Flashcards in LA 11 - Stanhope chapters 4 and 10 Deck (25)
What is the focus of the definition of health in the Ottawa Charter on Health Promotion?
a. Health is an outcome.
b. Enjoying life is more important than the need to maintain one’s health.
c. Health is incorporated into one’s activities of daily living.
d. Health is a way to maintain a stable environment.
The perspective taken in this text is based on the Ottawa Charter definition of health: “to reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment.” Therefore, the World Health Organization (WHO) identified health as a resource for everyday living, i.e., taking a holistic approach that includes physical, social, and personal capabilities, with health being viewed positively. When using this definition, health is no longer viewed as an outcome (or a state to be reached); rather, health is incorporated into one’s activities of daily living. Today, Health Canada continues to apply the Ottawa Charter definition of health. The view of health as a resource proposes that communities and individuals use this resource to manage and even change their environments.
What is the basis for the difference between health promotion and health protection?
a. The assurance of the highest possible quality in care
b. The motivation to change behaviour
c. Delivery of care by a group of health care providers
d. The achievements of social marketing campaigns
Pender et al. (2002) differentiate between health promotion and health protection on the basis of motivation for behaviour change. These authors describe health promotion as the motivation to change behaviour in order to enhance well-being and reach one’s optimal health potential. In contrast, the motivation for health protection is to avoid disease, to screen for early detection, and to restore health following illness.
In his document entitled Achieving Health for All: A Framework for Health Promotion, Epp supported a community and policy focus in health promotion. Which one of the following did he recommend?
a. Cooperating fully with the WHO member nations in implementing the plan internationally
b. Denying that the goal of health is socially and economically productive lives for all citizens
c. Taking actions that foster public participation
d. Focusing primarily on disease prevention and health promotion in selected areas
Epp’s framework supported a community and policy focus in health promotion through fostering public participation (e.g., heart-healthy physical activity promotion initiatives), strengthening community health services (e.g., increasing community mental health services), and coordinating healthy public policy (e.g., a nationwide ban on the sale and use of baby walkers).
Which of the following accurately describes an appropriate starting point for the application of a population health approach?
a. Emergency life-saving care
b. The determinants of health
c. Health promotion models
d. Risk management
The population health approach has, as its starting point, a focus on the determinants of health. Other starting points are also discussed but are not included in the above answer choices.
How is the contemplation stage for changing behaviour different from the precontemplation stage for changing behaviour?
a. During the contemplation stage, the client does not yet intend to change his or her behaviour within the next 6 months.
b. During the contemplation stage, there is a lack of readiness to change behaviour.
c. During the precontemplation stage, there is a readiness to change behaviour.
d. During the contemplation stage, the client is thinking about changing behaviour within the next 6 months.
In the precontemplation stage, an individual is not considering a change in behaviour within the next 6 months; there is no readiness for change. However, in the contemplation stage, an individual is starting to think about a change in behaviour within the next 6 months.
Which report focused on the introduction of the “health field concept” with its four domains?
a. Epp Report
b. Black Report
c. Lalonde Report
d. WHO Commission Report on Social Determinants
The Lalonde Report focused on the introduction of the health field concept with four domains: human biology, lifestyle, environment, and health care system as determinants of health.
What is the most important feature of the Diffusion of Innovation Theory?
a. It avoids high-cost treatments and suggests cheaper alternatives.
b. It gives members incentives to use only network providers.
c. It shows that individuals adopt innovations at different rates.
d. It advocates working with geographically based communities.
This theory shows that individuals adopt innovations at different rates.
The Canadian Community Health Nursing Standards of Practice identifies a community health nurse (CHN)’s role as advocate in creating public policy, as supporter of community action to influence public policy, and as instrument for societal change. Which one of the following is an example of a healthy public policy?
b. Behaviour change
c. Marketing materials
d. Crib/bed safety initiatives for infants and young children
Examples of a healthy public policy include crib/bed safety for infants and young children, restraint use in long-term-care institutions, seatbelt use for populations, and a tobacco ban in communities
Which one of the following is an example of self-efficacy?
a. Attending a walk-in clinic for health care
b. Allowing others input into one’s health decisions
c. Paying for a fitness centre membership
d. Making healthy food choices while grocery shopping
Self-efficacy refers to a belief that one can control one’s life and have the ability to carry out actions required to prevent disease; a specific example is making healthy food choices while grocery shopping.
Using the Community Mobilization Framework and the three health promotion community mobilization approaches, which element should be addressed first within the framework’s social planning component?
a. Shifting power relationships
b. Problem solving at the community level
c. Community participation
d. Community social concerns
The Community Mobilization Framework identifies the following three health promotion community mobilization approaches to bring about community change: 1) social planning (problem solving at the community level to deal with physical, mental, and social health concerns in the community), which is described as a task-oriented strategy that includes a health care professional as the “expert leader”; 2) locality development (community participation and cooperation to deal with community health concerns, with a focus on process, consensus, and community self-help), with the health care professional as facilitator; and 3) social action (a process with the focus on shifting power relationships and resources so that change occurs to the benefit of the disadvantaged in the community).
Which of the following main ideas was Lalonde highlighting in his report entitled A New Perspective in the Health of Canadians (1974)?
a. Access to health care and cost and quality of health care
b. Appropriate legislation to control health care organizations
c. The influence of biology, environment, and lifestyle on good health
d. Accessibility and health promotion
The Lalonde Report initiated a shift, especially in Canada, from a primarily biomedical view of disease and health to consideration of certain aspects of health promotion. The Lalonde Report increased the awareness of human biology, environment, and lifestyle as determinants of health and, therefore, as influencers of health. He urged improvements in the environment, increased knowledge in human biology, and modifications of self-imposed risks arising from individual health choices and related behaviours to increase the population health status of Canadians.
Which one of the following is perhaps the most helpful idea among the unlimited suggestions for how to improve health care in Canadian communities?
a. Increasing funding and personnel to advance new pharmaceutical interventions
b. Increasing funding for further research into the most effective medical interventions
c. Increasing technological advances to constantly improve surgical survival rates
d. Involving communities in their health care and encouraging their participation in decisions about health care
The strategy of strengthening community action, as outlined in the Ottawa Charter, refers to empowering communities. It involves engaging communities from the grassroots, or “bottom up” (referred to as “locality development” as outlined by Rothman), so as to involve community members in identifying health issues and planning and initiating interventions specific to their communities. In this way, communities take ownership and have control over health issues affecting them and the health of their members.
Which one of the following is the most important ingredient for effective community development?
a. Adequate funding
b. Appropriate location for the services provided
c. Community participation
d. Professional expertise
Community participation is absolutely essential to community development. The most effective changes come with active participation by the people who live in the community. Community development is a process whereby community members identify health concerns impacting their community that require the development of capacity-building skills to bring about a realization of the needed change, with the goal of a secure and healthy community that benefits all community members.
What is the focus of health promotion in Canada?
a. Achieving consensus on community health needs
b. Developing a population approach based on the determinants of health
c. Dictating interventions that match the government’s identified priorities
d. Promoting individual health status
In Canada, a population approach focusing on the determinants of health is the direction taken in health promotion, in contrast to the focus on promotion of individual health in some other countries, such as the United States.
Which one of the following options represents the steps in health program management?
a. Assess, plan, implement, evaluate
b. Identify, initiate, implement
c. Organize, operationalize, mobilize, subsidize
d. Substantiate, negotiate, evaluate
The health program management process is similar to the nursing process. Health program management consists of assessing, planning, implementing, and evaluating a health program, in partnership with the client.
What is the ultimate goal of program planning?
a. Avoiding unanticipated conflicts in the program development phase
b. Ensuring adequate funding to meet the program’s resource requirements
c. Ensuring that health care services are satisfactory, comparable, effective, and beneficial
d. Preventing unnecessary duplication of services
The comprehensive goal of program planning is to ensure that health care services are acceptable, equitable, efficient, and effective.
On the basis of projected increases in the number of older adult Canadian citizens, a planning committee wants to establish a daycare program for the community’s older adult population. Which stage would be used to assess the needs of this proposed program?
a. Preactive stage
b. Reactive stage
c. Inactive stage
d. Interactive stage
In the preactive stage, assessment is done on the basis of projections of future needs.
Which of the following descriptors meets all of the criteria for identifying a potential client for a program?
a. All women 40 to 50 years of age who have not had a menstrual period for 3 consecutive months
b. Immigrants residing in the district of Wakefield for less than 5 years who have difficulty understanding care instructions because of limited English proficiency
c. Pregnant women who have received nutritional counselling but whose nutritional status did not improve
d. Children aged 18 months to 5 years who have been treated for nutritional deficiencies at the district health clinic
A client should be identified on the basis of biological and psychosocial characteristics, by geographical location, and by the problems to be addressed. A correct example identifies who the client is, what the need is, and where the clients are located. The correct answer meets all the criteria (psychosocial characteristic = immigrant; location = Wakefield; problem = difficulty understanding care instructions). The other choices are lacking either a specific location or an identified problem.
Evaluation is under way for a province-wide program whose goal is to decrease teen injury and death associated with driving while under the influence of alcohol. Which of the following questions is most effective in helping make a summative evaluation of the program?
a. Are program participants completing all aspects of the program, and do their satisfaction scores indicate that they are pleased with the program?
b. What is the change in statistics for injuries and deaths associated with drunk driving among teens in the year following the program?
c. What is the difference in the amount of alcohol intake by teens before and after participant entry into the program?
d. What problems with program implementation have been identified?
Summative evaluation is evaluation to assess program outcomes or a follow-up of the results of program activities. Are program participants completing all options and what problems with implementation have been identified are examples of questions used for formative evaluation. The difference in the amount of alcohol intake by teens before and after the program assesses a goal that has not been identified in this scenario (i.e., the goal was not to decrease consumption of alcohol but to decrease driving under the influence of alcohol).
A committee concludes that a program’s objectives were met and that activities received positive ratings from the community, but decides that the program will be discontinued because its cost was triple the amount anticipated. In this scenario, which one of the following program evaluation measures has been identified as the problem?
The aspects of program evaluation include the following: evaluation of relevance (need for the program); adequacy (whether the program addresses the extent of the need); progress (tracking of program activities to meet program objectives); efficiency (relationship between program outcomes and the resources spent); effectiveness (ability to meet program objectives and the results of program efforts); impact (long-term changes in the client population); and sustainability (enough resources [usually money] to continue the program).
Which one of the following programs would best exemplify an emphasis on tertiary prevention?
a. Development of an in-school clinic that provides counselling on contraception
b. Providing a diabetes management program for persons with diabetes mellitus
c. Providing cardiovascular fitness evaluations at annual health fairs
d. Setting up free blood pressure screening at popular department stores and supermarkets
The aim of tertiary prevention programs is to reduce complications from diseases. Development of an in-school contraception clinic offers a primary prevention (pregnancy has not occurred). Providing cardiovascular fitness evaluations and setting up free blood pressure screening are secondary-prevention programs (screening identifies conditions early and determines incidence and prevalence).
A committee of health care professionals would like to establish a district-wide program to improve access to culturally competent health care services for Vietnamese immigrants. Which one of the following would be the best person to select as a key information provider about this community’s needs?
a. The hospital administrator
b. A Vietnamese community leader
c. A national expert on cultural competency
d. A provincial/territorial or municipal government official
Key information providers are leaders in a particular community who are knowledgeable about community needs. In this scenario, a Vietnamese leader most likely knows more about the needs of the Vietnamese community in question than would the other individuals listed.
Which of the following potential data sources would most likely be eliminated by the community health nurse (CHN) who wishes to conduct a needs assessment on a limited budget?
a. Community forums
b. Examination of community indicators
c. Focus groups
Surveys tend to be more expensive than other methods; therefore, the CHN would want to consider the other options if on a limited budget.
In order to evaluate a program designed to decrease obesity among school-aged children, which of the following questions would be the most important to consider?
a. Are the school-aged children satisfied with the program?
b. Can the parents and guardians support the program requirements?
c. Has obesity among the school-aged children decreased?
d. What is the program cost compared with the program benefit?
The major benefit of program evaluation is that it shows whether the program is meeting its goals. It should answer the following questions: Are the needs for which the program was designed being met? Are the problems it was designed to solve being solved? If the program does not achieve the purpose for which it is designed, concerns of satisfaction and cost are irrelevant.