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C
OMMUNITY
&
P H N
UBLIC EALTH URSING
Promoting the Public’s Health
8
th EDITION
Judith Ann Allender, EdD, MSN, MEd, RN
Professor Emeritus
Department of Nursing, College of Health and Human Services
California State University
Fresno, California
Cherie Rector, PhD, RN, PHN
Professor Emeritus
Department of Nursing
California State University, Bakersfield
Bakersfield, California
Kristine D. Warner, PhD, MPH, RN
Professor
School of Nursing
Director ASBSN Program
California State University, Stanislaus
Stockton, California
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Acquisitions Editor: Christina C. Burns
Product Manager: Katherine Burland
Production Project Manager: David Orzechowski
Editorial Assistant: Dan Reilly
Design Coordinator: Holly McLaughlin
Illustration Coordinator: Brett MacNaughton
Manufacturing Coordinator: Karin Duffi eld
Prepress Vendor: SPi Global
8th edition
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Copyright © 2010 by Wolters Kluwer Health | Lippincott Williams & Wilkins. Copyright © 2005 and 2001 by Lippincott
Williams & Wilkins. Copyright © 1996 by Barbara Walton Spradley and Judith Ann Allender. Copyright © 1990, 1985, and 1981
by Barbara Walton Spradley. All rights reserved. This book is protected by copyright. No part of this book may be reproduced or
transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any infor-
mation storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in
critical articles and reviews. Materials appearing in this book prepared by individuals as part of their offi cial duties as U.S. govern-
ment employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams &
Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at [email protected], or via our
Web site at lww.com (products and services).
9 8 7 6 5 4 3 2 1
Printed in China
Library of Congress Cataloging-in-Publication Data
Community and public health nursing: promoting the public’s health / [edited by] Judith A. Allender, Kristine D. Warner,
Cherie Rector. — 8th ed.
p. ; cm.
Rev. ed. of: Community health nursing / Judith A. Allender, Cherie Rector, Kristine D. Warner. 7th ed. c2010.
Includes bibliographical references and index.
ISBN 978-1-60913-688-8 (alk. paper)
I. Allender, Judith Ann. II. Warner, Kristine D. III. Rector, Cherie L. IV. Allender, Judith Ann. Community health nursing.
[DNLM: 1. Community Health Nursing—United States. 2. Public Health Nursing—United States. 3. Health Promotion—
United States. WY 108]
610.73'43—dc23
2012039468
Care has been taken to confi rm the accuracy of the information presented and to describe generally accepted practices. However,
the author(s), editors, and publisher are not responsible for errors or omissions or for any consequences from application of the
information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the
contents of the publication. Application of this information in a particular situation remains the professional responsibility of the
practitioner; the clinical treatments described and recommended may not be considered absolute and universal recommendations.
The author(s), editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text
are in accordance with the current recommendations and practice at the time of publication. However, in view of ongoing research,
changes in government regulations, and the constant fl ow of information relating to drug therapy and drug reactions, the reader is
urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions.
This is particularly important when the recommended agent is a new or infrequently employed drug.
Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited
use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or
device planned for use in his or her clinical practice.
LWW.com
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In memory of my husband, Gilbert F. Allender (1937–2009)—in my heart and
thoughts forever.
—Judy Allender
To my husband—my greatest supporter—and to my children and grandchildren,
who make it all worthwhile. This book is dedicated to them and to my parents,
who always encouraged me to keep learning and growing.
—Cherie Rector
To my son Sean and his family, my daughters Erin and Kathleen Whalen, and the
best mom in the world Dolores Warner—thank you for your unwavering love and support.
—Kris Warner
A C K N O W L E D G E M E N T S
We are grateful for the feedback we have received from to acknowledge the work of former contributors whose
nursing faculty and students, and have worked to incor- work may remain, in part.
porate many of your suggestions into this new edition. To our hardworking editors, Katherine Burland,
For the most part, feedback has been positive, but we Hillarie Surrena, and Christina Burns, along with other
appreciate all comments and suggestions. We hope that staff at Lippincott Williams & Wilkins (Wolters Kluwer),
this textbook meets your needs, and we encourage your we express our thanks.
continued feedback. We are indebted to our family and friends who pro-
We appreciate the efforts of many people who have vided support throughout this experience.
assisted us in writing this textbook. We are grateful to We look forward to the new generation of public
have such talented contributors and thank them for health nurses, and hope that this book may inspire stu-
sharing their knowledge and expertise. We also want dents to consider this exciting nursing specialty!
A B O U T T H E A U T H O R S
Dr. Judith A. Allender has been a nurse since 1963. For Bakersfi eld, Department of Nursing. She served as lead
30 years she taught nursing—fi rst at Good Samaritan faculty in community health nursing, Director of the
Hospital in Cincinnati, Ohio, and later at California School Nurse Credential Program and the RN to BSN
State University, Fresno, where she retired as a Professor Program there, and formerly was the Coordinator of the
Emeritus. Her nursing practice experiences were varied. School Nurse Credential Program at California State
She worked with surgical patients, in intensive care University, Fresno, where she also taught community
units, as a school nurse, in-patient hospice, home care, health nursing, health teaching, and leadership. She has
and community health nursing. She has authored fi ve served as the Director of Allied Health and the Disabled
nursing textbooks in addition to this one. During her Students Program at College of the Sequoias. She has
long career, she received several awards. The fourth edi- consulted with school districts and hospitals in the areas
tion of this textbook received a Robert Wood Johnson of child health, research, and evidence-based practice,
award for the end-of-life care content in 2001. She was and has practiced community health and school nurs-
voted RN of the Year in Education for the Central Valley ing as well as neonatal nursing in the acute care setting.
of California in 1998. In 2005 she was inducted into She currenty consults with a local Magnet hospital on
the Central San Joaquin Valley Nursing Hall of Fame. evidence-based practice and research. She has taught
Presently, Dr. Allender consulted for a nonprofi t immi- graduate-level courses in community health, vulnerable
grant and refugee center called Stone Soup of Fresno populations, research, family theories, interprofessional
until 2010. She wrote a weekly health column for a development, and school nursing. Her grants, research,
local newspaper from 2002 to 2010. Her undergradu- publications, and presentations have focused largely
ate nursing degree is from the State University of New on child and adolescent health, school nursing, public
York in Plattsburgh, master’s in guidance and counsel- health nursing, nursing education, and disadvantaged
ing from Xavier University in Cincinnati, Ohio, mas- students. She earned an associate degree in nursing
ter’s in nursing from Wright State University, Dayton, from College of the Sequoias over 40 years ago and,
Ohio, and a doctorate in education from the University later, a bachelor of science in nursing degree from the
of Southern California. When not busy at home, she Consortium of the California State Universities, Long
can be found traveling around the world. She and her Beach. She completed a master’s degree in nursing
late husband have a blended family with 7 children, (Clinical Nurse Specialist, Community Health) and a
14 grandchildren, and 3 great grandsons. school nurse credential from California State University,
Fresno. Her PhD in educational psychology is from
Dr. Cherie Rector is a native Californian who is an
the University of Southern California. She is an active
Emeritus Professor at California State University,
iii
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iv ABOUT THE AUTHORS
member of the American Public Health Association, the urban settings. Her current professional interests include
Western Institute of Nursing, and the Association of evidence-based practice, nursing education, emergency
Community Health Nursing Educators. Dr. Rector and preparedness, and health needs of vulnerable popula-
her husband have three grown sons, seven grandsons, tions. Her grants, research, publications, and presenta-
and two granddaughters. tions have focused on emergency preparedness, poverty,
chronic illness, and nutrition. Dr. Warner is a retired
Dr. Kristine Warner, also a native Californian, is a Navy Nurse Corps Captain, ending a 29-year career of
Professor at California State University, Stanislaus, both active and reserve service in 2002. She was recalled
with a specialization in Public/Community Health to active duty and stationed in the Saudi Arabian desert
Nursing. With over three decades in the fi eld of Public/ during the First Gulf War as Assistant Charge Nurse of a
Community Health, she has taught in nursing programs 20-bed medical unit. She received her BSN from Harris
in both Pennsylvania and California. Undergraduate College of Nursing, Texas Christian University, MPH
and graduate courses she has taught include commu- (Community Health Nursing) and MS (Community
nity health nursing, nursing research, program plan- Health Nursing & Nursing Education) from the
ning and development, and health policy. Her nursing University of South Florida, and PhD in Nursing from
career began in adult and pediatric acute care, and she the University of Pennsylvania. Dr. Warner has three
has practiced home care and public health in rural and grown children and two grandchildren.
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C O N T R I B U T O R S
Sheila Adams-Leander, RN, PhD Paula Dorhout, RN, MSN, APHN-BC Roberta Lavin, PhD, APRN
Assistant Professor Southeast Region Nursing Director Chair and Professor
Coordinator, Accelerated BSN Children’s Medical Services Department of Nursing
Program West Palm Beach, Florida Clarke University
St. Louis University Chapter 10 Dubuque, Iowa
St. Louis, Missouri Captain (Retired)
Chapter 5 Mary Ann Drake, PhD, RN US Public Health Service
Professor Washington, District of Columbia
Elizabeth M. Andal, PhD, MSN, Webster University Chapter 17
APRN-BC, FAAN St. Louis, Missouri
Mental Health Service Consultant Chapter 18 Jeanne M. Leffers, PhD, RN, APHN
Las Vegas, Nevada Professor
Chapter 27 Naomi E. Ervin, PhD, RN, University of Massachusetts,
PHCNS-BC, FAAN Dartmouth
Margaret Avila, PhD, PHN, RN/NP Professor (Retired) North Dartmouth, Massachusetts
Assistant Professor School of Nursing Chapter 9
School of Nursing Eastern Michigan University
California State University, Ypsilanti, Michigan Karin Lightfoot, MSN, RN-BC, PHN
Los Angeles Chapter 25 Lecturer
Los Angeles, California Community/Public Health Nursing
Chapter 29 Marie P. Farrell, EdD, MPH, RN, California State University, Chico
ACC Chico, California
Barbara Blake, RN, PhD, ACRN Professor Chapter 14
Associate Professor Human and Organizational
WellStar School of Nursing Development Barbara B. Little, DNP, MPH, RN,
Kennesaw State University Fielding Graduate University APHN-BC
Kennesaw, Georgia Santa Barbara, California Associate in Nursing
Chapter 23 Chapter 16 Florida State University, College of
Nursing
Lydia C. Bourne, BSN, RN, Sheila Holcomb, EdD, RN, MSN, PHN Tallahassee, Florida
MA, PHN School Nurse Chapter 10
Principal, Bourne & Associates Walnutwood High School
Legislative Advocate Rancho Cordova, California Eileen Lukes, PhD, RN, COHN-S,
El Macero, California Chapter 20 CCM, FAAOHN
Chapter 13 Health Services Manager
Katherine Laux Kaiser, PhD, RN, Boeing Company
Bonnie Callen, PhD, RN, APHN, BC Mesa, Arizona
C/PHCNS-BC Associate Professor Chapter 31
Associate Professor Department of Community-Based
College of Nursing Health Erin D. Maughan, RN, PhD, APHN-BC
University of Tennessee, Knoxville University of Nebraska Medical Director of Research
Knoxville, Tennessee Center, College of Nursing National Association of School
Chapter 24 Omaha, Nebraska Nurses
Chapter 21 Silver Spring, Maryland
Janna L. Deickmann, PhD, RN Chapter 30
Clinical Associate Professor Mary Lashley, PhD, RN, PHCNS-BC
University of North Carolina, Professor Mary Ellen Miller, PhD, RN
Chapel Hill Towson University Assistant Professor
Chapel Hill, North Carolina Towson, Maryland DeSales University
Chapter 26 Chapter 28 Center Valley, Pennsylvania
Chapter 31
v
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vi CONTRIBUTORS
Debra J. Millar, MSN, PHN Joann E. Smith, PhD, RN, APHN, CNE Gloria Ann Jones Taylor, DSN, RN
Program Manager Assistant Professor Professor
Public Health Institute College of Nursing and Allied Health WellStar School of Nursing
Center for Health Leadership and Sciences Kennesaw State University
Practice College of Medicine, Community and Kennesaw, Georgia
Oakland, California Family Medicine Chapter 23
Chapter 11 Howard University
Washington, District of Columbia Rose Utley, PhD, RN, CNE
Barbara J. Polivka, PhD, RN Chapter 22 Professor
Professor and Shirley B. Powers Missouri State University
Endowed Chair in Nursing Research Karen Smith-Sayer, MSN, RN, PHN Springfield, Missouri
University of Louisville School of Public Health Nurse Chapter 31
Nursing CA Department of Corrections
Louisville, Kentucky Pelican Bay State Prison Kristine D. Warner, PhD, MPH, RN
Chapter 4 Crescent City, California Professor
Chapter 8 School of Nursing
Cherie Rector, PhD, RN, PHN Director ASBSN Program
Professor Emeritus Sharon S. Strand, MSN, PHN, RN-BC California State University, Stanislaus
Department of Nursing Health Specialist Stockton, California
California State University, Mountain States Early Head Start Chapters 2, 3, 7, 11, 12, 14, 19,
Bakersfield Coeur d’Alene, Idaho and 32
Bakersfield, California Chapter 29
Chapters 1, 4, 5, 6, 10, 15, 21, 22, Joyce Zerwekh, EdD, RN
24, 25, and 29 Mary E. Summers, PhD, MSN, RN, Emeritus Professor of Nursing
PHN Concordia University
Bassam M. Salemeh, PhD Professor Emeritus Portland, Oregon
Instructor Sacramento State University Chapter 32
Microbiology and Biology Sacramento, California
Antelope Valley College Chapter 12
Lancaster, California
Chapter 7
Phyllis G. Salopek, MSN, FNP
Assistant Professor
California State University, Chico
Chico, California
Chapter 19
R E V I E W E R S
Jo Ann Abegglen, DNP, APRN, PNP Carolyn Braudaway, MS, RN Susan L. Fogarty, BSN, MSN
Associate Professor of Nursing Assistant Professor, Nursing Associate Professor
Brigham Young University College of Columbia Union College Ferris State University
Nursing (as of July 1, Washington Adventist Big Rapids, Michigan
Provo, Utah University)
Takoma Park, Maryland Sue K. Goebel, RN, MS, NP, SANE
Marie H. Ahrens, MS, RN Associate Professor of Nursing
Assistant Clinical Professor Angeline Bushy, PhD, RN, FAAN Mesa State College
The University of Tulsa Professor and Bert Fish Chair Grand Junction, Colorado
Tulsa, Oklahoma University of Central Florida, College
of Nursing Margaret Leahy Hopkins, MS, RN
Mary T. Bouchaud, MSN, CNS, RN, Daytona Beach, Florida Associate Professor
CRRN Elmira College
Community Clinical Coordinator and Karen J. Egenes, RN, EdD Elmira, New York
Nursing Faculty Associate Professor
Thomas Jefferson University School Loyola University Chicago, Niehoff Katherine Howard, MS, RN-BC
of Nursing School of Nursing Nursing Instructor
Philadelphia, Pennsylvania Chicago, Illinois Middlesex County College
Edison, New Jersey
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REVIEWERS vii
Kimberly Lacey, DNSc, MSN, BSN, Nadine F. Nelson, BSN, MN Julie Bertelson St. Clair, RN, MSN
CNS Lecturer II Instructor
Assistant Professor of Nursing School of Nursing University of Southern Indiana
Southern CT State University University of Michigan Evansville, Indiana
New Haven, Connecticut Ann Arbor, Michigan
Sharon J. Thompson, PhD, RN,
Susan Primm Lehmann, MSN, RN C. Virginia Palmer, PhD, RN MPH
Clinical Assistant Professor Professor of Nursing Associate Professor of Nursing
University of Iowa College of Millersville University Gannon University/Villa Maria School
Nursing Millersville, Pennsylvania of Nursing
Iowa City, Iowa Erie, Pennsylvania
Rosemary Ricks-Saulsby, RN, BS,
Ruth Elizabeth McShane, PhD, MSN, MA, PhD Joy E. Wachs, PhD, RN, PHCNS-BC,
APRN, MAPS Assistant Professor of Nursing FAAOHN
Faculty Member (Part-time) Chicago State University Professor
Marquette University Chicago, Illinois East Tennessee State University
Milwaukee, Wisconsin Johnson City, Tennessee
Carol Sapp, RN
Valerie Evans Minor, RN, BSN, Associate Professor Barbara Wind, MSN, RN
MSN Georgia College & State University Instructor
Associate Professor of Nursing Milledgeville, Georgia Community Health Nursing
Alderson-Broaddus College Frankford Hospital School of Nursing
Philippi, West Virginia Candide Sloboda, BN, MEd at Aria Health
Faculty Lecturer Philadelphia, Pennsylvania
Deborah Yoder Miranda, BSN, University of Alberta, Faculty of
Nursing
MSN, PhD, RNC-OB
Assistant Professor Edmonton, Alberta, Canada
Mississippi University for Women
Columbus, Mississippi Linda Spencer, PhD, RN
Director
Judith Mouch, RSM, MSN, MA Public Health Nursing Leadership
Associate Professor Program
University of Detroit Mercy Emory School of Nursing
Detroit, Michigan Atlanta, Georgia
O T H E R R E V I E W E R S
Janet Alexander Sue Bell Anne Bongiorno
Samford University Minnesota State University, Mankato State University of New York,
Birmingham, Alabama Mankato, Minnesota Plattsburgh
Plattsburgh, New York
Grace E. Ayton Carolanne Bianchi
Missouri Southern State University University of Rochester School of Cindy Bork
Joplin, Missouri Nursing Winona State University
Rochester, New York Winona, Minnesota
Dot Baker
Wilmington University Elizabeth H. Bicknell Mary Lou Bost
Georgetown, Delaware University of Maine Carlow University
Orono, Maine Pittsburgh, Pennsylvania
Cynthia Banks
Sentara College of Health Sciences Kelley Blackburn Bonnie Bowie
Chesapeake, Virginia University of Iowa Seattle University
Urbandale, Iowa Seattle, Washington
Mary Bannon
University of North Carolina at Debbie Bomgaars Jeri Brandt
Greensboro Northwestern College Nebraska Wesleyan University
Jamestown, North Carolina Orange City, Iowa Lincoln, Nebraska
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viii OTHER REVIEWERS
Brandy Brown Barbara Cornett Kim Dinsey-Read
Union University Otterbein University Northern Kentucky University
Michie, Tennessee Westerville, Ohio Highland Heights, Kentucky
Mary Bruun Ben Crandall Norma Hannigan
University of Mary Indiana Wesleyan University Columbia University
Bismarck, North Dakota Marion, Indiana New York, New York
Kathleen Buck Elizabeth Crusse Barbara Harrison
Huntington University Towson University College of Virginia Beach—Nursing
Huntington, Indiana Towson, Maryland Virginia Beach, Virginia
Angeline Bushy Sarah Coulter Danner Frances Long
University of Central Florida College Castleton State College Coastal Carolina University
of Nursing Castleton, Vermont College of Science
Daytona Beach, Florida Conway, South Carolina
Becky Davis
Minnie Campbell BryanLGH College of Health Sciences Juan Carlos Ramirez, BSN, DHS,
School of Nursing – Kean University Lincoln, Nebraska MBA
Union, New Jersey Professional Training Centers
Jean DeDonder Miami, Florida
Sharon Canclini Emporia State University
Texas Christian University Emporia, Kansas Cheryl Schlamb
Fort Worth, Texas West Chester University of
Glenda Dexter-Brown Pennsylvania
Susan M. Cherry Indiana University Northwest West Chester, Pennsylvania
University of Texas at Arlington Gary, Indiana
Arlington, Texas Amy Spurlock
Debra Dickman Troy University
Jane Christianson Blessing-Rieman College of Nursing Troy, Alabama
University of Cincinnati Quincy, Illinois
Cincinnati, Ohio
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