1. M 4225 Science of Health Promotion & Disease Prevention Health Promotion Basics

2. What is Health??? traditional medicine - absence of disease traditional medicine - absence of disease WHO (1947) – complete physical, mental & social well-being, not merely absence of disease and infirmity WHO (1947) – complete physical, mental & social well-being, not merely absence of disease and infirmity Murray & Zentner – state of well-being (where)…person uses purposeful, adaptive responses…to maintain relative stability and comfort Murray & Zentner – state of well-being (where)…person uses purposeful, adaptive responses…to maintain relative stability and comfort strive for personal objectives & cultural goals strive for personal objectives & cultural goals

3. Gorin and Arnold antithesis of disease (dis-ease) antithesis of disease (dis-ease) balanced state balanced state growth growth functionality functionality goodness of fit goodness of fit wholeness, well-being wholeness, well-being empowerment and transcendence empowerment and transcendence

4. G&A : Healthy Behaviors smoking cessation smoking cessation eating well eating well physical activity physical activity sexual awareness sexual awareness injury prevention injury prevention substance safety substance safety oral health oral health self development self development productivity productivity

5. Healthy People 2000 US federal program with 3 goals & 22 areas of risk reduction : US federal program with 3 goals & 22 areas of risk reduction : increase healthy life span increase healthy life span decrease health disparities decrease health disparities universal access to preventive services universal access to preventive services 1995 progress report : 1995 progress report : 50% objectives moving toward target 50% objectives moving toward target 18% moving away from target 18% moving away from target 3 % no change 3 % no change 29% QNS 29% QNS

6. Health People 2010 prevention agenda for the US with 28 areas of focus; 2 major goals prevention agenda for the US with 28 areas of focus; 2 major goals increase quality & quantity of healthy life increase quality & quantity of healthy life eliminate health disparities eliminate health disparities leading health indicators leading health indicators physical activity physical activity overweight & obesity overweight & obesity tobacco use tobacco use substance abuse substance abuse responsible sexual behavior responsible sexual behavior mental health mental health injury and violence injury and violence environmental quality environmental quality access to health care access to health care

7. Criteria for Health Promotion Programs address carefully defined, modifiable risk behaviors that are measurable in target group address carefully defined, modifiable risk behaviors that are measurable in target group reflect consideration of special characteristics, needs & preferences of target reflect consideration of special characteristics, needs & preferences of target effective and appropriate for setting effective and appropriate for setting make optimum use if available resources make optimum use if available resources organized and implemented so effect & outcomes can be measured and evaluated organized and implemented so effect & outcomes can be measured and evaluated

8. Health Promotion Theories emerging field emerging field previously, behavioral and social science theory most common previously, behavioral and social science theory most common focus on individual and ID-ing and quantifying determinants of behavior focus on individual and ID-ing and quantifying determinants of behavior health belief models health belief models theory of reasoned action theory of reasoned action

9. Assumptions about individual-level determinant theories individual is decision maker individual is decision maker good health is valued; will change behavior to prevent bad health good health is valued; will change behavior to prevent bad health all behavior is volitional all behavior is volitional cognitive predispositions drive health behaviors cognitive predispositions drive health behaviors research evidence does indicate that these theories are effective research evidence does indicate that these theories are effective

10. Process of change…. pre-contemplation pre-contemplation no plans to change ever! no plans to change ever! contemplation contemplation increasing awareness of need for change increasing awareness of need for change preparation preparation planning to take action….soon…. planning to take action….soon…. action action steps taken to modify a behavior or environment steps taken to modify a behavior or environment maintenance maintenance consistent engagement in new behavior consistent engagement in new behavior

11. Change may be facilitated or pushed by crisis…. a dis-equilibrium a dis-equilibrium emotional and cognitive, where old/usual coping mechanisms and/or problem solving skills ineffective emotional and cognitive, where old/usual coping mechanisms and/or problem solving skills ineffective developmental/predictable vs. accidental/situational developmental/predictable vs. accidental/situational identifiable points in life cycle where new coping skills and problem solving necessary identifiable points in life cycle where new coping skills and problem solving necessary unexpected accidents necessitating new coping skills unexpected accidents necessitating new coping skills

12. Antecedents of crisis theory… Lindemann Lindemann precursor of PTSD; also grieving stages precursor of PTSD; also grieving stages Caplan Caplan transitional period, self limiting to 4-6 weeks transitional period, self limiting to 4-6 weeks context of event important context of event important intervention most successful at height of crisis intervention most successful at height of crisis Aquilera and Messick Aquilera and Messick balancing factors include realistic perception of problem, amount and quality of social support and caliber of coping mechanisms balancing factors include realistic perception of problem, amount and quality of social support and caliber of coping mechanisms

13. Other emerging models precaution adoption/transtheoretical precaution adoption/transtheoretical steps of decision-to-take-precautions process ~ previously un-identified threat steps of decision-to-take-precautions process ~ previously un-identified threat information-motivation-behavioral skills information-motivation-behavioral skills helps understand factors which influence choices about health behaviors helps understand factors which influence choices about health behaviors elaboration likelihood elaboration likelihood framework for understanding attitude formation and change facilitation framework for understanding attitude formation and change facilitation authoritative parenting authoritative parenting not authoritarian – good for adolescents engaged in risky behaviors not authoritarian – good for adolescents engaged in risky behaviors

14. food for thought……. food for thought……. how does the concept of boundaries – separation of personal and professional ideas and beliefs – affect health promotion and disease prevention? how does the concept of boundaries – separation of personal and professional ideas and beliefs – affect health promotion and disease prevention? do nurses have an edge in health promotion and disease prevention activities? Why or why not? do nurses have an edge in health promotion and disease prevention activities? Why or why not?