Chapter 9 Planning for Community Change Flashcards
chapter highlights
- health planning at the state, national, and global levels
- social and environmental determinants of health
- social ecological model and multilevel interventions
- community coalitions
- health impact pyramid
- health equity and social justice
- Lewis change theory, force field analysis, and levers of change
- logic model
- role of the community health worker
- funding community health interventions
- evaluating community health interventions
- nurse managed health centers
health planning
- defintion
organized and systematic process in which problems are identified, priorities selected, and objectives set for the development of community health programs based on the findings of community health assessments and health surveillance data
what levels can health planning occur on
global
national
regional
state
county
local
common themes of current national and international health plans
- providing health promotion and disease prevention at the population level
- addressing social determiannts
- achieving health equity
common themes of current national and international health plans
- providing health promotion and disease prevention t what level
population
common themes of current national and international health plans
- addressing what
social determinants
common themes of current national and international health plans
- achieving what
health equity
incidence vs prevalence
indicience is new
prevalence is all
national level implementations (2)
healthy people
national prevention strategy
ongoing planning is driven by trends in health outcomes and health behavior identified from
disease survalence by states and CDC
national prevention goal
increase the number of Americans who are healthy at every stage of life
national prevention goal 4 strategic directions for national prevention
- creating healthy and safe community enviornments
- integrating clinical and community preventive services
- empowering people in making healthy choices
- eliminating health disparities
national prevention goal 4 strategic directions for national prevention
- creating what type of enviornments
healthy and safe
national prevention goal 4 strategic directions for national prevention
- integrating what into the clinical and community
preventative services
national prevention goal 4 strategic directions for national prevention
- empowering people in making what choices
healthy
national prevention goal 4 strategic directions for national prevention
- eliminating what
health disparities
community health improvement plan (CHIP) does what
emphasizes accountability and includes specific performance measures for improvement
community assessment: systematic process that may use several approaches including
- key informatnt interviews
analysis of data on health status and
behaviors - observation
- community surveys
system theory
social systems engage in reciprocal exchange or flows of information, energy, resources, and goods or services
systems within the community are interdependent and interconnected
system theory
- systems within the community are
interdependent and interconnected
to develop a plan for the community, what are the steps
1 plan
2. coalitions
3. stakeholders
develop a plan for the community
- first step
identify the population
- could be whole country, state, city
- or population aggregate (ex: adults over 50)
develop a plan for the community
- factors to consider in forming a coalition include
history of working together
- was it successful or not
social ecological model
- defintion
multiple determinants of health interact at different levels to affect the health status of individual people, population aggregates, or communities
impact pyramid
- defintion
useful framework for community health nurses when planning health promotion interventions at multiple levels
bottom level of impact pyramid
socioeconomic factors
level above socioeconomic factors of the impact pyramid
changing the context to make individual default decisions healthy
- laws
level above changing the context to make individual default decisions healthy of the impact pyramid
long lasting protective interventions
- vaccines
level above long lasting protective interventions of the impact pyramid
clinical interventions
level above clinical interventions of the impact pyramid
education and counseling
3 types of multilevel interventions
upstream
mainstream
downstream
upstream
societal, environmental, or policy level
mainstream
at the population or community level
downstream
at the individual level
obesogenic
enviornment not healthy
salutogenic
enviornment is healthy
3 levels to Lewin’s change theory
unfreezing
changing
refreezing
Lewin’s change theory
- unfreezing
community moves form denial or lack of awareness to the need to change/address
Lewin’s change theory
- changing
process of changing or transition begins
Lewin’s change theory
- refreezing
process of stabilizing once change has occurred with the goal of sustaining the change in the community
force field analysis
- definition
tool used to identity the forces driving or restraining change
levers of change
- definition/goal
increase driving forces and/or to decrease restraining forces
community readiness for chnage
planning programs or interventions to change community health status include and assessment of the communities readiness to undertake the change process related to specific health issue
a communities readiness for change is
issue-specific
planning community level interventions need 3 things
guide to community preventive service
logic model
smart goals
SMART goals
specific measurable achievable relevant time bound
guide to community preventive service
- task force on community preventive service connects reviews of research for evidence of the effusiveness of
community based prevention and health promotion programs
logic model
- definition
how a program or intervention is expected to produce desirable outcomes
logic model
- steps
inputs/resources
activies
outputs/measures
intermediate outcomes
logic model
- inputs/rescources
what do we need
logic model
- actives
what are we doing
logic model
- outputs/mesures
how to measure
logic model
- intermediate outcomes
what re you expecting to see
community health worker
- definition
help bridge the gap between the community health nurse and the community especially when there are cultural and language differences
things we need to consider when creating a community level intervention (4)
accountability
sustainability
replication
funding
accountability
accountable for how the program was implemented
sustainability
how will this continue after funding has ended
replication
can we establish or replicate in another community
funding types
government
private
local
