Health Promotion

According to social learning theory

, "human behavior is explained in terms of a three-way, dynamic, reciprocal theory in which personal factors, environmental influences, and behavior continually interact. And, that people learn through their own experiences and by observing actions of others and the results of those actions"

Pp model phases

1. Social assessment 2. ID health issues 3. identification of the health behaviors that are associated with the health issue selected in phase 2 and the identification of the key environmental influences that may be promoting or hindering health behavior. 4. Educational and ecological assessment - what will facilitate change 5. identification of organizational and administrative opportunities and barriers for developing and implementing a program. 6. Roger am implementation 7-9 see if it works

When did the first U.S. surgeon general note that smoking was bad for you

1964

Only 20% of Americans participate in recommended levels of daily physical activity (aerobic and muscle strengthening). So what's recommended

2008 Physical Activity Guidelines for Americans (PAG) 150 minutes of moderate intensity activity or 75 minutes of vigorous intensity activity each week (or combination of both) Muscle-strengthening activities involving all major muscle groups 2 or more days weekly. *Guidelines for adults 225 minutes a week for middle school children

Affordable care act

2010 Piece of legislation with a main goal of helping everyone receive quality affordable health insurance Emphasizes the important of wellness and health promotion and prevention Also requires companies to cover preventative services

Quality PE

A requirement 150 minutes for elementary school students 225 minutes for middle school students Size of the class Qualified pe teachers Meaningful content Inclusion of all students Not withholding pe as punishment Assessment

Theory

An explanation intended to account for the actions that people take or do take to promote health

Health Education

Any combination of learning experiences designed to help individuals and communities improve their health by increasing their knowledge or influencing their attitudes

Partnerships among multiple sectors to leverage resources and address community member needs; broadens access to opportunities for physical activity. National Physical Activity Plan provides recommendations in eight sectors

Business and Industry Education Health care Mass media Parks, recreation, fitness, and sports Public health Transportation, land use, and community design Volunteer and nonprofit

Diseases that smoking causes

Cardiovascular disease 1/3 of deaths from smoking Pulmonary disease

Obesity

Caused by an imbalance of calorie intake and output, often associated with poor diet, overeating, and/or physical inactivity Adults obesity rates increased from 15 - 34 % from 1976 to 2008; Children's rates increased from 5 - 17% during the same time frame Hispanics and African Americans generally report higher levels of obesity

Public Health

Concerned with health of the community as a whole Core Functions: - Assessment and monitoring - ID health problems and priorities - Formulate a plan and public policies - Ensure access to care

Family Smoking Prevention and Tobacco Control Act of 2009

Contains over twenty provisions with a main goal of preventing and reducing tobacco use by adolescents under the age of eighteen.

State Policy Strategies for Increasing Physical Activity

Create or enhance access to places for physical activity Schools, parks, playgrounds, recreation centers Enhance physical education and activity in child care settings Recess, walk to school, moderate-to-vigorous activity Support urban design, land use, and transportation policies Land use policies, cross walks, lightning, bike racks, bike lanes Develop and maintain a public health workforce competent in physical activity

Mobilizing for Action through Planning and Partnership (MAPP) model

Created by the National Association for County and City Health Officials (NACCHO) Assists local health departments and local health coalitions with program planning that specifically targets community health issues. Uses an interactive process to apply strategic thinking to prioritize public health issues and identify resources to address them

Ancel Keys Study

Cross cultural comparison of heart attack risk in populations of men engages in normal work. And comparing fat intake and diet Found the association between blood cholesterol levels and heart disease

Determinants of Health

Defines factors that significantly influence or have an impact on the health of individuals and communities: Genes Physical environment Health services Individual behaviors Policies

Social Cognitive Theory

Developed by Albert Bandura Frames individual behavior as a response to observational learning from the surrounding environment Emphasizes the concept of reciprocal determinism IDing that individuals are a product of their environment and also help make those environments

Theory of Planned Behavior

Developed from the theory of reasoned action stating behaviors result from intentions Constructs: Personal attitude Subjective norm Perceived control

Health Belief Model

Developed in the 1950s to understand people's reluctance to access disease prevention services Characterized by value-expectancy theories, which explains that behavior results from an individual's value of the outcome of the behavior and the expectation that a particular action or actions will lead to the outcome

Primary prevention

Emphasizes activities to avert illness injury or disease conditions

Secondary Prevention

Emphasizes identifying diseases at their earliest stage and treating the conditions early

80% of smokers start before the age of 18

FACT

According to the World Health Organization (2009) nutrition-related risk factors are responsible for more than sixteen million deaths per year globally (28% of global deaths).

FACT

America's westernized diet tends to be associated with higher risk of chronic illness compared to other diet patterns linked to reduced risk (i.e. Mediterranean and Asian).

FACT

Back in days 42% of people smoked before knowing it caused lung cancer

FACT

Cigarettes contain numerous carcinogens, compounds that can damage DNA and lead to cancerous growth of cells.

FACT

Moderate - more time lower heart rate Vigorous - short time high heart rate Maximum heart rate 220 - age = Maximum Heart Rate 50% of your MHR is fat burning Energy comes from carbohydrates stored as glycogen and fat stored as fatty acids

FACT

Physical inactivity is the fourth leading risk factor for global mortality, causing an estimated 3.2 million deaths each year.

FACT

The US Departments of Health and Human Services and Agriculture release a set of nutrition guidelines for Americans over the age of two years old every 5 years

FACT

Tobacco use is the single most preventable cause of death

FACT

Modifiable risk factors

Factors that an individual can change through his or her own actions

Nonmodifiable risk factors

Factors that cannot be changed by the individual Age Gender Family history

National Policy

Family Smoking Prevention and Tobacco Control Act of 2009 Contains over twenty provisions with a main goal of preventing and reducing tobacco use by adolescents under the age of eighteen.

Changes to the food we eat now vs back then

Farming practices (subsidies, pesticides, etc.) Culture Time (women working more) Marketing Availability Portion size

Consumer-based Planning Models

Focus on the consumer or intended audience, Using principles from the business marketing field and applying those concepts to health promotion. Program planners need to consider their "competition" and apply applicable business marketing concepts to promote, or "sell," health behavior change. The "product" program planners are advocating is a health behavior and improved health outcomes, and the "cost" to the customer is time, effort, and motivation for a change.

Heart disease

Generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina), or stroke Leading cause of death in developed countries Studies linking heart disease with nutrition date back to the 1900s Greater risk associated with high intake of saturated fat, trans fat, and sodiumthat can lead to a heart attack, chest pain (angina), or stroke Leading cause of death in developed countries Studies linking heart disease with nutrition date back to the 1900s Greater risk associated with high intake of saturated fat, trans fat, and sodium

Match Phases

Goal selection Intervention planning Program development Implementation preparations Evaluation

Health Communication Campaigns

Health promotion messages are communicated through numerous methods that can be categorized by the following: Mass media (e.g., television, radio, billboards) Small media (e.g., brochures, posters) Social media (e.g., Facebook, Twitter, web logs) Interpersonal communication (e.g., one-on-one or group education)

Perceived Barriers

Idv belief about the negative impact of making a behavior change

Self Efficacy

Important construct used in various models that describes an individual's perception of his or her capability to execute a course of action necessary to achieve a goal Observational learning Mastery experience Improving physical and emotional states Verbal persuasion

Social ecological model

Individual Relationships Community Societal

Physical Activity Behaviors and Barriers

Individual factors include demographics household and lifestyle characteristics preferences culture genetic factors and biological dimensions time allocation. Occupation Commuting and Transportation Choices Neighborhoods Social environment

Perceived severity

Individual's belief about the seriousness of negative health outcomes physically and emotionally

Perceived benefits

Individual's belief tHat behavior change will have a positive impact on health outcomes

Influences of an individual's perceived

Internal factors: Info, skills, and abilities Will power Emotions External factors: Opportunity and time Dependence on others

Other Initiatives to Increase Physical Activity

Let's Move! Launched by the First Lady Michelle Obama in 2010 Rails-to-Trails Working to create a nationwide network of trails from former rail lines Bike Shares Stations are strategically set up around the city to encourage people to bike to their destination. Blue Zones Project A community wellbeing improvement initiative designed to make healthy choices easier through permanent changes to environment, policy, and social networks.

Community Nutrition Efforts

Loans and grants offered to supermarkets built in disadvantaged areas Healthy Corner Store initiative increasing availability of fresh produce Shopping Matters educational programs in grocery stores Increased availability of Farmer's Markets

The food industry spends over $11 billion marketing its wares to American consumers each year

Marketing directed to children is of particular concern, especially children of populations already vulnerable to increase rates of obesity

Life expectancy

Measure of the health status of given population and is defined as the average number of years a person from a specific cohort is projected to live from s given point of time

Health promotion focuses on

Modifiable risks

Tools for healthy living

My plate Dietary guidelines

National Policy for helping health

National Policy Patient Protection and Affordable Care Act includes requirements for listing calorie content for menu items in restaurants Women, Infants, and Children program (WIC) updated to align with Dietary Guidelines for Americans State-level policy in California banned the use of trans fats in restaurants

Stroke

Occurs when the blood supply to part of the brain is interrupted or severely reduced, depriving brain tissue of oxygen and food; within minutes, brain cells begin to die 4th leading cause of death in the US Nutrients found to increase risk are trans fat, sodium, and saturated fat

Nutrition at the Work Site and School

On-site education Better vending machine and cafeteria offerings including menu labeling at the work site CDC recognizes nutrition as a component of comprehensive worksite wellness initiatives Healthy, Hunger-Free Kids Act updates nutrition standards for school meals and competitive foods Nutrition included as part of HealthierUS school challenge

Perceived self efficacy

Ones ability to control ones own health behaviors personal judgement

Evolution of Dietary Patterns

Paleolithic and Hunter-Gatherers: variety of plant and animal species including nuts, seeds, wild grasses, meat, and fish Agriculture: dominated by cereal grains and supplemented with legumes (beans), tubers (potatoes), and oil Industrialization and receding famine: significant changes in farming practices, cheaper foods, but low variety Noncommunicable disease: US pattern increasing throughout the world; characterized by high intake of saturated fat, sugar, and refined foods /low fiber intake Desired Societal and Behavior Change: US federal government's Dietary Guidelines for Americans

National Policies That Promote Increasing Physical Activity

Patient Protection and Affordable Care Act The Small Business Wellness Grant assists small businesses in developing comprehensive work site health promotion programs in which physical activity is a component. The ACA allows for employers to provide health plan premium differentials to employees who achieve health goals or participate in wellness programs Through the ACA, the CDC's Community Transformation Grants have awarded $103 million to sixty-one state and local government agencies, tribes, territories, and nonprofit organizations.

Physical activity

Physical activity is defined as any bodily movement produced by skeletal muscles that requires energy expenditure Any movement during the day is physical activity, including walking, climbing stairs, and housework.

CDCynergy Model

Principles of the model Using research to describe and determine the causes of the health issue Describing the audience affected by the health issue Exploring a range of strategies to address the issue or problem Developing a comprehensive communication plan that includes audience research, pretesting, production, and launch Planning for and conducting evaluation activities throughout the entire

Federal actions with tobacco

Purchasing Restrictions Legal age for purchasing tobacco products in most states is 18; there is no law restricting the use of tobacco products, though. Taxation Federal and state taxes on tobacco products are an important step in decreasing the numbers of users. 2009: federal tobacco tax increase from $0.62 to $1.01 State taxes range from $0.17 (Missouri) to $4.35 (New York); national average is $1.68

Tertiary prevention

Relies mainly on the health care system and highlights specific medical interventions to limit advancing conditions linked to chronic diseases

Second hand smoking

Research indicates that secondhand smoke can result in premature death and disease in children and adults. It is estimated that secondhand smoke exposure causes approximately three thousand deaths from lung cancer and forty-six thousand deaths from heart disease. 43% of the population greater than 4-years old are exposed to tobacco smoke.

Multilevel Approach to Community Health (MATCH) model

Similar to PRECEDE-PROCEED and considered an ecological model of program planning Focus on assessing population health and working with communities to help in identifying opportunities for improving community health Identify and implement evidence-based programs and policies to address the identified health issues. The emphasis of this model is on program implementation.

Smokeless tobacco

Smokeless tobacco is a tobacco product that is not smoked but rather placed directly in the mouth, cheek, or lip to be sucked or chewed; the saliva is either swallowed or spit out and is commonly referred to in the United States as dip, chew, or snuff. E-cigarettes are devices that vaporize a mixture of water, propylene glycol, nicotine, and flavorings. Often seen as the "safe" alternative to cigarettes and used as a "harm reduction" strategy, but are not regulated by the FDA Smokeless tobacco does still increase an individual's risk for developing cancer and cardiovascular disease and contributes to complications during and after pregnancy as well as oral complications such as gum disease and tooth loss.

State Policy

States are awarded funds each year under the MSA but these funds are not required to be used on anti-tobacco measures. Only two states use the settlement money on anti-tobacco measures that reach the CDC's recommended levels (North Dakota and Alaska) while 29 fund at less than 25%.

Education Programs in Schools

Studies suggest that children who are physically fit have improved attendance patterns, are more focused, better behaved in the classroom, and perform better academically. SHAPE America's Key Points of Quality Physical Education Opportunity to learn Meaningful content Appropriate instruction Student and program assessment

Transtheoretical Model (TTM)

TTM describes health behavior as a process and notes that at any given time individuals are at varying levels of readiness for change (stages of change). Messages and interventions should ideally be tailored to the target audience's related stage

People base food choices on

Taste Emotions Price Convenience Health and nutrition Culture and familiarity Environment Marketing

Efforts and Initiatives to Increase Physical Activity

Technology People are using smartphones, the Internet, and online applications to manage their health and fitness, locate and participate in group physical activities, and join virtual health or fitness-focused groups to stay accountable. Tracking Activity Virtual or online tracking build accountability into physical activity by enabling people to monitor, track, and share their activities. Many sites also create an online community allowing members to network with one another, ask questions, and post comments.

Master settlement agreement

The Master Settlement Agreement (MSA) is a joint lawsuit that was settled by forty-six states in November 1998. The settlement payout is $246 billion over twenty-five years; each state is awarded a yearly payment.

Type two diabetes

The body either resists the effects of insulin—a hormone that regulates the movement of sugar into the cells—or doesn't produce enough insulin to maintain a normal glucose level Nutrients associated with increased risk are total fat, trans fat, and saturated fat as well as high caloric intake Mothers who develop gestational diabetes give birth to children who are more likely to develop type 2 diabetes

Social environment

The personal relationships or networks that surround people

Health Promotion

The process of enabling people to increase control over and to improve their health. It moves beyond a focus on individual behavior toward a wide range of social and environmental interventions

Physical environment

The structures buildings or services that can either facilitate or hinder healthy behavior

Cancer

The term used for diseases in which abnormal cells divide without control and are able to invade other tissues 2nd leading killer in the US Accounted for 23% of all deaths (2010) Tobacco and obesity are risk factors, in addition to physical inactivity and poor diet Diets high in saturated fat, omega-6 fats, calories, and alcohol increase risk

Subdivided Theory Elements

Theories are subdivided and referred to as concepts. Concepts in a more concrete form are referred to as constructs which in their most applicable form are known as variables

Model

Theory based planning framework that helps guide program creation and evaluation

Sedentary Behavior...tell me about it

There is a consistent relationship between sedentary behavior and mortality and weight gain from childhood to adulthood. The average amount of adult sedentary behavior per day is seven to ten hours. Youths spend two to four hours each day in sedentary screen-based behaviors and a total of five to ten hours each day sedentary.

Cues to action

Triggers that motivate individuals toward a change in behavior

Effective program planning

Understand the health issue the program will be addressing Identify the population the program will target Identify the policy and educational approaches necessary to bring about or support the desired changes Establish a logical program development process Set priorities and goals Establish objectives to achieve Assess progress Measure impact and outcomes

Education Programs in Work Sites

Work site policies, such as allowing employees to participate in physical activity while on the job, offering flexible work hours, and providing physical activity incentives can significantly affect employee levels of physical activity. Education for employees at the workplace is useful in increasing physical activity. By providing follow-up consultation by health educators, coaches, or nurses after employees complete a health risk assessment, employees are able to set goals and better monitor their progress

Precede proceed model

a nine-phase logic model, using an ecological approach, applied in health promotion program planning Developed by Green and Krueter in the 1970s

Sociological ecological model

a planning model based on the interrelationships of human beings and their environments, recognizing that within the environment there are physical, social, economic, and cultural forces that have the potential to alter health outcomes Identify physical, social, economic, and cultural forces that alter health outcomes?

Faith-based interventions

are defined as those offering some degree of spiritual or religious involvement, referencing the Bible or other religious text, institutionalized into the faith-based organization, and delivered by trained faith-based organization volunteers.

The Dietary Guidelines for Americans includes information about

consuming fewer calories, making informed food choices, and being physically active to attain and maintain a healthy weight, reduce risk of chronic disease, and promote overall health Most Americans do not meet the nutrition goals outlined

Faith-placed interventions

do not have a spiritual or religious component but are located on the site of a faith-based organization.

Personal health goals

established by individuals: short or long-term goals (short-term goals are typically encouraged to improve self-efficacy and build on success)

Perceived facilitators of the desired health behaviors:

factors that improve success such as a tool or support

Perceived impediments to the desired health behaviors:

factors that inhibit success such as limited time or lack of transportation

The four main health factors

high blood pressure high blood glucose overweight, obesity high blood cholesterol

Exercise

is a subset of physical activity that is planned, structured, and repetitive and has as a final or an intermediate objective to improve or maintain physical fitness level. Aerobic, muscle-strengthening, bone-strengthening, and stretching activities

Built Environment

refers to human-made surroundings that provide the setting for human activity, the human-made space in which people live, work, and recreate on a day-to-day basis

Processes of change

refers to the covert and overt activities used to progress through the stages of change. These are divided into: Affective and cognitive experiential processes (thoughts and feelings) Behavioral processes Constructs of self-efficacy and decision balance (perceived pros and cons) are also included