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NURS 4540: Community Health > Week 6 > Flashcards

Week 6 Flashcards

1
Q

define: theory

A
  • presents a systemic way of understanding events or situation
  • a set of concepts, definitions, and propositions that explain or predict these events or situations by illustrating the relationships between variables
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2
Q

theories that are not as highly developed or that have not been as vigorously tested are referred to as…

A
  • conceptual models or frameworks
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3
Q

theory, research, and practice are ______. what does this mean?

A
  • reciprocal
    = theory provides roots that anchor both practice and research in the nursing discipline
  • practice and research in diverse settings contribute to development of new theories
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4
Q

theory assists practitioners, decision makers, educators, and researchers to… (3)

A
  • explain what they experience
  • inform their actions and decisions
  • articulate possible outcomes
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5
Q

for CHNs, theories may…

A
  • guide practice in situation where rigorous research-based evidence is not available
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6
Q

theories can support understanding of…

A
  • why things are the way they are
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7
Q

nursing theories are integrated with…

A
  • theories developed in public health, and the social sciences to guide the practice, research, and education of CHNs
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8
Q

what are important foundations for understanding theory and how it can be used (3)

A
  • core concepts
  • patterns of knowing
  • different levels of theoretical knowledge in nursing
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9
Q

what are key public health concepts (6)

A
  • social justice
  • population health
  • epidemiology
  • health promotion and prevention
  • ethics
  • commitment to community and health equity
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10
Q

what are community health nursing concepts (7)

A
  • health equity
  • DOH
  • capacity building
  • strengths-based approach
  • caring
  • cultural safety
  • collaboration
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11
Q

health equity is achieved when…

A
  • all people have the opportunity to reach their full health potential regardless of age, race, ethnicity, gender, or social class
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12
Q

what are the theoretical foundations of CHN?

A
  • florence nightingale –> impact of enviro on healing
  • virginia henderson –> basic needs
  • intersectionality (layered impacts)
  • ecological systems theory
  • calgary family assessment model
  • health promotion model
  • neuman’s system model
  • population health promotion model
  • self-care deficit model (Orem)
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13
Q

nursing theories focusing on illness in clinical settings are..

A
  • not always easily adapted to practice of community health nursing
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14
Q

Theories specifically about CHN are…

A
  • lacking
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15
Q

in 1987, Schultz argued that nursing tends to represent…

A
  • individual problems as isolated events rather than a pattern of responses in a community
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16
Q

what are more recent developments for nursing theory

A
  • nursing theories being adapted specifically to CHN
  • new conceptual frameworks specific to community health w emphasis on health promotion and prevention
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17
Q

describe the perspectives of First Nation, Metis, and Inuit people r/t community health nursing theory and practice

A
  • their perspectives are not well represented due to little acknowledgment of the colonial roots
  • they did not explicitly draw on Indigenous perspectives and may have been the resuklt of few FNMI nurses as community health nursing scholars, researchers, and leaders
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18
Q

2-eyes seeing and two-row campom demonstrate…

A
  • both traditional Indigenous knowledge and Western scientific understanding
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19
Q

diagram on first nations perspective on health and wellness model

A
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20
Q

the CHNC model of the most important types of theoretical foundations to the discipline includes:

A
  • CHN metaparadigm
  • philosophies encompassing CHN ethics and values
  • broad theoretical perspectives
  • conceptual models and frameworks (various health prmotion models, intervention wheels)
  • grand, middle range, and practice (or substantive) theories
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21
Q

describe the area of change in health promotion theories and models that focus on individuals

A
  • theories that explain health behavior and behavior change by focusing on the individual
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22
Q

what are theories or models that connect to health promotion theories and models for individuals (3)

A
  • theory of planned behavior (TPB)
  • transtheoretical (stages of change) model
  • health belief model (HBM)
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23
Q

what assumption is made with the theory of planned behavior

A
  • the intention to act is the most immediate determinant of behavior

ex. if your intention is not to smoke to improve your health, you are more likely not to smoke

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24
Q

theory of planned behavior diagram

A
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25
Q

what assumption is made with the transtheoretical (stages of change) model

A
  • behavior change is a process, not an event
  • individuals have varying levels of readiness to change
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26
Q

transtheoretical model (stages of change)

A
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27
Q

what are the stages in the stages of change model (6)

A
  • precontemplation
  • contemplation
  • determination
  • action
  • relapse
  • maintenance
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28
Q

describe the precontemplation stage of stages of change model

A
  • no intention of changing behavior
  • imp to build awareness & give info
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29
Q

describe the contemplation stage of stages of change model (5)

A
  • aware a problem exists
  • no commitment to action
  • assess pros and cons
  • reduce perceived conc
  • increase pros
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30
Q

describe the determination stage of stages of change model

A
  • intent upon taking action
  • commit & make a plan
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31
Q

describe the action stage of stages of change model (2)

A
  • implement and revise plan
  • design strategies to mitigate risk of relapse
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32
Q

describe the relapse stage of stages of change model (2)

A
  • offer support & mngmt
  • expected
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33
Q

describe the maintenance stage of stages of change model

A
  • integrate change into lifestyle
  • how to maintain this change

ex. taking BP 2x/day rather

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34
Q

describe the health belief model

A
  • the focus is on motivation to change/engage in health promotion behavior
  • looks at ones perception about changing a behavior (does somebody actually perceive that they’re at risk??)
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35
Q

the health belief model addresses… (3)

A
  • the individual’s perceptions of the threat posed by a health problem,
  • the benefits of avoiding the threat
  • factors influencing the decision to act (barriers, cues, self-efficacy)
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36
Q

the health belief model

A
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37
Q

HBM is used when we….

A
  • screen individuals
  • screening program gives cues to act
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38
Q

describe the area of change in health promotion theories and models that focus on communities

A
  • theories that explain change in communities and organizations
  • community action for health
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39
Q

what theories are connected to health promotion theories and models for communities (2)

A
  • diffusion of innovation
  • community mobilization/community organization
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40
Q

describe the theory: diffusion of innovation

A
  • how new ideas (practices, programs) are adopted by communities
  • focuses on diff categories of adopters based on time it takes to adopt innovation
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41
Q

diffusion of innovation diagram

A
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42
Q

what are the different categories of adopters in the diffusion of innovation theory (5)

A
  • innovators
  • early adopters
  • early majority
  • late majority
  • laggards
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43
Q

describe: innovators

A
  • open to risks and first to try new ideas
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44
Q

describe: early adopters (2)

A
  • opinion leaders
  • embrace change
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45
Q

describe: early majority

A
  • take time to make decisions
  • adopt new innovations before the average person
  • need evidence that it works before adopting
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46
Q

describe: late majority

A
  • more resistant to change but responsive to peer pressure
  • skeptical of change and will only adopt an innovation after it’s been generally accepted and adopted by the majority of the population
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47
Q

describe: laggards (3)

A
  • highly resistant to change
  • hard to reach
  • wait for a mainstream inventioned
  • last to make the changeover
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48
Q

what are variables effecting rate of adoption of innovations

A
  • relative advantage
  • compatability
  • complexity, simplicity
  • flexibility
  • trialability
  • observability
  • cost-efficiency
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49
Q

describe how relative advantage effects the rate of adoption of innovations

A
  • the degree to which an innovation is perceived as better than the idea it supersedes
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50
Q

describe how compatability effects the rate of adoption of innovations

A
  • the degree to which an innovation is perceived as being consistent with existing values, past experiences, and needs of potential adopters
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51
Q

describe how complexity/simplicity effects the rate of adoption of innovations

A
  • the degree to which an innovation is perceived as difficult to understand and use
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52
Q

describe how flexibility effects the rate of adoption of innovations

A
  • the degree to which an innovation is perceived as being easily accessed and modified for use
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53
Q

describe how trialability effects the rate of adoption of innovations

A
  • the degree to which an innovation may be experimented with on a limited basis
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54
Q

describe how observability effects the rate of adoption of innovations

A
  • the degree to which the results of an innovation are visible to others
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55
Q

describe how cost efficiency effects the rate of adoption of innovations

A
  • the degree to which the innovation is cost effective, especially compared to alternatives
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56
Q

what is the first law of public health

A
  • the right choice must be the easy choice
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57
Q

community mobilization/organization includes… (3)

A
  1. social planning
  2. community development
  3. social action
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58
Q

describe social planning r/t community mobilization/organization (3)

A
  • stresses problem solving
  • often relies on expert practitioners
  • task oriented
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59
Q

describe community development r/t community mobilization/organization (4)

A
  • aim is to develop group identity & cohesion
  • focus on building capacity
  • community members identify issues
  • process oriented
60
Q

describe social action r/t community mobilization/organization (3)

A
  • goal is to increase community’s capacity to solve problems and to make concrete changes that redress social injustice
  • task and process oriented
61
Q

community mobilization/organization

A
62
Q

community organization practice requires a…

A
  • capacity building approach, rather than a deficiency orientation approach
63
Q

what is the role of the CHN in community organization practice

A
  • external champion = must take lead of the community
64
Q

community organization practice requires…

A
  • maximum participation of community members in decisions related to program planning, implementation, or needed policy change
65
Q

with community organization practice, without some lvl of ________, health promotion strategies will not be effective long-term

A

empowerment

66
Q

what are common elements in community mobilization/organization (6)

A
  • empowerment
  • community capacity
  • participation
  • relevance
  • issue selection
  • critical consciousness
67
Q

describe empowerment r/t community mobilization/organization

A
  • a social action process thru which people gain mastery over their lives and their communities
68
Q

describe community capacity r/t community mobilization/organization

A
  • characteristics of a community that affect its ability to identify, mobilize around, and address problems
69
Q

describe participation r/t community mobilization/organization (2)

A
  • engagement of community members as equal partners
  • never do for others what they can do for themselves
70
Q

describe relevance r/t community mobilization/organization

A
  • community organizing that “starts where the people are”
71
Q

describe relevance r/t community mobilization/organization

A
  • community organizing that “starts where the people are”
72
Q

describe issue selection r/t community mobilization/organization

A
  • identifying immediate, specific, and realizable targets for change that unify and build community strength
73
Q

describe critical consciousness r/t community mobilization/organization

A
  • awareness of social, political, and economic forces that contribute to social problems
74
Q

define: healthy public policy

A
  • policies outside the health sector that promote health of individuals/communities by:

–> making it easier for people to adopt health practices
–> making it harder for people to adopt unhealthy practices
–> creating healthy physical and social enviro

75
Q

what is the area of change for health promotion theories & models that focus on change in public policy

A
  • theories that explain the development and implementation of healthy public policy
76
Q

what health promotion theories/models promote change in public policy (3)

A
  • milio’s framework
  • weiss’s framework
  • health impact assessment (HIA)
77
Q

describe milio’s framework (3)

A
  • stages and influences of development and implementation of healthy public policy
  • coined term “healthy public policy”
  • identified non-linear stages of, and influences on, HPP development & implementation
78
Q

describe weiss’s framework

A
  • evidence used in a variety of ways to lead, justify, support development of healthy public policy
79
Q

describe the health impact assessment

A
  • assess potential health impacts of proposed policy, and potential inequitable distribution of impacts
80
Q

weiss’s model of policy development focuses on… (5)

A
  • knowledge driven
  • problem solving
  • interactive
  • political
  • tactical
81
Q

describe the “knowledge driven” component of weiss’s model

A
  • new research knowledge rapidly accepted into policy development
82
Q

describe the “problem solving” component of weiss’s model

A
  • mechanisms during decision making process related to HPP development include collection and consideration of evidence
83
Q

describe the “interactive” component of weiss’s model (2)

A
  • evidence is collected from variety of sources
  • knowledge from research & social pressures, experience, and political situation
84
Q

describe the “political” component of weiss’s model

A
  • evidence is used to justify a predetermined position
85
Q

describe the “tactical” component of weiss’s model (3)

A
  • preferable data is used
  • evidence used to support an unpopular decision or to explain and avoid an unpopular decision
  • unsubstantiated research findings are used to delay decision making
86
Q

describe the area of change for health promotion theories and models that focus on systems

A
  • theories that have a system lvl focus and explore that relationships between individuals and communities, and between sociocultural and environmental factors that affect health
  • often referred to ecological models
87
Q

what theories/models focus on systems

A
  • population health promotion model
  • precede-proceed planning model
88
Q

population health promotion model

A
89
Q

precede-proceed model

A
90
Q

what are some HP strategies that focused on changing behavior in the behavioral/lifestyle approach (4)

A
  • health education (individual, group)
  • health communication
  • social marketing
  • regulatory measures
91
Q

HP strategies focused on changing behaviors

A
92
Q

what are the 4 P’s of marketing

A
  • product
  • price
  • place
  • promotion
93
Q

describe the use of marking principles

A
  • can be used to advance a social cause, idea, and promote change in social behaviors
94
Q

what is the goal of social marketing (2)

A
  • to encourage health promoting behaviors
  • to eliminate or significantly reduce behaviors that negatively impact a population’s health

ex. bell let’s talk day, MADD

95
Q

the six essential benchmarks considered the best strategic application of the “marketing mix” consists of…

A
  • the 4 P’s of product, prize, place, and promotion
96
Q

what are other Ps of marketing (2)

A
  • policy change
  • people
97
Q

interventions that only use the promotion P are…

A
  • social advertising, not social marketing
98
Q

health promotion strategies focused on changing the community, enviro, or policy are influenced by…

A

community, policy, ecological lvl change theories :
- ottawa charter strategies
- empowering strategies

99
Q

what are the 5 ottawa charter strategies

A
  • building healthy public policy
  • creating supportive enviro
  • reorienting health services
  • developing personal skills
  • strengthening community action
100
Q

define: health promotion

A
  • the process of enabling people to increase control over, and to improve, their health
101
Q

define: empowerment

A
  • an active, involved process where people, groups, and communities move toward increased individual and community control, political efficacy, improved quality of community life, and social justice
  • more group oriented
102
Q

large body of evidence suggests that.. (4)

A
  • individuals and communities lacking control over their destiny have poor health outcomes
  • being poor is associated w a stress-induced response in IQ
  • powerlessness leads to poor health outcomes (may not be a matter of absolute powerlessness)
  • being lower in the power/status hierarchy can contribute to poorer health choices
103
Q

what are powerlessness risk factors (70

A
  • living in poverty
  • lower in hierarchy
  • high demand psychological & physical needs
  • low control (perceived and actual)
  • chronic stress
  • lack of social support
  • lack of resources
104
Q

powerlessness

A
105
Q

what are some empowerment strategies (5)

A
  • political action
  • coalition advocacy
  • community organization development
  • personal care/empowerment
  • small group development
106
Q

what are some empowerment strategies for CHNs

A
  • CHN standard #5 –> capacity building
107
Q

what is the continuum of empowering strategies (5)

A
  • personal empowerment
  • small group development
  • community organization
  • coalition advocacy
  • political action
108
Q

describe personal empowerment

A
  • goal of direct service is to provide individuals w the knowledge and skills to enhance their competence and confidence to deal w life’s challenges

ex. health teachings, prenatal classes, connecting people w resources

109
Q

describe small group developmengt

A
  • individuals need opportunties to overcome isolation and to discover that they arent alone in their problems
  • organizing people around the issues that are unique to the group

ex. parenting support groups

110
Q

describe community organization empowerment-

A
  • community organizing involves local actions whereby people organize around issues or problems that are larger than group members own immediate concerns
  • may be an extension of small group work
  • often called commuity

ex. tenderlion project, harm reduction groups

111
Q

describe coalition advocacy

A
  • taking a position on an issue and initiating actions in a deliberate attempt to influence public or private policy
  • lobbying is done by several groups that temporarily come together to advocate a policy change
  • CHNs may be involved as representatives of their agencies
112
Q

describe political action empowerment

A
  • individual CHNs are less likely to be involved at this lvl as part of their work, in part due to inherent conflicts of interest, being bound by employer’s parameters, etc.
  • professional nursing associations are often involved at this level

ex. CHNs volunteering at a pop-up consumption site

113
Q

empowerment continuum

A
114
Q

describe the improtance of activism, research, and advocacy

A
  • important for research and action to seek partnership w and promote the health of individuals and communities
  • advocacy is a social justice issue and a mandatory component of public health and CN
  • nursing practice within communities will create more opportunities for nursing practice focused on health promotion and different forms of advocacy and activism
115
Q

activism as a public health intervention has been used to.. (4)

A
  • effect change for people living in poverty
  • changes for child labour
  • fight for women’s right to vote
  • distirbute birth control info to women
116
Q

summarize theory-informed practice in CHN r/t clients

A
  • examine the client within the community, as well as nurse-client interactions & the role of CHNs as community advocates
117
Q

summarize theory-informed practice in CHN r/t indigenoys peoples

A
  • first nations perspective on health & wellness model is used to guide care and decolonize and redesign health programs for FN
118
Q

summarize theory-informed practice in CHN r/t people experiencing social and health inequities

A
  • interweaving of multiple SDoH offers a more inclusive look at factors that cause oppression
119
Q

summarize theory-informed practice in CHN r/t the health system

A
  • theories help to broaden scope of effective and considerate care beyond treating illness in a clinical context
120
Q

summarize theory-informed practice in CHN r/t nursing profession

A
  • theory can refine, guide, and develop the practice of CHNs
121
Q

summarize theory-informed practice in CHN r/t policy

A
  • critical social theory support nurses to collab w other sectors to influence public policy and address the sturctural and systemic DOH
122
Q

summarize theory-informed practice in CHN r/t reserach

A
  • theory informs research, which produces the evidence used to guide the practice of CHNs in education, admin, and practitioner roles
123
Q

single interventions do not work. the future of behavior change and health promotion consists of 3 core components

A
  1. a behavior change approach
  2. a strong policy framework that creates a supportive enviro
  3. the empowerment of people to gain more control over making healthy lifestyle choices
124
Q

define: health education

A
  • one strategy for implementing health promotion and disease prevention programs
  • provides learning experiences on health topics tailored for their traget population
125
Q

health education includes…

A
  • the health benefits/threats they face
  • providing tools to build capacity and support behavior change in an appropriate setting
126
Q

what is the target of health education

A
  • individual people
127
Q

what is the goal of health education

A
  • changing the behavior of individual people
128
Q

what are the forms health education takes

A
  • lectures
  • presentations
  • courses
  • seminars
  • posters
  • videos
  • webinars
  • classes
  • workshops
129
Q

what is the evaluation of health education

A
  • asking participants if their behavior changed
130
Q

what are the primary features of health education(2)

A
  • providing info
  • presuading people to change their enviro
131
Q

what is the role of policy in health education

A
  • policy does not generally play a role in health education
132
Q

what are examples of health education

A
  • teaching a patient how to eat better
  • running a weight loss group for obese pts
  • trying to convince your pt why smoking is bad for COPD
  • encouraging your pt to exercise a little everyday
133
Q

define: health promotion

A
  • the process of enabling control over, and to improve their health
134
Q

health promotion involves…

A
  • public policy that addresses health determinants
135
Q

what is the target of health promotion

A
  • policies that influence health, either directly or indirectly
136
Q

what is the goal of health promotion

A
  • healthy public policy, to improve the health of the population
137
Q

what forms does health promotion take

A
  • policy development to support the health of population
138
Q

what is the evaluation of health promotion

A
  • statistics collected from the population to assess the value of policies and programs
139
Q

what is the primary feature of health promotion

A
  • impacting social, economic, and political factors to improve population health
140
Q

what is the role of policy in health promotion

A
  • policies should foster health and wellbeing in the population
  • healthy public policy is a key component of population health promotion
141
Q

what are examples of health promotion

A
  • reduce inequalities in income and wealth
  • create safe, supportive enviros in schools, workplaces, and community
  • ensure that individuals and families have access to the resources they need to sustain a healthy lifestyle
  • protect people and the earth from toxic pollution, resource depletion, and systemic global efforts
  • focus health promotion practice more on implementing policies that create healthy living conditions and less on policies that influence personal lifestyle behavior’s
142
Q

more differences on health education vs promotion

A
143
Q
A
144
Q
A
145
Q
A

NURS 4540: Community Health (12 decks)

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