HEALTH PROMOTION/TEACHING Flashcards
Exam 2
Health Promotion:
What are they?
Interventions that bring populations closer to wellness
Health Promotion:
What do they increase?
Increase the span of healthy life for all citizens
Health Promotion:
What do they reduce?
Reduce health disparities among population groups
Health Promotion:
What do they achieve?
Achieve access to preventive services for everyone
Social Determinants
Factors that influence an individual’s ability to maintain good health include social, economic, and physical factors such as:
Social Determinants
Factors that influence an individual’s ability to maintain good health include social, economic, and physical factors such as:
Access to social and economic opportunities
Safe housing
Quality education
Clean water, food, and air
Safe workplaces
Equitable social interactions
Adequate community resources
Overarching Goals Healthy People 2030 :
To Attain?
Attain healthy, thriving lives and well-being free of preventable disease, disability, injury, and premature death.
Overarching Goals Healthy People 2030 :
To eliminate?
Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.
Overarching Goals Healthy People 2030 :
To create?
Create social, physical, and economic environments that promote attaining the full potential for health and well-being for all.
Overarching Goals Healthy People 2030 :
To promote?
Promote healthy development, healthy behaviors, and well-being across all life stages.
Overarching Goals Healthy People 2030 :
To engage?
Engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all
Leading Health Indicators HP 2030 include:
Children, adolescents, and adults who use the oral health care system (2+ years)
Consumption of calories from added sugars by persons aged 2 years and over (2+ years)
Drug overdose deaths
Exposure to unhealthy air
Homicides
Responsible sexual behavior
Household food
insecurity and hunger
Persons who are vaccinated annually against seasonal influenza
Persons who know their HIV status (13+ years)
Persons with medical insurance (< 65 years)
Suicides
Levels of Prevention of Health Problems
What is prevention –
Minimizing potential disability or impairment by anticipating problems early.
Levels of Prevention of Health Problems
Three levels
Primary:
Secondary:
Tertiary:
Levels of Prevention of Health Problems
Three levels: Primary
Primary: Efforts to deter illnesses or injuries.
Levels of Prevention of Health Problems
Three levels: Secondary
Secondary: Detecting and treating existing diseases
Levels of Prevention of Health Problems
Three levels: Tertiary
Tertiary: Reducing the severity of a health problem to restore previous function
Question:
Which activity or activities reflect a community health nurse engaged at the primary prevention level?
A. Teaching handwashing to preschoolers
B. Performing adult diabetic screening
C. Encouraging women to do breast self-examination
D. Helping with a postmastectomy exercise program
A. Teaching handwashing to preschoolers
Rationale: An educational program that teaches handwashing to preschoolers is an example of primary prevention. Performing diabetic screening and encouraging breast self-exam are examples of secondary prevention level activities. A postmastectomy exercise program would be an example of a tertiary prevention level activity.
Health Promotion Through Change
CHN educator:
CHN educator: Enables changes in behavior
Health Promotion Through Change
Changing behavior: What are reasons for change?
Different reasons for change
Health Promotion Through Change
Changing behavior: What occurs before success?
Attempts and failure several times before success
Health Promotion Through Change
Changing behavior: How long to work on changes?
Working at some changes possibly lifelong
Health Promotion Through Change
Changing behavior: How do most people change?
Most people change on their own without special programs
Health Promotion Through Change
Changing behavior:
How are people?
People are different; what works for one may not work for another
Definitions and Types of Change:
What is change?
An imbalance or upset equilibrium requiring adjustments
Definitions and Types of Change:
Change is a process of what?
Process of adopting innovation
Definitions and Types of Change:
How is change?
Disruptive; generally new roles adopted
Definitions and Types of Change
Types of change:
Evolutionary:
Revolutionary:
Empiric–rational
Normative–reeducative
Power–coercive
Definitions and Types of Change
Types of change: Evolutionary
gradual;
adjustment on incremental basis
Definitions and Types of Change
Types of change: Revolutionary
rapid, drastic, threatening type; possible complete upset of balance of system
Definitions and Types of Change
Types of change: Empiric–rational
What is it and how are people?
Empiric–rational (similar to technostructural, data-based, and communication-related strategies)
People are rational; will adopt new practices that appear to be in their best interest
Definitions and Types of Change
Types of change: Normative–reeducative
What is it and how are people?
Normative–reeducative (similar to educational, facilitative, and persuasive strategies)
New information; direct influence on people’s attitudes and behaviors through persuasion
Definitions and Types of Change
Types of change: Power–coercive
What is it and how are people?
Power–coercive (similar to coercive strategy)
Use of coercion based on fear
Stages of Change:
Who was it first described by?
First described by Kurt Lewin
Stages of Change:
Stages include:
Unfreezing
Changing/moving
Refreezing
Stages of Change:
Stages include: Unfreezing
Unfreezing (when desire for change develops)
Stages of Change:
Stages include: Changing/moving
Changing/moving (when new ideas are accepted and tried out)
Stages of Change:
Stages include: Refreezing
Refreezing (when the change is integrated and stabilized in practice)
Planned Change:
What is it?
Purposeful and intentional
Change by design not default
Planned Change:
What is the aim?
Improvement as the aim for planned community health change
Planned Change:
How are accomplishments made?
Accomplishment through an influencing agent
Stages of Planned Change: 8 steps
Recognize symptoms
Diagnose need
Analyze alternative solutions
Select a change
Plan the change
Implement the change
Evaluate the change
Stabilize the change
Question:
Which characterizes normative–reeducative strategies for change?
A. Persuasion
B. Coercion
C. Rationality
D. Best interests
A. Persuasion
Rationale: The normative–reeducative strategy involves new information that directly influences people’s attitudes and behaviors through persuasion. Empiric–rational strategies are used to effect change based on the assumption that people are rational and when presented with information will adopt new practices that appear to be in their best interest. Power–coercive strategies use coercion based on fear to effect change.
Principles for Effecting Positive Change
Participation
Resistance to change
Proper timing
Interdependence
Flexibility
Self-understanding
Domains of Learning include:
Cognitive
Affective
Psychomotor
Domains of Learning include:
Cognitive:
Cognitive: mind and thinking processes
Domains of Learning include:
Cognitive: mind and thinking processes
Knowledge
Comprehension
Application
Analysis
Synthesis
Evaluation
Domains of Learning include:
Affective:
Affective: emotion, feeling, and affect
Domains of Learning include:
Psychomotor:
Psychomotor: visible demonstration of performance skills requiring some type of neuromuscular coordination
Learning Theories include:
Social
Humanistic
Learning Theories include:
Social learning theory is by:
Bandura
Learning Theories include:
Social learning theory: What are qualities of this?
Coincidental association
Inappropriate generalization
Perceived self-efficacy
Learning Theories include:
Humanistic: by who?
Abraham Maslow
Learning Theories include:
Humanistic: What is it?
Hierarchy of human needs
Learning Theories include:
Humanistic: Hierarchy of human needs
Physiologic
safety and security
love and sense of belonging
self-esteem
self-actualization
Adult Learners
Characteristics of adults with implications for learning
Self-directed
Life experience
Readiness to learn
Problem-centered time perspective
Health Teaching Models
include:
Health Belief Model (HBM)
Pender’s Health Promotion Model (HPM), revised
PRECEDE and PROCEED Models
Health Teaching Models
Health Belief Model (HBM):
Readiness to act on behalf of a person’s own health predicated on six concepts (perceived susceptibility, perceived seriousness, perceived benefits of action, barriers to taking action, cues to action, and self-efficacy)
Health Teaching Models
Health Belief Model (HBM):
Readiness to act on behalf of a person’s own health predicated on six concepts- including
(perceived susceptibility, perceived seriousness, perceived benefits of action, barriers to taking action, cues to action, and self-efficacy)
Health Teaching Models
Pender’s Health Promotion Model (HPM), revised
What does it include?
Individual characteristics and experiences
Behavior-specific cognitions
Behavior outcomes
Health Teaching Models
PRECEDE and PROCEED Models
What is included in PRECEDE?
Predisposing,
Reinforcing, and
Enabling Constructs in
Educational/Ecological
Diagnosis and Evaluation
Health Teaching Models
PRECEDE and PROCEED Models
What is included in PROCEED?
Policy,
Regulatory, and
Organizational Constructs for
Educational and
Environmental Development
Question
Which health teaching model explains the behaviors and actions taken by people to prevent illness and injury?
A. Health Belief Model (HBM)
B. Health Promotion Model (HPM)
C. PRECEDE model
A. Health Belief Model (HBM)
Rationale: The HBM is useful for explaining the behaviors and actions taken by people to prevent illness and injury.
The HPM includes three general areas: individual characteristics and experiences, behavior-specific cognitions, and behavioral outcomes.
The PRECEDE model involves social, epidemiological, and education/ecological assessments followed by administrative and policy assessment and intervention alignment, and implementation.
Teaching–Learning Principles include:
Client readiness
Client application
Client satisfaction
Subject Relevance
Client participation
Educational environment
Client perceptions
Teaching Methods and Materials
How can teaching be?
Formal or informal, planned or unplanned
Teaching Methods and Materials
Methods:
Lecture
Discussion
Demonstration
Role-playing
Teaching Methods and Materials
Materials include:
Materials (visual images, anatomic models, equipment, printed support materials, examples)
Teaching Methods and Materials
How should materials be?
Content, complexity, reading level, culturally appropriate
Teaching Plan Considerations:
Teaching in community health nursing-
Teaching in community health nursing is the facilitation of learning that leads to behavioral change in the client.
Teaching Plan Considerations:
Ideally, when is this done?
Ideally, this is done at the primary level of prevention.
However, much of the nurse’s work is done at the secondary and tertiary levels.
Clients with Special Learning Needs
What can it include?
Cultural or language differences
Hearing impairments
Developmental delays
Memory losses
Visual perception distortions
Problems with fine or gross motor skills
Distracting personality characteristics
Demonstrations of stress or emotions
Question
Is the following statement true or false?
Assessment and diagnosis is the first step in the teaching process.
False
Rationale: The first step in the teaching process is interaction, establishing basic communication patterns between clients and nurse. Assessment and diagnosis follows.
Planning for Community Change
What could be included:
Health impact pyramid
Health equity and social justice
Lewin’s change theory, force field analysis, and levers of change
Logic models
Role of the community health worker
Funding community health interventions
Evaluating community health interventions
Nurse-managed health centers
Health Planning: What kind of process is this?
What is identified? What is selected?
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.
Health Planning:
What are common themes of current national and international health plans?
Common themes of current national and international health plans include providing health promotion and disease prevention at the population level, addressing social determinants of health, and achieving health equity.
Community Health Planning:
What does it involve?
Systematic process that involves all sectors of a community to conduct a comprehensive community health assessment (CHA), identify priorities for action, develop and implement a community health improvement plan (CHIP), and guide future community decisions and resource allocations.
Determinants of Health- slide 36?
Do not get ittttt!
Levels of Interventions:
What interacts to affect the health status of people, populations or communities?
Multiple determinants of health interact at different levels to affect the health status of individual people, population aggregates, or communities.
Levels of Interventions:
What is needed to achieve change in complex community health conditions that have multiple determinants?
Multilevel interventions are needed to achieve change in complex community health conditions that have multiple determinants.
Concepts for Planning Community change
Force field analysis
Levers of change
Lewin’s Model of Change
Community readiness for change
Concepts for Planning Community change
levers of change
The purpose of using levers of change is to increase driving forces and/or to decrease restraining forces.
Concepts for Planning Community change
Force field analysis
Force field analysis is a tool used to identify the forces driving or restraining change.
Concepts for Planning Community change
levers of change: What is an example?
For example, tax increases on tobacco, alcohol, or soft drinks can serve as policy levers to bring about change in community health status.
Concepts for Planning Community change
Community readiness for change:
Planning programs or interventions to change community health status include an assessment of the community’s readiness to undertake the change process related to a specific health issue.
Planning Community-Level Interventions
Include:
The community guide from the Community Preventive Services Task Force (CPSTF).
Logic model
SMART objectives
Collaboration and Teamwork:
Community health workers
Community health workers can help bridge the gap between the community health nurse and the community, especially when there are cultural and language differences.
Collaboration and Teamwork
Nurses
Nurses can play an important role in their professional and personal lives as advocates and champions for health improvement, social justice, and health equity at the local, regional, national, and global levels.
Social Marketing
Use of marketing principles and practices to change health behaviors or beliefs, social or cultural norms, or community standards to improve health or benefit society
Community Benefit Programs
Community benefit programs of local or regional hospitals and HMOs may be valuable partners to the public health department or community health nurse in planning, implementing, and funding programs to improve population health.
Community Benefit Programs:
Nurse-managed health centers
Nurse-managed health centers provide health promotion and primary care services to vulnerable and underserved population aggregates.
