Community health exam one

Health Literacy

- "...the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions."* Important to consider - Individual - Group - Population - Culture - Language

Community based participatory research - benefits

- A benefits of this approach is that it is a co-learning process where the researchers and community members contribute equally and achieve a balance of research actions. In addition, it is a way of providing cultural competent care.

Windshield Survey

- A method of simple observation - Provides a quick overview of the community - Provides first step in generating data to identify community trends, stability, and changes

Cultural brokering

- Advocating, mediating, negotiating, and intervening between the client's culture and health care culture on behalf of the client.

Cultural context includes:

- Aspects of life that affect the health of individuals, such as food preferences, gender roles, birthing practices, language, and spiritual beliefs, to name a few. - A person's "luggage" that contains such things as beliefs, habits, norms, customs, and rituals that are handed down from one generation to the next through both verbal and nonverbal communication.* - "All facets of human behavior can be interpreted through the lens of culture."*

CHANGE Phases

- Assemble the community. - Develop a team. - Review community sectors. - Gather data from each sector. - Review data and reach consensus. - Enter data. - Analyze data and assign ratings to each sector. - Build an action plan.

Cultural Preservation

- Assisting the client to maintain traditional values and practices

cultural repatterning

- Assisting the client to modify cultural practices that are not beneficial to the client's health

Components of a community assessment

- Commitment to the community - Conflict containment and accommodation (working together) - Participant interaction - decision making - management of the relationship with society - participation (use of local servies) - self/ other awareness and - effective communication

Components of Community Assessment- Competence

- Conditions and select measures include commitment to the community, conflict containment, accommodation (working together), participant interaction, decision making, management of the relationships with society, participant (use of local services), awareness of self and others, and effective communication. - can identify its needs, achieve some goals and priorities, agree on ways to implement those goals, and collaborate effectively

Qualitative Data

- Data associated with a more humanistic approach to geography, often collected through interviews, empirical observations, or the interpretation of texts, artwork, old maps, and other archives.

Lillian Wald

- Emerged as leader of PH in early decades. Began the henry street settlement and the visiting nurse service of New York City - National organization for PHN was the first president

Intervention Wheel: Assumption 5

- Emphasis on Prevention

WHOS major function

- Global leadership in health - Health research - Set norms and standards for health - Establish ethical and evidenced-based policy - Provide technical support - Conduct disease surveillance and monitor health trends

Community Oriented Nursing

- Goal: Prevent disease and disability; promote, protect, and maintain health - Focus is on "health care" of individuals, families, and groups in community as a whole o Provide health care to promote quality of life o Community diagnosis, health surveillance, monitoring and evaluation of community and population o Coordination of health care, disease prevention, health promotion, health education.

Duties of CDC

- Health promotion and protection - Disease prevention: Communicable and noncommunicable diseases - Responds to health emergencies - Investigates outbreaks - Injuries - Disabilities - Environmental health threats - National surveillance system - Sets standards for disease prevention during outbreaks - Repository for health statistics - Workplace Hazards

Disparity

- If a health outcome is seen to a greater or lesser extent between population. o Serious ones in health exist at the global level, which can be seen by comparing life expectancies of high- and low-income countries. - To address these, public health as a science has shifted from focusing on dramatic cases to focusing on existing ones and addressing the underlying social determinants of health, such as poverty.

Aggregate

- In public health, this term represents individual units brought together into a whole or a sum of those individuals. In public health science, the term often refers to the unit of analysis, that is, the level at which the health-care provider analyzes and reports data.

Components of Community Assessment- Structure of a Community

- Includes the demographic data include such indicators as age, gender, socioeconomic indicators, racial/ethnic distributions, and education levels. - The community health services and resources include information about the resources available in the community as well as service use patterns, treatment, data, and provider/client ratio.

Unnatural Causes - theme

- Income. People who don't have enough money don't have as good of health care

Public Health Nurse Role

- Is the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences. - It focuses on improving population health by emphasizing prevention and attending to multiple determinants of health - Nursing practice includes advocacy, policy development, and planning which address issues of social justice

MAPP

- MAPP tool includes the full scope of health planning including assessing, diagnosing, developing an intervention, implementing the intervention, and evaluating the effectiveness of the intervention. Six phases: - Organizing for success - Vision - Performing four assessments - Identifying strategic issues - Formulation of goals and strategies - Action

W H O's goals

- MEradication of malaria - aternal-child health - Malnutrition - Communicable disease - P H infrastructure - Sanitation - Environmental health

10 Essentials Public Health Services

- Monitor health status to identify community health problems - Diagnose and investigate health problems and health hazards in the community - Inform, educate, and empower people about health issues - Mobilize community partnerships to identify and solve health problem - Develop policies and plans that support individual and community health efforts - Enforce laws and regulations that protect health and ensure safety - Link people to needed personal health services and assure the provision of health care when otherwise unavailable - Assure a competent public health and personal health care workforce - Evaluate effectiveness, accessibility, and quality of personal and population-based health services - Research for new insights and innovative solutions to health problems

Community Health Nurse Role

- Nurses conduct community assessments as the first step in the development of health programmed and interventions. Aimed at optimizing the health of the community or population

Intervention Wheel: Assumption 3

- PHN Practice Considers the Determinants of Health

Intervention Wheel: Assumption 9

- PHN Practice Contributes to the Achievement of the 10 Essential Services

Intervention Wheel: Assumption 2

- PHN Practice Focuses on Populations

Intervention Wheel: Assumption 10

- PHN Practice Is Grounded in a Set of Values and Beliefs

Intervention Wheel: Assumption 8

- PHN Practice Uses a Common Set of Interventions Regardless of Practice Setting

Intervention Wheel: Assumption 7

- PHN Practice Uses the Nursing Process at All Levels of Practice

Intervention Wheel: Assumption 6

- PHNs Intervene at All Levels of Practice

Primary sources of data

- Participant observation - Key informants - Focus group - Windshield survey - Spatial data: Geographic information systems (GIS) - Using primary data - Community Mapping

Pedagogy

- Pelearning strategies for children and individuals with little knowledge about a health-related topic - dagogy: correct use of teaching strategies to provide the best learning

Prevalence Pot

- Prevalence = number of cases/Total population

tertiary prevention

- Prevention of premature mortality - Prevention of adverse health consequences related to chronic disease - Case management - Chronic disease management

Natural History of Disease

- Provides foundation for the public health frameworks currently in use, especially the most wide used framework of primary, secondary, and tertiary prevention.

Community

- Refers to a group of individuals living within the same geographical area, such as a town or a neighborhood, or a group of individuals who share some other common denominator, such as ethnicity or religious orientation. - In contrast to aggregates and population, individuals recognize their membership based on social interaction and establishment of ties to other members, and often join collective decision making.

Components of Community Assessment- Health Status

- Selected biostatistics provide vital information about leading health issues in a community. - Statistics commonly used when doing a community assessment related to health and disease - These statistics include indicators such as mortality rates and morbidity rates ( the incidence and prevalence of disease). - Mortality is often depicted by crude rates or age adjusted rates.

Cultural accommodation

- Supporting and facilitating the clients use of cultural practices that are beneficial to the clients health

17 Public Health Interventions

- Surveillance - Disease and other health investigation - Outreach - Screening - Case finding - Referral and follow-up - Case management - Delegated functions - Health teaching - Consultation - Counseling - Collaboration - Coalition building - Community organizing - Advocacy - Social marketing - Policy development and enforcement

Public Health Core Functions - Assessment

- Systematic data collection, analysis, and monitoring of health problems and needs in a population - Includes monitoring the population's health status and providing/ disseminating information about the health of the community

Social Determinants of Health

- The conditions and circumstances in which people are born, grow, live, work, and age. - These circumstances are shaped by a set of forces beyond the control of the individual: economics and the distribution of money, power, social policies, and politics at the global, national, state, and local levels.

Public Health Core Functions- Policy Development

- Using scientific knowledge to develop comprehensive public health policies. Developing policies that support the health of the population through leadership and research

Secondary sources of data

- Websites, printed materials

downstream

- approach represents actions taken after disease or injury has occurred

Race

- categorizes groups of people based on superficial criteria such as skin color, physical characteristics, and parentage. As the field of genetics grows, so does the evidence that there is no scientific basis for placing an individual into one group.

Health Impact Pyramid

- counseling and education - clinical interventions - long-lasting protective interventions - changing the context to make individuals' default decisions healthy - socioeconomic factors

Population

- defined as a collection of individuals who share one or more personal or environmental characteristics - Members may or may not interact with one another - Share at least one characteristic such as age, gender, ethnicity, residence, or a shared health issue such as H I V/AIDS or breast cancer. The common denominator or shared characteristic may or may not be a shared geography or other link recognized by the individuals within that population. - The term may be used interchangeably with the term aggregate.

upstream

- focuses on eliminating the factors that increase risk to a population's health.

Environmental

- focuses on health protection by improving the safety of the environment such as fluoridating water, banning smoking in public places, enacting laws against drunk driving, enforcing clean air acts, and building green spaces for recreation

Ethnicity

- includes shared geographical origin, language or dialect, religious faith, folklore, food preferences, and culture. Care is required when using the term because of the variation in its use. Identifying it in a group of people by considering only broad shared characteristics may miss key cultural differences within the group.

Universal prevention

- intervention is one that is applicable to the whole population and is not based on individual risk

Selective prevention

- interventions are aimed at a subset of the population that has an increased level of risk for developing disease

Indicated prevention

- interventions are provided to populations with high probability of developing disease.

Cultural humility

- is an understanding that awareness about one's own culture is an ongoing process, and an acknowledgment that we must approach others as equals, with respect for their prevailing beliefs and cultural norms.*

Quantitative Data

- numerical data

Behavioral prevention

- often focused on health promotion strategies, is aimed at changing individual behaviors such as exercise promotion, smoking cessation, or responsible drinking.

Intervention Wheel: Assumption 4

- priorities identified through community assessment

Healthy People 2030

- provides 10-year, measurable public health objectives - Vision: "A society in which all people achieve their full potential for health and well-being across the lifespan. - Mission: To promote and evaluate the nation's efforts to improve the health and well-being of its people.

Community Health Assessment and Group Evaluation (CHANGE) model

- provides guidance for assessment o Helps communities build action plans based on: - Assets. - Areas of improvement. o Provides program evaluation in communities - Diagnosis - Action plan

Clinical prevention

- strategies are those that use a one-to-one delivery method between the health care provider and the patient, and usually occur in traditional health care settings These include health protection activities: vaccinations, screenings, and early detection of disease

specificity

- the ability of the screening test to give a negative finding when the person truly does not have the disease, or true negative

Sensitivity

- the ability of the screening test to give a positive finding when the person truly has the disease, or true positive

Andragogy

- the art and science of helping adults learn using the correct strategies. learning strategies for adults, older adults, and individuals with some health-related knowledge about a topic

Ethnocentrism

- the belief that one's own cultural beliefs and practices are correct and are the standard by which other beliefs and practices should be measured.

Intervention Wheel: Assumption 1

-Defining PHN Practice

community-based nursing

-Goal: Manage acute and chronic conditions - Focus in on "illness care" of individuals and families across the life span o Provide acute and chronic illness care and the provision of comprehensive, coordinated, and continuous care o A setting-specific practice, care is provided where people live, work, and attend school

CDC (Center for Disease Control)

-establish in 1946 - goal is to be the premier health promotion, prevention, and preparedness agency in the United States and a global leader in public health.

Eight Principles of Public Health Nursing

1. The client or "unit of care" is the population 2. The primary obligation is to achieve the greatest good for the greatest number of people or the population as a whole 3. The processes used by public health nurses include working with clients as an equal partner 4. Primary prevention is the priority in selecting appropriate activities 5. Selecting strategies that create healthy environmental, social, and economic conditions in which population may thrive is the focus 6. There is an obligation to actively reach out to all who might benefit from a specific activity or service 7. Optimal use of available resource to assure the best overall improvement in the health of the population is a key element 8. Collaboration with a variety of other professions, organization, and entities is the most effective way to promote and protect the health of the people

Primary prevention

Basic ways in which people learn information: - Behaviorism - Cognition - Constructivism - Humanism

Public Health Core Functions- Assurance

Public health agencies provide the services necessary to achieve agreed-upon goals - Making sure that essential community-oriented health services are available - Includes providing essential personal health services for individuals as well as a competent PH workforce

IHI Triple Aim

Requires health care organizations, public health departments, social service entities, school systems, and employers to cooperate. It is one overall aim for health and health care improvement that consists of three dimensions: - Improving the health of populations - Improving the individual experience of care - Reducing the per capita cost of care

secondary prevention

Testing of groups of individuals who are: - At risk for a certain condition - As yet asymptomatic - Not a diagnostic test - Key component Reliability Validity: sensitivity and specificity: - Positive predictive value and negative predictive value

World Health Organization (WHO)

Working on new model that addresses: - Globalization - Increased prevalence of noncommunicable diseases - Chronic communicable diseases Now is responder to public health emergencies: - Disasters - Manmade - Natural