National Health Goals and Behavioral Influences Nurse Essay

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National Health Goals and Behavioral Influences

Nurse Educators in Downstream, Midstream, and Upstream Obesity Interventions

The professional nurse has numerous opportunities to advocate for changes in social policy, community awareness, and behavioral risk factors associated with the choices of individual patients. With respect to obesity intervention, nurses can contribute their efforts to upstream, midstream, and downstream interventions. McKinley describes a framework that details the manner in which professional nurses can intervene to reduce the risk factors in obesity at three distinct levels: upstream, midstream, and downstream.

The types of obesity risk factors that exist at the upstream level include the prevalence of poor dietetic choices in the community, advertisement campaigns for unhealthful food choices targeted to children and other vulnerable populations, and the absence of government regulation over areas where appropriate legislation could reduce some of those risk factors by mandating socially conscious behavior on the part of food manufacturers that profit from the advertising and sale of food products known to contribute to obesity in the population. The types of obesity risk factors that exist at the midstream level include school and other youth programs that maintain non-nutritious food choices and that allow the sale of junk foods from automated dispensers on their premises.

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At the downstream level, obesity risk factors include the lack of knowledge on the part of individual patients about healthful nutrition and the failure to appreciate the gravity of various obesity-related diseases and chronic conditions.

More specifically, upstream nursing interventions would include militating for regulation of food marketing, lobbying of fast-food chains to reduce their saturation of low-income neighborhoods with unhealthful food options, and promotion of healthful dietetic information in public service message campaigns, and community health programs. At the midstream level of intervention, nurses can provide dietetic information and nutrition-improvement programs in schools and other facilities and organizations that are typically responsible for maintaining lunch programs for children and adolescents. At the downstream level, nurses can intervene by addressing specific behavioral patterns of individual patients both directly in conjunction with their treatment for obesity-related illnesses as well as indirectly, such as by furnishing important nutritional and diet-related information in the general context of healthcare services furnished to patients.

In principle, the upstream intervention opportunities to address obesity risk factors in the community emphasize the role of professional nurses as patient advocates. In that respect, the nursing profession has considerable….....

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