focus lies within the nutrition portion of the policy that regulates foods sold via vending machines. The policy is very specific about caffeine, added sweeteners, fats, and calories, but nothing in regards to AC. I want to include in the current policy that those beverages and snacks CANNOT have any AC. It is important for my nursing profession and as a mom because kids and parents need to be educated about the potential side effects that AC poses to our kids’ health. NR 506 Week 1 Assignment Formulating a Healthcare Policy Worksheet 1

Why this issue?

This topic is of personal interest to me since I have a family member who was diagnosed with Attention Deficit Disorder (ADD) and TICS as a child. The medical answer at the time was to medicate. Before starting any medication, a modification in the diet was suggested (removing any possible allergens as well as the removal of chemicals such as AC). This diet alone made a difference in the patient’s behavior; ultimately, no medication was needed. NR 506 Week 1 Assignment Formulating a Healthcare Policy Worksheet 1

Background: A food color is an actual additive (dye, pigment, or substance) that impacts color when it is added to food or other things such as make-up, drugs and even our bodies. Certified color additives are man-made and are cheaper and found in basically all of our foods. When food is processed, they lose color or change their natural hue (Food Insight, 2014 NR 506 Week 1 Assignment Formulating a Healthcare Policy Worksheet 1). Color is then added back to food to make up for the loss, make it more attractive, increase shelf life, or remove bacteria and make them “safe” (Rohrig, 2015). Artificial colors were, at some point, made from coal. Now a day, they are made from petroleum or crude oil. This does not sound safe.

Specific problem: Some people claim that AC causes hyperactivity or attention deficit hyperactivity disorder (ADHD) in children and/or exacerbates allergies.

Need of new law? No, the removal of artificial colors can be added to the existing Wellness Policy.

Is there a need for change to an existing law? No.

Is there need for a change in regulatory issues? Yes, it can be added to the current nutrition regulations.

Supportive evidence for this issue: The debate linking AC and hyperactivity in children has been ongoing since 1973. In 2007 the United Kingdom conducted an extensive study involving 300 children (split into 2 groups), where it revealed “statistically significant adverse responses in both groups of children to the food color challenge” (Weiss, 2012 NR 506 Week 1 Assignment Formulating a Healthcare Policy Worksheet 1). Another study showed show yellow #5 provoked irritability, fidgeting and sleep problems.

Mr. Weiss’s article also says that children with deficit or hyperactivity disorders and other behavioral problems could be exacerbated by exposure to certain food ingredients, such as artificial colors. The European Union has recommended eliminating 6 colors or making sure the manufacturer labels the food advising that the color may adversely affect activity and attention in children (Weiss, 2012). At the cellular level, yellow #5 causes inflammation in the gastric mucosa and an increase in lymphocytes and eosinophils, both known to be elevated in people with allergies.

Other side effects of yellow #5 include migraines, eczema, stomatitis, and nausea. Furthermore, when given to hyperactive kids, yellow #5 can cause zinc and iron depletion (Stevens et al., 2013). Eagle (2014) describes that sulfotransferase inhibition contained in foods (including artificial colors) have shown to worsen symptoms in patients with ADHD or other neurological behaviors.

Context

As stated above, evidence shows that artificial colors are not the safest ingredient in our kids’ snacks. The current Wellness Policy in our schools could be amended, thus providing healthier snacks to our kids. The project would not cost the schools any money since the vending machine provider would be the one selling the snacks. Johnson, Blum & Giedd (2009 NR 506 Week 1 Assignment Formulating a Healthcare Policy Worksheet 1) state that the “adolescent brain continues to mature well into the 20’s”; why add chemicals to our food that can affect children’s brains and their behavior? A school district in Minnesota removed artificial colors, artificial sweeteners, artificial preservatives, Trans fats/hydrogenated oils, antibiotics and hormones in meats, and bleached flour (Siegel, 2016). Similarly, something like this can be done in our school district here.

Goals/options: To eliminate school vending machine snacks that contain artificial colors.

Evaluation of options: This policy can begin as a pilot in a few schools. The project can then be evaluated and if successful, it can go bigger and include more schools to the point that includes all schools in the Miami-Dade County School District and possibly statewide.

Recommended solutions: To amend District Wellness Policy – Board Policy 8510. The revised policy should include all vending machines snacks and beverages that DO NOT contain artificial colors.

How can you find out the current status of this issue: Visit http://www.dadeschools.net/schoolboard/agchang.asp for new policies and amendments. The Board meets on a monthly basis where public and private meetings are held.

What level of government is your immediate target?

This policy is dealt with at a local level: Miami-Dade County School Board (my immediate target). Ms. Perla Tabares Hantman (Chair), [email protected]. Dr. Dorothy Bendross- Mindigall (Vice-Chair), [email protected]. (305) 995-1000.

Critique of empirical evidence

The challenge of doing research with kids and artificial colors is difficult. Parents need to give consent for their kids to be exposed to artificial colors and those types of studies are expensive. Eliminating artificial colors by diet elimination is hard, especially with so many tempting sugary snacks available. It is an ethical issue, maybe controversial, but at least some research has been done. If the current evidence suggests that artificial colors are harmful, then I support for more research to be done. In the meantime, educating the community on the information we have is vital. NR 506 Week 1 Assignment Formulating a Healthcare Policy Worksheet 1

Importance and impact of the chosen policy issue to nursing.

As a nurse, it is my professional responsibility to teach kids and their parents about making healthy selections and how to “read and interpret ingredients on labels” (Simmons, 2014). Artificial colors could not only be linked to hyperactivity but to allergies too. Teaching kids and parents on how to handle an allergic reaction is also fundamental (Simmons, 2010). It is all about education. The more the patient knows, the better decisions they will make, and thus assisting them in living a healthier lifestyle in which some illnesses could be better managed.

Friberg, Granun & Bergh (2012 NR 506 Week 1 Assignment Formulating a Healthcare Policy Worksheet 1) say that to develop proper patient education, we need to have evidence-based standards as well as patient education in health policy. Patient education will be hindered by limited pedagogical competence and the insecurity related to the accomplishment of educational tasks.

Concluding statements

In the U.S., food companies are obligated to disclose if their foods contain any allergens and in Europe, companies have to warn consumers that artificial colors “may cause hyperactivity in children” (Potera, 2010). Eating involves not just the taste of food but the way it smells and how it looks, thus the importance of putting healthy ingredients in our foods (Rohrig, 2015). Finally, based on the evidence found, it is imperative to stress the importance of educating parents and kids about making healthier snack choices.

NR 506 Week 1 Assignment Formulating a Healthcare Policy Worksheet 1 References

Eagle, K. (2014). ADHS impacted by sulfotransferase (SULT1A) inhibition from artificial food colors and plant-based foods. []. Physiology & Behavior, 135(2014), 174–179. http://dx.doi.org/org/10.1016/jphysbeh.2014.06.005

Friberg, F., Granum, V., & Bergh, A. (2012). Nurses’ patient-education work: conditional factors – an integrative review. Journal Of Nursing Management, 20(2), 170–176. http://dx.doi.org/10.1111/j.1365-2834.2011.01367.x

Johnson, S., Blum, R., & Giedd, J. (2009). Adolescent Maturity and the Brain: The Promise and Pitfalls of Neuroscience Research in Adolescent Health Policy. National Institute Of Health, 45, 316-221. http://dx.doi.org/10.1016/j.jadohealth.2009.05.016

Kuczek, L., Burgess, J. R., Stochelski, M. A., Arnold, L. E., & Galland, L. (2013). Mechanisms of behavioral, atopic, and other reactions to artificial food colors in children. Oxford Journals, 71, 268-281. http://dx.doi.org/10.1111/nure.12023

Potera, C. (2010). Children are our future, and their mothers are its guardians. Environmental Health Perspectives, 118(10), A428. Retrieved from http://eds.b.ebscohost.com.proxy.chamberlain.edu:8080/eds/pdfviewer/pdfviewer? sid=d95f34a5-dfa0-4d39-8918-9666d88dbd9f%40sessionmgr106&vid=0&hid=127

Q&A: Do Food Colors Cause Hyperactivity? (2014). Retrieved from www.foodinsight.org/Q_A_Do_Food_Colors_Cause_Hyperactivity

Rohrig, B. (2015). The Chemistry of Food Colorings. Retrieved from www.acs.org/content/acs/en/education/resources/highschool/chemmatters/past- issues/2015-2016/october-2015/food-colorings.html

Siegal, B. (2016). District Ditches Seven Problematic School Food Ingredients (But Who Pays for it?). The Lunch Tray. Retrieved from www.thelunchtray.com/school-district-ditches- seven-problematic-school-food-ingredients-pays/. NR 506 Week 1 Assignment Formulating a Healthcare Policy Worksheet 1

Simmons, S. (2014). Take the bite out of food allergies. Nursing2014, 44(12), 44–52. http://dx.doi.org/10.1097/01.NURSE.0000456364.47380.75

The School Board of Miami-Dade County Bylaws and Policies. (2011). Retrieved May 13, 2016, from www.neola.com/miamidade-fl/search/policies/po2410.htm

Weiss, B. (2012). Synthetic Food Colors and Neurobehavioral Hazards: The View from Environmental Health Research. Environmental Health Perspectives, 120(1). http://dx.doi.org/org/10.1289/ehp.1103827

NR 506 Week-1 Homework Assignment: Planning Your Visit Worksheet-1: Formulating a Healthcare Policy Worksheet-1

The purpose of the three ungraded worksheets for this course is to assist the student in identifying the key pieces of information necessary for completing the assignments and meeting the course outcomes. See the corresponding rubric for specific grading criteria and point breakdown. Do not upload the worksheet; the purpose of the worksheet is to support the rubric.

For this course, the student must first select a healthcare issue. The issue must be a public-health policy issue. Students may not use issues relevant for private organizations or institutions, such as internal policy issues. It must be an original policy; one not currently in legislation. The goal of this course is to get the student involved in healthcare-policy issues that impact the general public. This will involve a meeting with local policymakers such as city, county, and school-board officials. Students are free to work at the state or federal level as well. Students must carefully consider their particular policy issue, applicable level of government involved, course time constraints, and objectives/outcomes of the assignments.

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Students are to select a policy issue, research the issue including policy analysis, plan the policy, and plan meeting with a policymaker for the purpose of presenting the issue, proposing recommendations and asking questions about how change can occur. The student will reflect on the experience, develop plans for follow-up with the policymaker as needed, and consider ways in which advocacy efforts can continue.

This assignment must be submitted to TurnItIn™, as required by the TurnItIn™ policy. A Similarity Index of “blue” or “green” must be obtained. A score in the blue or green range indicates a similarity of less than 24% which is the benchmark for CCN graduate nursing students. Any other level of similarity index level requires the student to revise the assignment before the due date and time. To allow sufficient time for revision, early submission of the assignment to TurnItIn™ is highly encouraged. The final submission will be graded by faculty. If a Turnitin™ report indicates that plagiarism has occurred, the Academic Integrity policy will be followed.

NR 506 Week 1 Assignment Formulating a Healthcare Policy Worksheet 1