Educational Program Proposal
According to Saint Onge & Krueger (2017), the alterations between populations toward healthier behaviors will require ample time and systems support at many levels. Largely, health care providers are held responsible for encouraging patients toward a healthy lifestyle change, along with identifying that many changes are necessary for this to take place (Saint Onge & Krueger, 2017). Likewise, physicians and nurses can play a vital role in promoting healthier behaviors. This is mostly because many patients tend to put their trust in their health care providers’ advice. Subsequently, there are five main advocating steps a health care provider can complete to move towards helping a patient. They include: (1) Assessing the risk behavior, (2) advising changing, (3) agree on goals and an action plan via shared decision making, (4) assisting with treatment, and (5) arrange follow-up (Saint Onge & Krueger, 2017). It has been proved that these five steps can help create significant changes in many health behaviors including smoking cessation, alcohol consumption, dietary changes and even physical activity (Saint Onge & Krueger, 2017). Usually personal behavior can definitely influence one’s health, with people improving their health by managing their chronic condition or participating in health promotion that can bring upon behavior change (Silvestre, Bowers, & Gaard, 2015). It can have a major role in classifying behaviors that are analytical to health, as well as assessing the needs of individuals and groups with recommending health behaviors. This can help determine and guide in the preparation and delivery of interventions that are designed to enhance engagement in health behaviors with evaluating the effectiveness of the interventions (Silvestre, Bowers, & Gaard, 2015).
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Health promotion can demand people to initiate and maintain health behavior changes with having the patient-centered approach as a focus (Constand, MacDermid, Bello-Haas & Law 2014). This is when health care providers assist patients to create plans to reach their own goals. This can be considered as a positive approach to where people can be encouraged to get healthy and lead a healthy life (Constand et al., 2014). There are various elements involved in terms of patient-centered care that can be otherwise built and valued by the stakeholders involved. For instance, health care providers can have wide-ranging opinions about which components and outcomes of patient-centered care are most important. Patients can be more apprehensive with the fact of healthcare providers assessing the patients’ level of knowledge and coming up with the goals accordingly to the individual (Constand et al., 2014).
Regardless though, one significant barrier to effective medical treatment can be the patient’s failure to obey the recommendations of their healthcare provider which is usually their nurse who can be the patient advocate in many matters (Constand et al., 2014). Similarly, this all can come down to the aspect of self-efficiency that is one’s capability to be performing in a certain way to achieve specific goals and have the complete control. This includes the health risk behaviors that can be considered negative actions that can highlight the adverse effects (Spring et al., 2013). Therefore, The Transtheortical Model (TTM) of Behavioral Change is an example of a change model which can aid people in changing a behavior through the essential stages of change (SC) and their personal willingness towards that change (Han, Gabriel, & Kohl, 2017). So primarily throughout this process, there are five stages that include precontemplation, contemplation, preparation, action and maintenance (Han, Gabriel, & Kohl, 2017). The TTM model involves patients’ partaking in decision making regarding their health and treatment that can help better their health as a whole. Specifically, patients can be more open to take part in group therapy sessions and as well as one-on-one sessions with a therapist. The healthcare provider’s interpersonal communication skills and attitude can support to lead towards beneficial results for the patient’s health too (Han, Gabriel, & Kohl, 2017). Some other benefits consist of better patient satisfaction and trust, greater patients’ quality of life, enhanced understanding of particular characteristics of one’s health (Han, Gabriel, & Kohl, 2017). In this method, a nurse will be responsible to find out if a patient is ready, especially when a patient expresses verbally stating that they would like a change in their lifestyle. But the leading barriers to promote behavior change would be that patient are just too lazy to even to try to bring in improvement. However, the laziness can come from the pain the patients are experiencing or just have the insecurity of not getting better. It can be difficult to handle patients like this and the only way to help is to give them pain medication before getting them to go through any type of therapy or to guide them with distraction or other non-pharmalogical interventions. Also, the explanation of the benefits involved can bring encouragement to do the activity to better their health.
Spring et al. (2013) indicates that the middle age phase can be the developmental phase of the life span that can play a large role in emerging the components of cognitive, physical, mental and emotional health. The population sampled for this program consisted of fifteen healthcare professionals of different roles within a surgical environment. These roles consisted of OR nurses, certified surgical technicians, patient care technicians, sterile processing technicians, OR charge auditor, anesthesia technician, and OR supply chain coordinator. This program survey consisted of two males and thirteen females. It will be conducted with within an acute care facility. With this, there are one major risk categories of behavior that have been self-reported by the survey respondents is alcohol use (Health Behaviors of Adults, n.d). This is broken down in three components that consists of “lifetime abstainer, former drinker (no drink in the past year), current moderate drinker (12+ drinks in the past year but not current heavy drinker), or current heavy drinker (>14 drinks per week in past year for men; >7 drinks per week for women)” (Health Behaviors of Adults, n.d, p. 3). Frequently, health care professionals are expected to endorse and promote the aspect of self-care among their patients. Particularly, the focus is on the risks and issues alcohol use can create, and can lead to the potential of alcoholism. This is a risk behavior that can make people who do consume alcohol more than the recommended amounts can be putting themselves at risk for many negative consequences (Bakhshi & While, 2014). This can also be one of the major causes for escalating a person’s risk for violence, physical assault and other accidents (Bakhshi & While, 2014). But the overall risk assessment can evaluate the effect of all the alcohol consumption that can be related with changes in drinking habits and patterns as well as other health behaviors (Bakhshi & While, 2014).
In fact, Felicíssimo et al. (2014) found that intervention approaches that are based on TTM can upsurge the motivation for behavior change considering alcohol use among health care providers. As mentioned, there are many cognitive functions that may be affected in regard to the stages of change. It has been established that the population participants with less alcohol use and less verbal memory were on the precontemplation phase (Felicíssimo et al., 2014). On the contrary, the participants that were classified as alcohol dependents and with higher score of verbal memory were placed on the contemplation stage (Felicíssimo et al., 2014). Thus, the alcohol abusers were considered dependent participants with more recent behavior changes. Additionally, to the motivational stage of change, the aspect of self-efficacy in terms of alcohol use can be assessed with utilizing the eight-item form of the Alcohol Abstinence Self-Efficacy scale (AASE), the ten-item form known as the Alcohol Decisional Balance Scale (ADBS) and the twenty-item form of the Processes of Change questionnaire (Baumann, Staudt, Freyer-Adam, & John, 2018, p. 4). The objective of the AASE and ADBS is changing from “abstaining from alcohol” to “adhering to the low-risk drinking limits” (Baumann et al., 2018, p. 4). Low-risk drinking can be described as not going past seven alcoholic drinks per week for women and it is fourteen for men (Baumann et al., 2018, p. 4). There are the three alcohol-related risk levels that can be figured out through the auditing process. First are the Audit-C scores “four out of five or more for women or men and audit scores below twenty signify at-risk alcohol-use” (Baumann et al., 2018, p. 4). Secondly is when the Audit-C results in “twenty or above indicate more severe alcohol problems” (Baumann et al., 2018, p. 4). Some additional variables can include sex, age, levels of education, professional qualifications, marital status and employment status (Baumann et al., 2018, p. 4).
Furthermore, the randomization process consists of the essential steps to complete the intervention process. The first step is starting at the baseline where the participants need to respond to questions regarding their personal alcohol use and TTM concepts through a tablet computer (Baumann et al., 2018, p. 4). Then step two is system software examining the data given from the participants in association with the general population data (Baumann et al., 2018, p. 4). Step three is the feedback letter that will be sent to the participants by mail. Then step four will take place after three months, with “computer-assisted telephone interviews taking place with the inclusion of questions regarding the participants alcohol use and TTM involved” (Baumann et al., 2018, p. 4). Step five again will be sending a interdependent feedback letter to the participants on the baseline of three months (Baumann et al., 2018, p. 4). Step six will take place after six months after the intervention has taken place with “computer-assisted telephone interviews taking place with the inclusion of questions regarding the participants alcohol use and TTM involved” (Baumann et al., 2018, p. 4). Step seven is the software system generating “a ipsative feedback letter with comments and considerations for change in terms of alcohol use and TTM theories on the basis of six months” (Baumann et al., 2018, p. 4). Step eight will take place nine months after with “computer-assisted telephone interviews taking place with the inclusion of questions regarding the participants alcohol use and TTM involved” (Baumann et al., 2018, p. 4). Step nine is the software system generating “a ipsative feedback letter with comments and considerations for change in terms of alcohol use and TTM theories on the basis of nine months” (Baumann et al., 2018, p. 4).
According to Schulz, Kremers, & Vries (2018), the part of health literacy is when individuals have the competence to find and understand the basic health information services which can come in handy when making appropriate health decisions. Though the importance of this intervention is emphasized by the process of dealing with problems related to alcohol consumption and everyday life, it is clear that the notional framework on this issue still has a long way to be developed. There are many realistic applications of this assessment by which health care providers can use to move towards patient-centered healthcare. It can aim to provide better health care for each individual patient taking part in their own goals and values (Schulz, Kremers, & Vries, 2018). Principally, the quality of patient advocacy can come into the attention with having the opinions of the participants that can have greater influence on the decisions that can affect them.
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As mentioned, self-efficacy and other interpersonal factors of the health care provider and patient relationship can work together to form the part in determining a variety of patient after-effects including patient adherence to their recommendations of treatment (Schulz, Kremers, & Vries, 2018). Moreover, it can be key and helpful to address the potential barriers that may be preventing health professionals from raising alcohol-related concerns with their patients. Hence the TTM model is the best way that the needed behavioral changes can be brought forth. Not only with the understanding of the health-related attitudes and beliefs that can persuade the individual to change their behavior (Schulz, Kremers, & Vries, 2018). So those patients who do actually abuse alcohol can be advantageous from this intervention due to the awareness and the impact of alcohol intake in their daily life.
- Bakhshi, S., & While, A. E. (2014). Health Professionals’ Alcohol-Related Professional Practices and the Relationship between Their Personal Alcohol Attitudes and Behavior and Professional Practices: A Systematic Review. International Journal of Environmental Research and Public Health,11, 218-248. doi:10.3390/ijerph110100218
- Baumann, S., Staudt, A., Freyer-Adam, J., & John, U. (2018). Proactive expert system intervention to prevent or quit at-risk alcohol use (PRINT): Study protocol of a randomized controlled trialProactive expert system intervention to prevent or quit at-risk alcohol use (PRINT): Study protocol of a randomized controlled trial. BMC Public Health,18(851), 1-7. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6038316/pdf/12889_2018_Article_5774.pdf.
- Constand, M. K., MacDermid, J. C., Bello-Haas, V. D., & Law, M. (2014). Scoping review of patient-centered care approaches in healthcare. BMC Health Services Research,14(271), 1-9. Retrieved from https://bmchealthservres.biomedcentral.com/track/pdf/10.1186/1472-6963-14-271.
- Felicíssimo, F. B., De Barros, V. V., Pereira, S. M., Rocha, N. Q., & Lourenço, L. M. (2014). A systematic review of the transtheoretical model of behaviour change and alcohol use. Psychologica,57, 7-22. http://dx.doi.org/10.14195/1647-8606_57_1_1
- Han, H., Gabriel, K. P., & Kohl, H. W., III. (2017). Application of the transtheoretical model to sedentary behaviors and its association with physical activity status. PLoS ONE,12(4), 1-13. doi:doi.org/10.1371/journal. pone.0176330
- Health Behaviors of Adults: United States, 2005–2007. (n.d.). 10-245. Retrieved from https://www.cdc.gov/nchs/data/series/sr_10/sr10_245.pdf.
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- Lowrey, O., Ciampaglio, K., Messerli, J. L., & Hanson, J. D. (2019). Utilization of the Transtheoretical Model to Determine the Qualitative Impact of a Tribal FASD Prevention Program. Sage Open,1-8. doi:10.1177/2158244018822368
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