Health promotion and disease prevention have always been essential to public health nursing. With the changing health care system and an increased emphasis on cost-containment, the role of the nurse is expanding even more into this arena. A challenge for public health nurses, then, is to motivate and facilitate health behavior change in working with individuals, families, and communities and designing programs based on theory. Leading causes of death continue to relate to health behaviors that require change. The purpose of this article is to integrate theory with practice by describing the Transtheoretical Model of Change as well as the principles of motivational interviewing that can be used in motivating behavioral change. A case scenario is presented to illustrate the use of the models with effective interviewing skills that can be used to enhance health. Implications for practice with an emphasis on providing an individually tailored matched intervention is stressed.

To review the latest studies on risk and protective factors for the development of substance abuse and the effectiveness of prevention interventions for the pediatric population.Data Sources: Multiple bibliographic databases, including MEDLINE and ERIC, were used to develop a comprehensive review of the literature on substance abuse prevention during the last 10 years. Selected indexing terms included substance abuse prevention, risk factors, and protective factors. Research monographs from the National Institute on Drug Abuse and the Center for Substance Abuse Prevention were used, along with information from authors of prevention curricula.Study Selection: Study populations included children from birth through adolescence who were enrolled in controlled, prospective, and/or longitudinal studies of either protective or risk factors for the development of substance abuse or response to substance abuse prevention programs. Studies of adult patients that investigated predisposing risk factors for substance abuse (eg, genetic implications) were also used. Care was taken to ensure studies included children from diverse racial and social backgrounds.Data Extraction: Information was abstracted and summarized from peer-reviewed publications. Controlled random-designed studies were used to determine prevention program efficacy.Data Synthesis: Main results of the review are summarized in a qualitative format.Conclusions: Factors that contribute to the emergence of substance abuse in the pediatric population are multifactorial. Behavioral, emotional, and environmental factors that place children at risk for the development of substance abuse may be remediated through prevention and intervention programs that use research-based, comprehensive, culturally relevant, social resistance skills training and normative education in an active school-based learning format.