community exam 3

people; demographics

(assessment) Core of the wheel = __ who make up the community; __ of the pop. + their values, beliefs, and hx. They're affected by the 8 subsystems (recreation, economics, communication, health & social services, politics & govt, safety & transport, education, physical environment).

collaboration; screening; surveillance; case management; social marketing

(health focus) Level of Practice : Box 14.2 , pg 258 - Community-and-Systems based - Interventions: counseling, __, __, outreach, __, __ __, __ __, health teaching, advocacy, etc

community diagnosis

- "High IMR in Rosemont related to Inadequate resources of the health department's Sunvalley Clinic to meet antepartum care needs as manifested by specific data from clinic about lack of personnel and no city bus to Sunvalley clinic - "High prevalence of dental caries among children at Temple Elementary School in Rosemont related to lack of dental assessment and treatment at the Third street clinic as manifested by no dental program at the third street clinic" - Single problem, s/s may be multiple (related to)--etiologies are drawn from several subsystems - All community factors (subsystems) join to determine the health status of a community. No one subsystem is more important or crucial than any other in determining a community's health.

TANF - Temporary Assistance for Needy Families

- (aka WELFARE)= Social Welfare Policy - Federal assistance program that began on July 1st, 1997 and succeeded the Aid to Families with Dependent Children (AFDC) program, providing cash assistance to indigent American families with dependent children through the US Department of Health and Human Services. - This cash benefit is often referred to simply as "welfare". - Created by the Personal Responsibility and Work Opportunity Act instituted under President Bill Clinton in 1996. The Act provides temporary financial assistance while aiming to get people off of that assistance, primarily through employment - 60 months to benefit within one's lifetime, but some states have instituted shorter periods. States also have the authority to eliminate payments to recipients altogether. Under the new act, TANF recipients are required to find a job within 24 months of receiving aid.

minor; 60; immediate; airway; bleeding; ongoing

- *The first step of the START process rescuers instruct persons at the scene of the incident to move to a designed area away from the scene.* - Those able to move to the designated area are considered to be ___ care, on the assumption that their care can be delayed. - Rescuers move systematically through persons unable to move, allotting __ seconds or less per patient, performing assessments, and designating patients to a general category based on the patients' treatment needs. - The triage assignment is to locate patients in the immediate care priority, address __ or severe __ issues, apply an immediate tag, then move on to the next victim - It should be an __ activity, because injured persons with potential or suspected injuries can change rapidly. - START method suggests persons with potential or suspected injuries be rechecked as often as resources and time permit.

Tuskegee syphilis study

- 40 year study - African men, impoverished sharecroppers, with syphilis were not treated in order to observe the progression of the disease - received free meals, medical care, and burial insurance - PCN available in 1940 -- veracity, non-maleficence, autonomy

Berk's bias

- Also, medical documentation is not always complete. Hospitalized patients are also more likely to have coexisting illnesses. This phenomenon is called __ __ and it creates a likelihood of finding false association between two or more illnesses.

public policy

- Applies to ALL members of a society & includes prescribed sanctions for failure to comply - Formulated by governmental bodies & frequently restricts personal choice to improve public welfare EXAMPLE: -- Fines for driving while intoxicated -- Fines for for factories that do not comply with emission regulations -- Fines for unsafe driving -- Seat belt laws for both children & adults

progress

- Are program activities following the intended plan? - Are appropriate staff and materials available in the right quantity and at the right time to implement program activities? - People showing up? - Input/outputs meet some predetermined plan? - Answers to these questions measure the () of the program and are part of process or formative evaluation.

assessing our cultural awareness

- Ask self-questions about cultural beliefs- how were you taught those; try and find common ground w/ clients - The ultimate goal in planning collaborative approaches to illness treatment and healing is to preserve the dignity of the client and to foster health promotion and healing programs that are likely to meet with adherence because they support rather than offend the client.

autonomy v. public good

- Can't make EVERYTHING mandate to reach Healthy People 2020 goals Beneficence vs. personal choice -Goal is to reduce smoking, reckless sexual activity, obesity, ect -> Can't mandate personal lifestyle choices. Is it really free will/choice when you can't afford healthy choices due to low SES?

patient communication

- Clients in the community are becoming more informed, and will expect nurses to be equally as informed. - Community nurses use a variety of information to make health decisions and are expected to use informatics in practice to reduce errors: to obtain, evaluate and manage information; in decision making; and in communication→ nurses need to be able to get the information and then be able to communicate the info

national security; cybersecurity; board; Collaboration; evacuation; infectious diseases;

- DHS recommends planning that strengthens critical infrastructure vital to __ __, including reinforcement of __. - In preparing for an all-hazards approach, include __ community collaborative planning and response (i.e. law enforcement, health systems, city leaders, churches, etc.). __ with nearby cities, counties, and the state facilitates effective planning and preparing for any possible disaster. __, provisions for shelters, or sheltering in place, control of __ __, ensuring communication systems, emergency and routine health care and recovery efforts need to be addressed.

Parent Peer Groups

- Establishing parent ()in which parents agree to certain rules of behavior for the children or teens, such as curfews and party rules, is helpful to parents and school personnel - Parents can agree not to allow drinking of alcohol, use of tobacco, or drugs at their houses--Parents in the group can feel comfortable when their teens are in company of peers whose parents subscribe to same rules - A CONSISTENT approach sets limits for youth while providing a atmosphere of positive peer pressure

primary vaccine failure

- Failure of a vaccine to stimulate an immune response and can be caused by improper storage that may render them ineffective, improper administration route, or exposure of light sensitive vaccines to light. - Some immunized pt's never seroeovert, owing to either failure of their own immune system or some other unknown reason.

WIC (women, infants, children)

- Federal assistance program of the Food and Nutrition Service (FNS) of the US Department of Agriculture (USDA) and healthcare and nutrition and low-income pregnant women, breastfeeding women, and infants and children under the age of 5. - Their mission is to be a partner with other services that are key to childhood and family well-being. - The basic eligibility requirement is a family income below 185% of the federal poverty level. - Currently, WIC serves 53% of all infants born the in US (that meet federal poverty level requirements).

Organizational Policy

- Formed & applies to groups that have similar interests or special interests, such as professional associations EXAMPLES: -- State Nurses' Association -- pecialty nursing organization that determines governing rules for membership, such as designated credentialing or registration

institutional policy

- Govers work sites - Based on the institution's mission & goals - Determine how the institution will fxn & relate to employees EXAMPLES: - State when the work shifts begin & end - The location & rules of smoking - Environments for employees & clients - Criteria for paid sick leave & vacation time

Health Policy

- Includes the laws to promote the health of citizens - Often considered part of public policy when it is directly related to legislated health care services & reimbursement (Medicare & Medicaid) - Health policy is established in many ways including legislation, rules & regulations, & institutions mission & goals - Determine what services are paid for & by whom, who is eligible to receive care, & who qualifies for financial assistance EXAMPLES: -- medicare -- medicaid -- State CHildren's Health Insurance Program (SCHIP) -- TANF -- WIC

medicare

- It provides health insurance for Americans aged 65 and older who have worked and paid into the system through the payroll tax. It also provides health insurance to younger people with some disabilities status as determined by the social security administration, as well as younger people with end stage renal disease and amyotrophic lateral sclerosis (ALS)

medicaid

- Largest source of funding for medical and health-related services for people with low income in the US. It is a means-tested program that is jointly funded by the state and federal governments and managed by the states, with each state currently having broad leeway to determine who is eligible for its implementation of the program. States are not required to participate in the program, although all have since 1982 - Social health care program for families and individuals with limited resources - Recipients must be US citizens or legal permanent residents, and may include low-income adults, their children, and people with certain disabilities. Poverty alone does not necessarily qualify someone for Medicaid.

Social Welfare Policy

- Policy that promotes the welfare of the public - Tends to focus on the nation's minorities & vulnerable populations EXAMPLE: -- Child labor laws -- Income assistance such as Social Security

biomagnification (cont)

- Pollutant is concentrated in organisms at a low trophic level, where it is further concentrated and passed to the third level, and so on. For example, polychlorinated biphenyls (PCBs) are a large class of 209 separate chemical compounds that held many industrial applications before 1976, when they were banned in the U.S.. Each of these compounds were associated with adverse health effects in people eating fish from the Great Lakes.

vision and hearing

- Screen all new students within 120 days of enrollment. - Screen students in kindergarten, 1st, 3rd, 5th, 7th, and 9th by May of each school year (Certification is required)

notifiable diseases reports

- The CDC and the US Public Health Services report data collected by the state and the local health departments on legally reportable diseases and periodically requests voluntary reporting of non-notifiable health conditions of special interest. Criteria for a notifiable disease include 1) the ability of the disease to cause death 2) the communicability of the disease.

15-19; 10

- The US Public Health Service has a Healthy People objective to reduce rates of occupational injuries treated in emergency departments among working adolescents __-__ years of age by __% by 2020, from the 2007 rate of 4.9 injuries per 100 full-time equivalent workers.

equilibrium

- The agent, host, and environment can coexist --- Disease and injury occur only when there is an integration or altered equilibrium - Equilibrium does not signify optimum health, but simply the usual pattern of illness and health in a population. Any change in of one of the factors (agent, host, or environment) will result in disequilibrium --- A change in the usual pattern

beneficience

- The desire to act in the best interest of others, beneficence, is perhaps the strongest guiding ethical principle of health care professionals. Because of the desire to help people, to take care of them, and to alleviate their suffering, health care professionals often find themselves faced with conflicts between their desire to help (beneficence) and their respect for the other person's right to choose (autonomy). - A community health initiative as apparently benign as an immunization campaign to protect community members from a communicable disease may conflict with the autonomy of people whose religious beliefs do not support the practice.

autonomy

- The right of individuals to self-determination is the core value of western European and American law and ethics. In application to health care, it means that decisions should be made by those most affected, be they individuals, families, groups, or communities. The altruistic nature of health care professionals presents a central challenge to the autonomy of those who receive their care. - For some community health care providers, it seems that the urge to help is so strong that it can get in the way of empowering people to help themselves.

Grandparents Day

- The school actively involves () which includes activities such as visitation, a healthy lunch, a BP screening - Students above 7th grade can learn how to take a BP which actively promotes awareness of the importance of preventing heart disease and monitoring BP

secondary

- The waning of immunity following an initial immune response. This occurs in immunosuppressed pt's whos immune memory is destroyed.

Justice (nurses)

- Therefore, it is important for community health nurses, to be active and help community residents establish a voice within the local, state, and national political arena. - Knowing their own city, county, and state reps., nurses can serve as a link between the community and its elected officials to facilitate interactions and support. - If the community can find ways to support politicians (photo opps, voting, attending rallies), then it is more likely that politicians will reciprocate by funding needed programs.

autonomy v. beneficence

- Those who want to help and those who need it are in disagreement -Ex. Chronic smokers; Want to help with AIDS but need to help with basics like housing first; arsenic water supply -> some water is better than no water in the communities eyes; no health services close so have to dangerously travel 50 miles to get help - Access to Care (Autonomy, Beneficence, and Justice) - Rural vs. urban; ethnicity; SES differences - Pay $50 for CHIP or get free care at ER? Provide care at home or make them come to a facility?

effectiveness

- Were program objectives met? - Were the clients satisfied with the program? - Were program providers satisfied with the activities and client involvement? - () focuses on formative evaluation as well as the immediate, short-term results.

outcome

- What are the long-term implications of the program? - Measures whether the program activities changed the initial reason for the program. - Fundamental Question: DID THE PROGRAM MEET ITS GOAL? (Was health improved?)

cost-efficiency

- What is the cost? - Measures the relationship btwn results (benefits) and costs presenting the program (such as staff salary/materials). - Could it have been less $$$$? Cost/benefit analysis requires skill beyond the scope of this text.

Culturally Competent Agency

- Work to change sociopolitical influences that create barriers to quality care - Generic outreach- not well rcvd because they are "mainstream" services. They are not individualized to serve a specific population or group. This outreach serves to maintain barriers as opposed to removing them. - Best approach: mainstream support of local programs and services that employ and use staff who have similar cultural backgrounds to those for whom the services are intended- multicultural and multilingual services; requires needs assessment to determine the types of services and the systems of service delivery that are most acceptable and efficient. - Culturally competent services, systems, agencies, and practitioners possess the capacity to respond to the unique needs of populations whose cultures differ from dominant or mainstream America. - Assess types of services wanted and needed by target populations is crucial to the reception and use of services by people with culturally diverse backgrounds.

chamber of commerce

- an association, primarily of people in business, to promote the commercial interests of an area - Extracommunity or intracommunity facilities are identified best through ()

Process of Formative evaluation

- answers the question: are we doing what we said we would do? That is, did we deliver the program, provide a place to meet, include handouts at our meeting, and so forth? - For example, when the first effective-parenting training program was offered in Rosemont from 8-9 only 5 parents attended. - They stated that time was too late for them to return home and complete bedtime activities for their school aged children. - As a result this formative evaluation, the time was changed to 7-8 pm and attendance increased to 20 parents. - The distinction between formative and process evaluation can be done by using processes to denote the evaluation conducted during the program, whereas formative may be applied at formative or pre-program stages.

artificially active

- antigens are introduced in vaccines; body produces antibodies and specialized lymphocytes

agent

- cause a disease- examines factors that affect the host - Major causes of infant mortality: LBW, birth injuries, congenital malformations, SIDS, accidents, homicides --- An investigator may try to determine whether there has been a change in any of the other agents.

environment

- combination of physical, biologic and social factor that surround/ influence agent/ host - The mother is a significant part of the infant's prenatal and postnatal environment. Therefore, Investigators will analyze birth and infant mortality patterns according to factors such as maternal age, ethnicity, parity, prenatal care, and education or SES. - Disease & injury only occur when there is an interaction or altered equilibrium between them ---- Analyze birth/infant mortality according to maternal age, ethnicity, parity, prenatal care, education or socioeconomic statu

ethnic group

- composed of people who share a unique cultural background and social heritage that is passed from one generation to another. - Our ethnicity gives us a sense of belonging and engender us - Often based on cultural criteria: common ancestry, shared history, a common place or origin, language, dress, food preferences, rituals, networks, clubs or activities - In health and illness, an ethnic group's shared beliefs, symbols, and customs serves as common reference point that members use to judge the appropriateness of the decisions and actions

red ribbon week

- drug free - goal is to inc awareness of dangers of tobacco, alcohol, and other drugs. - Each student recites a promise to stay away from drugs and wears a red ribbon for the wk. - *Do NOT have guest speakers who are recovering abusers or high-profile ppl bc they can make mistakes later.* - Invite ordinary community members - established in 1988 by US congress; parents can be invited; - *media coverage* is an important strategy that schools often use; older students influence younger students by positive peer pressure, such as wearing their ribbons, participating in all activities, and having major role in organizing and implementing activties

muscle mover club, triathlon, walk-a-thon

- encourages physical activity by rewarding aerobic exercise (swimming, running, walking). - Each child receives a badge & can add stickers for city blocks or track laps. - Healthy competition can be encouraged by racing to a goal individually or as team or classroom. - Encourage parent involvement--sign off on triathlon or walk-a-thon mileage sheet; in addition to health promotion, these strategies reinforce positive adult role modeling. - Although research has typically focused on preventing risky behaviors, a recent emphasis has been on increasing protective factors--such as school connectedness, parental presence, and having a meaningful relationship with at least one caring adult

OR (boolean)

- enlarges the search yield by identifying all information focused on both terms searches. - If a topic is referred to by more that one term, the () word can be useful to identify info. - When searching a topic such as smoking and adolescents, for example, the search string might be "adolescents OR teenagers" AND smoking to search for information about smoking that relates to this aggregate.

fidelity

- faithfulness - To work with communities or individuals, the health care professional must be careful in making promises and steadfast in keeping them. This obligation may be embodied as simply as making and keeping appointments. It may also extend to keeping a pledge to report back to community leaders on the outcome of a project. Much of the work of the community health nurse, then, involves building relationships to advocate effectively for treatment for community members diagnosed with serious health conditions. - An effective approach is to consider what one's community, one's associates, or oneself might have to offer in advance of asking the favor. It is also good to know about tax incentives, public relations, referrals, and other non-altruistic motives as well.

Health Information Technology for Economic and Clinical Health Act (HITECH act)

- gave incentive payments to clinicians and hospitals who utilize EHR correctly meeting the meaningful use criteria - nursing informatics supported indirectly by this - enacted as a result of American Recovery and Reinvestment Act (ARRA) which incentivized payments to clinicians and hospitals who utilize ​Electronic Health Records (EHR)​ correctly meeting a meaningful criterion --- Note: payments will amount up to 27 billion over 10 years for eligible providers and in 2015 Medicare started penalties for those non-compliant

cultural competence

- implies an awareness of, sensitivity to, and knowledge of the meaning of culture and its role in shaping human behavior - Ability to express an awareness of one's own culture, to recognize the differences b/t oneself and others, and to adapt behaviors to appreciate and accommodate those differences

boolean searching

- is a mathematical system used in computers and will increase the precision of a search. - are commands, including AND, OR, and NOT. When used in the search string, they instruct the search engine how to retrieve info indexed by the keywords chosen. - For example: a community might enter the search string "crime AND Mytown, Texas." The search engine would return all info indexed that pertains to crime as indexed in Mytown, TX.Searching crime alone would return too much info on crime everywhere, and the location alone would yield too much info on the city/town.

thinking upstream

- is about addressing the things that have the greatest influence on our health, including income, employment, education, early childhood development, housing, nutrition and the wider environment. - health for all

cultural competence

- is evident when all people are treated in ways that respect their uniqueness and preserve their dignity. - means that we understand how cultural and ethnic beliefs and practices influence our daily lives, and recognize that people with cultural backgrounds different from our own have unique values, lifeways, health practices, and interpersonal styles.

veracity

- is the commitment to tell the truth. - centers on honesty about who you are and what you bring to the community.Community health nurses, as community advocates, should help ensure that they and other researchers are honest with the community about exactly is to be provided.

medicaid

- low income - pregnant women - children under 19 - people who are 65+ - people who are blind - people who are disabled - people who need nursing home care

direct

- mode of transmission immediate transfer of an infectious agent from an infected host or reservoir to a portal of entry in the human host through physical contact such as: ▪ Touching ▪ Biting ▪ Kissing ▪ Sexual contact

indirect

- mode of transmission spread of infection through a vehicle of transmission outside the host ▪ Fomites- inanimate object or material (food, water, blood) ▪ Vectors- animals, insects, arthropods

medicare

- people65 & older - people of any age who have kidney failure or long term kidney disease - people who are currently disabled and cannot work - people who are currently disabled and cannot work

host

- population at risk for developing the disease - Second area of assessment- examines characteristics about the host - Examines infant birth and death patterns in terms of age, ethnicity, sex, and birth weight --- It may be possible to identify groups of infants who are at particularly increase risk of dying.

Medical and Hospital Records

- provide valuable info for community health research. - EHRs have facilitated data mining or the usage of large amounts of info from patient records. - It is important to note that, though these records contain completely comprehensive info about patients seeking services, they do not provide a completely representative or valid picture of community health.

National Electronic Disease Surveillance System

- provides an integrated surveillance system that transmits public health laboratory and clinical data via the internet. - This process improves the nation's ability to identify and track emerging infectious diseases and potential bioterrorism attacks. - It is important for state health departments in investigating outbreaks and monitoring disease trends in that it is used for surveillance and analysis of notifiable diseases.

NHDR (National Health Disparities report)

- purpose is to monitor health care quality and health disparities in the US. - The 2012 report indicated that despite an overall improvement in the quality of healthcare, access to quality healthcare for minority and economically disadvantaged groups had not improved. - Particular areas of concentration centered around DM and cancer care, and care of persons living in the southern regions of the US.

Herd immunity

- refers to a state in which those not immune to an infectious agent will be safe is aertain proportion (generally considered to be 80%) of the population has been vaccinated or is otherwise immune. - This effect applies only if those immune are distributed among the population. Without the presence of a susceptible population to infect, the organism will be unable to live because the vast majority of the population is immune

willowbrook state school

- residents: children and intellectually disabled - were deliberately infected with hepatitis to boost immune responses among residents - Krugman's goal was to study the best ways to protect from hepatitis -- non-maleficence, veracity

nonmaleficence

- the avoidance of harm, is the silent partner of beneficence. - Often health care decisions may offer no really good option that will provide positive results, but at least there may be a choice that does not cause any outright harm. - When proposals are considered for community health initiatives, it is important to evaluate not only what positive good (beneficence) might come from the activity, but also what harm might result.

distributive justice

- the fair distribution of rights, and resources - discussions often center on allocation of scarce resources in ways that are fair and of greatest benefit to the most people. In this context, community health care programs that lead to better quality of life (beneficence) for the greatest number of people in the community (respect for people)

synergism

- the simultaneous action of separate substances or agencies that together produce a greater total effect than the sum of their individual effects. - It is common to discover a given substance behaves in one fashion in a controlled laboratory environment and in another when introduced into a natural ecosystem, where it interacts with a number of environmental physical and chemical properties.

primary prevention (bullying)

- there needs to be awareness and involvement of key adults in the school community. 1) conduct a teacher/staff in-service program to educate the members on the problems of bullying 2) If not policy exists, assist school administration to develop a school Policy for handling bullying/peer sexual harassment situations 3) Formulate a coordinating group of teachers, staff, school nurse, administration, parents, community members, and Students

NOT (boolean)

- used to limit yields when searching by identifying what you do not want. - Limit setting is a tool to increase the precision of searches. - If you need to learn about resources in your community that are provided by the private sector, the () operator might be used to remove government agencies for the returned list of websites

adapting skills

-Delivering culturally competent care implies a contextual understanding that treating the illness and understanding what it means to the individual are as important as working to resolve the disease process. - Sound physical and psychosocial assessment skills, sensitive interviewing skills, active listening- no slang/jargon, presentation of questions, paraphrasing, long questions, neutral body language: not everyone likes touch!, and self-awareness are the basic attributes required of culturally competent providers. - Eliciting patient and family explanations of health status and illness

biomagnification

0ccurs when the accumulation of a pollutant exceeds the rate in which an organism eliminates it

justice

2 aspects, both of them applicable to health care decision making. Most often, discussions of health-related justice center on: distributive & Retributive

relevancy, progress, cost-efficiency, effectiveness, outcome

5 components of evaluating

We Can!

A collaboration with NIHLBI to promote eating right, getting active, and reducing screen time.

environmental; cultural; health

AINTAIN A CLEAR HEALTH FOCUS - Always ask, "Does it focus on health" - __ and __ Support -- ID the environmental and cultural practices and policies that are in conflict with the proposed community-based health program - Level of Prevention -- Focus on __, NOT on the activities of the program by using nursing practice model as a guide (primary, secondary, tertiary levels of prevention)

emergency kit; prepare; practice; CPR/AED; first aid

ARC has identified simple emergency preparedness steps: - Assemble an __ __. - __ and __ your personal/family emergency plan. - Get trained to ensure at least one household member is trained in __/__ and __ __ - Get involved in your community; know the most likely disasters and assist the community to prepare for these.

American Lung Association

Air Quality, Waste Management, and Recycling: The following resources are available from the __ __ __: - Prepare to Go Back to School with Asthma - IAQ School Action Kits - The Magic School Bus Gets Cleaned Up

media; educational; field trips; campaign; asthma; attendance; performance; recycling

Air Quality, Waste Management, and Recycling: - Aided by the __ focus on environmental issues, a conscientious, environmentally responsible generation is emerging. - There are numerous ways to involve youth through environmentally friendly __ programs and __ __ - Lessons on air quality and waste management and recycling can be embedded within the school curricula and involve administration, faculty, staff, facility managers, parents, and students. - Here are some ideas: Involving teachers, staff, and parents, the school nurse can lead the __ to improve the indoor air quality (IAQ) for all students, especially those diagnosed with __. - Such efforts promise to keep all students healthier, improve __ and in turn school __. - Field trips can be arranged for students to visit a __ or reuse center. There is nothing as effective as actually observing piles of refuse, bales of plastic bags, and blocks of aluminum cans to demonstrate to youngsters the monumental scale of the waste that would occur without reusing and recycling.

Natural; man-made; traumatic; explosive; Nuclear; biological; Chemical

All-hazards planning includes five hazard categories for which all health professionals should be prepared: - ___ or accidental __-__ disasters (storm or fire) - __ or __ disasters: deliberate (bomb) or accidental (plane crash) - __ (nuclear weapon detonation) or radiation (dirty bomb) disasters - __ disasters: intentional release of pathogens or biological agents to cause harm, also termed bioterrorism (such as anthrax), or natural or unintentional exposures such as SARS - __ disasters: deliberate or accidental release of a harmful chemical (such as cyanide or chloride).

READ

Box 17.2 Tool for Assessing Educational Needs of Faith Communities - Cardiopulmonary resuscitation skills, cancer prevention, cardiovascular risk factors, community safety, diabetes education, domestic violence, end-of-life issues, exercise, first aid, - HIV + information, navigating managed care, nutrition for youngsters, parenting and child care issues, retirement issues, screening programs, sexuality, stress management, warning signs: stroke/heart attack, weight management, other

aggression; repetition; power; indirect; criminal; prosocial; sexual harassment

Bullying Prevention Programs: - The definition of bullying includes 3 elements: __, __, and __ imbalance - There is direct bullying and relational bullying - Girls are said to engage more than boys in __ bullying which can be just as devastating to a childhood development - Solutions to bullying must target the bully, the bullied, and by-standards. - Most bullying takes place takes place on or near school grounds in classrooms, bathrooms, hallways, and playgrounds during school hours and dismissal. It can also take place on school buses. - Students with a bullying history were 4X more likely to engage in __ behavior in their twenties. It can escalate to dating violence and adult intimate partner violence. - The school must promote __ behavior and not accept antisocial behavior such as bullying and other forms of aggression including electronic aggression is the most important strategy. This involves a multidimensional and multifaceted approach involving students, administration, teachers, staff, and parents - Federal law requires a __ __ policy be in each school.

colds; appetite; fear; sore throat; respiratory; GI; headaches; stomach; sleeping; articulate; bystander

Bullying prevention programs: - Bullying has been associated with a variety of physical, psychosomatic, and mental health effects such as __, poor __, and __ of going to school. - School nurses should consider bullying as a possible contributory factor when children come to the school clinic complaining of a __ __, cold, __ problems, and __ ailments. - Students BULLIED weekly were twice as likely to develop __, ___ aches, and __ problems. They were also 2-4X likely to develop feelings of "low", "lonely", "irritable", or "nervous." - It is important to address bullying at an early stage with young students and students should be encouraged to know what their personal boundaries are and to __ when someone is crossing the line. - Standing up for themselves and learning to be an active __ when others are being victimized nurtures healthy social development.

stage 3 (adaptation of reinkemeyer's stages of planned change)

CLARIFICATION or DIAGNOSIS of the community's problem, need, or objective

comprehensive; demographics; age; race; sex; employment; income; migration; education; bias; underrepresents; marital; financial; Educational; housing; transportation

Census: - The most __ source of health-related data for the US. It provides data for the US population and surveys for basic __. It also provides information about community characteristics such as __, __, __, along with other factors such as __, __, __, and __. - __ can occur because many people many answer personal questions dishonestly. - It also __ low income residents, minorities, and transients--These people are most difficult to locate, enumerate, and tend to be less likely to respond to census surveys. - collects data on __ status and __ characteristics, including the percentage of households below poverty level in the community. - __ status information, including years of school completed, school enrollment by type of school, and language spoken, can be located in the social characteristics section of the census data. - The population and __ characteristics section of census data provides information about private __ sources and the number of persons with a transportation disability.

Macro; root; societal; population; lasting

Characteristics of Upstream Interventions: - __ level interventions (large scale) - Address the __ of the problem - Implemented at the __ or __ level - Effects more likely to be __ - Example of Upstream: a nurse lobbies in congress to pass laws that require that public schools provide nutritious meals and a minimum of 30 min. Of physical activity 3-4 times a week.

person; environment; health; nursing

Community as Partner Model 4 concepts - __, __, __, and __

costs; consequences; dollars; compare; exceed;

Cost Benefit Analysis (CBA) -Lists all __ and __ of a particular program - Consequences or benefits of a program are valued in terms of __. - Makes it possible to __ between/among different programs - The worth of a project can be judged by asking if dollar benefits __ dollar costs Ex: Disproportionate share of federal $ allocated to Medicare recipients in last year of life?

dollar value; effective;

Cost Effective Analysis (CEA) - Does NOT place __ __ on either costs or consequences -Useful if costs of programs are the same or if the objective is to select the most __ program - This is because benefits or costs are difficult to measure - You can't place a dollar value on each suicide prevented by the program - Used to compare programs with similar goals and objectives (Ex: comparing MADD vs StopBullying.org; which program had more effective results in terms of death averted for suicide prevention vs drunk driving?) - Can also be used to compare programs

labeling; marketing; taxes; funding primary; family; societal

Curbing Childhood Obesity - Areas to address: nutrition __, __ of unhealthy food and beverages to children, food __ and subsidizations, and __ for health promotion and physical campaigns - Excess weight is RF for chronic conditions like heart disease, HTN, stroke, Type II DM, some types of cancer - Essential that school health programs focus on healthy eating and physical activity to promote healthy weight; more effective to address unhealthy childhood weight gain as __ prevention level than treat it once it ahs occurred - Evidence that school health programs implemented without concurrent __ interventions and __ campaigns against overweight/obesity may be ineffective - lets move campaign

stage 2 (adaptation of reinkemeyer's stages of planned change)

DEVELOPMENT of a change relationship between the community health nurse and the community

vital statistics

Data that describe legally registered events such as births, deaths, marriages, and divorces. Researchers tend to consider vital statistics as "hallowed" because they are legal data.

secondary

Decontamination and infection control are ___ prevention of disaster response

questionnaire; feedback report; evaluate

Delphi Technique​ (Slide 36) - Initial __ distributed ​by mail​ to preselected group - Individuals complete and return questionnaire​ - assures anonymity so no power struggled for voice - Based on responses, a __ __ and​ ​revised questionnaire​ ​are sent to respondents - Using feedback information, respondents __ their first answers and complete questionnaire again

questionnaire; feedback report; revised; evaluate

Delphi technique: - An initial __ is sent by mail to a community - Respondents share their thoughts through the questionnaire and return it - Based on the responses, a __ __ and __ version of the questionnaires are sent back to the respondents. - Using feedback information, the respondents __ their first answers and complete the questionnaire again - This process continues in a circle.

objectives; knowledge; behaviors; attitudes; changes; sequential; measurable; time frame; magnitude; measuring

Development of objectives (planning): - Once program activities have been established, learning __ are written. These are derived from a goal and describe the precise behavior or changes that will be required to achieve the goal. They specify what changes in ___, __, or __ are expected as a result of program activities. - Learning objectives focus on the learner and state what __ the learner can expect as a result of participating in the program. - Both program and learning objectives can be written in __ steps that are required to reach the goal, or each objective may have different aspects that, when combined, achieve the goal. - Goals and objectives need to be __, to make a statement measurable, use precise words. - Each goal and objective should include: 1) a __ __ for attaining the change 2) the direction and __ for the change (increase immunization levels up to 95%) 3) The method of __ the change (after the session, each participant will demonstrate...) - Goals and subparts of goals (objectives) help to clarify a program and establish the expected changes that will result from the program.

37; employment; accommodations; recreation; transport; limited; equipment

Disability: - More than __ million people or 12.1% of the population in the US are estimated to be living with a disability. - Congress that ensures that persons with disabilities are not discriminated against in __ opportunities and public services, including public __, __, and __. - For example: reading, bending, and communication, as well as bodily function (immune system, bowel/bladder) are all identified as potential disabilities. - Two simple questions can be asked by nurses to assess disability: 1) Are you __ in any way in activities because of a physical, mental, or emotional problem? 2) Do you now have any health problem that requires you to use special __ such as a cane, wheelchair, a special bed, or special telephone? - Because the definition of disability is evolving it is difficult to report the prevalence of persons with disabilities in general.

government; health care; law enforcement; emergency services; financial; faith; volunteers

Disaster planning - Historically, individuals and local communities, and local governments have been responsible for disaster planning, however, higher __ authorities may intervene if these entities become overwhelmed. - Multiple organizations may be involved in disaster planning and management, including __ __, __ __, __ __ and first aid, __ institutions, emergency shelters, __-based groups, utility companies, and the postal service. - Individuals serving as __ have also played important roles. Cooperation and coordination among all are essential for rapid and effect planning and response.

simple; drills; equipment; locate; family

Disaster plans should be __, realistic, clear, easy to implement regardless of the nature of the disaster or who must implement the plan. They should be tested via __ and __ checks and updated regularly, and evaluated periodically by those in charge of implementation. All healthcare workers should be able to __ and implement the plan at their workplace, and nurses should also consider personal preparations and develop and practice personal __ disaster plans. Nurses should also encourage community members to develop and practice their personal disaster plans.

EHR; health; human services; 27; Medicare

EHR/ HITECH/ informatics - use of certified __ technology in a meaningful manner (for example electronic prescribing); ensuring that the certified EHR technology is connected in a manner that provides for the electronic exchange of health information to improve the quality of care; and that in using certified EHR technology the provider must submit to the Secretary of __ & __ __ (HHS) information on quality of care and other measures. - We have become increasingly less paper-record oriented. Many facilities want to capture medicare and federal dollars, so they subscribe to the HITECH Act. Payments totaling up to __ billion over 10 years to eligible providers - In 2015, __ began to penalize those who were not using some sort of EHR to track their patient's outcomes and inpatient populations. - It was enacted as a result of ARRA (American Recovery and Reinvestment Act 2009) - the Stimulus bill, which distributed funds through tax benefits, contracts, grants, loans and entitlements. - The HITECH Act is a part of ARRA

stage 4 (adaptation of reinkemeyer's stages of planned change)

EXAMINATION of alternative routes and tentative goals and intentions of actions (planning)

height; weight; BP; nutritional; dental; developmental; Acanthosis Nigricans

Each state mandates certain requirements to maintain the health of school-aged children: - They also measure __, __, __, and perform __, __, and __ screenings. Some schools screen for __ __ (AN) which is a skin condition associated with high levels of insulin in the body which can lead to Type 2 DM later in life. In Texas AN screening is mandatory. - Nurses conduct these screenings privately and confidentiality and also look for bruising. Here the nurse has the opportunity to engage the child in health-related conversation such as "What did you have for breakfast this morning?" - Immunizations -Nutrition, Violence, Substance Use, Mental Health Issues, Personal Safety, Sexuality, Environmental, and Societal Influences (See Box 16.1 on page 285 for more specific examples).

MODIFIABLE; multifaceted

Elderly: - **Health promotion strategies should focus on __ risk behaviors, matched to the leading health problems by age** To maximize health promotion for community elders, a __ approach is needed** Interventions should target individuals and families as well as groups and communities**

5; Toxic agents; environmental; 15; 10

Environment/exposure: __% - __ __ → occupational exposures such as asbestos - __ exposure → particulates, carbon monoxide, environmental tobacco, lead - Texas city refinery explosion in 2005 killed __, injured 70. - Water in Flint Michigan, lead in water supply Health care: __% -- is influenced by our traditional healthcare system

communicable; equilibrium; AGENT; HOST; ENVIRONMENT

Epidemiologic triangle and components (remember) - Traditional view of health and disease developed when epidemiology was concerned chiefly with __ disease. - Triangle is in normal state of __. Equilibrium does not signify optimum health but simply the usual pattern of illness and health in a population. A change in 1 factor results in disequilibrium- or a change in the usual pattern. - __ - Cause - __- Person or animal infected - __ - Conditions allowing the organism to grow or curtailing growth

volunteers; needs assessment; language

Establishing a Lasting Partnership with Faith Communities - Recruit high school and/or college __ to help with organizational details. Many are required to do service hours as a condition for graduation. They may be waiting to find just such an opportunity. - Have a team meeting and plan nursing actions. Probably the first action would be to conduct a __ __. Be sure it is conducted in __ that reflect the constituency.

all-hazards

Experts generally recommend an __-__ approach to disaster preparedness. This recognizes that people may encounter multiple types of hazards depending on where they live, work, play and travel. - planning involves the identification of potential hazards, assessment of vulnerabilities, and determination of potential effects

Needs assessment;

FAITH: Planning a Health Promotion Program Just like with Any Health Program Planning: Must start with the assessment process - __ __ (questionnaires, health risk appraisals) -Once needs Identified Proposal Presentation of why needed? - Is it possible to implement? - What has worked per research? - Business Plan on How to Conduct with Costs and Benefits to the company and its employees Finally: Is it Feasible?

assessments; annual; analysis

Faith Needs Assessment: Initiating Healthy Partnerships with Faith Communities: - __ (monthly screenings), __ surveys, and __ of the components of participants' needs dictate what intervention programs need to be implemented (e.g. healthy eating classes, exercise classes, walking clubs, or diabetes management instruction). These programs are implemented in a timely fashion that is most supportive of the participants.

Lets move (child care)

Focus is on starting healthy habits early in a child's life.

information sessions; peer groups; breakfast meetings; grandparents; breast cancer; nutrition; TIMING; breakfast;

Following ideas for healthy partnerships with parents - Parent __ __ - Parent __ __ - Late __ __; "second cup of coffee meeting" - __ day - Breast __ __ - Parents __ committee -- Most difficult part of planning health promotion activities that include parents is __! -- Most parents are employed and have little flexibility in their work schedules -- __ meetings that are short and occur as children are brought to school may be well attended -- issues must appeal to parents, and is always a good idea to conduct a needs assessment before deciding on topics -- respecting time constraints of parents and guardians fosters rapport and in turn encourages involvement

SCHIP

For ppl that are too wealthy for Medicaid but cannot afford insurance

underserved; persistent poverty; insurance; TRANSPORTATION; lower

GEOGRAPHIC AND SOCIAL FACTORS THAT IMPACT HEALTH IN RURAL AREAS: - Rural areas are "__"- not enough health care providers for population (Note*- these statistics do not take into consideration the health status of the population and there is an assumption that adequate health services are a necessary condition for population health. - Maybe the most telling demographic marker as a determinant of health and health behaviors is "___ ___"= 20% or more of population living in below the federal poverty level for three successive census periods (30 years). - Lack of health __, lack of __ - Life in these areas is qualitatively different than other parts of the country - Life expectancy is generally __ in areas with persistent poverty, but these may vary according to other factors, like race and ethnicity.

fewer; obesity; substance abuse

GEOGRAPHIC AND SOCIAL FACTORS THAT IMPACT HEALTH IN RURAL AREAS: - Rural populations face all the same preventable illnesses that are faced by urban populations. But since there are __ local public health departments or offer limited number of services, the larger health promotion activities are taken on my healthy community coalitions, hospitals, primary health clinics, schools social services, law enforcement, and local businesses. - Rural populations and Health: Determinants, Disparities, and Solutions assess community needs, as well as address smoking prevention, oral health, physical activity, farm-related injuries, mental health, cancer prevention, and adolescent health. The two major issues that challenge these prevention partnerships and coalitions in rural communities are ​__ ​and ​__ __​.

detection; response; prevention; control; economic; political; social; affordable care ;

Health People 2020, misc: - HP 2020 included a global health goal to improve public health and strengthen US national security through global disease __, __, __ and __ strategies. - The new public health nursing standards, released in 2013, converge __, __ and __ factors including HP 2020 and the patient protection and __ __act (ACA) to provide a directive for improving health of populations. - Four main goals, plus: there are nearly 600 objectives in HP 2020, with more than 1,300 measures organized into more than 40 topic areas. In that these objectives are based on national data, as well as rigorous criteria, they can be used as standards against which we can compare local data. They also provide excellent examples of clearly written, measurable objectives.

developmental; observing; management; teachers; counselors; nurses parents; marketing; students

Health Programs for School-Aged Children - These programs must be age appropriate (i.e breast and testicular self examinations are not appropriate for elementary school children). It is important to assess the __ and maturity level of the children before deciding on the educational content of the program or strategy. Mind that each class is different. - Important info is gained from __ the student population before planning programs. Visit the classroom and observe how the students and teachers interact. - Classroom __ skills are essential. Rely on the regular classroom teacher for assistance is best. - Teachers may not have enough time to devote to programs so make sure that you involve key people such as __, __, __, and __ from the very beginning of the planning phase - Programs that are researched based provide evidence of successful outcomes and data can be shared with teachers, parents, etc. to further buy-in for implementing the specific program. - __ your program is important because if no one attends or follows through it will be a waste of time. Use flyers, bulletin boards, and public address announcements to reach your audience. Involving __ in the promotion is ideal.

neighboring

Health Promotion Strategies for the Community: - Involving the __ community in health promotion programs can benefit school-aged children and their families, as well as members of the surrounding community.

BP; cancer; payroll; heart; TB

Health Promotion Strategies for the School - __ screenings on the same day each month - __ awareness programs - Stuffing __ envelopes with health promotion material - Healthy __ lunches such as salad day once a week - Referral and resource info - __ skin testing

mobilize; assess; plan; implement; track

Health Promotion Strategy Box 17.8 MAP-IT Strategy for Creating a Healthy Community - __: individuals that care about the faith community's health into a coalition - __: the areas of greatest need in your community, and the resources and strengths you can tap into to address those areas - __: your approach: start with a vision of where you want to be as a community; then add strategies and action steps to help you achieve that vision. - __: your plan using concrete actions steps that can be monitored and will make a difference - __: your progress over time

appropriate; effective; affordable; low; Census; management; budget; smoking; obesity; chronic; substance; suicide; child

Health Risks (RURAL) - Rural health issues= issues that affect timely access to __, __, __ services for persons who live in areas of __ population density, often at a distance from specialty and tertiary care that results in greater role for primary care as compared with urban areas. - US Bureau of the __ and White House Office of __ and __ (OMB) define what is "rural" by defining what is urban, and then what doesn't fall into that definition is "rural" - Rural areas are less healthy than urban in almost all of the following health indicators according to National Center for Health Statistics: __, __, __ disease, __ abuse, __ and __ health. - Rural areas are worse off in demographics such as age, education, income and health insurance status

elderly; civic; drug-free; traffic; smoke-free; immunization; clinics; gun

Health promotion strategies involving the community may include the following: - Involve the __ in school activities such as reading programs, mentoring, and monitoring lunch. - Collaborate with the local __ association. - Establish a __-__ zone. - Have a community parade celebrating being drug free. - Establish a safe __ pattern. - Publicize a __-__ environment for all who work at or visit the campus. - Contact radio and television stations, and newspapers and ask them to report health promotion events. - Plan __ programs. - Provide school-based family __. - Use the community forum to address neighborhood alcohol availability/consumption. - Collaborate with local law enforcement to conduct a __ safety awareness program, including handgun issues.

primary; promotion; protection; functional; independence; meaningful; empowerment

Health protection and ethical principles: ELDERLY - Health promotion and health protection are two elements of __ prevention - Health ____ → emphasis on helping people change their lifestyles and move toward a state of optimal health - Health ____​ → focuses on protecting people from disease and injury by providing immunizations and reducing exposure to carcinogens, toxins, and environmental health hazards - Healthcare goals for elderly persons MUST focus on improving __ ability, maintaining __ (autonomy)​, and helping them find __ activities in life - The goal is __ of the elderly and their families to make rational health decisions

screenings; lifestyle; education; counseling; immunizations; safety; in-home; social;

Health protection and ethical principles: ELDERLY - Some categories of health promotion and health protection intervention that target the individual and/or family are → health __, __ modification, health __ (one-to-one or group), __, support groups, primary health care, __, home __, __-__ care (home health, personal care, or household care), home-delivered meals, __ support (telephone reassurance, and home visiting), case management, home maintenance help - Make sure to involve elders in planning health promotion and disease prevention activities because it increases their sense of independence. - Selected health promotion and health protection needs of community elders include health services, nutrition, exercise and fitness, fall prevention, community safety, driving safety.

individual/family interventions (elder)

Health screenings, lifestyle modification, health education, counseling, support groups, primary health care, immunizations, home safety, in-home care, home delivered meals, social support, case management, home maintenance help

preventable; disability; injury; premature; equity; disparities; environments

Healthy People 2020 aims to reach four overarching goals: - Attain high-quality, longer lives free of __ disease, __, __, and __ death. - Achieve health __, and eliminate __. - Improve the health of ALL groups. - Create social and physical __ that promote good health for all.

prevent; prepare; respond; recover; workforce; communication; prevention; mitigation

Healthy People 2020 has identified a national preparedness goal: Improve the Nation's ability to __, __ for, __ to, and recover from a major health incident. HP 2020 has also identified related objectives: - Develop and maintain the __ needed for national health security - Ensure timely and effective __ - Ensure __ or __ of environmental and other emerging threats to health

health services; preventive; environmental; injury; violence; mental; nutrition; obesity; oral; reproductive; social; tobacco

Healthy People Leading Health Indicators: Topical Areas - Access to __ __ - Clinical __ services - __ quality - __ & __ - Maternal, Infant, and Child health - __ health - __, physical activity, and __ - __ health - __ and Sexual Health - __ determinants - Substance abuse - __

stage 1 (adaptation of reinkemeyer's stages of planned change)

IDENTIFICATION and development of a felt need and desire for change

Collaboration; coordination; publicizing

IMPLEMENT A UNIFIED PROGRAM - __ and __ between agency personnel who will implement the program and the program's recipients - PSAs, newspaper articles, bulletin inserts, religious associations, flyers sent home with children - Allow plenty of time for )) the program can make a crucial difference in whether people attend and what the subsequent impact will be - Unified Goals= HP1990, 2000, 2010, 2020

measles; Philippines; 382

Immunization rates - Globalization of infectious disease: __ outbreak among Amish - __ > Brought home by Amish missionary > to an Amish community in Ohio > Once he felt better he went to church - Spread rapidly (highly contagious; droplets live for hours on surfaces) among Amish due to lower immunization rates - No deaths (__ cases) - When large communities do not vaccinate, it is a public health problem.

first; 30;

Immunizations and state law -Required by state law to be current and on file before or on the ___ day of school, although a school district can establish a short grace period,usually __ days. Must be strictly supported by the school administration. Each state must set its standard; a district can increase the requirements but must include the minimum standard. For example, TB screening for school age children may not be required by state law; however, school districts can set a higher standard and require new students to have an approved skin test for TB. Can also require school personnel to be tested annually.

immediate; learned; intent; self-reports

Impact or Summative evaluation - is concerned with the __ impact of a program on a target group. - If you program is aimed at changing a group's knowledge and behavior relating to STIs, for instance, you might build in a test to find out what they __ and what their __ is about modifying behavior. - In the case of effective parenting classes, summative evaluation criteria might include parental __-__ of changes in their attitudes toward physical punishment and disciplinary practices before and following the program.

chronic disabilities; homelessness; immigrants

Included among marginalized groups are: - Persons with __ __ - Persons who are experiencing __ - __, refugees, and migrants

Marginalized groups

Individuals or groups who live on the fringes or margins of society lack key resources and are most often underserved or not served at all, particularly in health care systems --- Gender, ethnicity or race, education or income, geographic location, or sexual preference may account for group differences that lead to marginalization and subsequent health inequities. - Minority groups are less likely to obtain health care than whites -

objectivity v. bias

Info is used to inform the reader; sometimes, info is used to influence the reader. As you read info, be aware of potential bias exhibited by author or website. Some information is produced to influence your opinions; likewise, some info may be omitted to influence your opinion.

relevancy

Is there a need for the program? - determines reasons for having a program or set of activities. - Questions of () may be more important for existing programs than for new programs. Common constraint to beginning a new program: inadequate staff/budget → Remedy = relevancy evals of existing programs

credibility and accuracy

Is this info true, and can you confirm it with at least two other sources? Or is this info different from everything else you have found on the topic?

navigation

Is this site easy to navigate? Are you lost constantly and unable to get back to the homepage, or is there so much flashing that you feel overwhelmed by the site? Or does this site make it clear how to find the information you need?

generation; factual; resources; Michelle Obama; PE

Lets move campaign: - Hopes to curb childhood obesity within one __ and offers __ information about the health implications of obesity, as well as __ for parents and educators; campaign encourages consuming more fruits and vegetables, eating a healthy breakfast, and drinking more water - First Lady's nationwide initiative to combat childhood obesity in the current generation of children - endorsed by __ __, movement recognizes that children today have very different lifestyles from 30 years ago when the norm was to walk to school, to have active recess time, and to participate regularly in gym class; today most children ride to school, __ is not often prioritized, and resources are not available for extracurricular programs

24th; uninsured; 50; 18; 7; 75; Japan; Australia; heart; breast; lung; poverty; bioterrorism; violence;

Life Expectancy: US compared to other countries: - Cost does not equal quality: US ranks __ worldwide in life expectancy; chronic illness focus is NOT prevention. - High rate of __ Americans under 65 (__ million) - __% of GDP- unaffordable health care - Lack of emphasis on health promotion __/10 deaths in US are defined as "preventable" and __% of our health care dollars treat those diseases - We spend the most but among other countries- our health outcomes rate lower than __, __ - High death rates of African American Women in __ disease and __ and __ cancer - globalization (factoids VPD) - __ and subsequent health disparities - __, __, injuries and social disintegration

move, assess, sort, send

MASS stands for what?

tertiary prevention (bullying)

Maintenance program aimed at reducing the prevalence of future bullying is crucial and includes: 1) have regular meetings of the coordinating committee 2) formally assess for bullying behaviors on an annual basis 3) continue school meetings and teacher-student discussion groups 4) encourage parental involvement in a variety of school activities.

payroll; premiums; beneficiaries; 55

Medicare: - A single-payer, national social insurance program administered by the US federal government since 1966, currently using about 30-50 private insurance companies across the US under contract for administration --- Funded by a __ tax, __ and surtaxes from __, and general revenue --- In 2015, Medicare provided health insurance for over __ million - 46 million people ages 65 and older and 9 million younger people --- On average, covers about half of the health care charges for those enrolled. The enrollees must then cover their remaining costs either with supplemental insurance, separate insurance, or out-of-pocket for uncovered services-such as for long-term, dental, hearing, and visions care- and supplemental insurance premiums

site; recipient; practitioner; competencies; initial; changes

Model for Program Evaluation, Information to Collect--Process (Formative): Program implementation, including: - __ response - __ response - __ response - __ of personnel WHEN TO APPLY: - __ implementation of a program or when __ are made in a developed program (e.g., moved to a new site, provided to a different population)

Outcome

Model for Program Evaluation, Information to Collect--___ (Long-Term Outcome) - Incidence and prevalence of risk factors, morbidity, and mortality WHEN TO APPLY: - To measure if incidence and prevalence have been altered. For example has the immunization rate of 2 year olds increase, did the rate of admissions for illness decrease? did the industry filter its polluting smoke stack?

Impact

Model for Program Evaluation, Information to Collect--___ (Summative; short-term outcome) Immediate effects of program on, for example: - knowledge - attitudes - perceptions - skills - beliefs - access to resource - social support WHEN TO APPLY: To determine if factors that affect health--both within the individual and in the environment--have changed. For example, did the person's behavior? What the new policy implemented?

Pretest-posttest one-group design

Most appropriate survey for Health Care Setting? __-__ __-__ - Control group (similar demographically to experimental) AND experimental group

self-examination; mammography; worship; self-examination; scout; FFA

Mother-Daughter and Father-Son Programs: - Cancer prevention programs for mothers and daughters can promote breast __-__ and __ - Culturally appropriate programs can be designed to attract women of various ethnic backgrounds, for example, if it is not culturally acceptable to discuss breast matters in public meetings, perhaps you can involve the local __ centers or other culturally acceptable agencies where information could be hosted--perhaps mother-daughter talks can be scheduled at same tim eas father-son talks - Fathers & sons: testicular cancer and testicular __-__ - Girl & Boy __ troops or local F__FA chapters (Future Farmers of America) might be interested in sponsoring a family awareness day because these groups usually meet at a school and are interested in hosting activities that contribute to the development of students and the good of the community.

identification; solution; Decision making;

Nominal Group Technique (NGT) - ​(Slide 33) Group process involving - (1) ​Problem __​ (2) ​__ generation​ (3) ​__ __ - Used in groups of many sizes who want to make their decision quickly, as by vote, ​but want everyone's opinions taken into account as opposed to traditional voting - Useful in health promotion programs

structured; share; without; clarified; evaluated; votes; cooperation

Nominal Group: - __ group meeting, all group members are given a task. - Each member is asked to respond on a piece of paper and not __ it with others - Then, all members present their ideas __ discussion (so everyone can see all responses) - Next, discussion begins where responses are __ and __ - Finally, the group __ to determine the order in which to address different areas - Involving the entire group both decreases selective perception and promotes individual __ with the group's decision; it helps people believe they have been involved with the decision-making process

Lobby; POLITICS; politician; LISTEN; positive; patient; passion

Nurses role in health policy - ___ for the allocation of resources and shape policies by analyzing the impact of the policy on community health . THIS DEFINES ___ ^^ - Be a __ for health - Stay focused on the needs of the citizens and __ TO WHAT THEY SAY Be __, be prepared with data to show how problem is affecting community health, be __ (IS VITAL) , exhibit __ for the health issue, be professional in every way and in everything you do

parental; student; plate waste; committees; sample; menus; satisfaction; recommendations

Nutrition Awareness - If the school meal program is not healthy, form an ad hoc committee to study the problem. The committee should consist of students, parents, the public health/school nurse, cafeteria personnel, representatives of the faculty and administration, and a dietitian, if available. *Action steps would include the following* - Conduct a survey to assess __ interest and areas of concern. What would parents like to see happen? What are they willing to do to make change happen? - Conduct a survey to assess __ opinion and food preferences. - Do a __ __ study to determine what children are actually eating - Form a __, remembering to include the students. - Based on what you learned in steps 1, 2, and 3, identify other options to evaluate the present menu, such as hiring a nutritionist to study the present food service. - You may also want to organize a committee to visit other schools to __ food, look at __, and talk to those students about __. - Make __ to the school administration. - Make a presentation to the school board. - Pilot alternatives.

leveled off; increase; 25; Rural Active Living; codebook

Obesity:​ Childhood obesity rates in the U.S. have only recently __ __. The past 40 years have shown an __ in obesity rates consistently. Childhood obesity rates are highest in low SES and racial/ethnic minority populations. Study found that rural children are about __% more likely to be overweight than metropolitan counterparts.​ It is only recently that there is a more intensive focus on rural communities in reducing obesity rates. __ __ __ Assessment (RALA) tools are available to determine the activity levels in local communities as well as a "__" to explain the RALA tools.

recruit; 2; tray return; trash; types; amount;

PLATE WASTE STUDY (BOX 16.5) 1. __ parent volunteers, cafeteria staff, and teachers to help you. 2. Choose at least __ days of the week to conduct the study. 3. Place volunteers next to the __ __ and __ containers. 4. Record __ and __ of food put into the trash. 5. Look into lunch bags for types of discarded, uneaten food. 6. Record all information (perhaps onto form with different food types). 7. You now have important information, such as nutritious food waste and the amount of soft drinks and candy consumed (from the wrappers). 8. Write a one-page report. 9. Give the report to parents, staff, and students. 10. Present the results to school administration along with suggestions to decrease food waste.

outcomes; ownership; WITH

PROMOTE COMMUNITY OWNERSHIP - Essential to achieving __ of intervention- active participation of the community - MUST feel sense of __ in program, which can only come with their full participation in the decisions regarding planning as well as their assuming some responsibility for implementation - Nursing attitude of doing __ the community not doing TO the community or FOR the community (EMPOWER COMMUNITY to get involved and change things themselves)

bioaccumulation

Refers to the introduction of substances into ecologic food webs.

simple triage and rapid treatment --- It is a systematic approach based on 3 observations: Respirations, Perfusion, and Mental Status (RPM)

START (stands for what--triage)

assignments; health; food; clothing; unawareness; homeless; services

School Success Barriers: Frequent mobility - Inability to complete __ - Poor __/inadequate medical care - Lack of __/__ - Teacher/staff __/insensitivity - Isolation or stigma associated with being __ - Difficulty accessing __ (psychological, special education, english as a second language instruction, and so forth

spinal

Screen all 6th and 9th grade students. This is where they ID spinal deformities that actually progress to require surgical intervention i.e. scoliosis

Secondary Prevention (bullying)

Screen for bullying behaviors to determine the prevalence of both victimization and perpetration of bullying. 1) assess for bullying by providing a questionnaire 2) have a school conference day to disseminate the results of the survey and launch a multicomponent plan to tackle the problem 3) Implement effective adult supervision during recess, lunch, breaks in the halls and places where students congregate 4) Teacher-student discussion groups to reinforce anti bullying messages and contribute to changing the culture 5) implement steps to block cyberbullying using technology 6) develop classroom rules based on respect. --- On an individual level: counsel bullies and victims and involve parents of bullies and victims in the discussions, develop individual care plans for students (bullies and victims), and make referrals to HCPs

popular, folk, professional

Sectors of cultural Health systems (3)

15; Neighborhood; economic; education; Social; healthcare

Social determinants: __% - __ and built environment - __ stability/income - __ - __ and community context - Health and __

ALCOHOL; binge; methamphetamine; Drug Abuse Resistance Education; norms; availability; enforcement; Enforcement; call-out

Substance Abuse:​ is a majorly affects the rural youths disproportionately. The substance most often abused in young people is ___.​ Young rural people are more likely to __-drink, to use alcohol more frequently, to drive while intoxicated, __ use, prescription drug abuse than urban teens.​ Traditionally, we focused prevention efforts on teens in the schools, with programs such as __ __ __ __ (DARE), which seeks to build self worth and autonomy in young people to make wise decisions. "Holding youth solely responsible for underage drinking is like blaming fish for dying in a polluted stream." This statement sparked a movement to "purify the water in the stream." The attitudes needed to change in order for better substance abuse outcomes is three-pronged __, __, and __.​ - __ is a critical part of the plan, since it would include not only reducing teens' access to booze, but also communicating the community's standards for acceptable behavior. To assure a "zero-tolerance" policy, the sheriff's department developed a "__-__" system so extra officers can be brought in to assist in house parties. Access was also addressed by issuing citations to adults who furnish minors with alcohol. Outcomes since this implementation improved and showed signs of "going in the right direction."

support; marketing; sponsor; supplies; volunteer;

Suggestions from the textbook (faith) - Obtain __ from the clergy and administration - Identify a core of health professionals willing to participate. Ideally they will be participants in the faith community. - Establish a __ system - Find a school of nursing or a community college to assist you in developing the ministry - ID __ support through faith community members and neighborhood establishments (local businesses are usually supportive because they recognize that their clients are of the faith community. Check advertisements in the neighborhood gazette or church bulletin). - Acquire __, such as cotton swabs, disposable gloves, stethoscopes, BP cuffs, glucose meters, and so forth from various sources. - Recruit additional __ health professionals to participate. - Recruit high school and/or college volunteers to help with organizational details. Many are required to do service hours as a condition for graduation. They may be waiting to find just such opportunity. - Have a team meeting and plan nursing actions. Probably the first action would be to conduct a needs assessment. Be sure it is conducted in languages that reflect the constituency.

stage 7 (adaptation of reinkemeyer's stages of planned change)

TERMINATION of the relationship between the community health nurse and the community

stage 5 (adaptation of reinkemeyer's stages of planned change)

TRANSFORMATION of intentions into actual change (intervention)

passive

Temporary resistance that has been donated to the host through transfusions of plasma proteins, immunoglobulins, and antitoxins, or transplacentally from the mother to neonate. Lasts only as long as the substance is in the blood

Immunizations; motor vehicle; Workplace; infectious diseases; heart; strokes; foods; mothers & babies; Family planning; Fluoridation; 70; 60; Tobacco

Ten Great Public Health Achievements: - ___: w/vaccines + improvement in environmental sanitation -> considerable decline in morbidity and mortality d/t communicable diseases - Improvements in __ __ safety - roads, policies, safer vehicles - __ safety - OSHA , MSDS - Control of __ __- STD, TB, flu, HIV prevention, screen, tx - Decline in deaths from __ disease and __ - Safe and healthier __- fortification, less microbe contamination - Healthier __ and __- infant mortality decline since 1900; folic acid - __ __- social and economic opportunities, smaller families, and health benefits - __ of drinking water- since 1945, reduced childhood decay by __%, adult tooth loss decreased by __% - __ as health hazard- policy, smoking bans, sin taxes resulting in behavior change-only 20% now smoke

Patient Protection; Affordable Care

The __ __ and __ __ Act significantly expanded both eligibility for and federal funding of Medicaid. Under the law as written, all US citizens and legal residents with income up to 133% of the poverty line, including adults without dependent children, would qualify for coverage in any state that participated in the Medicaid program.

agent-specific

The __-__ approach addresses the most likely threats of hazards, i.e. planning for flooding in communities in flood-prone areas, with emphasis on public warning systems, flood prevention efforts, determination of evacuation routes and procedures, public education and shelter provision.

transport; transformation; bioaccumulation; biomagnification; synergism

The five pollutant mechanisms that are of particular concern are: __, __, __, __, and __.

educational needs; meetings; suggestion box; faith

The following are some strategies for identifying faith community needs: -Distribute an __ __ survey to various groups within the faith community, such as the women's auxiliary, the young mothers' support group, the young adult group, the elder group, the men's' organization, and the non-English-speaking community -Attend __ for the different groups -For focus groups to discuss options to increase health or join an initiative already in progress, such as prayer groups or faith renewal groups -Provide a __ __ -Form an ad hoc committee to study the health ministry, and include key people such as clergy, lay ministers, school principal social and health agency personnel, and so forth. - Be sure that both formal and informal leaders are included -Remember to only make decisions with input from the __ community

maintenance (change process)

The new behavior is ingrained in the lifestyle behaviors. A crisis or major stressor at work or personal life can become the impetus to revert to the previous behavior. The employee needs reinforcement, support, and opportunities to practice the new behavior. The employee benefits by sharing the newly learned behavior.

respect for the people

The second essential ethical principle, respect for people, recognizes that every person and community has intrinsic value. - - Applying this principle to community health directs health care professionals to evaluate the effect of proposed initiatives in light of their implications for all who might be affected. Example: encourage a community to reevaluate its proposal to resolve its solid waste or toxic waste problem by transporting this waste to another community. - The benefit to people in one community creates potential harm for those in another. - Example: give careful consideration before introducing Western medical practices and ideals that might conflict with a community's cultural norms and folk-healing practices.

behaviors; hazards; relationships

There are 3 essential elements of health promotion: 1) encourage the individuals to change and sustain personal __ that prevent disease and promote healthy lifestyle 2) encouraging health-promoting behaviors that discourage __-__ behaviors of individuals 3) creating an environment that promotes health by eliminating health __ from the physical environment. The nurse needs to focus their energy on building __ in the process of participatory research which is critical to the success of all community programs.

preparedness; response; recovery; mitigation

There are several disaster stages or phases for the planning process. One commonly described model has four stages: __, __, __, and __.

VAERS

To monitor actual and potential vaccine-related problems, health care providers must report specific post vaccination "adverse events" to the Vaccine Adverse Event Reporting System (VAERS). Information and reporting forms are available in both the FDA Drug Bulletin and the Physicians' Desk Reference and through 24-hour recording telephone message at 1-800-822-7967.

biodegradation; Methylmercury; Minamata; acid rain

Transformation: - Harmful substances can be rendered innocuous or even helpful during the __ process. - Occasionally, a relatively harmless substance is transformed into a noxious form. An example is the transformation of metal or inorganic murvery, which is relatively immobile, into methylmercury by microorganisms living in aquatic sediments. - ___ is readily incorporated into detrital food chains, which may terminate with human consumption of contaminated fish/shellfish, producing the neurologic disorder known as __ disease. Nonbiogenic chemical transformations are more common in the environment (e.g., the conversion of sulfur dioxide and nitrous oxides in the atmosphere to form sulfuric and nitric acids and create __ __)

restricted; downstream; insecticides

Transport: - The dispersion of pollutants is more ___ in aquatic than in terrestrial systems because movement is always ___, until the pollutants reach the ocean. - Efficacy of ocean transport has been demonstrated by the spread of several ___ throughout the world; their area of distribution even includes the Antarctic continent

helmets; seatbelts; education; equipment

Traumatic brain injury and types of prevention - Wearing __ and __? I look in the lecture and chapter and couldn't find anything. Type of community programs local/state/national: Decreased TBI among high school athletes with improved __ and proper __

urgent; safety; ABCs; infection control

Triage; - In an overwhelming mass casualty event or a true disaster, the emphasis of triage may shift from meeting the most __ individual need to meeting the needs of the largest numbers of victims to maximize the number of lives saved. - During times of emergencies, nurses and other providers should remain focused on three actions: --- Maintenance of patient and healthcare worker __ --- Maintenance of patients' __ --- Establishment and maintenance of __ __

choose my plate

U.S. Department of Agriculture educational initiative has lots of helpful tips starting with pregnant women and breast-feeding.

30

Variables which impact health: - Genetics: __%--Not controllable, think colon cancer

40; LBW; HTN; colon; CVA; Sexual; firearm

Variables which impact health: Behavioral: __% **** LARGEST VARIABLE IS MODIFIABLE/ PT CAN CHANGE! - Tobacco use: contributes to __ infants; CA, CAD and COPD - Diet and activity patterns: type 2 DM; fast food generation (increased sodium → __); contributes to __ cancer; __ - Alcohol use: MVA, cirrhosis, cancer - Exposure to microbial agents: pneumonia, influenza, nosocomial, hepatitis - __ behavior - __ use: 57% suicides, 40% homicides, domestic abuse, gang violence

Green; yellow; delayed; red; black; hazmat

Victims are triaged into 4 categories: - __/ Minor: Minor- care can be delayed up to 3 hours; Walking Wounded - __/ __- URGENT CARE!! systemic but not yet life-threatening complications, URGENT, delayed up to 1 hour - __: Immediate-life-threatening conditions that can be stabilized and have a high probability of survival - __: Dead- no ER care needed, comfort care given - __: contaminated

medical; morbidity; mortality; disease; demographic; health care; fertility; maternal; Record linkage

Vital Record Linkage: - this connects data and info contained in two or more __, __ or __ records, and other vital event records and other vital event records. - They provide excellent sources of info on the courses of __, __ data, __ __ services utilization, __, __ health issues, child health concerns, chronic disease tracking, and the natural history of specific disease or morbidity-related events. - __ __ is facilitated by the advent of modern computers. This system offers a potentially rich source of information and may facilitate research on measures of public health.

respectful; childhood; empathy; behavior; multifaceted

Ways to curb bullying: - Strive to teach the Golden Rule- Do the right thing! - Insist on a __ school environment - Keep in mind what __ was like - Incorporate ways to encourage __ in day to day interactions - Focus on the __, not the technology - Success depends on a __ approach

websites; letters; visits; call; Advocate; knowledgeable

What can a Nurse Do to Influence Health Policy - Learn by visiting __ of local, state and federal governments; visit government internet sites that inform/educate citizens on how to participate in local/city government by serving on boards or committees - Read local paper and pay attention to local community issues - Look on government websites - Write __, make __, or __ representatives. Can also provide nursing expertise as policies and programs are being designed and to work with coalitions who have similar interests in the issues - __ for the people that they serve. Be __ of new programs, evaluate whether targeted groups are being served as proposed and keep policy makers aware of progress or lack of progress towards goals.

active

When the body produces its own antibodies against an antigen, either as a result of infection w/ the pathogen or introduction of it through a vaccine

currency

When was this info last updated? Is it current, or is more recent info available? Websites often have dates cited at the bottom of the first page to identify when the =website was last updated. You will need to look for this date to know if the website is current.

author

Who wrote the info? Does the author(s) have credentials to be a content expert? Does the website show institutional affiliation? Has the author written before on this topic or show other evidence of expertise?

health

a resource for everyday life, social & personal resources as well as physical capacities

tertiary prevention

aims to maintain and restore a more-or-less healthy state. Examples: rehabilitation and meditation

ADA definition: disability

an impairment that substantially limits one or more major life activities, record of such impairment, or being regarded as having such impairment

natural passive

antibodies pass from mother to fetus via placenta or to infant via the mother's milk - mom's milk

natural active

antigens enter the body naturally: body induces antibodies and specialized lymphocytes - infection

Waste and water treatment plants

are the best source of information about sanitation in the community.

Peace Corps

assists people to develop the skills needed to improve their own circumstances. Outside helpers work as catalysts to help people in communities discover their potential and as advocates to help the community learn how to access resources needed to move toward their goals

uptake; retention nonessential; strontium; cesium

bioaccumulation: - Chemicals that behave in a manner similar to essential elements are most susceptible to rapid __ and __. Due to humans and their activities, ecologists must now be concerned with the cycling of __ elements. - For example, the radionuclides of __ and __, whose chemical behavior is analogous to calcium and potassium, respectively, and introduced into the environment by murclar reactors and represent a potential health hazard.

phytoplankton; zooplankton; 50; trout; fatty; herring gull; 50,000

biomagnification: - The PCBs were acquired by __ that acted as scavengers, reaching levels of only 2.5 parts of PCB per billion parts of phytoplankton. These were then eaten by zooplankton, which, in turn, were eaten by larger __, in which PCB concentrations increased nearly __-fold, reaching 123 parts per billion. The zooplankton were eaten by small fish, rainbow smelt, with PCBs increasing ninefold to 1 part per million (ppm). Next, smelt were eaten by lake __, which reach 5 ppm PCB, and finally consumed by humans (or other end-chain carnivores). - At each step, the PCBs were sequestered in the __ tissue of the carrier and stored. The final concentration of PCBs in __ __ eggs, which are rich in stored fat and sometimes consumed by humans, was 124 ppm, or __ times greater than the original concentration in the phytoplankton.

other school age programs

breast self exam/ testicular self exam, swim to bermuda, ride to alaska, monthly health bulletin board, make a cookbook or start a vegetable garden, pet responsibility, arts-based interventions;

dashed line; flexible line of defense

buffer zone = dynamic level of health resulting from a temporary response to stressors (ex. Neighborhood mobilization against an environmental stressors such as flooding or a social stressor such as unwanted adult bookstore).

fecal-oral

can be direct/indirect

culture

can include gender, religion, SES, sexual orientation, age, environment, family background, life experiences

fall prevention (elder)

collab with PT/OT to conduct fall prevention classes. Fall assessment questionnaire, balance testing, demonstration of ways to prevent falls, and individualized counseling regarding fall hazards are all effective in preventing falls

Validating; categorize; confidentiality; identify; negotiate

community nursing diagnosis: - ___ the community nursing diagnosis is an important step for establishing and maintaining the partnership with the community residents.It should focus on meeting their needs. - Review the community nursing diagnoses and __ them according to the population most affected. --- Equally important is the right of community leaders, organizations and residents to __ of privileged information and the right to choose to not participate in health planning. --- Communities can __ their own health needs & can __ with the community health nurse regarding interventions & specific programs

underutilization

cultural competence: Health services that are not culturally competent can → __ - Why? Because it is that the services are not responsive to the needs of those they intend to serve. - As a result of the diversity, healthcare providers will have more and more interaction with different cultures.

170; industrialized

curbing childhood obesity: - Over the past 3 decades, the rates of childhood overweight/ obesity have increased steadily and dramatically, with approx. __ million children worldwide deemed overweight - __ nations have had highest prevalence rates! WHO has developed population-based policies and initiative aimed at combating childhood obesity by advocating for multicomponent campaigns beginning in daycare settings

degree of reaction

determined by stressors & lines of resistance (strengths) of the community. It's the amt of disequilibrium or disruption that results from the Stressors.

health risk appraisal

easily administered, confidential tool used to determine life expectancy based on current risk behaviors.

preparation (change process)

employee has decided to try and change a behavior. The person desires help in making the change and is ready for information and skills to maintain the behavioral change.

contemplation (change process)

employee is at least considering making an effort to change behavior. They are weighing the pros and cons. They may not know how to change and may consider the change to be almost impossible. The attempt to change is not worth the effort if failure is to occur. The goal is to help them identify the benefits and to decide that putting forth an effort to change is worthwhile.

precontemplation (change process)

employee is not even thinking about changing their behavior. The goal is to make the person aware of the benefits of change and to get them to start thinking about the possibility of change

action (change process)

employee is practicing the new behavior; however, it is not yet incorporated into their lifestyle. The new behavior requires lots of effort, which leaves them at risk for relapsing to the old behavior. The employee needs support, incentives and sincere encouragement.

transportation; immunizations; school records; residencys; school fees

enrollment barriers: - __ - Lack of __/medical records - Lack of previous __ __ - Guardianship/__ issues - __ __

needs; meetings; focus groups; suggestion box; leaders; decisions

faith First - Assessment - What are the __ of the various groups within the faith community? - Attend __ of various groups - Form __ groups - __ __ - Talk with key __ - Make __ with input from the faith community

minority

group of people who, because of their physical or cultural characteristics, are singled out from others in the society in which they live, for differential and unequal treatment, and who therefore regard themselves as objects of collective discrimination

county health planning board

has information about health needs and practices.

law enforcement department

have statistics regarding incidence of crime, vandalism, and drugs

health services (elder)

immunizations, screening for chronic illnesses, manage and control existing chronic illnesses, knowledge of coverage and reimbursement of medicaid/medicare etc., advocacy efforts to ensure linkage of elderly people to needed resources (health advocates, health coaches), education on med mismanagement, connection to support groups

herd immunity; diphtheria; rubeola; rubella; mumps; tetanus; varicella; pertussis; meningococcal; poliomyelitis; affidavit

immunizations/ state law: - The CDC provides reliable information in English and in Spanish to help health care professionals and consumers better understand vaccine issues and maintain "__ __". - Slide: In Texas: All children must be immunized against __, __, __, __, __, hepatitis A, hepatitis B, __, __, __ and __ to comply with Section 38.001 of the TEC.15 A student may be exempt from immunizations if they submit an __ signed by a physician stating that the immunization would be harmful to the health of the child or a member of the child's household. Chapter §97.62 of the Texas Administrative Code (TAC) describes the conditions under which individuals can seek exemptions from Texas immunization requirements. Exclusions from compliance are allowable on an individual basis for medical contraindications, reasons of conscience, including a religious belief, and active duty with the armed forces of the United States. - At enrollment has 30 days to provide updated vaccination record.

CDC;

immunizations/ state law: - The __ is the best source for recommended immunization schedules for adults and children. - Although most parents are vigilant about immunizing their children in a timely manner, some parents question the need for safety of some vaccines or the practice of receiving multiple vaccines at one visit. They may have concerns about immunizing in general, or they may have specific questions related to select vaccines, the combinant form, or the recommended timing. Nurses in school settings are well positioned to respond to such concerns and provide parents and guardians with accurate information to make informed choices about immunizing their children.

folk

interaction between a client and sacred and secular healers. Sources of holistic health problems are believed to include relationships the client has with other people, the natural environment and with supernatural forces. Treatment rituals are prescribed to correct disequilibrium and to promote healing. Healers have little formal training and are believed to receive healing powers through family position, inheritance, signs, revelations or gifts.

lines of resistance

internal mechanisms that defend against stressors. Ex. recreational program for kids keeps them from vandalism. Ex. a freestanding, no-fee health clinic to dx and tx STD.

partnerships with community (elders)

involve elders in planning health promotion and disease prevention activities bc they are sensitive to potential loss of independence, and involving them increases sense of independence.

primary prevention

is aimed at reducing possible encounters with stressors or strengthening the lines of defense. Examples: sunscreen to prevent cancer; Immunizations

summative evaluation

is done at the END of the program

windshield survey

is the best thing to do if you have limited time and money/resources

formative evaluation

is typically done midway (or many times) through the program

popular

made up of informal healing relationships that occur within one's own social network, such as family, people linked by kinship, friendship, residence, occupation or religion. Healers are not based on professional education and licensure.

environment

may be thought of as community (i.e. a network of ppl & their surroundings). The links b/w the ppl in the community may be where they live, the work they do, their ethnicity/race, the way they live, and any other factors they have in common

- recreation - economics - communication - health and social services - politics & govt - safety and transportation - education - physical environment REST CHSS GEP

name the 8 subsystems

solid line

normal line of defense ; level of health that community has reached over time (high rate of immunity, low infant mortality, or middle-income level; patterns of coping + problem-solving capabilities)

FEMA (GOVERNMENT)

now part of DHS. Support citizens and first responders to ensure that as a nation we work together to build, sustain and improve our capability to prepare for, protect against, respond to, recover from, and mitigate all hazards.

community safety (elder)

nurses can work w/ law enforcement agencies to develop community programs like Neighborhood Crime Watch Programs, Citizens on Patrol, and other programs. Elders can be educated in physical and psychological self-defense programs. Programs can make the elderly aware of their vulnerability to specific types of crimes in the community, including frequency and time of day of occurence. Direct deposits of monthly checks are encouraged to decrease vulnerability to violence

secondary prevention

occurs after the stressor crosses the line of defense and causes a reaction, and it is aimed at early detection to prevent further damage. Examples: breast self-examination

exercise & fitness (elder)

older adults who participate in 20-30 min of moderate-intensity exercise on most days of the week have better physical function than older persons who are active throughout the day or who are inactive. Exercise activity for elders must be suitable to health and functional status.

transport

once the pollutant has been introduced into the environment, it is transported via wind patterns or aquatic systems.

professional

organized health professionals who are formally educated and legally sanctioned

nutrition (elder)

perform nutritional assessments and build on existing strengths, offer classes that educate the elderly on nutrition and risk management nutrition, make sure the class is highly interactive to help enforce learning

person

population or aggregate (elderly, teens, nurses) or community (total population)

artificially passive

preformed antibodies in immune serum are introduced by infection

DHS (GOVERNMENT)

prevent terrorism and enhance US security, secure and manage US borders, enforce and administer US immigration laws, safeguard and secure cyberspace, ensure US disaster resilience

nursing

prevention (primary, secondary, and tertiary)

ARC (NON-GOVERNMENT)

provides assistance to humans affected by disaster both nationally and globally.

-- Aid to Families with Dependent CHildren (ADFC) -- TANF - supplemental security income

public welfare programs (3)

driving safety (elder)

recommended that older drivers relearn to drive to accommodate neuromuscular and sensory changes. Encourage them to periodically reevaluate their driving abilities, including vision and hearing checkups and other physical changes that might affect driving. AARP sponsored safety programs help elders improve their driving skills → refer them to these resources

READ (2)

rural: - Even in areas that are more wealthy, have access to healthcare and transportation- they still have higher rates of smoking, obesity, etc BC of CULTURE OF RURAL AREAS! Ex in book: if someone in a rural community started jogging every day, others would think they are trying to be better than everyone else. HOWEVER, if the community gets behind the public health issue and work together to change the problem, the outcome can be greater than expected​ (the Vitality Project in Albert Lea, Minnesota)

nominal group technique

s a useful technique that is structured in a way that although it is a group session, it does focus on individual experiences and opinions rather than group consensus. Participants at various points in the session are asked to give their individual opinions which are ranked at the end.

stage 6 (adaptation of reinkemeyer's stages of planned change)

stabilization and evaluation

planned change; Kurt Lewin; Unfreezing; moving; refreezing

steps in planning: - Theories of __ __ are important bc they can be used to guide and direct the planning process - __ __ (early change theorist) described three stages of planned change: - __- client system becomes aware of problem and need for change (From here problem is diagnosed, solutions are identified, one is chosen) - __- Change actually occurs (problem is clarified, program for solving the problem is planned in detail and begun) - __- accomplished changes integrated into values of client system.

Self-administered; Descriptive; Analytical; summative; relevance; progress; Reliability; Validity

survey: - __-__ questionnaires or personal interviews - __ (describe)- Ex: type of children in juvenile probation - __ (explain relationships)- Ex: Determine what risk taking behaviors they engage in and why - Usually __ (done at the END of a program) - MOST USEFUL TO MEASURE __ OR __ - Surveys should produce: Reliability and Validity --- __- same responses by various observers recorded with the same survey at a different time --- __- measure what is intended to be measured

transformation

takes place in many ways.

stressors

tension-producing stimuli that have potential of causing disequilibrium in the system. May originate outside of community (ex pollution from nearby industry) or inside the community (ex closing of a clinic)

Retributive justice

the arena of reward and punishment. Because of their generally altruistic nature, health care professionals may be reluctant to address this principle. Allocation of resources is very often determined politically, and resources are awarded to those who have provided support to those in control of the resources.

string searches

the words and commands you enter into a search box to identify your desired information. Single word searching is keyword searching; adding Boolean terms or quotes around a phrase can increase the precision of the information yielded from the search engine

autopsy records

these have a very severe inherent bias. The patient may have been so ill that death occurred. They are not performed for all deaths. They include a disproportionate number of cases of violent deaths and people for whom the cause of death was unknown until after autopsy.

colorado

thinnest state

more precise terms

to identify, to discuss, to list, to compare and contrast, to state, and to decrease by 20%.

less precise words

to know, to understand, to realize, to appreciate, to be aware, and to lower

social disintegration

traditional familial structure and stress from disruption of traditional social support systems

smokestacks; waterways; runoff; dissolved

transport: - Pollutants can be dispersed as particulates or in a gaseous state, they can travel long distances as dust or be carried in rain water. - The construction of __ created to relieve pollution results in greater dispersal, thus enlarging the area affected without decreasing the quantity of pollutant released. - Once air pollutants have settled to earth, they continue their movement by traveling along __. - After a single heavy rainfall, stormwater __ can mobilize more suspended particles than may be transported during the rest of the year. - __ pollutants may be transported long distances before settling onto the bottom sediments through precipitative mechanisms.

1; respirations; perfusion; mental status

triage and treatment: - Used in multi casualty or mass casualty incident -Triage of injured person should occur in less than __ minute based on: - __, __, and __ __ -Uses people with minor injuries to assist -Person is tagged with a colored triage tag -Victims moved to the treatment area

confidentiality; privileged; identify; negotiate; provide; assist; completeness; validity

validation of diagnosis cont: A. Community leaders, organizations, and residents have right to __ of privileged information and the right to choose not to participate in health planning B. Communities have the right to __ their own health needs and to __ with the community health nurse with regard to interventions and specific programs C. The community health nurse has the responsibility to __ or __ with with the development of information needed for this process D. The __ and __ of the diagnoses that have been derived will be tested during the next stage of the nursing process and will form the foundation of that Stage—the planning of a health program

risk; positive; encouragement; interactive; individualized; 2; Confidentiality; nutritional; weight; fitness

workplace: Health risk appraisal (remember) - Can calculate how much __ can be avoided with lifestyle changes, some can determine the readiness to change behavior (above) - Can be used as a teaching tool that gives __ feedback for healthy behaviors and __ for changing the unhealthy ones - Completed on an __ computer program and provides an accurate __ report to each employee in a timely manner (within __ wks) - useful to employer if a large chunk of the company participates 70-80% - __ of HRA program can boost future participation - There are specific HRA's for __ status, __, and general __ status

library

would have historical data on the community.

airborne

▪ Aerosols, droplets- TB = DROPLET ▪ The time frame which an airborne particle can remain suspended and the size of the particle greatly influence the infectivity of the organism