Health Promotion

Health and Wellness Continuum

• The illness–wellness continuum, developed by John W. Travis, is a tool used to understand health
• The continuum displays health and illness, and the right side shows a high level of health and wellness
• The other side illustrates illness and poor health, including death
• The middle of the continuum is a neutral zone without either wellness or illness

Health Promotion Strategies

• The World Health Organization (WHO) defines health promotion as empowering people to increase control over and improve their health
• Interventions for health improvement can be national or individual
• The U.S. government uses Healthy People objectives and laws to promote national health
• Healthcare providers aim to improve individual client health
• Governments implement policies and fund science-based communication strategies to enhance public health
• Taxing unhealthy products like alcohol and tobacco decreases their use
• Workplace safety equipment policies reduce injuries
• Laws to create community parks and trails promote exercise
• Public health campaigns address seatbelt use, opioid overuse, and diabetes awareness
• Health campaigns are delivered through print, radio, television, and digital platforms
• The CDC's anti-smoking campaign uses real-life stories to deter tobacco addiction
• Statistics show a decline in tobacco usage, indicating campaign success

Health Education

• Healthcare providers promote health education, such as focusing on reducing heart disease incidence
• Education includes informing individuals about the risks of being overweight, consuming high saturated fats and salt, and not exercising
• Lifestyle changes are promoted by reviewing information and providing follow-up materials

Healthy People Initiative

• The U.S. Department of Health and Human Services (DHHS) established Healthy People to improve Americans' health
• The program's website offers current and past health data, goals, and resources
• DHHS sets new decade-long goals every 10 years using gathered data
• Principles guiding Healthy People 2030 include:
  • A framework for foundational principles
  • Development of overarching goals
  • Action plan construction
  • Providing historical context for healthy American habits
• Public access to data on American health trends and issues from the past 10 years
• Tools for health professionals to use with clients and communities
• Interactive access so that the public can use the information
• Communities use the information to identify valuable and relevant issues
• Groups and individuals set goals for improved health
• The public selects Healthy People objectives fitting their needs to improve health
• Since 1979, the initiative has lowered health issues like heart disease, cancer, and infant mortality
• Healthy People ensures data transparency to impact health
• A long-term goal is for the U.S. to lead in population health and reduce obesity and chronic diseases

Self-Care

• Knowledge and health literacy are increased, improving the understanding of health, wellness, and disease
• Mental well-being and self-awareness are achieved
  • Measures are implemented to improve life satisfaction and awareness of one's health status
• Physical activity is included through moderate exercise several times a week
• Healthy eating habits include nutritious food intake
• Risk avoidance is key through vaccinations, safe sex practices, avoiding tobacco and limiting alcohol
• Good hygiene is maintained through handwashing, dental care, and washing foods
• Rational use of products and services includes safe use of prescription and nonprescription medications

Nurse Self-Care

• Nurses have extensive health knowledge but may neglect their own lifestyle choices and self-care
• Paradoxes stem from demanding work environments including:
  • Long hours
  • Few breaks
  • Stress
  • Unpredictable eating and sleep patterns
  • Lack of exercise
• Harvard Medical School and Brigham and Women’s Hospital's Women’s Health Study highlighted work-health imbalance in nurses over 20 years
• The health of nurses is affected by many factors, and ongoing efforts are needed to improve nurse health in the workplace and individually
• The atmosphere for healing is not conducive to the health of the nurses themselves
• Workplace conditions can produce:
  • Physical strain
  • Mental strain
  • Back injuries
  • Relationship problems -Coping issues
• Caring for children and families when not working causes fatigue and poor self-care
• Prioritizing self-care and self-awareness is vital, like caring for clients
• The American Nurses Association (ANA) emphasizes “taking positive and sustainable action” for lifelong habits to improve mental and physical health
• Strategies include:
  • Healthy snacks and meals for work
  • Daily exercise
  • Stress-reduction techniques
  • Connecting with others
  • Adequate sleep

Risk Factors

• Risk factors are conditions that increase the likelihood of developing a disease
• Risk factors can be modifiable or nonmodifiable
• Educating clients about their health risks promotes health and disease prevention

Modifiable Risk Factors

• Interventions and education can impact many diseases by addressing modifiable risk factors
• WHO has identified three common modifiable risk factors responsible for most chronic diseases:
  • Unhealthy diet
  • Lack of exercise
  • Tobacco use
• Educating and motivating clients to change these behaviors lowers risk of:
  • Heart disease
  • Stroke
  • Cancer
  • Chronic respiratory disease
  • Diabetes

Nonmodifiable Risk Factors

• Education on nonmodifiable risk factors includes preventive screening, such as:
  • Colonoscopies
  • Blood pressure checks
  • Cholesterol tests
  • Mammograms
• Risk factor awareness increases compliance with medical screening and detection
• Early recognition and treatment improve health outcomes

Environmental Factors

• The environment is an external factor impacting health
• Elements affecting health include:
  • Air and water quality
  • Toxic pollutants
  • Hazards
  • Waste
  • Safety of homes, workplaces, and schools
• Healthy People includes objectives to decrease these risks to public health
• The quality of air, drinking water, and recreational waters affects health
• Diminished air quality from exhaust, wildfires, cigarette smoke, and ozone depletion
• Populations with poor air quality have higher rates of asthma, respiratory infections, lung disease, strokes, and heart disease
• Waterborne disease outbreaks arise from contaminated water
• Indoor environments must be safe, since people spend time at home, work or school
• Concerns include:
  • Poor indoor air quality
  • Heating and sanitation
  • Electrical and fire hazards
  • Structural safety
  • Lead paint
• Compromised indoor air quality results from cockroaches, mice, or radon (gas) and lead
• Children under six are at risk for lead poisoning from lead-based paints
• Dust from lead sources enters the body
• Lead exposure causes:
  • Learning disabilities
  • Lower intelligence rates
  • Speech and hearing difficulties
  • Growth delays
  • Behavioral issues

Socioeconomic Factors

• Poverty negatively impacts health outcomes
• Low-income clients report poor health and have higher rates of:
  • Stroke
  • Heart disease
  • Diabetes
  • Other chronic diseases
• Poverty increases stress, anxiety, and depression
• Low-income individuals have less:
  • Health insurance
  • Ability to afford treatments
  • Access to healthcare providers
• This population has more modifiable risk factors like:
  • Smoking
  • Obesity
  • Substance abuse
  • Sedentary lifestyle
• Poor neighborhoods lack access to:
  • Fresh foods
  • Green spaces
  • Educational opportunities
• These communities have higher rates of:
  • Violence
  • Unemployment
  • Lack of basic housing

Health Literacy

• Literacy is the ability to read and comprehend written text
• Health literacy is the ability to process health information for appropriate healthcare decisions
• Half of all healthcare clients have difficulty understanding health information and are “health illiterate.”
• Limited health literacy can affect:
  • Following medication instructions
  • Self-care actions
  • Follow-up appointments
• It also reduces understanding of health teachings

Cultural Beliefs

• Cultural beliefs can impact:
  • Adherence to medication plans -Preference for alternative treatment methods
  • Decision for withdrawing care
  • Communication styles
  • Who makes health decisions in the family
  • Expression of pain
  • Seeking care for pain
• Nurses must avoid stereotypes and ask about clients’ cultural preferences
• Understanding values builds trust and enhances quality care
• Nurses should examine their cultural beliefs to identify biases

Family Dynamics

• Family relationships influence health
• Family members play a role in decision-making and home care
• Relationship status impacts coping and stress levels
• Institute of Medicine recommends patient- and family-centered care (PFCC) for all ages
• PFCC involves clients and support systems in planning interventions
• “Family” includes those biologically, legally, or emotionally related
• Clients define their family and involvement in care
• Families can provide insight into cultural and societal factors that impede self-care
• Family education improves compliance, recommendations, and outcomes

Prevention

• Prevention includes primary, secondary, and tertiary prevention levels

Quaternary Prevention

• Quaternary prevention protects clients from excessive medical interventions that can cause harm
• It involves medical tests, medications, and treatments that don't benefit clients
• Broad screening of asymptomatic clients without risk factors may yield abnormal results
• Withdrawal post-treatment initiation can be difficult, regardless of whether intervention was needed
• Clients without risk factors or symptoms might not benefit from treatment

Risk Assessment

• Risk assessment involves analyzing risk factors to identify possible modifications

• Mutually agreeable goals are adopted, and support systems are identified for the client

• Clients are referred to educational, community, or support resources to help

  • Recognize benefits
    • (e.g., not smoking reduces the risk of lung cancer
  • Overcome barriers
    • (e.g., covering healthful pursuits costs)

• Advocacy for changes in the community

• Using behavior- change strategies to identify: -Client readiness -Acceptable interventions

• Promoting healthy lifestyle behaviors:

  • Stress management strategies
  • Adequate sleep and rest
  • Nutritious diet
  • Avoid saturated fats
  • Regular physical activity
  • Protective clothing, sunscreen, and avoiding sun exposure
  • Safety gear for physical activity
  • Avoiding tobacco, alcohol, and illegal drugs
  • Safe sex
  • Seeking necessary medical care
  • Recommended self-examinations