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Health Promotion and Risk Reduction

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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