nursing 116 #1

health promotion

the process of enabling people to increase control over, and to improve, their health

four attributes of health promotion

* optimization of health
* patient/ community centered
* social determinants of health
* health literacy

optimization of health

measures to maintain high levels of wellness, prevent illness, and detect and manage disease early if/when it occurs

patient/community centered

interventions must be valued and desired by the individual/community impacted

social determinants of health

the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life

health literacy

the degree to which individuals have the ability to find, understand, and use information to inform health-related decisions and actions for themselves and others

scope of levels of prevention

primary, secondary (screening), tertiary (disease management)

health continuum and health promotion

perfect health→ moderate health →marginal health (primary)→ exposure/lifestyle risks → early disease (secondary)→ late disease→ death (tertiary)

primary prevention

* comes before disease or disability- upstream approach
* purpose is to decrease vulnerability of individual or groups
* examples: health education, immunizations, advocating for health policy

secondary prevention

* early identification (screening) of disease/disability
* purpose is to minimize effects of disease/disability in order to maximize function
* examples: vision screening, hearing test, blood pressure clinics, harm reduction programs

teritary prevention

* minimizes the effects of disease and disability
* purpose is to return the individual to highest level of health possible
* examples: rehabilitation, ongoing treatment (long term medications/treatments)

stages of health/disease and levels of prevention

* stage of health: healthy→ early disease or injury→ chronic
* level of prevention: primary→ secondary→ tertiary
* key interventions: health promotion and prevention→ screening, diagnosis and treatment → rehabilitation, remediation, maintenance

theoretical links: individual focused models

* transtheoretical model of change
* health promotion model

transtheoretical model of change

health related behavioral changes progress through 6 stages of behavior change on a continuum

health promotion model

health behaviors are influenced by integration of unique characteristics, experiences, and influences of behaviors

5 steps of transtheoretical model of change

1. precontemplation: no
2. contemplation: maybe
3. preparation: prepare/plan
4. action: do
5. maintenance: keep going

precontemplation

educate on risks vs benefits and positive outcomes related to change

contemplation

identify barriers and misconceptions, address concerns, identify support system

preparation

develop realistic goals and timeline for change provide positive reinforcement

action

provide positive reinforcement

maintenance and relapse prevention

provide encouragement and support

theoretical links: community focused models

social ecological model: emphasizes that multiple variables influence health behavior, from individual influences to public policy

healthy people 2030

national goals that outline 358 measurable objectives to promote health and wellness in our population (ex: how sleep affects people, are sleep rates positive or negative) → priority areas: healthy equity, social determinants of health, health literacy

vulnerable populations

those with greater than average risk of developing health problems by virtue of their marginalized sociocultural status, their limited access to economic resources, or their personal characteristics such as age and gender

social determinants of health

* education access and quality
* health care and quality
* neighborhood and built environment
* social and community context
* economic stability

health disparities

are preventable differences in the burden of disease, injury, violence, or in opportunities to achieve optimal health experience by socially disadvantaged racial, ethnic, and other population groups, and communities. Health disparities exist in all age groups, including other adults

CHIP program

Child Health Insurance Program

poverty

the extent to which an individual does without resources

resources include

* financial
* emotional
* mental
* spiritual
* physical
* support services
* role models
* knowledge of hidden rules

assessment:

consider…

* individuals
* families
* communities

individuals

* health status
* health behaviors
* risks
* goals/priorities

families

* health behaviors
* family strengths
* risks
* relationships and dynamics
* goals/priorities

communities

* data collection
* community structure
* population
* resources
* priorities/goals
* risk

allostatic load

stress

health literacy

top 5 best practices

* everyone is at risk of low health literacy
* use plain non-jargon language when talking to patients
* limit information to 1-3 need to know items per session
* ask open ended questions in a patient centered manner
* use “teach back” to confirm understanding

everyone is at risk of low health literacy

can’t tell by looking

high literacy can still have low health literacy.

should use easy to understand materials for all patients

use plain non-jargon language when talking to patients

5th grade level speaking, plain language. Focus on “need to know information” that is shame free. Confirm understanding

list information to 1-3 need to know items per session

1. illness and stress are major barriers per session
2. patients typically retain less than 50% of what is shared
3. start with the more important information first and circle back to it at the end
4. focus on what they need to DO, not facts

social ecological model

* individual
* interpersonal
* organizational
* community
* public policy

individual

knowledge, skills, attitudes (KSA)

interpersonal

families, friends, social networks

organizational

organizations, social institutions

community

relationships between organizations

public policy

state, local laws and regulations