Community Health Nursing —Non-Communicable Diseases

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Non-communicable diseases are long-duration conditions shaped by behavioral, metabolic, environmental, genetic, and social factors. Community Health Nursing emphasizes risk reduction, screening, early diagnosis, treatment adherence, medication safety, complication prevention, referral, rehabilitation, and long-term follow-up. Major community priorities include cardiovascular disease, diabetes, obesity, cancer, chronic respiratory disease, and chronic kidney disease.

1️⃣ NCD Burden & Prevalence in the Philippines

📊 Burden Pattern

🔷 Define concept + CHN relevance

🔷 Identify key factors + risks

🔷 Assess community/client needs

🔷 Apply prevention + health promotion

🔷 Coordinate care + resources

🔷 Evaluate outcomes + document

❤️ Major NCD Groups

🔷 Define concept + CHN relevance

🔷 Identify key factors + risks

🔷 Assess community/client needs

🔷 Apply prevention + health promotion

🔷 Coordinate care + resources

🔷 Evaluate outcomes + document

⚠️ Premature Mortality

🔷 Define concept + CHN relevance

🔷 Identify key factors + risks

🔷 Assess community/client needs

🔷 Apply prevention + health promotion

🔷 Coordinate care + resources

🔷 Evaluate outcomes + document

🏘️ CHN Significance

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

2️⃣ Behavioral NCD Risk Factors

🚬 Tobacco

🔷 Tobacco → CVD + cancer + respiratory risk ↑

🔷 Secondhand smoke also harms

🔷 Assess smoking/vaping exposure

🔷 Give brief cessation advice

🔷 Refer to cessation support

🔷 Smoke-free environments → exposure ↓

🍺 Harmful Alcohol Use

🔷 Excess alcohol → disease + injury risk ↑

🔷 Assess amount + frequency

🔷 Binge/heavy use → harm ↑

🔷 Use nonjudgmental questions

🔷 Counsel according to risk

🔷 Dependence/withdrawal risk → referral

🍟 Unhealthy Diet

🔷 Salt ↑ → BP risk ↑

🔷 Free sugar ↑ → obesity/diabetes risk ↑

🔷 Saturated/trans fat ↑ → CVD risk ↑

🔷 Fruit + vegetables + fiber support health

🔷 Portion + food environment matter

🔷 Teaching should be practical + affordable

🏃 Physical Inactivity

🔷 Inactivity → CVD + diabetes + obesity risk ↑

🔷 Assess activity + limitations

🔷 Encourage gradual regular activity

🔷 Reduce prolonged sitting

🔷 Adapt activity to condition

🔷 Community programs support movement

3️⃣ Metabolic NCD Risk Factors

🩸 Raised Blood Pressure

🔷 Define concept + CHN relevance

🔷 Identify key factors + risks

🔷 Assess community/client needs

🔷 Apply prevention + health promotion

🔷 Coordinate care + resources

🔷 Evaluate outcomes + document

🍬 Raised Blood Glucose

🔷 Define concept + CHN relevance

🔷 Identify key factors + risks

🔷 Assess community/client needs

🔷 Apply prevention + health promotion

🔷 Coordinate care + resources

🔷 Evaluate outcomes + document

⚖️ Overweight & Obesity

🔷 Define concept + CHN relevance

🔷 Identify key factors + risks

🔷 Assess community/client needs

🔷 Apply prevention + health promotion

🔷 Coordinate care + resources

🔷 Evaluate outcomes + document

🧪 Dyslipidemia

🔷 Define concept + CHN relevance

🔷 Identify key factors + risks

🔷 Assess community/client needs

🔷 Apply prevention + health promotion

🔷 Coordinate care + resources

🔷 Evaluate outcomes + document

4️⃣ NCD Prevention & Levels of Prevention

🌱 Primary Prevention

🔷 Primary → prevent disease

🔷 Secondary → detect early disease

🔷 Tertiary → limit complications/disability

🔷 Match action to disease stage

🔷 Combine population + individual strategies

🔷 Evaluate coverage + outcomes

🔎 Secondary Prevention

🔷 Primary → prevent disease

🔷 Secondary → detect early disease

🔷 Tertiary → limit complications/disability

🔷 Match action to disease stage

🔷 Combine population + individual strategies

🔷 Evaluate coverage + outcomes

♿ Tertiary Prevention

🔷 Primary → prevent disease

🔷 Secondary → detect early disease

🔷 Tertiary → limit complications/disability

🔷 Match action to disease stage

🔷 Combine population + individual strategies

🔷 Evaluate coverage + outcomes

🏘️ Population Strategies

🔷 Primary → prevent disease

🔷 Secondary → detect early disease

🔷 Tertiary → limit complications/disability

🔷 Match action to disease stage

🔷 Combine population + individual strategies

🔷 Evaluate coverage + outcomes

5️⃣ NCD Risk Assessment & Community Screening

🔎 Risk Assessment

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

🩸 BP & Glucose Screening

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

⚖️ Anthropometric Screening

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

🔗 Referral & Follow-Up

🔷 Assess symptoms + risk factors

❤️ Disease Pattern

🔷 Define disease + core pathophysiology

🔷 Identify modifiable + nonmodifiable risks

🔷 Early disease may be asymptomatic

🔷 Recognize major complications

🔷 Comorbidity may alter management

🔷 Long-term prevention + control are central

🔎 Signs & Diagnostics

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

💊 Treatment & Medication Safety

🔷 Lifestyle measures support treatment

🔷 Therapy depends on diagnosis + risk

🔷 Assess contraindications + interactions

🔷 Monitor response + adverse effects

🔷 Teach adherence + warning signs

🔷 Reassess benefit + complications

🏘️ CHN Interventions

🔷 Identify high-risk clients

🔷 Provide targeted health education

🔷 Coordinate referral + services

🔷 Track missed visits + follow-up

🔷 Engage family/community support

🔷 Document outcomes + unmet needs

8️⃣ Coronary Artery Disease

🫀 Disease Pattern

🔷 Define disease + core pathophysiology

🔷 Identify modifiable + nonmodifiable risks

🔷 Early disease may be asymptomatic

🔷 Recognize major complications

🔷 Comorbidity may alter management

🔷 Long-term prevention + control are central

⚠️ Signs & Symptoms

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

🧪 Diagnostics & Treatment

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

🏘️ Prevention & CHN Care

🔷 Identify high-risk clients

🔷 Provide targeted health education

🔷 Coordinate referral + services

🔷 Track missed visits + follow-up

🔷 Engage family/community support

🔷 Document outcomes + unmet needs

9️⃣ Heart Failure

❤️ Heart Failure Pattern

🔷 Define concept + CHN relevance

🔷 Identify key factors + risks

🔷 Assess community/client needs

🔷 Apply prevention + health promotion

🔷 Coordinate care + resources

🔷 Evaluate outcomes + document

⚠️ Signs & Symptoms

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

🧪 Diagnostics

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

💊 Treatment & CHN Care

🔷 Lifestyle measures support treatment

🔷 Therapy depends on diagnosis + risk

🔷 Assess contraindications + interactions

🔷 Monitor response + adverse effects

🔷 Teach adherence + warning signs

🔷 Reassess benefit + complications

🔟 Stroke / Cerebrovascular Disease

🧠 Stroke Pattern

🔷 Define concept + CHN relevance

🔷 Identify key factors + risks

🔷 Assess community/client needs

🔷 Apply prevention + health promotion

🔷 Coordinate care + resources

🔷 Evaluate outcomes + document

🚨 FAST & Warning Signs

🔷 F = facial droop

🔷 A = arm weakness

🔷 S = speech difficulty

🔷 T = time → emergency response

🔷 Sudden vision/balance deficit also concerning

🔷 Stroke symptoms → immediate emergency referral

🧪 Diagnostics & Acute Treatment

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

♿ Prevention & Rehabilitation

🔷 Primary → prevent disease

🔷 Secondary → detect early disease

🔷 Tertiary → limit complications/disability

🔷 Match action to disease stage

🔷 Combine population + individual strategies

🔷 Evaluate coverage + outcomes

1️⃣1️⃣ Diabetes Mellitus

🍬 Disease Pattern

🔷 Define disease + core pathophysiology

🔷 Identify modifiable + nonmodifiable risks

🔷 Early disease may be asymptomatic

🔷 Recognize major complications

🔷 Comorbidity may alter management

🔷 Long-term prevention + control are central

🔎 Signs & Diagnostics

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

💊 Treatment & Medication Safety

🔷 Lifestyle measures support treatment

🔷 Therapy depends on diagnosis + risk

🔷 Assess contraindications + interactions

🔷 Monitor response + adverse effects

🔷 Teach adherence + warning signs

🔷 Reassess benefit + complications

🏘️ CHN Interventions

🔷 Identify high-risk clients

🔷 Provide targeted health education

🔷 Coordinate referral + services

🔷 Track missed visits + follow-up

🔷 Engage family/community support

🔷 Document outcomes + unmet needs

1️⃣2️⃣ Diabetes Complications & Foot Care

🦶 Foot Risk

🔷 Neuropathy → injury may go unnoticed

🔷 Poor circulation → healing ↓

🔷 Inspect feet daily

🔷 Avoid barefoot walking

🔷 Proper footwear → injury risk ↓

🔷 Ulcer/infection → prompt clinical care

👁️ Microvascular Complications

🔷 Define concept + CHN relevance

🔷 Identify key factors + risks

🔷 Assess community/client needs

🔷 Apply prevention + health promotion

🔷 Coordinate care + resources

🔷 Evaluate outcomes + document

❤️ Macrovascular Complications

🔷 Define concept + CHN relevance

🔷 Identify key factors + risks

🔷 Assess community/client needs

🔷 Apply prevention + health promotion

🔷 Coordinate care + resources

🔷 Evaluate outcomes + document

🛡️ Prevention

🔷 Primary → prevent disease

🔷 Secondary → detect early disease

🔷 Tertiary → limit complications/disability

🔷 Match action to disease stage

🔷 Combine population + individual strategies

🔷 Evaluate coverage + outcomes

1️⃣3️⃣ Obesity & Metabolic Syndrome

⚖️ Disease Pattern

🔷 Define disease + core pathophysiology

🔷 Identify modifiable + nonmodifiable risks

🔷 Early disease may be asymptomatic

🔷 Recognize major complications

🔷 Comorbidity may alter management

🔷 Long-term prevention + control are central

🔎 Assessment

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

🥗 Management

🔷 Lifestyle measures support treatment

🔷 Therapy depends on diagnosis + risk

🔷 Assess contraindications + interactions

🔷 Monitor response + adverse effects

🔷 Teach adherence + warning signs

🔷 Reassess benefit + complications

🏘️ Community Prevention

🔷 Identify high-risk clients

🔷 Provide targeted health education

🔷 Coordinate referral + services

🔷 Track missed visits + follow-up

🔷 Engage family/community support

🔷 Document outcomes + unmet needs

1️⃣4️⃣ Cancer

🎗️ Cancer Pattern

🔷 Define concept + CHN relevance

🔷 Identify key factors + risks

🔷 Assess community/client needs

🔷 Apply prevention + health promotion

🔷 Coordinate care + resources

🔷 Evaluate outcomes + document

⚠️ Warning Signs & Risks

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

🧪 Diagnostics

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

💊 Treatment & CHN Support

🔷 Lifestyle measures support treatment

🔷 Therapy depends on diagnosis + risk

🔷 Assess contraindications + interactions

🔷 Monitor response + adverse effects

🔷 Teach adherence + warning signs

🔷 Reassess benefit + complications

1️⃣5️⃣ Cancer Screening & Early Detection

🔎 Screening Principles

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

🎀 Breast & Cervical Health

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

🩺 Colorectal & Other Screening

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

🔗 Abnormal Result Follow-Up

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

1️⃣6️⃣ Asthma

🫁 Disease Pattern

🔷 Define disease + core pathophysiology

🔷 Identify modifiable + nonmodifiable risks

🔷 Early disease may be asymptomatic

🔷 Recognize major complications

🔷 Comorbidity may alter management

🔷 Long-term prevention + control are central

⚠️ Signs & Triggers

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

🧪 Diagnostics

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

💊 Treatment & Education

🔷 Lifestyle measures support treatment

🔷 Therapy depends on diagnosis + risk

🔷 Assess contraindications + interactions

🔷 Monitor response + adverse effects

🔷 Teach adherence + warning signs

🔷 Reassess benefit + complications

1️⃣7️⃣ COPD / Chronic Respiratory Disease

🫁 Disease Pattern

🔷 Define disease + core pathophysiology

🔷 Identify modifiable + nonmodifiable risks

🔷 Early disease may be asymptomatic

🔷 Recognize major complications

🔷 Comorbidity may alter management

🔷 Long-term prevention + control are central

🔎 Signs & Diagnostics

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

💊 Treatment & Medication Safety

🔷 Lifestyle measures support treatment

🔷 Therapy depends on diagnosis + risk

🔷 Assess contraindications + interactions

🔷 Monitor response + adverse effects

🔷 Teach adherence + warning signs

🔷 Reassess benefit + complications

🚭 Prevention & CHN Care

🔷 Identify high-risk clients

🔷 Provide targeted health education

🔷 Coordinate referral + services

🔷 Track missed visits + follow-up

🔷 Engage family/community support

🔷 Document outcomes + unmet needs

1️⃣8️⃣ Chronic Kidney Disease

🫘 CKD Pattern

🔷 Define concept + CHN relevance

🔷 Identify key factors + risks

🔷 Assess community/client needs

🔷 Apply prevention + health promotion

🔷 Coordinate care + resources

🔷 Evaluate outcomes + document

🔎 Assessment & Diagnostics

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

💊 Management

🔷 Lifestyle measures support treatment

🔷 Therapy depends on diagnosis + risk

🔷 Assess contraindications + interactions

🔷 Monitor response + adverse effects

🔷 Teach adherence + warning signs

🔷 Reassess benefit + complications

🏘️ Prevention & CHN Care

🔷 Identify high-risk clients

🔷 Provide targeted health education

🔷 Coordinate referral + services

🔷 Track missed visits + follow-up

🔷 Engage family/community support

🔷 Document outcomes + unmet needs

1️⃣9️⃣ Dyslipidemia & Cardiovascular Risk

🧪 Lipid Pattern

🔷 Define concept + CHN relevance

🔷 Identify key factors + risks

🔷 Assess community/client needs

🔷 Apply prevention + health promotion

🔷 Coordinate care + resources

🔷 Evaluate outcomes + document

🔎 Risk Assessment

🔷 Assess symptoms + risk factors

🔷 Perform focused examination

🔷 Use appropriate screening/diagnostic tests

🔷 Screening ≠ confirmed diagnosis

🔷 Assess complications + red flags

🔷 Urgent findings → prompt referral

💊 Management

🔷 Lifestyle measures support treatment

🔷 Therapy depends on diagnosis + risk

🔷 Assess contraindications + interactions

🔷 Monitor response + adverse effects

🔷 Teach adherence + warning signs

🔷 Reassess benefit + complications

❤️ CVD Prevention

🔷 Primary → prevent disease

🔷 Secondary → detect early disease

🔷 Tertiary → limit complications/disability

🔷 Match action to disease stage

🔷 Combine population + individual strategies

🔷 Evaluate coverage + outcomes

2️⃣0️⃣ NCD Medication Safety & Adherence

💊 Adherence Pattern

🔷 Adherence = taking therapy as agreed

🔷 Asymptomatic disease → adherence may ↓

🔷 Complex regimen → missed doses ↑

🔷 Cost + access affect adherence

🔷 Side effects may cause stopping

🔷 Therapeutic alliance → adherence ↑

⚠️ Common Barriers

🔷 Lifestyle measures support treatment

🔷 Therapy depends on diagnosis + risk

🔷 Assess contraindications + interactions

🔷 Monitor response + adverse effects

🔷 Teach adherence + warning signs

🔷 Reassess benefit + complications

🔎 Monitoring

🔷 Lifestyle measures support treatment

🔷 Therapy depends on diagnosis + risk

🔷 Assess contraindications + interactions

🔷 Monitor response + adverse effects

🔷 Teach adherence + warning signs

🔷 Reassess benefit + complications

📣 Medication Teaching

🔷 Explain medicine name + purpose

🔷 Teach dose + timing

🔷 Discuss major adverse effects

🔷 Review important precautions

🔷 Include OTC/herbal products

🔷 Teach-back → understanding ↑

2️⃣1️⃣ Diet, Exercise & Lifestyle Modification

🥗 Healthy Diet

🔷 Define concept + CHN relevance

🔷 Identify key factors + risks

🔷 Assess community/client needs

🔷 Apply prevention + health promotion

🔷 Coordinate care + resources

🔷 Evaluate outcomes + document

🏃 Physical Activity

🔷 Define concept + CHN relevance

🔷 Identify key factors + risks

🔷 Assess community/client needs

🔷 Apply prevention + health promotion

🔷 Coordinate care + resources

🔷 Evaluate outcomes + document

⚖️ Weight Management

🔷 Lifestyle measures support treatment

🔷 Therapy depends on diagnosis + risk

🔷 Assess contraindications + interactions

🔷 Monitor response + adverse effects

🔷 Teach adherence + warning signs

🔷 Reassess benefit + complications

😴 Sleep & Stress

🔷 Define concept + CHN relevance

🔷 Identify key factors + risks

🔷 Assess community/client needs

🔷 Apply prevention + health promotion

🔷 Coordinate care + resources

🔷 Evaluate outcomes + document

2️⃣2️⃣ Community NCD Education & Family Support

📚 Health Education

🔷 Identify high-risk clients

🔷 Provide targeted health education

🔷 Coordinate referral + services

🔷 Track missed visits + follow-up

🔷 Engage family/community support

🔷 Document outcomes + unmet needs

👥 Family Support

🔷 Identify high-risk clients

🔷 Provide targeted health education

🔷 Coordinate referral + services

🔷 Track missed visits + follow-up

🔷 Engage family/community support

🔷 Document outcomes + unmet needs

🌱 Behavior Change

🔷 Identify high-risk clients

🔷 Provide targeted health education

🔷 Coordinate referral + services

🔷 Track missed visits + follow-up

🔷 Engage family/community support

🔷 Document outcomes + unmet needs

🏘️ Community Action

🔷 Identify high-risk clients

🔷 Provide targeted health education

🔷 Coordinate referral + services

🔷 Track missed visits + follow-up

🔷 Engage family/community support

🔷 Document outcomes + unmet needs

2️⃣3️⃣ NCD Referral, Follow-Up & Long-Term Monitoring

🔗 Referral

🔷 Identify high-risk clients

🔷 Provide targeted health education

🔷 Coordinate referral + services

🔷 Track missed visits + follow-up

🔷 Engage family/community support

🔷 Document outcomes + unmet needs

📅 Follow-Up

🔷 Identify high-risk clients

🔷 Provide targeted health education

🔷 Coordinate referral + services

🔷 Track missed visits + follow-up

🔷 Engage family/community support

🔷 Document outcomes + unmet needs

📊 Disease Monitoring

🔷 Identify high-risk clients

🔷 Provide targeted health education

🔷 Coordinate referral + services

🔷 Track missed visits + follow-up

🔷 Engage family/community support

🔷 Document outcomes + unmet needs

🚨 Red Flags

🔷 Identify high-risk clients

🔷 Provide targeted health education

🔷 Coordinate referral + services

🔷 Track missed visits + follow-up

🔷 Engage family/community support

🔷 Document outcomes + unmet needs

🏁 Conclusion

Community NCD nursing combines population risk reduction with individual screening, early diagnosis, treatment support, medication safety, referral, rehabilitation, and long-term monitoring. Nurses address tobacco, alcohol, diet, inactivity, hypertension, hyperglycemia, obesity, and dyslipidemia while supporting clients with cardiovascular disease, diabetes, cancer, respiratory disease, and CKD.