Health Promotion Exam 2

The Roman Empire

.Focused on community health measures .Transportation of clean water .Paved streets, street cleaning .Sanitary waste disposal

Continuum of Interpersonal Skill

Starting point----Ethnocentrism Cultural awareness Cultural knowledge Cultural change Cultural competence Ending point----Enculturation

Objectives 2

.Explain the stress-diathesis model and how it affects health outcomes. .Define epigenetics and its mechanisms.

Objectives 3

.Explain the significance of both genetics and environmental factors on health. .Develop health promotion strategies using the ecological framework.

Genetic Determinants of Health-2

-Gene-environment interaction - accepted by science -Occurs at cellular level -Risk behaviors are an example of this interaction .Acquired mutations - "somatic" not passed on

Social Determinants of Health- WHO [World Health Organization]definition:

-The circumstances in which people are born, grow up, live, work & age, as well as the systems put in place to deal with illness -These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics .Health promotion strategies can result in meaningful interventions.

The Ecological Framework 2

.A departure from past nature-nurture dichotomies (what's more important? Nature? Or nurture?) .Genes, behavior, & social environment link to influence health .Broader perspective on changing behavior p. 98 ."Multi-level interventions are most effective at changing behavior"

The Social Gradient of Health- 2

.A suggested factor is difference in social status. -The assumption is that there is less stress as one goes up the social gradient.

Introduction

.Advances in nutrition, vaccines, sanitation , and infant survival have improved quality of life and increased life spans. -Early 20th century - 100 of 1000 babies died by age of 1 -Now about 6-7%; unequal - eg. race = difference -Multiple, intertwining factors affect health

Health Education- Definition

.An activity that informs the individual about the causes of health & illness and the individual's level of risk associated with their lifestyle -Whitehead, 2004 as cited in Clark, 2008 .Motivate the person to accept a process of change

Summary 1

.An individual is responsible for their health .Nurses can enhance the self-care health promotion behavior of clients by presenting the strategies for change that are likely to be most effective

Bloom's Cognitive Sub-Domains -2

.Applying -Can the person use the info in a new way? choose, demonstrate, dramatize, employ, illustrate, interpret, operate, schedule, sketch, solve, use, write. .Analyzing -Can the person distinguish between the different parts? appraise, compare, contrast, criticize, differentiate, discriminate, distinguish, examine, experiment, question, test.

Cultural Competence- How it has been define

.Appropriate & effective communication that requires one to . Be willing to listen & learn from members of diverse populations .Provide info in the appropriate language at the right literacy levels .Provide info within the context of the person's health belief system

Ways of Improving Health Literacy 1

.Ask the individual if he or she prefers verbal instructions, computer-based education, videos, or written material .Translate written information into the person's primary language .Interactive education is most effective.

Ways of Improving Health Literacy 2

.Assess and document literacy needs of patients .Motivational interviewing (See article in Readings) .Theme parks and health museums .Universal design -Usable by everyone regardless of health -literacy, age, or access needs; cost-effective because it doesn't need to be modified for various groups .Health-related websites

Later Childhood

.Attending school widens their world .Capable of concrete, logical thinking, & reasoning .Including children in teaching is key .Explain procedures in simple, straightforward way .Children can report symptoms accurately

The Medieval Pandemics

.Bubonic plague and pulmonary anthrax occurred between 1000 and 1453. .Moved from Asia to Africa, the Crimea, Turkey, Greece. and then Europe .Quarantine was used for travelers from plague-infested areas

Children: Enhancing their Health Promotion

.Childhood is a critical period to develop a healthy lifestyle .This developmental stage is characterized by growth in cognitive & social skills.

The Stress-Diathesis Model- 3

.Chronic stress (with related hormones) leave person vulnerable to disease -Diseases linked to stress include depression, ulcers, colitis, heart disease, and adult-onset diabetes.

Health Education- Goals

.Client participates in health decisions & manages their care .Improved compliance with health recommendations .Develop self-care ability; Improve coping .Adopt healthier lifestyle

Bloom's Taxonomy of Learning Domains- (1956) Three types of learning

.Cognitive: mental skills = Knowledge .Affective: growth in feelings or emotional areas = Attitude .Psychomotor: manual or physical skills = Skills .Perceptual - Awareness of differences

Life Span Considerations in Pt. Educ

.Concept of developmental changes / tasks / differences throughout the life span .Approaches differ depending on developmental stage .Client -not the disease- is focus of the educ. program .Identify aspects of pt. education associated w/ the specific life stage

Prenatal Period

.Crucial period = impact on healthy life .Life situation should be considered (partner?) .Nurse is non-judgmental & supportive .Upcoming lifestyle change can be source of stress Content: .Nutrition, exercise, L&D, Lamaze, infant care, postpartum care

Objectives

.Define self care in the context of health education. .Analyze the process of health education .Develop appropriate health education objectives considering the developmental stage of the patient .Evaluate strengths & weakness of 2 health teaching vignettes

Self Care

.Deliberate activities by person, family, or community to achieve, maintain, or promote maximum health & well-being .Not a top-down approach .Basis for health promotion strategies .Patient empowerment

Teaching Strategies

.Depend on age of clients, their personal characteristics, content, objectives, time available, mitigating factors (post-surg?) .Internet .Self-paced .Use of AV aids .Reinforcement methods

Objectives 1- chapt. 2

.Describe the ancient Greek approach to health promotion. .Discuss how the health promotion movement was influenced by historical developments, critical documents, and international conferences.

Planning

.Discuss learning needs & possible goals collaboratively .Set broad goal/s & specific, measureable long-term & short-term objectives using action verbs & terms from Bloom's Taxonomy

Key General Principles of Learning -1

.Effective learning takes place in shame-free environment .Curriculum development should be team effort .Before health education occurs, there must be trust with disenfranchised communities .Culturally-diverse teams should help develop programs for diverse groups

Parents & Children

.Establish rapport w/ parent; parents ultimately impact Tx or prevention program .Assess quality of relationship between parent & child .Child is your focus & the client .Direct instruction to child .Age appropriate, at eye level; begin with getting to know child

Young Adulthood

.Establishing long-term relationship .Sexual orientation & related teaching about STDs / STIs, stress, parenting issues .Mental disorders may surface .Dual roles of parenting & career advancement are part of this stage

Bloom's Cognitive Sub-Domains 3

.Evaluating -Can the person justify a stand or decision? argue, defend, judge, select, support, value, evaluate. .Creating -Can the person create new product or point of view? assemble, construct, create, design, develop, formulate, write.

The Social Gradient of Health -1

.Evidence has shown that mortality increases with decreasing socioeconomic position. -Not just between low and high socioeconomic positions, but within those levels

Health Literacy Issues for Children

.Health literacy education is being included in preschools, day-care centers, and schools. .Health attitudes and behaviors formed during childhood have a direct effect on adult health habits. .Often, education needs to be targeted to both the young person and the parent or guardian.

Summary

.Health literacy is one of the 4 top priorities in public health in the US. .Health literacy predicts health status and outcomes better than economic status, age, or ethnic/racial background. The Test of Functional Health Literacy in Adults (TOFHLA) is the gold standard. .Numerous techniques can be employed to improve health literacy.

The later Years

.Health professional attitudes may be a barrier in teaching this group .Fastest growing segment of the US population .Decreased hearing, vision, independence .Anxiety r/t losses .Retirement & increase in chronic illness

Summary

.Health promotion's earliest roots include Indian, Chinese, Egyptian, and Hebrew influences. .The latter part of the 20th century was the most influential in shaping current health promotion practices. .Nurses need to clearly articulate the philosophical and theoretical underpinnings of their health promotion practice.

Teaching Barriers

.Help client decrease barriers .Lack of motivation, physical barriers, personal values/beliefs, family barriers, financial, support systems, psychological barriers .Explore reason for not attaining objective/s

Epigenetic mechanisms

.Highly influenced by the internal and external cellular environment .Two main mechanisms: DNA methylation & histone modification .See work with rats on maternal behavior changing gene expression p. 107

Objectives 1

.Identify the major determinants of health. .Explain the ecological model and its application in health promotion. .Apply the ecological model to a health promotion program.

Objectives 2 chapter 2

.Identify which perspectives about health promotion correspond to a given historical era, document, or organization. .Analyze how historical developments in health promotion have influenced - chptnursing practice.

Older Adult -Health promotion activities should focus on:

.Improving quality of life, management of chronic illness .Increasing activity levels .Enhancing self-care ability .Decreasing barriers to engagement in social/activity events

The Role of Nursing Leaders in Health Promotion 1

.In 1862, Florence Nightingale's school to educate district nurses devoted a full year to community health promotion. .In the early 20th century, Lillian Wald's Henry Street Settlement nurses were active in political lobbying .The Flexner report (1910) narrowed focus of health promotion to primary prevention.

The Stress-Diathesis Model- 1

.In the Ecological framework Examines how social circumstances & individual responses to stressful events affect health -At the cellular and physiological level

Current Health Education Approaches --Interventions to promote understaning

.Interventions to promote understanding -Oral communication (Eg. Radio ads, PSA, TV ads) -Plain language materials -Pictures / AV aids -Groups -Tailored sessions -Online / Web-based appropriate - remember "Digital Divide" -Community workers

Key General Principles of Learning-2

.Key Message r/t Principles of Learning: -Messages should include most relevant content to target audience -Highlight most important concepts -Personalize messages -Messages should invite the client to act & enhance motivation

Cultural Perspectives 2- Leininger's Theory

.Leininger's theory of culture care diversity and universality gives a framework to understand cultural dimensions [anthropologist] Leininger: "Culturally congruent care"

Delivery Related Principles of Learning 1

.Link info to existing knowledge .Interactive presentation; multiple modes .Use clear language - avoid professional jargon .Bulleted .Written info should be verbally reinforced .Allow time for assimilation; evaluation

The Role of Nursing Leaders in Health Promotion 2

.Mary Breckinridge, in 1925, created a nurse-managed midwifery service in Kentucky. .In Canada in 1994, a nursing union lost its lawsuit claiming that health promotion was exclusively nurses' work. .It is critical for nurses to reclaim their health promotion legacy

Young Adults 1

.Must accept responsibility for modeling healthy behaviors and self-care for children.

Summary and the nurse role

.Nurses need to be educated about genetics and understand genetic influences on disease. .Important factors are cultural perspectives and the social gradient.

The Ecological Framework 1

.Nurses need to look at different determinants of health for health promotion planning . Determinants of health Determinants (WHO) p.96 Biological / Social / Cultural / Environmental

What Are Next Steps for Nursing?

.Nursing should be visible and vocal in discourse about health promotion. .The Healthy People Curriculum Task Force aims to increase the proportion of schools of nursing, medicine, & health professional training that teach health promotion based on Healthy People goals.

The Stress-Diathesis Model-2

.One's current health status reflects physiological responses to past experiences - Childhood in chronic stress linked to impaired response to stress in future

Critical Look at Orem's Theory

.Orem's model of Self-Care = criticized because it is based on assumption that individuals can control their environment as they pursue health .Many individuals & families have little control over their physical & social environment

Planning /Implementing Health Ed Programs 1

.Prioritize learning needs = begin with assessment .Develop goals (broad) & objectives (more narrow & can measure) .Select content = relevance most important .Select teaching strategies = look at age of clients, their personal characteristics, content, objectives, time available, mitigating factors (Eg. Is this post-surgical?)

Preschool

.RNs mostly interact w/ children when they are ill .Vocabulary 2,000-2,500 words .Still concrete thinkers .Reasoning not extensively developed Fear of pain / bodily harm

Health Protection (until 1830s)

.Relied on religious and cultural rules Spiritual practices Community taboos Quarantine of contagious individuals .Poor living conditions affected the health -The people would get sick from drinking the water from the same well - This led to conclusions about how to make situations healthier

Bloom's Cognitive Sub-Domains 1

.Remembering -Can the person recall or remember the info? define, duplicate, list, memorize, recall, repeat, reproduce, state .Understanding -Can the person explain ideas or concepts? classify, describe, discuss, explain, identify, locate, recognize, report, select, translate, paraphrase

Middle aged

.Sandwich generation" & associated stresses .Teaching is related to health risk factors, prevention of diseases, exercise, benefits of screening, body changes r/t aging (Eg. menopause)

2. Sanitary Control 1840s-1870s

.Sanitation aims to promote health through the prevention of humans coming into contact with hazardous wastes & proper disposal of harmful substances (sewage, human and animal feces, solid wastes, and domestic wastewaters) .Started during the Industrial Revolution .Why: filthy working conditions, unsafe water supplies, poor drainage systems & inadequate sewage disposal resulted in many deaths

Genetic Determinants of Health -1

.Searching for genetic causes of disease like cancer, CVD, DM, Alzheimer's (cause most of the disease & death in U.S.) -Caused by BOTH heredity & non-heredity factors, like aging, diet, lifestyle, exposure to chemicals, etc. .Gene regulation and mutations -Gene regulation turns genes "on" or "off"—critical to maintaining life. -Mutations can change gene regulation. -Mutations can be harmless = or can cause disease.

Adolescence

.Seeking freedom / separation from .parents RNs need to understand stage well to be effective .Teen is major focus of teaching .Abstract thought & logical reasoning .Many potential health topics

What is the purpose of health education Dorothea Orem -Nursing Theorist

.Self-Care: Focuses on activities that individuals perform on their own behalf to maintain life, health & well-being .Concept important in health promotion = emphasizes that the individual is responsible for own health .Key concepts: individual accountability & active involvement in managing own care

Current Health Education Approaches - Supportive

.Supportive-Educative model -Advocacy -Empowerment: -Process of communication where -knowledge, values, & power are shared -Developmentally appropriate -Self-efficacy -Health literacy sensitive

Adolescence: Enhancing Self-Care for H. Promo. 1

.The internet is primary source of info for this group .Mis-match between biological & social maturity .Change, transition & risk-taking characterize this stage .Positive parent-child relationships, communication & consistent discipline important

Sumary 2

.The role of the nurse in enhancing the client's self care depends on the needs of the patient & the client's developmental stage .Flexibility is critical to meeting the client's needs & goals

Intervention Strategies - Vulnerable Populations

.Time orientation: Is it past, present or future? .Access to & acceptance of program: -Use resources in the community -Assess the barriers -Partner with programs already effective in the community .

Bloom's Taxonomy of Learning Domains -Revised Cognitive Domain

.Two important changes: -Changing names in the 6 categories from noun to verb forms -Slight rearrangement of categories By former student of Bloom, in mid-90's -New taxonomy = more active form of thinking

Cultural Perspectives 1 - Leiningers's theory

.Understanding cultural diversity and the complex nature of culture is the cornerstone of health promotion .Culture influences how we perceive health & illness and our personal health care practices

Implementation

.Use info from assessment & planning stages to develop learning activities .Operationalize the objectives At least 15-30 min (minimum time span for education activities) .Individual or small group (4-6 optimal); better use of RN's time & giving customized instruction .Supportive environment

Key Organizations, Conferences, Task Forces, and Documents 2

.WHO: Declaration of Alma-Ata on Primary Health Care (1978) .Health People (1979-2020) Achieving Health for All: The Epp Report (1986) .WHO: Ottawa Charter for Health Promotion (1986)

Evaluation of the outcome

.What progress has been made toward reaching health goal/s? .To what extent have objectives been met? .Collaborate = direct or indirect assessment .Use a combination of evaluation methods 2 types of evaluation = Formative & Summative

Key Organizations, Conferences, Task Forces, and Documents (1 of 2)

.World Health Organization (1948-present) .International Union for Health Promotion and Education (1951-present) .The Lalonde Report (1974)

Health Education-Primary purpose

.participatory learning process that enables people to make informed decisions about their health (Clark, 2008) .Individual, family, group, community

Tool to Assess Health Literacy - for Individual (REALM)-Takes 2-3 minutes to administer (in BB) Score = 0 to 66

0-18 words correct 3rd grade 19-44 words correct 4th-6th grade 45-60 words correct 7th-8th grade 61-66 words correct 9th grade

Those with Below-basic skills were more likely to get info about health issues from

Radio and TV

Six Phases in the Evolution of Primary Care/Prevention

1.Health protection (until 1830s) 2.Sanitary control (1840-1870) 3.Contagion control (1880s-1930s) 4.Prevention (1940s-1960s) 5.Primary health care (1970s-1980s) 6.Health promotion (1990s-present

Culturally Appropriate Approaches 1

10Peripheral strategies -Package materials so it's specific to the group. Pictures match the culture 2)Evidential strategies-Provide information specific to the group -ensure relevance 3)Linguistic strategies -Info is in the dominant language of the culture

Summary of Historical Chronology 1970

1970s: Focus was on preventing disease & reducing risk behaviors through health education

Children: Enhancing their Health Promotion 2

3 main influences in whether children develop healthy behavior: 1.Family - most important to change behaviour 2.Schools 3.Media

Adolescence: Enhancing Self-Care for H. Promo. 2

3 main influences in whether teens develop healthy behavior: 1.Peers - can have the biggest influence on adlescence 2.Family 3.Media

Culturally Appropriate Approaches 2

4)Constituent-involving strategies --Using lay or community workers 5)Socio-cultural strategies -Interventions build on the culture's beliefs or values 6)Cultural tailoring -Any unique combination of strategies used to reach a particular individual -

Greek Antiquity

460 to 136 BC First civilization to emphasize that health is function of physical and social environments as well as human behavior

Examples of Tasks r/t Literacy- Basic level =

= required giving 2 reasons a person with no symptoms of a specific disease should be tested for the disease, by using info in a pamphlet (22% of adults)

Assessing Health Literacy in Communities 2 Research

A pilot study was conducted to evaluate the feasibility of including the Rapid Estimate of Adult Literacy in Medicine (REALM), (health literacy) in a routine health assessment. The REALM was used to measure health literacy in 3 populations who sought health information and/or care in urban, community- based sites 91 participants from community & university health fairs and a BP clinic

Basic & Below-Basic Health Literacy

About 36% of adults had Basic or Below-basic health literacy skills Were less likely than others to get info about health issues from written sources [newspaper, magazines, books, brochures, on Internet]

Designing Health Promotion Programs for Vulnerable Populations.

Assess: Demographic characteristics Age, gender, language, religion, literacy level (functional literacy is the ability to read at the 5th grade level, where they live) What is the most important of these to assess? (NIH CLAS standards) .Assess: Cultural characteristics Social customs, traditional health beliefs, generation in US .Assess: Health Care System Access to health care, insurance, use of prevention services

Planning /Implementing Health Ed Programs 2

Assessment .Prioritize learning needs = get data/info (interview, records) .Use good interviewing techniques: establish trust, choose right time & place, use open-ended questions & active listening skills .Be sure to assess reading & literacy level of the client

The Roman Empire 2

Believe the state rather than the individual had the greatest influence on health.

Intervention Strategies - Vulnerable Populations - Communication

Communication: .Program is in primary language .Involve the community .Use non- traditional methods of communication for abstract terms .Explore the culture's meaning of health

Primary Care & Medical Homes

Considered by many to be a promising approach for high-quality, cost effective primary care -especially with chronic health conditions ..Personal physician / Primary Care .Provider .Team practice .Coordinated care .Health IT (electronic health records & analytical tools modeling) .Expanded access to health practitioners .Access easier -open scheduling, expanded & after-hours

Summary- Social gradient

Determinants of health are biological, social, cultural, and environmental. Genes and the environment are intricately linked.

4. Prevention 1940s-1960s

Definition: measures taken to prevent diseases, or injuries rather than curing them or treating their symptoms. .In the Affordable Care Act: "ensure that all Americans have access to free preventive services under their health insurance plans and invests in prevention and public health to encourage innovations in health care that prevent illness and disease before they require more costly treatment." .Under the Affordable Care Act people will have better access to preventive services. Eg., immunizations

Delivery Related Principles of Learning 2

Develop at 1-2 grade levels below highest grade completed .Remember Health Literacy (p. 267) .Functional health literacy: read & write to function daily .Interactive literacy: cognitive & social skills needed .Critical literacy: evaluate & use info to gain control over situation .Ask screening questions to determine literacy

Ancient Health Promotion Practices: Egyptian and Hebrew

Egyptian:From 200 BC, community systems collected rainwater, disposed of waste, inoculated people against smallpox. Hebrew: Mosaic Law addresses disease prevention, disposal of waste, segregation of infectious persons, a weekly day of rest.

Cultural Education

Ethnocentric-One's own way is best .Cultural awareness-Sensitivity to other cultures & beliefs .Cultural knowledge-Gaining insight & understanding of other cultures .Cultural change-Process continues .Cultural competence-Provider has skills to develop & use appropriate health promotion activities .Enculturation-Fully internalizes values & develops programs collaborating with members of the culture

4. Forms of Prevention

Examples include: Immunizations for when going to school, teachers, health care workers Exercise programs for adults and children to prevent obesity. Ex. Yoga, gym memberships, employment opportunities (discounts on programs) Sports: stretching before a game, PEP program to prevent knee injuries (specifically in teenage girls).

Intervention Strategies - Vulnerable Populations - Family Relationship

Family relationships: Understand the role of the family in health care If appropriate, involve all family members in the program

Summary of Historical Chronology- 1990s

Focus on setting and environment.

.Health Promotion 1990s-to present 3

For health promotion to work, each person must be treated as unique in regard to their background, current situation, economic resources, education, and lifestyle. We must know & understand what keeps people from changing as well as what would prompt them to adapt to new behaviors that would improve their health.

Who was the first Roman Physician

Galen

Tools for Measuring Health Literacy 2

Health Activity Literacy Scale (HALS) Adult Literacy and Life Skills Survey (ALLS) Wide Range Achievement Test (WRAT)

Health Literacy for Immigrant Populations 2

Health education should: Incorporate cultural beliefs and values, culturally sensitive images, and common healing practices Use narrative descriptions and visual presentations to reinforce discussions of statistical risk Use the primary language Explore whether family members should be involved in care

Introduction- chpt 2

Health promotion practice today has been shaped by: .Historical practices .Key documents .Task forces and international conferences

Greek Antiquity-Hippocrates defined health

Hippocrates defined health as an equilibrium between: .Environmental forces .Individual habits

Culture and the Social Gradient 1

In addition to cultural values of individuals and social groups, the nurse needs to consider: Demographic factors such as income and education How these factors interact with other influences in the ecological environment to contribute to the determinants of health

Summary of Historical Chronology- in general

In general, health promotion shifted from healthcare professionals educating individuals, to involving people in decision making, program design, intervention, and evaluation.

3. Contagion Control 1880s - 1930s

In the 1880s-1930s, Contagion Control focused on containing the virus or infectious disease that was affecting the population. .In order to control it they made filtration of water an important factor of daily health. .Doing this eliminated many harmful substances. .Robert Koch - central person to this effort

Summary of Historical Chronology- 1980s

Increasing attention to supportive environments, social influences, economic resources, health inequalities.

Ancient Health Promotion Practices: Indian, Chinese,

Indian:Systems of medicine trace back to 5000 BC.Ayurvedic practices focused on preventive factors such as personal hygiene and sanitation. Chinese :Systems of medicine date back to 2700 BC.Included hygiene, diet, hydrotherapy, massage

Health Literacy for Immigrant Populations 1

Language and health literacy challenges interfere with immigrants obtaining adequate care for disparities that disproportionately affect them. Heart attacks Cancer Diabetes Strokes HIV/AIDS

Disparity in Health Care: Major Factors 2

Major reasons for the disparities in health outcomes: .Language & low literacy level .SES .Discrimination .Access to care .Cultural barriers

What is SMOG( Simple Measure of Gobbledgook)

My readability formula SMOG estimates the years of education needed to understand a piece of writing. SMOG is widely used, particularly for checking health messages.

Young Adults 2

Need to learn how & when to access health care Benefit from: .Supportive attitude .Reinforce client self-esteem .Teach self-care skills they can use immediately .Access to health information

Tools for Measuring Health Literacy 4

Newest Vital Sign (NVS) Spoken Knowledge in Low Literacy Patients with Diabetes (SKILLD) Literacy Assessment for Diabetes (LAD)

The Nurse's Role 1

Nurses need to be educated about genetics (single genes and their effects) and understand genetic influences on disease in order to: -Convey genetic information & disease risks to patients -Effectively participate in disease management -Assess patients for familial patterns of disease

Tools for Measuring Health Literacy 3

Rapid Estimate of Adult Literacy in Medicine (REALM) Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA)

Revised Bloom's Taxonomy: Cognitive Domain

Old - ---------New Evaluation - Evaluating Synthesis -- Creating Analysis-- --Analyzing Application -- Applying Comprehension -- Understanding Knowledge -- to Remembering

Assessing Health Literacy in Communities 1 - Resutls

On average, the population studied can read just below high school level. 40% of scores in one setting were 5-8th grade reading level; majority of participants were female African- American Supports including literacy assessment at selected sites

Chapter 2 _ History of Health Promotion

PowerPoint

Chapter 4 - Genetic and Social Determinans: Health: an Ecological Perspective

PowerPoint

5. Primary Health Care 1970s-1980s

Primary Health Care saw a focus on: Preventative health care Emphasis on equity Community participation Access to services Understanding of the social determinants of health Links were forged between health care & socio economic development Multicultural & participatory community-based interventions were priorities (!!)

Short Forms of the REALM

REALM - SF (Short Form) - 6 items Adultmeducation Assesment tool - 11 items Short Assesment of Health Literacy for spanish Adults

Tool to Assess Health Literacy - for Individual -Rapid Estimates of Adult Literacy in Medicine (The REALM)

Rapid Estimates of Adult Literacy in Medicine (The REALM) = a 66-item tool to measure health literacy (Davis et al, 1993)

Assessing Health Literacy in Communities 1

Research and Results

Disparity in Health Care: Major Factors 1

Result from: Complex interactions of psychosocial, environmental, personal health behaviors & cultural factors (Determinants of health)

Older Adult 1

Risk: inadequate diet; decreasing functional capacity; inadequate social supports

Tool to Assess Health Literacy - for Individual (REALM)-Is a medical-word recognition & pronunciation test

Starts with simple 1-syllable words (Eg, pill, eye) & ends with multi-syllable words (Eg, antibiotics, potassium). Patients read the list, pronouncing aloud as many words as they can. The nurse scores the number of words pronounced correctly using standard dictionary pronunciation for scoring.

4. Diets (Prevention

Taking away vending machines in schools that contain regular soda and candy. Weight Watchers, Nutrisystem, South Beach Diet Numerous programs to help with weight management are preventive because being at a healthy weight helps with having normal body functions, therefore being in a state of good health.

Tools for Measuring Health Literacy(1 of 2)

Test of Functional Health Literacy in Adults (TOFHLA) Gold standard National Assessment of Adult Literacy (NAAL)

1st time Health Literacy was assessed

The ability to perform basic readings task needed to function in the health care environment

Define determinants of health.

The complex interactions between biological and social elements, environment, and their influence on health, are called the determinants of health.

Which history era was the most influtential to Health Promotion

The latter part of the 20th century was the most influential in shaping current practices

What is Word Count use for?

This tool has been established to help users communicate better in all forms including writing, speaking, researching, educating. We are adding features and growing. It also use SMOG Formular too

Disparity in Health Care: Major Factors 3

Vulnerable Populations Those people who are at the greatest risk of developing physical and mental health problems & who have the poorest health outcomes & the fewest resources (money, social capital & access to care)

6.Health Promotion 1990s-to present 2

What It's About - Includes: Health education Identification / reduction of health risks for selected individuals or populations Empowerment Advocacy Preventative health care Health policy development

Critique & Promise Associated with Nursing's Role in Health Promotion

Whitehead (2008) finds that nursing continues to primarily rely on the traditional health education paradigm. .Morgan and Marsh (1998) agree. Other researchers suggest that nurses need to clearly articulate the philosophical & theoretical underpinnings of their health promotion practice.

6.Health Promotion 1990s-to present

Why this Phase? The health promotion "phase" of care is meant to enable people to take control of their health. It doesn't just involve the individual as in previous phases. It also involves social & environmental interventions.

"Ecology =

interrelationships between organisms & their environments" Ecological model = "no one factor is responsible for one's health status" p. 97

Examples of Tasks r/t Literacy-Below Basic level

level = required finding 1 piece of info -the date- on a medical appointment slip that was shorter & simpler than the text in the Basic task (14% of adults)

Genomics is the study

of all genes in human genome & their interactions with the environment.

Patient education for Self care Across life span and blooms taxanomy

power point

Examples of Tasks r/t -Literacy Intermediate level =

required adults to interpret or apply info that was presented in complex graphs, tables, or other health-related texts or documents (53% of adults - the majority

Examples of Tasks r/t Literacy-Proficient level

required drawing abstract inferences, comparing or contrasting multiple pieces of information within complex documents, or applying abstract/complicated info

IOM Health Literacy Definition (2004)

the degree to which individuals have the capacity to obtain process and understand basic health infomation & services needed to make appropriate health decisions

"Epigenetics" refers

to inheritance that is not explained by changes in the DNA