The main focus of health promotion and disease promotion programs is to keep people healthy. They aim is to engage and empower people to adopt healthy behaviors to reduce the risk of developing chronic diseases. It includes many social and environmental interventions intended to benefit and protect the community’s health and quality of life.
Target Community
The target community for health promotion is the elderly with Alzheimer’s disease. The risk of the disease increases with age but early onset can occur in people below the age of 65. Alzheimer’s occurs due as result of damage to brain neurons affecting the ability to communicate with each other. The death of these neurons affects memory, behavior, and physical functions over time.
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The rationale behind developing the program is help people improve control over the health risks and their determinants. A promotion program is a justifiable investment to produce desired health outcomes to the targeted population. A health promotion program would manage and coordinate funds, increase awareness about making healthy choices, and ensure commitment and participation of relevant stakeholders.
Health Promotion Program
Typical activities for health promotion in the community include communication, education, and changing policy. Communication involves raising awareness about healthy behavior in the community. Strategies in communication include social media campaigns, newsletters, and public service announcements. Education entails empowering behavior change by providing information and increasing knowledge. Training and support groups are some of the strategies to enhance education in the community. Policy and systems include better laws and regulations and functional organizational components.
The health promotion plan will involve behavioral change and community social action. Matters of interest in behavioral change include:
Quitting smoking – dropping this behavior improves brain health and reduces the risk of Alzheimer’s and other chronic diseases.
Managing cholesterol levels – this will be done by engaging the target population in physical exercise.
Engaging more in social interactions – it involves encouraging older people and those around them to interact more.
Drinking less alcohol – for those who take alcoholic drinks, it is advisable to do so in moderation.
Dietary changes – excess weight can be a problem to people with advanced Alzheimer’s as physical functioning deteriorates. Healthy eating manages weight.
The community social action to help the elderly cope with Alzheimer’s will involve:
Caregiving to those with Alzheimer’s.
Assessing the needs of people with Alzheimer’s to see how best to help them.
Providing trained volunteers and community support workers to help the affected with activities they are not able to carry out themselves.
Providing direct practical help with light chores such as cooking and laundry.
Creating support networks for advice and encouragement. This helps the elderly feel socially connected and gives them a sense of belonging and purpose.
Offering the affected family reprieve by spending time with the person living with Alzheimer’s.
Behavioral Change Health Promotion Approach
The behavioral approach in health promotion utilizes the individual change in lifestyle that are suitable to people’s settings. It is assumed that for individuals to change lifestyle they have to first understand a particular health issue, form positive attitudes, learn appropriate skills, and be provided with access to essential services. Some negative behaviors such as smoking and excessive drinking result in ill-health . Persuading people to adopt positive ones will reduce the prevalence of chronic illnesses. The behavior change approach promises quantifiable results in a given period of time. Research suggests that physical activity, alcohol consumption, and smoking are some of the most important behavioral health determinants. While temporary behavior changes are unlikely to have significant effects, permanent changes have meaningful effects.
Health promoters have continuously extensively invested in the behavior change approach. This type of intervention uses behavior change communication to provide new knowledge and techniques that individuals need to adopt in their lifestyle. Change agents include motivation, communication and information technologies, counseling, and coercion. Health promotion programs often employ top-down approaches like multi-risk factor reduction interventions and health education. Community assessment and the promotion of health are more effective when there is a strong framework in place to create a conducive environment and enable people to empower themselves to make the right healthy lifestyle steps. A strong framework involves the collaboration of the affected people, the community, non-governmental organizations, the private sector, and the relevant government agencies. The ideal health promotion program addresses behavioral risks and is best implemented as part of a more robust comprehensive policy framework with communication strategies designed to target a specific behavior or disease. Multifaceted interventions that are also comprehensive are often effective in changing behavior that can cause negative health issues. A strong policy framework empowers people living with a chronic disease have more control over their lives (Laverack, 2017). It is therefore critical for behavior change programs to be supportive of a strong policy framework.
Health promotion programs rely on the participation of the targeted population. The majority of community members will willingly participate if they are properly engaged and their interest in the program communicated clearly. Capacity building and local action are more effective than a top-down model that uses the authority of practitioners to control the situation (Laverack, 2017). Empowering models help the community work together to have more control over their health.
Community Social Action
People have always worked together to meet their needs in the areas of their basic needs like food, shelter, and health. The community action approach takes different forms and reflects current knowledge and local concepts. They have also been at times influenced by the extent of locally available resources. Community social actions are dependent on the nature of the relationship that exists between the community and the formal health system. Traditionally, health care has been the reserve of medical care entrusted to trained health professionals. Community groups and the lay public have had limited involvement. The distance in health issues between formal professionals and the general population has created some challenges. Health care has become costly, administratively complex, and increasingly a political matter.
Various social and political changes have made people more aware of the importance of participating in the health development process. Today, there is increased education and greater exposure generated by mainstream and social media. The public now feels that they can provide more contribution and provide guidance on options to be pursued. After finding that many concerns about health care have gone unresolved, many public health interest groups have cropped up to seek remedies for issues such as Alzheimer’s disease, heart conditions, and cancer (Golinowska et al., 2016). Such groups mobilize resources and technical expertise designed to create a partnership between the formal health sector and the community. The community assumes a greater role in health care programs once it realizes that it is to its benefit to doing so. (Golinowska et al., 2016). The community’s role includes providing support to the families affected and volunteers to help people living with Alzheimer’s. There has also been a growing awareness among health care professionals that promotion programs cannot work without community action. It will be difficult to achieve behavioral and social changes without the intervention of the community.
Overarching Goals and Specific Objectives
Quality of Life
The main goal of the community health program is to improve the overall quality of life of those diagnosed with Alzheimer’s disease. It is suitably determined by the opinions of the patient using measures set by health experts. The quality of life of those living with Alzheimer’s can be significantly improved through participation in meaningful and pleasant activities, interacting with other people, and listening to music. They should also eat nutritious meals and engage in physical activities. Such engagements are learned through health promotion approaches like behavioral change and community social action. These activities help people with Alzheimer’s disease improve relations with family members, increase feelings of competence, and reduce depression.
Objectives
The program logic models define inputs, outputs, and the outcomes of an intervention to explain the design behind a program. It charts the way for the specific program actions that are used to obtain desired results (CDC, 2020). Inputs are resources invested and outputs are activities carried out while outcomes are the results of the intervention. For Alzheimer’s patients, the measured domains in outcome assessment in the elderly are:
Physical functioning
Social functioning
Mental functioning
These are the three main objectives that the community health promotion program should seek to improve. Physical functioning includes activities of daily living and additional exercise. Activities of daily living include bathing, dressing, feeding, and general mobility. These features assess the general health status of a person with Alzheimer’s disease. Physical health indicators should be looked into keenly by both the physician and the patient’s side as elderly people tend to rate their health status more positively than health professionals do. Functional ability in Alzheimer’s is closely associated with cognitive ability.
Mental status measures are critical with older people with Alzheimer’s. Social functioning encompasses all human relationships and activities within the community. Social support has a profound effect on health and illness recovery among the elderly. Social functioning includes social interactions and resources, subjective wellbeing, coping, and fitting in the environment. Such programs are particularly important to the elderly as behaviors considered awkward and disruptive may reduce if activities are targeted for specific affected individuals.
Health Promotion Programs Approaches Assessment
The effectiveness of the behavior change approach is largely unclear. Single health promotion programs that target a specific behavioral risk often have little effect on determinants that cause poor health, especially for the elderly. This does not stop the behavior change approach from being widely adopted (Golinowska et al., 2016). The behavior change approach should, therefore, incorporate a strong policy framework and empowerment of the people to have a supportive environment and have individuals gain more control over their decisions.
Limitations of the behavior change approach
The individual behavior model faces limitations since diseases are caused by a complex interaction of different factors driven by social, political, and economic determinants.
Community social action aims to bring changes in the social, economic, and physical environment to transform the society. This approach prefers societal change over individual behavior. It enables members of a community to make healthier choices based on cost, availability, and accessibility of health care. Community social action targets groups and populations with interventions to promote health. New regulations and laws may be introduced to deter people from making unhealthy choices such as smoking in public. Adequate awareness is made to the public using various means available.
Limitations of Community Social Action
Limitations of this approach include making radical changes and at times requiring the highest level of political support. It requires the overwhelming support of the community and the general public. Laws and regulations designed to improve the health of the population may be frequently broken. They may also receive backlash from some sections of the community as too harsh. Community action may take long periods to take full and desired effect. An outcome evaluation based on the program logic model would show the changes done and the results in the improvement of health in the community. This health promotion approach may have challenges in proving the link between the interventions as change is often a lengthy process.
The Role of the Community Health Nurse
Nurses are an integral part of the promotion of health programs. In their practice, they possess multi-disciplinary knowledge and experience of health promotion. Their contribution will help reduce symptoms of chronic diseases, ease access to health care services, and increase cost-effectiveness (Maier et al., 2018). The inclusion of nurses in health promotion programs will help improve patients’ quality of life, adherence to health choices, knowledge about the illness, and self-management. The role of nurses in the program will be:
Impassion the elderly to engage in healthy lifestyle through education and mentorship.
Work formally and informally as case managers.
Help those living with Alzheimer’s and their families navigate through the health care system
Act as consultants for the community and other organizations to define health care needs for the elderly
Due to increased recognition of different health care groups such as the elderly, different health promotion needs have been identified. Nurses can be deployed as patient-focused health promoters for groups that require high levels of treatment and care such as those with Alzheimer’s disease. Nurses also act as managers of health promotion programs. They are able to establish, implement, and assess community health promotion programs (Maier et al., 2018). They have advanced clinical skills and can take responsibility in supervision and research of the actions needed in health promotion interventions. Nurses possess the requisite communication skills to encourage patients, families, and communities in decision-making. They have the ability to support behavior changes in people and respond effectively to their attitudes and beliefs. Community nurses are also entrusted with information gathering and interpretation, time management, and convincing communities.
References
CDC. (2020). Logic models. center for disease control and prevention. https://www.cdc.gov/eval/logicmodels/index.htm
Golinowska, S., Groot, W., Baji, P., & Pavlova, M. (2016). Health promotion targeting older people. BMC health services research. pp 345-356. https://doi.org/10.1186/s12913-016-1514-3
Laverack, G. (2017). The challenge of behavior change and health promotion. Multidisciplinary Digital Publishing Institute . pp 1-4. file:///C:/Users/user/Downloads/challenges-08-00025%20(1).pdf
Maier, C.B., Budde, H. & Buchan, J. (2018). Nurses in expanded roles to strengthen community-based health promotion and chronic care: policy implications from an international perspective; A commentary. Isr J Health Policy Res. pp 64
Srivarathan, A., Jensen, A.N. & Kristiansen, M. (2019). Community-based interventions to enhance healthy aging in disadvantaged areas: perceptions of older adults and health care professionals. BMC Health Serv Res . pp 19. https://doi.org/10.1186/s12913-018-3855-6
