Health Promotion NRS-116

Health Promotion UP defintion

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

• it means to work with people and help the improve their health

Attributes of health promotion

1) Optimization of Health

2) Patient/Community impacted

3) Social determinants of health

4) Health Literacy

Optimization of Health

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

• Ex: covid; prevent spread of illness by handwashing, wearing masks, social distancing. Tests; looking for symptoms

Patient/Community Centered

Interventions must be valued and desired by the individual or the community impacted

• talking to neighborhoods

Social determinants of health

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

• account to 50% of health outcomes

• what their job, lifestyle is like matters when it comes to health outcomes

• lack of access to clean H2O?

Health Literacy (different than actual 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

• different than actual literacy

Scope: Levels of Prevention

1) Primary Prevention

3) Secondary Prevention (screening)

3) Tertiary Prevention (Disease management)

Primary Prevention

Comes before disease or disability and the purpose is to decrease vulnerability of individual or groups

• Ex: health education, immunizations (greatest public health innovation), advocating for health policy (laws; legal drinking age and food safety laws)

Primary actions examples

• teaching people to swim to prevent drowning

• fixing bridges to prevent accidents

• seat belt use to prevent injury

• no smoking indoors

• bicycle helmet being used

• cleaning needles

• health providers saying you should eat more fruits and vegetables

• Getting good sleep

Secondary Prevention

Early identification (screen) of disease and diability

• purpose is to minimize effects of disease/disability in order to maximize function

• screen is the method of looking for a disorder, or any risk factors

Secondary Prevention examples

• screening

• hearing tests

• blood pressure clinics

• harm

• reduction programs

• short term treatment for step throat

• preventing further problems

Tertiary Prevention

Minimizes the effects of disease and disability

• purpose is to return the individual to highest level of health possible

• minimize damage (ex: asthma)

• how to keep this person as healthy as possible

Tertiary Prevention examples

• rehabilitation

• ongoing treatment (long term medication/treatments)

• specific life style changes like exercising (which can also be primary prevention)

Poverty

The extent to which an individual does without resources

• its not just about money but the extent to which an individual does with resources

Resources

• financial

• metal

• emotional

• spiritual

• physical

• role models

• supports services

• knowledge of hidden rules

Lack of resources

poverty

Theoretical Links: Individual Focused Models

1) Transtheoretical Model of Change

2) Health Promotion Model

Transtheoretical Model of Change

Health related behavioural changes progress through six stages of behaviour change on a continuum

Health Promotion Model

Healthy behaviours are influenced by integration of factiors, unique characteristics, past experiences, and influences of behaviour

Transtheoretical Model of Change: Precontemplation

Educate on risks vs benefits and positive outcomes related to change

• ex: friend invites you to a fitness club and you say no because you don’t see the purpose in it

Transtheoretical Model of Change: Contemplation

Identify barriers, and misconceptions; address concerns; identify support system

• thinking about the pros and cons and telling your friend I’ll think about it!

Transtheoretical Model of Change: Preparation

Develop realistic goals and timeline for change; provide positive reinforcement

• SMART goals: primary and tertiary

Transtheoretical Model of Change: Action

Provide positive reinforcement

• taking action to complete your goals

Transtheoretical Model of Change: Maintenance and Relapse Prevention

Provide encouragement and support

• how do we keep the behavioural change?

• preventing relapse from previous behaviours

Social Ecological Model: Community Focused Models

emphasizes that multiple variables influence health behaviour, from individual influences to public policy

• nurses need to look at all of the levels

• there are a lot of variables that influence behaviour

Social Ecological Model: Individual

knowledge, attributes, and skills

Social Ecological Model: Interpersonal

families, friends, social networks

• your peers who are against immunization = means you are less likely to get immunization ad vice versal

Social Ecological Model: Organizational

organizations, social institutions

• Ex: Healthcare systems or schools and business who are in. acommunity that support immunizations

Social Ecological Model: Community

relationships between organizations helping promote health regulation. Organizations partnering with a school to provide easier access to care

Social Ecological Model: Public Policy

national, state, local laws and regulations

• ex: in oregon requires public attendance and immunizations which increases rates of immunizations

Healthy People 2030

National Goals that outlines 358 measurable objectives to promote health and wellness in our population

• five overarching goals

• make new ones every 10 years

• Priority areas (Health Equity, Social Determiniants of Health, Health Literacy)

5 overarching goals

1) Attain healthy thriving lives and well-being, free of preventable disease, disability, injury and premature death

2) eliminate health disparities, achieve healthy equity, and attain health literacy to improve health and well-being

3) create social, physical, and economic environments that promote attaining full potential health and well-being

4) promote health development, and health behaviours, and well being across all life states

5) Engage leadership, key constituents, and the public across multi sectors to take action

Vulnerable populations

are those with a 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

vulnerable populations example

• black pregnant people

• homelessness

• immigrants (non-english speakers/undocumented)

• POC

• LGBTQ

• Obese people

• Females

• elderly people

Social determinants of health: Education Access and Quality

worldwide goals; are people able to get access to education?

Social determinants of health: Health Care and Quality

Health care access; helps with health outcomes

Social determinants of health: Neighborhood and Built environments

where do people live?

• are there side-walks

• access to clean water?

• public transport

• safe to go outside?

• green spaces: trees (lowers average temperature)

Social determinants of health: Social and Community context

whats happening in that neighborhood; how does your culture, family, fit into that community; reflects how supported you are/included

Social determinants of health: Economic Stability

can be finances, is there an industry that the community relies on that is no longer there?

ex: during covid, countries who relied on tourism had negative impact

Health disparities

preventable differences in the burden of diseas, injury, violence, or in oppurtunities to achieve optimal health experienced by socially disadvantaged racial, ethnic, and other population groups (vulnerable populations) and communities.

• exists in all age groups, including older adults

• linked to social determinants of health

• those who don’t have access to economic stability make a difference in health outcomes

Healthcare disparities

discrimination or preferential treatment given by health professionals when working with diverse groups

• ex: when nurses are not aware of their own biases that make folks not feel welcomed by giving discrimination and preferential treatment

• goal is health equity

Health equity

reducing health disparities brings us closer

Knowledge of Hidden rules

knowing the unspoken habits of people that are unwritten;

• how do you dress for an interview?

• how do you write an email?

• how you interact with people

• do you have knowledge to access services

Assessment: Individual

• health status

• health behaviours

• risk

• goals/priorities

Assessment: family

• health behaviours

• family strengths

• risk

• relationships and dynamics

• goals and priorities

assessment: community

• data collection

• community structure

• population

• resources

• priorities/goals

• risk

• organization

Health Literacy

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

Top 5 best practices

1) EVERYONE is at low health literacy (even those with high literacy)

2) Use plain, non-jargon language when talking to patients (5th grade level)

3) limit information to “1-2” need-to-know items per session (there are barriers to learning b/c patients can be stressed out or in pain)

• pts usually retain less than 50% of what’s shared

4) ask questions in patient-centered manner (open-ended questions)

5) Use “teachback” to confirm understanding (show us what we just taught you)

5) People can be highly literate but have a low health literacy rate

The “upstream approach” is most closely aligned with which level of health promotion? 

a.Quaternary

b.Tertiary

c.Seconday

d.Primary

primary

Healthy People 2030 is best described as: 

Question 2Answer

a. Ways to reducing the impact of climate change on people’s health 

b. A plan to improve health and well-being of people in the United States 

c. Health initiatives that benefit vulnerable populations 

d. Universal goals for worldwide health

A plan to improve health and well-being of people in the United States 

Which of the following is the best example of tertiary prevention? 

Question 4Answer

a. Using a screening tool to check for depression 

b. Long term medication to manage hypertension (high blood pressure) 

c. An influenza vaccine 

d. Antibiotics to treat a bacterial sinus infection 

Long term medication to manage hypertension (high blood pressure)

Examples of social determinants of health (SDoH) include which of the following? (select all that apply) 

a. Education access

b. Age

c. Genetic predisposition

d. Social inclusion  

e. Access to adequate nutrition 

f. Housing opportunities

a. education

d, social inclusion

e. access to adequate nutrition

f. housing oppurtunities

Which of the following is an example of using active voice on a health education handout? 

a. Measles vaccines are required to go to kindergarten 

b. Not being vaccinated puts you at risk for getting measles 

c. Your child should get their measles vaccine at their one-year check up 

d. The first measles vaccine is given at 1 year of age

Your child should get their measles vaccine at their one-year check up 

Health promotion is best described as  

a. Interventions to create healthier communities 

b. The process of enabling people to increase control over, and improve, their health 

c. The things that nurses and other health care members do to help people 

d. Educational materials that encourage healthy lifestyles

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

Poverty influences health: 

a. At each life stage/at every age 

b. Mostly among the elderly population 

c. When people are uneducated

d. Only in young children

At each life stage/at every age 

Which choices are best practices for patient teaching and supporting health literacy? Select all that apply

Question 9Answer

a. Provide patients or caregivers with three topics they need to know and two topics they should look up on their own.   

b. Use technical terms to help elevate the patient or caregiver’s healthcare literacy. 

c. Provide handouts in languages other than English if needed 

d. People with college or graduate degrees have excellent health literacy.   

e. Use the teach-back method to confirm understanding 

f. When taking a health history, ask patient-centric questions.

c. Provide handouts in languages other than English if needed 

e. Use the teach-back method to confirm understanding 

f. When taking a health history, ask patient-centric questions.

In order for a health promotion to be patient/community centered, it must be ____ and ___ by the individuals impacted

valued, desired

community

Interventions aimed to increase coordination among organizations address which level of the Social Ecological model?

organizational

S recently lost 5 lbs and believes that it was because their office stopped giving out donuts every morning.They attribute their weight loss to which level of the Social Ecological model?

What are the social deteminants of health

Non-medical factors that influence health outcomes, including 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. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems. (WHO)

What is vulnerable populations?

Experience greater than average risk of developing health problems due to marginalized sociocultural status, limited access to economic resources, and/or personal characteristics such as age and gender.