Exam 1 Flashcards
What is health education
Any combination of learning experiences designed to predispose, enable, and reinforce voluntary behavior conducive to healthy individuals, groups, or communities
cognitive learning domain for health education
knowledge, memory, recognition, understanding, reasoning, application, problem solving
affective learning domain for health education
changes in attitudes and values, motivation
psychomotor learning domain for health education
skills, skill performance, demonstration, hands-on
what is the goal of health education
to translate knowledge into relevant interventions and strategies for health enhancement, disease prevention, and chronic illness management
what are the roles of nursing in health education
-become a partner with the client; collaborate
-offer appropriate health information and educational interventions– appropriate for culture, literacy, beliefs, etc.
-promote self-care, self-efficacy, and self-advocacy (empowerment)
-serve as catalyst for change
-activate ideas
-negotiate with client or mediate between client and other
-identify, link to, and facilitate navigation of recourses
-serve as counselor, consultant, case manager as necessary
what is the framework for developing health communications
- planning and strategy development
- developing and pretesting concepts, messages, and materials
- implementing the program
- assessing effectiveness and making refinements
what is part of the planning and strategy (step 1) stage for health education
-establish a relationship with clients
-assess what clients want to learn and what they think is important- this should be the crucial determinant of all goals of health education programs
-assess where clients are baseline
health education- stage 1, planning and strategy selection
-who is the audience?
-what is known about the audience and from what sources?
-what are the education objectives/goals?
-what evaluation strategies will the nurse use?
-what are the issues of most concern?
-what is the health issue of interest?
review data
get community partners involved
obtain new data
determine perceptions of health problems
determine communities assets and strengths
identify underlying issues and knowledge gaps
establish goals and objectives
assess resources
Most importantly:
-establish relationship with clients
-assess what clients want to learn and what is important to them
-assess where clients are baseline
health education stage II, developing and pretesting concepts, messages, and materials
questions:
-what channels are best?
-what communication educational formats should be used?
-what is the best setting to use?
-what is the best way to launch the program
-are there existing resources?
-how can the nurse present the message?
-how will the intended audience react to the message?
-will the audience understand, accept, and use the message?
-what changes may improve the message?
actions to take:
-id messages and materials
-decide whether to use existing materials or produce new ones
-select communication channels and formats
-develop relevant materials with the target audience
-pretest the message and materials and obtain audience feedback
-Brainstorming sessions
-roleplaying
-group discussions
-health fairs
-demonstration
-social media campaign
-select program setting
-determine how program will be “launched”
-evaluate all health materials before disseminating
-use materials in addition to teaching
-assess/address barriers to learning
what is health literacy
ability to read, understand, and act on health information
what is the REALM-SF
looks at understanding of medical terminology recognition not comprehension or proficiency.
estimates adult literacy in medicine
Rapid estimate adult literacy in medicine, short form
scores literacy level
they are given a list of medical terminology and asked to read out loud
higher score = higher literacy
REALM-SF Scoring
0- third grade and below, will not be able to read most low-literacy materials, will need repeated instructions, will need materials with primarily instructions
1-3: fourth-6th grade; will need low literacy materials; may not be able to read prescription labels
4-6: 7th to 8th grade; will struggle with most patient education materials; will not be offended by low literacy materials
7: high school; will be able to read most patient education materials
Newest Vital Sign (NVS)
assess numeracy and comprehension
uses nutrition label that clients must read and interpret
total of six questions related to label provided
SMOG readability formula
can be used to adapt anyone’s written materials to a specific audience reading level
flesch-kincaid formula
measures materials written between the 5th-grade and college level
important considerations with health literacy
dont assume low literacy
don’t ask directly
look for cues
ask indirectly- do you find it helpful for someone to read the health information with you?
assess using health literacy tools using language to explain that it is sensitive to the client
assess understanding– teach back
if suspicious of health illiteracy can intervene by reading materials and employing teach-back method to assess understanding
assessing relevancy of health materials
Do materials match the intended audience?
Are materials appealing and culturally and linguistically relevant?
Do they convey accurate and up-to-date information?
Are messages clear and understandable?
Do messages promote self-efficacy and motivation?
tips for teaching effective educational programs
-present a clear message
-use clear and concise language
-stick with essentials
-pace according to learners abilities
-summarize often
-involve clients in active and participatory learning
-allow time for questions
-employ teach-back methods
-conduct other forms of learner verification
the more input and participation the client has the more they will learn
tips for effective educational programs in general
-ID motivating factors
-set realistic goals and objectives
-develop a glossary of common words
-create positive learning environment throughout program/intervention
-space teaching over time and pace to learners abilities
-personalize health messages
-incorporate methods of illustration, demonstration, and real-life examples
-be a giver and receiver
-use creative methods
-id supportive recourses
-put clients at ease
-be encouraging, praise often
-remember that comprehension and understanding take time and practice
-evaluate the teaching plan
community
a group of individuals who interact as social units, sharing common characteristics, interests, values, and/or geographic locale
types of community
-face to face community or virtual community
-community based on political jurisdictions or physical boundaries
-neighborhood, city, state, national, or international community
-community of identifiable need or of special interest
nursing process in regards to community
Assessment of the community
Diagnosis- community focused
Planning with the community (mutual goals and objectives)
Implementation: with the community; intervention address the health of the community
Evaluation: with the community; outcomes are measured at the level of the community
what is the purposes of community assessment
provides opportunities to
-begin to know the community
-initiate partnerships and develop collaborations with community members
provides the basis for:
-identifying risk factors in the community and at-risk populations
-identifying community needs and community strengths
-identifying resources in community
what is included in a community assessment
-geography
-population
-environment
-industry
-education
-recreation
-religion
-communication
-transportation
-public services
-political organizaiton
-community development or planning
-disaster programs
-health statistics
-social problems
-health manpower
-health professional organizations
-community services
blooms taxonomy
Bloom identified 6 levels within the cognitive domain that represent intellectual activity
Lowest to highest level: basic to more abstract
knowledge- observation and recall information
Comprehension- understanding information
Application - use information
Analysis - see patterns
Synthesis- use old ideas to create new ones
Evaluation- compare and discriminate between ideas
sociodemographic community assessment data
-size
-age, gender, racial/ethnic distributions
-culture
-economic status
-employment
-educations
Health community assessment data
-general health status of community members
-risk factors and factors that support health
-environmental health
community assessment: primary data sources
-viral statistics
-epidemiological data
-census data
-hospital data
-data from the CDC
-literature reviews
What is the purpose of the windshield survey?
-community vitality
-indicators of social and economic conditions
-health resources
-environmental conditions related to health
-social functioning
-attitudes toward health and health care
What is the purpose of the key informant interview in the community assessment?
To collect information from a wide range of people, including community leaders, professions, or residents with firsthand knowledge about the community
Health planning model
- ID health problems and needs
- Prioritize identified problems and needs
- Analyze both primary and secondary data
- Priority health needs
- ID focus population/aggregate
- ID factors that contribute to the health need
Risk of… (disability, disease, etc)
Among (community or population)
Related to… (etiological statments)
As evidence by… (health indicators if appropriate )
Formative evaluation
Ongoing throughout the intervention, although can be at one time point during and a second time point at end of study
This is a way to determine if program is operating per planned
SUMMATIVE evaluation
Evaluation at the completion of intervention
Evaluation of the final product/outcome
Outcome evaluation
Focuses on the observable conditions or behaviors that the program was expected to affect most directly and immediately
Impact evaluation
Examines long-term outcomes- observable conditions or behaviors the program was expected to affect long term based on the program goals
what is public health?
the promotion of health and quality of life by preventing and controlling disease, injury, and disability
the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, communities, and individuals
what is the mission of public health
social justice, which entitles all people to basic necessities such as adequate income and health protection and accepts collective burdens to make this possible
what are some major public health achievements in the 20th century
-safer, healthier foods
-vaccine-preventable diseases
-flouridation of drinking water
-healthier mothers and babies
-family planning
-reduction in coronary heart disease and stroke
-safer, healthier workplaces
-motor vehicle safety
-control of infectious disease
John snow
connected water contamination to human disease (chlorea), removed the handle from the broad street pump
Florence Nightingale
she and a team of nurses improved the unsanitary conditions at a british base hospital, reducing the death count by two-thirds. Her writings sparked worldwide health care reform
lilian wald
nurse who created the henry street settlement in NYC. Connected poverty, justice, environmental conditions to health and was instrumental in training and expanding PHN role
Mary Breckinridge
Established the Frontier Nursing Service
what distinguishes public health from other specialties
focus- is on populations/communities or groups without populations/communities
goal- is to promote health and prevent disease of populations
outcome- healthy communities and populations
healthy people 2020
the national health promotion and disease prevention initiative
goals: attain high-quality, longer lives free of preventable disease, disability, injury, and premature death
achieve high equity, eliminate disparities, and improve the health of all groups
create social and physical environments that promote good health for all
promote quality of life, healthy development and health behaviors across all stages of life
what are the 3 CORE functions of public health
Assessment, policy development, assurance
Term
assessment core function of public health
assess health needs, investigate health problems & analyze the determinates of health
- monitor health status to identify and solve community health problems
- diagnose and investigate health problems and health hazards in the community
policy development core function of public health
advocate for resources to address needs, prioritize, and address health needs & plan and develop policies to address the priority health needs
- inform, educate, and empower people about health issues
- mobilize community partnerships and action to identify and solve health problems
- develop policies and plans that support individual and community health efforts
assurance core function of public health
manage resources, implement programs to address priority health needs, evaluate how those interventions are affecting populations & informing the community about health issues that are or could impact them and the resources available to them
-enforce laws and regulations that protect the health and ensure safety
-link people to needed personal health services and assure the provision of health care when otherwise unavailable
-assure competent public and personal health care workforce
-evaluate effectiveness, accessibility, and quality of personal and population- based health services
-research for new insights and innovative solutions to health problems
what is public health nursing
-the practice of promoting and protecting the health of populations
-uses knowledge from nursing as well as social and public health sciences to promote and protect the health of populations
-is population focused, with the goals of promoting health and preventing disease and disability for all people
what is upstream thinking that is utilized in public health nursing
-the focus is NOT to treat disease AFTER it occurs
-it is to critically analyze why disease occurs and to use this knowledge to prevent disease
-upstream thinking focuses on modifying economic, political, and environmental factors to support better health outcomes “downstream”
what is primary disease prevention
The steps you take to stop a disease from invading your body before it is present
what is secondary disease prevention
these are preventive efforts that occur during an infection, but in early stages before signs and symptoms appear and onset of disease
screenings– in an attempt to detect a disease EARLY– taking a blood pressure for someone in screening for hypertension
what is tertiary disease prevention
A form of prevention that occurs when an individual already has a disease and whose goals are to limit the negative impact of the disease
surveillance
describes and monitors health events through ongoing and systematic collection, analysis, and interpretation of health data for the purpose of planning, implementing, and evaluating public health interventions
outreach
locates populations of interest or populations at risk and provides information about the nature of the concern, what can be done about it, and how services can be obtained
screening
identifies individuals with unrecognized health risk factors or asymptomatic disease conditions in populations
referral and follow up
assists individuals, families, groups, organizations, and communities to identify and access necessary resources in to prevent or resolve problems or concerns
case management
optimizes self care capabilities of individual and families and the capacity of systems and communities to coordinate and provide services
delegated functions
direct care tasks a rn carries out under the authority of a health care practitioner as allowed by law. Delegated functions also include any direct care tasks a RN entrusts to other appropriate personnel to perform
health teaching
communicates facts, ideas, and skills that change knowledge, attitudes, values, beliefs, behaviors, and practices of individuals, families, systems, and/or communities
counseling
establishes an interpersonal relationship with a community, a system, family, or individual intended to increase or enhance their capacity for self-care and coping. Counseling engages the community, a system, family, or individual at an emotional level.
consultation
seeks information and generates optional solutions to perceived problems or issues through interactive problem solving with a community, system, family, or individual. the community, system, family, or individual selects and acts on the option best meeting the circumstances.
collaboration
commits two or more persons or organizations to achieve a common goal through enhancing the capacity of one ore more of the members to promote and protect health
coalition building
promotes and develops alliances among organizations or constituencies for a common purpose. it builds linkages, solves problems, and/or enhances local leadership to address health concerns
community organizing
helps community groups to identify common problems or goals, mobilize resources, and develop and implement strategies for reaching the goals they collectively have set
advocacy
pleads someone’s cause or act on someone’s behalf, with a focus on developing the community, system, individual or family’s capacity to plead their own cause or act on their behalf
social marketing
utilizes commercial marketing principles and technologies for programs designed to influence the knowledge, attitudes, values, beliefs, behaviors, and practice of the population of interest
policy development
places health issues on decision-makers agendas, acquires a plan of resolution, and determines needed resources. Policy development results in laws, rules, and regulation, ordinances, and policies
policy enforcement
compels others to comply with the laws, rules, regulations, ordinances and policies created in conjunction with policy development
health
health is a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity
health promotion
the process of enabling people to increase control over, and to improve their health
risk
refers to the chance or probability that a specific event will occur
In public health, risk refers to the chance or probability that disease, deterioration of disease status, or injury will occur.
ex: nonsmokers who are exposed to secondhand smoke at home or at work increase their risk of developing lung cancer by 20-30%
risk factor
individual attributes or characteristics of the physical and social environment that increase the likelihood that someone will engage in potentially harmful behaviors or suffer negative health outcomes
ex: negative attitudes among peers about condom use is a risk factor for unprotected sex.
ex: poor infrastructure for pedestrian safety is a risk factor for road traffic injuries
risk behavior
refers to a behavioral risk factor that increases the likelihood of disease, deterioration of disease status, or injury
ex: excessive alcohol use
risk exposure
things that may have negative impacts on health are generally considered part of one’s environment and largely outside of an individuals control
ex: developing respiratory distress as a result of indoor air pollution
ex: becoming infected with dengue after a mosquito bite
risk/harm reduction
policies, programs, and practices that aim to minimize negative health outcomes using evidence based practice
focuses on positive change and on working with people without judgement, coercion, or discrimination “meeting people where they are”
health promotion activities/interventions
-tools for the individual, interpersonal, community, or population
-ideas/resources for interventions at your clinical sites or population levels
healthy people 2030
comprehensive set of 10-year, national goals and objectives for improving the health of all Americans
five main topic areas with objectives –
-health conditions
-health behaviors
-populations
-settings and systems
-social determinants of health
social determinants of health
a set of conditions present in the environment where people are born, live, learn, work, play, worship, and age that affects health, daily functioning, life outcomes and risks
examples of social determinants
-economic stability
-education access and quality
-healthcare access and quality
-neighborhood and built environment
-social and community context
appalachian-specific social determinants
-median household income
-poverty
-disability
-education
-social associations
approaches to promote nutrition
individual:
-dietary assessment (food log)
-determine dietary needs
-explore family and cultural influences on food choices
-investigate accessibility to healthy options
population:
-influencing local grocers to sell fresh fruits/vegetables and low-fat and low-sodium products
-farmers markets/community gardens
-school contracts with local producers to provide healthy foods for school lunches
what is theory at a glance: application to health promotion
describes influential theories of health-related behaviors, processes of shaping behavior, and the effects of community and environmental factors on behavior
written for public health workers in state and local agencies, also for health promotion practitioners and volunteers
designed to help users understand how individuals, groups, and organizations behave and change
perceived susceptibility
beliefs about the chances of getting a condition
perceived severity
beliefs about the seriousness of a condition and its consequences
perceived benefits
beliefs about the effectiveness of taking action to reduce risk or seriousness
perceived barriers
beliefs about the material and psychological costs for taking action
cues to action
factors that activate readiness to change
self-efficacy
confidence in ones ability to take action
Behavior
The manner in which something acts, functions, responds, or reacts
Health behavior
The actions, responses, or reactions of an individual, group, or system that prevents illness, promote health and maintain quality of life
What is an example of individual health behavior
Using a condom
Getting vaccinated
Buckling your seatbelt
What is an example of group health behavior
Improving public parks
Instituting a citywide smoking ban
Preventive behavior
Health-related behaviors of people who are healthy and try to maintain their health
Illness behavior
Behavior undertaken by individuals who perceive themselves to be ill and who seek relief or definition of illness
Sick-role behavior
The treatment plan once an individual is diagnosed with a disease
microscopic change
Individuals as the focus
Macroscopic change
Community of society as the focus of change
Micro and macro change
Individual/family/AND community/society/systems as the focus of change
T/f: individuals can enter and exit the stages of change model at any time in the cycle
True
Milio’s Theory
Behavioral patterns are the result of habitual selection from limited choices which challenges the common idea that lack of knowledge was the main determinant of unhealthy behaviors
chrono system
-sociohistorial circumstances and environmental events that change over time; life transitions
Ex: children leaving home, administration changes, historic flood or fire
Macro system
Comprised of attitudes, ideologies, patterns of the culture that manifest in the micro, meso, and ecosystem; the agencies and agents of the larger solar system
Ex: patriarchy, capitalism, privelage
Exosystem
Larger social system /setting and the factors affecting ones life except there is no direct role in the system
Ex: depression of a spouse
Mesosystem
Essentially a system of Microsystems, defined by the individuals inter-relations/interactions with multiple settings in their micro system at developing points in time
Ex: role and setting of a farther pursuing his doctorate degree in public health
Microsystem
Groups, persons, or environments directly contacting the individual
Ex: the 7 children of a father, parents, spouse, professors, and coworkers of his three jobs
Individual
Sex, age, perceived stress, and family hx that encompasses process-person-conext-time (PPCT)
Ex: farmers age and sex as well as physical and psychosocial stress associated with farming demands
Community assessment: secondary data sources
-viral statistics
-epidemiological data
-census data
-hospital data
-data from the CDC
-literature reviews
