What is policy development?use of information gathered during assessment to develop local and state health policies and and to direct resources toward those policiesWhat is assurance?Focuses on availability of necessary health services throughout the community. Includes maintaining ability of both public health agencies and private providers to manage day-to-day operations and the capacity to respond to critical situations and emergenciesWhat are the three levels of health prevention?primary, secondary, tertiaryWhat is primary prevention?Prevention of problems before they occur Health promotion and health protectionWhat is secondary prevention?Early detection and intervention Early diagnosis and treatmentWhat is tertiary prevention?Correction and prevention of deterioration of a disease state Limitation of disability and rehabilitationWhat are the three levels of the PHN intervention wheel?- system - community - individual/familyWhere did biological warfare begin?siege of KaffaWhat was the first written health code?LeviticusWho discovered vaccination?Edward JennerWho discovered how cholera was transmitted?John SnowWhat did Luis Pasteur do?- theory of existence of germs - discovered immunizations in 1881 - discovered rabies vaccine in 1885Who discovered the causative agent for cholera and the tubercle bacillus in 1882Robert KochWho had surgical success with wound care?Joseph ListerWhat was the purpose of the house on Henry St.?community people undeserved to help and learn how to care for themselvesWho founded the house of Henry St.?Lilian WaldWhat is an aggregate?community composed of people who have common characteristicsTrue/false: people can be a part of multiple aggregatesTrueWhat is community of solution?common problem unites individualsWhat is a geographic boundary?location delineated by boundaries and influenced by the passage of time (EX: nicknames for things, people come and go)Are geographic boundaries subjective or objective?SubjectiveWhat are geopolitical boundaries?political boundaries. Includes census tracts that subdivide larger communities (EX: city limits)Are geopolitical boundaries subjective or objective?ObjectiveWhat is phenomenological community?Place, but group has a lot in common EX: churchDifference between open and closed phenomenological community:open- no rules/regulations closed- rules/regulations for being part of communityWhat is a social system?interrelationships of aggregates fulfilling community functions (have common interest goals and characteristics)What is gentrification?Process by which character of a poor urban area is changed by wealthier people moving in, improving housing, and attracting new businesses, typically displacing current inhabitants in the processWhat is the defining characteristic of healthy communities?resiliency; interconnectednessWhat are the two types of data collection:Primary: collection of direct data; collect it yourself Secondary: Collection of reported/existing data (public documents/health surveys)What is a metropolitan area?a major city and its surrounding suburbsWhat are vital statistics?The vital statistics include births, deaths, marriages and divorces, spontaneous fetal deaths, and abortions.What is the difference between downstream and upstream thinking?Downstream: only focused on immediate care Upstream: actions focused on modifying economic, political, and environmental factors that are precursors of poor healthWhat is Orem's Self-Care Deficit Theory?Microscopic approach. Nursing is a response to a person's incapacity to care for themselves self due to health; based on the assumption that self-care needs and activities are the primary focus of nursing practiceWhat is the health belief model?Focus on the individual as the locus of change. Based on the assumption that the major determinant of preventative health behavior is disease avoidance (oh no I am threatened → oh no I should do something about it)What is Milio's Framework for Prevention?provides a mechanism for directing attention upstream and examining opportunities for nursing intervention at a population levelWhat is community focused health intervention?Working in the community (kinda downstream)What is systems focused heath intervention?preventing thing to start with (providing classes at school; health policy/tax stuff)What are the microscopic theories of theoretical approaches?- Orem's self care deficit - Health belief modelWhat is the macroscopic theory in theoretical approaches?Milio's framework for preventionWhat is the difference between health promotion and health protection?Promotion: helping people do better Protection: behaviors that have specific intent to prevent disease or injuryWhat is Pender's Health Promotion Model (HPM)?Biopsychosocial factors influencing the pursuit of health-promoting behaviors Doesn't use threats to motivateWhat is the difference between Penders health promotion model and the health belief model?The belief model is more of a reaction to a perceived threat of disease, while Penders is looking at all perspectives and making an action plan. Health belief model looks at changing person's belief about their healthWhat is the health belief model?As individuals take greater investment in their health they are more likely to make relevant and meaningful behavior changes. Must feel that the risks outweigh the benefits.What is risk?probability a specific event will occur in a given time frameWhat is a risk factor?any attribute, characteristic or exposure of an individual that increases the likelihood of developing a disease or injuryWhat is a risk assessment?a systematic way of distinguishing the risks posed by potentially harmful exposuresWhat is risk reduction?Activities directed towards enhancing protective behaviors and avoid risksWhat are the social determinants of health?conditions in which people are born, grow, live, work and age - Neighborhoods/built environment - Economic stability - Health and healthcare - Education - Social and community contextWhat are broad determinants of health?Biology Behaviors Social/physical environment Policies and interventions Access to high-quality healthcare Income and social status Working conditions Support networks Coping skills Community context Education Social capital NutritionWhat is the leading cause of preventable death?tobacco useWhat are the alcohol guidelines for men and women?1 drink/day women 2 drinks/day menWhat is epidemiology?study of distribution and determinants of health-related states or events in specified populations and the application of this study to the control of health problemsWhat are analytic epidemiology studies?investigates the cause of disease by determining why a disease rate is lower in one population than in another - cause/effect relationship between a preexisting eventWhat are descriptive epidemiology studies?The study of the amount and distribution of disease - Person/place/timeWhat are the three types of observational studies?- cross-sectional - Retrospective - Prospective/longitudinalWhat is a cross-sectional study?examine relationships between potential relationships and disease at a specific time (EX: nutrition studies linking to disease)What is a retrospective study?compare individuals to a particular condition or disease to those who don't have disease (EX: tobacco and lung cancer- compare the lifestyles of those who have lung disease to those who don't)What is a prospective/longitudinal study?monitors a group of disease-free individuals to determine when and where disease occurs (EX: follow individuals from like the 70s to determine heart disease risk throughout lifetime)What is a type of analytical study?Experimental studies (RCT)- apply experimental methods to evaluate strategies for treatment and preventionWhat is descriptive epidemiology?focuses on amount and distribution of health problems within a populationWhat is the purpose of descriptive epidemiology?to describe people who are protected from disease and those who have disease - Looks at multiple demographic factors and geographyWhat are the components of the epidemiologic triangle?- host - agent - environmentWhat is the wheel model and what is it used for?- multiple causation model - chronic condition analysisWeb of Causation ModelInteraction among many variables creates a more powerful combination of factors that predispose the person to illnessRate Calculationrate=number of health events is a specified period/population in the same area in the same specified period Rates: arithmetic expressions that help practitioners consider a count of event relative to the size of the population from which it is extractedWhat are the two types of morbidity rates?1. Incidence rates 2. Prevalence ratesWhat is incidence rate?the ratio of new cases of the disease to the total number of people at risk per unit of timeWhat is prevalence rate?Proportion of the population affected by a disease at a specific point in timeWhat is a prevalence point?the number of people with a specific disease at a specific point in time (Prevalence rate(P))= Incidence (I) x Duration (D) (any alteration in incidence or duration changes the prevalence)What is crude death rate (CDR)?The total number of deaths in a year for every 1,000 people alive in the society.What is crude birth rate (CBR)?The total number of live births in a year for every 1,000 people alive in the society.What is age-specific rate?# of cases per age group of a populationWhat are intrinsic risk factors?internal factors (EX: genetic, asthma)What are extrinsic risk factors?environmental exposuresWhat is attributable risk?Estimate of disease burden in a populationExamples of health promotion (primary prevention):General in nature/foster healthy lifestylesExamples of specific protection (primary prevention):aimed at reducing the risk of specific diseaseExamples of secondary prevention:health screenings (diabetes, high blood pressure, self examinations)Examples of tertiary prevention:- pts with spinal cord injuries- limit permanent disability - Chronic CHF- medications, exerciseSix criteria for cause and effect relationship for definitive causality:1. Strength of association (people who work in a factory are more likely to get lung cancer) 2. Dose-response relationship (more that worked in a certain area of factory had higher exposure to chemicals that caused lung cancer) 3. Temporally correct relation (factory changed product in last 12 months causing increase of lung cancer) 4. Biological plausibility (how likely is it that the chemical causes lung cancer- compare to lung cancer research studies) 5. Consistency with other studies 6. Specificity (is it specific to this population)True/false: it is rare to establish definitive causalityTRUE; most often establish possible causalityWhat is surveillance?- Ongoing collection of community health information - Monitoring changes in prevalence and incidenceSynonymous with causal factors:risk factorsComponents of the health belief model:Perceived susceptibility- obesity puts me at risk for heart dz Perceived impact- heart dz will impede my ability to work Perceived advantage of change- greater mobility appraisal of barriers- i hate exercise self efficacy- conviction that you can successfully do the thing that produces outcomes "i can join the gym close to work"Components of Penders health promotion model:- based on individual characteristics and experience prior behaviors - behavior specific cognitions and affect-activity related affect, situational factors, perceived benefits of health promoting behaviors, perceived barriers to health promoting behaviors, commitment to plan of action, immediate competing demands and preferencesWhat are CLAS standards?National standards for culturally and linguistically appropriate healthcareWhat is the framework for developing health communications?1. planning/ development 2. Developing and pretesting concepts, messages, and materials 3. Implementing the Program 4. Assessing effectiveness and making adjustmentsWhat are the 5 spheres of empowerment?- Interpersonal (individual) - Intragroup (small group) - Intergroup (community) - Interorganizational (Coalition building) - Political ActionWhat is health literacy?- being able to read and write at 5th-grade level - A constellation of skills needed to perform basic reading tasks required to function in a healthcare environment for accessing, understanding, and using health information to make informed decisionsWhat are the 7 areas of environmental health?1. Built environment 2. Work-related exposures 3. Outdoor air quality 4. Healthy homes 5. Water quality 6. Food safety 7. Waste managementWhat is the built environment?Things that we have altered in our environment; things we have "built"What are work-related exposures?- Poor working conditions that result in potential injury or illness - Occupational health nurses collaborate to reduce and eliminate work-related exposures, illness, and injuriesWhat is sick-housing syndrome?when at environment, you feel sick. You feel better when not in particular environmentWhat is the leading cause of lung cancer in non-smokers?Radon gasWhat are some problems with the US water supply?- Sediment from construction, agriculture, and deforestation is often present - Underground water, if contaminated, cannot be cleansed - Many aquifers are contaminated with pesticides and fertilizers - More than 45 million Americans drink untreated waterWhat are the core competencies of environmental health?Assessment Management Communicationcommunity-based nursingthe provision of acute care and care for chronic health problems to individuals and families in the communitycommunity health nursingnursing practice in the community, with the primary focus on the health care of individuals, families, and groups in a community. The goal is to preserve, protect, promote, or maintain healthExamples of community based nursing:Occupational health nursing School nursing Home health Hospice Parish nursingExamples of community health nursing:Synthesis of nursing practice in public Population health Health promotion/disease prevention populations

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