Baltimore City: Evidence-Based Population Health Improvement Plan

Community Needs Assessment

Baltimore is a large metropolitan community located in the state of Maryland. Its racial composition is comprised of African Americans (62.5%), Whites (30.4%), Hispanics (5%), Asians (2.6%), and American Indians and Alaska Native (AIANs) (“QuickFacts,” 2019). The median household income between 2014 and 2018 was $48,840, with 21.8% of the people living in poverty (“QuickFacts,” 2019). The community is diverse, both in religion and ethnicity or race.

The Baltimore City Health Department conducted a comprehensive health needs assessment in the community and identified six major health concerns. These issues include alcohol and drug addiction, diabetes, overweight and obesity, heart diseases, smoking, and tobacco use (Pugh & Wen, 2017). To determine the significance and impact of the aforementioned health concerns on the population, the chronic disease indicators (CDI) data from the CDC were used.


CDI enables policymakers and public health experts to retrieve uniformly delineated metropolitan and state-level data for chronic disorders. The analysis showed that about 31% of the adults are obese, and 66% are either overweight or obese. About 14.4% of the population binge drink, while 5.2% are heavy drinkers (“Chronic disease indicators,” 2019). Approximately 12.7% of the adults in the community smoke (“Chronic disease indicators,” 2019). Mortality from total cardiovascular diseases was 221 cases per 100,000 people (“Chronic disease indicators,” 2019). From the above analysis, obesity is a critical health priority because it affects a large percentage of the populace. Arguably, obesity could be a contributing factor to the high rates of cardiovascular conditions experienced by the community.


Promote healthy behaviors to reduce obesity and overweight rates in the community

Health education is considered one of the most important behavioral health interventions that can promote populations’ health. A survey by Haghani et al. (2017) showed that this approach could result in general lifestyle changes and weight reduction among populaces. The strategy changes the attitude, beliefs, and perceptions of a given population towards healthy living (Ali, & Katz, 2015). Therefore, implementing the intervention may result in behavioral adjustments which can improve obesity-related outcomes.

Value and Relative Weight of Supporting Evidence

The study’s evidence is level II for the following reasons:

  • It is a quasi-experimental study.
  • The sample size is sufficient for the study design.
  • The results and recommendations are reasonably consistent with the literature review which was based on empirical evidence.

The study contains a title which accurately describes the article. The abstract is representative of the research and gives a clear outline of the whole survey. The introduction clearly states the purpose and justification for conducting the research; however, it lacks a theoretical framework.

The quasi-experimental design was appropriate for the survey because it was not feasible to conduct a randomized control study of the target population. Questionnaires were utilized to collect data and their reliability evaluated through a test-retest method. Various validity tests were performed to determine the extent to which the study variables accurately measured the author’s intention. Chi-square and t-test were used to analyze the data of the study’s variables. The results are presented on a table, and the statistics are clearly explained. The discussion describes the significance of the study findings. The implications of the study’s limitations are also well illustrated.

Health Improvement Plan


  • Reduce the number of overweight and obese adults from 66% to 33.9% within 24 months. Our target goal, 33.9%, has been adopted from the Healthy People 2020 obesity goals.


  • Educate the community on the benefits of healthy lifestyles through evidence-based and engaging programs.

Action Needed

  • Community members will be engaged in healthy lifestyle education through sponsored community-wide education programs.
  • The education programs will also be aired on a popular radio station, especially during rush hours, to reach the target population as they leave work.
  • Two monthly live or outreach events will be conducted during weekends to educate the public on healthy living. The events will use equipment such as accommodative chairs and tables, private weighing areas, weighing procedures, and reading materials sensitive to the emotions of individuals.
  • Free community screening on BMI/weights and referrals will be conducted during the community-wide education programs.

N/B: Healthy living resources will be provided during outreach events and education programs. The education program will also cover healthy nutrition and diet plans, a wide-ranging physical activity plan, and lifestyle changes.

Criteria for Evaluating Intervention Outcomes


To evaluate the program’s success in bringing the expected change, data on key performance indicators will be collected. The performance measures include:

  • An increase in the number of participants with normal BMI after the intervention.
  • An increase in self-reported awareness and knowledge: a pre-intervention survey will be conducted to establish a baseline while a post-intervention will determine the impact of the program

Communication Strategy

Communication Goal

  • Generate health awareness on the prevalence and effects of obesity

Target Population

  • Media, community and professional organizations, public, advocates, healthcare providers, and healthcare centers.

Communication Plan

  • Create promotional media including brochures, podcasts, and website content.

The health education content will be simple and free of medical jargon. The images used in the brochures and podcasts will be representative of the communication racial/ethnic composition. For example, the minority groups such as Asians will be depicted on the front pages of promotional media. Diagrams will be used as an illustrative technique to help individuals with low literacy levels comprehend the message. All promotional and educational content will be sensitive to social issues such as racism affecting the community. Considering minority groups, social issues, and education levels in every aspect of our educational program will help us account for the individual differences and ensure that everyone is treated equally.

  • Identify communication channels and event locations.
  • Conduct geographical mapping to identify the best locations to display advertising media and events.


Ali, A. & Katz, D. L. (2015). Disease prevention and health promotion. American Journal of Preventive Medicine, 49(503), S230–S240.

Chronic disease indicators (2019). Centers for Disease Control and Prevention.

Haghani, S., Shahnazi, H., & Hassanzadeh, A. (2017). Effects of tailored health education program on overweight elementary school students’ obesity-related lifestyle: A school-based interventional study. Oman Medical Journal, 32(2), 140–147.

Pugh, C., & Wen, L. (2017). Community health assessment [PDF document].

QuickFacts: Baltimore City, Maryland. (2019). United States Census Bureau.

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NursingBird. (2023, January 6). Baltimore City: Evidence-Based Population Health Improvement Plan. Retrieved from


NursingBird. (2023, January 6). Baltimore City: Evidence-Based Population Health Improvement Plan.

Work Cited

"Baltimore City: Evidence-Based Population Health Improvement Plan." NursingBird, 6 Jan. 2023,


NursingBird. (2023) 'Baltimore City: Evidence-Based Population Health Improvement Plan'. 6 January.


NursingBird. 2023. "Baltimore City: Evidence-Based Population Health Improvement Plan." January 6, 2023.

1. NursingBird. "Baltimore City: Evidence-Based Population Health Improvement Plan." January 6, 2023.


NursingBird. "Baltimore City: Evidence-Based Population Health Improvement Plan." January 6, 2023.