Chapter 4 Flashcards
What is the focus of the definition of health in the Ottawa Charter on Health Promotion?
a. Health is an outcome.
b. Enjoying life is more important than the need to maintain one’s health.
c. Health is incorporated into one’s activities of daily living.
d. Health is a way to maintain a stable environment.
c. Health is incorporated into one’s activities of daily living.
The Ottawa Charter for Health Promotion (1986) defines health as more than just the absence of disease—it is a resource for everyday life, not just an end goal.
The correct answer (c. Health is incorporated into one’s activities of daily living) aligns with this definition because the Charter emphasizes that health should be integrated into all aspects of life, including work, education, family, and community participation. This perspective shifts the focus from just treating illness to creating conditions that support overall well-being, such as safe environments, social support, and healthy lifestyles.
How is health promotion distinct from health protection?
a. Health promotion focuses on assuring the highest possible quality in care.
b. Health promotion is concerned with enabling increased control over determinants of health.
c. Health promotion is the specific delivery of care by a group of health care providers.
d. Health promotion includes the particular achievements of social marketing campaigns.
b. Health promotion is concerned with enabling increased control over determinants of health.
Health Promotion vs. Health Protection: What’s the Difference?
Health Promotion (Proactive, Empowerment-Based)
• Goal: Helps individuals and communities gain control over their health by improving social, economic, and environmental factors.
• Focuses on: Education, policies, and lifestyle changes that promote long-term well-being.
• Example: Encouraging healthy eating, physical activity, and smoking cessation programs.
Health Protection (Reactive, Risk Prevention-Based)
• Goal: Protects people from health threats through regulations, interventions, and surveillance.
• Focuses on: Preventing illness, injury, and exposure to harmful factors.
• Example: Vaccination programs, food safety laws, environmental regulations, and infection control measures.
Key Difference:
• Health promotion = Making people healthier by empowering them (education, policies, behavior change).
• Health protection = Shielding people from health risks (laws, regulations, interventions).
Both are important in public health, but promotion is about empowerment, while protection is about prevention and regulation.
In his document entitled Achieving Health for All: A Framework for Health Promotion, Epp supported a community and policy focus in health promotion. What did he recommend?
a. Cooperating fully with the WHO member nations in implementing the plan internationally
b. Denying that the goal of health is socially and economically productive lives for all citizens
c. Taking actions that foster public participation
d. Focusing primarily on disease prevention and health promotion in selected areas
c. Taking actions that foster public participation
Who is Jake Epp and What is “Achieving Health for All”?
Jake Epp was Canada’s Minister of National Health and Welfare in the 1980s. In 1986, he introduced the document “Achieving Health for All: A Framework for Health Promotion,” which built on the Ottawa Charter for Health Promotion and set the foundation for Canada’s health policies.
Key Focus of the Document:
• Emphasized social and economic determinants of health
• Promoted public participation in health initiatives
• Shifted focus from treating illness to preventing it
• Advocated for community-based health policies
Why the Correct Answer is C (Public Participation)
Epp’s framework argued that people should have an active role in shaping their own health and that policies should be designed with community input, not just by governments or health professionals. The goal was to empower individuals and communities to take control over their health.
Why Not the Other Options?
• A (WHO cooperation) → While international cooperation is important, Epp’s focus was on Canada’s internal health policies.
• B (Denying social/economic goals of health) → This goes against the whole point of the framework, which recognized health as a social and economic issue.
• D (Focusing only on disease prevention in selected areas) → Epp’s framework was nationwide and broader than just disease prevention.
Bottom Line:
Epp’s “Achieving Health for All” was a landmark health policy document that pushed for public participation, social determinants of health, and prevention-focused policies in Canada.
Which of the following is an appropriate starting point for the application of a population health approach?
a. Emergency life-saving care
b. The determinants of health
c. Health promotion models
d. Risk management
b. The determinants of health
How is the contemplation stage for changing behaviour different from the precontemplation stage for changing behaviour?
a. During the contemplation stage, the client does not yet intend to change his or her behaviour within the next 6 months.
b. During the contemplation stage, there is a lack of readiness to change behaviour.
c. During the precontemplation stage, there is a readiness to change behaviour.
d. During the contemplation stage, the client is thinking about changing behaviour within the next 6 months.
d. During the contemplation stage, the client is thinking about changing behaviour within the next 6 months.
This question refers to the Stages of Change Model (also known as the Transtheoretical Model) developed by Prochaska and DiClemente. This model is commonly used in health behavior change interventions, such as smoking cessation, weight loss, and medication adherence.
Here’s a breakdown of the relevant stages:
1. Precontemplation Stage
• The individual is not considering changing their behavior.
• They may be unaware of the problem or resistant to change.
• They do not intend to take action within the next 6 months.
2. Contemplation Stage
• The individual is aware of the problem and thinking about change.
• They are considering the pros and cons of changing but have not yet committed.
• They intend to take action within the next 6 months.
Answer Explanation:
The correct answer (d) states that during the contemplation stage, the client is thinking about changing behavior within the next 6 months. This aligns with the model because contemplation involves recognizing the need for change but not yet taking action.
Which report introduced the concept of health promotion?
a. Epp Report
b. Black Report
c. Lalonde Report
d. WHO Commission Report on Social Determinants
c. Lalonde Report
The Lalonde Report (1974), officially titled “A New Perspective on the Health of Canadians,” was a groundbreaking Canadian government report that introduced the concept of health promotion and the idea that health is influenced by more than just medical care.
Key Contributions of the Lalonde Report:
• Introduced the “Health Field Concept”, which identified four key determinants of health:
1. Human biology (genetics and physiology)
2. Environment (physical and social surroundings)
3. Lifestyle (individual behaviors and habits)
4. Healthcare organization (medical services and systems)
• Shifted focus from medical treatment to prevention and the importance of healthy behaviors.
• Pioneered the global movement toward health promotion and public health interventions beyond just medical care.
The Lalonde Report is named after Marc Lalonde, who was Canada’s Minister of National Health and Welfare when the report was published in 1974. He spearheaded the initiative to explore factors beyond healthcare that influence health, leading to a groundbreaking shift in public health policy.
What is the most important feature of the Diffusion of Innovation Theory?
a. It avoids high-cost treatments and suggests cheaper alternatives.
b. It gives members incentives to use only network providers.
c. It shows that individuals adopt innovations at different rates.
d. It advocates working with geographically based communities.
c. It shows that individuals adopt innovations at different rates.
The Diffusion of Innovation Theory, developed by Everett Rogers, explains how new ideas, technologies, or practices spread within a society or social system. The key takeaway from this theory is that individuals adopt innovations at different rates, which is why option C is correct.
Key Concepts of Diffusion of Innovation Theory
1. Categories of Adopters:
• Innovators (2.5%) – First to adopt new ideas, willing to take risks.
• Early Adopters (13.5%) – Opinion leaders who influence others.
• Early Majority (34%) – Deliberate adopters who follow early adopters.
• Late Majority (34%) – Skeptical, adopting only after seeing success.
• Laggards (16%) – Resistant to change, last to adopt.
2. Stages of Adoption:
• Knowledge → Persuasion → Decision → Implementation → Confirmation
3. Factors Influencing Adoption:
• Relative advantage (Is it better than the existing method?)
• Compatibility (Does it fit with current values or needs?)
• Complexity (Is it easy to understand and use?)
• Trialability (Can it be tested before full adoption?)
• Observability (Are results visible to others?)
Relevance in Healthcare
• Helps in understanding how new medical practices, technologies, or public health interventions spread among healthcare professionals and the public.
• Used in nursing and public health to promote evidence-based practices, such as vaccination programs, telehealth adoption, or hand hygiene protocols.
The Canadian Community Health Nursing Standards of Practice identifies a community health nurse (CHN)’s role as advocate in creating public policy, as supporter of community action to influence public policy, and as instrument for societal change. What is an example of a healthy public policy?
a. Immunizations
b. Behaviour change
c. Marketing materials
d. Crib/bed safety initiatives for infants and young children
d. Crib/bed safety initiatives for infants and young children
What is an example of self-efficacy?
a. Attending a walk-in clinic for health care
b. Allowing others’ input into one’s health decisions
c. Paying for a fitness centre membership
d. Making healthy food choices while grocery shopping
d. Making healthy food choices while grocery shopping
Using the Community Mobilization Framework and the three health promotion community mobilization approaches, which element should be addressed first within the framework’s social planning component?
a. Shifting power relationships
b. Problem solving at the community level
c. Community participation
d. Community social concerns
b. Problem solving at the community level
The reason “Problem solving at the community level” is addressed first over the other elements (shifting power relationships, community participation, and social concerns) within the Community Mobilization Framework (CMF) is because effective mobilization starts with identifying and addressing a specific problem collectively. Here’s why:
Step-by-Step Breakdown of Prioritization
1. Problem Identification & Problem-Solving (First Priority)
• Before community members can shift power dynamics or increase participation, they must first define the issue affecting them.
• This stage involves data collection, assessing community needs, and prioritizing concerns.
• Without a clear, shared understanding of the issue, efforts at participation or shifting power structures may be misguided or ineffective.
2. Community Participation (Second Priority)
• Once a problem is clearly identified, engaging community members ensures they are active stakeholders in the process.
• Participation is key for sustainability and ensures solutions are culturally appropriate and widely accepted.
3. Shifting Power Relationships (Third Priority)
• As the community works on solving the problem, they can then start redistributing power—ensuring marginalized voices are heard and decision-making is more equitable.
• This is essential for long-term change but is difficult to achieve without first identifying and solving immediate concerns.
4. Community Social Concerns (Ongoing Process)
• Addressing broader social issues like inequality, discrimination, or systemic barriers can be embedded throughout the process.
• These concerns are important but require a solid foundation of problem-solving and participation first to drive meaningful action.
Why Not Start with Shifting Power or Participation?
• If power dynamics are the initial focus, without a clear problem-solving strategy, the community may struggle to rally around a specific action plan.
• If participation starts before problem-solving, efforts may lack direction, leading to engagement without clear goals.
Real-World Example (Public Health Nursing)
Imagine a rural community facing high rates of childhood obesity:
1. Problem-Solving First – Nurses and public health officials assess the root causes (lack of grocery stores, poor school meal options).
2. Community Participation – Parents, teachers, and local businesses join to create solutions (starting a farmer’s market, improving school meals).
3. Shifting Power – The community advocates for policy changes, ensuring better food access.
4. Addressing Social Concerns – Long-term efforts tackle poverty, food insecurity, and education on healthy eating.
Would you like more examples related to nursing or healthcare settings?
Which main idea did Lalonde highlight in his report entitled A New Perspective in the Health of Canadians (1974)?
a. Access to health care and cost and quality of health care
b. Appropriate legislation to control health care organizations
c. The influence of biology, environment, and lifestyle on good health
d. Accessibility and health promotion
c. The influence of biology, environment, and lifestyle on good health
What is perhaps the most helpful idea among the unlimited suggestions for how to improve health care in Canadian communities?
a. Increasing funding and personnel to advance new pharmaceutical interventions
b. Increasing funding for further research into the most effective medical interventions
c. Increasing technological advances to constantly improve surgical survival rates
d. Involving communities in their health care and encouraging their participation in decisions about health care
d. Involving communities in their health care and encouraging their participation in decisions about health care
Which of the following is the most important ingredient for effective community development?
a. Adequate funding
b. Appropriate location for the services provided
c. Community participation
d. Professional expertise
c. Community participation
What is the focus of health promotion in Canada?
a. Achieving consensus on community health needs
b. Developing a population approach based on the determinants of health
c. Dictating interventions that match the government’s identified priorities
d. Promoting individual health status
b. Developing a population approach based on the determinants of health
Which of the following represents a set of strategies and ideas aimed at reducing harm to an individual or society by modifying harmful or hazardous behaviours that are difficult and, in some cases, impossible to prevent?
a. Health promotion
b. Harm reduction
c. Tertiary care
d. Risk avoidance
b. Harm reduction
