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Community Health Promotion InitiativesTerm Paper

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Community Health Promotion Proposal

The objective of this study is propose a community health initiative. This will be accomplished by reviewing priorities for health promotion stated by Healthy People 2020.

The work of Navarro et al. (2007) entitled "Charting the Future of Community Health Promotion: Recommendations From the National Expert Panel on Community Health Promotion" published by the Centers for Disease Control and Prevention reports "In the decades since chronic illnesses replaced infectious diseases as the leading causes of death, public health researchers, particularly those in the field of health promotion and chronic disease prevention, have shifted their focus from the individual to the community in recognition that community-level changes will foster and sustain individual behavior change." (p. 1) It is stated that the National Center for Chronic Disease Prevention and Health Promotion and the Division of Adult and Community Health "invited an external panel of experts to participate in the National Expert Panel on Community Health Promotion" in order to identify methods that these problems could be addressed at the local and national levels. (Navarro et al., 2007, p. 1) Community health promotion is such that "emphasizes the social, cultural, and environmental contexts that shape health status and works through collaborative partnerships to improve the health of a population within a defined geographic area. Community-based participatory strategies, such as community organization and mobilization, bring to bear shared values and experiences of community members, who are viewed as having the best knowledge of and perspective on improving the health of their community. The community is regarded as an influential determinant of health, and community members are involved in all aspects of public health research, interventions, and evaluations." (Navarro et al., 2007, p. 1) It is reported that the largest challenge that presents to public health leaders is the emphasis of the "important role of long-term community health promotion in addressing the social and environmental determinants of health in an atmosphere that demands evidence of health impact and return on investment." (Navarro et al., 2007, p. 1)

Findings stated by the expert panel include that "ecological models have been useful in furthering community health promotion efforts, particularly as they relate to environmental influences on health status and behavior. In addition, the panel acknowledged CDC's valuable role in validating effective practices of community health promotion and supporting community-based participatory research and public health surveillance. The panel also affirmed CDC's role in disseminating public health knowledge across communities and serving as the voice among federal agencies for community health promotion." (Navarro et al., 2007, p. 1)

The expert panel is reported to have noted that "… even the best operational measures of the socioecological approach missed critical opportunities for change, including mental health and wellness, spirituality, and complementary and alternative medicine; access to care; political and economic contexts of decisions; race, racism, and discrimination; cultural beliefs and values as risk factors and protective factors; and elements of community efficacy, such as social capital and community competencies. The panel reported the need for an ecological approach to be sufficiently flexible to allow community choices based on available resources and local realities. Additionally, future approaches should facilitate discussions on power relationships, the political process, chronic social stressors (e.g., poverty), acute situations (e.g., hurricanes), and the engagement of nontraditional partners." (Navarro et al., 2007, p. 1)

Included among the panel recommendations are the following stated recommendations: (1) there needs to be enhancement of "surveillance systems beyond the tracking of individual risk factors to include community health indicators and social determinants of health; (2) promotion of participatory research that is community based; (3) training and capacity building need to be supported to make sure that the public health workforce is in possession of the "knowledge, skills, and tools necessary to implement community health promotion approaches; (4) promotion of a "state-of-the-art e-mechanism to share expertise and knowledge about community health promotion"; (5) support of a focus on wellness to include "mental health, spirituality, and complementary and alternative medicine (CAM); (6) There is a need to "shift a measurable part of NCCDPHP's community health promotion programs to focus on improving living conditions across the lifespan"; (7) there is a need for maximizing the "impact of federal resources dedicated to community health promotion"; and (8) a need exists to provide "funding tailored to the realities of community health." (Navarro et al., 2007, p. 1)

The work of Freudenberg and Ruglis (2007) entitled "Reframing School Dropout as a Public Health Issue" published by the Centers for Disease Control and Prevention reports that good education is predictive of "good health, and disparities in health and in educational achievement are closely linked. Despite these connections, public health professionals rarely make reducing the number of students who drop out of school a priority, although nearly one-third of all students in the United States and half of black, Latino, and American Indian students do not graduate from high school on time." (p.1) Additionally reported by Freudenberg and Ruglis is that while education is "highly correlated with income and occupation, evidence suggests that education exerts the strongest influence on health." (2007, p. 1) In fact, education of a formal nature is reported as "consistently associated with lower death rates, while less education predicts earlier death. The less schooling people have, the higher their levels of risky health behaviors such as smoking, being overweight, or having a low level of physical activity." (Freudenberg and Ruglis, 2007, p. 1) Health interventions focused on reductions in school dropout rates are such that have the objective of changing "individuals, families, schools, school systems, or public policies related to poverty, welfare, or employment. Interventions that have the potential to improve school achievement and reduce school dropout rates by improving the health of students are of particular interest to health professionals." (Freudenberg and Ruglis, 2007, p. 1) Interventions that are school-based are reported to include "coordinated school health programs; health clinics; mental health programs; substance abuse prevention and treatment programs; comprehensive sex education, human immunodeficiency virus infection prevention, and pregnancy prevention programs; special services for pregnant and parenting teens; violence prevention programs; and interventions to change the schools' social climate." (Freudenberg and Ruglis, 2007, p. 1)

Five priorities for action were recommended by Freudenberg and Ruglis including the following stated five recommendations: (1) Targeting of schools and cities that had the highest rates of dropout for problems that needed intensive intervention; (2) Development, implementation and evaluation of health interventions that serve to bring about improvement in completion rates of students; (3) Strengthening of support for teachers of health education as well as the development and implementation of "new approaches to school-based health education and health services that can reduce dropout rates will require well-trained school health education teachers, nurses, and mental health professionals, each currently in short supply" (Freudenberg and Ruglis, 2007, p. 1); (4) Advocacy for interventions that are evidence-based and that serve to improve health as well as bring about a reduction in dropout rates; and (5) Placement of the reduction of "high school dropout rates on the public health agenda." (Freudenberg and Ruglis, 2007, p. 1)

I. Health Promotion Initiative

The health promotion initiative chosen for this study is one that involves health promotion at the community level led by nurse practitioners. The information previously reviewed in the introduction of this study supports health promotion, education promotion and due to the shortage of health professionals available in today's workforce, specific promotion of educational initiative and opportunities in the field of health care is at focus.

II. Nurse Practitioners and Public Health Promotion

Nurse Practitioners are reported to be "registered nurses who are prepared through advanced education and clinical training at the Master's or Doctorate level and have advanced certification in a specialty area." (American College of Nurse Practitioners, 2011, p. 1) Nurse Practitioners are reported to make provision of "a wide range of preventive interventions, acute health care services and chronic illness management to individuals of all ages. Nurse Practitioners diagnose and treat acute and chronic illnesses, interpret laboratory and x-ray results" and in some U.S. states prescribe as well as manage patient medications. (American College of Nurse Practitioners, 2011, p. 1)

Nurse Practitioners additionally are reported to "emphasize individual holistic care. They focus not only on a persons' physical health condition or illness, but also on their functional, emotional, spiritual and mental health needs. They evaluate the interaction between illness, quality of life and family dynamics." (American College of Nurse Practitioners, 2011, p. 1 ) Nurse Practitioners additionally are stated to "emphasize health promotion and illness prevention, and encourage and foster self-care. Nurse Practitioners empower people to become active participants in their health care and encourage them to participate in decisions regarding their health care." (American College of Nurse Practitioners, 2011, p. 1)

It is reported that the Family Care Partnership interdisciplinary team (IDT) staff is inclusive of "the member and others specified by the member, a registered nurse (RN), a social services coordinator (SSC) and a Nurse Practitioner (NP). The Nurse Practitioner works collaboratively with the IDT… [END OF PREVIEW]

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