Community Health Nursing: Theoretical Models & Approaches Flashcards

Theory Purpose

Provide answers to "why?" questions; explain behavior and phenomena; increase knowledge; realign thoughts and opinions

Theory Definition

Method to help understand concepts and explain why things happen in certain ways

Health Belief Model (HBM) Definition

Theoretical model for health promotion and disease prevention programs; explains and predicts individual health behavior changes

HBM Developer

Social psychologists (1958) - originally to explain TB screening participation failure

HBM Major Limitation

Burden of action is on the client

HBM Key Elements

Focus on individual beliefs about health conditions that predict health-related behaviors

HBM Constructs

Perceived Severity, Perceived Susceptibility, Perceived Benefits, Perceived Barriers

HBM Key Factors

Perceived threat to illness, belief of consequence, potential positive benefits, perceived barriers, cues to action, self-efficacy

HBM Example

Michigan Model for Health™ - school curriculum targeting social/emotional health challenges

HBM Assessment

Gather information through health needs assessments; identify at-risk populations

HBM Communication

Convey consequences clearly; communicate action steps and benefits

HBM Support

Identify/reduce barriers; demonstrate actions through skill development; enhance self-efficacy

HBM Cues to Action

Must be meaningful and appropriate for target population

Milio Developer

Nancy Milio (1976)

Milio Purpose

Complements HBM; directs nursing interventions at population level

Milio Core Concept

Health deficits result from imbalance between population's health needs and health-sustaining resources

Milio Context

Understand health behaviors in societal milieu

Milio Resource Balance

Too little resources = infectious disease vulnerability; Too much = obesity

Pender Developer

Nola Pender (1980s, revised 1996)

Pender Purpose

Complementary counterpart to health protection models

Pender Health Definition

Positive dynamic state, not simply absence of disease

Pender Focus Areas

Individual characteristics/experiences, behavior-specific cognitions/affect, behavioral outcomes

Pender Desired Outcome

Health-promoting behavior (endpoint of model)

Pender Results

Improved health, enhanced functional ability, better quality of life

Pender Influences

Immediate competing demands and preferences can derail behavior

PP Developer

Dr. Lawrence W. Green and colleagues

PP Purpose

Community assessment, health education, planning, evaluation

PP Predisposing Factors

People's characteristics that motivate health-related behaviors

PP Enabling Factors

Conditions in people/environment that facilitate or impede health behaviors

PP Reinforcing Factors

Feedback from support persons/groups from health behavior performance

P - PRECEDE

Predisposing

R - PRECEDE

Reinforcing

E - PRECEDE

Enabling

C - PRECEDE 1st

Constructs

E - PRECEDE 1st

Educational

D - PRECEDE 1st

Diagnosis

E - PRECEDE

Evaluation

Social Assessment - PRECEDE

Determine social problems/needs; identify desired results

Epidemiological Assessment - PRECEDE

Identify health determinants; set priorities and goals

Ecological Assessment - PRECEDE

Analyze behavioral/environmental determinants that predispose, reinforce, enable

Administrative Assessment - PRECEDE

Identify policy factors; match appropriate interventions

Implementation - PRECEDE

Implement interventions

P - PROCEED

Policy

R - PROCEED

Regulatory

O - PROCEED

Organizational

C - PROCEED

Constructs

E - PROCEED

Educational

E - PROCEED

Environmental

D - PROCEED

Development

Implementation - PROCEED

Design intervention; assess resources; implement program

Process Evaluation - PROCEED

Determine if program reaches target population and achieves goals

Impact Evaluation - PROCEED

Evaluate behavior change

Outcome Evaluation - PROCEED

Identify decrease in negative behavior incidence/prevalence or increase in positive behavior

PP Structure

Supports planning and implementation of health promotion/disease prevention programs

PP Effectiveness

Works well for many health topics; supports one-time interventions or long-running programs

PP Community Involvement

Invites community participation; increases community ownership

PP Considerations

Consider if all parts appropriate for program and available resources; components may be adapted over time