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I. Intervention Wheel
(Figure 14.3 pp 498 e-book Public Health Practice Models and in article Intervention Wheel)
The Public Health Intervention Wheel Interventions are actions that public health nurses take with individuals, families, systems, and communities to improve or protect health status. This framework, known as the "intervention model," defines the scope of public health nursing practice by the type of intervention. It also defines where the interventions will be carried out (systems, community, and individual/family). The intervention model describes the scope of practice by what is similar across settings and describes the work of public health nursing at the community and systems practice levels as well as the typical individual/family level. The Intervention Wheel is composed of 3 distinct elements of equal importance First the model is population based Second the model encompasses three levels of practice (community, systems, individual/family) Third the model identifies and defines 17 public health interventions
1. Review chapter in text book and review article intervention wheel.
2. Describe the three levels of interventions: systems, community, and individual/family.
3. Review each case and determine which level of intervention should be used and why. Also identify the interventions being used and which can be used and why.
Case 1 - The public health agency provides the central intake function for children with special needs for the entire county. Physicians, schools, the local follow-along program, public health nurse, social workers, and others refer children.
Case 2 - This past summer many county public health departments in Minnesota agreed to participate in dead bird reporting, i.e. making "dead bird calls." Through widespread media outreach including newspaper articles, radio and TV news reports, persons were asked to report the sighting of a dead bird to a health department.
Case 3 - (This case involves several interventions on the wheel and more than one level) The long and short of the situation is that a family in Marshall County, MN had Labrador puppies to sell and advertised them in local newspapers. Before being sold, a skunk attacked the puppies. When two puppies died from rabies the State Veterinarian at the Minnesota Department of Health became involved. She contacted the Public Health Director to alert her to the situation.
One of the puppies had contact with numerous children before it died. The puppy had attended several school and sporting events and also lived across the street from an elementary school. The whereabouts of the other four puppies from the litter was unknown. School officials sent letters home with students as the media notified parents to expect the letters. The media also informed the public of the situation, providing information about the known location of the rabid puppies. The media alerted the public that there were puppies whose location was not known, and advised individuals to seek advice from public health or a health care provider regarding concerns. Call from parents started flooding the telephone lines at the public health department, the hospital and clinics. Not having the staff to vaccinate the number of people needing rabies vaccination, the hospital requested that the public health department do a public rabies vaccination clinic at the hospital. Vaccine was ordered to cover the number of exposed persons.
The regional epidemiologist and public health nurse consultant were in contact with the public health director providing information and support. Other counties were informed of the situation and asked to be on alert in case more assistance was needed for vaccinating. While planning for the clinic, the preparedness guidelines for mass dispensing clinics were considered. This was done since so many people, primarily children, needed the vaccine and to better accommodate anxious parents accompanying each child.
Planning was also done to accommodate needs of those potentially exposed over the month long period during which the vaccine series would be administered. Minnesota Department of Health June, 2006 Office of Public Health Practice Page 6 Local public health, in partnership with the hospital and clinic, ended up being able to handle the initial vaccination and follow-up vaccinations for the 198 people who decided to receive the vaccine series. As a result of this experience, a policy change is in the works at the school to not allow animals at school events.
Case 4 - During a flood, "the PHNs spend part of the day doing 'rounds' among the rows of people living in a large emergency shelter set up in a gymnasium. The PHNs talk to the people and ask how everything is going, given the circumstances. They have concerns about the mental health of this population who has gone through so much, so they assess for withdrawal, depression, and inability to cope. While the PHNs note that most adults are coping, they observe that the children are not coping as well. They question parents and hear stories about night terrors and atypical behavior. To prevent further development of problems among children, the PHNs request child mental health counselors from the Emergency Response team. They also work with the parents in the shelter to set up a 'toddler corner where children can play and act like children. Parents take turns staffing the corner. They also set up a 'reading corner for older children to simulate their school environment."
Case 5 - The Hmong Health Care Professionals Coalition received a grant to do community education to the elderly Hmong population regarding depression. Depression was considered a risk for Hmong elders because there had been several suicides in that population. Many Hmong elders were isolated and did not view depression as a disease. In addition, other agencies serving this population had also identified depression as an issue for elders. In doing outreach to the target population several adaptations specific to the Hmong culture were made. One was in regards to eligibility criteria. Even though the program targeted persons over 50, people were allowed to determine their own eligibility. That is, if they "felt old," they qualified. Second, although the Coalition had a booth at the annual Hmong Health Fair, the Coalition members considered it unlikely that the elders would come to the booth. Therefore, the interviewers decided to walk around and talk with elders in a more relaxed setting. They approached elders while sitting under shade trees, selling products at the market booth and the like. Third, interviews were done entirely in the Hmong language. Elderly persons were screened, provided information about depression and given a listing of community resources.
II. Develop community-based strategies for intervention to prevent illness, injury, disability, and premature death. As a community health nurse in a rural and economically depressed area, you have noticed that a large percentage of your patients have body mass index (BMI) values higher than 30 indicating a classification of obese. A survey of the community reveals a higher number of fast-food restaurants than in neighboring communities with similar demographics and economic indicators. In addition, from studying the EHR reports on patient indicators, it appears that diabetes and hypertension are also on the rise. Lastly, there is one fresh open farmers' market that opens once a week in the community.
As a result, you have met with the providers for your health care center to discuss this matter.
- Think of the vulnerable population
- Write a community nursing diagnosis and a wellness diagnosis for that population using the community nursing format
- The community format for the nursing diagnosis is Risk for _____ among (the vulnerable population) related to _______.
- Next develop 2 goals and 2 objectives
- Develop interventions using the intervention wheel.
III. Literature Assessment Activities
Develop community-based strategies for intervention to prevent illness, injury, disability, and premature death. Read Article located in resources on Jacobson, J. (2012). Fighting obesity, locally and nationally. American Journal of Nursing, 112(6), 17. Related question #1 Your local community leaders decided to combat the obesity epidemic in your local area after reading the Jacobson (2012) article and created a massive media campaign. After 6 months of this campaign, an assessment was conducted on the efficacy of the campaign.
Please watch the following YouTube video: Public Reactions to Obesity-Related Health Campaigns: A Randomized Controlled Trial.
Because your local health leaders have been getting negative feedback on the media campaigns and have seen weight gains in the population since the media campaigns began, they contacted you as the community health nurse to assist them in creating campaigns that would have a positive effect and motivate the community to adopt healthier lifestyles.
- Please create a media campaign using PowerPoint presentation slides with a voice-over to positively impact the community in losing weight and combating obesity.
- Limit your Presentation to 5 slides with voice over.
- Upload your presentation to the discussion forum.
- Please include in the forum a written excerpt on what you decided and why.
Attachment:- Assignment File.rar