A social group of any size whose members reside in a specific geographical location, share cultures, values, norms and are respected and loved by each other according to their relation is defined as community (Laverack, 2007 & World Health Organization, 2018). Community empowerment, capacity building and community action are the key concepts of health promotion which play a vital role to improve community health by working with people and addressing their needs by engaging, organizing and mobilize communities (Laverack, 2007). This essay is aimed to address the chronic obstructive pulmonary disease among Men in Queensland, Australia by working along with communities. Furthermore, Laverack’s ladder of community-based interaction is used for the involvement in communities and implement a prevention program to address the chronic obstructive pulmonary disease in men in Queenland Australia. In addition, to educate and motivate the community about the prevention program for health issue of chronic obstructive pulmonary disease, the core domains of capacity building are identified by Liberato et al (2011) and community empowerment; models and approaches of health promotion have been used.
Preventable Health Issue
According to WHO (2018), ” Chronic Obstructive Pulmonary Disease (COPD) is not one single disease but an umbrella term used to describe chronic lung diseases that cause limitations in lung airflow. The more familiar terms ‘chronic bronchitis’ and ’emphysema’ are no longer used but are now included within the COPD diagnosis. The most common symptoms of COPD are breathlessness, or a ‘need for air’, excessive sputum production, and a chronic cough.” About 65 million people are suffering from moderate to severe chronic obstructive pulmonary diseaseand 3 million people died of COPD, which is 5% of all death rate globally (World Health Organization, 2018). In Australia, one of the top 5 leading underlying causes of death in 2016 for both male and female of all ages is chronic obstructive pulmonary disease (AIHW, 2018). As per AIHW, the number of people affected by COPD in Australia aged 45 and over was 5.1%, an estimated 460,400 people in 2014-15 in which 5.2% were males and 4.9% females respectively. In men COPD was more popular at one time, but the disease now affects men and women almost equally due to increased tobacco use among women in high-income countries and the higher risk of exposure to indoor air pollution (such as biomass fuel used for cooking and heating) in low-income countries (World Health Organization, 2018). The WHO predicted that by 2030 COPD will become third leading cause of death (World Health Organization, 2018). COPD can be mild, moderate and severe; however, effective COPD management can be done (World Health Organization, 2018) by working with communities and by adapting effective community approaches to improve the health and lives of the people.
PART 1 – Key Strategies to address the health issue
A ‘community’ and the its members ability to interact are the two concept-communities of Community- based interaction (Laverack, 2007). The community-based key concepts include community participation, community capacity-building and community development that overlaps with community empowerment (Laverack, 2007). Re-dressing inequalities in the distribution of power is the purpose of these four concepts (Laverack, 2007). One interpretation of what in practice, is a dynamic and often complicated process is provided by the ‘Ladder of Community based interaction’ (Laverack ,2007). A framework from community readiness, to participation, to engagement, organization, development, capacity building and community empowerment is provided by the ladder (Laverack, 2007). Therefore, the concept of community-based interaction is important for planning, evaluation and implementation of health promotion program for men suffering from COPD.
The Strategies used to engage with community to implement a program and address the issue of chronic obstructive pulmonary disease among men in Queensland, Australia:
1. Community Participation:
Community participation creates an opportunity to interact with different people and share their ideas and experience to address a board range of common needs. Practically, participation for everyone is not possible in community participation. It was first initiated by UNICEF (1977) to explain a way in which to mobilize the resources and to facilitate the accessibility of health services (Laverack, 2007). By participating in different health program people can develop their knowledge for the management of COPD. In addition, participation to awareness programmes can encourage to stop smoking which is the major cause of COPD. Furthermore, participation to different physical programme can result in improvement in breathing in such patients.
2. Community Engagement
This includes the finding solution by identifying problems affecting peoples live by listening and communication, participation, need assessment and working together in partnerships. The process involves two or more people including outside agency (such as NGO) and the community working together by sharing a ideas and experiences for a common goal (Laverack, 2007). Many studies represent worsening condition and quality of life of COPD patients due to occurance of dyspenea, anxiety and depression, Therefore, engaging the COPD patients in different programmes such as walking test. COPD patients smoking level can be decreased through community engagaement (Kubincová).
3. Community Empowerment
The process of enabling communities to increase control over their decision and resources that improve their lives, including social determinants of health is known as community empowerment (Laverack, 2007). Community empowerment creates an opportunity to the individual and groups to work and share common needs from government agencies to bring about social and political change. Community awareness programmes for the COPD patients. The community empowerment supports patient by providing evidence-based care at what time they need it and where they want it (Hennessey ; Suter, 2011).
PART 2- Core domains of capacity building for community empowerment
The process by which individuals and organisations obtain, improve, and retain their skills, knowledge, tools, equipment and other resources to do their job for solving problems is known as capacity building (Cruz, Bussolo ; Lacovone, 2018). According to World Health Organisation, 2018 the development and strengthening of human and institutional resources is called as capacity resources. Furthermore, capacity building plays a significant role on the health policy decisions in a country or a state, which are run by the policy analysts (Anchala, Parakkad
; Nair, 2012). The primary preventive of diseases and promotion of health can be achieved by interventions of capacity building in community (Anchala, Parakkad ; Nair, 2012). Out of 17 Liberato et al (2011) has identified 9 core domains which support and nurture the development of competent communities by serving as a foundation for community-based work.
The domains of capacity building allow increased community ability to respond to emerging health issues by utilizing resources. Therefore, the relationship between positive health outcomes and community capacity has remained limited (Liberato et al, 2011). Capacity building should be be used in every steps for planning, implementation and evaluation of program, new policies for improvement of social and health outcomes for COPD patients among men in Queensland in Australia (Liberato et al, 2011).
The core domains used to empower communities (men in this case) and to own prevention program for COPD are:
One of the most important aspect for building capacity in communities is carried out by outstanding leaders, to whom communities can trust and share their problems as well as solutions and suggestions for health promotion. This makes easy for other members of communities to share their knowledge and experience regarding their disease for the primary prevention and care of diseases (Liberato et al, 2011). All the community members are responsible to work in group by respecting individual ideas.
Every member of community has their own rights for sharing their ideas and views and this opportunity can be created through open channels for two-way communication for the feedback and suggestions. In addition, it enables the community members for enquiry if there is any question regarding any information, ideas and thoughts about the problem (Liberao et al, 2011).
Partnerships allows different peoples (for example: victim, skilled, non-skilled and experience) to work together in same project within a same country or internationally. This is also known as networking or linkages process which have the benefits of working together for community by sharing their knowledge and ideas.
PART 3 – Theories and Approaches of health promotion
Health promotion is the process of enabling people to increase control over the determinants of health and thereby improve their health including social determinants of health (WHO, 2018). An ecological model for health improvement through the complex interaction of environmental, organizational, and personal factors can be considered by health promotion conceptual framework (Dickerson et al, 2018). Furthermore, health education and education are the important aspect of health promotion (Gottwald ; Goodman-Brown, 2012). Health promotion is not only directed at strengthening the skills and capabilities but also enables towards changing environment to alleviate their impact on populations and individual health (Lindstrom, 2018). There is link between the behaviour and health status of individual (Dickerson et al, 2018). Therefore, ‘Health Belief Model’ of behavioral change and Education approach to health promotion which will motivate the communities (men) to participate and educate them about the COPD prevention program in Queensland, Australia is focussed in this essay.
Health Belief Model
Health Belief Model is extensively used in multiple health context. To develop interventions and to predict preventive health behaviours health belief model is used (Patterson, 2018). One of the most widely recognized conceptual frameworks of health behavior, focusing on behavioral change at the individual level is health belief model (Hayden, 2009). This model describes the following beliefs:
1. Perceived Susceptibility- Smokers and other people who are directly or indirectly exposure to smoke and polluted air will be aware about the risk factors and that they are highly susceptible to the COPD.
2. Perceived Severity-In this step, the information about the seriousness of the COPD, how it affects their health, and any existing symptoms will be given.
3. Perceived Benefits- In this belief, the benefits of stopping smoking and implementation of above health guideline will be informed to decrease the risk of COPD.
4. Perceived Barrier- The smokers men will be notified about the benefits versus cost that how they are spending money for smoking which is directly affecting their health.
5. Cues to Action- In this, men will be taught about the signs and symptoms of COPD and smoking should be banned in public areas as well as cigarette price should be increased.
6. Self-efficacy-In the final stage, training and guidance can be provided about how to quit smoking.
Advantages (Gottwald ; Goodman-Brown, 2012 ; Naidoo and Wills, 2009)
1. It provides information about the cost of smoking and treatment of symptoms by stopping smoking behaviors.
2. It focuses on awareness program about the cause of COPD and effect on family.
3. Different peoples such as skilled and non-skilled can work together for prevention of disease by sharing their experience and knowledge.
Disadvantages (Gottwald ; Goodman-Brown, 2012 ; Naidoo and Wills, 2009).
1. The patients who are not involved in community may not get the benefits of any community awareness programs.
2. This model does not participates all group of population.
Educational approach helps individuals in improving their health by changing their attitudes towards behaviour by providing education and training regarding different types of diseases and its prevention (Gottwald ; Goodman-Brown, 2012). Community can learn about the behaviour and attitude change towards the cause and prevention of disease. Different types of program, including physical activities can be given through education. Furthermore, different types of programs can engaged people which can decrease the level of smoking.
Advantages (Gottwald ; Goodman-Brown, 2012 ; Naidoo and Wills, 2009).
1. It gives knowledge and information about the disease cause by their behaviour.
2. It enables the individuals of community to take right decisions about their future.
Disadvantages (Gottwald ; Goodman-Brown, 2012 ; Naidoo and Wills, 2009).
1. Educational approach is theory basis, its works on assumption.
2. It is more time consuming.
Community is a social group of any size whose members reside in a specific geographical location, share cultures, values, norms and are respected and loved by each other according to their relation. Community empowerment, capacity building and community action are the key concepts of health promotion which play a vital role to improve community health by working with people and addressing their needs by engaging, organizing and mobilize communities. This assay focussed on preventable health concern of COPD by engaging and motivating men(communities). Laverack’s ladder of community-based interaction is used for the involvement in communities and implement a prevention program to address the chronic obstructive pulmonary disease in men in Queenland Australia. Finally, core domains of capacity-building to support the prevention program is been used. Health promotion health belief model and educational approach has also been used.
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