COMMUNITY HEALTH

NURSING (continuation)
Unit 2, Module 1 Week 1
Basic Concepts of CHN
1. Primary focus/emphasis- health promotion and disease prevention:
Health promotion are activities that enhance resources directed at improving
well-being.
Disease prevention are activities that protect people from disease and the effects
of disease.
2. Primary goal- self reliance in health or enhanced capabilities
3. Ultimate goal- raise level of # of citizenry
4. CHN practices -to benefit ( individual, family, special population, community)

Population-focused approach: concentrated in specific groups of people and

focuses in health promotion and disease prevention, regardless of geographical
location. Population-focused practice is concerned with many distinct and over-
lapping community.
Basic Concepts of CHN
5. CHN is integrated and comprehensive – involves concern for those who do and
for those who do not receive health services.
6. CHN are generalists- matter of community health work. The generalist
community health nurse holds a baccalaureate degree and is able to plan and
intervene with individual groups, aggregates and subpopulations..
7. All types and levels of HC:
Levels of prevention:
Primary prevention – activities prevent a problem before it occurs (e.g.
immunization to prevent disease)
Secondary prevention – activities provide early detection and intervention
(e.g. screening for STDs)
Tertiary prevention – activities correct a disease state and prevent it from
further deterioration (e.g teaching insulin administration in the home)
Theoretical Models/approaches
1. Health Belief Model (HBM)

https://www.bing.com/videos/search?
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Theoretical Models/approaches
2. Milio’s Framework for Prevention
https://brainmass.com/health-sciences/health-care-management/milio-s-framework-
for-prevention-model-438257

3. Nola Pender’s Health Promotion

https://www.nursing-theory.org/nursing-theorists/Nola-Pender.php

4. Lawrence Green’s PRECEDE – PROCEED MODEL

The Precede-Proceed Model of Health Program Planning & Evaluation 

http://www.lgreen.net/precede.htm
Milio's framework for prevention model

• The framework provides that the health status existing in the

population occurs due to too little or excess critical health sustaining
resources whereby people who are have enough and safe food,
shelter, water and environment are vulnerable to infectious diseases
which too much food will lead to obesity. Population behavior
patterns also affect health since knowledge and perception is
influenced by informal and formal learning and also by experience
(Milio, n.d). Health is also influenced by organizational behavior which
includes policy makers since they provide options available to thus
influencing selections made by individuals.
Nola Pender’s Health Promotion
• There are five key concepts in the Health Promotion Model: person, environment,
nursing, health, and illness.
• The person is a biophysical organism shaped by the environment, but also seeks to
create an environment in which human potential can be fully expressed. Because of
this, the relationship between person and environment is reciprocal. Individual
characteristics and life experiences shape behaviors. The environment is described as
the social, cultural, and physical context in which life unfolds. It can be manipulated
by the individual to create a positive context of cues and facilitators for health-
enhancing behaviors. The role of nursing is a collaboration among patients, families,
and communities to create the best conditions for the expression of optimal health
and high-level well-being. Health is defined as the actualization of human potential
through goal-directed behavior, self-care, and relationships with others with
necessary adjustments made to maintain relevant environments. Illnesses are discrete
events in the life that can hinder or facilitate the patient’s continuing quest for health.
PRECEDE-PROCEED MODEL
• The PRECEDE–PROCEED model is a cost–benefit evaluation framework proposed in 1974 by 
Lawrence W. Green that can help health program planners, policy makers and other evaluators, analyze
situations and design health programs efficiently.
• It provides a comprehensive structure for assessing health and quality of life needs, and for designing,
implementing and evaluating health promotion and other public health programs to meet those needs. 
• One purpose and guiding principle of the PRECEDE–PROCEED model is to direct initial attention to
outcomes, rather than inputs. It guides planners through a process that starts with desired outcomes and
then works backwards in the causal chain to identify a mix of strategies for achieving those objectives. 
• A fundamental assumption of the model is the active participation of its intended audience — that is, that
the participants ("consumers") will take an active part in defining their own problems, establishing their
goals and developing their solutions.
PRECEDE-PROCEED MODEL
•In this framework, health behavior is regarded as being influenced by both individual and
environmental factors, and hence has two distinct parts.

•First is an "educational diagnosis" – PRECEDE, an acronym for Predisposing, Reinforcing

and Enabling Constructs in Educational Diagnosis and Evaluation.

•Second is an "ecological diagnosis" – PROCEED, for Policy, Regulatory,

and Organizational Constructs in Educational and Environmental Development.

•The model is multidimensional and is founded in the social/behavioral sciences, epidemiology,

administration, and education. The systematic use of the framework in a series of clinical and
field trials confirmed the utility and predictive validity of the model as a planning tool.
Different fields
• School Nursing – is a type of public health nursing that focuses n the promotion of
health and wellness of the pupils/students, teaching and non-teaching personnel of
the schools
Objective – To provide and maintain the health of the school populace by
providing comprehensive and quality nursing care
Skills needed to deliver effective and health care:

 Assessment and screening skills

 Health counselling skills
 Social mobilization skills
 Good oral and written communication skills
 Basic management skills
 Life skills
Different fields
Putting up a functional school clinic – RA 124 mandates that all schools are to
provide school clinics for the treatment of minor ailments and attendance to
emergency case.
Duties and responsibilities:
1. Health advocacy
2. Health and nutrition assessment including other screening procedures such as
vision and hearing
3. Supervision of the health and safety of the school plant
4. Treatment of common ailments and attending to emergency cases
5. Referrals and follow-up of pupils and personnel
6. Home visits
7. Community outreach like attending to community assemblies and organizing
community health councils
8. Recording and reporting of accomplishments
9. Monitoring and evaluation of programs and projects
Different fields
Occupational Health Nursing – is the specialty practice that provides for and
delivers health care services to workers and worker population.
Concepts:
1.Occupational health nurses focus on the “promotion, protection and restoration of
workers’ health within the context of a safe and healthy work environment.

2. Autonomy and independent nursing judgment characterize the practice of

occupational health nursing
3. With a research-based foundation, occupational health nursing’s theoretical,
conceptual and factual framework is multidisciplinary.
4. Occupational health nurses are advocates for worker’s and “encourage and enable
individuals to make informed decisions about health care concerns”.
Different fields
Concepts:
5. Through collaborative practice with other occupational health and safety
professionals, occupational health nurses are “key to the coordination of a holistic
approach to the delivery of quality, comprehensive occupational health services” .

6. Occupational health nurses are professionally accountable to workers (their

primary responsibility), employers, their own profession and themselves.

7. The essential elements of occupational health and safety services are defined by
the Standards of Occupational Health Nursing Practice.
Different fields
Community Mental Health Nursing:
https://jobdescriptionandresumeexamples.com/community-mental-health-nurse-job-
description-duties-and-responsibilities/
Occupational Health Nursing