Importance of Public Health Nursing Journal Peer Reviewed
Pamela A. Kulbok, DNSc, RN, PHCNS-BC, FAAN
Esther Thatcher, MSN, RN
Eunhee Park, BSN, RN
Peggy S Meszaros, PhD
Abstract
Public wellness nursing (PHN) practice is population-focused and requires unique knowledge, competencies, and skills. Early on public health nursing roles extended beyond sick care to cover advocacy, community organizing, health pedagogy, and political and social reform. Likewise, gimmicky public wellness nurses do in collaboration with agencies and customs members. The purpose of this article is to examine evolving PHN roles that address complex, multi-causal, customs issues. A brief background and history of this function introduces an explanation of the community participation health promotion model. A community-based participatory enquiry project, Youth Substance Use Prevention in a Rural County provides an exemplar for clarification of evolving PHN roles focused on community health promotion and prevention. Also included is discussion about specific competencies for PHNs in customs participatory health promoting roles and the contemporary PHN role.
Citation: Kulbok, P.A., Thatcher, E., Park, Due east., Meszaros, P.S. (May 31, 2012) "Evolving Public Health Nursing Roles: Focus on Community Participatory Wellness Promotion and Prevention" OJIN: The Online Journal of Issues in Nursing Vol. 17, No. 2, Manuscript 1.
DOI: 10.3912/OJIN.Vol17No02Man01
https://doi.org/10.3912/OJIN.Vol17No02Man01
Key words: community wellness promotion, community-based participatory inquiry (CBPR), public health nursing, PHN competencies, nursing roles
[Public health nursing] roles involve collaboration and partnerships with communities and populations to address health and social weather condition and problems.Public health nursing (PHN) involves working with communities and populations as equal partners, and focusing on main prevention and health promotion (ANA, 2007). These and other distinguishing characteristics of PHN evolved in the context of historical and philosophical perspectives on health, preventive health care, and the professionalization of nursing. Specifically, these are roles that involve collaboration and partnerships with communities and populations to address health and social atmospheric condition and problems.
Public health nursing adult as a distinct nursing specialty during a time when expanding scientific knowledge and public objection to squalid urban living conditions gave ascension to population-oriented, preventive health care. Public health nurses were seen every bit having a vital role to attain improvements in the health and social atmospheric condition of the most vulnerable populations. Early leaders of PHN also saw themselves equally advocates for these groups.
In the 21st century, public health nurses practise in various settings including, just not limited to, community nursing centers; home health agencies; housing developments; local and state health departments; neighborhood centers; parishes; school health programs; and worksites and occupational health programs. High-chance, vulnerable populations are often the focus of care and may include the delicate elderly, homeless individuals, sedentary individuals, smokers, teen mothers, and those at risk for a specific disease.
Contemporary PHN practice, like the practice of early PHN leaders, is often provided in collaboration with several agencies and focused on population characteristics that cross institutional boundaries (Clan of Community Health Nursing Education [ACHNE], 2003). PHN practise and roles are divers from,
...the perspective, noesis base, and the focus of care, rather than past the site in which these nurses practice. Even though they are ofttimes employed by agencies in which direct care is provided to individuals and families, these nurses view individual and family care from the perspective of the customs and/or the population as a whole (ACHNE, 2003, p. x).
...PHN knowledge and competencies prepare nurses to accept a leadership role to assess avails and needs of communities and populations... At an advanced level, PHN knowledge and competencies prepare nurses to take a leadership office to assess assets and needs of communities and populations and to propose solutions in partnership. Community- or population-focused solutions can have widespread influence on health and illness patterns of multiple levels of clients including individuals, families, groups, neighborhoods, communities, and the broader population (ACHNE, 2003).
The purpose of this article is to describe evolving roles in the specialty of public health nursing. A brief history of PHN provides a historical and philosophical background for current practice. A model for community participation with ethnographic orientation, and an exemplar of its use in a rural youth substance use prevention projection, illustrates current advanced PHN practice. The commodity concludes with a give-and-take of essential PHN competencies, bear witness that supports evolving PHN roles, and implications for gimmicky public health nursing roles.
Brief Background and History of PHN Role
Prevention and curative care have been distinct concepts since ancient times. In Greek mythology, Hygeia was the goddess of preventive health, and her sister Panacea was the goddess of healing (Lundy & Bough, 2001). The notion of wellness care as healing, or treating those already sick, maintained dominance over preventive care for many centuries. During the mid-19thursday century however, new scientific understanding of transmission of affliction enabled successful sanitation interventions that prevented affliction on a large scale.
To deport preventive intendance forward, commune nursing evolved every bit the first office for public wellness nurses, and Florence Nightingale meantime professionalized nursing equally an occupation (Brainard, 1922, 1985). Evolving PHN practice required an understanding of how culture, economic science, politics, psychosocial problems, and sanitation influenced health and illness and the lives of patients and families (Fitzpatrick, 1975). Public wellness nursing in the Us (U.Due south.), England, and other countries quickly grew to include working with vulnerable populations in diverse settings including communities, homes, schools, neighborhoods, and worksites.
The new public health nursing function struggled, and continues to struggle, with appropriate interventions that would achieve quick results, but as well get out lasting improvements in the population.With the advent of preventive wellness care, a moral tension arose between giving resources to the needy, and pedagogy them how to meet their own needs. Nursing of the acutely ill fits more than easily into a model of one-mode flow of resources from nurse to patient (Buhler-Wilkerson, 1989). The new public health nursing function struggled, and continues to struggle, with appropriate interventions that would achieve quick results, but also leave lasting improvements in the population. The Christian principle of helping those who help themselves guided this tension, but could not easily resolve it (Brainard, 1922, 1985). Public wellness nurses were urged to residual "wisdom and kindness" (Buhler-Wilkerson, 1989, p.32). Giving gratis services or free supplies to the poor was seen equally creating dependency and upsetting the natural social fabric of communities. Public wellness nurses have addressed this moral tension over many years with innovative solutions that seek positive health outcomes, also as advocate for vulnerable populations.
Past the early 1900s, public wellness nursing roles extended across the intendance of the sick to comprehend advocacy, customs organizing, health educational activity, and political reform (American Nurses Clan [ANA], 2007). Several examples of exceptional PHN initiatives testify how these roles improved the health of communities and populations. The visionary work of Lillian Wald's Henry Street Settlement, started in New York City in 1906, evolved from finding and caring for the ill poor, to advocating and educating nigh the poor to other organizations. Wald expanded this mission to advocating for new federal agencies and a host of local improvements (Stanhope & Lancaster, 2011).
In the 1920s in Mississippi, Mary Osborne formed a collaborative between public health nurses and African-American (AA) lay midwives to better perinatal mortality of AA women and babies (Lundy & Bender, 2001). In the 1960s in Detroit, Nancy Milio integrated community organizing, community decision-making, and PHN to develop a maternal-child health middle that was highly accustomed and even protected by the AA neighborhood during the "Detroit riots" (Milio, 1970). Public wellness nurses and other community professionals take continued to recognize the advantages of community participatory methods, including the potential for more than effective intervention outcomes and capacity-building for long term do good to the community (Roughshod et al., 2006).
Community Participatory Health Promotion Model
The community participation and ethnographic model (see Figure 1) is an innovative framework that demonstrates evolving public health nursing practice. It was developed, based on the piece of work of Aronson, Wallis, O'Campo, Whitehead, and Schafer (2007a), by an inter-professional enquiry squad from the University of Virginia (UVA), Virginia Polytechnic Institute and State Academy (Virginia Tech [VT]), and Carilion Clinic (CC) (Kulbok, Meszaros, Bond, Botchwey, & Hinton, 2009) to address youth substance use prevention in a rural tobacco-growing county of Virginia. The community participation and ethnographic model builds on assumptions underlying community-based participatory research (CBPR) and encourages engagement of community members and trusted community leaders in processes from trouble identification to project evaluation and dissemination. The CBPR approach is philosophically based in critical and social action theory; information technology builds partnerships with community members beyond social-economic status and focuses on community avails and resources rather than on deficits (Israel, Eng, Schulz, & Parker, 2005; Kretzmann & McKnight, 1997). CBPR seeks balance between community members and practitioners or researchers through shared leadership, co-teaching, and co-learning opportunities; it benefits from the expertise of both community members and practitioners or researchers (Anderson, Calvillo, & Fongwa, 2007; Isreal et al., 2005).
| Figure 1. A Customs Participation and Ethnographic Model |
The community participation and ethnographic model is specially appropriate for public health nurses working with communities and populations because information technology provides a framework that builds upon local community knowledge. This enables public wellness nurses and their community partners to be sensitive to the ecological context and culture. The model is a useful guide for developing programs to promote salubrious communities and health equality (Isreal et al., 2005). An ethnographically informed approach to community and population assessment and evaluation involves data collection and analysis that goes across adopting qualitative methods (Aronson, Wallis, O'Campo, & Schafer, 2007b). It is an arroyo that allows socio-cultural contexts, systems, and meaning to emerge through a collaborative process between public health nurses and customs members.
Early on ethnographic work in substance use prevention (Agar, 1973; Agar, 1986; Trotter, 1993) provided a foundation for the community participation and ethnographic model. Karim (1997) pointed out that the work of Agar (1973; 1986) and Trotter (1993) described the importance of acquiring local community knowledge of substance nonuse and employ to provide a richer understanding of the health-related assets and needs of the community; circumstances and surroundings surrounding substance-related health and illness; community and population weather; and attitudes, beliefs, and traditions directed toward substance nonuse- or use-related health risk behaviors.
Mapping enables community partners and practitioners or researchers to assess neighborhoods, cities, and/or counties to target interventions and to place geographic trends over time. Unique strategies utilized in the community participation and ethnographic model include mapping, e.k., Geographic Information Systems (GIS), and Photovoice, eastward.g., picture-taking past community members and practitioners or researchers. GIS is a tool that facilitates assessment and assay of the ecological context of a population, as well every bit phenomena such every bit youth substance nonuse and apply within the community (Aronson et al., 2007b). Mapping enables customs partners and practitioners or researchers to appraise neighborhoods, cities, and/or counties to target interventions and to place geographic trends over fourth dimension (Shannon et al., 2008).
GIS has been used to identify unmarried teen mothers (Blake & Bentov, 2001); intervention locations for syringe distribution (Shannon et al., 2008); and minority diabetes direction (Gesler et al., 2004). Using mapping methods allows community partners and practitioners or researchers to identify specific areas for both assessments and interventions (Cravey, Washburn, Gesler, Arcury, & Skelly, 2001). With community input, maps tin can exist generated depicting areas where customs members, i.east., youths, parents, and community leaders, report protective- or risk-related factors; increased or decreased substance use; and potential intervention sites.
Photovoice, or picture-taking to create a photograph narrative, incorporates CBPR assumptions and enables economically and politically disenfranchised populations to express themselves with greater voice. This results in more than counterbalanced ability, a sense of ownership, development of trust, potential to build capacity, and a new sensitivity to cultural preferences (Castleden, Garvin, & Nation, 2008). Photovoice uses pictures taken by customs members to promote constructive sharing of beliefs, noesis, and thoughts nearly a given topic.
Practitioners or researchers have used Photovoice to facilitate group conversations and develop activity steps... Practitioners or researchers have used Photovoice to facilitate group conversations and develop action steps (Wang & Burris, 1994) in many means. Examples include examining quality of life with AA chest cancer survivors in rural Northward Carolina (Lopez, Eng, Randall-David, & Robinson, 2005); engaging youths in wellness promotion (Strack, Magill, & McDonagh, 2003), and building community with youths, adults, and policy-makers (Wang, Morrel-Samuels, Hutchison, Bell, & Pestronk, 2004). The goals of Photovoice in the context of the community participation and ethnographic model are to (ane) enable people to record their community's assets and strengths, as well every bit concerns and areas for improvement; (2) promote critical dialogue and knowledge about important problems through grouping discussion of photographs; and (3) attain policy-makers.
Youth Substance Use Prevention in a Rural County: An Exemplar
The Trouble
Adults and youths in rural southern states have some of the highest rates of cigarette and smokeless tobacco (ST) utilise in the US (Centers for Disease Command and Prevention [CDC], 2010). Adolescent tobacco use is highly correlated with use of booze and other drugs (Pilus, Park, Ling, & Moore, 2009; Kulbok & Cox, 2002). Tobacco, alcohol, and other drug employ remain pervasive problems worldwide and are responsible for a big proportion of morbidity and mortality in the US (CDC, 2010). Healthy People (HP) 2020 (U.S. Department of Health and Homo Services [DHHS], 2010) pointed to the long-term health threat of adolescent substance use and the need to increase the proportion of adolescents who remain substance complimentary. Many rural counties, however, take fiddling cognition of constructive intervention strategies to prevent adolescent substance use. Healthy People 2020 (DHHS, 2010) recommended increasing population-oriented, chief prevention programs provided by community-based organizations to forbid youth tobacco, alcohol, and drug use.
The Project
A project involving the customs participation and ethnographic model provides an exemplar of evolving PHN roles in community participatory health promotion. An inter-professional team, led by an advanced practice public health nurse and a human being development specialist, is currently using these innovative, community participatory strategies, including GIS mapping and Photovoice, to design a substance employ prevention program in a rural tobacco-growing county in the south. Public health nurses and interdisciplinary researchers created a squad with youths, parents, and community leaders, to consummate a comprehensive community and environmental assessment of the county, its rural ecological context and culture; and, to review evidence-based prevention programs, every bit the foundation for a youth substance employ prevention plan that volition exist acceptable, effective, relevant, and sustainable by the rural county.
The inter-professional research squad previously worked with youths, parents, and community leaders in a rural tobacco-growing county of Virginia on 2 collaborative enquiry projects focused on youth tobacco prevention (Kulbok et al., 2010; Kulbok, Meszaros, Hinton, Botchwey, & Noonan, 2009). With first-paw knowledge of the challenges faced by this rural county when attempting to prevent youth substance use, the team proposed and received funding for a project (Kulbok, Meszaros, Bond et al., 2009) based on Good for you People 2020 (DHHS, 2010) recommendations for community-based, population-oriented primary prevention. The projection aims were to:
- Establish a community participatory research team (CPRT) in a rural county equanimous of youth, parents, and trusted community leaders;
- Acquit a community and ecology assessment with the CPRT to identify ecological, cultural, and contextual factors influencing substance-free and substance-using adolescent lifestyles;
- Evaluate the effectiveness of prevention programs with the CPRT in low-cal of the customs's ecological, cultural, and contextual dimensions, wellness attitudes and behaviors, and on that basis develop a tobacco, booze, and drug use preventive intervention for this rural tobacco-producing community; and,
- Pilot examination the intervention to determine feasibility, acceptability, obtain preliminary effectiveness data, and refine the intervention for formal testing in other rural communities.
This youth substance apply prevention project is currently in year three, the final stages of designing and testing a preventive intervention with the CPRT. The project, which is being implemented in stages that correspond to the aims, was reviewed and canonical by the Institutional Review Boards of the University of Virginia and Virginia Tech. The inter-professional person project team currently includes an advanced practice public health nurse and specialists from anthropology, architecture and urban planning, epidemiology, man development, and psychology. The team also includes public health nursing and psychology doctoral students. The community members of the CPRT, during the course of the three yr project, included four community leaders, twelve youths, and eight parents. All of the adult CPRT members successfully completed research ethics education required past the Instuitional Review Boards.
The CPRT completed a comprehensive community and environmental assessment of the rural county to place assets and needs related to five assessment domains: the community's people and history, and its concrete environment, thought systems, social systems, and belief systems. In club to get together qualitative data most substance use in this county, the team completed 14 individual interviews of community leaders and five youth group interviews, with a total of 34 youths, 14 to xviii years of age. The team also completed one grouping interview with vii parents. Analysis of the data from these multiple sources was integrated into a comprehensive community assessment by the CPRT. Guided by the community participatory and ethnographic model, and using innovative strategies (i.e., GIS and Photovoice) described in the previous department, the squad used the GIS method to visualize and analyze the assessed data related to substance employ.
Innovative Strategies for Community Assessment
A series of community assessment maps displayed socio-demographic information about teens in the community, besides as important "teen places" that were associated with substance nonuse and use (refer to Effigy 2 for one hypothetical map of "teen places" with comments from CPRT members). The data used to create these maps was collected during monthly CPRT meetings held in the canton and semi-structured interviews conducted by teams of CPRT members with customs leaders, youths, and parents. Interview questions were developed by the CPRT to obtain customs assessment data, and identify assets and needs. Public health nurses tin use GIS mapping to visualize and analyze cess data more effectively.
| Figure ii. Map of "Teen Places" and Factors Related to Youth Substance Nonuse and Utilise (View full size figure [pdf]) |
Photovoice is some other method public health nurses can use in the community cess process. The CPRT utilized the Photovoice method as part of their community cess and in response to semi-structured interview questions about their rural county. Five youths received instructions to take pictures as a visual means of answering the community assessment questions. After, their pictures were displayed on "moving-picture show boards" according to the five community cess domains, i.east., people and history, physical surroundings, idea systems, social systems, and belief systems, and used to facilitate discussion during group interviews with youths and parents. These "picture boards" were displayed at the end of the youth and parent group interviews to enhance each group's clarification of youth substance nonuse- and use-related factors in their community.
Analysis to Date
During the timeframe that the community assessment was conducted, the CPRT used nominal grouping process to clarify and select six relevant effectiveness criteria for a youth substance utilise prevention program in their rural canton. These criteria were selected from ten established criteria on substance utilize prevention (Winters, Fawkes, Fahnhorse, Botzet, & August, 2007). The CPRT and then examined three existing substance use prevention programs with effectiveness data to assess whether they met these criteria. Pick of a prevention programme that meets the called effectiveness criteria and fits with the ecological context and culture of their rural community is a challenging process. It is ongoing at this time and involves consideration of multi-level factors identified in the community assessment process including culture, economic science, politics, and psychosocial concerns related to youth substance nonuse and apply.
Although the CBPR procedure is challenging, the resulting local cognition and understanding of the unique characteristics of this rural canton are providing direction in the pick of a program. For instance, preliminary decisions made by the CPRT include: (one) the target population for the prevention program volition be heart school-aged adolescents; (2) the about feasible and desirable setting for a prevention program is the summertime 4-H youth campsite held in the county; and, (iii) high school students, four-H camp counselors, may be the best "instructors" for the prevention plan.
This exemplar demonstrates the need for specialized noesis, competencies, and skills utilized by public wellness nurses to successfully comport out complex assessments and interventions in communities. Emphasis on essential knowledge and skills in core PHN competencies and didactics helps to ensure that public wellness nurses are prepared to motion their nursing practice into the future as leaders in community participatory health promotion and prevention.
Competencies for PHNs in Community Participatory Wellness Promoting Roles
[PHN] competencies and skills are requisite for public wellness nurses to serve in gimmicky, evolving roles with communities and populations that face complex, multifaceted challenges... Public wellness nurses tin can acquire important knowledge, competencies, and skills to promote and protect the health of communities and populations by agreement and applying CBPR approaches. These competencies and skills are requisite for public health nurses to serve in contemporary, evolving roles with communities and populations that face up complex, multifaceted challenges (Levin et al., 2008) such as public wellness threats that affect at-risk populations (eastward.k., lack of access to health care, emerging infectious diseases, poor environmental and living weather condition, the epidemic of overweight and obesity, and the culture of substance apply and abuse).
The nature of many threats is not unlike threats that faced PHN leaders in the early 20th century. They involve an appreciation of culture, economics, politics, and psychosocial problems as determinants of wellness and illness. The core competencies in PHN (Quad Council Public Wellness Nursing Organization [Quad Council], 2011) discussed beneath provide a guideline for PHN practise. Past using CBPR methods, public health nurses tin apply and enhance these competencies.
Analytic Assessment
Analytic assessment skills represent an important domain of PHN competencies utilized when applying community participatory health promotion strategies (Quad Council, 2011). Public health nurses should develop analytic cess skills to pursue health promotion and prevention in partnership with communities facing complex challenges. Analytic assessment skills are used in community participatory approaches such as CBPR and provide opportunities to hear multiple voices from community insiders when conducting assessments (Andrews, Bentley, Crawford, Pretlow, & Tingen, 2007).
Public health nurses tin raise these skills by interacting with customs members and using agile communication to gain in-depth insights about the community's avails and needs.Public health nurses tin raise these skills by interacting with community members and using active communication to gain in-depth insights nigh the community's assets and needs. For example, when Andrews et al. (2007) used participatory methods to assess an AA population living in an impoverished neighborhood, they were assisted past community partners, advisory board members, and community health workers in interpreting the data through a series of the customs forums. Therefore, they were able to reveal multi-level factors related to smoking patterns of that community by partnering with community insiders, which provided a foundation for developing effective smoking cessation interventions. In addition, every bit shown in the case of the CPRT piece of work related to youth substance employ prevention, public health nurses can utilise analytic assessment skills past utilizing different, useful methods such as GIS, Photovoice, and private and/or grouping interviews with agile participation of community members.
Cultural Competence
Another important domain of PHN is cultural competence skills (Quad Council, 2011). This core ability enhances other competencies used by public health nurses when engaging in partnerships with communities and populations (Anderson & McFarlane, 2011). Cultural competence helps public health nurses sympathize invisible factors in the customs that promote health and prevent disease, such as assets, values, strengths, and special characteristics of the communities (Anderson & McFarlane, 2011).
Public health nurses can improve their cultural competence through the use of participatory practices with diverse communities.Public wellness nurses tin improve their cultural competence through the use of participatory practices with diverse communities (Marcus et al., 2004; McQuiston, Parrado, Martinez, & Uribe, 2005; Perry & Hoffman, 2010; Zandee, Bossenbroaek, Friesen, Blech, & Engbers, 2010). As mentioned previously, the community participation and ethnographic model is rooted in local cognition, which can be derived from community members of differing race and ethnicity, with divergent attitudes, beliefs, and values (McGrath & Ka'ili, 2009). Listed hither are several examples of research supporting acquisition of cultural competence skills using a customs participatory arroyo:
- Perry and Hoffman's (2010) study demonstrated that adopting a community participatory approach enabled them to develop a strategy based on American Indian youth culture to assess their level of physical activity by integrating community insiders in the process of cess and program planning.
- In a CBPR project to reduce substance corruption in a tribal customs, Thomas, Donovan, Sigo, Austin, and Marlatte (2009) provided an example of how public health nurses could attain culturally sensitive knowledge of the tradition, history, and strengths of the community past encouraging full participation of advisory councils as "cultural facilitators" in their meetings (p.four).
- McQuisiton and colleagues (2005) applied an ethnographic community participatory arroyo to reveal important cultural aspects, through the use of nominal group process in meetings, when assessing health disparities in a Latino population.
- Zandee et al. (2010) described how applying CBPR enabled PHN students to better understand the cultural background of the communities in which they worked and thus improve their cultural competence past partnering with community wellness workers.
Programme Planning
Plan planning skills are used in community participation approaches to optimize community health promotion and disease prevention by public health nurses (Quad Council, 2011). In program planning for community health promotion and prevention, PHNs tin program evidence-based programs by using in-depth analytic cess skills, and tin implement programs more effectively by utilizing collaborations and partnerships gained from the CBPR method (Andrews et al., 2007; Hassouneh, Alcala-Moss, & McNeff, 2011; Marcus et al., 2004; Perry & Hoffaman, 2010).
Public wellness nurses can develop sustainable programs and build community capacity for health promotion by taking into account the ecological context of the community from an ethnographic assessment.Public health nurses tin can develop sustainable programs and build community capacity for health promotion past taking into account the ecological context of the community from an ethnographic assessment (Andrews et al., 2007; Perry & Hoffaman, 2010). Perry and Hoffman (2010) demonstrated how PHNs tin incorporate findings from their assessment into plan development by having lively discussions and distributing information to develop the tailored program in the community. Marcus and colleagues (2004) showed how CBPR was used to develop a plan to decrease HIV/AIDS in AA adolescents past creating a coalition between university-based investigators and church-based stakeholders. PHNs strategically utilized these partnerships to design and implement the program. These CBPR strategies were besides utilized successfully to develop effective prevention and intervention programs (including both primary and secondary prevention programs) for cardiovascular affliction prevention (Fletcher et al., 2011).
Customs Dimensions of Practice
Community dimensions of practice skills focus on communication, collaboration, and linkages between public health nurses and the many stakeholders in a community (Quad Council, 2011). These skills are primal to PHNs' participation in CBPR and enable a focus on the ecological context in developing health promotion programs.
...PHNs tin develop these skills by building community capacity and engaging community members and partners to blueprint more effective, sustainable health-promoting programs.Public health nurses are able to proceeds these skills by creating collaborative partnerships with community leaders and stakeholders and identifying resources and solutions to issues through the CBPR method (Fletcher et al., 2011; Hassouneh et al., 2011; Marcus et al., 2004). These skills are enhanced by empowering customs members to address their community's health bug and increasing individual and community self-efficacy for health promotion throughout the CBPR procedure (Andrews et al., 2007; Marcus et al., 2004). Ultimately, PHNs tin develop these skills by building community capacity and engaging customs members and partners to design more effective, sustainable health-promoting programs.
Again, there are examples of enquiry that used a community participatory approach to foster these community exercise skills. Andrews et al. (2007) illustrated community dimensions of do skills when partnering with customs stakeholders to develop multiple levels of interventions using an ecological framework that enhanced sustainability. In another report, PHNs built partnerships with community stakeholders (Hassouneh et al., 2011) to increase trust and to ameliorate employ community resources in applying interventions such equally training. Every bit shown in these examples, public health nurses tin use CBPR to enhance partnerships and empower community members as participants by including them in the controlling processes of assessment and programme planning (Andrews et al., 2007; Hassouneh et al., 2011; Perry & Hoffaman, 2010).
Other Skills
The important skills of analytic assessment, cultural competence, program planning, and community dimensions of practice are critical for pursuing customs health promotion goals equally public health nurses become more widely involved in community participatory approaches. Other important competencies for the health promotion part are required for public health nurses, including communication; financial planning and management; leadership and systems thinking; policy development; and public health scientific discipline (Quad Quango, 2011). Public health nurses can further develop these skills past continuing to engage in community participatory practices. For case, PHN practice utilizes public health scientific discipline cognition, competencies, and skills by partnering with public wellness educators and researchers to develop prove-based prevention interventions programs and thus contribute to nursing science. Community initiatives by PHNs tin contribute to the development of policies based on in-depth evidence, assist customs health advocates, and lead to improved long term outcomes (Fletcher et al., 2011).
The Contemporary Public Health Nursing Role
...it is essential to emphasize collaboration and partnerships with communities and populations as gimmicky PHN roles evolve... Public health nursing exercise at the generalist and advanced or specialist level is competency based. PHN core competencies include knowledge and skills derived from the core public wellness workforce competencies, which were developed past the Council on Linkages (COL) (Quango on Linkages, 2010). These PHN core competencies include the three tiers of exercise used in the COL competencies, i.e., Tier ane -- the PHN generalist; Tier 2 -- the PHN specialist or manager; and, Tier iii -- the PHN organisation leader or executive level administrator (Quad Council, 2011). These core competencies are necessary to implement community participatory health promoting roles. In improver, it is essential to emphasize collaboration and partnerships with communities and populations as contemporary PHN roles evolve in the context of Healthy People 2020 (DHHS, 2010), the Patient Protection Affordable Care Act (ACA) (U.South. Business firm of Representatives, 2010), and the National Prevention, Wellness Promotion, and Public Wellness Quango (Executive Order 13544, 2010). These national initiatives provide new opportunities for emerging roles in PHN focused on community health promotion and prevention practices.
...national initiatives provide new opportunities for emerging roles in PHN focused on customs wellness promotion and prevention practices. The customs participation and ethnographic model includes of import long-standing PHN processes, besides as innovative strategies that public health nurses tin can utilize in community assessment and prevention program development. Using PHN cadre competencies (Quad Quango, 2011) and guided by the community participation and ethnographic model, public wellness nurses can empower communities and populations to get more than involved in customs health promotion and prevention. This empowerment can reduce health threats and increase health equity.
Every bit the roles of public health nurses as advocates, collaborators, educators, partners, policy-makers, and researchers evolve in the surface area of customs health promotion and prevention, greater emphasis on community participatory and ethnographic approaches in PHN instruction volition provide benefits to students at the generalist and advanced practice levels (Zandee et al., 2010). Moreover, basic and advanced public health nursing exercise roles, which emphasize inter-professional person collaboration, community participatory strategies, and the importance of local noesis to address community health problems, will go on to contribute to improved customs and population health outcomes.
Acknowledgement: This projection was supported past a grant from the Virginia Foundation for Healthy Youth (formerly the Virginia Youth Tobacco Settlement Foundation) 2009-2012.
Authors
Pamela A. Kulbok, DNSc, RN, PHCNS-BC, FAAN
Email: pk6c@virginia.edu
Dr. Kulbok is a Professor of Nursing and Public Health Sciences at the Academy of Virginia (UVa). She is Chair of the Section of Family, Community, and Mental Health Systems and Coordinator of the Public Health Nursing Leadership track of the MSN Program. Dr. Kulbok is the chief investigator of an inter-professional, cross-institution, community-based participatory inquiry project funded past the Virginia Foundation for Healthy Youth to design a substance employ prevention program with youth, parents, and community leaders in a rural tobacco-growing canton. While at UVa, she has co-directed ii advanced education nursing (AEN) training grants: the first was focused on altitude education and leadership in Health Systems Direction (HSM) and Public Wellness Nursing (PHN), the second used distance applied science to prepare rural nursing leader in HSM, PHN, and Psychiatric Mental Health. Prior to her faculty engagement at UVa, she was a faculty member at the Cosmic University of America and the University of Illinois at Chicago, where she was project director of customs/public health nursing AEN training grants. Dr. Kulbok currently serves as the Chair of the American Nurses Association (ANA) workgroup to revise the Public Health Nursing: Scope and Standards of Do. She previously served every bit President-Elect and President of the ACHNE, and member and Chair of the Quad Council of Public Health Nursing Organizations. She also completed a four-year term on the ANA, Congress of Nursing Exercise and Economic science. Dr. Kulbok holds a BS in Nursing and an MSN in Community Wellness Nursing from Boston Higher. She earned her doctorate at Boston University and did postdoctoral work in psychiatric epidemiology at Washington Academy in St. Louis.
Esther Thatcher, MSN, RN
Electronic mail: ejm4p@virginia.edu
Ms. Thatcher is a PhD student at the University of Virginia (UVa) Schoolhouse of Nursing. She too received her BSN and MSN in Customs/Public Wellness Leadership at UVa. Ms. Thatcher's enquiry interest is community-level interventions to prevent and reduce chronic disease in underserved communities. Her planned doctoral enquiry is to examine the community food surround in an economically disadvantaged rural Appalachian area, to place influences on food choices that may lead to obesity and other health conditions. Ms. Thatcher previously worked as a public health nurse in a local health section, as a care coordinator in a primary care practice, as an inpatient nurse in a hospital, and as a rural outreach nurse to Hispanic migrant farmworkers. She also volunteered in wellness programs in Latin America, including the Pan-American Health System'due south Healthy Communities programme. Equally a BSN student, Ms. Thatcher was a founding member of Nursing Students Without Borders, an organization that connects nursing students to international communities.
Eunhee Park, BSN, RN
E-mail: ep9j@virginia.edu
Ms. Park is a BSN to PhD pupil at the University of Virginia (UVa) School of Nursing. She is currently pursuing her Main'south degree specializing in Public Health Nursing Leadership (PHNL). Ms. Park'south research interest is youth health promotion in vulnerable populations and nursing educational activity to enhance leadership among public health nurses. She is working with in a community based participatory enquiry team to design a youth substance employ prevention programme in a rural canton. Ms. Park previously worked equally a staff nurse at the Pediatric Cardio Surgical Unit of measurement, Emergency Room, and Maternity Unit in Seoul National University of Infirmary, S Korea. She earned her BSN degree at Kyungpook National University in South korea.
Peggy S. Meszaros, PhD.
E-mail: meszaros@vt.edu
Dr. Peggy S. Meszaros is the William E. Lavery Professor of Human Development and Director of the Eye for Information Technology Impacts on Children, Youth and Families. She has received degrees from Austin Peay State University, the University of Kentucky, and Academy of Maryland, College Park. During more than than 30 years of work in higher teaching, her inquiry interests take focused on positive youth development, engineering science impacts, human ecological, family, and gender bug. She has published over xc scholarly articles, iii books, numerous volume chapters and received over 6 million dollars in external enquiry grants. She is currently the Master Investigator (PI) on the National Science Foundation funded enquiry grant, Appalachian Information technology Extension Services, the PI on the Virginia Salubrious Youth Foundation research grant The Development and Implementation of a Family Based Substance Corruption Prevention Model for Youth Receiving Behavioral Health Services, and Co-PI on Partnering with Youth, Parents, and Customs Leaders to Develop an Intervention for Substance Abuse in a Rural Community. Dr. Meszaros has received many honors and awards, including being named a Truman Scholar Mentor at Oklahoma State University and induction into the University of Kentucky Distinguished Hall of Fame.
References
Agar, M.H. (1973). Ethnography and the addict. In Nadar, L., and Maretzki, T.W., (eds.) Cultural Disease and Wellness. Washington, DC: American Anthropological Association.
Agar, Chiliad.H. (1986). Speaking of ethnography. Beverly Hills, CA: Sage Publications
American Nurses Association (ANA) (2007). Public health nursing: Scope and standards of practice. Washington, DC: American Nurses Publishing.
Anderson, Eastward. T., & McFarlane, J. (2011). Community every bit partner: Theory and practice in nursing (6th ed.). Philadelphia, PA: Wolters Kluwer Health / Lippincott Williams & Wilkins.
Anderson, N.Fifty.R., Calvillo, Due east.R., & Fongwa, M.N. (2007). Customs-based approaches to strengthen cultural competency in nursing pedagogy and exercise. Journal of Transcultural Nursing, 18(1-S), 49s-59s.
Andrews, J. O., Bentley, One thousand., Crawford, South., Pretlow, Fifty. & Tingen, M. S. (2007). Using community-based participatory enquiry to develop a culturally sensitive smoking cessation intervention with public housing neighborhoods. Ethnicity and Disease, 17(ii), 331-337.
Aronson, R.Due east., Wallis, A.B., O'Campo, P.J., Whitehead, T.Fifty., & Schafer, P. (2007a). Ethnographically informed community evaluation: A framework and approach for evaluating community-based initiatives. Maternal Child Health Periodical, eleven(2), 97-109.
Aronson, R.E., Wallis, A.B., O'Campo, P.J. & Schafer, P. (2007b). Neighborhood mapping and evaluation: A methodology for participatory community health initiatives. Maternal Child Wellness Journal, 11(iv), 373 – 383.
Association of Customs Health Nursing Educators (2003). Essentials of chief'due south level nursing education for avant-garde community/public health nursing exercise. Latham, NY: Author.
Blake, B.J. & Bentov, L. (2001). Geographical mapping of unmarried teen births and selected sociodemographic variables. Public Health Nursing, 18(1), 33-39.
Brainard, A. K. (1922, 1985). The Evolution of public wellness nursing. New York: Garland.
Buhler-Wilkerson, K. (1989). False dawn: The rising and decline of public wellness nursing, 1900-1950. New York: Garland.
Castleden, H., Garvin, T., & Nation, H.A.A.F. (2008). Modifying photovoice for community-based participatory Ethnic enquiry. Social Science and Medicine, 66(6), 1393-1405.
Centers for Disease Control and Prevention. (2010). Tobacco command state highlights, 2010. Atlanta: U.S. Department of Health and Human being Services, Centers for Disease Control and Prevention, National Eye for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
Council on Linkages between Academia and Public Health Practice (Council on Linkages, COL). (2010). Core competencies for public health professionals. Retrieved from www.phf.org/resourcestools/Documents/Core_Public_Health_Competencies_III.pdf
Cravey, A.J., Washburn, S.A., Gesler, W.Chiliad., Arcury, T.A., & Skelly, A.H. (2001). Developing socio-spatial knowledge networks: a qualitative methodology for chronic disease prevention. Social Science Medicine, 52(12), 1763-1775
Executive Order 13544-- Establishing the national prevention, health promotion, and public health council. (2010). Retrieved world wide web.whitehouse.gov/the-press-office/executive-order-establishing-national-prevention-health-promotion-and-public-health
Fitzpatrick, M. L. (1975). The national organization for public health nursing, 1912–1950: evolution of a practice field. New York: National League for Nursing.
Fletcher, B.J., Himmelfarb, C.D., Lira, One thousand.T., Meininger, J.C., Pradhan, S.R., & Sikkema, J.S. (2011). Global cardiovascular affliction prevention: A call to action for nursing customs-based and public health prevention initiatives. European Journal of Cardiovascular Nursing, 10(2), S32-S41.
Gesler, Due west.M., Hayes, M., Arcury, T.A., Skelly, A.H., Nash, South., & Soward, A.C.Grand. (2004). Utilize of mapping technology in health intervention inquiry. Nursing Outlook, 52(iii), 142-146.
Pilus, E.C., Park, G.J., Ling, T.J., & Moore, K.A. (2009). Risky behaviors in late boyhood: Co-occurrence, predictors, and consequences. Journal of Adolescent Health, 45(3), 253-61.
Hassouneh, D., Alcala-Moss, A. & McNeff, E. (2011). Applied strategies for promoting total inclusion of individuals with disabilities in community-based participatory intervention research. Research in Nursing and Wellness, 34, 253-265.
Israel, B.A. Eng, E., Schulz, A.J. & Parker, Eastward.A. (Eds.). (2005) Methods in community-based participatory research for health, San Francisco: Jossey-Bass.
Karim, G. (1997). In living context: An interdisciplinary approach to rethinking rural prevention. In E.B. Robertson, Z. Sloboda, G.M. Boyd. L. Beatty & N.J. Kozel, eds. Rural substance abuse: State of knowledge and issues (National Institute of Drug Abuse, Monograph 168). Rockville Doc: US Department of Health and Human being Services.
Kretzmann, J.P., & J.50. McKnight. (1997). Building communities from the inside out: A path toward finding and mobilizing a customs's avails. Chicago, IL: ACTA Publications.
Kulbok, P.A. & Cox, C.L. (2002). Dimensions of adolescent wellness beliefs. Periodical of Boyish Health, 31(v), 394-400.
Kulbok, P.A., Meszaros, P., Bond, D.C., Botchwey, N.D., & Hinton, I. (2009). Partnering with rural youth and parents to pattern and test a tobacco, alcohol, and drug use prevention program model (Abstract). Virginia Foundation for Healthy Youth (formerly the Virginia Tobacco Settlement Foundation). Retrieved from http://healthyyouthva.org/vtsf/research/projects.asp
Kulbok, P., Meszaros, P., Botchwey, N, Hinton, I., Bovbjerg, V., Rhee, H.,... Noonan, D. (2010). Female parent-girl advice: A protective gene for not Smoking. The Journal of Addictions Nursing, 21, (2-3), 69-78.
Kulbok , P.A., Meszaros, P.S., Hinton, I., Botchwey, N., & Noonan, D. (2009). Protective factors and tobacco-free male adolescents in rural Virginia. Paper presented at the 137th APHA Almanac Meeting, Philadelphia, PA.
Levin, P., Cary, A, Kulbok, P., Leffers, J., Molle, 1000., & Polivka, B. (2008). Graduate educational activity in public health nursing: At the crossroads. Public Wellness Nursing, 25(ii): 176-93.
Lopez, E.D.S., Eng, E., Randall-David, E., & Robinson, Due north. (2005). Quality-of-life concerns of African American breast cancer survivors inside rural Northward Carolina: Blending the techniques of photovoice and grounded theory. Qualitative Wellness Research, 15(1), 99-115.
Lundy, M. S., & Bender, K. W. (2001). History of community health and public health nursing, in Community Health Nursing: Caring for the Public'southward Health. Sudbury, MA: Jones and Bartlett.
Marcus, T. Thou., Walker, T., Swint, J. M., Smith, B. P., Brownish, C., Busen, N., ... von Sternberg, 1000. (2004). Community-based participatory research to preclude substance corruption and HIV/AIDS in African-American adolescents. Journal of Interprofessional Intendance, xviii(four), 347-359.
McQuiston, C., Parrado, E. A., Martinez, A. P., & Uribe, L. (2005). Community-based participatory research with Latino community members: Horizonte Latino. Journal of Professional person Nursing, 21(iv), 210-215.
McGrath, B. B., & O.Kali, T. (2009). Creating project Talanoa: A culturally based community health program for U.Southward. Pacific Islander adolescents. Public Health Nursing, 27(1), 17-24.
Milio, N. (1970). 9226 Kercheval: The storefront that did not burn. Ann Arbor, MI: University of Michigan Press.
Perry, C. & Hoffaman, B. (2010). Assessing tribal youth physical activity and programming using a customs-based participatory inquiry approach. Public Health Nursing, 27(2). 104-114.
Quad Council of Public Health Nursing Organizations. (2011). Core competencies for public health nurses. Washington, DC: Quad Quango of Public Health Nursing Organizations.
Vicious, C. L., Xu, Y., Lee, R., Rose, B. 50., Kappesser, & Anthony, J. South. (2006). A case study in the utilise of community-based participatory research in public health nursing. Public Health Nursing, 23(5), 472-478.
Shannon, Chiliad., Rusch, M., Shoveller, J., Alexso, D., Gibson, Yard., & Tyndall. M.W. (2008). Mapping violence and policing as an environmental-structural barrier to health service and syringe availability amidst substance-using women in street-level sex piece of work. International Periodical of Drug Policy, xix(2), 140-147.
Strack, R.West., Magill, C., & McDonagh, Thou. (2003). Engaging youth through photovoice." Wellness Promotion Practice, 5(1), 49-58.
Stanhope, K., & Lancaster, J. (2011). Public wellness nursing: Population-centered intendance in the customs (8th ed.). St. Louis, MO: Mosby.
Thomas, L. R., Donovan, D. Thou., Sigo, R. LW., Austin, L., & Marlatt, G. A. (2009). The community pulling together: A tribal community-university partnership project to reduce substance abuse and promote good health in a reservation tribal community. Journal of Ethen Substance Abuse, 8(3), i-xiii.
Trotter, R. (1993). Ethnographic methods and inhalant use among three ethnic populations. Paper presented at the Inhalant Conference, Fort Collins, CO, August 1993.
U.S. Department of Health and Human Services (2010).Healthy people 2020. Washington, DC: U.S. Authorities Printing Part.
U.S. House of Representatives. (2010). Patient protection and affordable care human activity. Retrieved from http://docs.house.gov/energycommerce/ppacacon.pdf
Wang, C.C. & Burris, M.A. (1994). Empowerment through photovoice: Portraits of participation. Health Educational activity Quarterly, 21(two), 171-186.
Wang, C.C., Morrel-Samuels, S., Hutchison, P., Bell, L., & Pestronk, R.M. (2004). Flint photovoice: Community edifice among youth, adults, and policy makers. American Periodical of Public Health, 94(six), 911-913.
Winters, Thou.C., Fawkes, B.A., Fahnhorse, T., Botzet, & August, M. (2007). A synthesis review of exemplary drug abuse prevention programs in the United States. Periodical of Substance Corruption Handling, 32(4), 371-380.
Zandee, G., Bossenbroek, D., Friesen, Thousand., Blech, K., & Engber, R. (2010). Effectiveness of community wellness worker/nursing student teams as a strategy for public health nursing education. Public Health Nursing, 27(three), 277-284.
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