Community

Front 1

Non-Isolated Community Semi-Isolated COmmunity Isolated Community & Remote, Isolated Community

Back 1

N.I.C: road access less than 90km to doctor

S.I.C: road access greater than 90km to doctor

I.C: shceduled flying (access to dr), good telephone service, no roads

R.I.C: minimal radio/telephone no roads, no scheduled flights

Front 2

Rural means

Back 2

low population density

distance from major center

particular

Front 3

Rural Health (risks)

Back 3

increased prevalence of smoking and obesity

more people with low education and income

life expectancy lower in rural

higher mortality risks in rural

cancer rates lower in rural

Front 4

Unique Groups in Rural

Back 4

Aboriginals: nurses need to understand historical context, healthcare issues, challenges/rewards to working with them

Religious Groups: Amish, mennonites. most work in agriculture. Religion impacts healh behaviours and knowledge. (silence about childbearing) Lowe literacy rates, no immunization,

Front 5

Inequalities and disparities in Rural Living

Back 5

Access to healthcare services due to affordability concerns

Lack of available services (diagnostic and preventative)

Safety concerns related to travel

Front 6

Romanow Report - Directions for change

Back 6

-a rural and remote access fund to deliver new approaches to healthcare services

-Use fund to increased HCP's in rural communities

-expand telehealth

Front 7

Health Connections

Back 7

health authority based travel assistance program for those that travel for non-emergency care

Front 8

Nursing practice in rural communities

Back 8

limited continued education

often no back-up

nurse becomes jack of all trades

Front 9

Community dvlp in rural communities

Back 9

often one industry independent

migration of young people

often focussed on local services: ambulance, communications and technology, socialization and community connection

Front 10

Correctional Health

Back 10

higher risk of disease

limited access to healthcare prior to incarceration

-nurse assists with chronic diseases, management, education, preparing for discharge

-high prevalence of mental disorders (stress, social isolation,

-increasing aging population, lot of chronic dx, CVD, arthritis, etc

Infectious Disease: STI's. TB, HIV, Hep. nurses must assess for infection, educate

Substance abuse: withdrawal, drug-seekers, (prison needle and syring programs and harm reduction (methadone) in other countries)

Front 11

Program Planning- what is a program?

Back 11

a well organized series of activities designed to facilitate change in a well-defined target group

-to address prblems, needs

-planned by HCP's with own agenda for solving healthcare problems

Front 12

Logic Model

Back 12

What the program is supposed to do, with whom, and why.

-typically flow sheets, diagrams, or some other type of visual map the reflects sequence of events

includes:

-Input (what we invest)-partnership

-Outputs (activities/participation)

-Outcomes (impact) short, med, or long term

Front 13

Challenges in Program Planning

Back 13

-Health behaviour driven by more than knowledge, beliefs, and attitudes

-Health behaviour usually must be sustained for a long period before health benefits are achieved

Front 14

Program Planning Steps (4)

Back 14

1. identifying needs and community resources

2. addressing needs: a program everyone will want/need

3. delivering health promotion and disease prevention

4. program evaluation, what worked, didnt work, what needs to be changed

Front 15

Purpose of logic model

Back 15

planning: goals and how to meet them

Communication: share with media, stakeholders, investors

Orientation & Training: good hiring for new staff

Monitoring & evaluation:

Grant Applications: increases success,

(summarizes a program)

Front 16

Principles of Primary Health Care

Back 16

Public Participation (collaboration)

Health Promotion (control over health)

Appropriate technology (skills of pts, utiliza technology to increase health)

Intersectoral collaboration (working together)

Accessibility (transportation)

Front 17

Population Health - 5 Components

Back 17

Evidence-based

Focus on population

reduce inequities between popul'n groups

intersectoral collaboration

Actions directed at entire population

Front 18

Challenges to population Health

Back 18

-Inequalities in the health of people

-Unexpected increase in health problems because of aging, globalization, worldwide transmission of communicable disease, and burden of chronic and non-communicable disorders

Front 19

Evidence-Based Practice Integrates 3 componenets

Back 19

-research evidence gained from quality research findings

-clinical expertise

-individual/community preferences and available healthcare resources

Front 20

Ottawa Charter of health Promotion

Back 20

Strengthem Community Action (empower communities, educate)

-Develop Personal Skills (increase skills, knowledge)

-BUild Healthy Public Policy (in schools, workplace)

-Create Supportive Environments (communities take care of each other)

-Reorient Health Services (regionalization to increase access)

Front 21

Population Health Promotion Model

Back 21

Bridges the gap between population health and health promotion

-Strategies for health promotion

-determinants of population health

-levels of potential intervention

Can address health issues of groups at risk of poor health

Front 22

Community Development Key concepts (4)

Back 22

Community Empowerment

COmmunity Competence

Participation

Issue Selection (identified by community, specific and achievable)

Front 23

Community Dvlp

Back 23

a process in which members of a community care enabled to work together to solve a problem they face, and dvlp skills and power over issues that impact their lives

Front 24

Community Dvlp Phases: (5)

Back 24

Entry Phase (window survey)

Needs assessment

PLanning (

Doing

Renewal

Needs Assmnty: gather facts, opinions, health needs, gain commitment to actions

Gather Primary (directly from source( and secondary data( collecting already identified data)

Front 25

Epp

Back 25

reduce inequities

increase prevention

enhance coping

Front 26

population health components

Back 26

focus on group (popul'n)

evidence-based

reducing inequalities

global responsibility

Front 27

Health Belief Model

Back 27

Individuals that will act to promote their health if they believe that:

the are susceptible to a condition

consequences are severe

recommended actions are beneficiary

benefits of taking action outweigh costs or barriers

Front 28

Cultural Congruence

Back 28

A set of congruent behaviors, practices, attitudes andpolicies thatcome together in a system or agency or among professionals, enabling effectivework to be done in cross-cultural situations

Front 29

Social justice

Back 29

“Fairdistribution of resources and responsibilities among the members of apopulation, with a focus on the relative position of one social group inrelationship to others in society as well as on the root causes of disparitiesand what can be done to eliminate them”

Front 30

Acquiring Cultural Competence

Back 30

-Starts with awareness

-Grows with knowledge

-Enhanced with specific skills

-Polished through cross-culturalencounters

Front 31

Canada Health Act: 5 principles

Back 31

1. Public Administration: insurance plans on non-profit basis and accountable to provincial gov't

2. Comprehensiveness: Must cover all insured health services provided by hospital, physicians, dentist

3. Universality: Must be entitled to insured health services provided by prov insurance plans on uniform terms and conditions

4. Portability: Moving province to province continued coverage from home province during any waiting period imposed by new province.

5. Accessibility: Residents have reasonable access to insured hospital, medical, dental 9surg) services on uniform terms and conditionss

Front 32

Shortcomings of CHA

Back 32

preventative, promotive, protective services not required to meet critera.

strongly biomedical approach

Front 33

Primary Health Care

Back 33

accessible, affordable, acceptable healthcare

continuum of services from promotive to rehabilitative

disesase prevention and control

maternal and child health as minimum services

emphasis on community involvement and empowerment

Front 34

Culture

Back 34

-Culture is individual

-Individual culture influenced by many factors (race, gender, ethnicity, religion, sexual orientation)

-nurse responsible for responding approp to -clients cultural expectations and needs

-socially constructedv(norms, behaviours, values)

Front 35

Cultural competence (5 constructs)

Back 35

-cultural awareness (self examination)

-cultural knowledge

-cultural skill (collecting data)

-cultural encounters (process of relationships)

-cultural desire (motivation of HCP)

Front 36

Health Promotion Program Planning Models

Back 36

serve as frames from which to build; provide structure and organization for the planning process

-ie. logic model

Front 37

Barriers to culturally competent health promotion

Back 37

-lack of community participation

-cost

-insufficient resources

-access to transport

-inconsistent practice

Front 38

How to ensure cultural competence?

Back 38

-ask for feedback from communtity

-adequately funded language services

Front 39

How can nurses improve the health of a community?

Back 39

-Advocate

-Build capacity (empower)

-Political action

Front 40

Factors affecting health & well-being

Back 40

-healthy conditions and environments

-psychological factors

-effective health services

-healthy lifestyle

-social supports

-public policy

Front 41

3 levels of intervention and examples

Back 41

1. Primary: vaccinations

2. Secondary: mammograms

3. Tertiary: Diabetic education and management

Front 42

Health Promotion

Back 42

process of enabling people to increase control over their health and its determinants

Front 43

Change theory

Back 43

Behaviour Change is an ongoing process, people have varying levels of motivation to change

Front 44

Inputs (of logic model) are\;

Back 44

human, financial, organizational, and community resources a program has available to direct towards the work

Front 45

Outputs (of logic model) are;

Back 45

directproducts of programactivities andmay include types, levelsand targetsof services to be delivered by the program.

Front 46

Outcomes (of logic model) are:

Back 46

changes in short, medium or long term behaviour, attitudes, etc.

Front 47

2 types of program evaluation:

Back 47

formative: period, throughout

Summative: at the end

Front 48

Successful programs:

Back 48

-empower

-encourage collaboration

-include an evaluation component

-use multiple strategies based on best evidence

Front 49

What is a policy?

Back 49

-Aprinciple, value or course of action which guides decision-making

-Canbe informal or formal

-Can provide more equitable access to thedeterminants of health

-Hasa consequence for non-compliance and some method of enforcement.

Front 50

Public Policy

Back 50

-theactions of legitimate political or administrative bodies to address an issue ofpublic concern

Front 51

Healthy Public Policy

Back 51

Healthypublic policy ischaracterizedby an explicit concern for health and equity in all areas of policy (diet,transportation, housing, etc.). Its mainaim is to create a supportive environment

Front 52

Characterisitcs of Healthy Public Policy

Back 52

1) It is directed at reducing inequities

2) It recognizes both the importance ofeconomic, social and physical environments as determinants of health

3) It facilitates public participation

Front 53

Developing Policy (8 steps)

Back 53

1. identify problem

2. assess community capacity and readiness

3. Develop goals, objectives and policy options

4. Identify decision makers and influencers

5. Build support for policy among decision makers

6. Write/revise policy

7. Implement policy

8. Evaluate and monitor policy

Front 54

Vulnerable Populations

Back 54

groups that are not well integrated into the health care system because ofethnic, cultural, economic, geographic, or health characteristics. Thisisolation puts members of these groups at risk for not obtaining necessarymedical care, and thus constitutes a potential threat to their health”

Front 55

Community Mapping

Back 55

A map of the community indicating occurences of illness, disease, resources, environmental conditions, accessibility and barriers to access

Front 56

Program evaluation steps

Back 56

-determine that needs to be evaluated

-method of measurement

-collecting and analyzing data

Front 57

Components in community assessment

Back 57

-living/working conditions

-income and social status

-social supports

-culture and religion

-recreation

-education and healthy child dvlp

Front 58

Risk assessment

Back 58

identify and target clients most likely to contract disease, or dvlp unhealthy behaviours

Front 59

Community Dynamics (3)

Back 59

-Leadership

-Decision-making

-communication

Front 60

Purposes of communty assessment (4)

Back 60

environmental scan: windshield survey, familiarize with environment

Needs Assmnt: what community needs, resources it has

Problem Investigation: in response to a problem, investigate occurrence and distribution of disease

Resource Eval: assmnt and eval of resources

Front 61

COmmunity Participatory Approach

Back 61

-community decides what needs to be done, who will do it, are empowered

Front 62

government that deals with aborginals

Back 62

Department of Indian Affairs and development