A nurse is implementing interventions to improve the health of the community. Which of the fol-lowing approaches should be taken by the nurse?
a. A top-down approach with ration-al-empirical problem solving
b. A top-down approach with community practice planned by experts
c. A bottom-up approach with facilitation of communication
d. A bottom-up approach with multisectoral planning and action for health
ANS: D
A bottom-up approach with multisectoral planning and action for health incorporates community participation. A bottom-up approach uses broad-based community problem solving that includes health professionals, local officials, service providers, and other community members, including those at risk for health problems. The top-down approach describes when professionals and ex-perts tell the citizens what to do rather than involving and asking them. Social planning stresses rational-empirical problem solving, usually by outside professional experts with a top-down ap-proach. This approach does not focus on building community capacity or fostering fundamental social change.
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