Health Promotion Notes

Components of Health Promotion

• Health promotion involves interventions to enable people to increase control over and improve their health and well-being.

• Healthy People 2030 establishes health promotion guidelines for the nation.

Defining Health

• Health integrates human dimensions including:

  • Physical

  • Emotional

  • Intellectual

  • Sociocultural

  • Environmental

  • Spiritual

Health Promotion

• Health Promotion Definition: Interventions designed to enable people to increase control over, and to improve their health and well-being (adapted from WHO).

• Healthy People 2030 establishes health promotion guidelines for the nation as a whole.

Healthy People 2030 Goals

• Healthy People 2030 sets data-driven national objectives to improve health and well-being over the next decade.

• Leading Health Indicators (All Ages):

  • Children, adolescents, and adults who use the oral health care system (2+ years).

  • Consumption of calories from added sugars by persons aged 2 years and over (2+ years).

  • Drug overdose deaths.

  • Exposure to unhealthy air.

  • Homicides.

  • Household food insecurity and hunger.

  • Persons who are vaccinated annually against seasonal influenza.

  • Persons who know their HIV status (13+ years).

  • Persons with medical insurance (<65 years).

  • Suicides.

Social Determinants of Health

• Social determinants of health, as defined by Healthy People 2030, include:

  • Education Access and Quality

  • Economic Stability

  • Social and Community Context

  • Health Care Access and Quality

  • Neighborhood and Built Environment

Detailed Social Determinants

• Economic Stability:

  • Employment

  • Income

  • Expenses

  • Debt

  • Medical bills

  • Support

• Neighborhood and Physical Environment

  • Housing

  • Transportation

  • Safety

  • Parks

  • Playgrounds

  • Walkability

  • Access to healthy options

• Education

  • Literacy

  • Language

  • Early childhood education

  • Vocational training

  • Higher education

• Community and Social Context

  • Social integration

  • Community engagement

  • Discrimination

  • Linguistic and cultural competence

  • Social Support

• Health Care System

  • Health coverage

  • Provider availability

  • Provider training

  • Quality of care

Health Outcomes

• Mortality

• Morbidity

• Life expectancy

• Health care expenditures

• Health status

• Functional limitations

Disease and Illness

• Disease: a medical term, referring to pathologic changes in the structure or function of the body or mind.

• Illness: the response of the person to a disease.

• Acute: rapid onset, short duration.

• Chronic: permanent change, causes irreversible alterations in normal A&P, long period of care or support, slow onset, possible periods of remission.

Models of Health Promotion and Illness Prevention

• Model: a theoretical way of understanding a concept or idea.

• Models:

  • Maslow's Hierarchy of Needs

  • Health Belief Model

  • Health Promotion Model

  • Health-Illness Continuum

  • Agent-Host-Environment Model

  • Stages of Change Model

Maslow's Hierarchy of Needs

• Self-actualization: morality, creativity, spontaneity, acceptance, experience purpose, meaning and inner potential.

• Self-esteem: confidence, achievement, respect of others, the need to be a unique individual.

• Love and belonging: friendship, family, intimacy, sense of connection.

• Safety and security: health, employment, property, family and social stability.

• Physiological needs: breathing, food, water, shelter, clothing, sleep.

Health Belief Model

• Describes health behaviors.

• Based on the assumption that people fear diseases, and health actions are motivated in relation to:

  • The degree of fear (perceived threat).

  • Expected fear-reduction potential of actions, as long as that potential outweighs practical and psychological obstacles to taking action (net benefits).

Health Promotion Model

• Illustrates how people interact with their environment as they pursue health.

• Individual characteristics and experiences can be useful to predict if a person will incorporate and use health-related behaviors.

• Behavior-specific knowledge, beliefs, and relationships are considered major motivators for health-promoting behaviors.

• Outcome: Behaviors may induce either a positive or negative subjective response or affect.

Health-Illness Continuum

• Ranges from premature death to high-level wellness.

• Includes a neutral point where there is no discernible illness or wellness.

Agent-Host-Environment Model

• Traditional Model.

• Views the interaction between an external agent, a susceptible host, and the environment as causes of disease in a person.

Stages of Change Model

• Precontemplation: no intention to take action in the next 6 months.

• Contemplation: intends to take action in the next 6 months.

• Preparation: intends to take action within the next 30 days.

• Action: has changed behavior for less than 6 months.

• Maintenance stage: has changed behavior for more than 6 months.

• Relapse: cycle will begin again.

Risk Factors

• Variables that increase the vulnerability of an individual or a group to an illness or accident.

Levels of Health Promotion and Preventative Care

• Primary: directed toward promoting health and preventing the development of disease processes or injury.

• Secondary: focus on screening for early detection of disease with prompt diagnosis and treatment of any found.

• Tertiary: begins after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate patients to a maximum level of functioning.

Factors Affecting Health and Wellness

• Variables influence how a person thinks and acts.

• Health beliefs can negatively or positively influence health behavior or health practices.

• Human dimensions (internal or external).

Internal Variables/Dimensions

• Physical dimension

• Emotional dimension

• Intellectual Dimension

• Spiritual Dimension

External Variables/Dimensions

• Environmental dimension

• Sociocultural dimension

Active and Passive Strategies for Health Promotion

• Active: patient must be motivated to change.

• Passive: patient benefits from the activities of others without necessarily acting themselves.

Nurse's Role in Health Promotion

• Understand your clients’ perception of health and wellness.

• Identify areas of risk.

• Identify internal and external variables.

• Identify stage of change and readiness to learn.

• Identify the topic with the highest need.