NURS 340 PUBLIC HEALTH PH notes quiz 2 Questions and Answers,100% CORRECT

NURS 340 PUBLIC HEALTH PH notes quiz 2 Questions and Answers Chapter 11 - Introduction o Cut health care cost by keeping population healthy o Nurses health promotion with education ▪ Prevention levels ▪ Work with individuals, families and communities ▪ Knowledge healthcare decisions - Healthy People 2020 o Education objectives ▪ Based on age and ethnicity • Unintentional injury • Violence • Suicide • Alcohol/substance abuse • Unintended pregnancy • AIDS/HIV • STD • Inadequate activity - Typical Steps in Developing a Health Education Program o Identify a population specific learning need o Select one or more learn theories o Consider which educational principles are most likely to increase learning ▪ Choose by most feasible and most appropriate o Examine educational issues ▪ Population specific ▪ Cultural concerns ▪ Literacy/ teaching strategies based on • Age • Gender • Culture • Learning needs o Design and implement the educational program using carefully chosen strategies o Evaluate the effects - Education and learning o Education ▪ Activity “undertaken or initiated by one or more agents that is designated to effect changes in knowledge, skill and attitudes of individuals, groups or communities” • Designed to help change attitude, skills and knowledge of a specific topic ▪ Establishment and arrangement of events to facilitate learning, including providing knowledge and skills • Knowledge can lead to the change of behavior o Learning ▪ Process of gaining knowledge and skills that lead to behavioral changes - How people learn o Shift in ideas how people learn ▪ From sponge or vessel approach to active process between instructor and learner • Active learning o What we hear is filtered through our assumption, values, levels of attention and knowledge o Learners accept information based on a range of factors ▪ What they already know ▪ What they believe ▪ The culture they were raised ▪ Generational experiences ▪ How well they can understand and relate to the information - Three education principles o The nature of learning ▪ Examine the cognitive (thinking), affective (feeling), and psychomotor (acting) • Each domain has specific behavioral components that form a hierarchy of steps or levels • Each level builds on the previous one o The educational process ▪ Identify education needs • Systemic and thorough assessment ▪ Establish educational goals and objectives ▪ Select appropriate educational methods ▪ Implement the educational plan ▪ Evaluate the educational process o The skills of effective educators ▪ Gain attention • Important and beneficial ▪ Inform the learner of the objectives of instruction ▪ Stimulate recall of prior learning • Link new knowledge with old ▪ Present the material • Clear, organized and simple to match the needs of the learner ▪ Provide learning guidance ▪ Elicit performance • Demonstration to improve skills ▪ Provide feedback ▪ Assess performance ▪ Enhance retention and transfer of knowledge - Motivational interviewing o A tool designed to help clients verbalize their own motivations to change ▪ Collaborative partnership o Four essential steps: ▪ Engaging • Person-centered ▪ Empathic listening ▪ Guiding ▪ Evoking • Particular identified target for change • Evoking pt own motivations for change o Change talk ▪ “DARN-CAT” ▪ Desire—I want to change • Change to commitment—I will make changes ▪ Ability—I can change • Change to activation—I am ready, prepared and willing ▪ Reason—it is important to change/ Need—I should change • Change to taking steps—I am taking actions - Developing effective programs o Message ▪ Clear message to learner o Format ▪ Select most appropriate learning format o Environment ▪ Best learning environment o Participation ▪ Engaging to learn o Evaluation - Educational issues o Population considerations ▪ Age, culture, ethnicity o Pedagogy ▪ Learning strategies for children or individuals with little knowledge on health related topic ▪ What will be learn and how will be learned ▪ Teacher directed o Andragogy ▪ Adults, older adults or individuals with some knowledge - Barriers to learning o Educator related barriers ▪ Fear of public speaking ▪ Lack of credibility with respect to topic ▪ Limited professional experiences related ▪ Unable to deal with difficult people ▪ Lack of knowledge about gaining participation ▪ Lack of experience in timing presentation ▪ Uncertain how to adjust instruction ▪ Uncomfortable when learners ask questions ▪ Doesn’t get feedback from learners ▪ Not prepared for use of media equipment ▪ Has difficulty with opening and closings ▪ Overly dependent on notes o Learned related barriers ▪ Low literacy • Health literacy o Degree to which individuals have capacity to obtain and process health care information to make the most appropriate decisions ▪ Lack of motivation to learn • Health belief model o Value o Expectancy o affective • Transtheoretical model • Precaution adoption process model - Use of technology in health education o Examples: computer games, videos, CDs, Internet ▪ May want to use a variety of technology tools o These technologies may: ▪ Enable the learner to control the pace of instruction ▪ Offer flexibility in the time and location of learning ▪ Be engaging ▪ Provide immediate feedback ▪ Be more consistent with how the learner prefers to receive other kinds of information - Criteria for assessing quality of internet health information o Authorship ▪ Credentials/ affiliation listed? o Caveats ▪ Site clarify function is for information or to market products? o Content ▪ Disclaimer provider? o Credibility ▪ Sources posted? o Currency ▪ Dates listed o Design ▪ Easy to navigate? o Disclosure ▪ User disclosed for purpose of site o Interactivity ▪ Feedback mechanism o Links - Evaluate the educational process o Evaluate the educator o Process evaluation o Evaluate the educational product o Evaluate health and behavioral changes ▪ Long-term evaluation - Working to effectively educate groups o Groups can be used to initiate and implement changes for individuals, families, organizations, and the community. o Community groups represent the collective interests, needs, and values of individuals; they provide a link between the individual and the larger social system. o Groups can bring about changes to improve the health and well-being of individuals and communities. ▪ Some individual changes for health are difficult or impossible to achieve without group support and encouragement. o Through community groups, nurses help people identify priority health needs and capabilities and make valuable community changes. - Group concepts o Group definition ▪ Interacting individuals who have a common purpose ▪ Effective and powerful medium to initiate and implement changes for individuals, families, organizations and community o Key elements: Member interaction, group purpose o Group development o Cohesion ▪ Attraction between each member to the group o Task and maintenance functions o Norms: Task, maintenance, reality o Group culture o Leadership o Group structure - Promoting health through group education o Health behavior is influenced by the groups to which people belong. o Groups who will support an individual’s health changes are unavailable to some people because of their social or emotional isolation. o Choosing groups for health change o Established groups o Selected membership groups o Beginning interactions o Conflict o Strategies for change o Evaluation of group progress Chapter 21 - Vulnerability o Those at greater risk for poor health status and health care access ▪ Related to current economic status of community • Lay offs, part-time, no health coverage ▪ Natural history of disease model • Physiology and environment impact a population o More likely for health problems ▪ Web of causation model • Predisposition of illnesses ▪ Vulnerable population group • Subgroup of a population • Homeless, elderly, babies • Pregnant teens • Immigrants • Mental health pt • Substance abusers • HIV/STD • Incarcerated • LGTBQ ▪ Multiple cumulative risks • Environmental hazards • Social hazards • Genetics • behaviors ▪ Resilience • Members of vulnerable pop that do not succumb to diseases • Individuals living in poverty that manage to attend school and get out of the vulnerable population o Susceptibility to actual or potential stressors that may lead to an adverse effect ▪ Results from the interaction of internal and external factors that cause a person to be susceptible to poor health o Health disparities: wide variations in health services and health status among certain populations ▪ Goal is for equity - Factors Contributing to vulnerability o Lack of resources ▪ Physical • poverty ▪ Environmental • Hazardous working environment ▪ Personal ▪ Biopsychosocial o Disenfranchisement ▪ Feeling of separation from mainstream society • Dangerous to community • Danger to themselves o Social determinants of health ▪ Economic status • Poverty • Lack of health insurance ▪ Education ▪ Access to health care ▪ Nutrition ▪ Stress ▪ Prejudice o Health status ▪ Age ▪ Changes in normal physiology - Vulnerable populations o More likely to develop health problems as a result of exposure to risk o More sensitive to risk factors because they are often exposed o More likely to suffer from health disparities o Vulnerability results from combined effects of limited resources - SDOH o Neighborhood and built environment o Health and health care o Social and community context o Education o Economic stability - Health Equity o Ensuring all individuals are able to access resources, not that all individuals are given the same exact resources - Seven WHO Factors o Income and social status o Education o Physical environment o Social support networks o Genetics/personal behavior and coping skills o Health services access o gender - Health Status o Age Is related to vulnerability o Physiologic changes can predispose o Life experiences ▪ Especially childhood trauma ▪ Levels of stress (positive to toxic) o Protective social factors o Locus of control - Outcomes of Vulnerability o Negative or positive o Often have worse health outcomes o Cycle to vulnerability ▪ One problem solved, another emerges ▪ Feelings of hopelessness - Nursing Approach o Trend toward providing more comprehensive, family centered services when treating vulnerable pop ▪ One stop services • Wrap around services • Comprehensive services o Advocacy ▪ Social justice - Healthy People 2020 o Emphasize improving healthy by modifying the individual, social and environmental determinants of health ▪ Coordinates health services and provides preventive services - Levels of prevention o Primary ▪ Influenza vacc o Secondary ▪ Tb screening o Tertiary ▪ Therapy group for severely mentally ill adults - Assessment issues o Socioeconomic resources o Preventive health needs o Congenital and genetic predispositions o Amount of stress o Living environment o Neighborhood surroundings - Planning and Implementation o Create trusting environment o Show respect, compassion and concern o No assumptions o Coordinate services and providers o Advocate o Focus on prevention Chapter 22 - Rural vs Urban o Farm residency vs nonfarm o Metropolitan area ▪ Core urban 50k+ o Micropolitan ▪ More than 10k, less than 50k - Moving to rural areas o Fastest growing areas o More affordable housing - Population Characteristics o Under insured o Last of physicians/practices ▪ Traveling long distance o Higher proportion of whites o More likely widowed or married o Tend to be poorer - Health status of rural residents o Poorer perception of overall health and function o Less likely to engage in preventive behavior o More likely to have chronic conditions o Health care providers ▪ Small staff to service large area ▪ Provide care to people who live in several counties - Womens health o Higher infant and maternal morbidity rates o Higher proportion of racial minorities o Extreme variations in pregnancy outcomes o Higher at risk ▪ Live on or near Indian reservation ▪ Migrant workers ▪ African American descent and live in rural deep south ▪ Victims of sexual assault - Health of children o Urban children more likely to see pediatrician when ill o Rural adults and children more likely to have general practitioner o Children who work on farms o School nurses - Mental health o Delay seeking care o Depression ▪ High rate of poverty ▪ Insufficient number of mental health services o Domestic violence o Alcohol, tobacco, and other drug use and abuse - Occupational and environmental health problems in rural areas o High risk industries found in primarily in rural ▪ Forestry ▪ Mining ▪ Fishing ▪ Agriculture o Lack of OSHA regulation for farming o Common injuries ▪ Getting ran over from tractors due to accidental falls o Exposure to chemicals ▪ Pesticide exposure - Rural health care o Barriers: available, affordable, accessible, or acceptable services o Providers attitudes, insights and knowledge o Designing community health programs - Health of minotires o Characteristics o Migrant lifestyle o Housing - Issues in migrant health o Lack of knowledge about services o Inability to afford care o Availability of services o Transportation o Hours of service o Mobility and tracking o Language barriers o Discrimination o Documentation o Cultural aspects o Children of migrant workers o Dental disease o Incidence of TB o Incidence of HIV/AIDS o Depression o Anxiety related disorders o Domestic violence - Cultural considerations in migrant health care o Nurse client relationship ▪ Lack of trust o Health values beliefs and practices ▪ Women are caretakes ▪ Men are decision makers ▪ Want to try to be healthy for children ▪ Will bow and say yes to everything • Need to ensure they are understanding - Nursing care in rural environments o Community oriented nursing vary by community o Need for ▪ School nurses ▪ Family planning services ▪ Prenatal care ▪ Care for individuals with AIDS and their families ▪ Emergency care services ▪ Children with special needs ▪ Mental health services ▪ Services for older adults Chapter 23 - Introductuon o Four vulnerable populations: ▪ Poor ▪ Homeless ▪ Pregnant teens (and s/o) ▪ Mentally ill - Attitudes and Beliefs o Cultural attitudes ▪ Perspectives about individuals responsibility for health and well being are influenced - Poverty o Poverty and homelessness affect peoples health status o Federal income poverty guidelines ▪ Temporary assistance to needy families (TANF) ▪ Women, infants, and children (WIC) ▪ Head Start o Persistent poverty o Neighborhood poverty o The Near Poor ▪ Earn slightly above the poverty level; income inadequate but ineligible for Medicaid and similar services o Factors affecting growing number of poor persons ▪ Decreased earnings ▪ Increased unemployment rates ▪ Changes in the labor force ▪ Increase in female headed households ▪ Inadequate education and job skills ▪ Inadequate antipoverty programs and welfare benefits ▪ Weak enforcement of child support statues ▪ Dwindling social security payments to children ▪ Increased numbers of children born to single women o Higher rates of chronic illness o Higher infant morbidity and mortality o Shorter life expectancy o More complex health problems o More significant complications and physical limitations resulting from chronic disease o Hospitalization rates three times more than for persons with higher incomes - Effects of poverty o Has a negative effect on: ▪ Women of childbearing age ▪ Adolescent women ▪ Children ▪ Older adults ▪ Both urban and rural communities - Community and poverty o Poor neighborhoods are linked with the following: ▪ Poorer general health status ▪ Higher mortality rates ▪ Higher rates of disability, injury, and violence ▪ Less access to healthy food and health care ▪ Few opportunities for good employment ▪ Inadequate transportation ▪ Problem related to police brutality ▪ Poor housing conditions - Homelessness o Poverty can lead to homelessness o Determining number of people who are homeless ▪ Point in time counts ▪ Period prevalence counts o Crisis poverty o Persistent poverty - Homelessness in the united states o Crisis poverty ▪ Marked by hardship and struggle ▪ Transient or episodic ▪ Brief stays in shelters ▪ Younger and the majority o Persistent poverty ▪ Chronic state; fewer ~16% ▪ Older with disabilities, addictions, sever metal or chronic physical illness ▪ Significant family difficulties o Effects on health ▪ Hypothermia and heat related illness ▪ Infestations and poor skin integrity ▪ Peripheral vascular disease and htn ▪ DM and nutritional deficits ▪ Respiratory infection and COPD ▪ TB ▪ HIV/AIDS ▪ Trauma ▪ Mental illness ▪ Use and abuse of tobacco, alcohol and illicit drugs o At risk populations ▪ Pregnant women ▪ Children ▪ Adolescents ▪ Older adults - Levels of prevention o Providing affordable, adequate housing ▪ Low income housing ▪ Supportive housing ▪ Emergency housing o Primary o Secondary o Tertiary - Trends in adolescent sexual behavior o Teens making better decision o Reproductive health care services to teens o Support needed during and after pregnancy o Background factors o Sexual activity, use of birth control, peer/partner pressure o Other factors ▪ Sexual victimization o Young men and paternity o Early identification of the pregnant teen o Special issues in caring for the pregnant teen ▪ Violence ▪ Nutrition ▪ Infant care ▪ Schooling and educational needs - Mental Illness o High prevalence rates o Deinstitutionalization o At risk ▪ Children/ adolescents ▪ Adults ▪ Adults with serious illness ▪ Older adults ▪ Cultural diversity - Levels of prevention o Primary ▪ Affordable hosing ▪ Housing subsidies ▪ Effective job training ▪ Employer incentives ▪ Preventive health care services ▪ Multisystem case management ▪ Birth control services ▪ Safe sex education ▪ Needle exchange program ▪ Parent education ▪ Counseling o Secondary ▪ Reducing prevalence of pathologic nature of condition ▪ Supportive and emergency housing ▪ Soup kitchens ▪ Screening for depression o Tertiary ▪ Prevention attempts to restore and enhance functioning ▪ Support affordable housing ▪ Promotion of psychosocial rehabilitation programs Chapter 24 - Introduction o Number-one national health problem is abuse of tobacco, alcohol and illicit drugs ▪ Causing more deaths, illnesses and disabilities o Substance abuser is not only at risk for personal health problems but also may be a threat to the health and safety of family members, coworkers, and other members of the community. - Scope of problem o ATOD [alcohol/tobacco/other drugs] abuse and addiction can cause multiple health problems for individuals. o Contributing factors. ▪ Lack of knowledge about use of drugs ▪ Labeling of certain drugs (alcohol, nicotine, caffeine) as nondrugs ▪ Lack of quality control of illegal drugs ▪ Law enforcement rather than prevention and treatment ▪ Drug laws that label certain drug users as criminals • Encourages negative attitudes and stigma o Every culture has beliefs and attitudes toward ATOD. These attitudes are influenced by the way society categorizes drugs as either “good” or “bad.” o In US good drugs ▪ Over the counter ▪ Prescription drugs o Bad drugs ▪ Illegal drugs, users are criminals regardless of addiction ▪ (NOT OKAY) - Definitions o Alcohol, tobacco, and other drugs (ATOD) ▪ leading drug problems o Substance abuse ▪ Use of any substance that threatens health, or impairs social/economic functioning o Drug dependence ▪ Physiological change in CNS as a result of chronic use ▪ Withdrawal—needs to keep taking to prevent • Taper off o Drug addiction ▪ Pattern of abuse categorized by compulsive use of a drug securing its supply o Alcoholism ▪ Addiction to alcohol - Psychoactive drugs o Psychoactive drugs: drugs that affect mood, perception, and thought. o Are used for enjoyment in social and recreational settings and for personal use to self-medicate physical or emotional discomfort. o Psychoactive drugs are divided into categories according to their effect on the CNS and the general feelings or experiences the drugs may induce. - Depressants o Depressants: drugs that reduce the activity of the central nervous system. ▪ Lower the body’s overall energy level, reduce sensitivity to outside stimulation, and, in high doses, induce sleep • Low doses produce stimulation caused by initial sedation o In general, depressants decrease heart rate, respiration rate, muscular coordination, and energy while dulling the senses. o Higher doses lead to coma and, if the vital functions shut down, death. o Major categories include alcohol, barbiturates, benzodiazepines, and the opioids. - Stimulants o Stimulants: drugs that increase the activity of the CNS, causing wakefulness ▪ The stimulant causes the nerve fibers to release noradrenaline and other stimulating neurotransmitters. ▪ These drugs do not give the person more energy; they only make the body expend its own energy sooner and in greater quantities than it normally would. ▪ Can be useful with little affect if used carefully and appropriately • Allow body time to replenish • Cost for high is the feeling of down o Sleepiness, mental fatigue, depression o Nicotine o Cocaine o Caffeine o Amphetamines - Alcohol o Oldest and most widely used psychoactive drug in the world. o About two-thirds of American 12 years or older drink alcohol. o Binge drinking. o Chronic alcohol abuse. ▪ National Institute on Alcohol Abuse and Alcoholism ▪ Nutritional deficiency • Folate • Iron • Niacin ▪ GI disturbances • Inflammation • Cancer ▪ Cardio • Dysrhythmias • Myopathy • HTN • Atherosclerosis - Tobacco ▪ CNS • Memory loss • Sleep disturbances • Alcohol withdrawal syndrome o Smoking is the foremost preventable cause of death in the United States. ▪ Cardiovascular disease ▪ Respiratory diseases o Nicotine acts as both depressant and stimulant. o Mainstream smoke. ▪ Inhaled by the smoker o Secondhand smoke (sidestream smoke). ▪ Inhaled by others in vicinity of a cigarette ▪ Contains higher concentration of toxic and carcinogenic compounds than mainstream o Chewing tobacco or snuff. ▪ Higher concentrations of nicotine, because not burned by smoke ▪ Enters blood stream less directly - Caffeine o One of the most widely used psychoactive drugs in the world o Found in coffee, tea, soft drinks, and various medications o Moderate dose ▪ 100-300 mg per day ▪ Increase mental alertness o High dose ▪ Health effects • Insomnia • Irritability • Anxiety • Dysrhythmias • GI disturbances • headaches ▪ Withdrawal symptoms • Headaches • Slowness • Occasional depression - Illicit drugs o Epidemic in US of poisoning deaths of overdose ▪ 200% increase since 2000’s due to opioids o Heroin ▪ Most often recreationally used opioid. • Oxycodone/hydrocodone most commonly prescribed natural/semi-synthetic opioid o Most overdose ▪ Tolerance and physical dependence develop quickly. ▪ Serious complications result from unsanitary administration of the drug and complications due to overdose or the intoxication it can cause. o Cocaine ▪ Expensive ▪ Has effects on brain, heart and emotions ▪ Extremely addictive ▪ Injected or smoked cocaine produces hyperstimulation, alertness, euphoria, and feelings of competence and power. • Power- snorted or injected • Crack- made by chemical process in order to be smoked ▪ Young men 18-25 biggest users ▪ Interaction with dopamine seems to be the basis for the addictive patterns. • Feeling of high o Increased energy, alertness o Elevated mood o Feeling of supremacy ▪ Signs • Dilated pupils • High levels of energy, activity • Excited, exuberant speech • Affects wear off in 30-120 minutes ▪ Crack addiction develops rapidly and is expensive. o Amphetamines ▪ Similar to cocaine but effects last longer and the drugs are cheaper. ▪ Have a chemical structure similar to adrenaline and noradrenaline and are generally used to decrease fatigue, increase mental alertness, suppress appetite, and create a sense of well-being. • Can be taken by pills, injected, snorted, smoked o IV- intense rush ▪ User can go on “speed run”—crash and sleep for 18+ hours • Cause elevation in mood • Increase wakefulness, alertness, concentration • Intensified physical performance • Feeling of well being • Enhance sexual desire, but erectile function in men ▪ Users prone to accidents. • Associated with unsafe sex • Produces static of excitement and grandiosity o Usual danger warning signals do not worth effectively o Marijuana ▪ The most widely used illicit drug in the United States. • Little toxicity • Safest therapeutic agents ▪ Psychological dependence can occur with chronic use, but little is known about any potential physical dependence. ▪ Because of its illegal status, there is no quality control, and a user may consume contaminated marijuana. ▪ Mild euphoria, relaxed feeling +intensity of sensory perceptions • Dreamy state of consciousness o Ideas seem disconnected, unanticipated, free flowing o Time, color, special perceptions are altered ▪ Side effects • Dry, red eyes • Increased appetite • Dry mouth • Drowsiness • Mild tachycardia ▪ Adverse effects • Anxiety • Paranoia • Disorientation ▪ Greatest concern • Respiratory concerns from smoking - Psychoactive drugs: Hallucinogens o Hallucinogens: drugs that stimulate the nervous system and produce varied changes in perception and mood ▪ Bath Salts • Crystalling powder that can be swallowed, inhaled or injected • Extremely addictive • Contain man-made stimulants similar to amphetamines • Increase dopamine levels and increase feeling of euphoria ▪ Ectasy (MDMA) • Man-made stimulant • Snorted or injected • Increases levels of chemicals in the brain o Serotonin, dopamine and norepinephrine o Can cause intoxication and lead to altered perception and impaired judgment ▪ Response to these drugs is related to user’s mood, basic emotional makeup and expectations, including the ability to cope with perceptual distortions, expectations and the immediate surroundings o Chronic use can lead to psychological effects and impaired judgement which can then lead to dangerous decisions or accidents o Indole hallucinogens; hallucinogens that resemble adrenalin and amphetamines - Predisposing/contributing factors o Drug o Set: refers to the individual using the drug ▪ expectations o Setting: refers to the influence of the physical, social and cultural environment within which the use occurs o Two major variables influence experience are set and setting - Primary Prevention o Promotion of healthy lifestyles and resiliency factors ▪ Assisting clients to achieve optimal health ▪ Teaching assertiveness and decision-making skills ▪ Teaching stress reduction and relaxation techniques o Drug education ▪ Teaching that no drug is completely safe and that any drug can be abused ▪ Helping persons learn how to make informed decisions about their drug use to minimize potential harm - Secondary Prevention o Assessing for ATOD problems o Drug testing o High-risk groups ▪ Adolescents ▪ Older adults ▪ Injection drug users ▪ Drug use during pregnancy ▪ Use of illicit drugs o Codependency and family involvement - Tertiary Prevention o Detoxification o Addiction treatment o Smoking cessation programs o Support groups ▪ Alcoholics Anonymous (AA) ▪ Narcotics Anonymous (NA) ▪ Pills Anonymous for persons with polydrug addictions ▪ Overeaters Anonymous ▪ Gamblers Anonymous Chapter 25 - Introduction o Violence o Significant mortality and morbidity result from violence o Nurses often care for the victims, the perpetrators and those who witness physical and psychological violence o Nurse can also take an active role in developing community responses to violence through working on public policy and needed resources - Social and community factors o Work o Education o Media o Organized religion o Population o Community facilities - Work o Fulfilling and contribute to a sense of well being; it can also be frustrating and unfulfilling, contributing to stress that may lead to aggression and violence o Frustration and resentment may contribute to violent behavior o May have difficulty separating feelings generated at work from those at home o People hesitate to give up jobs even if they are frustrating, boring, or stressful ▪ Particularly true in times of economic downturns - Education o Schools have assumed many responsibilities traditionally assigned to the family ▪ Sex ed ▪ Disciple o Spanking o Bullying o Powerful contributor to nonviolence - Media o TV programs and print articles can inform and increase public awareness about family violence o Abused women and rape victims benefit from media attention o Can indirectly lead people to choose violence - Organized religion o Generally teaches nonviolent conflict resolution - Population o Community’s structure can influence the potential for violence ▪ Crowded conditions= greater potential for tension and violence o Lack of jobs and low paying jobs can lead to feelings of inadequacy, despair, and social alienation o Gangs - Community facilities o Differ in the resources and facilities they provide to residents ▪ Some are more desirable places to live, work and raise families and have facilities that can reduce the potential for crime and violence ▪ Recreational facilities such as playgrounds, parks, swimming pools, movie theaters, and tennis courts provide socially acceptable outlets for a variety of feelings, including aggression - Violence against individuals or oneself o Homicide o Assault o Sexual violence o Suicide - Family violence and abuse o Development of abusive patterns o Types of family violence ▪ Physical abuse ▪ Sexual abuse ▪ Neglect ▪ Child abuse • Indicators ▪ Intimate partner abuse • Signs of abuse • Abuse as a process ▪ Abuse of older adults