Health Promotion And Adult Education Flashcards

1
Q

When did emphasis on health promotion begin?

A

With the nineteenth century epidemiologic revolution

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2
Q

Nineteenth century focus of health promotion

A
  1. Hygiene
  2. Sanitation
  3. Housing
  4. Working conditions
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3
Q

Twentieth century focus of health promotion

A

Disease prevention and health

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4
Q

1970s focus of health promotion

A

Recognition that more than half of premature deaths were preventable by lifestyle changes

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5
Q

Early 1980s focus of health promotion

A

Comprehensive workplace health promotion programs instituted to help people change their behaviors

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6
Q

1990s focus of health promotion

A

Concept of workplace health broadened to include not only behavioral and lifestyle change, but also organizational strategies that supported healthy work environments

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7
Q

Twenty-first century and beyond focus of health promotion

A

As healthcare costs continue to soar, adding a significant burden to the industry, the major thrust becomes one of cost containment

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8
Q

Health promotion activities are conducted by and draw upon expertise from the following fields

A
  1. Nursing
  2. Health education
  3. Medicine
  4. Psychology
  5. Nutrition
  6. Occupational and physical therapy
  7. Safety
  8. Ergonomics
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9
Q

Health promotion focuses on

A
  1. Prevention of illness and injury with return to work strategies to prevent relapse
  2. Promotion of personal health accountability while partnering with the employer for enhanced outcomes
  3. Development of strategies for behavioral change
  4. Movement to optimal health by balancing physical, emotional, social, spiritual and intellectual health
  5. Creation of a supportive work environment through policy, programs and culture
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10
Q

Consumerism

A

Used to describe the provision of education to consumers of healthcare so that they become more prudent users of healthcare services and can advocate for better care

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11
Q

Self-care

A

Refers to individuals, each taking responsibility for his or her own health

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12
Q

Percent of GDP spent on healthcare by large companies in 2004 and projected estimate for 2013

A
  1. 5%

18. 4%

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13
Q

Business goals of health promotion

A
  1. Improved employee productivity
  2. Improved employee morale
  3. Reduced health care costs
  4. Recruitment and retention of employees
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14
Q

Personal health goals of health promotion

A
  1. Identification and reduction of major health risks
  2. Maintenance and improvement of health and health conditions
  3. Improved energy and resilience
  4. Balanced work and personal life
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15
Q

Recommended guidelines for physical exams

A

One per year

Have an established relationship with a provider and schedule appropriate preventative care

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16
Q

Recommended guidelines for tetanus diphtheria

A

Every 10 years

Evaluate need for booster after injury

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17
Q

Recommend guidelines for influenza vaccine

A

Annual vaccination

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18
Q

High risk patients for influenza

A
Heart problems 
Lung problems 
Over 65
Diabetes
Kidney dysfunction 
Lowered immunity
Care takers if high risk persons
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19
Q

Recommended guidelines for travel immunizations

A

Consult with personal provider with each trip and as soon as you know you will be traveling

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20
Q

Recommended guidelines for blood pressure

A

Goal

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21
Q

Recommended guidelines for fecal occult blood testing

A

Start at age 40

Annually

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22
Q

Recommended guidelines for colonoscopy

A

Start at 50

Flexible sigmoidoscopy every 3-5 yrs
Colonoscopy every 5-10yrs

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23
Q

Recommended guidelines for oral exam and cleaning

A

Every 6 months

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24
Q

Recommended guidelines for eye exams

A

20-29: one complete eye exam
30-39: at least 2 exams
40-64: exams every 2-3yrs
65+: exams every 1-2yrs

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25
Q

Recommended guidelines for PAP smear and cervical exam

A

Every 1-3yrs after age 18 to screen for cervical cancer

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26
Q

Recommended guidelines for clinical breast exam

A

Every 1-3yrs

Annually after age 40

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27
Q

Recommended guidelines for mammography

A

40-49: every 1-2yrs
50+: annually
At risk women consult with healthcare provider for frequency

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28
Q

Recommended guidelines for prostate cancer screening

A

Start at age 40: at risk personal or family history and if African American- annual digital rectal exam

Age 50: annual digital rectal exam

Discuss PSA blood testing with healthcare provider

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29
Q

Recommended guidelines for testicular exam

A

Annual healthcare provider exam

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30
Q

Ways health promotion programs reduce unnecessary health cre utilization

A
  1. Encourages appropriate use of health care delivery services
  2. Prevents acute illness and injury and delaying development of chronic illness
  3. Reducing symptom severity, discomfort and disability
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31
Q

Items that may be included in a health promotion program

A
  1. Awareness and support programs
  2. Screening programs and services
  3. Lifestyle behavior change services and programs
  4. Work-culture enhancement
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32
Q

Examples of awareness and support programs

A
  1. Newsletters
  2. Flyers
  3. Posters
  4. Seminars
  5. Health fairs
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33
Q

Examples of lifestyle behavior change programs

A
  1. Regular exercise
  2. Good nutrition
  3. Stress management
  4. Smoking cessation
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34
Q

Examples of work/culture enhancement

A
  1. Work/life programs
  2. Organizational change efforts
  3. Flexible work alternatives
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35
Q

Contributions of occupational and environmental health nurses to heal promotion

A
  1. Keeping healthy people healthy
  2. Identifying high risk populations and developing targeted interventions
  3. Developing interventions for the management of disease conditions
  4. Contributing to the comprehensive healthcare strategy for the organization
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36
Q

Healthy People 2010

A
  • Objectives for improving health
  • 467 objectives
  • 28 focus areas
  • seek to increase life expectancy and quality of life and to eliminate health disparities
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37
Q

To meet these goals, the implementation plan:

A

Supports gains in knowledge, motivation, and opportunities for better decision making

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38
Q

Healthy People 2010 encourages local and state leaders to accomplish the following:

A
  1. Develop community and state efforts to promote healthy behaviors
  2. Create healthy environments
  3. Increase access to high quality health care
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39
Q

Areas of Healthy People 2010 of interest to occupational and environmental professionals

A
  1. Physical activity
  2. Obesity and weight loss
  3. Tobacco use
  4. Substance use
  5. Mental health
  6. Injury
  7. Violence
  8. Immunizations
  9. Sexual behavior
  10. Environmental quality
  11. Improved access to health care
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40
Q

Occupational and environmental health nurses use Healthy People 2010 objectives to:

A
  1. Benchmark with national norms
  2. Justify program and service needs in discussions with management
  3. Focus interventions
  4. Develop site-specific population health goals and outcomes based on population data
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41
Q

Examples of Healthy People 2010 goals for a company population

A
  1. Increase proportion of workers who exercise regularly
  2. Increase the proportion of workers and their families who are at their desired weight
  3. Increase the proportion of workers and their families who do not smoke tobacco
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42
Q

Example of strategy to “ Increase proportion of workers who exercise regularly” and impact of strategy

A

Strategy: Employer will improve walking paths near the worksite and will allocate space for after hours exercise class

Impact: workers will have more energy, better weight control, less mental stress, and fewer disability claims

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43
Q

Example of strategy to “Increase the proportion of workers and their families who are at their desired weight” and impact of strategy

A

Strategy: company nurse will provide lunchtime nutrition courses

Impact: workers will generally feel better, they will have more energy, less mental stress and fewer disability claims

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44
Q

Example if strategy to “Increase the proportion of workers and their families who do not smoke tobacco” and impact of strategy

A

Strategy: at least one smoking cessation lecture series will be offered each quarter

Impact: workers will generally feel better, they will have more energy, less mental stress and fewer disability claims

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45
Q

Health models are developed as…

A

A means of explaining the concept of health and it’s relationship to people’s health decisions

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46
Q

Health Belief Model

A
  • Developed by Godfrey Hochbaum, Stephen Kegeles, Howard Leventhal and Irwin Rosenstock
  • Developed in 1950s
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47
Q

Major components of Health Belief Model

A
  1. Perceived susceptibility
  2. Perceived severity
  3. Perceived benefits
  4. Perceived barriers
  5. Cues to action
  6. Self-efficacy
  7. Likelihood of an action being taken is driven by the positive difference between the perceived barriers and the perceived benefits
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48
Q

Perceived susceptibility

A

An individual’s subjective estimation of his or her own personal risk of developing a specific health problem

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49
Q

Perceived severity

A

Refers to an individual’s own personal judgement of how serious a health condition may be

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50
Q

Perceived susceptibility and perceived severity are often combined into….

A

Perceived threat

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51
Q

Perceived benefits

A

An individual’s estimation of how effective a health recommendation may be against removing a threat

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52
Q

Perceived barriers

A

An individual’s estimation of the obstacles to the performance of a health-related behavior

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53
Q

Cues to action

A

Strategies to activate one’s readiness for action

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54
Q

Self efficacy

A

Refer’s to one’s confidence in one’s own ability to take action

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55
Q

Health Promotion Model

A
  • Pender
  • 2002
  • Derived from social learns theory (Section IV.C)
  • Organized like the Health Belief Model
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56
Q

Health Promotion Model is based on the following premises:

A
  1. Health promotion is directed at increasing the level of well being and self actualization of an individual or group
  2. Health promoting behaviors are continuing activities that must be an integral part of an individual’s lifestyle
  3. Health promoting behaviors are viewed as proactive rather than reactive
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57
Q

Health Promotion Planning Model

A
  • known as PRECEDE

- used to help plan and evaluate health promotion activities

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58
Q

PRECEDE Model consists of:

A
  1. Predisposing factors
  2. Reinforcing factors
  3. Enabling factors
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59
Q

Predisposing factors

A
  1. Attitudes

2. Knowledge

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60
Q

Reinforcing factors

A
  1. Rewards

2. Positive feedback

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61
Q

Enabling factors

A

Resources that facilitate or hinder performance of desired outcome

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62
Q

Health Promotion Planning a model considers multiple factors that shape health such as:

A
  1. Behavior
  2. Lifestyle
  3. Environment
63
Q

In the Health Promotion Planning Model —— and —— are viewed as important influences on the quality of life

A

Health promotion education

Policy

64
Q

Expected outcome of Health Promotion Planning Model

A

Quality of life

65
Q

Application of Health Promotion Planning Model begins with

A

The determination to work on controllable behaviors

66
Q

Model of Health Promotion Behavior

A

Proposes that self efficacy beliefs play a central role regarding health beliefs and behavior

67
Q

Basic premises of Model of Health Promotion Behavior

A
  1. Optimal health represents a balance between physical, emotional, social, spiritual and intellectual health
  2. Programs and services are targeted at three levels
68
Q

Targeted three levels of Model of Health Promotion Behavior

A
  1. Awareness
  2. Lifestyle and behavioral change
  3. Supportive environments
69
Q

An expanded version of the Model of Health Promotion Behavior includes a dimension labeled….

A

Occupational/Environmental

70
Q

Expanded version of Model of Health Promotion Behavior

A
  • more comprehensive model
  • includes the concept of work
  • draws attention to the importance of work and how work is integrated into the fabric of our lives
71
Q

Harm Reduction Model

A

Assumes that health risks can be decreased by asking clients:

  1. What is healthier, safer or less risky than what I am doing now?
  2. What steps am I willing to take in order to be healthier, safer or less risky?
72
Q

Basic principles of Harm Reduction Model

A
  1. Most people are competent to make informed decisions about health behaviors
  2. Needs are diverse, so it is better to offer numerous behaviors rather than one solution
  3. Incremental changes in steps will work better than making large, difficult changes
  4. People need social support, eduction, referrals and assistance to make changes
73
Q

An analysis of psychotherapy theories for behavior change was performed to…..

A

Identify psychotherapeutic principles that relate to helping people change their behavior

74
Q

Types of psychotherapy theories for behavior change:

A
  1. Verbal theories

2. Action or behavioral theories

75
Q

Verbal theories

A

Use language and emotion to guide changes in behavior

76
Q

Types of verbal theory

A
  1. Consciousness raising
  2. Catharsis
  3. Choosing
77
Q

Conscious raising

A

Uses the individual’s personal experience feedback to stimulate responses

78
Q

Catharsis

A

Allows individuals to express emotions, which produces personal relief and improvement

79
Q

Choosing

A

Gives alternatives responses for individuals, and self liberation occurs when they choose an alternative

80
Q

Action or behavioral theories

A

Use stimuli outside the individual to evoke an action or behavior

81
Q

Types of action or behavioral theory

A
  1. Conditional stimuli
  2. Counter-conditioning
  3. Stimulus control
  4. Contingency control
  5. Reevaluation
82
Q

Conditional stimuli

A

Refers to critical changes made in the stimuli that influence responses

83
Q

Counter-conditioning

A

Occurs when an individual changes his or her response to a stimulus

84
Q

Stimulus control

A

Occurs when the environment is changed

85
Q

Contingency control

A

Refers to managing change by making changes in the environment to cause individuals to change

86
Q

Reevaluation (action or behavioral theory)

A

Occurs when individuals change in response to consequences without contingency changes in the environment

87
Q

Transtheoretical theory- stages of change model

A
  • Prochaska & DiClemente
  • 1983
  • describes interventions tailored to individual responses at specific levels or stages
88
Q

Transtheoretical theory- stages of change model was formulated by……

A

Using numerous psychotherapy theories to develop the stages of change model to produce sustained behavioral change

89
Q

The content of the Transtheoretical theory- stages of change model theory varies from client to client depending on the client’s……

A
  1. History of actions
  2. Present environment
  3. Personality
90
Q

The stages of change in the Transtheoretical theory- stages of change model include the following:

A
  1. Precontemplation
  2. Contemplation
  3. Planning
  4. Action
  5. Maintenance
91
Q

Precontemplation stage of Transtheoretical theory- stages of change model

A

Clients are not considering making a change

92
Q

Contemplation stage of Transtheoretical theory- stages of change model

A

Clients are beginning to explore or think about making a change

93
Q

Planning stage of Transtheoretical theory- stages of change model

A

Clients are determined to stop and begin developing a plan

94
Q

Action stage of Transtheoretical theory- stages of change model

A

Clients modify their behavior, which may also mean they change their environment

95
Q

Maintenance stage of Transtheoretical theory- stages of change model

A

Continues as the new behavior continues to be practiced

96
Q

Central premise of Transtheoretical theory- stages of change model

A

That people progress through a series of stages when they attempt to change behaviors

97
Q

—- different processes are used to enhance progression through the stages of change

A

Ten

98
Q

Processes used to enhance profession through stages of change include:

A
  1. Consciousness raising
  2. Dramatic relief
  3. Environmental reevaluation
  4. Self-reevaluation
  5. Self-liberation
  6. Relationships
  7. Social liberation
  8. Counterconditioning
  9. Stimulus control
  10. Reinforcement management
99
Q

Consciousness raising

Transtheoretical theory- stages of change model

A

Increasing awareness

100
Q

Dramatic relief

Transtheoretical theory- stages of change model

A

Experiencing and expressing feelings

101
Q

Environmental reevaluation

Transtheoretical theory- stages of change model

A

Assessing how environment affects the situation

102
Q

Self-reevaluation

Transtheoretical theory- stages of change model

A

How person feels about the situation

103
Q

Self-liberation

Transtheoretical theory- stages of change model

A

Belief in ability to change

104
Q

Relationships

Transtheoretical theory- stages of change model

A

Support

105
Q

Social liberation

Transtheoretical theory- stages of change model

A

Assessing social changes that support changes

106
Q

Counterconditioning

Transtheoretical theory- stages of change model

A

Substituting healthier behaviors

107
Q

Stimulus control

Transtheoretical theory- stages of change model

A

Restructuring the environment

108
Q

Reinforcement management

Transtheoretical theory- stages of change model

A

Getting rewards

109
Q

Identifying and classifying the population into the stages of change should guide…..

A
  1. Program planning

2. Interventions

110
Q

Behavior change tools developed using the stages of change……

A

Provide a comprehensive framework to move more behaviors towards maintenance

111
Q

Stages of change theory using psychotherapy theories examples of processes in contemplation stage to facilitate change

A
  1. Consciousness raising

2. Feedback

112
Q

Stages of change theory using psychotherapy theories examples of processes in planning stage to facilitate change

A
  1. Choosing
  2. Self-liberation
  3. Catharsis
113
Q

Stages of change theory using psychotherapy theories examples of processes in action/maintenance stage to facilitate change

A
  1. Contingency control
  2. Reevaluation
  3. Conditional stimuli
  4. Stimulus control
114
Q

Stages of change theory using health promotion activities examples of processes in precontemplation stage to facilitate change

A
  1. Posters
  2. Invitation classes
  3. Buddy system
115
Q

Stages of change theory using health promotion activities examples of processes in contemplation stage to facilitate change

A
  1. Health fairs
  2. Newsletters
  3. Brochures
  4. Pamphlets
  5. Health education classes
  6. Buddy system
  7. HRA
116
Q

Stages of change theory using health promotion activities examples of processes in planning stage to facilitate change

A
  1. Health education classes
  2. Counseling
  3. Health planner
117
Q

Stages of change theory using health promotion activities examples of processes in action/maintenance stage to facilitate change

A
  1. Follow-up contact
  2. Environmental supports
  3. Health education
118
Q

Social learning theory

A

Proposes that people’s thoughts have a strong effect on their behavior, and their behavior affects their thoughts

119
Q

Social cognitive-self-efficacy theory

A
  • Bandura, 1986

- describes the factors involved in making decisions related to healthy behavior

120
Q

Factors involved in making decisions related to healthy behavior according to social cognitive-self-efficacy theory

A
  1. Personal efficacy
  2. Social support
  3. Environmental support
  4. Behavioral experiences
121
Q

Self-efficacy

Social cognitive-self-efficacy theory

A

An individual’s confidence in his or her ability to perform

122
Q

An individual’s efficacy expectation determines:

A
  1. His or her choice of activity
  2. How much effort he or she will expend
  3. How persistent he or she will be
123
Q

Supporting an individual’s ——— may be the single st important factor in a person’s success in changing personal health behaviors

A

Self efficacy efforts

124
Q

According to the Locus of Control Theory types of locus of control

A
  1. Internal locus of control

2. External locus of control

125
Q

Internal locus of control

A

An individual’s belief (outcome expectation) that his or her own behavior determines reinforcement (outcomes)

126
Q

External locus of control

A

An individual’s belief (outcome expectation) that reinforcements (outcomes) are controlled by others

127
Q

Theoretically, individuals with ——— locus of control are rode likely to take control of their health and engage in health promotion activities that are those with ——- locus of control

A

Internal

External

128
Q

Ways to motivate individuals for improved internal locus of control

A
  1. Intrinsic motivation
  2. External stimulus applied to to intrinsic motivation
  3. Extrinsic motivation
129
Q

Example of intrinsic motivation to improve internal locus of control

A

Increase participants’ perception of success

130
Q

Example of external stimulus applied to intrinsic motivation to improve internal locus of control

A

Reinforce positive actions

131
Q

Examples of extrinsic motivation to improve internal locus of control

A
  1. Provide incentive for participation and accomplishment of goals
  2. Involve family support
  3. Reinforce health messages in the environment, for example, vending machines, cafeteria, work spaces, and management communications
132
Q

Transactional theory

A

Is characterized by “reciprocal determinism”, in which individuals change behavior then begin to actively participate with others in the new behavior

133
Q

Reciprocal determinism strengthens the individual’s……

A

Desire to continue that new behavior or find the need to change the environment

134
Q

Efficacy and support can….

A

Modify behavior

135
Q

Direct experience with e new behavior increases….

A

The level of efficacy and support

136
Q

Actions the occupational and environmental health nurse can take to reinforce the principles of transactional theory

A
  1. Recreational leagues
  2. Teams
  3. Buddy systems
  4. Support groups
137
Q

The Theory of Reasoned Action

A

Proposes that behavioral intentions are the result of one’s attitudes and subjective norms

138
Q

Attitudes

The Theory of Reasoned Action

A

Are determined by beliefs regarding the consequences of a behavior and one’s positive or negative evaluation of those consequences

139
Q

Subjective norms

The Theory of Reasoned Action

A

Refer to a person’s beliefs or perceptions about what others think he or she should do

140
Q

Intentions

The Theory of Reasoned Action

A

The immediate determinant of behavior

141
Q

Theory of Planned Behavior

A
  • builds on the Theory of Reasoned Action
  • the element added to that theory is the belief that one has the resources to perform the behavior
  • Ajzen, 1988
142
Q

Theory of Goal Setting

A

States that setting goals can help people change health-related behaviors by focusing effort, persistence, and concentration

143
Q

The steps to setting goals include:

A
  1. Determination of commitment to change
  2. Analysis of tasks required to make changes; breaking complex tasks into smaller tasks
  3. Assessment of the client’s self-efficacy for performing required behaviors
  4. Establishment of reasonable goals
  5. Feedback for continued success
144
Q

Theory of Social Behavior

A

States that the probability that an act will occur in a specific situation is equal to the sum of the person’s habit and intention

145
Q

Protection Motivation Theory

A

Combines features of the Health Belief Model with self-efficacy theory and other social psychologic constructs such as fear, arousal, appraisal and coping

146
Q

Health Action Process Approach

A

States that health behavior change takes place over time

147
Q

Levels of prevention

A
  1. Primary prevention
  2. Secondary prevention
  3. Tertiary prevention
148
Q

Primary prevention

A

Is aimed at eliminating or reducing risk of disease through specific actions

149
Q

Examples of primary prevention

A
  1. Immunizations
  2. Stress management
  3. Smoking avoidance
  4. Risk factor appraisal
  5. Seat belt use
  6. Work-site walk-throughs
  7. Use of personal protective equipment
150
Q

Secondary prevention

A

Is directly aimed at early case-finding and diagnosis of individuals with disease in order to institute prompt interventions

151
Q

Examples of secondary prevention interventions

A
  1. Screening programs
  2. Health surveillance
  3. Monitoring health and illness trend data
  4. Preplacement examinations
  5. Periodic examinations
152
Q

Tertiary prevention

A

Is directed at rehabilitating and restoring individuals to their maximum health potential

153
Q

Examples of tertiary prevention interventions

A
  1. Disability case management
  2. Early return to work
  3. Chronic illness monitoring
  4. Substance abuse rehabilitation
154
Q

Health promotion

A

A process that supports positive lifestyle changes through corporate policies, individual efforts to lower risk of disease and injury and the creation of an environment that provides a sense of balance among work, family, personal health and social concerns