1. 1. QUESTION

   —Aristotle

   The proper implementation of policy that addresses population health issues frequently can stimulate change in individual behaviors. Consider, for example, cigarette smoking. The Robert Wood Johnson Foundation reported that the number of adults living in smoke-free homes increased from 43% in 1992 to 79% in 2007 (RWJF, 2009). During that time period, many states were adopting the Indoor Clean Air Act and prohibiting smoking in public places. These actions may have made cigarette smoking less socially acceptable, thus encouraging many adult smokers to quit. How can such initiatives affect population health?
   Policy-driven initiatives and government-funded programs increasingly focus on prevention to address potentially problematic behaviors at the population level, thereby reducing costs associated with acute and chronic care. As noted in Week 4, one of the advantages of focusing on population health versus individual health is the ability to concentrate on specific problems that affect large groups. This week, you will examine strategies for addressing behavioral risk factors in a particular population. You will also consider characteristics of effective health care prevention programs.
   Reference:
   Good Reads. (2012). Quotable quotes: Aristotle. Retrieved from http://www.goodreads.com/quotes/show/20103
   Learning Objectives
   Students will:
   Evaluate interventions for addressing at-risk behaviors using the Population-Based Intervention Model
   Photo Credit: [Plume Creative]/[DigitalVision]/Getty Images
   Learning Resources
   Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
   Required Readings
   Knickman, J. R., & Kovner, A. R. (Eds.). (2015). Health care delivery in the united states (11th ed.). New York, NY: Springer Publishing.
   Chapter 7, “Health and Behavior” (pp. 119–144)

   This chapter discusses the role of behavior on health and describes behavioral risk factors and potential community-based interventions.
   Backer, E. L., Geske, J. A., McIlvain, H. E., Dodendorf, D. M., & Minier, W. C. (2005). Improving female preventive health care delivery through practice change: An Every Woman Matters study. Journal of the American Board of Family Practice, 18(5), 401–408.
   Retrieved from the Walden Library databases.

   This article informs the Assignment as an example of a health program that was not successful. You will conduct additional research on this topic to determine current advocacy programs that have been more effective.
   Hancock, C., & Cooper, K. (2011). A global initiative to tackle chronic disease by changing lifestyles. Primary Health Care, 21(4), 24–26.
   Retrieved from the Walden Library databases.

   This article details the efforts of the C3 Collaborating for Health charity. In particular, C3 focuses on minimizing the risk factors of poor dieting, smoking, and low physical activity.
   Schwartz, S. M., Ireland, C., Strecher, V., Nakao, D., Wang, C., & Juarez, D. (2010). The economic value of a wellness and disease prevention program. Population Health Management, 13(6), 309–317.
   Retrieved from the Walden Library databases.

   The authors of this article detail a study that sought to determine the economic consequences of a disease prevention program conducted by the Hawaii Medical Service Association.
   Tengland, P. (2010). Health promotion and disease prevention: Logically different conceptions? Health Care Analysis, 18(4), 323–341.
   Retrieved from the Walden Library databases.

   This article investigates the differences and causal connections between health promotion and disease prevention.
   Discussion: Addressing Behavioral Risk Factors
   “It is unreasonable to expect that people will change their behavior easily when so many forces in the social, cultural, and physical environment conspire against such change”

   (Kovner and Knickman, p. 139).

   When seeking to lessen behavioral risk factors in different populations, one of the greatest challenges is addressing the systemic issues within the population that enable the risky behavior to occur in the first place. Consider the health risks of school-age children not being immunized or drug users sharing needles. As Dr. Beilenson discussed in the Week 4 media program, these risky behaviors led to increases in individual and population health problems. Thus, when planning health prevention programs, it is important to consider how to effectively address risky behaviors at both the individual and the population level.
   The Discussion this week focuses on the use of the Population-Based Intervention Model outlined in the course text Health Care Delivery in the United States, as well as how this model can be applied to strengthen advocacy programs.
   To prepare:
   Select one of the behavioral risk factors from the Healthy Population 2010 Objectives (listed in Table 7.1 on p. 122 of the course text) that is of interest to you.
   Using the Walden Library and other credible websites, research how this risk factor is affecting your community or state.
   With your selected risk factor in mind, review the information on the Population-Based Intervention Model on pp. 132-137 in the course text, Health Care Delivery in the United States. In particular, focus on the concept of downstream, midstream, and upstream interventions. Consider at least one intervention that could be put into place at each stage.

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