Health Promotion And Adult Education Flashcards
0
Q
When did emphasis on health promotion begin?
A
With the nineteenth century epidemiologic revolution
1
Q
Health promotion
A
A process that supports positive lifestyle changes through corporate policies, individual efforts to lower risk of disease and injury and the creation of an environment that provides a sense of balance among work, family, personal health and social concerns
2
Q
Nineteenth century focus of health promotion
A
- Hygiene
- Sanitation
- Housing
- Working conditions
3
Q
Twentieth century focus of health promotion
A
Disease prevention and health
4
Q
1970s focus of health promotion
A
Recognition that more than half of premature deaths were preventable by lifestyle changes
5
Q
Early 1980s focus of health promotion
A
Comprehensive workplace health promotion programs instituted to help people change their behaviors
6
Q
1990s focus of health promotion
A
Concept of workplace health broadened to include not only behavioral and lifestyle change, but also organizational strategies that supported healthy work environments
7
Q
Twenty-first century and beyond focus of health promotion
A
As healthcare costs continue to soar, adding a significant burden to the industry, the major thrust becomes one of cost containment
8
Q
Health promotion activities are conducted by and draw upon expertise from the following fields
A
- Nursing
- Health education
- Medicine
- Psychology
- Nutrition
- Occupational and physical therapy
- Safety
- Ergonomics
9
Q
Health promotion focuses on
A
- Prevention of illness and injury with return to work strategies to prevent relapse
- Promotion of personal health accountability while partnering with the employer for enhanced outcomes
- Development of strategies for behavioral change
- Movement to optimal health by balancing physical, emotional, social, spiritual and intellectual health
- Creation of a supportive work environment through policy, programs and culture
10
Q
Consumerism
A
Used to describe the provision of education to consumers of healthcare so that they become more prudent users of healthcare services and can advocate for better care
11
Q
Self-care
A
Refers to individuals, each taking responsibility for his or her own health
12
Q
Percent of GDP spent on healthcare by large companies in 2004 and projected estimate for 2013
A
- 5%
18. 4%
13
Q
Business goals of health promotion
A
- Improved employee productivity
- Improved employee morale
- Reduced health care costs
- Recruitment and retention of employees
14
Q
Personal health goals of health promotion
A
- Identification and reduction of major health risks
- Maintenance and improvement of health and health conditions
- Improved energy and resilience
- Balanced work and personal life
15
Q
Recommended guidelines for physical exams
A
One per year
Have an established relationship with a provider and schedule appropriate preventative care
16
Q
Recommended guidelines for tetanus diphtheria
A
Every 10 years
Evaluate need for booster after injury
17
Q
Recommend guidelines for influenza vaccine
A
Annual vaccination
18
Q
High risk patients for influenza
A
Heart problems Lung problems Over 65 Diabetes Kidney dysfunction Lowered immunity Care takers if high risk persons
19
Q
Recommended guidelines for travel immunizations
A
Consult with personal provider with each trip and as soon as you know you will be traveling
20
Q
Recommended guidelines for blood pressure
A
Goal <120/80
Check annually if normal
21
Q
Recommended guidelines for fecal occult blood testing
A
Start at age 40
Annually
22
Q
Recommended guidelines for colonoscopy
A
Start at 50
Flexible sigmoidoscopy every 3-5 yrs
Colonoscopy every 5-10yrs
23
Q
Recommended guidelines for oral exam and cleaning
A
Every 6 months
24
Recommended guidelines for eye exams
20-29: one complete eye exam
30-39: at least 2 exams
40-64: exams every 2-3yrs
65+: exams every 1-2yrs
25
Recommended guidelines for PAP smear and cervical exam
Every 1-3yrs after age 18 to screen for cervical cancer
26
Recommended guidelines for clinical breast exam
Every 1-3yrs
| Annually after age 40
27
Recommended guidelines for mammography
40-49: every 1-2yrs
50+: annually
At risk women consult with healthcare provider for frequency
28
Recommended guidelines for prostate cancer screening
Start at age 40: at risk personal or family history and if African American- annual digital rectal exam
Age 50: annual digital rectal exam
Discuss PSA blood testing with healthcare provider
29
Recommended guidelines for testicular exam
Annual healthcare provider exam
30
Ways health promotion programs reduce unnecessary health cre utilization
1. Encourages appropriate use of health care delivery services
2. Prevents acute illness and injury and delaying development of chronic illness
3. Reducing symptom severity, discomfort and disability
31
Items that may be included in a health promotion program
1. Awareness and support programs
2. Screening programs and services
3. Lifestyle behavior change services and programs
4. Work-culture enhancement
32
Examples of awareness and support programs
1. Newsletters
2. Flyers
3. Posters
4. Seminars
5. Health fairs
33
Examples of lifestyle behavior change programs
1. Regular exercise
2. Good nutrition
3. Stress management
4. Smoking cessation
34
Examples of work/culture enhancement
1. Work/life programs
2. Organizational change efforts
3. Flexible work alternatives
35
Contributions of occupational and environmental health nurses to heal promotion
1. Keeping healthy people healthy
2. Identifying high risk populations and developing targeted interventions
3. Developing interventions for the management of disease conditions
4. Contributing to the comprehensive healthcare strategy for the organization
36
Healthy People 2010
- Objectives for improving health
- 467 objectives
- 28 focus areas
- seek to increase life expectancy and quality of life and to eliminate health disparities
37
To meet these goals, the implementation plan:
Supports gains in knowledge, motivation, and opportunities for better decision making
38
Healthy People 2010 encourages local and state leaders to accomplish the following:
1. Develop community and state efforts to promote healthy behaviors
2. Create healthy environments
3. Increase access to high quality health care
39
Areas of Healthy People 2010 of interest to occupational and environmental professionals
1. Physical activity
2. Obesity and weight loss
3. Tobacco use
4. Substance use
5. Mental health
6. Injury
7. Violence
8. Immunizations
9. Sexual behavior
10. Environmental quality
11. Improved access to health care
40
Occupational and environmental health nurses use Healthy People 2010 objectives to:
1. Benchmark with national norms
2. Justify program and service needs in discussions with management
3. Focus interventions
4. Develop site-specific population health goals and outcomes based on population data
41
Examples of Healthy People 2010 goals for a company population
1. Increase proportion of workers who exercise regularly
2. Increase the proportion of workers and their families who are at their desired weight
3. Increase the proportion of workers and their families who do not smoke tobacco
42
Example of strategy to " Increase proportion of workers who exercise regularly" and impact of strategy
Strategy: Employer will improve walking paths near the worksite and will allocate space for after hours exercise class
Impact: workers will have more energy, better weight control, less mental stress, and fewer disability claims
43
Example of strategy to "Increase the proportion of workers and their families who are at their desired weight" and impact of strategy
Strategy: company nurse will provide lunchtime nutrition courses
Impact: workers will generally feel better, they will have more energy, less mental stress and fewer disability claims
44
Example if strategy to "Increase the proportion of workers and their families who do not smoke tobacco" and impact of strategy
Strategy: at least one smoking cessation lecture series will be offered each quarter
Impact: workers will generally feel better, they will have more energy, less mental stress and fewer disability claims
45
Health models are developed as...
A means of explaining the concept of health and it's relationship to people's health decisions
46
Health Belief Model
- Developed by Godfrey Hochbaum, Stephen Kegeles, Howard Leventhal and Irwin Rosenstock
- Developed in 1950s
47
Major components of Health Belief Model
1. Perceived susceptibility
2. Perceived severity
3. Perceived benefits
4. Perceived barriers
5. Cues to action
6. Self-efficacy
7. Likelihood of an action being taken is driven by the positive difference between the perceived barriers and the perceived benefits
48
Perceived susceptibility
An individual's subjective estimation of his or her own personal risk of developing a specific health problem
49
Perceived severity
Refers to an individual's own personal judgement of how serious a health condition may be
50
Perceived susceptibility and perceived severity are often combined into....
Perceived threat
51
Perceived benefits
An individual's estimation of how effective a health recommendation may be against removing a threat
52
Perceived barriers
An individual's estimation of the obstacles to the performance of a health-related behavior
53
Cues to action
Strategies to activate one's readiness for action
54
Self efficacy
Refer's to one's confidence in one's own ability to take action
55
Health Promotion Model
- Pender
- 2002
- Derived from social learns theory (Section IV.C)
- Organized like the Health Belief Model
56
Health Promotion Model is based on the following premises:
1. Health promotion is directed at increasing the level of well being and self actualization of an individual or group
2. Health promoting behaviors are continuing activities that must be an integral part of an individual's lifestyle
3. Health promoting behaviors are viewed as proactive rather than reactive
57
Health Promotion Planning Model
- known as PRECEDE
| - used to help plan and evaluate health promotion activities
58
PRECEDE Model consists of:
1. Predisposing factors
2. Reinforcing factors
3. Enabling factors
59
Predisposing factors
1. Attitudes
| 2. Knowledge
60
Reinforcing factors
1. Rewards
| 2. Positive feedback
61
Enabling factors
Resources that facilitate or hinder performance of desired outcome
62
Health Promotion Planning a model considers multiple factors that shape health such as:
1. Behavior
2. Lifestyle
3. Environment
63
In the Health Promotion Planning Model ------ and ------ are viewed as important influences on the quality of life
Health promotion education
| Policy
64
Expected outcome of Health Promotion Planning Model
Quality of life
65
Application of Health Promotion Planning Model begins with
The determination to work on controllable behaviors
66
Model of Health Promotion Behavior
Proposes that self efficacy beliefs play a central role regarding health beliefs and behavior
67
Basic premises of Model of Health Promotion Behavior
1. Optimal health represents a balance between physical, emotional, social, spiritual and intellectual health
2. Programs and services are targeted at three levels
68
Targeted three levels of Model of Health Promotion Behavior
1. Awareness
2. Lifestyle and behavioral change
3. Supportive environments
69
An expanded version of the Model of Health Promotion Behavior includes a dimension labeled....
Occupational/Environmental
70
Expanded version of Model of Health Promotion Behavior
- more comprehensive model
- includes the concept of work
- draws attention to the importance of work and how work is integrated into the fabric of our lives
71
Harm Reduction Model
Assumes that health risks can be decreased by asking clients:
1. What is healthier, safer or less risky than what I am doing now?
2. What steps am I willing to take in order to be healthier, safer or less risky?
72
Basic principles of Harm Reduction Model
1. Most people are competent to make informed decisions about health behaviors
2. Needs are diverse, so it is better to offer numerous behaviors rather than one solution
3. Incremental changes in steps will work better than making large, difficult changes
4. People need social support, eduction, referrals and assistance to make changes
73
An analysis of psychotherapy theories for behavior change was performed to.....
Identify psychotherapeutic principles that relate to helping people change their behavior
74
Types of psychotherapy theories for behavior change:
1. Verbal theories
| 2. Action or behavioral theories
75
Verbal theories
Use language and emotion to guide changes in behavior
76
Types of verbal theory
1. Consciousness raising
2. Catharsis
3. Choosing
77
Conscious raising
Uses the individual's personal experience feedback to stimulate responses
78
Catharsis
Allows individuals to express emotions, which produces personal relief and improvement
79
Choosing
Gives alternatives responses for individuals, and self liberation occurs when they choose an alternative
80
Action or behavioral theories
Use stimuli outside the individual to evoke an action or behavior
81
Types of action or behavioral theory
1. Conditional stimuli
2. Counter-conditioning
3. Stimulus control
4. Contingency control
5. Reevaluation
82
Conditional stimuli
Refers to critical changes made in the stimuli that influence responses
83
Counter-conditioning
Occurs when an individual changes his or her response to a stimulus
84
Stimulus control
Occurs when the environment is changed
85
Contingency control
Refers to managing change by making changes in the environment to cause individuals to change
86
Reevaluation (action or behavioral theory)
Occurs when individuals change in response to consequences without contingency changes in the environment
87
Transtheoretical theory- stages of change model
- Prochaska & DiClemente
- 1983
- describes interventions tailored to individual responses at specific levels or stages
88
Transtheoretical theory- stages of change model was formulated by......
Using numerous psychotherapy theories to develop the stages of change model to produce sustained behavioral change
89
The content of the Transtheoretical theory- stages of change model theory varies from client to client depending on the client's......
1. History of actions
2. Present environment
3. Personality
90
The stages of change in the Transtheoretical theory- stages of change model include the following:
1. Precontemplation
2. Contemplation
3. Planning
4. Action
5. Maintenance
91
Precontemplation stage of Transtheoretical theory- stages of change model
Clients are not considering making a change
92
Contemplation stage of Transtheoretical theory- stages of change model
Clients are beginning to explore or think about making a change
93
Planning stage of Transtheoretical theory- stages of change model
Clients are determined to stop and begin developing a plan
94
Action stage of Transtheoretical theory- stages of change model
Clients modify their behavior, which may also mean they change their environment
95
Maintenance stage of Transtheoretical theory- stages of change model
Continues as the new behavior continues to be practiced
96
Central premise of Transtheoretical theory- stages of change model
That people progress through a series of stages when they attempt to change behaviors
97
---- different processes are used to enhance progression through the stages of change
Ten
98
Processes used to enhance profession through stages of change include:
1. Consciousness raising
2. Dramatic relief
3. Environmental reevaluation
4. Self-reevaluation
5. Self-liberation
6. Relationships
7. Social liberation
8. Counterconditioning
9. Stimulus control
10. Reinforcement management
99
Consciousness raising
Transtheoretical theory- stages of change model
Increasing awareness
100
Dramatic relief
Transtheoretical theory- stages of change model
Experiencing and expressing feelings
101
Environmental reevaluation
Transtheoretical theory- stages of change model
Assessing how environment affects the situation
102
Self-reevaluation
Transtheoretical theory- stages of change model
How person feels about the situation
103
Self-liberation
Transtheoretical theory- stages of change model
Belief in ability to change
104
Relationships
Transtheoretical theory- stages of change model
Support
105
Social liberation
Transtheoretical theory- stages of change model
Assessing social changes that support changes
106
Counterconditioning
Transtheoretical theory- stages of change model
Substituting healthier behaviors
107
Stimulus control
Transtheoretical theory- stages of change model
Restructuring the environment
108
Reinforcement management
Transtheoretical theory- stages of change model
Getting rewards
109
Identifying and classifying the population into the stages of change should guide.....
1. Program planning
| 2. Interventions
110
Behavior change tools developed using the stages of change......
Provide a comprehensive framework to move more behaviors towards maintenance
111
Stages of change theory using psychotherapy theories examples of processes in contemplation stage to facilitate change
1. Consciousness raising
| 2. Feedback
112
Stages of change theory using psychotherapy theories examples of processes in planning stage to facilitate change
1. Choosing
2. Self-liberation
3. Catharsis
113
Stages of change theory using psychotherapy theories examples of processes in action/maintenance stage to facilitate change
1. Contingency control
2. Reevaluation
3. Conditional stimuli
4. Stimulus control
114
Stages of change theory using health promotion activities examples of processes in precontemplation stage to facilitate change
1. Posters
2. Invitation classes
3. Buddy system
115
Stages of change theory using health promotion activities examples of processes in contemplation stage to facilitate change
1. Health fairs
2. Newsletters
3. Brochures
4. Pamphlets
5. Health education classes
6. Buddy system
7. HRA
116
Stages of change theory using health promotion activities examples of processes in planning stage to facilitate change
1. Health education classes
2. Counseling
3. Health planner
117
Stages of change theory using health promotion activities examples of processes in action/maintenance stage to facilitate change
1. Follow-up contact
2. Environmental supports
3. Health education
118
Social learning theory
Proposes that people's thoughts have a strong effect on their behavior, and their behavior affects their thoughts
119
Social cognitive-self-efficacy theory
- Bandura, 1986
| - describes the factors involved in making decisions related to healthy behavior
120
Factors involved in making decisions related to healthy behavior according to social cognitive-self-efficacy theory
1. Personal efficacy
2. Social support
3. Environmental support
4. Behavioral experiences
121
Self-efficacy
Social cognitive-self-efficacy theory
An individual's confidence in his or her ability to perform
122
An individual's efficacy expectation determines:
1. His or her choice of activity
2. How much effort he or she will expend
3. How persistent he or she will be
123
Supporting an individual's --------- may be the single st important factor in a person's success in changing personal health behaviors
Self efficacy efforts
124
According to the Locus of Control Theory types of locus of control
1. Internal locus of control
| 2. External locus of control
125
Internal locus of control
An individual's belief (outcome expectation) that his or her own behavior determines reinforcement (outcomes)
126
External locus of control
An individual's belief (outcome expectation) that reinforcements (outcomes) are controlled by others
127
Theoretically, individuals with --------- locus of control are rode likely to take control of their health and engage in health promotion activities that are those with ------- locus of control
Internal
External
128
Ways to motivate individuals for improved internal locus of control
1. Intrinsic motivation
2. External stimulus applied to to intrinsic motivation
3. Extrinsic motivation
129
Example of intrinsic motivation to improve internal locus of control
Increase participants' perception of success
130
Example of external stimulus applied to intrinsic motivation to improve internal locus of control
Reinforce positive actions
131
Examples of extrinsic motivation to improve internal locus of control
1. Provide incentive for participation and accomplishment of goals
2. Involve family support
3. Reinforce health messages in the environment, for example, vending machines, cafeteria, work spaces, and management communications
132
Transactional theory
Is characterized by "reciprocal determinism", in which individuals change behavior then begin to actively participate with others in the new behavior
133
Reciprocal determinism strengthens the individual's......
Desire to continue that new behavior or find the need to change the environment
134
Efficacy and support can....
Modify behavior
135
Direct experience with e new behavior increases....
The level of efficacy and support
136
Actions the occupational and environmental health nurse can take to reinforce the principles of transactional theory
1. Recreational leagues
2. Teams
3. Buddy systems
4. Support groups
137
The Theory of Reasoned Action
Proposes that behavioral intentions are the result of one's attitudes and subjective norms
138
Attitudes
The Theory of Reasoned Action
Are determined by beliefs regarding the consequences of a behavior and one's positive or negative evaluation of those consequences
139
Subjective norms
The Theory of Reasoned Action
Refer to a person's beliefs or perceptions about what others think he or she should do
140
Intentions
The Theory of Reasoned Action
The immediate determinant of behavior
141
Theory of Planned Behavior
- builds on the Theory of Reasoned Action
- the element added to that theory is the belief that one has the resources to perform the behavior
- Ajzen, 1988
142
Theory of Goal Setting
States that setting goals can help people change health-related behaviors by focusing effort, persistence, and concentration
143
The steps to setting goals include:
1. Determination of commitment to change
2. Analysis of tasks required to make changes; breaking complex tasks into smaller tasks
3. Assessment of the client's self-efficacy for performing required behaviors
4. Establishment of reasonable goals
5. Feedback for continued success
144
Theory of Social Behavior
States that the probability that an act will occur in a specific situation is equal to the sum of the person's habit and intention
145
Protection Motivation Theory
Combines features of the Health Belief Model with self-efficacy theory and other social psychologic constructs such as fear, arousal, appraisal and coping
146
Health Action Process Approach
States that health behavior change takes place over time
147
Levels of prevention
1. Primary prevention
2. Secondary prevention
3. Tertiary prevention
148
Primary prevention
Is aimed at eliminating or reducing risk of disease through specific actions
149
Examples of primary prevention
1. Immunizations
2. Stress management
3. Smoking avoidance
4. Risk factor appraisal
5. Seat belt use
6. Work-site walk-throughs
7. Use of personal protective equipment
150
Secondary prevention
Is directly aimed at early case-finding and diagnosis of individuals with disease in order to institute prompt interventions
151
Examples of secondary prevention interventions
1. Screening programs
2. Health surveillance
3. Monitoring health and illness trend data
4. Preplacement examinations
5. Periodic examinations
152
Tertiary prevention
Is directed at rehabilitating and restoring individuals to their maximum health potential
153
Examples of tertiary prevention interventions
1. Disability case management
2. Early return to work
3. Chronic illness monitoring
4. Substance abuse rehabilitation
