Capstone Change Project Outcomes

Marginalized groups are often disproportionately affected by disease. Many of them experience higher morbidity, mortality, and disability rates than other groups in the society (Baah et al., 2019). This is mainly due to the socio-economic disadvantaging they are subjected to because of their gender, sexual orientation, race, ethnicity, social values, health status, and level of poverty (O’Donnell et al., 2016; Baah et al., 2019). There is need to put in place effective disease prevention and control initiatives in order to improve the health outcomes of the marginalized groups. This can be achieved through adoption of effectual policies by the health system. These include training of more healthcare workers, recruitment of enough healthcare personnel, establishment of more healthcare facilities, provision of affordable health insurance, ensuring access to health education, emphasizing on quality care, promoting community engagement, and incorporating cultural competency into practice.

Assessment of Organizational Policies

Most healthcare organizations around the world are facing an acute shortage of healthcare professionals, especially nurses. Poor remuneration and lack of motivation is forcing many people to leave the healthcare sector for other works. This has made it difficult for the healthcare system to retain experienced and highly qualified professionals. Marginalized groups are the most affected by this trend. This situation has made it necessary to train more nurses and other healthcare personnel (Galea & Vaughan, 2019). The trainees can fill the gaps and help to reduce the shortage that is currently being experienced.

Due to the high turnover of nurses and other healthcare professionals, many healthcare organizations do not have enough healthcare personnel.  For instance, most racial minorities residing in remote areas are underserved by healthcare workers. As a result, they always find it difficult to access quality healthcare services for their conditions. It is such situations that have necessitated the recruitment of many healthcare workers (O’Donnell et al., 2016; Galea & Vaughan, 2019). Many of these workers are now being recruited to remote regions. This is an important effort that is contributing to equity in the provision of healthcare services.

Most marginalized communities are not only underserved by healthcare professionals, but also healthcare facilities. This as well hinders them from accessing healthcare services of high quality. This condition has also necessitated the effort of creating more health facilities that can help to serve the communities (O’Donnell et al., 2016; Galea & Vaughan, 2019). Some of the facilities are established in a way that they are able to meet the healthcare needs of the targeted population groups. Examples include the facilities designed to meet the care needs of veterans who live with various healthcare conditions and disabilities.

Health information plays a crucial role in promoting positive health outcomes among patients. Patients often use this information to make informed health care decisions. It is for this reason that it is important for every person to access the information. Unfortunately, many marginalized groups cannot access this important information. For instance, racial and ethnic minorities find it difficult to access this information due to high levels of illiteracy and language barrier. Due to this, there is an effort in place to have the information published in languages that everybody can easily understand (Baah et al., 2019; Pratt, 2019).

Many people from the groups that are considered to be marginalized are not covered by health insurance. Poverty makes it difficult for them to have this cover. This explains why many of them experience poor health outcomes. To change the situation, many recent healthcare legislations focus on the provision of health insurance that all people can afford, including the marginalized groups (Baah et al., 2019; Stephenson-Hunter & Dardeck, 2019). It is believed that this trend can help to ensure that many of these marginalized people benefit from various healthcare services. This can be important for their adverse conditions.

Nurses and other types of healthcare providers are required to provide quality services that can help to promote the achievement of quality healthcare services. This is emphasized on in the professional code of ethics of the various groups of healthcare providers. Therefore, every nurse or healthcare worker is expected to make an effort in ensuring that patients receive services of high quality (O’Donnell et al., 2016; Stephenson-Hunter & Dardeck, 2019). This is normally achieved through provision of safe services, and care services that are regarded as being patient-centered. Such services help to enhance better care outcome.

For any project to be effectively implemented in a given area, it is important for the community that will benefit from it to be well engaged. This will help to ensure that the views of the beneficiaries are incorporated into the process of project planning and implementation. Giving the local community an opportunity to air its views can help to promote the acceptance and ownership of the propose project. This requirement has increasingly seen the healthcare policy makers engaging various stakeholders within the marginalized groups (Pratt, 2019). The engagement has helped to ensure that various healthcare projects and programs are successfully implemented among the groups.

Culture is an important factor in the healthcare system. It influences the beliefs help about various diseases and the process of healing. Therefore, there is need to ensure that healthcare providers are sensitive to the cultures of the people they serve. To achieve this, it has become necessary for the healthcare system to emphasize on the cultural competency of the healthcare workers serving various groups, including the marginalized ones (Pratt, 2019). Cultural competency promotes positive person-to-person interaction. In the healthcare system, it helps to enhance patient satisfaction in the provision of various care services.

Outcomes of the Proposed Intervention

From the above assessment of various organizational policies pertaining to the improvement of disease control and prevention among the marginalized groups, the following list of measurable outcomes was generated:

  1. Enabling marginalized groups to access quality healthcare services.

Training and recruiting more nurses can help to ensure that underserved marginalized communities have enough healthcare personnel. The same case applied to establishment of many or more healthcare facilities (O’Donnell et al., 2016; Galea & Vaughan, 2019).

  1. Making it easy for marginalized populations to access health information.

Health information is useful for making important healthcare decisions (Baah et al., 2019; Pratt, 2019). Ensuring that this information is translated into a language that many people in the marginalized communities are able to understand is important.

  1. Ensuring equity in distribution of various healthcare services.

Every person is entitled to quality healthcare services. Therefore, it is necessary to ensure that everybody is able to access various health services regardless of his or gender, sex, racial background, socio-economic status, and other factors that form the basis for discrimination (Pratt, 2019).

  1. Promoting improved patient outcomes among marginalized communities.

Promoting prevention and control of disease among the marginalized groups is an important effort. It helps to ensure that the different diseases that affect the marginalized populations are effectively dealt with (Baah et al., 2019).

  1. Ensuring interprofessional collaboration in the delivery of healthcare services.

Interprofessiona collaboration helps to ensure that nurses and other healthcare providers share their experiences and expertise (O’Donnell et al., 2016). This is necessary for the delivery of both safe and quality care services to marginalized groups.


Baah, F. O., Teitelman, A. M., & Riegel, B. (2019). Marginalization: Conceptualizing patient vulnerabilities in the framework of social determinants of health – An integrative review. Nurs Inq., 26 (1): e12268. doi: 10.1111/nin.12268.

Bowen, D. M., & Forrest, J. L. (2017). Translating Research for Evidence-Based Practice. Retrieved from

Galea, S., & Vaughan, R. D. (2019). Public Health and Marginalized Populations: A Public Health of Consequence, October 2019. American Journal of Public Health, 109 (10), 1327–1328.

Institute for Healthcare Improvement. (2021). Science of Improvement: Testing Changes. Retrieved from

Lewin, K. (2021). Change Theory. Retrieved from

O’Donnell, P., Tierney, E., O’Carroll, A., Nurse, D., & MacFarlane, A. (2016). Exploring levers and barriers to accessing primary care for marginalised groups and identifying their priorities for primary care provision: a participatory learning and action research study. Int J Equity Health, 15 (197).

Pratt, B. (2019). Inclusion of Marginalized Groups and Communities in Global Health Research Priority-Setting. Journal of Empirical Research on Human Research Ethics, 14 (2) 169-181.

Stephenson-Hunter, C., & Dardeck, K. L. (2019). Locus of Control and Health Promotion for Marginalized Populations. Journal of Social, Behavioral, and Helath Science, 13. DOI:

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