Health promotion is a broad and complex process that overarches all health strategy related to primary health care, public health, population health and community health. It is often an overtly political and policy-driven process that includes types of health education activity such as ‘radical’ health education (Clavier & de Leeuw, 2013; Green et al., 2019). When it comes to primary health care program planning and evaluation, the terms health promotion and health education are also often used interchangeably but this is less of a problem than already stated. Health promotion approaches, often by default, include health education interventions. Reflecting this, many ‘health’ planning and evaluation tools and models incorporate both health promotion and health education processes (Raingruber 2014; Whitehead & Irvine, 2010). This chapter aims to highlight good practice as it applies to essential health promotion and health education programs required to demonstrate effective process. It does so by presenting these in a logical and sequential process and offers an overview of models and frameworks for guiding this process.

Many health care professionals undertake roles that require them to visit the home of the client or a range of other possible locations, rather than the client coming into the health care service setting. Primary health care nurses usually work alone and often have little control over the environment so their role requires a different approach to risk management. Assessment of risk is necessary to identify any potential harm or risk to safety. This should be considered from both personal and professional perspectives. Although risk is present in all activities of life, the management of risk is essential when providing services that meet the needs of clients while minimising the chance of undesirable incidents. This chapter identifies common safety concerns when providing health care in people’s homes and explains the purpose of risk assessment and the mechanisms through which risk is managed. It also describes measures for reducing risk and discusses proactive behaviour for self-protection.

Mental illness continues to be a leading cause of illness in Australia and New Zealand. The effects of reduced mental health have significant and far-reaching consequences for individuals, families and the community. Prevention and early intervention are crucial to improve health outcomes throughout the lifespan. Much of the support and care for individuals and families experiencing mental health illness occurs within the community, and nurses are major providers of that care. This chapter focuses on the role of community mental health nurses in providing recovery-orientated care for individuals living with mental illness and their families.

The health and well-being of families is an important consideration for all governments – federal, state and local. Based on past morbidity and mortality rates and recent knowledge of early childhood development (Marmot, 2010), family health policies have evolved to emphasise the importance of providing every child with the best possible start to life. This acknowledges that childhood sets the foundation for future health and well-being and recognises the 1979 United Nations’ Convention on the Rights of the Child (United Nations Children Fund, 2009). In order to have an impact on health inequalities, government policies and services must address the social determinants of early child health, development and well-being (Brinkman et al., 2012; Marmot, 2010). This chapter introduces maternal, child and family health nursing and outlines the key functions of this crucial community nursing role. Foundational principles of primary health care practice are explored and case studies used to explain strengths-based, family-centred care.

Sexual health nurses are employed to work in a range of practice settings and with diverse population groups. Sexual and reproductive health care is considered a human right and social justice issue (Simmonds et al., 2017; World Health Organization, 2011). Work settings include dedicated sexual health clinics, family planning services, community health centres, women’s health services, correctional services, general practices and tertiary education settings. The scope of practice varies between settings within and across states and territories. Some practice settings may be gender-specific but in general, sexual health nurses work with people of any gender and diverse sexualities. As there is a lack of consistency in role expectation, this chapter explores a range of activities that may be undertaken by sexual health nurses.

Some people living with long-term intellectual, physical or mental disability, whether present at birth or acquired later in life, are among the most disadvantaged and marginalised groups in our community. They experience poorer health status and significantly higher morbidity and mortality rates than the general population, and often encounter a health system that fails to meet their needs (Australian Institute of Health and Welfare, 2016; World Health Organization, 2018). This chapter focuses on informing health care professionals and better equipping them to understand and respond to the needs of people living with disability so that they might attain the highest possible outcomes in health and well-being throughout their lives.

The world is facing an unprecedented number of displaced people as a result of war, conflict and natural disasters (The United Nations High Commissioner for Refugees [UNHCR], 2019). The UNHCR's UN Refugee Agency estimates that 70.8 million people around the world were forcibly displaced at the end of 2018 as a result of persecution, conflict, violence or human rights violations. During the course of the year, 13.6 million people were newly displaced including 37,000 people every day. Fifty per cent of the world’s refugees and displaced are children. Overwhelmingly, it is developing countries that are most affected. Permanent resettlement occurs in less than one per cent of cases (UNHCR, 2019). This chapter provides readers with a general overview of the impact of war and displacement on health, and an insight into the current Australian humanitarian programs for refugees arriving, including the offshore medical assessment and onshore settlement programs.

This chapter describes the role and activities of community health nurses and identifies the main focus of the role from a primary health care perspective. It also describes the process for identifying and responding to community needs, and provides understanding of the complexity and diversity of the role. In the 1970s, community health nursing emerged in Australia and New Zealand alongside the rise ofprimary health care. Primary health care shifted the focus from a disease model and treating illness to a preventative model focused on population and social health, community development, health promotion, illness prevention and early intervention. This created new roles for nurses with the evolution of community health nursing, sometimes referred to as primary health care nursing, as a specialised area of nursing practice.

Home-based care has had a long tradition in Australia and New Zealand with care being provided in people’s homes for over 100 years. Over time, there have been significant changes to the overall goals and how services are delivered. Home-based care now takes many forms including the acute care program, Hospital in the Home and a range of chronic disease programs. Other home-based care programs provide personal care to older people living in their own homes. Not only is home-based care diverse but the setting in which it is delivered can be equally varied. Regardless of the care required and the environment in which it is delivered, home-based care is based on a person-centred philosophy that has the potential to deliver individualised and responsive care. The role is not without its challenges. Nurses who undertake home visits go into uncontrolled and sometimes confronting environments that may be less than optimal for the delivery of health care. This chapter covers the history of home-based nursing, the changing contexts of home-based care, home visiting and multidisciplinary practice.

This chapter introduces Indigenous approaches to health care that have relevance for the Australian and Āotearoa New Zealand contexts. Several of the principles for practice are readily transferrable to other culturally and linguistically diverse populations. The challenges are undeniably major but the rewards are potentially transformative. Nursing training and education is most often located within mainstream, non-Indigenous settings. Health professionals who want to make a positive difference to the health outcomes of Indigenous clients should be equipped with knowledges and understandings that will facilitate effective engagement. Further, this chapter examines the historical influences that impacted on the health and well-being of Indigenous peoples in both Āotearoa New Zealand and Australia, and considers the need for adopting Indigenous approaches to health care practice and engagement such as cultural safety, cultural responsiveness and other cultural frameworks. Finally, it examines the role of the community nurse in Indigenous primary health care

Nurses are the best distributed and largest professional group in the rural health workforce in Australia (Bragg & Bonner, 2015; Gardner & Duffield, 2013). In New Zealand, the rural nurse specialist has developed in response to the declining numbers of GPs who practice in rural areas (Adams, Carryer & Wilkinson, 2017; Bell, 2015). Usually, rural health nurses have well-defined catchment areas or communities in which they practise. Community nurses practising in rural areas are necessarily generalists as they need to provide care for clients who have a broad range of health issues and contexts (Barrett et al., 2016; Knight, Kenny & Endacott, 2016). An increased scope of practice and greater reliance on collaboration, interdisciplinary and transdisciplinary practice is common. Rural health nurses may be sole practitioners, providing health care on their own, or as part of a small team that sometimes may include doctors. This chapter describes the purpose and key functions of this community nursing role, identifies the main focus of the role in terms of primary care and primary health care, and explains how the role does or does not address issues of social justice, equity and access.

This chapter discusses the impact of chronic conditions on idividuals, their families and the broader community. The World Health Organization (WHO, 2018) has reported that chronic conditions, or non-communicable diseases, are the leading cause of deaths worldwide. In 2016, chronic conditions were responsible for 41 million of the 57 million deaths occurring globally (WHO, 2018). The majority of these deaths are due to four major chronic diseases: cardiovascular disease (CVD), chronic respiratory disease, diabetes and cancer (WHO, 2018). However, other chronic conditions, including injuries that result in persistent disability and mental health disorders, also contribute to increased morbidity and mortality. The significant increase in preventable chronic conditions and the management of these are major health care concerns of the industrialised world.

This chapter examines the significant impact of sex and gender to health and health outcomes for both men and women. Sex relates to biological attributes whether born female or male, while gender is sociocultural identity that is learned over time (Canadian Institute of Health Research, 2016; World Health Organization [WHO], 2016). The differences in morbidity and mortality between women and men have been well recognised (WHO, 2016). Biological characteristics expose both women and men to different health risks and heath conditions. Gender also exposes women and men to different health risks and gender inequity impacts on their potential to achieve health and well-being. This chapter also focuses on both biological and sociocultural factors that impact on women's and men’s health and how health professionals, in particular community nurses, can mitigate health disparities and inequities.

This introductory chapter explains the social model of health and social determinants of health. It also introduces the concept of health promotion, a fundamental component of primary health care, that is then further developed throughout the text, and explores how nurses and other health care professionals may work in or with the community.

Community and primary health care nursing is experiencing a rapid metamorphosis as our population ages and the prevalence of chronic and complex conditions increase. To meet these changing needs, our health workforce has evolved with a range of specialised disciplines now working in diverse health settings. Throughout these changes, nursing continues to be the largest global health workforce providing the most direct client care. Historically, nurses were the original transdisciplinary health care workers, providing basic physiotherapy, occupational therapy, nutritional advice and all other care as required. As more detailed knowledge developed in an area of practice, specialised areas of care evolved and a variety of allied health professions emerged. Nursing itself became more specialised due to developments in clinical practice, technological advances and clients requiring more complex care. This chapter examines how professional identity and culture influence interprofessional practice, describes the behaviour and skills that facilitate effective communication, and identifies the barriers and facilitators to multidisciplinary health professionals working well together.