|
Level of prevention | Goals | Interventions |
|
Primary
| (1) Reduce exposure | Advise and encourage: self-care activities on heavy vog days: no exercise, stay indoors, and AC Educate the residents on: |
(a) The pattern of “clean air” hours for each geographic area during typical meteorological conditions to allow planning of daily activities [16] |
(b) The use of “real-time” air quality data accessible on the internet |
(c) The emergency response plan for high vog events |
Establish: |
(a) Disaster shelters and renovate hospitals as needed to ensure clean indoor air [16] |
(b) A policy of notification for new building/construction permits of the potential structural effects on indoor air quality [16] |
Continue and enhance: |
(a) The school system’s vog response plan (air quality equipment, training of personnel) [16] |
(b) Assistance to senior centers (air testing, air quality equipment) |
(c) The emergency response plan (revise as needed for current evidence, equipment needs, and evacuation activities for homebound or disabled residents) |
(d) Communication between public health and healthcare agencies with volcanologists |
(e) Opportunities for community participation from residents |
(f) Health notices on air quality for tourists visiting vog-exposed areas |
(2) Promote general health | Advise and encourage: |
(a) “Heart healthy” lifestyles [17] |
(b) Prevent initiation of smoking with evidence-based interventions |
Support and develop: |
(a) Ongoing educational and resource needs of health care clinicians in vog-exposed areas |
(b) The Rural health association |
(c) The role of public health nursing [18] |
(d) Policies for nonsmoking in public areas |
|
Secondary | (1) Identify disease in early stage(s) (2) Treat promptly | Screen the population for disease: |
(a) Conduct community health nursing fairs with screening and referral [19] |
(b) Clinicians should include spirometry as part of regular assessment during annual physicals |
Educate: |
(a) Importance of annual health screening regardless of age |
(b)Parents on subtle symptoms of respiratory illness in children |
(c) On increasing awareness and not ignoring adverse symptoms needing clinical assessment (e.g., stroke, heart attack, SOB, chronic cough) |
Treat: smoking using a family disease perspective and evidence-based interventions Enhance: Access to culturally-responsive healthcare and follow-up services |
|
Tertiary | (1) Prevent disease progression (2) Maintain quality of life | Persons with asthma: |
(a) Clinicians implement guidelines from the National Heart Lung and Blood Institute [17] |
(b) Ensure all patients have a current “asthma action plan” and carry emergency medications as advised [17] |
(c) Provide innovative asthma education and support for children and their parents (e.g., camps, web-based activities) |
(d) Continue the public health nursing asthma plan for schools |
(e) Enhance the Hawaii Asthma Initiative to address the unique challenge of vog [20] |
Persons with cardiovascular disease: |
(a) Encourage self-care behaviors of monitoring BP and eating “heart healthy” |
(b) Educate on the importance of taking their prescribed medications and communicating with their practitioner about annoying side effects, instead of not taking the medicine |
|