Learning Outcomes
By the end of this section, you should be able to:
- 12.6.1 Discuss real-world applications of epidemiologic data in public health nursing.
- 12.6.2 Describe strategies to communicate epidemiological information to improve the population's health.
Nurses from all fields use epidemiologic data to inform client care. This can range from health promotion education on the heart health benefits of exercise, to a nutritious diet to support healthy bone growth, to smoking cessation to prevent lung cancer, to avoiding addiction by using the least amount of pain medication needed. The fields of nursing touched upon include acute bedside nursing, rehabilitation nursing, emergency nursing, nursing research, school nursing, corrections nursing, occupational health nursing, and community and public health nursing.
Application of Epidemiologic Data in Public Health Nursing
Epidemiologic research can assist in the identification of problems within a community or population and can assist in discovering the etiology of the problem or risk factors for the development of the issue. Epidemiologic health research can be descriptive or analytical and guide nurses and other public health professionals on a path of evidence-based interventions and recommendations to address the issue.
Community health nurses use health research from epidemiology as the foundation of evidence-based nursing practice and to inform and educate the public. A great example is Racial and Ethnic Approaches to Community Health (REACH), a program administered by the CDC to reduce racial and ethnic health disparities. This program provides grant money to local health departments, communities, and related agencies to establish local and culturally appropriate programs that address various health issues among Black, Indigenous, and people of color (BIPOC) communities (CDC, 2022c). One such program is the fruit and vegetable prescription program in the Navajo Nation. A Community Outreach and Patient Empowerment (COPE) group in New Mexico created a fruit and vegetable prescription program (FVRx) to promote healthy eating (Society for Public Health Education, 2020). Clinic providers and community health workers identified eligible families and asked them to participate. The organizers collaborated with local stores so that these families received monthly vouchers to purchase fruits and vegetables. These families also met with community health workers to learn more about healthy eating and its impact on the incidence of obesity, heart disease, and diabetes. The FVRx led to community-level changes with improved access to nutritious food (Society for Public Health Education, 2020).
As the Agency for Healthcare Research and Quality (AHRQ) (2019) notes, research translation refers to the practice of taking scientific research and evidence and applying it to a practical setting. This is a vital aspect of a nurse’s role as health promoter, educator, and advocate. Population and public health professionals can translate research into a usable tool to help prevent or address health events and diseases. For the underlying research to be trusted and used appropriately, public health professionals must learn to communicate the scientific findings in an easy-to-understand yet hard-to-forget manner. Technical terms must be put into simple language before they are disseminated. Communication techniques include tailoring the message, targeting the message to groups, using storytelling, and framing the message in a hard-to-forget manner (AHRQ, 2019).
Dissemination is the distribution of information to a particular audience to spread knowledge about a disease and its associated interventions. Dissemination can occur through different channels, settings, and contexts to increase the reach of the evidence and increase the motivation and ability to apply it (AHRQ, 2019). Using history as a guide, Semmelweis would have been more effective in his quest to save lives via handwashing had he clearly presented his supporting evidence and communicated the need for intervention based on it. If he had been able to garner professional and political support and articulate the case for why or how his intervention was feasible and cost-effective, the lives of many more women in labor could have been saved (Celentano & Szklo, 2019).
Communicating Epidemiological Information
Nurses play a large role in communicating important health-related epidemiological information to individuals, communities, and government departments. Before implementing a health promotion program, nurses must be sure they understand the underlying research and have reviewed the studies for quality and rigor. They can then tailor their message to the target population. The goal is to effectively educate individuals and community members on health-promoting behaviors such as lifestyle changes, appropriate health screenings, and vaccines. Having a strong foundation in epidemiologic research makes the information the nurse presents more persuasive and trustworthy. Recent examples include vaccine campaigns for COVID-19 and campaigns educating the public on the new guidelines for colon cancer screening.
Outbreak communication requires a different approach. Before communicating with the public during an outbreak, it is key for the nurse to think about how risk perception may influence the community (Trumpey et al, 2018). Many individuals view public health recommendations as just that: recommendations—suggestions for actions they do not necessarily need to follow. That is, they view advice through their own risk-benefit lens. It is important for nurses to consider factors influencing risk perception when working with communities during an outbreak or other public health crisis. See Table 12.4 for factors influencing risk perception (Trumpey et al, 2018).
| Acceptable Risks Are Perceived as | Less Acceptable Risk Is Perceived as |
|---|---|
| Being voluntary | Being imposed |
| Being under an individual’s control | Being controlled by others |
| Having clear benefits | Having vague or delayed benefits |
| Naturally occurring | Human-made |
| Generated by a trusted source | Generated by an untrusted source |
| Being familiar | Being new |
| Affecting adults | Affecting children |
During an outbreak, trust and credibility of the individual delivering any communication significantly influences the communication’s ability to persuade others to follow public health recommendations. Risk communication literature has recognized several factors associated with coming across as trustworthy and credible. They are empathy and caring, honesty and openness, dedication and commitment, and competence and expertise (Trumpey et al., 2018).
During an outbreak, public health professionals must effectively engage the community with information and guidance to promote disease control and prevention efforts. At the beginning, there are a lot of unknowns, and it can be difficult to communicate effectively. It is crucial to determine and define the roles and responsibilities of individuals involved in the outbreak response (Trumpey et al., 2018). For a public health nurse, this may include interfacing with the community, or it may be more behind-the-scenes. Either way, determining one’s role is the first step. After role delineation, the nurse must be able to identify the target audience and tailor health-related recommendations to that population.