| Course | NSG 323 Community and Public Health Nursing |
|---|---|
| Unit | Unit 8 |
| Paper type | Levels of prevention analysis |
| Length | About 1,090 words, 6 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | RN to BSN |
| Updated | October 2026 |
Free sample paper for NSG 323 Unit 8
Cervical Cancer in One County Across Three Levels of Prevention: Vaccination, Screening, and Care After Diagnosis
Student Name
Department of Nursing, Herzing University
NSG 323: Community and Public Health Nursing
Instructor Name
March 10, 2026
Cervical Cancer in One County Across Three Levels of Prevention: Vaccination, Screening, and Care After Diagnosis
The Problem in This County
This analysis concerns a composite county of roughly 210,000 residents, including a large population of immigrant families and a federally qualified health center that serves about a quarter of residents. Figures come from the state cancer registry, the state immunization registry, and the health center's quality reports, and are presented as illustrations for this composite setting. Cervical cancer incidence in the county has averaged about 11 cases per 100,000 women a year over the most recent five years, against about 7.5 for the state. About 55% of cases were diagnosed at a regional or distant stage, when treatment is harder and survival lower. Among adolescents aged 13 to 17, about 52% are up to date on HPV vaccination. At the health center, 58% of eligible women are up to date on cervical cancer screening.
Cervical cancer is almost entirely caused by persistent infection with high-risk types of human papillomavirus (HPV), and it develops slowly through precancerous changes that can be found and treated. Those two facts are why each level of prevention has something specific to offer.
Definitions Used in This Analysis
Primary prevention acts before a disease begins, by removing a cause or increasing resistance to it. Secondary prevention detects disease early, in people who have it but do not know, so that it can be treated before it causes harm; for cervical cancer, this includes finding and treating precancerous changes before they become cancer. Tertiary prevention limits damage and disability in people already diagnosed with the disease. Each intervention below is tested against these definitions, and the test is applied to what the intervention does, not to whether it feels preventive.
Primary Prevention: HPV Vaccination
Intervention: HPV vaccination, routinely recommended at ages 11 to 12, with catch-up vaccination through age 26 and shared clinical decision-making for some adults aged 27 to 45 (Meites et al., 2019). Why primary: vaccination prevents the infection that causes the disease, before any disease exists.
Evidence: Swedish registry data covering the whole female population aged 10 to 30 showed that women who received the vaccine before their 17th birthday went on to develop invasive disease far less often than unvaccinated women (Lei et al., 2020). The benefit was smaller, though still present, for women vaccinated at 17 to 30, which is the reason to vaccinate before exposure to HPV begins. Population reached: the roughly 15,000 adolescents aged 11 to 17 in the county, of whom about half are currently not up to date.
Nursing actions: school-located vaccination clinics in the two middle schools with the lowest rates; reminder and recall through the immunization registry; and training for clinic staff to recommend the vaccine as part of the routine adolescent visit rather than as an optional extra. Presenting the vaccine as cancer prevention, and offering it at the same visit as other adolescent vaccines, addresses the most common reason parents give for delay, that no one recommended it.
Secondary Prevention: Screening and Treatment of Precancer
Intervention: screening women aged 21 to 65 according to current recommendations: cytology every 3 years from 21 to 29, and from 30 to 65 either cytology every 3 years, high-risk HPV testing alone every 5 years, or both together every 5 years (U.S. Preventive Services Task Force [USPSTF], 2018). Why secondary: screening does not prevent HPV infection; it finds precancer or early cancer that is already present. Follow-up of abnormal results and treatment of precancerous lesions also belong here, because they act on disease already detected, before invasive cancer develops.
Performance: HPV testing is more sensitive for high-grade precancer than cytology, at the cost of more positive results that require follow-up. A screening program is only as good as its follow-up, and at the health center, about one in five women with an abnormal result has no completed follow-up within six months.
Population reached: about 58,000 women aged 21 to 65 in the county. Nursing actions: outreach through the health center's patient navigators to women overdue for screening, evening and Saturday clinics, and a tracking list for every abnormal result, with a nurse responsible for closing each one.
Tertiary Prevention: Care After a Cancer Diagnosis
Intervention: navigation to prompt treatment for women diagnosed with invasive cervical cancer, and survivorship care that addresses the effects of treatment, such as lymphedema, sexual health, bowel and bladder changes, and emotional distress. Why tertiary: these actions limit harm in people who already have the disease.
Population reached: about 20 to 25 women diagnosed each year in the county. Nursing actions: a nurse navigator who contacts each newly diagnosed woman within a week to arrange the gynecologic oncology referral, which in this county is 70 miles away, along with transportation, interpretation, and insurance help; and a survivorship care plan shared with the woman's primary care clinician.
Comparing the Levels
The three levels reach very different numbers of people. Tertiary care reaches perhaps two dozen women a year and matters greatly to each of them, but it cannot change the county's incidence. Screening reaches tens of thousands and can find disease early enough to prevent most deaths. Vaccination reaches the next generation and, over decades, can prevent most cases. A county plan that invested only in tertiary care would help the women already diagnosed while leaving the rate unchanged; one that invested only in vaccination would do nothing for the women aged 30 to 65 who were never vaccinated. Each level is needed, for different people.
Measuring Progress at Each Level
Each level needs its own measure, because each works on a different timescale. For vaccination, the measure is the share of 13- to 17-year-olds up to date, reported yearly from the registry. For screening, it is the share of eligible women up to date and the share of abnormal results with completed follow-up within six months, reported quarterly by the health center. For tertiary care, it is the time from diagnosis to first treatment. Incidence and late-stage diagnosis will change slowly and should be read over five-year periods.
Common Misplacements to Avoid
Screening is sometimes filed as primary prevention because it happens to healthy-feeling people. It is secondary, because it looks for disease that already exists. Treatment of precancerous lesions is sometimes filed as tertiary because it involves a procedure. It is secondary, because it acts before cancer develops. Health education about HPV is primary only when its aim is vaccination or avoiding infection; education encouraging screening supports secondary prevention.
References
Lei, J., Ploner, A., Elfström, K. M., Wang, J., Roth, A., Fang, F., Sundström, K., Dillner, J., & Sparén, P. (2020). HPV vaccination and the risk of invasive cervical cancer. New England Journal of Medicine, 383(14), 1340-1348. https://doi.org/10.1056/NEJMoa1917338
Meites, E., Szilagyi, P. G., Chesson, H. W., Unger, E. R., Romero, J. R., & Markowitz, L. E. (2019). Human papillomavirus vaccination for adults: Updated recommendations of the Advisory Committee on Immunization Practices. MMWR Morbidity and Mortality Weekly Report, 68(32), 698-702.
U.S. Preventive Services Task Force. (2018). Screening for cervical cancer: US Preventive Services Task Force recommendation statement. JAMA, 320(7), 674-686. https://doi.org/10.1001/jama.2018.10897
What the NSG 323 Unit 8 instructions ask for
Unit 8 asks you to apply the three levels of prevention to one health problem in a community. Expect to describe the problem, define the levels, describe an intervention at each level, compare their reach and timing, set measures and identify common errors. Many versions ask why screening is secondary rather than primary and where the nurse fits at each level. Check whether your section names the problem. Use current guidelines for each intervention. Comparing reach shows where effort pays off most. Measures should match each level's timescale, since vaccination effects appear years later. Addressing common misplacements shows you understand the definitions, not only the examples. Name groups with lower vaccination or screening rates, since equity shapes where effort goes.
How this NSG 323 Unit 8 example is built
The analysis opens with the problem in the county, including groups at higher risk. The definitions section states each level precisely. Three sections describe one intervention at each level, with who is reached, the evidence and the nurse's role. The comparison section sets reach and timing side by side. The measures section gives one measure per level suited to its timescale. The misplacements section explains why screening is secondary and why survivorship care is tertiary. The analysis ties every level to the same county, which keeps the comparison concrete. Each intervention cites a current guideline, so the levels rest on evidence rather than textbook examples. Groups with lower screening rates are named so later sections can target them.
Reading the NSG 323 Unit 8 rubric
Herzing's rubric for a levels of prevention analysis usually covers the problem, accurate definitions, interventions at each level, the nurse's role, comparison, measures and correction of misplacements. Placement is the first thing checked: screening must sit at the secondary level and vaccination at the primary level. Intervention points reward current guidelines. Nurse role criteria look for specific contributions at each level. Comparison earns credit for reach and timing. Measures should fit each level. Correcting misplacements is often credited. Attention to groups with lower vaccination or screening rates is often credited because it shows where the gaps are. Lei's study of HPV vaccination and invasive cancer and the Task Force cervical screening statement belong in the APA 7 list.
NSG 323 Unit 8 help before you submit
Levels of prevention papers in Unit 8 often slip by placing screening under primary prevention. Another frequent problem is describing the levels with textbook examples unrelated to the problem. Students often forget the nurse's role at each level. Without a comparison of reach, the reader never learns where effort pays off most. Measures are the same for every level. Guidelines are outdated, such as old screening intervals. Tertiary prevention is limited to treatment, missing survivorship. Finally, keep one problem and one community throughout, because graders reward an analysis where all three levels speak to the same population. Another weak spot is forgetting groups with lower rates, such as recent immigrants, which is where the nurse's work matters most.
Get a NSG 323 Unit 8 example written to your instructions
Send the Unit 8 instructions and the rubric from your NSG 323 classroom, plus the community problem your analysis addresses. We write a custom example that tests every intervention against the definitions and weighs which level offers most, returned in 24 to 48 hours. The first custom sample is free.
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NSG 323 Unit 8 questions, answered
Why is screening secondary rather than primary?
Because the condition already exists. Primary prevention stops something occurring; screening finds it early in people who have it and do not yet know. The confusion is understandable, since screening programs are often called preventive, but the distinction is exactly what this assignment is testing and misplacing it undermines everything built on top.
How do I decide which level to emphasize?
Consider how many people each reaches and how much benefit is available. Primary prevention touches an entire population and often yields small individual effects; tertiary reaches few people with large effects each. For a problem already widespread, secondary and tertiary may offer more immediate benefit; for an emerging one, primary usually does. Make the argument explicitly.
Where does the nurse fit at each level?
Differently at each, and saying how is part of the assignment. Primary work is often education, advocacy and policy; secondary is screening delivery, follow-up and ensuring results are acted on; tertiary is case management, self-management support and coordination. An analysis that describes programs without placing the nurse in them has answered a public health question rather than a nursing one.
Where can I find a free NSG 323 Unit 8 sample paper?
This page holds the whole NSG 323 Unit 8 cervical cancer prevention analysis free, all three levels, the comparison and the measures. An analysis of a different problem can be written on request.
Why is screening secondary prevention rather than primary?
Screening finds disease or precancer early, after it has begun, so treatment can stop progression. Primary prevention stops disease from starting, as HPV vaccination does. This sample explains the difference for cervical cancer.