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Chapter 4
Health Promotion and Risk Reduction
.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
Health Promotion Is…
…any combination of health education and related organizational, economic, and environmental supports for behavior of individuals, groups, or communities conducive to health (Green & Kreuter, 1991)
…that which is motivated by the desire to increase well-being and to reach the best possible health potential (Parse, 1990)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Health Protection Is …(Cont.)
… those behaviors in which one engages with the specific intent to prevent disease, detect disease in the early stages, or maximize health within the constraints of disease (Parse, 1990)
… an important step in maintaining health
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Defining Health
The way health is defined has shifted from a focus on the curative model, to a focus on multidimensional aspects such as the social, cultural, and environmental facets of life and health (Benson, 1996)
Health is viewed not only as an important goal, but as a resource for living (WHO, 1986)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Healthy People 2020 …
… is the health promotion initiative for the nation.
… challenges individuals, communities, and professionals … to take specific steps to ensure that good health, as well as long life, are enjoyed by all.
– U.S. Department of Health and Human Services, 2012
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Healthy People 2020 … (Cont.)
Broad goals
Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.
Achieve high equity, eliminate disparities, and improve the health of all groups.
Create social and physical environments that promote good health for all.
Promote quality of life, healthy development, and healthy behaviors across all life stages.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Determinants of Health
Biology
Behaviors
Social environment
Physical environment
Policies and interventions
Access to high-quality health care
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Figure 4-1
From U.S. Department of Health and Human Services.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Theories in Health Promotion
Pender’s Health Promotion Model (HPM)
Health Belief Model (HBM)
Transtheoretical Model (TTM)
Theory of Reasoned Action (TRA)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Risk and Health
Risk is “the probability that a specific event will occur in a given time frame” (Oleckno, 2002).
A risk factor is an exposure that is associated with a disease (Friis & Sellers, 2004).
Risk Assessment is a systematic way of distinguishing the risks posed by potentially harmful exposures.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Steps in Risk Assessment
Hazard identification
Risk description
Exposure assessment
Risk estimation
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Risk Assessment
Modifiable risks
Individual has control
Examples: smoking, lifestyle, eating habits, activities
Nonmodifiable risks
Individual has little or no control
Examples: genetics, gender, age, environmental exposure
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Risk Reduction …
… is a proactive process
… enables individuals to react to actual or potential threats to their health
Risk communication …
… is the process of informing the public regarding threats
… is affected by perceptions, process, and actions
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Tobacco and Health Risk
Leading cause of preventable death
Most common in less educated populations and those living below poverty level
Most common form of chemical dependency
Tobacco in all forms is harmful.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Health Promotion Activities
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Look for teachable moments
Assess client’s tobacco use
Explore willingness to quit
Refer to cessation programs
Encourage attempts to quit
Alcohol Consumption and Health
Third leading lifestyle-related cause of death for the nation
Short-term use causes acute risks
Long-term effects have major impact on health and social issues
Influenced by legal drinking age
# 1 used and abused drug among U.S. youth
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Health Promotion Activities (Cont.)
Prevent underage drinking
Assist with enforcement of legal drinking age
Identify individuals and groups at risk of abuse and dependence
Educate adults and youth on dangers of alcohol
Requires a community-wide effort to address the problem on several fronts
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Diet and Health
Diet—one of most modifiable risk factors
Imbalance of caloric intake and physical activity
Complex interplay among metabolism, genetics, behavior, environment, culture, and socioeconomic status
Geographic areas, age, ethnicity all influence weight
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Health Promotion Activities (Cont.)
Special populations have different nutritional needs
For individualized plans, see http://myplate.gov/
Educate clients about:
Balancing caloric intake and physical activity
Servings vs. portion control
Eating away from home affects “portion distortion”
Using social media and mobile applications to help
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Physical Activity and Health
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Physical activity serves both health promotion and disease prevention purposes
Leisure activities are influenced by level of education, gender, age, economic level, geography
One’s environment plays a significant role in activity level
Health Promotion Activities (Cont.)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Support and develop “walkable” neighborhoods and cities
Determine recommended exercise levels for individuals
Visit http://www.cdc.gov/physicalactivity/data/facts.html
Sleep and Health
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Sleep is an essential component of chronic disease prevention and health promotion
Requirements change with age and life circumstances
Regulated by waking time and circadian rhythms
Hormones during sleep affect memory, blood pressure, and kidney function.
Health Promotion Activities (Cont.)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Sleep assessment is important
Identify disorders that may affect daily activities
Keep sleep log
Practice sleep hygiene
Establish environment that promotes sleep
Avoid food and activities that interfere with sleep
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