Week 3-5 Flashcards
Rural Health Inequities
- Access to care
- Access to technology
- Water quality
- Food insecurity
Rural Health Barriers
- Low income
- Lower secondary education rate
- Increase smoking & obesity
- Lower life expectancy
- Higher mortality risks
- Social exclusion
Family Assessment
- Strength-based
- Create therapeutic relationship
- Information gathering (exploratory & prior)
- Check personal biases
McGill Model
- All families possess health potential
- Engagement in health-related problem solving
- Competence in health behavior
- Improve health status
Genogram
- Family structure through composition
- Identify individual/family strengths
Ecomap
- Family within community context
- Clients social network
Spiralling Process
Phase 1
- Exploring
- Look for strengths
Phase 2
- Zeroing in
- Identify workable goals
- Prioritize goals
Phase 3
- Working out
- Plan into action
Phase 4
- Reviewing
- Appreciate strengths/resources
- Clients feelings
Community Health Needs Assessment
- Identify strengths/needs of community
- Collaborative action planning
- Improving health status/quality of life
Community as Partner Model
- People in community
- Stressors penetrate community
- Effects on equilibrium
- Interventions on various prevention levels
Community as Capacity Model
- Strengthen ability of community
- Members take action
- Further development
Community Health Promotion Model
- Acknowledge determinants
PISO
- Who is population
- What is the intervention
- Where is the setting
- What is anticipated outcome
Community Assessment Types
- Environmental scan (preliminary)
- Problem investigation
- Resource evaluation
- Needs assessment
Community Data Sources
- Surveys
- Forums
- Focus groups
- Windshield surveys
- Literature review
- Census/government data
Community Governance
- Group of members take lead
Community Development
- Involvement of community members
- Identify & strengthen aspects
- Support health concern
Community Mobilization
- Few community members
- Commence taking action to develop solution
- Other members will join
Empowerment Components
- Access to information
- Range of options
- Assertiveness to express ideas
- Stand up for oneself
- Belief that one can make a difference
- Learn critical thinking
Nursing Empowerment
- People gain greater control over their health
- Enhancing capacity of individuals
- Make choices to achieve their goals
Canadian Community Health Nursing Practice Standards
- Health promotion
- Professional relationships
- Evidence informed practice
- Prevention & health protection
- Capacity building
- Professional responsibility & accountability
- Health equity
- Health, maintenance, restoration & palliation
Capacity Building CHN
- Encourages community to be active
- Take ownership of health issues
- Decision making
- Recognize health barriers
- Building existing strengths
Community Asset Map
- Outline assets & capacity
- Identify strengths
- Identify potential resources for interventions
Data Collection
- Skills & experiences
- Services
- Physical & financial resources
Intersectoral
- Collaborative actions
- Involve 1+ specialized agency
- Completing different roles
- Achieve common goal
CNH Role in Intersectional
- Education
- Housing
- Public works
- Coordinate efforts
- Upstream or downstream
Older Adult Health Promotion
- Physical activity & fall prevention
- Healthy eating
- Medication safety/polypharmacy
- Immunizations
- Sexual health
- Mental health
- Abuse
Gender Identity
- How the individual defines & understands
- Based on options they know exist
Gender Expression
- Unique ways gender is demonstrated
- Dress, actions, demeanor
Institutionalized Gender
- Distribution of power between genders
Overgeneralization
- If its good for men, its good for women
Gender Based Lens
- Examine context to identify constraints & opportunities
- Examine impact of gender, biological sex, gender bias
Gender Lens Application
- How is problem different for men/women
- Different contexts in lives of men/women
- Identification of diversity within subgroups of men/women
- Intended/unintended outcomes for men/women
- Social, political, economic realities
Leading Health Issues (Men)
- Cardiovascular disease
- Respiratory disorders
- Stress/depression
- Suicide
- Accidental injuries
- Addiction/substance misuse
Leading Health Issues (Women)
- Violence/abuse
- Anxiety, depression, stress
- Body dissatisfaction
- Getting older, poverty
- MSK disease
- Autoimmune diseases
- Cardiovascular disease
Community Health Programs
- Series of activities
- Supported by group of resources
- Achieve specific outcome
- Target groups
Situational Assessment (Step 1)
- Learn more about population
- Identify wants, needs, assets
- Set priorities
Data Gathering Plan (Step 2)
- Health status reports
- Community health survey
- Public health agency
Gathering Data (Step 3)
- Environmental scans
- Quantitative (research, reports)
- Qualitative (focus groups)
SWOT Analysis (Step 4)
- Strengths
- Weaknesses
- Opportunities
- Threats
Communicate & Consider (Steps 5, 6)
- Tell stakeholders key findings
- How to proceed with planning
Logic Model
- Program planning & evaluation
- Diagrammatic representation
- Relationships among program components
Logic Model Planning
- CAT (components activities target groups)
- SOLO (short & long term outcomes)
Logic Model Components
- Goal, overall long-term health
- Inputs, resources invested
- Outputs, products produced
- Outcomes, changes expected
External Factors
- Affect program
- Beyond control of planners
Program Evaluation
- Ongoing & dynamic
- Determines what is working
- Further refinement of program
- Identify gaps
Formative Evaluation Stage
- What are others doing
- What does community need
- Is it working
Process Evaluation Stage
- How are we doing
- What actually happened
- What was supposed to happen
Outcome Evaluation Stage
- Did we do it
- Were objectives achieved
- Reach overall goal
Low Income Risk Factors
- Type II diabetes
- Hypertension
- Asthma
- Chronic pulmonary disease
Poverty & Indigenous Populations
- Persistent inequitable access
- Income
- Employment
- Housing
- Food security
- Education
Poverty in Rural Canada
- Limited employment opportunities
- Lack of access to supportive infrastructures
- Higher incidence of poverty
Poverty Defining Scales
- Low income measure
- Market basket measure (MBM)
- Low income cut-off (LICO)
Groups at Risk of Poverty
- Indigenous living off reserve
- Lone parents with 1+ child
- Unattached individuals ages 45-64
- Physical & mental disabilities impacting work
- Recent immigrants (past 10 yrs)
Homeless Access Barriers
- Mistrust of providers
- Competing survival priorities
- Financial barriers (afford medications)
- Transportation
Housing First Program
- 1990’s Toronto & New York
- All people deserve housing
- Housing is a precondition to recovery
- Housing then supports
- Housing not contingent upon readiness/compliance
Upstream Interventions
- Advocate for increased minimum wage rates
- Increased social assistance rates
- Affordable housing & childcare
Downstream Strategies
- Facilitate access to care for people with barriers
- Building trusting relationship
- Preserving respect
- Acknowledging client concerns with importance
- Sensitivity to peoples life circumstances
