NR553 Week 7 Discussion, Promoting Health in Global Communities

Promoting Health in Global Communities NAME Chamberlain College of Nursing Nr 553: Global Health Policy DATE Introduction of new health services or technology to communities in developing nations requires planning, communication, and insight. Discuss one theory of behavior change and how it could be utilized when planning to implement a new service or technology in a developing community. Week 7: Promoting Health in Global Communities According to Green and Murphy (2014), the health belief model which was developed in the 1950s by psychologists working in the Public Health Service in the US is one of the most widely recognized conceptual frameworks of health behavior. The theory asserts that people are risk averse and therefore afraid of getting serious illnesses, consequently, one’s health-related behaviors reflect their level of fear, which is dependent on the level of the threat they perceive and their expected fear-reduction potential by taking action. Further, individuals perform a net assessment of whether the benefits of behavior change outweigh its psychological and practical costs or any other barriers. The model identifies four significant aspects which include the risk perception, perceived severity of illness, perceived benefits of behavior change and the perceived barriers to taking action. However, the self-efficacy or the perceived ability to take the recommended action is also recognized as a vital factor (Green and Murphy, 2014) According to Frost and Reich (2009), many developing countries lack access to essential health technologies such as life-saving medicines like antiretroviral for HIV/AIDS, vaccines against debilitating diseases, preventive technologies such long-lasting insecticide-treated nets, contraceptives among other numerous vital technologies. The health belief model can be utilized in the introduction of these technologies through the creation of awareness of the risks posed by a condition or disease. For example, the perceived susceptibility to HIV, the perceived seriousness of the AIDS condition, belief in the effectiveness of new behaviors such as the use of condoms as well as perceived benefits of preventive action, and barrier to taking the preventive measure may be significant factors to consider when planning on the introduction of technologies to deal with HIV/AIDS. If all these aspects are looked into, appropriate technologies and interventions that are acceptable to the targeted communities can be effectively introduced, and the barriers overcome. References Green, E. C., & Murphy, E. (2014). Health belief model. The Wiley Blackwell encyclopedia of health, illness, behavior, and society. Frost, L. J., & Reich, M. R. (2009). Creating access to health technologies in poor countries. Health Affairs, 28(4), 962-973. RESPONSE TO PROFESSOR: Amy, thank you for describing SDT. Please share a successful initiative using this theory. Dr. Fildes and Amy, After reviewing Amy's post about self-determination theory, I was intrigued to learn that SDT is a solid approach to consider in order to promote health-related behaviors. There is a growing body of research that demonstrates the importance of autonomous motivation for a range of health behaviors, such as physical activity, smoking cessation, medication adherence, alcohol reduction, and healthy eating. The article I researched by Girelli, Manganelli, Alivernini, & Lucidi looks at using SDT interventions to promote healthy eating and physical activity with the aim to reduce childhood obesity in underserved school-aged children in Italy. According to Girelli et al., “Ready, Steady, Go! the intervention was developed to enhance children motivation toward physical activity and healthy eating supporting their basic needs for autonomy, competence and relatedness in order to enhance active lifestyles and energy-balance nutritional behavior in underserved school-aged children" (2016). Parents of the participants were asked to complete a questionnaire about their children's attitude, motivation and behavior in the two investigated areas: healthy eating and physical activity (Girelli et al., 2016). The study was conducted for the entire school year (9 months) and the participants included 579 children ages 6-11 years old for the intervention group and 477 children from the same age group for the control group (Girelli et al., 2016). The children in the intervention group were given the opportunity to be more active and to eat healthier was offered to them as a game. To make them more independent, they were asked to create their own games. The control group only received a seminar about the benefits of eating healthy and being more active. The results showed the children in the intervention group showed a more positive attitude toward physical activity and would spend more time in a moderate exercise in their free time, as reported by their parents, compared to the control group (Girelli et al., 2016). The children in the intervention group were also reported making healthier food choices and consuming less high-calories snack compared to the control group (Girelli et al., 2016). According to the self- determination theory the intervention was successful in enhancing children's' attitude toward physical activity and participating in physical activity. Also, the intervention group reported greater consumption of healthy food and less consumption of unhealthy food daily, thus remaining consistent with the principles of self-determination theory. Amy thanks for the post! Reference Girelli, L., Manganelli, S., Alivernini, F., & Lucidi, F. (2016). A Self-determination theory based intervention to promote healthy eating and physical activity in school-aged children. / Una intervención basada en la teoría de la autodeterminación para promover la alimentación saludable y la actividad física en los niños en edad escolar. Cuadernos De Psicología Del Deporte, 16(3), 13-19. RESPONSE TO PEER POST: Community mobilization seeks to engage participants in a way that increasingly allows them to make decisions and shape their own lives (Kuhlmann, 2014). India implemented a HIV prevention program for female sex workers (FSWs) with community involvement. A high rate of community (FSWs) volunteer serving on intervention planning, implementation and oversight committees is a critical indicator of community mobilization (Kuhlmann, Galavotti, Hastings, Narayanan, & Saggurti, 2014). The primary goal is to reduce HIV infection by promoting risk reduction behaviors an enabling environment among high risk groups. Across Avahan, a common core of targeted intervention activities are implemented including drop-in centers, peer outreach, condom distribution, crisis response and services for sexually transmitted infections (Kuhlmann et al., 2014). India must recognize community mobilization as an important intervention strategy to improve HIV prevention outcomes. Rhonda, Thank you for the post regarding community mobilization. After further research, I learned that with community mobilization, participation is about meeting the interests of the whole community. When every member of a community has the chance, directly or through representation, to participate in the design, implementation, and monitoring of community-level initiatives, there is a higher likelihood that the initiative will accurately reflect their real needs and interests. Community mobilization encourages stakeholders to develop and implement strategies that reflect the culture of the given community. When this happens, community mobilization initiatives become powerful tools in developing strategies that are culturally competent, relevant and compelling for marginalized communities. The transtheoretical model (TM) of behavior change to prevention programs for women at risk for or infected with HIV would be ideal for community mobilization. Authors Cabral, Cotton, Semaan, & Gielen review the application of the transtheoretical model for two different approaches models for intervention delivery. The first approach a community-level project (including the production of small media materials, street outreach, and community mobilization) employed two integrated strategies for tailoring interventions to stages and the specific processes of change associated with each stage (Cabral, Cotton, Semaan, & Gielen, 2004). According to Cabral et al., "the TM was applied to the production of print materials for at-risk women and individual outreach encounters conducted by trained community members in public housing developments and other residential areas, businesses, and public areas where women with risk behaviors congregate" (2004). Community volunteers also referred to as peer networkers, distributed the materials through various community networks attempting to reach women where they lived, worked, and socialized (Cabral et al, 2004). The peer networkers also provided HIV prevention information and referrals. The second strategy, a stage-based outreach encounter was delivered by paraprofessionals, called outreach specialists, who were often community members who were trained to apply the TM model (Cabral et al., 2004). Outreach specialists were trained to assess the women’s stage for their condom use by engaging them in a discussion regarding their intentions for and consistency of use. The outreach specialist was trained in reflective listening skills and applying the TM to real-life situations. If a woman was in pre-contemplation and did not understand that her behavior is risky, the outreach specialist could provide information on HIV transmission, thus focusing on the process of change (Cabral et al., 2004). The second approach was used in facility-based settings, including family planning clinics, drug treatment centers, homeless shelters, and primary care clinics for HIV-infected women (Cabral et al., 2004). Women were offered enhanced counseling on condom use, on reproductive decision making and contraception, and on the use of reproductive health services. The counseling services were provided by peer paraprofessional counselors called advocates. The advocates were citizens from local communities and were selected for their interpersonal skills and empathy (Cabral et al., 2004). Advocates conducted stages-of-change counseling with clients for up to 6 months and were then directed toward ongoing support groups and other social services. The transtheoretical model is functionally adaptable for community-level interventions where women or men are contacted directly by workers from the community. Reference Cabral, R. J., Cotton, D., Semaan, S., & Gielen, A. C. (2004). Application of the transtheoretical model for HIV prevention in a facility-based and a community-level behavioral intervention research study. Health Promotion Practice, 5(2), 199-207.