Frameworks for Health Promotion, Disease Prevention, and Risk Reduction

Chapter 5: Frameworks for Health Promotion, Disease Prevention, and Risk Reduction

Chapter Highlights #1

Influences on health and well-being

Role of the nurse as an interdisciplinary team member in health promotion and prevention

Health promotion programs

Epidemiologic models of health promotion and public health science

Levels of prevention and pathogenesis

Immunizations

Chapter Highlights #2

Screening

Behavior change theories

Ecologic model and women living with HIV/AIDS

Health literacy

Interactive health literacy and health education

Critical health literacy and health promotion

Question #1

Is the following statement true or false?

International goals and directives to maintain the health of individuals, families, and communities are significant road maps for healthcare professionals.

Answer to Question #1

False

National, not international, goals and directives to maintain the health of individuals, families, and communities are significant road maps for healthcare professionals.

Health

Health—a quality, an ability to adapt to change, or a resource to help cope with challenges and processes of daily living

Well-being—a subjective perception of full functional ability as a human being

Health Promotion, Disease Prevention, and Risk Reduction as Core Activities of Public Health

Providing essential input to interdisciplinary programs

Evaluating health trends and risk factors

Working with communities or specific population groups within the community

Participating in assessing and evaluating healthcare services

Healthy People Initiatives

To increase quality and years of healthy life

To eliminate any barriers to accessing care, specifically through health disparities

Road Maps to Health Promotion

Epidemiologic model and prevention

Levels of prevention

Primary

Secondary

Tertiary

Question #2

Is the following statement true or false?

Tertiary prevention—maximizing health and wellness through strategies that are set in place at the early and active chronic stages of pathogenesis of illness and injury.

Answer to Question #2

False

Rationale: Secondary prevention—maximizing health and wellness through strategies that are set in place at the early and active chronic stages of pathogenesis of illness and injury. Tertiary prevention—maximizing health and wellness through strategies that are set in place at the palliation and end-stage of disease and injury trajectories.

Levels of Prevention

Primary prevention—maximizing health and wellness through strategies that are set in place before illness or injury is present

Secondary prevention—maximizing health and wellness through strategies that are set in place at the early and active chronic stages of pathogenesis of illness and injury

Tertiary prevention—maximizing health and wellness through strategies that are set in place at the palliation and end stage of disease and injury trajectories

Question #3

Is the following statement true or false?

Learning model—a behavior change model that considers the severity of the potential illness or physical challenge, the level of conceivable susceptibility, the benefits of taking preventive action, and the challenges that may be faced in taking action toward the goal of health promotion.

Answer to Question #3

False

Rationale: Health belief model—a behavior change model that considers the severity of the potential illness or physical challenge, the level of conceivable susceptibility, the benefits of taking preventive action, and the challenges that may be faced in taking action toward the goal of health promotion. Learning model—a behavior change model emphasizing reinforcement of social competence, problem solving, autonomy, and sense of purpose

Behavior Models

Motivational interviewing—client-centered communication style for eliciting behavior change by helping clients and groups explore and resolve ambivalence to change

Behavior change models—models that assist clients, groups, and communities to redirect activities toward health and wellness

Learning Model

A behavior change model emphasizing reinforcement of social competence, problem solving, autonomy, and sense of purpose

Health Belief Model

A behavior change model that considers the severity of the potential illness or physical challenge, the level of conceivable susceptibility, the benefits of taking preventive action, and the challenges that may be faced in taking action toward the goal of health promotion

Transtheoretical Model

Precontemplation

Contemplation

Preparation

Action

Maintenance

Relapse

Theory of Reasoned Action

A behavior model that emphasizes that individual performance of a given behavior is primarily determined by a person’s intention to perform that behavior

Social Learning

A behavior change model that considers environmental influences, personal factors, and behavior as key components of change

Theories of Social Support

Family members, friends, neighbors, and adjacent communities influencing change by offering instrumental assistance, informational support, emotional support, and/or appraising support

The Relapse Prevention Model

Negative emotional states

Lack of or limited coping skills

Decreased motivation

Stress

High-risk experiences

Ecologic Model

Belief that all processes occurring within individual people and their environment should be viewed as interdependent

Use of the Ecologic Model: Evidence for Health Promotion Intervention #1

Emphasize the unique developmental nature of variables that influence behaviors

Use a multilayered understanding of influence on behaviors

Test variables from each of the identified systems in the model to guide the assessment, development, implementation, and evaluation of targeted interventions

Use of the Ecologic Model: Evidence for Health Promotion Intervention #2

Ontogenic system—personal factors

Microsystem—relationship between women and the environment

Exosystem—formal and informal social structures

Macroculture—values and beliefs of culture

Health Promotion and Secondary/Tertiary Prevention for Women Living with HIV/AIDS

Prevention initiative that is community-based, peer-led, and interdisciplinary

Positive prevention

African American women experiencing disproportionate interpersonal mistrust, adherence to treatment plan, delays in seeking care, and compromised self-advocacy

Consideration to mental health

Health Literacy

Information-literate

Visually literate

Communication-literate

Computationally literate

Analytically literate

Computer-literate

Health Literacy and Health Education

Establishing supportive learning environment

Effective questioning

Evidence-based health literacy universal precautions

Healthy People 2020 and health literacy

Health Literacy and Health Promotion

Build healthy public policies

Create supportive environments

Strengthen community action

Develop personal skills

Reorient health services

Role of Nurses

Knowledge of the three levels of health literacy allows the community health nurse to intervene at the individual, provider, and community level:

Functional

Interactive

Critical

Frameworks for Health Promotion, Disease Prevention, and Risk Reduction

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