Psychology
Penny20
FrameworksforHealthPromotion225.pptx
Frameworks for Health Promotion, Disease Prevention and Risk Reduction
Healthy People 2020 https://www.healthypeople.gov/
National measurable health objectives developed from:
PH experts
Population illness stats (m & m; progression of diseases/injuries)
Business communities
American citizens
Objectives organized into 42 topics, including several new ones
https://www.healthypeople.gov/2020/topics-objectives
Two main goals
Increase quality and years of a healthy life.
Improve access to healthcare for everyone/prevent healthcare disparities.
Guidelines for nurses as part of interdisciplinary teams in PH
Example of Topic and Objective: Older Adults
https://www.healthypeople.gov/2020/topics-objectives/topic/older-adults
Objective: Prevent Fall Injuries:
https://www.cdc.gov/steadi/materials.html
https://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/index.html
Class Exercise: Healthy People 2020
Collaborate in
Collaborate in small teams of no more than 3 students while IN CLASS (up to instructor preference).
Begin by
Begin by viewing the following links which explain the basics of HP2020: https://www.healthypeople.gov/node/5840 https://www.healthypeople.gov/sites/default/files/HP2020Framework.pdf
Select
Select a Leading Health Indicator TOPIC area (there are 12). Use the following link to see a list: https://www.healthypeople.gov/2020/leading-health-indicators/2020-LHI-Topics
Summarize
Succinctly summarize the “Overview and Impact” information r/t the topic. This includes any information about the importance of monitoring this topic.
List
List the specific health indicators under the topic. For example, see https://www.healthypeople.gov/2020/leading-health-indicators/2020-LHI-Topics (there are ONLY 1 to 4 per topic area—don’t confuse these w/ other multiple objectives).
Summarize
Succinctly summarize overall progress made r/t LHIs. YOU MUST EMPHASIZE IF PROGRESS HAS BEEN MADE, OR NOT, OR NO SIGNIFICANT CHANGE HAS BEEN NOTED TO DATE. THIS IS IMPORTANT GIVEN THAT HP 2030 IS COMING ON STRONG!
Disease Prevention
We focus on MODIFIABLE risks of acquiring disease/injury.
We rely on PH science (ex., epidemiology) about
the natural history of diseases
disease trends
Morbidity and Mortality Weekly Report (MMWR)
https://www.cdc.gov/mmwr/index.html
We engage in best clinical practices at three levels of prevention:
Primary
Secondary
Tertiary
Primary Prevention
Community/population is without signs or symptoms
Concerned with the onset of disease; it aims to reduce the incidence of disease. It involves interventions that are applied before there is any evidence of disease or injury.
This is done by reducing exposures to hazards that cause disease or injury, altering unhealthy or unsafe behaviors that can lead to disease or injury, and increasing resistance to disease or injury should exposure occur.
Examples include protection against the effects of a disease agent, as with vaccination.
Examples of Primary Prevention Strategies
Education to enhance awareness and use of prevention strategies
Prevent exposures: PPE, relocation, workplace safety…
Healthy lifestyle: diet, exercise, limit exposures…
Class Exercise: Primary Prevention
How would you educate the public about…..?
Hygiene
Road safety: Promotion of safe driving/transportation practices
Food safety: Prevention of food-borne illnesses
Proper exercise: Exercise recommendations
Childhood and adult vaccinations: Vaccination promotion strategies
Proper nutrition: Guidelines for healthy eating
Violence: IPV, Elder abuse, Gun Safety
Other
Secondary Prevention
The initial recognition of disease
Screening to identify diseases in the earliest stages, before the onset of signs and symptoms, through measures such as mammography and regular blood pressure testing.
Science of screening (Box 5.5 p. 107):
Mass screening of the entire population (ex. Pap smears)
Selective screening of high-risk populations (ex. Mammograms, Tb tests)
Multiphasic screening in the same population on the same occasion
Class Exercise: Secondary Prevention
What type of screening is recommended for …?
Breast cancer
Depression in adult population (including pregnant and postpartum)
Intimate Partner Violence
Diabetes
"Search All"
Tertiary Prevention
Long-term management of chronic and/or progressive illnesses.
https://www.ncbi.nlm.nih.gov/books/NBK263824/
Includes
Rehabilitation
Palliative care
https://www.nationalcoalitionhpc.org/ncp-guidelines-2013/
Other supportive care
Resources:
https://www.thecommunityguide.org/sites/default/files/assets/CG_flyer.pdf
https://www.uspreventiveservicestaskforce.org/
Models of Behavior Change
Why is it so hard to change?
https://www.goodtherapy.org/blog/why-change-is-so-hard-the-power-of-habit-in-the-human-brain-0317155
Google: Neuroscience of change
http://epi-cafe.blogspot.com/2009/09/social-determinants-of-health.html
Changing Health-Related Behaviors
Incorporate understanding of diverse client perspectives
Use counseling skills
Use Motivational Interviewing: “directive, client-centered communication style for eliciting behavior change by helping clients/groups explore and resolve ambivalence.” p. 109
Focused, goal-directed
Directed to resolution of ambivalence so client becomes motivated to change
http://motivationalinterviewing.org/
https://www.youtube.com/watch?v=_KNIPGV7Xyg
Role of Nurses
Health Promotion
Health Literacy
Health Education
Health Promotion
Health Literacy
Definition: "The degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate decisions" p. 118
Considers:
Listening, speaking, numeracy, reading, writing skills
Ability to access information and services
Ability to use information to make effective health-related decisions
Health Literacy Universal Precautions
Strategies and practices to be used with all clients to reduce communication barriers to understanding health information.
Includes:
Establishing supportive learning environment
Effective questioning (Ask Me 3)
Agency for Healthcare Research and Quality (AHRQ): Health Literacy Toolkit (AHRQ Health Literacy Slide Show)
Health Education
Barriers to learning:
Age
Culture
Reading/comprehension skills
Language
Access to information
Lack of motivation
Learning Theories
Behavioral: Use of reinforcement methods to change learner's behaviors
Cognitive: Ongoing discussion and inquiry to increase learners' depth of knowledge leading to change in thinking and behaviors
Developmental: Use of techniques specific to developmental stage of learner
Humanistic: Emphasis on emotions and relationships to prompt actions that are in learners' self-interest
Social learning: Links information to beliefs and values
Learning Styles
Visual: "Think in pictures" (Videos/presentations)
Auditory: Listening (lectures; VOPP; discussion)
Tactile/kinesthetic: Doing (simulations; skills; return demo)
Domains of Learning
Cognitive: Knowledge/intellect
("what did I learn?")
Affective: Change in attitude/values ("How did I feel?")
Behavioral: Performance of a skill
("What did I do?")
Developing Health Education Plan
Assess needs
Prioritize problems
Set objectives (SMART)
Implement EBP Interventions
Evaluate
** Pay attention to learning theories and barriers to learning
Instructional Strategies
Thank you for your attention
These slides were a created as a collaborative effort between members of the Community Health team at Resurrection University 11_2019
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