Green provides some clear guidelines to assist health education and promotion specialists in the identification and design of health promotion techniques for implementation in health promotion and disease prevention programs. Discuss how five of the guidelines presented by Dr. Green could assist you in the selection of an appropriate health promotion technique. Support your answer with appropriate examples.
The module gives really simple guidelines as to the how the process of health education promotion can work in today's world. Healthcare is a social industry and hence understanding the community structure and its needs is the primary concern. According to the directions given by Dr. Green, the following factors have to be considered before designing and implementing health promotion and disease prevention programs. Hence the process is structured by first identifying the needs of the community and then setting the goals (short-term and long-term) accordingly. Once this is done the following steps are completed in order to design and implement efficient health promotion and disease prevention programs: the settings of the community are examined (cultural, political, norms, etc.); the population characteristics and demographics are identified; the extent of change is calculated (individual vs. community); all the resources and capital available for the health promoter are identified and used in accordance with prior health promotion/disease prevention experiences within the community; a theory or model that best suits the promotion technique is then recognized and applied. Once these steps are covered, the health promoter then divides all functions across three different tiers; the primary, secondary and tertiary. In the following description, we present an example of how a health promoter can market the prevention of nosocomial infections in the ICU amongst the employees of a hospital. The example will show the entire process divided across the aforementioned three tiers (Green, Module 1a and b).
With regards to reducing nosocomial infections rates, in a recent study on the C-difficile infection impacting the state of patients in ICU, Muto and colleagues (2007) also concentrated on a number of sanitizing practices that could prove to be helpful in reducing nosocomial infection rates in ICU settings. They supported the use of these practices by also providing scientific and monitory proof of the success of these practices which proved to an efficient disease prevention marketing technique in the long run (Green, Module 1a and b). Even though they had little success initially, the subsequent tests and trials on helpful practices proved to be successful. They even highlighted the most appropriate ways to clean the rooms of the patients (Muto et al., 2007; Kollef, 2008). Some of the successful practices that were consequently adopted since the publication of the study included the following:
(1) The increased use of soap and water for hand sanitization to reduce transfer of bodily substances that might lead to infections,
(2) The utilization of frequent infection-control reviews and examinations to identify the loopholes or flaws in the sanitization processes for ICU, and (3) The decreased use of chemical sanitizers like ceftriaxone, clindamycin, and levofloxacin. Three other studies that supported these findings, namely, Muto et al. (2007), Gerding et al. (2008) and McMullen et al. (2007).
According to the study conducted by Muto and colleagues in 2007, the consistent use of the aforementioned practices and methods was very effective in reducing the infection rates for patients in ICU as the annual rates of infections dropped down to 3.0 in 2006 from an extreme high of 10.4 in the year 2000 (Muto et al., 2007). This proves that the primary prevention technique in disease prevention or health promotion can be best supported by practical or scientific proof (Green, Module 1a and b).
In another recent research, Isakow and colleagues (2007) found that the use of probiotics can be a very successful option to control the GI tract within the ICU setting. They further support the use of probiotics due to the simple and easy management that it requires as well as the overall safety report it has and the low expenses and thus the prevention promotion techniques focused on these aspects when marketing its use in the hospitals (Isakow et al., 2007; Green, Module 1a and b). On the contrary, in a prior study, McFarland (2006) highlights that probiotics were successful in decreasing the RR of any and all antibiotic-associated diarrhea but practical result showed a differing outcome. McFarland (2006) found that only 13 out of a total of 25 studies (which is only 50%) have shown results where the ICU patients have had significantly successful results with the use of probiotics (McFarland, 2006). These variations in the results could have numerous factors behind it like the form of probiotics used, the sample chosen, the complementing antibiotic used, the overall dosage and administration, etc. This is why Isakow and colleagues agree that further studies are needed to determine the most effective preventive measures to decrease the infection of C. difficile-associated diarrhea within the ICU setting (Isakow et al., 2007; Kollef, 2008).
Some of the other common infections in the ICU that also need further screening include the following:
• Pneumonia (Use of chest X-ray is important for screening)
• Ventilator-associated Pneumonia (VAP) (assessment and identification of bacterial spread is important for screening)
• Urinary tract infection (UTI) (regular utilization of prophylactic antibiotics is an important aspect of screening)
• Surgical Site Infections (SSI) (hand sanitization and proper incision technique is an important aspect of screening) (Kollef, 2008)
The application of these findings show that the clear determinant factor of the success of failure of infection-prevention techniques used in the hospitals is the adherence and obedience of the doctors and healthcare workers (Green, Module 1a and b). There is little evidence presented by the writer that supports this to be the determinant factor but there is enough evidence for the writer to conclude that the overall structure of infection control in the ICU will improve if and when the following aspects are controlled:
• Expenses and costs of the necessary equipment and procedures were decreased to manageable and affordable values, • There was an adequate and timely supply of the necessary capital or sources
• The scheduling and training of the doctor and nurses was more flexible and lenient so as to not get them overworked and exhausted
• Level of dissatisfaction amongst patients was decreased through conducting surveys and identifying what caused them discomfort
• The possibility of making mistakes with new procedures that discouraged higher levels of participation was controlled by backing and supporting all procedures with proper training, education and scientific proof of success.
• The disarray between the nurses and the doctors and the somewhat blame game was managed with proper delegation and distribution of responsibilities and decision making tasks
All these aspects were then included in the regular training session for the nurses and doctors within hospitals so as to ensure that they remain up-to-speed with the recent demands and needs of the patients and the community and were thus able to mobilize the community and its resources accordingly (Green, Module 1a and b).
2. Dr. Perko discusses the National Cancer Institute's Health Communication Wheel. Outline the basic components of this process and explain how this can be used to assist the health educator to develop effective health messages.
The health communication wheel and components discussed by Dr. Perko include the following aspects:
The diagram/wheel above was structured by me in view of the discussion conducted by Dr. Perko and it shows how and when each step should be completed. Below is a further discussion of these aspects.
Step 1: Review Background Information
- The increase in contact information using forms: the use of forms that have integral patient information i.e. personal contact information is an integral part for any communication in the short- and long-term (Perko, Module 4)
Step 2: Set Communication Objectives and Channels
- The provision of a 24-hour contact number for the healthcare provider and company is also an integral part of the communication wheel. The 24-hour helpline can be provided to the customers with the forms that they are required to fill out with their personal contacts (Perko, Module 4)
- The provision of a website and email address is also an integral part in the modern world where the use of internet is believed to be far more convenient and efficient as a means of communication (Perko, Module 4)
- The objective will be to primarily understand the problem that the customer is currently facing and recognizing strategies that can help resolve it.
Step 3: Target audience
- The target audience is recognized by the health promotion team e.g. all nosocomial infection prevention tactics will be promoted within the staff of the hospital as opposed to the end consumer (Perko, Module 4)
Step 4: Identify message
- It has to be recognized whether the message is for the health promotion tactics or the disease prevention tactics; this will then determine whether humor, theatrics, direct/indirect communication, etc. must be used (Perko, Module 4)