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Content in this curriculum is specifically directed toward persons who have traditionally been left out of the mainstream of health education. Consideration in its preparation included the inclusion of content recommended by participants in professional focus groups across the country and parents and client preferences. After reviewing this data, the authors added additional content to support a model of preventive health care that is the foundation and organizing framework for the curriculum.
A prevention/wellness oriented model was chosen for several reasons. Persons at high risk for illness or disability include those who have a low income, congenital or acquired disease or disability, certain ethnic backgrounds, and limited education. Prevention is a more cost effective approach to health care than a model that focuses on curing or rehabilitation. Persons who engage in prevention/wellness behaviors are not only healthier, but they have increased self-esteem. All of these reasons are particularly relevant to the population of traditionally underserved persons who are deaf.
Health experts from across the nation created a document, Healthy People 2000: National Health Promotion and Disease Prevention Objectives (1991), published by the U.S. Department of Health and Human Services, which serves as the cornerstone of a comprehensive agenda to improve the health of all Americans. Attaining the objectives depends on our collective action and support. People with low income and those with disabilities are particularly vulnerable to illness and injury in comparison to the general population. These objectives are related to national health priorities for the year 2000 and were considered in the development of this curriculum. The following are specific objectives that were related to challenges facing the target population of this project. The numbers prior to each objective refer to the corresponding number in the Healthy People 2000 document.
The objectives are:
1.5 Reduce to no more than 15 percent the proportion of people aged 6 and older who engage in no leisure time physical activity.
2.3 Reduce overweight to a prevalence of no more than 20 percent among people aged 20 and older and no more than 15 percent among adolescents aged 12 through 19.
3.5 Reduce the initiation of cigarette smoking by children and youth so that no more than 15 percent have become regular cigarette smokers by age 20.
4.12 Establish and monitor in 50 states comprehensive plans to ensure access to alcohol and drug treatment programs for traditionally underserved people.
6.5 Reduce to less than 35 percent the proportion of people aged 18 and older who experienced adverse health effects from stress within the past year.
6.6 Increase to at least 30 percent the proportion of people aged 18 and older with severe, persistent mental disorders who use community support programs.
6.7 Increase to at least 45 percent the proportion of people with major depressive disorders who obtain treatment.
6.8 Increase to at least 20 percent the proportion of people aged 18 and older who seek help in coping with personal and emotional problems.
16.12 Increase to at least 95 percent the proportion of women aged 18 and older with uterine cervix who have ever received a Pap test, and to at least 85 percent those who received a Pap test within the preceding 1 to 3 years.
17.14 Increase to at least 40 percent the proportion of people with chronic and disabling conditions who receive formal patient education including information about community and self-help resources as an integral part of the management of their condition.
17.19 Increase to at least 75 percent the proportion of worksites with 50 or more employees that have a voluntarily established policy or program for the hiring of people with disabilities.
17.2 Reduce to no more than 8 percent the proportion of people who experience a limitation in major activity due to chronic conditions.
21.2 Increase to at least 50 percent the proportion of people who have received, as a minimum within the last appropriate interval, all the screening and immunization services and at least one of the counseling services appropriate for their age and gender as recommended by the U.S. Preventive Services Task Force.
21.5 Assure that at least 90 percent of people for whom primary care services are provided directly by publicly funded programs are offered, at a minimum, the screening, counseling, and immunization services recommended by the U.S. Preventive Services Task Force.
22.4 Develop and implement a national process to identify significant gaps in the Nation's disease prevention and health promotion data, including data for racial and ethnic minorities, people with low incomes, and people with disabilities, and establish mechanisms to meet these needs.
As can be seen from reviewing these objectives, content is quite applicable to our target population. However, it is important to note that it is up to the trainers to decide what to include in their presentations. It is hoped that the trainers will be persons who are very familiar with their clients and therefore able to use this knowledge to advantage by selecting appropriate sequence of presentation. The authors understand that clients are unique, and that not all content may be appropriate to all clients. It will be up to the trainer to address this uniqueness. The authors do encourage trainers to try as much content as possible --they may well be surprised at how interested clients will be and how well they will respond to the various experiences!