This document discusses behavior change models that can guide patient engagement programs. It compares individual models like the Health Belief Model and Theory of Planned Behavior, which focus on personal beliefs and intentions, versus ecological models that consider environmental influences. It also examines the Chronic Care Model, which informs chronic illness management by addressing multiple levels of the healthcare system. Comparing these theories can help design effective interventions that encourage behavior change and patient participation in their own care.
The document discusses several models of health behavior:
1) The Basic Risk Perception Model focuses on likelihood and severity of harm from not acting. Higher risk perception predicts greater motivation to act.
2) The Health Belief Model includes perceived susceptibility, severity, benefits, and barriers in predicting preventive health behaviors. Perceived barriers are the strongest predictor.
3) Protection Motivation Theory assesses threat and coping appraisal processes. Response costs have the strongest impact on health behaviors and attitudes.
4) The Transtheoretical Model proposes stages of change and processes of change to explain behavior progression. Decisional balance and self-efficacy also predict stage of change.
This document discusses factors related to developing and implementing a diversity and inclusion template for sustainability across settings in healthcare. It identifies several key factors to consider, including the characteristics of the intervention, contextual factors in the environment, and strategies to promote sustainability. Methods for measuring adoption, outcomes and effectiveness are discussed. Frameworks for evaluating sustainability at the organizational and system level are also presented. The document provides references to support the concepts discussed.
Intervention Mapping was developed to address questions about how and when to use...
Theory
Empirical findings from the literature
Data collected from a population
... to create an effective behavior or systems change intervention.
Intervention Mapping provides a systematic framework for decision making at each step of intervention planning, and evaluation
This document summarizes three individual health behavioral models: the Health Belief Model, Health Behavioral Model, and Household Health Production Model. The Health Belief Model focuses on perceived susceptibility, seriousness, benefits and barriers of preventative health actions. The Health Behavioral Model incorporates predisposing, enabling, and need characteristics. The Household Health Production Model views health behaviors as inputs that parents choose to maximize household health, considering costs and resources. While useful, these models are limited as they assume individuals act alone and don't adequately capture social and community influences on health behaviors.
The document describes the development of the Adolescent Health Utility Measure (AHUM), a multi-attribute health classification system and survey used to obtain health state preferences (utilities) for adolescents. Key points:
1) The AHUM was developed based on literature reviews and input from adolescents with Hunter syndrome. It contains six health dimensions with multiple severity levels to describe 16,800 possible health states.
2) A survey of 312 UK adults used a time trade-off method to provide utilities on a scale of 0 to 1 for 62 representative AHUM health states.
3) When applied to a clinical trial for Hunter syndrome, the AHUM utilities showed greater improvement in quality of life for patients receiving the treatment compared
Jhu fall 2011 group 5 hbm t heory ppt due 11 21-2011tatia30
This document describes the utilization of the Health Belief Model (HBM) to address childhood obesity in a primary care setting. It provides background on the childhood obesity epidemic and relevance to nursing. The key concepts of the HBM are described, including perceived susceptibility, severity, benefits, and barriers. The rationale for using the HBM to solve childhood obesity is given. Potential solutions and problems with implementation are discussed.
The document discusses Nola Pender's Health Promotion Model. Some key points:
- Pender developed the Health Promotion Model in the 1980s to explore factors influencing health behaviors. It focuses on health promotion rather than disease/illness.
- The model has cognitive-perceptual factors like perceived benefits/barriers, and modifying factors like interpersonal/situational influences. Commitment to a plan and competing preferences also factor in.
- The model draws from social cognitive theory and expectancy value theory. It views individuals as active in regulating their own behavior and interacting with their environment.
- Pender's research career focused on health promotion. The Health Promotion Model is widely
Corporations are looking to lower healthcare costs and reduce absenteeism that may be due to illness or pain. Including lifestyle wellness and lifestyle medicine strategies into corporate wellness programs is an innovative approach for managing pain, reducing illness, reducing injury, improving employee job satisfaction, and increasing employee productivity. Here is a practical approach for corporations.
For additional information, please visit www.integrativedpt.com.
The document discusses several models of health behavior:
1) The Basic Risk Perception Model focuses on likelihood and severity of harm from not acting. Higher risk perception predicts greater motivation to act.
2) The Health Belief Model includes perceived susceptibility, severity, benefits, and barriers in predicting preventive health behaviors. Perceived barriers are the strongest predictor.
3) Protection Motivation Theory assesses threat and coping appraisal processes. Response costs have the strongest impact on health behaviors and attitudes.
4) The Transtheoretical Model proposes stages of change and processes of change to explain behavior progression. Decisional balance and self-efficacy also predict stage of change.
This document discusses factors related to developing and implementing a diversity and inclusion template for sustainability across settings in healthcare. It identifies several key factors to consider, including the characteristics of the intervention, contextual factors in the environment, and strategies to promote sustainability. Methods for measuring adoption, outcomes and effectiveness are discussed. Frameworks for evaluating sustainability at the organizational and system level are also presented. The document provides references to support the concepts discussed.
Intervention Mapping was developed to address questions about how and when to use...
Theory
Empirical findings from the literature
Data collected from a population
... to create an effective behavior or systems change intervention.
Intervention Mapping provides a systematic framework for decision making at each step of intervention planning, and evaluation
This document summarizes three individual health behavioral models: the Health Belief Model, Health Behavioral Model, and Household Health Production Model. The Health Belief Model focuses on perceived susceptibility, seriousness, benefits and barriers of preventative health actions. The Health Behavioral Model incorporates predisposing, enabling, and need characteristics. The Household Health Production Model views health behaviors as inputs that parents choose to maximize household health, considering costs and resources. While useful, these models are limited as they assume individuals act alone and don't adequately capture social and community influences on health behaviors.
The document describes the development of the Adolescent Health Utility Measure (AHUM), a multi-attribute health classification system and survey used to obtain health state preferences (utilities) for adolescents. Key points:
1) The AHUM was developed based on literature reviews and input from adolescents with Hunter syndrome. It contains six health dimensions with multiple severity levels to describe 16,800 possible health states.
2) A survey of 312 UK adults used a time trade-off method to provide utilities on a scale of 0 to 1 for 62 representative AHUM health states.
3) When applied to a clinical trial for Hunter syndrome, the AHUM utilities showed greater improvement in quality of life for patients receiving the treatment compared
Jhu fall 2011 group 5 hbm t heory ppt due 11 21-2011tatia30
This document describes the utilization of the Health Belief Model (HBM) to address childhood obesity in a primary care setting. It provides background on the childhood obesity epidemic and relevance to nursing. The key concepts of the HBM are described, including perceived susceptibility, severity, benefits, and barriers. The rationale for using the HBM to solve childhood obesity is given. Potential solutions and problems with implementation are discussed.
The document discusses Nola Pender's Health Promotion Model. Some key points:
- Pender developed the Health Promotion Model in the 1980s to explore factors influencing health behaviors. It focuses on health promotion rather than disease/illness.
- The model has cognitive-perceptual factors like perceived benefits/barriers, and modifying factors like interpersonal/situational influences. Commitment to a plan and competing preferences also factor in.
- The model draws from social cognitive theory and expectancy value theory. It views individuals as active in regulating their own behavior and interacting with their environment.
- Pender's research career focused on health promotion. The Health Promotion Model is widely
Corporations are looking to lower healthcare costs and reduce absenteeism that may be due to illness or pain. Including lifestyle wellness and lifestyle medicine strategies into corporate wellness programs is an innovative approach for managing pain, reducing illness, reducing injury, improving employee job satisfaction, and increasing employee productivity. Here is a practical approach for corporations.
For additional information, please visit www.integrativedpt.com.
The document summarizes the Health Promotion Model (HPM) developed by Dr. Nola Pender. The HPM focuses on helping individuals achieve higher levels of well-being and health by empowering healthy lifestyle choices. It considers how individual characteristics and experiences, as well as behavioral and cognitive factors, influence health behaviors. The model also examines interpersonal and situational influences on health behaviors and outcomes. The goal of the HPM is to help individuals not just prevent illness but pursue ideal health.
This document describes a study that tested an ecological theory-based health intervention called Health is Power (HIP) for African American and Hispanic/Latina women. The study was aimed at increasing physical activity and improving dietary habits using a multi-level intervention approach. Women were randomized into physical activity or fruit/vegetable groups and participated in six intervention sessions over six months. The intervention targeted both individual and environmental influences based on the Ecological Model of Physical Activity and incorporated group dynamics and social support strategies. Results suggested interventions using social ecological models can effectively initiate and maintain health behavior changes by addressing multiple levels of influence.
The PRECEDE-PROCEED model provides a comprehensive framework for designing, implementing, and evaluating health promotion programs. It consists of 9 phases: (1) social diagnosis to identify community health issues, (2) epidemiological diagnosis to determine associated health problems, (3) behavioral and environmental diagnosis to analyze behavioral and environmental factors, (4) educational diagnosis to select factors to modify behaviors, (5) administrative diagnosis to assess resources and policies, (6) implementation, (7) process evaluation, (8) impact evaluation, and (9) outcome evaluation to determine effects on health and quality of life. The model takes a participatory approach and considers both individual and environmental influences on behaviors.
- The study systematically reviewed physical activity interventions for adolescent cancer patients and survivors. Four controlled trials involving physical activity during or after cancer treatment were identified.
- The limited evidence available suggests physical activity is safe for adolescent cancer patients, but more high-quality studies are needed to determine effectiveness on health outcomes due to few existing studies.
- Future research should investigate optimal timing, settings, durations and intensities of physical activity interventions as well as potential moderating factors like age, gender and cancer type.
The document provides an overview of the Health Belief Model (HBM). It was developed in the 1950s to explain why people do or do not engage in health-promoting behaviors. The HBM posits that individuals will take action to prevent or control illness if they feel susceptible to a condition, believe it could have serious consequences, believe a course of action can reduce susceptibility or seriousness, and feel the benefits outweigh the costs. The model's key components are perceived susceptibility, severity, benefits, and barriers. Cues to action and self-efficacy were later added. The HBM is applied to develop health messages focusing on threat, coping responses, and self-efficacy to influence health behaviors. While useful
Models Of Health Behaviors By Yusuf Abdu MisauYusuf Misau
The document discusses various models of health behavior that can be used to understand factors influencing human behaviors and to develop health promotion programs. It describes several key models - the Health Belief Model, Theory of Planned Behavior, Transtheoretical Model, Social Cognitive Theory. For each model, it explains the core concepts and assumptions. It also provides case studies and discusses how the models can be applied in clinical practice, research, and program development.
Intervention Mapping To Develop A Culturally Appropriate Intervention to Prev...Mohammad Aslam Shaiekh
Intervention Mapping To Develop A Culturally Appropriate Intervention to Prevent Childhood Obesity: The HAPPY (Healthy and Active Parenting Program for Early Years) Study
The document discusses several models related to health behavior and nursing care, including the health belief model, holistic health model, and Pender's health promotion model. The health belief model proposes that health-related actions depend on perceptions of susceptibility, severity, benefits and barriers. The holistic health model sees people as ever-changing systems influenced by environment. Pender's health promotion model focuses on factors influencing health-promoting behaviors.
Psychosocial factors of malocclusion /certified fixed orthodontic courses by ...Indian dental academy
This document discusses the psychosocial factors related to malocclusion and orthodontic treatment. It begins by outlining Wright's classification of child behavior in dental offices and models of health behavior including the health belief model, theory of reasoned action, self-regulation theory, and stages of change model. It then discusses the psychosocial impact of malocclusion, including social judgments and patients' self-adjustments. While malocclusion can impact social perceptions, studies show patients generally have positive self-concepts and self-esteem. The document concludes by noting patients' expectations for psychosocial benefits from orthodontic treatment such as improved self-confidence and relationships.
The document summarizes several prominent health behavior theories that are relevant for nursing practice and research. It describes theories such as the health belief model, social cognitive theory, transtheoretical model, and theories of reasoned action. Key concepts discussed include an individual's perceptions, self-efficacy, environmental influences, and how behavior change is best understood as a process rather than a single event. The theories provide guidance for nurses to enhance patient motivation and effectively support individuals through the various stages of behavior change.
Theories applied in community health nursingKalpana B
The document discusses several theories relevant to community health nursing. It describes Florence Nightingale's environmental theory which views nursing as altering the patient's environment to promote healing. It also outlines Dorothea Orem's self-care theory, which posits that individuals should be self-reliant in caring for themselves and others. Orem's theory identifies universal, developmental, and health-derived self-care requisites. Nursing is needed when self-care capabilities do not meet the therapeutic self-care demands. The document provides overviews of several other theories used in community health nursing.
This document proposes a community-based intervention called "Get out Live, Love Life: Park 30" aimed at increasing physical activity. It will enhance an urban park and conduct outreach to educate community members. Baseline surveys will assess park usage and safety concerns. Partnerships will be formed and the park improved. Marketing will publicize the changes and physical activity recommendations. Participants will complete pre- and post-tests to evaluate stage of physical activity change according to the Transtheoretical Model. The goal is for the intervention to create a supportive environment that increases park use and physical activity levels in the community.
EMPHNET-PHE course: Module03 ethical issues in surveillance, screening and ou...Dr Ghaiath Hussein
This is a series of presentations I gave in the Eastern Mediterranean Public Health Network (EMPHNET)'s Public Health Ethics (PHE) that was held in Amman in June 2014.
This presentation outlines the ethical issues related to surveillance, screening, and outbreak investigation.
This document outlines a proposed intervention to increase physical activity among freshmen at Kansas State University. The intervention includes physical activity classes, laboratory sessions teaching exercises, and providing exercise kits for dorms. An evaluation plan involves initial and final surveys of freshmen to assess changes in physical activity, as well as monthly process surveys to track program participation and feedback. The goal is to increase physical activity knowledge and self-efficacy, leading to higher physical activity levels and potential long-term health benefits for students.
The Pender's Health Promotion Model specifies that health behaviors are influenced by personal factors and the surrounding environment. The model aims to identify, assess, and modify these influencing factors to encourage health-promoting behaviors. It provides a framework for understanding how individuals can improve their health and well-being. Key concepts include the interaction between the person, environment, health behaviors, and nursing. Research shows the model can be used effectively in clinical settings to develop health-promoting behaviors.
This document discusses several models for health maintenance and disease prevention, including ecological models, the health belief model, relapse prevention model, stages of change model, social cognitive theory, and theory of planned behavior. It provides details on key concepts and components of each model. Additionally, it covers strategies for facilitating dietary change and assessing and treating pain.
This document outlines a study exploring associations between executive function and health behaviors. The study aims to identify which executive function facets (inhibitory control, mental flexibility, working memory) are associated with dietary behaviors (unhealthy snacking, fruit and vegetable consumption). It also aims to see if better executive function performance predicts adherence to stated diet intentions over 48 hours. The methods section describes the cross-sectional study design, objective executive function tests used, dietary assessment, and analysis plan to examine correlations and regressions between variables. Limitations including the small sample size and need for future work controlling additional variables are discussed.
1. Sustainable development in health systems requires changing practices, but behavior change is difficult.
2. Thinking behaviorally can help by diagnosing the behaviors to change, measuring psychological determinants of the behaviors like capability, opportunity and motivation, and developing interventions to target those determinants.
3. An example project measured determinants like motivation before and after an emergency care course, finding increased perception of opportunity was linked to changed practice, showing how interventions can be improved.
The document discusses various concepts related to health, wellness, and illness. It defines health according to different organizations such as WHO and provides perspectives from various fields such as biomedicine, ecology, and sociology. Several models of health and illness are described, including the health-illness continuum model, high-level wellness model, agent-host-environment model, health belief model, and holistic health model. The dimensions of wellness, components of high-level wellness, and factors influencing health status are also outlined.
8 l 4 snyman et al - icf and ipep - amee 2013Stefanus Snyman
The document discusses using the International Classification of Functioning, Disability and Health (ICF) framework to guide interprofessional education and practice. It describes how assessing healthcare students' case presentations using the ICF framework:
1) Drove interprofessional practice among students and professionals by facilitating a biopsychosocial approach to patient-centered care.
2) Resulted in improved patient outcomes.
3) Strengthened health systems by fostering appreciation of different professions and commitment to teamwork between education and healthcare services.
PUH 5304, Health Behavior 1 Course Learning OutcomVannaJoy20
PUH 5304, Health Behavior 1
Course Learning Outcomes for Unit VI
Upon completion of this unit, students should be able to:
5. Examine health behavior intervention strategies.
5.1 Assess the many aspects that accompany intervention planning such as goals and objectives,
setting, community resources, and timelines.
5.2 Identify an intervention strategy that relates to intervention implementation within a community.
Course/Unit
Learning Outcomes
Learning Activity
5.1
Unit Lesson
Chapter 12
Unit VI Assignment
5.2
Unit Lesson
Chapter 12
Unit VI Assignment
Reading Assignment
Chapter 12: Translating Research to Practice: Putting “What Works” to Work
Unit Lesson
In Unit V, we addressed how theories and models such as the social cognitive theory, the health behavior
model, and the theory of planned behavior play a role in intervention planning. This unit, we will build on the
foundation of theories and models and look at how to be strategic in determining interventions. The reading
highlights the concerns that health educators should have as it relates to the design and evaluation process to
determine the successfulness of interventions for a given health behavior.
Intervention Strategizing
When a health educator is developing an intervention strategy to help with a particular health behavior, there
are a few key factors to consider: identifying the target population, selecting a setting, setting goals and
objectives, and identifying resources and a timeline. Each of these factors are a concern for health educators
when developing interventions (Powell et al., 2017).
Target population: Who are you planning the intervention for? Are there any special needs? For instance,
adolescents have special needs because they are in school during the day, so an intervention for them would
need to be after school, on the weekend, or through the school. An intervention for seniors should be held
during the day because seniors normally shy away from being out at dusk or dark. If the intervention were for
the working population, there would be better attendance in the evenings or weekends. The goal with
determining the population for the intervention is to think of alleviating any barriers that may affect most of the
population (Powell et al., 2017).
Setting: Where will the intervention be held? Is there handicap access for seniors or elevator accessibility? Is
the location easily accessible? Is there public parking? What is the room reservation process? Is the setting
outdoors, and if so, are there backup plans in case of bad weather? As the health educator, you should take
into account the best setting to meet the needs of the population that has been identified (Nilsen, 2015).
UNIT VI STUDY GUIDE
Interventions for Health Behavior
PUH 5304, Health Behavior 2
UNIT x STUDY GUIDE
Title
Goals/Objectives: The health educator should be clear on the goals and objectives of ...
The document summarizes the Health Promotion Model (HPM) developed by Dr. Nola Pender. The HPM focuses on helping individuals achieve higher levels of well-being and health by empowering healthy lifestyle choices. It considers how individual characteristics and experiences, as well as behavioral and cognitive factors, influence health behaviors. The model also examines interpersonal and situational influences on health behaviors and outcomes. The goal of the HPM is to help individuals not just prevent illness but pursue ideal health.
This document describes a study that tested an ecological theory-based health intervention called Health is Power (HIP) for African American and Hispanic/Latina women. The study was aimed at increasing physical activity and improving dietary habits using a multi-level intervention approach. Women were randomized into physical activity or fruit/vegetable groups and participated in six intervention sessions over six months. The intervention targeted both individual and environmental influences based on the Ecological Model of Physical Activity and incorporated group dynamics and social support strategies. Results suggested interventions using social ecological models can effectively initiate and maintain health behavior changes by addressing multiple levels of influence.
The PRECEDE-PROCEED model provides a comprehensive framework for designing, implementing, and evaluating health promotion programs. It consists of 9 phases: (1) social diagnosis to identify community health issues, (2) epidemiological diagnosis to determine associated health problems, (3) behavioral and environmental diagnosis to analyze behavioral and environmental factors, (4) educational diagnosis to select factors to modify behaviors, (5) administrative diagnosis to assess resources and policies, (6) implementation, (7) process evaluation, (8) impact evaluation, and (9) outcome evaluation to determine effects on health and quality of life. The model takes a participatory approach and considers both individual and environmental influences on behaviors.
- The study systematically reviewed physical activity interventions for adolescent cancer patients and survivors. Four controlled trials involving physical activity during or after cancer treatment were identified.
- The limited evidence available suggests physical activity is safe for adolescent cancer patients, but more high-quality studies are needed to determine effectiveness on health outcomes due to few existing studies.
- Future research should investigate optimal timing, settings, durations and intensities of physical activity interventions as well as potential moderating factors like age, gender and cancer type.
The document provides an overview of the Health Belief Model (HBM). It was developed in the 1950s to explain why people do or do not engage in health-promoting behaviors. The HBM posits that individuals will take action to prevent or control illness if they feel susceptible to a condition, believe it could have serious consequences, believe a course of action can reduce susceptibility or seriousness, and feel the benefits outweigh the costs. The model's key components are perceived susceptibility, severity, benefits, and barriers. Cues to action and self-efficacy were later added. The HBM is applied to develop health messages focusing on threat, coping responses, and self-efficacy to influence health behaviors. While useful
Models Of Health Behaviors By Yusuf Abdu MisauYusuf Misau
The document discusses various models of health behavior that can be used to understand factors influencing human behaviors and to develop health promotion programs. It describes several key models - the Health Belief Model, Theory of Planned Behavior, Transtheoretical Model, Social Cognitive Theory. For each model, it explains the core concepts and assumptions. It also provides case studies and discusses how the models can be applied in clinical practice, research, and program development.
Intervention Mapping To Develop A Culturally Appropriate Intervention to Prev...Mohammad Aslam Shaiekh
Intervention Mapping To Develop A Culturally Appropriate Intervention to Prevent Childhood Obesity: The HAPPY (Healthy and Active Parenting Program for Early Years) Study
The document discusses several models related to health behavior and nursing care, including the health belief model, holistic health model, and Pender's health promotion model. The health belief model proposes that health-related actions depend on perceptions of susceptibility, severity, benefits and barriers. The holistic health model sees people as ever-changing systems influenced by environment. Pender's health promotion model focuses on factors influencing health-promoting behaviors.
Psychosocial factors of malocclusion /certified fixed orthodontic courses by ...Indian dental academy
This document discusses the psychosocial factors related to malocclusion and orthodontic treatment. It begins by outlining Wright's classification of child behavior in dental offices and models of health behavior including the health belief model, theory of reasoned action, self-regulation theory, and stages of change model. It then discusses the psychosocial impact of malocclusion, including social judgments and patients' self-adjustments. While malocclusion can impact social perceptions, studies show patients generally have positive self-concepts and self-esteem. The document concludes by noting patients' expectations for psychosocial benefits from orthodontic treatment such as improved self-confidence and relationships.
The document summarizes several prominent health behavior theories that are relevant for nursing practice and research. It describes theories such as the health belief model, social cognitive theory, transtheoretical model, and theories of reasoned action. Key concepts discussed include an individual's perceptions, self-efficacy, environmental influences, and how behavior change is best understood as a process rather than a single event. The theories provide guidance for nurses to enhance patient motivation and effectively support individuals through the various stages of behavior change.
Theories applied in community health nursingKalpana B
The document discusses several theories relevant to community health nursing. It describes Florence Nightingale's environmental theory which views nursing as altering the patient's environment to promote healing. It also outlines Dorothea Orem's self-care theory, which posits that individuals should be self-reliant in caring for themselves and others. Orem's theory identifies universal, developmental, and health-derived self-care requisites. Nursing is needed when self-care capabilities do not meet the therapeutic self-care demands. The document provides overviews of several other theories used in community health nursing.
This document proposes a community-based intervention called "Get out Live, Love Life: Park 30" aimed at increasing physical activity. It will enhance an urban park and conduct outreach to educate community members. Baseline surveys will assess park usage and safety concerns. Partnerships will be formed and the park improved. Marketing will publicize the changes and physical activity recommendations. Participants will complete pre- and post-tests to evaluate stage of physical activity change according to the Transtheoretical Model. The goal is for the intervention to create a supportive environment that increases park use and physical activity levels in the community.
EMPHNET-PHE course: Module03 ethical issues in surveillance, screening and ou...Dr Ghaiath Hussein
This is a series of presentations I gave in the Eastern Mediterranean Public Health Network (EMPHNET)'s Public Health Ethics (PHE) that was held in Amman in June 2014.
This presentation outlines the ethical issues related to surveillance, screening, and outbreak investigation.
This document outlines a proposed intervention to increase physical activity among freshmen at Kansas State University. The intervention includes physical activity classes, laboratory sessions teaching exercises, and providing exercise kits for dorms. An evaluation plan involves initial and final surveys of freshmen to assess changes in physical activity, as well as monthly process surveys to track program participation and feedback. The goal is to increase physical activity knowledge and self-efficacy, leading to higher physical activity levels and potential long-term health benefits for students.
The Pender's Health Promotion Model specifies that health behaviors are influenced by personal factors and the surrounding environment. The model aims to identify, assess, and modify these influencing factors to encourage health-promoting behaviors. It provides a framework for understanding how individuals can improve their health and well-being. Key concepts include the interaction between the person, environment, health behaviors, and nursing. Research shows the model can be used effectively in clinical settings to develop health-promoting behaviors.
This document discusses several models for health maintenance and disease prevention, including ecological models, the health belief model, relapse prevention model, stages of change model, social cognitive theory, and theory of planned behavior. It provides details on key concepts and components of each model. Additionally, it covers strategies for facilitating dietary change and assessing and treating pain.
This document outlines a study exploring associations between executive function and health behaviors. The study aims to identify which executive function facets (inhibitory control, mental flexibility, working memory) are associated with dietary behaviors (unhealthy snacking, fruit and vegetable consumption). It also aims to see if better executive function performance predicts adherence to stated diet intentions over 48 hours. The methods section describes the cross-sectional study design, objective executive function tests used, dietary assessment, and analysis plan to examine correlations and regressions between variables. Limitations including the small sample size and need for future work controlling additional variables are discussed.
1. Sustainable development in health systems requires changing practices, but behavior change is difficult.
2. Thinking behaviorally can help by diagnosing the behaviors to change, measuring psychological determinants of the behaviors like capability, opportunity and motivation, and developing interventions to target those determinants.
3. An example project measured determinants like motivation before and after an emergency care course, finding increased perception of opportunity was linked to changed practice, showing how interventions can be improved.
The document discusses various concepts related to health, wellness, and illness. It defines health according to different organizations such as WHO and provides perspectives from various fields such as biomedicine, ecology, and sociology. Several models of health and illness are described, including the health-illness continuum model, high-level wellness model, agent-host-environment model, health belief model, and holistic health model. The dimensions of wellness, components of high-level wellness, and factors influencing health status are also outlined.
8 l 4 snyman et al - icf and ipep - amee 2013Stefanus Snyman
The document discusses using the International Classification of Functioning, Disability and Health (ICF) framework to guide interprofessional education and practice. It describes how assessing healthcare students' case presentations using the ICF framework:
1) Drove interprofessional practice among students and professionals by facilitating a biopsychosocial approach to patient-centered care.
2) Resulted in improved patient outcomes.
3) Strengthened health systems by fostering appreciation of different professions and commitment to teamwork between education and healthcare services.
PUH 5304, Health Behavior 1 Course Learning OutcomVannaJoy20
PUH 5304, Health Behavior 1
Course Learning Outcomes for Unit VI
Upon completion of this unit, students should be able to:
5. Examine health behavior intervention strategies.
5.1 Assess the many aspects that accompany intervention planning such as goals and objectives,
setting, community resources, and timelines.
5.2 Identify an intervention strategy that relates to intervention implementation within a community.
Course/Unit
Learning Outcomes
Learning Activity
5.1
Unit Lesson
Chapter 12
Unit VI Assignment
5.2
Unit Lesson
Chapter 12
Unit VI Assignment
Reading Assignment
Chapter 12: Translating Research to Practice: Putting “What Works” to Work
Unit Lesson
In Unit V, we addressed how theories and models such as the social cognitive theory, the health behavior
model, and the theory of planned behavior play a role in intervention planning. This unit, we will build on the
foundation of theories and models and look at how to be strategic in determining interventions. The reading
highlights the concerns that health educators should have as it relates to the design and evaluation process to
determine the successfulness of interventions for a given health behavior.
Intervention Strategizing
When a health educator is developing an intervention strategy to help with a particular health behavior, there
are a few key factors to consider: identifying the target population, selecting a setting, setting goals and
objectives, and identifying resources and a timeline. Each of these factors are a concern for health educators
when developing interventions (Powell et al., 2017).
Target population: Who are you planning the intervention for? Are there any special needs? For instance,
adolescents have special needs because they are in school during the day, so an intervention for them would
need to be after school, on the weekend, or through the school. An intervention for seniors should be held
during the day because seniors normally shy away from being out at dusk or dark. If the intervention were for
the working population, there would be better attendance in the evenings or weekends. The goal with
determining the population for the intervention is to think of alleviating any barriers that may affect most of the
population (Powell et al., 2017).
Setting: Where will the intervention be held? Is there handicap access for seniors or elevator accessibility? Is
the location easily accessible? Is there public parking? What is the room reservation process? Is the setting
outdoors, and if so, are there backup plans in case of bad weather? As the health educator, you should take
into account the best setting to meet the needs of the population that has been identified (Nilsen, 2015).
UNIT VI STUDY GUIDE
Interventions for Health Behavior
PUH 5304, Health Behavior 2
UNIT x STUDY GUIDE
Title
Goals/Objectives: The health educator should be clear on the goals and objectives of ...
This document provides an overview of various behavior models used in health promotion, including definitions, history, and applications. It discusses models such as the Health Belief Model, Trans-Theoretical Model, Theory of Reasoned Action/Planned Behavior, Social Cognitive Theory, Locus of Control, and Sense of Coherence. It also provides examples of applications of these models to oral health research, such as using the Health Belief Model to design an oral health education program and examining oral hygiene behaviors using the Trans-Theoretical Model.
Theories and-models-frequently-used-in-health-promotionDanzo Joseph
The document discusses several theories and models that are frequently used in health promotion. At the individual level, theories include the health belief model, stages of change model, and relapse prevention model. Interpersonal level theories cover social learning theory, theory of reasoned action, and theory of planned behavior. Community level models involve the community organization model, ecological approaches, organizational change theory, and diffusion of innovations theory. Each theory or model addresses key concepts relevant to health behavior change.
✚ The Scope of Health Behavior
✚ The Changing Context of Health, Disease, and Health Behavior
✚ Health Behavior and Health Behavior Change
✚ Settings and Audiences for Health Behavior Change
✚ Progress in Health Behavior Research and Practice
+What is the main idea of the story Answer in one paragraph or lo.docxadkinspaige22
+What is the main idea of the story? Answer in one paragraph or longer at least 5-7 sentences)
https://www.youtube.com/watch?v=maCsqrN-irQ
+Go to the following link, and read the article by Michael Bronski, “A Gay Man’s Case Against Gay Marriage”.
https://www.beliefnet.com/news/2004/05/a-gay-mans-case-against-gay-marriage.aspx
Why is Bronski against homosexual marriage? (1 paragraph or longer)
What does Bronski say about his own parents’ marriage? (1 paragraph or longer)
Does Bronski believe in equal rights for homosexuals? (1 paragraph or longer)
Note:
Each paragraph is at least 5-7 sentences, and sentence is not too short
Healthy People 2020
Healthy People was a call to action and an attempt to set health goals for the United States for the next 10 years.
Healthy People 2000 established 3 general goals:
Increase the span of healthy life.
Reduce health disparities.
Create access to preventive services for all.
Healthy People 2010 introduced 2 general goals:
Increase quality and years of healthy life.
Eliminate health disparities.
Practical Policy for Preventive Services
The U.S. health care system faces significant challenges that clearly indicate the urgent need for reform.
There is broad evidence that Americans often do not get the care they need even though the United States spends more money per person on health care than any other nation in the world.
Preventive care is underutilized, resulting in higher spending on complex, advanced diseases.
Practical Policy for Preventive Services
Patients with chronic diseases too often do not receive proven and effective treatments such as drug therapies or self management services to help them more effectively manage their conditions.
These problems are exacerbated by a lack of coordination of care for patients with chronic diseases.
Reforming our health care delivery system to improve the quality and value of care is essential to address escalating costs, poor quality, and increasing numbers of Americans without health insurance coverage.
Why policies need to be developed?
Basic needs are not being met (e.g., People are not receiving the health care they need)
People are not being treated fairly (e.g., People with disabilities do not have access to public places)
Resources are distributed unfairly (e.g., Educational services are more limited in neighborhoods of concentrated poverty)
Why policies need to be developed?
Current policies or laws are not enforced or effective (e.g., The current laws on clean water are neither enforced nor effective)
Proposed changes in policies or laws would be harmful (e.g., A plan to eliminate flextime in a large business would reduce parents' ability to be with their children)
Existing or emerging conditions pose a threat to public health, safety, education, or well-being (e.g., New threats from terrorist activity)
Marjory Gordon’s Functional Health Patterns
Marjory Gordon was a nursing theorist and professor who created a.
MBA 7294Week 6 Case Study AnalysisPlease discuss the folloAbramMartino96
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Week 6 Case Study Analysis
Please discuss the following in your case study analysis:
(1) Define currency risk.
(2) Discuss factors that cause and contribute to changes in currency exchange rates and a firm’s exposure to exchange rate fluctuations.
(3) Discuss how currency rate fluctuations and currency risks apply to a firm’s:
Discuss the effect on Balance Sheet
Discuss the effect on Income Statement
Discuss the effect on Cash Flow Statement
(4) Discuss the economic performance of Germany and the United Kingdom from 1988 to 1992.
Discuss the effect of differences in economic performance affect exchange rates
How does the Exchange Rate Mechanism (ERM) work
(5) Discuss the attack on the Hong Kong dollar.
Discuss the mechanics of a speculative attack and the “double play” process.
(6) Provide an evaluation of the actions taken by the Hong Kong government compared with alternatives it might have taken.
How does Mundell’s Trinity factor into your analysis?
Was this a first-, second-, or third-generation crisis?
Science of Improvement Model
Continuous quality improvement in the health sector can be defined as the structured organizational process that involves health care professionals in planning and implementation of improvements that are proactive and ongoing in the delivery of care to improve the quality of care and patient outcomes (Bendermacher et al., 2020). A program promoting physical activity in a community with a diverse population may benefit from the Science of Improvement Model adopted by the Institute of Healthcare Improvement. This model has two main parts. In the first part of the model, there are three important questions that must first be answered. The first question seeks to determine the aims of a project. For the program of physical improvement, the aim is to reduce the number of chronic conditions associated with lack of physical exercises by 50% within two years. The other aim is to increase the number of people in the community engaging in physical exercises by 70 percent or higher.
The next question seeks to determine performance measures to be considered in the implementation of the project. It involves the identification of quantitative measures to be used to determine the effect of changes. The performance measures to be used for this program includes the number of new non-communicable diseases diagnosis in health care facilities and the daily attendances in parks and gyms. This will help in identifying an increase or decrease in physical activities in the community and the effects it has on the health of individuals. The third question considers changes that should be implemented. After completion of this first step, the model has a second part which is called the Plan-Do-Study-Act cycle. This model is used in the testing o ...
The document discusses the ecological model of health behavior. It provides a history of ecological models emerging from various disciplines that converged to form the foundations of health promotion. The core concepts are described as behavior being influenced by multiple levels, including intrapersonal, interpersonal, organizational, community and public policy levels. Applications to tobacco control and diabetes management are outlined at each level. Strengths include a focus on multiple influences and environmental/policy interventions, while weaknesses involve lack of specificity about influences and interaction across levels.
This document provides an overview of a health education course offered at Roosevelt College. The 3-unit, 54-hour course is taught over the summer term to 2nd year Bachelor of Science in Nursing students. The course aims to teach students concepts, principles, and strategies for clinical and classroom teaching. It also helps students develop skills in designing teaching plans using the nursing process framework. The document further provides details on course objectives, content, and theories that will be covered, including perspectives on teaching and learning in healthcare.
Pender's health promotion model from 1982 explains factors that influence healthy behaviors. The model identifies individual characteristics, cognitions regarding behaviors, and interpersonal/situational influences as impacting behavioral outcomes. It draws from expectancy value theory and social cognitive theory. Research has applied the model to areas like cancer screening, HIV care, smoking cessation, and health behaviors in homeless women. The model provides a framework for nurses to assess factors impacting patients' health behaviors and design interventions accordingly.
CONCEPTUAL MODELS IN COMMUNITY HEALTH.pptxNatalya80
This document discusses several conceptual models used in community health:
- The Precede-Proceed Model is an 8-phase model for planning, implementing, and evaluating public health programs by first assessing needs and then implementing and evaluating an intervention.
- The Donabedian Model examines health care quality using three concepts: structure, process, and outcomes to evaluate how structure influences processes and outcomes.
- The Health Belief Model suggests individuals' health-related actions depend on their perceptions of susceptibility, severity, benefits, and barriers of diseases or health behaviors. It includes six constructs related to risk perceptions and decision-making.
EMPHNET-PHE COurse: Module08 ethical codes and frameworksDr Ghaiath Hussein
This document outlines a module on ethical codes and frameworks for public health. It lists the module's objectives of describing current public health codes and frameworks, utilizing ethical analysis frameworks to identify issues, and applying tools to systematically analyze ethical issues. The module outline discusses what codes and frameworks are, the differences between them, examples of applying them to analyze public health ethics issues, and having participants assess programs using frameworks. It also lists several codes and frameworks, including the American Public Health Code, Kass' ethics framework, and Nuffield Council on Bioethics' stewardship model.
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Required ResourcesRequired Text1. McKenzie, J. F., Neiger, B. .docxaudeleypearl
Required Resources
Required Text
1. McKenzie, J. F., Neiger, B. L., & Thackeray, R. (2017). Planning, implementing, & evaluating health promotion programs: A primer (7th ed.). Retrieved from https://www.vitalsource.com/
a. Chapter 1: Health Education, Health Promotion, Health Education Specialists, and Program Planning
b. Chapter 2: Starting the Planning Process
c. Chapter 3: Planning Models in Health Promotion
d. Chapter 7: Theories and Models Commonly Used for Health Promotion Interventions
Recommended Resources
Multimedia
1. V.E.A. (2010). What is health promotion? [Video clip]. In Strategies to Promote the Health of Individuals. Retrieved from Films On Demand database
· This video clip provides an overview of health promotion and the foundations of the work. To easily access this clip, type 42231 in the search bar at the top of the Films On Demand website.
2. V.E.A. (2010). Public health approaches to health promotion [Video clip]. In Strategies to Promote the Health of Individuals. Retrieved from Films On Demand database
· This video clip provides an overview of the public health approach to health promotion. To easily access this clip, type 42231 in the search bar at the top of the Films On Demand website.
Websites
1. Green, L. (2014). The PRECEDE-PROCEED model for health program planning and evaluation (Links to an external site.). Retrieved from http://lgreen.net/
· This website is a compilation of various resources related to the PRECEDE-PROCEED model, which was created by Dr. Larry Green.
2. National Institutes of Health, Office of Behavioral and Social Science Research. (n.d.). Social and behavioral theories (Links to an external site.). E-Source: Social and Behavioral Science Research. Retrieved from http://www.esourceresearch.org/tabid/724/default.aspx
· This online book chapter provides an overview of some health behavior theories and discusses how to choose the right theory to address a health behavior problem in a particular population and context.
3. University of Kansas, Work Group for Community Health and Development. (2014). Community Tool Box (Links to an external site.). Retrieved from http://ctb.ku.edu/en/table-of-contents
· This online book provides practical, step-by-step guidance in community-building skills and developing health promotion programs. Take some time to get familiar with it, as we will refer to various sections of this resource throughout the course.
Supplemental Materials
1. U. S. Department of Health and Human Services, National Cancer Institute. (2005). Theory at a Glance: A Guide for Health Promotion Practice (Links to an external site.) (2nd Ed.). Retrieved from http://www.med.upenn.edu/chbr/documents/TheoryataGlance.pdf
· This booklet provides a summary of major health behavior theories, which are the focus of this week’s quiz.
2. Winch, P. & The Johns Hopkins University. (2012). Ecological models and multilevel interventions: Health behavior change at the individual, household ...
Small Steps to Health and Wealth In Depth Training-04-15Barbara O'Neill
This document provides an overview of a workshop on integrating health and personal finance topics. It begins with introductions of the presenter and their qualifications. Various research findings are presented showing linkages between health behaviors and financial outcomes. Behavior change theories are discussed, including the Transtheoretical Model of Change and the Theory of Planned Behavior. The workshop objectives are to teach strategies from the Small Steps to Health and Wealth program, which encourages participants to simultaneously improve their health and finances through achievable behavior changes.
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This document provides an overview of several common health behavior models:
- The Health Belief Model focuses on perceptions of susceptibility, severity, benefits and barriers to taking health actions. It has been widely used to study preventive health behaviors.
- The Trans-Theoretical Model proposes that individuals progress through stages of change when adopting healthy behaviors. The stages are precontemplation, contemplation, preparation, action, and maintenance. Processes of change and decisional balance are also discussed.
- Applications of these models to oral health are mentioned, such as using stages of change for tobacco cessation counseling. While useful, more research is still needed on using these frameworks to predict oral health behavior change.
This document provides an overview of several common health behavior models, including the Health Belief Model and Trans-Theoretical Model. It discusses key concepts and constructs of each model, such as perceived susceptibility, severity, benefits and barriers. The Health Belief Model focuses on attitudes and beliefs that influence behaviors. The Trans-Theoretical Model examines an individual's readiness to change behaviors through different stages. Both aim to help understand health behaviors and design effective interventions.
Similar to Patient Centered Care | Unit 2b Lecture (20)
Culture of healthcare_ week 1_ lecture_slidesCMDLMS
This lecture provides an overview of the culture of health care. It defines key terms like health, disease, illness, and health care. It explains that culture refers to integrated patterns of human behavior within groups, and defines the culture of health care. The lecture outlines several themes in the literature on the culture of health care, including patient and workforce diversity and various professional cultures. It emphasizes that health care involves a complex mix of cultures that are not always apparent from within.
Unhappy customers can significantly impact a company's bottom line through negative word-of-mouth advertising and lost sales. Studies show that 68% of unhappy customers felt disinterested or indifferent, and one dissatisfied luxury car owner can cost a dealership $100 million in annual revenue from lost sales. As social media has made it easier for customers to share negative opinions, companies place high value on resolving issues with challenging customers to maintain satisfaction and minimize financial losses.
This document discusses key principles for effective communication between support agents and customers. It emphasizes that listening is an active skill that takes effort. Both parties must be actively involved in the interaction to ensure understanding and progress towards resolution. Trust in the relationship allows for open communication, while mutual alignment of goals establishes shared expectations for resolving issues.
The document lists several challenges that were addressed and initiatives that were implemented including stopping upselling, establishing a quality control team, enforcing support tickets, creating organizational structures, identifying talent, delegating responsibilities, developing KPIs, creating autonomous customer service units, implementing various tools like WalkMe and Izenda, conducting HIPAA awareness sessions, creating a client retention unit, using Power BI for reporting, conducting in-house marketing, and creating CRs for CureX. It also shows the results of a survey on recognition, feedback, suggestions, happiness, satisfaction, wellness, ambassadorship, relationships with managers, relationships with colleagues, and company alignment for the Operations team at CureMD.
This lecture discusses how health information technology can help facilitate error reporting and analysis to improve patient safety. It presents three key HIT mechanisms: automated surveillance systems, online event reporting systems, and predictive analytics/data modeling. The lecture also emphasizes the importance of a culture of safety that encourages open discussion and learning from mistakes without blame. Error reports are analyzed using a risk assessment model to distinguish near misses from events that cause patient harm.
This document discusses quality improvement tools for analyzing health information technology (HIT) errors, including root cause analysis (RCA), failure mode and effects analysis (FMEA), and hazard analysis. RCA is a structured problem-solving process that considers all potential causal factors of an incident. FMEA prospectively predicts error modes by assessing the likelihood and impact of process failures. The document provides examples of using RCA and FMEA to analyze HIT-related errors and identifies key areas of focus for HIT safety measures.
This lecture discusses learning from mistakes and errors in health information technology (HIT). It covers types of errors like slips, mistakes, active failures and latent conditions. It also examines unintended consequences of HIT like new or more work, workflow issues, overdependence on technology, and copy-paste errors. The objectives are to assess HIT for negative consequences and examine common HIT design deficiencies. References from AHRQ and other sources on error reporting and analysis in HIT are also provided.
This document discusses electronic clinical quality measures (eCQMs) which are designed to leverage health information technology (HIT) to improve quality measurement. eCQMs use standardized data elements and terminology to measure care quality based on information in electronic health records. Effective eCQM reporting requires structured, coded data and use of standards for measure specification, calculation, and reporting. Widespread use of eCQMs could revolutionize quality measurement by facilitating automated reporting and improving data quality.
This lecture discusses key attributes of data quality including consistency, currency, timeliness, granularity, precision, and relevancy. It provides examples of each attribute and recommendations for maintaining data integrity such as establishing data governance and defining standards for data collection. The lecture also notes that data quality is important for research and quality improvement efforts and that poor data quality can lead to errors.
This lecture discusses assessing data quality and identifies 10 key attributes of data quality: definition, accuracy, accessibility, comprehensiveness, consistency, currency, timeliness, granularity, precision, and relevancy. Poor data quality can threaten patient safety and quality of care, reduce effectiveness of decision making, and increase costs. The lecture provides examples and recommendations for ensuring each of the 10 data quality attributes.
This lecture discusses assessing data quality and improving it through health information technology (HIT). It identifies common causes of insufficient data quality, such as unclear definitions, incomplete data, and programming errors. Both systematic and random issues can negatively impact data quality. The lecture outlines best practices for preventing, detecting, and improving data quality issues. Standardizing terminology, structuring data entry, and utilizing technologies like voice recognition can enhance data quality. Overall, high quality clinical data is important for healthcare decisions, and HIT professionals can implement strategies to enhance data quality.
This document discusses strategies for implementing health information technology (HIT) systems. It compares "big bang" implementations, where a system is launched system-wide at once, to "staggered" or phased implementations. While big bang implementations have faster rollout, they carry higher risk. Staggered implementations have lower risk but slower return on investment. The document also emphasizes the importance of user training and long-term support during and after implementation to ensure success. Contextual factors like organizational culture and individual user needs must also be considered in planning. Nested implementation teams and designated super-users or internal consultants can help provide support.
The document discusses effective health IT implementation planning. It outlines characteristics of effective implementation teams, including communication, understanding roles, and practical expertise. Three key strategies for health IT implementation are reviewed: single vendor, best of breed, and best of suite. Clinical workflows and the needs of different care settings like primary care and critical access hospitals are also addressed. The goal is to assist organizations in designing customized implementation plans that meet their unique quality and safety needs.
This document discusses a lecture on how health information technology (HIT) can impact patient safety culture. The lecture covers strategies for adaptive work that can be useful for HIT initiatives, including being unwavering in goals while inviting others to help achieve them, addressing real and perceived losses from changes, and assuming healthcare providers want to help patients. References are provided for images and content used in the lecture.
This document discusses health information technology (HIT) and its impact on patient safety culture. It provides learning objectives on adaptive leadership, frameworks for patient safety culture, and differentiating technical and adaptive change. It also summarizes a 2013 medical error case study where a patient received a 39-fold overdose due to a 50-step error-prone process. Root causes of use errors with HIT are identified, such as patient identification errors and data accuracy errors. Frameworks for risk assessment and classifying human interaction with HIT systems are presented. The document concludes that HIT has potential to reduce errors but also introduce new opportunities for errors and overreliance on technology.
This document is a lecture on how health information technology (HIT) can impact patient safety culture. It discusses applying quality improvement tools to analyze HIT errors. It highlights the success of efforts led by Dr. Peter Pronovost to reduce central line bloodstream infections through standardization, independent checks, and learning from defects. Checklists, data collection, and adopting practices from high-reliability industries like aviation and Toyota have helped significantly reduce infection rates.
This document provides an overview of quality improvement methods and tools. It describes several common quality improvement models including the API model, Baldrige criteria, FOCUS-PDCA, PDSA cycle, ISO 9000, Kaizen, Lean thinking, and Six Sigma DMAIC. A variety of basic quality improvement tools are also outlined, such as flowcharts, cause-and-effect diagrams, control charts, Pareto charts, and checklists. Finally, potential mistakes in quality improvement initiatives are reviewed, including choosing an inappropriate topic, lack of defined roles/expectations, and failure to sustain improvements.
This document provides an overview of quality improvement methods for healthcare settings. It describes strategies for quality improvement, including the role of leadership in creating a culture that supports quality improvement. The document discusses concepts like the PDSA cycle and foundations of quality improvement developed by thinkers like Shewhart, Deming, and Juran. The goal is to introduce methods that can be used to identify and redesign processes, collect and analyze data, and make improvements to eliminate problems and strategically change healthcare systems over time.
- Alerts and reminders have the potential to improve patient safety but can also cause clinician frustration and "alert fatigue" if too many are nuisance alerts that provide little benefit.
- Successful alerts are specific, sensitive, clear, concise and support clinical workflow, allowing for safe, efficient responses. They include drug and lab alerts, practice and administrative reminders.
- Research found that drug interaction alerts, disease-drug contraindication alerts and dosing guidelines improved prescribing behaviors while unnecessary lab test repeats dropped with test result reminders.
- Clinical decision support (CDS) aims to improve healthcare decisions and outcomes by providing clinicians with relevant patient information and clinical knowledge. However, CDS has not been widely adopted by clinicians.
- Effective CDS provides the right information to the right person in the right format through the right channels at the right time. It can take many forms, including alerts, order sets, and guidelines.
- CDS helps with administrative tasks, managing clinical complexity, controlling costs, and supporting clinical decision-making. However, poor design can also lead to unintended consequences like alert fatigue.
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Introduction: Substance use education is crucial due to its prevalence and societal impact.
Alcohol Use: Immediate and long-term risks include impaired judgment, health issues, and social consequences.
Tobacco Use: Immediate effects include increased heart rate, while long-term risks encompass cancer and heart disease.
Drug Use: Risks vary depending on the drug type, including health and psychological implications.
Prevention Strategies: Education, healthy coping mechanisms, community support, and policies are vital in preventing substance use.
Harm Reduction Strategies: Safe use practices, medication-assisted treatment, and naloxone availability aim to reduce harm.
Seeking Help for Addiction: Recognizing signs, available treatments, support systems, and resources are essential for recovery.
Personal Stories: Real stories of recovery emphasize hope and resilience.
Interactive Q&A: Engage the audience and encourage discussion.
Conclusion: Recap key points and emphasize the importance of awareness, prevention, and seeking help.
Resources: Provide contact information and links for further support.
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Patient Centered Care | Unit 2b Lecture
1. Patient-Centered Care
Behavior Change Strategies
Lecture b
This material (Comp 25 Unit 2) was developed by Johns Hopkins University, funded by the Department of Health
and Human Services, Office of the National Coordinator for Health Information Technology under Award
Number 90WT0005.
This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International
License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/.
3. Some Definitions: Health Models
• Health promotion: can be defined as the process of
empowering people to make healthy lifestyle choices
and motivating them to become better self-managers.
• Theory: a theory presents a systematic way of
understanding events; it is a set of concepts, definitions,
and propositions that explain such events by
demonstrating the relationships between variables.
• Models: models are graphic or mathematical
representations of a theory’s constructs and how they
interact.
3
4. Types of Models — 1
• Health Belief Model: many of these
theories highlight the importance of self-
efficacy in predicting behavior change.
– People with high self-efficacy believe that they
are capable of performing in a certain way to
achieve set goals.
– People with low self-efficacy believe that they
do not have the power to affect their own
performance or outcomes.
4
5. Types of Models — 2
• Transtheoretical Model (Stages of Change Model): individuals
move through stages:
1) being either aware or unaware of a problem with their behavior
with no thought to change (precontemplation);
2) wanting to change behavior (contemplation);
3) making imminent plans to change (preparation);
4) exhibiting the new behavior (action);
5) maintaining the new behavior over an extended period of time
(maintenance);
6) stopping the behavior (termination).
• Theory of Reasoned Action/Theory of Planned Behavior:
intentions to engage in activity are a good predictor of future
physical activity; intentions among individuals vary due to the
influences of personal attitudes and adherence to social
norms. 5
6. Types of Models — 3
• Chronic Care Model: many patient-
centered care programs are based on the
need to address consumers’ chronic
illnesses.
6
7. Overview of the Health Belief
Model
2.02 Figure. Adapted by Eric W. Ford, PhD, 2016.
7
8. Challenges Defined in the
Health Belief Model
• Perceived susceptibility: perception of personal
vulnerability to a condition.
• Perceived severity: evaluation of medical/clinical
consequences (death, disability, pain) and social
consequences (work, family life, social relations).
• Perceived benefits of action: perception of feasibility
and efficacy of action.
• Perceived barriers: perceptions of action as
expensive, dangerous, unpleasant, inconvenient,
time-consuming.
8
9. Description of the Health Belief
Model
2.03 Figure. Adapted by Eric W. Ford, PhD, 2016.
9
10. Overview of the Theory of Planned
Behavior
Source: Ajzen, I. (1991 December). The theory of planned behavior. Organizational Behavior and Human
Decision Processes, 50(2), 179–211.
2.04 Figure. Adapted by Eric W. Ford, PhD, 2016. 10
11. Definitions of TPB Constructs
• Perceived behavioral control: “perceived
control over the behavior.”
• Control belief: “perceived likelihood of
occurrence of each facilitating or
constraining condition.”
• Perceived power: “perceived effect of each
condition in making performance difficult
or easy.”
11
12. Description of the Theory of
Planned Behavior
Source: Ajzen, I. (1991 December). The theory of planned behavior. Organizational Behavior and Human
Decision Processes, 50(2), 179–211.
2.05 Figure. Adapted by Eric W. Ford, PhD, 2016. 12
13. Individual versus Ecological
Models
• Individual models are good for identifying the
program elements that are needed to change a
person’s behaviors.
• One limitation that is often cited is that these
models neglect important aspects of the
environment that influence the behaviors being
targeted.
• E.g., healthy dining options on fast food
restaurants’ menus.
13
14. Why Use a Socio-Ecological
Model?
• It’s very difficult to change human behavior!
• Human behavior is influenced by multiple
factors; socio-ecological models help to identify
opportunities to promote participation in
physical activity.
• When multiple levels of influence are
addressed at the same time, change in
behavior is more likely to be successful and
sustained.
14
15. Components of the Social-
Ecological Model (SEM)
• Intrapersonal.
• Perceived environment.
• Behavior: active living domains.
• Behavior settings: access and
characteristics.
• Policy environment.
15
17. Overview of the Chronic Care
Model
2.07 Figure. The MacColl Institute.
17
18. Toward a Chronic Care Oriented
System
• Reviews of interventions in other conditions show that
practice changes are similar across conditions.
• Integrated changes with components
directed at:
– Use of non-physician team members.
– Planned encounters.
– Modern self-management support.
– Intensification of treatment.
– Care management for high-risk patients.
– Electronic registries.
18
19. Description of the Chronic Care
Model
2.08 Figure. The MacColl Institute.
19
20. Behavior Change Strategies
Summary — Lecture b
• Theories and models can help guide the
building of effective patient engagement
programs.
• Both individual and ecological models inform
the design for patient engagement
interventions.
• Ecological models often include aspects of
health information that need to be in place for
effective patient engagement.
20
21. Behavior Change Strategies
References — Lecture b — 1
References
Bodenheimer, T., Wagner, E. H., & Grumbach, K. (2002, October 16). Improving primary
care for patients with chronic illness: The chronic care model, Part 2. Journal of the
American Medical Association, 288(15), 1909–1914.
Davis, F. D., Bagozzi, R. P., & Warshaw, P. R. (1989). User acceptance of computer
technology: A comparison of two theoretical models. Management Science, 35(8),
982–1003.
Smith, D., et al. (2006). Live it up 2: VCE Physical Education Units 3 & 4. Australian
Council for Health, Physical Education and Recreation, Queensland.
Wagner, E. H., Austin, B. T., Davis, C., Hindmarsh, M., Schaefer, J., & Bonomi, A. (2001,
November–December). Improving chronic illness care: Translating evidence into
action. Health Affairs (Millwood), 20(6), 64–78.
Wagner, E. H., Davis, C., Schaefer, J., Von Korff, M., & Austin, B. (1999). A survey of
leading chronic disease management programs: Are they consistent with the
literature? Managed Care Quarterly, 7(3), 56–66.
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22. Behavior Change Strategies
References — Lecture b — 2
Charts, Tables, Figures
2.02 Figure: Eric W. Ford, PhD, Department of Health Policy and Management,
Bloomberg School of Public Health, Johns Hopkins University (2016). The Health
Belief Model. Adapted from Janz, N. K., & Becker, M. H. (1984, Spring). The Health
Belief Model: A decade later. Health Education Quarterly, 11(1), 1–47.
2.03 Figure: Eric W. Ford, PhD, Department of Health Policy and Management,
Bloomberg School of Public Health, Johns Hopkins University (2016). The Health
Belief Model. Adapted from Janz, N. K., & Becker, M. H. (1984, Spring). The Health
Belief Model: A decade later. Health Education Quarterly, 11(1), 1–47.
2.04 Figure: Eric W. Ford, PhD, Department of Health Policy and Management,
Bloomberg School of Public Health, Johns Hopkins University (2016). Adapted from
Ajzen, I. (1991, December). The theory of planned behavior. Organizational Behavior
and Human Decision Processes, 50(2), 179–211.
2.05 Figure: Health, Johns Hopkins University (2016). Adapted from Ajzen, I. (1991,
December). The theory of planned behavior. Organizational Behavior and Human
Decision Processes, 50(2), 179–211.
2.06 Figure: Sallis, J. F., Cervero, R. B., Ascher, W., Henderson, K. A., Kraft, M. K., &
Kerr, J. (2006). An ecological approach to creating active living communities. Annual
Review of Public Health, 27, 297–322. Used with permission.
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23. Behavior Change Strategies
References — Lecture b — 3
Charts, Tables, Figures
2.07 Figure: The MacColl Institute. ACP-ASIM Journals and Books. Retrieved April 14,
2016, from
http://www.improvingchroniccare.org/index.php?p=Chronic+Care+Model&s=124. Used
with permission.
2.08 Figure: The MacColl Institute. ACP-ASIM Journals and Books. Retrieved April 14,
2016, from
http://www.improvingchroniccare.org/index.php?p=Chronic+Care+Model&s=124. Used
with permission.
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24. Patient-Centered Care
Behavior Change Strategies
Lecture b
This material (Comp 25 Unit 2) was
developed by Johns Hopkins University,
funded by the Department of Health and
Human Services, Office of the National
Coordinator for Health Information
Technology under Award Number
90WT0005.
24
Editor's Notes
Welcome to Behavior Change Strategies. This is Lecture b.
The objective for this lecture is to:
• Compare behavior change models.
In particular, we want to look at some individual models, as well as at some organizational, population, environmental, or what we largely call population/ecological models of behavior change.
First a few definitions that will help, though. Health promotion — this is the process of empowering people to make healthy lifestyle choices and motivating them to become better self-managers. It's worth noting that this isn't just the absence of illness. Health promotion is actually about wellness, happiness, connectedness, having people engaged in their communities in a meaningful and healthy way. We could even go further with the definition and say it is a means of creating shared value and values in the community.
Another concept we will define is a theory. And what is a theory? Well, it's a systematic way to think about how various parts of activities relate to one another. And we often hypothesize that if we change somebody's health behavior — say we have them exercise more — we’ll have an outcome, such as weight loss. And we may even have a secondary outcome, such as lower cardiovascular disease rates. And that might be a theory in simple terms, where we have constructs described, we hypothesize about their relationships, and move from there.
And then to make those theories easier to understand, we may make models. And these are often graphic or mathematical representations of the constructs and how they interact.
So I want to talk about a few different theories — three in particular — though I'm going to mention another one in passing. The first is the Health Belief Model. And this has been used by people in public health for many years now and is worth knowing. And it is very focused on individuals' behaviors, their perceptions of their health status, and the ability to change those statuses.
It often deals with people's self-efficacy. And one's self-efficacy is the belief that I can actually do something, that I can make the change and realize the outcome that I hope to have happen.
A second model is the Transtheoretical Model, or the Stages of Change Model. And I'm not going to go into this in depth. But this often describes how individuals move through six stages. The first stage is being aware of a problem. The second stage is wanting to change. Third comes planning to change, that is making preparations. The fourth stage is action, which is followed by the fifth stage, maintenance. The sixth stage would be termination.
So if you think about this as your New Year's resolution, you might say, “Oh look, it's December. I might want to make a New Year's resolution.” That's sort of this precontemplation period. The contemplation period would then involve deciding what sort of New Year's resolution you want to make. Is it that you want to go to the gym every day? Lose 10 pounds? Something along those lines. Then comes preparation. This is where you go out and buy the gym membership. You actually invest and get your key fob and hope to go to the gym. Step four would be action. And this is the hard part — where you actually show up at the gym every morning and make it a reality. And this is where a lot of us tend to fall down on these things. And you might even think about the fifth stage — the maintenance — as being February when you haven't really made it all that often in January, so you’re just going to stop altogether. You cancel the gym membership, stage six — the termination. And try to think of some other way to lose weight.
Another sort of transtheoretical model that many of you would be familiar with is the Kübler-Ross model, which describes the stages of grief — denial, anger, bargaining, depression, and acceptance. We’re not going to spend a lot of time on transtheoretical models. Just be aware of them. It's something to think about as you make program plans. And to that end, I'll try to incorporate some of that transtheoretical thought into the Theory of Reasoned Action/Theory of Planned Behavior. This is where we're actually developing programs around activities to try and get individuals to improve.
And the last model is the Chronic Care Model. For many of you who actually work in health systems or in care delivery settings, this Chronic Care Model may be something you want to consider, because it talks about how to better coordinate with other parts of the system.
So the first model we’ll discuss in some depth is the Health Belief Model.
So what are the challenges defined in the Health Belief Model? Well, the first two are the perceptual elements. This is how susceptible you believe you are to a particular illness.
You often hear it said about teenagers, for example, that they believe themselves to be invincible. In other words, they have a low perception of their susceptibility to bad outcomes, particularly things that they view as being way later in life, things like heart disease and cancers. The perceived severity is also very low because the time when these bad outcomes are going to occur is so far away. So perceived severity is an evaluation of the consequence.
Another challenge in the Health Belief Model is the perceived benefits of action. Do I really think that changing the way I act will have some real-time discernible benefit to me?
And lastly, you have the perceived barriers. In other words, how hard is it for me to make this change?
So let's take a longer look at this model, presented here as a flowchart. And let's move from left to right here. Individual perceptions are on the left. And these perceptions really depend on people's awareness of two elements: 1) their susceptibility to a disease, and 2) how serious they think that disease is.
Say, for example, you're a middle-aged man — so we can also take in some of these modifying factors appearing in the middle of the chart — the demographic variables. And you come from a socioeconomic background where it's not unusual for people to have cardiovascular disease, heart attacks, and other illnesses. So you might perceive yourself to have elevated susceptibility.
How serious you consider the disease is another important component, because it is the two elements taken together — perceived susceptibility and perceived seriousness — that factor into your overall perception of disease threat, which appears in the box in the center of this model.
As mentioned earlier, there are modifying factors above and below the total perceived threat of disease, and those modifying factors include demographic characteristics. In cancer, for example, it's well known that women who have a mother, an aunt, a grandmother, or sister who has had breast cancer have elevated susceptibility to the disease. And breast cancer's a very serious illness that's received a lot of attention, so women with those modifying factors are likely to perceive breast cancer to be very serious. Therefore, their perceived threat of that disease is likely to be very high.
You'll notice that I mentioned a couple of cues to action, which fall under modifying factors in the center of the chart. This model, which originally appeared in Health Education Quarterly many years ago, has been modified to include social media. More and more we see things like Facebook and other media campaigns that connect us, such as Twitter, really helping to increase our awareness and give a more accurate perception of threat. But there are other forms of cues to action. You may get a postcard from your dentist reminding you that it's time to get your teeth cleaned. A family member or friend may get ill and make you think about it — those sorts of things.
The other parts of the Health Belief Model that are important fall under likelihood of action, which appears on the right-hand side of the chart. And the first action has to do with decision making. And this is where you look at your perceived benefits and subtract the barriers to action. This is really sort of a cost-benefit analysis. And it involves deciding whether doing what needs to happen to improve health is worth the cost of doing it? In other words, is it worth it to me to get up early every morning and go to the gym and pay gym fees in order to lower my risk of cardiovascular disease?
And taken together, those factors will determine the likelihood of my taking an action. So you'll notice that the arrows are flowing in a very particular order. It's my overall perception of threat — the middle box — coupled with the cost-benefit analysis of action that will factor into my likelihood of taking an action.
The Theory of Planned Behavior, or TPB, served those of us in public health very well for many years.
There are a few benefits of this for the constructs you need to know. And these are very similar to what you just saw in the Health Belief Model. It's a perception of your behavioral control — the likelihood that engaging in an activity will lead to a desired outcome. And this has another important component, which is my perceived power. Do I really think that I can change my health or the condition I live in?
Here's how this model, which has been slightly modified, looks. But rather than simply having two factors acting on my intention — as in the Health Belief Model — I now have three. And the first is this subjective norm. Are there people in my community engaged in healthy behavior whom I should be modeling myself after? So if you live in a community where everybody's jogging, riding their bikes to work, eating salads at lunch, using the stairs — if there is all that type of subjective and social norming happening around you — it may have a fairly dramatic effect on your planned behaviors. It may even influence your attitudes toward behaviors.
Lastly, the other leading element is perception of behavioral control, the belief that I can actually make the necessary change. And you'll see that these first three elements — the subjective norm, attitude toward the behavior, and perceived behavioral control — feed into one's intention, that is, my desire to do it. And then that intention, once it gets strong enough or my desire is high enough, will result in a behavior.
You may notice that one of these early constructs is actually having a deleterious effect on actual behavior. In other words, your perception that there aren't good biking paths, jogging paths, local gyms, or healthy food options may be very real. You may live in a community that's a food desert, where healthy foods are not readily available. And that has a very real impact on behavior.
The other big set of models are ecological models. And these involve trying to change the operation, the environment around individuals. So individual models are good for identifying program needs to impact the individual. As a planner, you need to consider the individual, but you also need to consider the environment. Can people actually access the things they need to improve their health? One example, is putting healthy dining options on fast food restaurant menus. And this is something we've seen more and more in recent years.
So why use a socio-ecological or an environmental model to change behavior? Well, human behavior is difficult to change. And it takes a lot of things pushing on us — not just one typically — to make those changes happen.
So what are some of the components of the socio-ecological model? Well, there are the interpersonal components. If you hang around with people who are getting up and going to the gym, chances are you'll get up and go to the gym, too.
Then there is the perceived environment. In the past people often said that California was a healthy place to live. People perceived Californians as being healthier for a variety of reasons — that they spent lots of time out in the sun surfing, jogging, wanting to look like movie stars, those sorts of things. So the behaviors themselves are an active living domain.
Behavior settings, we mentioned that at some great length.
And the policy environment — and this is not trivial. So now we're getting further and further away from individual, you'll see. And do we have good policies? Does your local government promote parks, bike paths, other healthy options in the community?
So here's the ecological model as it's often depicted with concentric ellipses. At the center are intrapersonal characteristics, and furthest out is the policy environment, which takes all types of policy — such as zoning, health care, transportation, and media regulations — into consideration.
Just inside the policy environment is the environment in which people are living, the behavioral setting, as we might call it. The behavior setting includes factors such as walkability, recreational opportunities, and the social climate.
Moving inward, you'll find active living domains. And this is really where you're getting into the nitty-gritty of where people work, where they live, and how they get back and forth to those places.
Even more internal to the person is their perception of that environment. Is this environment a healthy one? Am I safe? Is it attractive? Are there conveniences that I can take advantage of?
And lastly, at the center, there's intrapersonal well-being. Am I happy, well-balanced, and leading the life that I want?
Note that the information environment, the social and cultural environment, and the natural environment are all important.
The last model we’ll talk about just briefly is the Chronic Care Model. And this is something for those of you who work in a health system or a doctor's office or are in any way engaged in patient care. This is something on which we’re often working if you are in the private sector.
So what's the chronic care oriented system? Well, it reviews interventions and other conditions to see how we can change the way we are currently practicing the delivery of services within our organizations.
There are many examples. Non-physician team members or physician extenders give patients more contact with people operating as support toward improving their care. Planned encounters are a way to increase the number of activities in which people have the opportunity to change their behavior. And that flows directly into modern self-management support through tools like personal health records and the watches that tell us to get up and exercise and track how many steps we take — those sorts of things.
Then there’s intensification of treatment. Often we’ve been encouraged to keep people out of the hospital, and we have perhaps discharged patients prematurely in order to reduce what we used to call length of stay. We may want to intensify or lengthen those treatments in some instances.
Again, care management for high-risk patients — it's not just my part that matters. I need to understand how other caregivers and how other organizations in the community are interacting with this patient to make sure that we're coordinated in a way that's effective.
And electronic registries — these are tools that let us know when somebody has a particular chronic illness that we should be aware of and helping them manage.
So here's a graphic depiction of the Chronic Care Model.
The big oval represents the greater community. What are its resources? How does public policy affect how we deal with individuals?
And then we have the health system itself represented by a smaller circle that's completely contained within the community. And you might ask, within your community, whether there’s self-management support. And, by the way, that may occur within and outside the health system. You might also ask whether the health system is integrated. Is there a delivery system design that ensures that patients discharged from the hospital are receiving proper follow-up care?
Then there’s decision support. For example, you might want to know whether a doctor’s office has tools that can recommend that a person be prescribed one drug over another under a certain set of conditions. What sorts of aftercare do they deserve, et cetera? And all that is dependent on people's clinical information systems, electronic medical records, et cetera. Do these tools actually support better decision support and integration?
And all of those things in the ovals — at the community and health system levels — feed down into having informed, activated patients and a prepared, proactive practice team. If you have all those things, you'll actually have improved outcomes.
This concludes Lecture b of Behavior Change Strategies. So in summary, theories and models can be very helpful in helping you design your patient engagement program. Both the individual and ecological perspectives should come to bear as you make those designs. And, in particular, you may have more control over ecological elements of your engagement program.