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Health Promotion

• It helps people gain more control over their health
• It encompasses health, wellbeing, disease, and illnesses
• It aims to strengthen individual skills and capabilities and implement broader change
• Participation is essential for health promotion

Population Health

• It involves the health outcomes of a population and the distribution of these outcomes

Patient Education

• It equips patients and families with education for informed decisions
• It supports participation in healthy living

Leadership

• It is an interactive process to provide guidance
• Nursing involves leadership when addressing patient care
• It requires a situation, a leader, and followers

Communication

• It is an interaction process that exchanges symbols to create meaning

Collaboration

• It is a partnership for optimal outcomes, considering patient, family, and community needs

Strengths-Based Nursing

• It promotes empowerment, self-efficacy, and hope in patient care
• The focus is on individual strengths

Core Values

• The eight core values includes health and healing, uniqueness, holism, subjective reality and creative meaning, people and environment, self-efficacy, learning/time/readiness and collaborative partnership

Social Determinants of Health

• Health is influenced by circumstances and environment
• Social, environmental, and economic factors impact individual and population health
• Specific determinants includes: income, education, employment, childhood experiences, physical environment, social support, healthy behaviors, access to services, genetics, gender, culture, and race/racism

Health Disparities

• They are unavoidable differences in health status among populations
• An example would be a population being prone to heart disease or obesity
• Healthcare disparities pertains to access and availability of healthcare services
• Health status involves varying rates of disease occurrences across populations

Health Inequalities

• They are unfair circumstances stemming from unequal distribution of social determinants of health
• An example would be lower income individuals being less likely to own a home
• People in rural areas have less access to nutritional foods

Health Equality

• It is the absence of disparities or avoidable differences in health status and outcomes
• It means there is no increased disease rate in a population

Social Justice

• It is the equal distribution of society’s benefits
• It addresses the root causes of inequalities
• Social injustice has a large negative impact

Canada Health Act

• It is federal legislation for healthcare delivery, passed in 1984
• It promotes fairness in healthcare access
• It is based on five principles which are public administration, portability, universality, accessibility, and comprehensiveness

Alma ATA (WHO/UNICEF Report)

• Argued for governments to collaborate in protecting the health of all people

Ottawa Charter (1986)

• It outlined five strategies for achieving "health by the year 2000"
• It emphasized the impact of environment on health and self-care

Ottawa Charter Strategies

• Strengthening community action means encouraging public involvement
• Creating public health policy requires health-conscious rules
• Creating supportive environments involves safe spaces for work and play
• Developing personal skills involves educating people for informed decisions
• Reorienting healthcare shifts focus from illness to prevention

Epp Report/Framework

• Aimed to achieve health for all

Three Challenges

• Current healthcare practices and policies have challenges with: disadvantaged groups, preventable disease decrease and chronic illness/ lack of community support

Shifting Paradigm Conference

• It challenged western medicine

Two Ideas

• This challenged western medicine and gave rise to two ideas which are self responsibility for health as well as health and lifestyle being affected by social structure and conditions

Beyond Health Care Conference

• It brought health promotion into the political arena

Two Ideas

• The Beyond Health Care Conference also gave rise to two ideas which are health in public policy as well as health in cities and community projects

Population Health Model

• It involves three main questions which are with whom, on what and how

Lalonde Report (1974)

• It offered a new perspective on health for Canadians
• It shifted focus from biomedical to behavioral factors
• It focused on lifestyle and populations

Four Key Areas

• The four key areas include human biology, lifestyle, environment and healthcare organization

Health Belief Model (Rosenstocks)

• It was made to explain individual decisions on health screening
• It focuses on the individual in understanding beliefs about health

Three Primary Points

• Key considerations include: individual perception of disease susceptibility and severity, the belief that illness can be avoided through action and the belief in one's ability to make necessary changes

Health Promotion Model (Pender)

• It addresses behavior change and health practices
• It focuses on optimizing wellness instead of avoiding illness

Social Cognitive Theory (Bandura 1997)

• The theory emphasizes the impact of beliefs on healthy behaviors
• An example would be parents modeling behaviors to their children

Transtheoretical Model of Change

• It is also known as the stages of change model
• It identifies a person's readiness for behavior change
• It acknowledges relapse as part of the process

Stages of Transtheoretical Model of Change

• Pre-contemplation involves not considering behavior change
• Contemplation involves thinking about change within 6 months
• Planning involves starting to change or seriously thinking about it in the next month
• Action involves concrete behavior change, sustained for 6 months
• Maintenance involves sustaining the change for 6 months after the initial change

Diffusion of Innovation Model

• Individuals adopt innovation at varying rates
• People are likely to adopt ideas that are compatible, flexible, reversible, simple, and cost-effective

Five Categories

• The model includes: innovators (quick adopters), early adopters (keeners), early majority, late majority and laggers (resistant to adopting the innovation)

SMART Goals

• Goals should be specific, measurable, achievable,realistic and time-phased

Protection-Motivation Theory (Ronald 1975)

• Behavior is influenced by beliefs, social norms, networks, and policies
• It relies on health belief model focusing on fear as an influence for change
• An example would be social marketing like stop-smoking campaigns

Code of Ethics for Nursing

• It provides guidance for ethical relationships, behaviors, and decision-making
• It addresses responsibilities, proper care, and barriers to service
• It offers ethical bases for nurses to advocate

Biomedical Approach

• Health is defined by the absence of illness
• Health promotion strategies can include vaccinations

Behavior Approach

• The Lalonde Report places responsibilities for health on individuals
• Success comes with anti-smoking and exercise campaigns

Socio-Environmental Approaches

• They consider factors beyond the individual and recognises the complexity of health.
• SDOH are a key element in this approach

Primary Health Care

• It involves essential healthcare accessible to individuals, families, and communities
• The system is built on the foundation of Canada's healthcare
• It emphasizes continuity of care
• It is a model for improving healthcare access, with emphasis on health promotion and disease prevention

Examples in NL

• Examples include 811, collaborative clinics, cancer patients navigator and community based services

Benefits

• A team approach improves care and the healthcare team has an improved understanding of what other healthcare providers do
• Improved access to services

Barriers

• Individual level barriers
• Practice level barriers
• System level barriers

Principles

• Accessibility
• Public Participation
• Health Promotion
• Appropriate Technology
• Intersectional Collaboration

Primary Care

• It focuses on personal health services

Five Types of Care

• Promotive
• Preventive
• Curative
• Rehabilitation
• Supportive/ palliative

Social Marketing

• It is a process that aims to influence the acceptability of a social idea or cause through planned processes of change.
• These programs are designed to influence voluntary behavior change in a targeted population to improve their well-being and society
• Social marketing is a strategy for health promotion that is not advertising

Steps for Social Marketing

• Identify behavior that requires change
• Identify the change to be made
• Identify true barriers to change
• Reduce those barriers
• Pre-test ideas on small group

The 4 P's of Social Marketing

• Products (what is being promoted)
• Price (time/effort, risk/embarrassment)
• Place (where will the product reach consumers)
• Promotion (persuasive communication, has 2 components: messages, tactics)

Other P's of Social Marketing

• Partnerships
• Policy
• Politics

Challenges of Social Marketing

• Measuring outcomes before change occurs
• Measuring unintended outcomes
• Failing

Primordial Prevention

• It is the newest level of prevention that addresses risk factors
• An example would be healthy eating programs and creating bike/walking paths in schools

Primary Prevention

• It involves health promotion
• An example would be vaccines

Focus of Prevention

• Maintaining/improving the general health of individuals, families and community, reducing threats to health and encouraging lifestyle change

Secondary Prevention

• It focuses on early detection because earlier treatment is more favorable to limit disability from disease
• Examples would be mammograms and pap tests

Tertiary Prevention

• It focuses on rehabilitation to restore function and prevent further injury
• An example would be cardiac rehab after MI, turning every 2h to prevent pressure sores