12 Apr A group of nursing students wanted to learn more about the health behaviors of adolescents in their community. They decided to ha
A group of nursing students wanted to learn more about the health behaviors of adolescents in their community. They decided to have students at the local high school complete a questionnaire about their health behaviors. After the adolescents completed the questionnaire, the nursing students reviewed the responses and tallied the results. They discovered that over half of the adolescents who completed the questionnaire engaged in risky sexual behaviors. They reviewed the literature, which stated that sexually transmitted infection (STI) rates in this population are on the rise.
The nursing students decided to educate the adolescents about safe sexual practices and the prevention of STI transmission. The overall goal of the program was to decrease the number of adolescents engaged in risky sexual behaviors. The nursing students developed the following objectives and teaching strategies for this educational program:
- To instill adolescents with an intrinsic motivation to become aware of their own risky sexual behavior through class discussions and cooperative learning exercises
- To promote safe sexual practices with the adolescents through demonstration of appropriate safe sex practices and inquiry-guided instruction
- To develop students’ positive sexual health behaviors through scenario-based case presentations and discussions
Review the Healthy People 2030 Leading Health Indicators (LHIs). Identify the LHI that best matches STIs and transmission through risky sexual behaviors.
Critique the objectives and teaching strategies used by the student nurses.
- How do the objectives and teaching strategies address the identified LHI?
- What action by the nursing students illustrates the planning phase of the health planning model? Refer to Figure 7.2 in Community Health Planning, Implementation, and Evaluation.
- Which system level is primarily being addressed through the educational program? Refer to Box 7-2 in Community Health Planning, Implementation, and Evaluation.
- What level of prevention is being applied by the educational program that the nursing students are providing? Refer to your textbook for levels of prevention.
Cite specific examples from practice or literature.
BOX 7-2
Systems Framework Premises
I. Each system is a goal-directed collection of interacting or interdependent parts, or subsystems.
II. The whole system is continually interacting with and adapting to the environment, or suprasystem.
III. There is a hierarchical structure (suprasystem → system → subsystems).
IV. Each system is characterized by the following:
A. Structure: Arrangement and organization of parts, or subsystems
1. Organization and configuration (e.g., traditional vs. nontraditional; greater variability [no right or wrong and no proper vs. improper form])
2. Boundaries (open vs. closed; regulate input and output)
3. Territory (spatial and behavioral)
4. Role allocation
B. Functions: Goals and purpose of system and activities necessary to ensure survival, continuity, and growth of system
1. General
a. Physical: Food, clothing, shelter, protection from danger, and provision for health and illness care
b. Affectional: Meeting the emotional needs of affection and security
c. Social: Identity, affiliation, socialization, and controls
2. Specific: Each family, group, or aggregate has its own individual agenda regarding values, aspirations, and cultural obligations
C. Process and dynamics
1. Adaptation: Attempt to establish and maintain equilibrium; balance between stability, differentiation, and growth; self-regulation and adaptation (equilibrium and homeostasis)
a. Internal: Families, groups, or aggregates
b. External: Interaction with suprasystem
2. Integration: Unity and ability to communicate
3. Decision making: Power distribution, consensus, accommodation, and authority
Primary prevention relates to activities directed at preventing a problem before it occurs by altering susceptibility or reducing exposure for susceptible individuals. Primary prevention consists of two elements: general health promotion and specific protection. Health promotion efforts enhance resiliency and protective factors and target essentially well populations. Examples include promotion of good nutrition, provision of adequate shelter, and encouraging regular exercise. Specific protection efforts reduce or eliminate risk factors and include such measures as immunization, seat belt use, and water purification.
Secondary prevention refers to early detection and prompt intervention during the period of early disease pathogenesis. Secondary prevention is implemented after a problem has begun, but before signs and symptoms appear, and targets those populations that have risk factors. Mammography, blood pressure screening, scoliosis screening, and Papanicolaou tests are examples of secondary prevention.
Tertiary prevention targets populations that have experienced disease or injury and focuses on limitation of disability and rehabilitation. Aims of tertiary prevention are to keep health problems from getting worse, to reduce the effects of disease and injury, and to restore individuals to their optimal level of functioning. Examples include teaching how to perform insulin injections and disease management to a patient with diabetes, referral of a patient with spinal cord injury for occupational and physical therapy, and leading a support group for grieving parents.
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