Question

Alice is the school health coordinator for Wagoner County, a rural county whose main farm crop is tobacco. Nurse Alice would like to evaluate the risky health behaviors of middle and high school students in Wagoner County. She decides to use the Youth Risk Behavior Survey (YRBS) of the Centers for Disease Control and Prevention (CDC) to assess students' current health behaviors. Survey results reveal that many students are trying and using tobacco as early as 12 years of age. Furthermore, the survey shows that the students were trying to get cigarettes by stealing them from parents and siblings who smoked or from unsupervised cigarette machines. They also obtained cigarettes through older students who were able to buy them at convenience stores without being asked for ID. Of students who were smoking on a regular basis, 40% believed that smoking was bad for them and had tried to quit, but were unsuccessful.

With help from school administrators, school nurses, and volunteers, Nurse Alice develops a health promotion plan to reduce adolescent tobacco use. School nurses in the middle and high schools will provide smoking cessation classes to help teens who are using tobacco quit smoking. Smoking-cessation classes will also be offered to family members of students in the schools. Additionally, school principals created the new policy that smoking is not allowed by anyone (e.g. students, teachers or parents) on school grounds.

Answer the following questions about this case study:

1) What are the advantages and disadvantages of Nurse Alice's using a health-risk appraisal survey to assess the health risks of students at her school?

2) What social factors does Nurse Alice need to be aware of when planning a health promotion program to decrease tobacco use among adolescents? Why is it important to keep these things in mind?

3) With use of the Integrative Model for Community Health Promotion, what is Nurse Alice's focus of care, and what client system in her health promotion plan will decrease adolescent smoking? (Hint: There is more than one client system).

Answer 1

ANS 1 -

a) Extensive research has shown that HRAs have following advantages:

• Identify health risk factors.
• Predict health-related costs
• Measure absenteeism and presenteism
• Evaluate the efficacy and return on investment of health promotion strategies

There is also recent evidence to suggest that taking a HRA alone can have a positive effect on health behavior change and health status.

b) The dis-advantages of HRAs are -

The limitations of a HRA are largely related to its usage and it is important to recognise that a HRA highlights health risks but does not diagnose disease and should not replace consultation with a medical or health practitioner.

ANS 2 - a) When planning a health promotion program to decrease tobacco use among adolescents Alice needs to keep following things in mind -

1. Peer pressure
2. Self image of the students
3. Confidentiality
4. Tobacco is the main source of income for the families in the county

b) These things are important to be kept in mind as these social factors are very cause that led to smoking from a very young age. Moreover , some questions may hurt the sentiments of the people as well as confidentiality comes under ethical ground. Also there are some issues that need to be addressed in an innovative way such as peer pressure, which is one of the main reason for smoking. For effective health promotion plan all these factors need to be kept in mind while formulating the plan.