A public health nurse is discussing how to improve client outcomes with county legislators. Which of the following interventions should the nurse recommend to improve outcomes for clients impacted by the cycle of poverty?

Choice A Reason:
The Social Cognitive Theory, developed by Albert Bandura, emphasizes the role of observational learning, social experiences, and reciprocal determinism in behavior change. It considers both internal factors (such as self-efficacy) and external factors (such as social influences and environmental conditions) in motivating behavior change. Therefore, it does not focus solely on internal factors.

Choice B Reason:
The Ecological Model, also known as the Social-Ecological Model, looks at multiple levels of influence on behavior, including individual, interpersonal, organizational, community, and public policy levels. This model highlights the interaction between individuals and their physical and sociocultural environments. It does not focus exclusively on internal factors but rather on a broad range of influences.

Choice C Reason:
The Transtheoretical Theory, also known as the Stages of Change Model, describes the process of intentional behavior change through five stages: precontemplation, contemplation, preparation, action, and maintenance. While it considers internal factors such as motivation and readiness to change, it also acknowledges the role of external factors and interventions in facilitating progress through these stages.

Choice D Reason:
The Health Belief Model focuses on individual perceptions and beliefs as the primary motivators for adopting healthier behaviors. It considers factors such as perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. This model is centered on internal cognitive factors that influence a person's decision to engage in health-promoting behaviors, making it the correct answer for a model that looks only at internal factors.

Choice A Reason:
The Tuskegee Syphilis Study does not provide guidelines for the recruitment of Black and African-American research participants. Instead, it is a historical example of unethical research practices that led to significant harm and mistrust within the Black community. The study involved misleading and withholding treatment from Black men with syphilis, which has had long-lasting effects on their willingness to participate in research.

Choice B Reason:
The Tuskegee Syphilis Study did not demonstrate a correlation between coronary artery disease and syphilis. The study was focused solely on the natural progression of untreated syphilis in Black men. It did not investigate or establish any links to coronary artery disease. This choice is incorrect as it misrepresents the purpose and findings of the study.

Choice C Reason:
The Tuskegee Syphilis Study did not exclude Black men; in fact, it specifically targeted Black men for participation. The study involved 600 Black men, 399 of whom had syphilis and 201 who did not. The men were misled about the nature of the study and were not provided with adequate treatment, even after penicillin became the standard treatment for syphilis. This choice is incorrect as it inaccurately describes the study's participant selection.

Choice D Reason:
The Tuskegee Syphilis Study is indeed a source of distrust and a barrier to Black clients participating in research studies. The unethical treatment of the participants, including the lack of informed consent and the withholding of effective treatment, has led to a deep-seated mistrust of medical research within the Black community. This mistrust can make it challenging to recruit Black participants for research studies, as they may fear similar exploitation and harm.