Chapter 20: Promoting Health Through Healthy Communities and Cities

Healthy Communities and Cities is based on which of the following premises? a. When people have the opportunity to work out their own locally defined health problems, they will find sustainable solutions to those problems. b. When the health of a community is improved, the focus will be on life expectancy rather than quality of life. c. When health professionals assume a leadership role, the health of the community will improve. d. When cities recruit enough health professionals to care for those needing medical care, the cities health will improve.

A Healthy Cities is based on the premise that when people have the opportunity to work out their own locally defined health problems, they will find sustainable solutions to those problems. Healthy Cities aims to add to quality of life. Healthy Cities focuses on collaboration by all members of the community. Healthy Cities uses a multifaceted approach to problem solving when trying to improve health.

The Healthy Communities and Cities initiative supports the idea that: a. healthy cities and communities must be both environmentally and socially sustainable. b. healthy public policy is the responsibility of elected officials. c. physical environments cannot be changed, thus strategies must be developed in order to cope with them. d. the World Health Organization (WHO) is the primary source of information for cities.

A Healthy cities and communities must be both environmentally and socially sustainable through a strategy of primary care. Healthy public policy should involve collaboration at all levels. Supportive environments should be created. The WHO originally began this movement, but now sharing occurs among those participating in this initiative.

The goal of the Healthy Communities and Cities initiative is to: a. promote health through community participation. b. reorganize the current health care system. c. maximize the cost-benefit ratio of health care. d. improve the quality of care in communities.

A The goal of the Healthy Communities and Cities initiative is the promotion of health through community engagement and collaboration. This leads to addressing the health and quality of life for all through a process that includes diverse citizen participation, mobilization of all sections of the community, and community ownership. Reorganization of the current health care system, maximizing the cost-benefit ratio of health care, and improving the quality of care in communities are not part of the Healthy Communities and Cities initiative.

A nurse performs a community assessment as part of the Community Health Promotion Model. Which of the following best describes the rationale for this action? a. To become more acquainted with the multiple factors that influence health status b. To survey the citizens in the community about their wants and needs c. To allow special interest groups a say in health policy d. To provide a narrow focus for the committee work

A The purpose of including a community assessment in the implementation of the Community Health Promotion Model is to become more acquainted with the multiple biological, behavioral, social, and physical factors that describe and influence health status of residence. The assessment provides the frame of reference for identifying the community's strengths, needs, and resources. The community assessment involves multiple factors, which is more than surveying citizens or asking special interest groups for their opinions. The community assessment has a broad focus, not a narrow focus.

A nurse uses the Community Health Promotion Model to address the problem of increasing teenage pregnancy rates in the community. Which of the following steps would be used by the nurse? (Select all that apply.) a. Identifying interest in the topic through use of community forums b. Building a partnership with parents of teenagers to address this problem c. Counseling teenagers about effective birth control methods d. Contacting other cities with similar problems and issues e. Referring teenagers to Planned Parenthood

A, B The implementation of the Community Health Promotion Model includes identifying interest by community forums and building the partnership. Counseling and referring teenagers and contacting other cities may be usEd by the nurse but are not part of the steps identified by the Community Health Promotion Model.

What principles were used in the creation of the Healthy Cities movement? (Select all that apply.) a. Primary care b. Equity in health promotion c. Community participation d. High technologic environments e. Relationship building

A, B, C The Healthy Cities movement was based upon the principles of primary care, equity in health promotion, and community participation. Relationship building and high technologic environments were not part of the creation of the Healthy Cities movement.

According to the Ottawa Charter for Health Promotion, which of the following are included in the areas for health promotion action? (Select all that apply.) a. Creating supportive environments b. Developing personal skills c. Building healthy public policy d. Reorienting health services

A, B, C, D Creating supportive environments, developing personal skills, building healthy public policy, and reorienting health services are all areas for health promotion action identified by the Ottawa Charter for Health Promotion in 1986. Developing community partnerships was not addressed by the Ottawa Charter for Health Promotion.

A nurse is involved in implementing the Community Health Promotion Model. Which of the following best describes the action being taken by the nurse? a. Changing public policy b. Establishing a team to plan and coordinate the work c. Providing nursing diagnoses for the community d. Revising an objective for Healthy People 2020

B A structure in the community for health promotion should be developed through the establishment of a steering committee that will plan and coordinate the work. The nurse would not change public policy, but rather provide information based on data to policy makers. The nurse would not be revising objectives in Healthy People 2020 as that is not an action that individuals are able to take. Nursing diagnoses are not written as part of this model.

A nurse utilizes the Centers for Disease Control and Prevention's (CDC's) Healthy Communities Program. Which of the following factors should the nurse recognize that will influence the continuance of this program? a. Time b. Community participation c. Federal involvement d. Technology

B Community participation can influence the continuance of the Healthy Communities and Cities movement. Time, federal involvement, and technology are not as major of factor to continuation as is participation by the community.

A nurse is leading a team responsible for evaluating the health of a community using the Community Health Promotion Model. Based on this model, which of the following steps would you expect the nurse to complete? a. Ensuring high technological access before the plan can be implemented b. Soliciting the consent of every member of the community c. Assessing the community d. Restructuring the public health policy in the community

C Assessing the community is one of the nine steps of the Community Health Promotion Model. Restructuring public health policy, soliciting consent of all community members, and ensuring high technological access before implementing the plan are not part of this model.

The wearing of seat belts is required in many communities. Children of a certain age must be restrained in a car seat or seat belt when riding in a car. Which of the following best describes what has happened in this community? a. Unilateral action of lawmakers b. Participation in health fairs c. Healthy public policy d. Media interest in protecting the public

C Examples of healthy public policy are seat belt legislation, nonsmoking policies, and immunization policies for school-age children. Participation in health fairs involves providing health education and resources out in the community. Unilateral action of lawmakers does not demonstrate community involvement. Media interest does not create the legislation.

A nurse was involved in the initial implementation of the Healthy Communities and Cities initiative in the United States. Which of the following problems would have most likely been addressed? a. Reduction to the amount of pollutants released into the environment b. Provision of fire and police protection c. Creation of a coalition to address health disparities d. Elimination of crime and violence from the community

C The concept of a healthy community or city is based on the belief that the health of the community is largely influenced by the environment in which people live and that health problems have multiple causes: social, economic, political, environmental, and behavioral. Creation of a coalition engages residents in addressing the problem, which is impacted by multiple factors. The initial activities of this initiative focused on the problems of diverse populations. Reduction of the amount of pollutants and provision of fire and police protection do not address problems of diverse populations. Although crime and violence in a community may be decreased, it is not possible to eliminate it.

A nurse is implementing the steps of the Community Health Promotion Model. Which of the following does this most resemble? a. Collaboration process b. WHO's Ottawa Charter c. Nursing process d. CDC's monitoring program

C The steps of the Community Health Promotion Model are very similar to the nursing process. The steps include assessment, planning, implementation, and evaluation. The collaboration process, WHO's Ottawa Charter, and the CDC's monitoring program do not contain steps similar to the Community Health Promotion Model.

A nurse is implementing interventions to improve the health of the community. Which of the following approaches should be taken by the nurse? a. A top-down approach with rational-empirical problem solving b. A top-down approach with community practice planned by experts c. A bottom-up approach with facilitation of communication d. A bottom-up approach with multisectoral planning and action for health

D A bottom-up approach with multisectoral planning and action for health incorporates community participation. A bottom-up approach uses broad-based community problem solving that includes health professionals, local officials, service providers, and other community members, including those at risk for health problems. The top-down approach describes when professionals and experts tell the citizens what to do rather than involving and asking them. Social planning stresses rational-empirical problem solving, usually by outside professional experts with a top-down approach. This approach does not focus on building community capacity or fostering fundamental social change.

A nurse is implementing the Community Health Promotion Model. Which of the following underlying principles should the nurse use in order to facilitate active participation? a. Individuals should work in groups to complete necessary tasks. b. Individuals participating should represent all segments of the population. c. People will work together if they like the leadership. d. People will participate when they see the issues as worthy of their time.

D People participate when they feel a sense of community and see their involvement in the issues as relevant and worthy of their time. This is the second step of the Community Health Promotion Model. There should be a broad-based representation on the planning committee, but it may not represent all segments of the population. The tasks may need to be completed by both groups and individuals. Although the likability of leadership may influence who participates, it most likely will not influence whether they are able to work together.

When the Healthy Communities and Cities concept was brought to the United States: a. the cities chosen for the initial work were Los Angeles and New York City. b. Canada adopted the program at the same time for continuity across borders. c. the same strict guidelines that were implemented in Europe were used. d. smaller communities and localities were targeted instead of large cities.

D The concept of Healthy Communities was used to incorporate localities that were not necessarily cities. The initial projects were Healthy Cities Indiana and the California Healthy Cities project. Healthy Communities and Cities operates in other parts of the world under different names and national networks have been developed among countries. There are not strict guidelines for implementation of this program.

A nurse is designing interventions and evaluating results of Healthy Municipalities and Cities. Which of the following considerations should be made by the nurse? a. Influence of individual actions b. Acute care hospital services in the community c. Social results and endorsement of law makers for policy changes d. Effectiveness of health services, including delivery of preventive services

D The effectiveness of health services, including the delivery of preventive services, should be considered when designing interventions and evaluating the results of Healthy Municipalities and Cities. Influence of individual actions, acute care hospital services, and social results and endorsement of law makers are not part of Healthy Municipalities and Cities.