Chapter 9: Planning for Community Change
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Chapter Highlights #1
Health planning at the state, national, and global levels
Social and environmental determinants of health
Social ecologic model and multilevel interventions
Community coalitions
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Chapter Highlights #2
Health impact pyramid
Health equity and social justice
Lewin’s change theory, force field analysis, and levers of change
Logic models
Role of the community health worker
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Chapter Highlights #3
Funding community health interventions
Evaluating community health interventions
Nurse-managed health centers
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Question #1
Is the following statement true or false?
Health planning occurs on both an ongoing and an episodic basis.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Answer to Question #1
True
Rationale: The timing of health planning depends on the responsibilities of the planning agency, the type of assessment data, and the nature of the health problem.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Health Planning
Organized and systematic process in which problems are identified, priorities selected, and objectives set for the development of community health programs based on the findings of community health assessments and health surveillance data.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Common Themes
Common themes of current national and international health plans include providing health promotion and disease prevention at the population level, addressing social determinants of health, and achieving health equity.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Levels of Health Planning
Global
National and state levels
Healthy People 2020
National Prevention Strategy
State Departments of Public Health
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Community Health Improvement Planning Process
Systematic process that involves all sectors of a community to conduct a comprehensive community health assessment (CHA), identify priorities for action, develop and implement a community health improvement plan (CHIP), and guide future community decisions and resource allocations.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Community Assessment
Systematic process that may use several approaches including key informant interviews, analysis of data on health status and health behavior indicators, observation, and community surveys.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Systems Theory
Social systems engage in reciprocal exchange or flows of information, energy, resources, and goods or services. Systems within the community are interdependent and interconnected.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Working With the Community
Defining the population of interest
Coalitions
Stakeholders and opinion leaders
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Social Ecologic Model
Based on general systems theory and health promotion theory
Multiple determinants of health interact at different levels to affect the health status of individual people, population aggregates, or communities.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Question #2
Is the following statement true or false?
The purpose of using levers of change is to decrease driving forces and/or to increase restraining forces.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Answer to Question #2
False
Rationale: The purpose of using levers of change is to increase driving forces and/or to decrease restraining forces.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Health Impact Pyramid
Useful framework for community health nurses when planning health promotion interventions at multiple levels
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Multilevel Interventions
Multilevel interventions are needed to achieve change in complex community health conditions that have multiple determinants.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Social Determinants of Health
Obesogenic and salutogenic environments
Health impact assessment
Health disparities, health equity, and social justice
Community empowerment model
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Change Theory
Lewin’s Model of Change
Unfreezing
Changing
Refreezing
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Force Field Analysis
Force field analysis is a tool used to identify the forces driving or restraining change.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Levers of Change
The purpose of using levers of change is to increase driving forces and/or to decrease restraining forces.
Public policies such as tax increases on tobacco, alcohol, or soft drinks can serve as policy levers to bring about change in community health status.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Community Readiness for Change
Planning programs or interventions to change community health status include an assessment of the community’s readiness to undertake the change process related to a specific health issue.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Planning Community-Level Interventions
Guide to community preventive services
Logic model
SMART objectives
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Collaboration and Teamwork
Community health workers can help bridge the gap between the community health nurse and the community, especially when there are cultural and language differences.
Nurses can play an important role in their professional and personal lives as advocates and champions for health improvement, social justice, and health equity at the local, regional, national, and global levels.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Evaluating Community-Level Interventions
Develop evaluation questions.
Determine indicators or measures you will use to answer your evaluation questions.
Identify where you will find the data you need to measure your indicators and answer your questions.
Decide what method you will use to collect data.
Specify the time frame for when you will collect data.
Plan how you will analyze your data based on the type of data you are using.
Decide how you will communicate your results.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Funding Community-Level Intervention Programs
Accountability
Sustainability
Program replication
Project funding
Government
Private
Local
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Community Benefit Programs
Community benefit programs of local or regional hospitals and HMOs may be valuable partners to the public health department or community health nurse in planning, implementing, and funding programs to improve population health.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Social Marketing
Use of marketing principles and practices to change health behaviors or beliefs, social or cultural norms, or community standards to improve health or benefit society
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Nurse-Managed Health Centers
Nurse-managed health centers provide health promotion and primary care services to vulnerable and underserved population aggregates.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Chapter 8: Gathering Evidence for Public Health Practice
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Chapter Highlights
Epidemiologic/public health research defined
Observational studies: Descriptive versus analytical research
Strengths and limitations of epidemiologic research methodology
Applying epidemiologic research to public health nursing practice
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Question #1
Is the following statement true or false?
In descriptive studies, the researcher relies on comparisons between groups to determine the role of various risk factors in causing the problem.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Answer to Question #1
False
Rationale: In analytical studies, the researcher relies on comparisons between groups to determine the role of various risk factors in causing the problem. In descriptive studies, the researcher collects information to characterize and summarize the health event or problem.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Epidemiologic Research
Epidemiologic/public health research can be descriptive or analytical. Study designs are based on the problem under study and range in strength on a continuum, with the weakest design being the retrospective design and the strongest being the experimental design.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Observational Studies
In descriptive studies, the researcher collects information to characterize and summarize the health event or problem.
In analytical studies, the researcher relies on comparisons between groups to determine the role of various risk factors in causing the problem.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Descriptive Studies
Descriptive studies are most frequently used in public health research. They may be observational or analytical
Case studies
Survey research
Cross-sectional studies: examine the relationship of health-related characteristics and other variables of interest in a defined population at a particular point in time
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Analytical Studies
Cohort studies, also called longitudinal studies, examine phenomena prospectively to observe presumed effects over time.
Case‒control studies retrospectively compare subjects (cases) with a condition (disease) and matched subjects/control without the condition/disease.
Advantages: Allow for the examination of multiple exposures for a single outcome, suitable for studying rare diseases and those with long latency periods, require fewer case subjects, generally quicker, less expensive, and well suited for outbreak investigation
Disadvantages: Not appropriate for rare exposures, subject to bias because of the method used to select controls, do not allow direct measure of incidence
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Question #2
Is the following statement true or false?
Cohort studies involve an in-depth analysis of an individual, group, or social institution.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Answer to Question #2
False
Rationale: Case studies involve an in-depth analysis of an individual, group, or social institution. Cohort studies, sometimes referred to as prospective studies, are longitudinal studies, which monitor subjects over time to find associations between risk factors and health outcomes.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Question #3
Is the following statement true or false?
Case–control studies, also known as prospective studies, work backward from the effect to the suspected cause.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Answer to Question #3
False
Rationale: Case–control studies, also known as retrospective studies, work backward from the effect to the suspected cause. Cohort studies, sometimes referred to as prospective studies, are longitudinal studies, which monitor subjects over time to find associations between risk factors and health outcomes.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Intervention (Experimental) Studies
Preventive trials
Therapeutic trials
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Question #4
Is the following statement true or false?
Intervention study is the epidemiologic investigation designed to test a hypothesized relationship by modifying an identified factor in a population. The study is preventive.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Answer to Question #4
False
Rationale: Intervention study is the epidemiologic investigation designed to test a hypothesized relationship by modifying an identified factor in a population. Studies may be therapeutic (clinical) or preventive.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Quasi-experimental and Experimental Design
Quasi-experimental and experimental designs are used to examine causality.
The “gold standard” for research design is the randomized, control group design.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Question #5
Is the following statement true or false?
The “gold standard” for research design is the randomized, experimental group design.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Answer to Question #5
False
Rationale: The “gold standard” for research design is the randomized, control group design.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Essay Writing Service Features
Our Experience
No matter how complex your assignment is, we can find the right professional for your specific task. Achiever Papers is an essay writing company that hires only the smartest minds to help you with your projects. Our expertise allows us to provide students with high-quality academic writing, editing & proofreading services.
Free Features
Free revision policy
$10Free bibliography & reference
$8Free title page
$8Free formatting
$8How Our Dissertation Writing Service Works
First, you will need to complete an order form. It's not difficult but, if anything is unclear, you may always chat with us so that we can guide you through it. On the order form, you will need to include some basic information concerning your order: subject, topic, number of pages, etc. We also encourage our clients to upload any relevant information or sources that will help.
Complete the order form
Once we have all the information and instructions that we need, we select the most suitable writer for your assignment. While everything seems to be clear, the writer, who has complete knowledge of the subject, may need clarification from you. It is at that point that you would receive a call or email from us.
Writer’s assignment
As soon as the writer has finished, it will be delivered both to the website and to your email address so that you will not miss it. If your deadline is close at hand, we will place a call to you to make sure that you receive the paper on time.
Completing the order and download