Adherence/Non-Adherence; Bias/Implicit Bias & Social determinants

Question 1

The degree to which the use of a medication/treatment corresponds to the prescribed regimen

Answer 1

adherence in the context of medical care

Question 2

Degree to which a patient does not follow a prescribed medical treatment/regimen
Can be intentional or nonintentional

Answer 2

non-adherence

Question 3

non-adherence is preferred over the term:
why?

Answer 3

non-compliant
has a less judgmental tone

Question 4

patient related factors for non-adherence

Answer 4

demographic factors
mental health/social support
disease factors
ethnicity, cultural, religious beliefs
education/ literacy level
socioeconomic status
health literacy

Question 5

what are some demographic factors for non-adherence

Answer 5

Age, ethnicity/cultural beliefs, education, socioeconomic status, health literacy, language barrier

Question 6

what are some mental health reasons for non-adherence

Answer 6

Untreated anxiety/mood disorders/addiction/personality disorders; cognitive difficulties (dementia)

Question 7

what are some socioeconomic factors for non-adherence

Answer 7

patients do not have transportation/have to take bus(es) to get to an appointment; ability to take time off of work to go to an appointment

Question 8

therapy related factors of non-adherence

Answer 8

Health Literacy
Route/Frequency of [medication] administration
Treatment complexity/Duration
Side Effects
Degree of behavior change required- do they think it is important???

Question 9

Healthcare Provider/Health System Related Factors of non-adherence

Answer 9

Provider or Ancillary Staff/Patient rapport
Long waiting times
Accessibility of the building

Question 10

the challenges of adherence

Answer 10

Chronic Conditions
Multiple Chronic Conditions
Risk of Mental Health Conditions (anxiety/depression) increases with each added chronic condition

Question 11

Consists of attitudes and beliefs we have about a person or group of people
Can be negative or positive; not accurate
Examples: Racial or ethnic;

Answer 11

explicit bias

Question 12

the behavior (not hiring women because they may want to start a family/get pregnant/not be available to work; unfair treatment to someone based on race/ethnicity/sexual and gender minority status/

Answer 12

discrimination

Question 13

Attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner.

Answer 13

implicit bias

Question 14

key factors of implicit bias

Answer 14

We ALL have them
They do not necessarily align with our declared beliefs
Implicit and explicit biases are related but different constructs
We generally tend to hold implicit biases that favor our own ingroup
The GOOD NEWS: Implicit bias is malleable

Question 15

non-profit collaboration between international researchers interested in implicit social cognition –our thoughts outside our conscious awareness and control.

Answer 15

project implicit

Question 16

what are actions to decrease implicit bias

Answer 16

Take you time!!! Feeling stressed or pressured can cause us to make decisions that are not necessarily how we truly want to act (auto drive)
See others as individuals rather than members of a certain gender, race, religion, or ethnic group.
Put yourself in their shoes – or position; this can help to develop empathy
Look for evidence against stereotypes –
Educate yourself – learn more about whatever group of people (race, culture/ethnicity, those with addictions)
KNOW this is a lifelong growth process!!!

Question 17

social determinants of health for economic stability

Answer 17

employment
income
debt
medicals bills
support

Question 18

social determinants of health for neighborhood and physical environment

Answer 18

housing
transportation
safety
parks
playgrounds
walkability
zip code/geography

Question 19

social determinants of health for education

Answer 19

literacy
language
early childhood education
vocational training
higher education

Question 20

social determinants of health for food

Answer 20

hunger
access to healthy options

Question 21

social determinants of health for community and social context

Answer 21

social integration
support systems
community engagement
discrimination
stress

Question 22

social determinants of health for the health care system

Answer 22

health coverage
provider availability
provider linguistic and cultural competency
quality of care

Question 23

health outcomes from social determinants of health

Answer 23

mortality
morbidity
life expectancy
health care expenditures
health status
functional limitations

Question 24

Everyone receives the same opportunities for health

Answer 24

equality

Question 25

Recognizes different individual circumstances and provides the resources (e.g. and removes barriers) for each person to achieve their level of optimal health

Answer 25

equity

Question 26

describes avoidable gaps in health outcomes; barriers that prevent individuals and populations from attaining maximum health

Answer 26

health inequity

Question 27

how is health equity achieved

Answer 27

when everyone has a fair opportunity to attain their full health potential

Question 28

health disparity exists when:

Answer 28

a health outcome is seen to a greater or lesser extent between populations.”** …and it is preventable.

Question 29

Poverty and lack of access to resources are important risk factors for infant death and help to explain the differences seen among racial groups with a higher percentage living in poverty

Answer 29

health disparities

Question 30

examples of health disparities

Answer 30

Chemical Plant Map
Household Income Map
Census tract life expectancy
Crime Map

Question 31

nursing implications for SDOH

Answer 31

Social Justice and Advocacy
participation on committees, boards, and professional organizations
Know your resources
Ask the hard questions
Use The Nursing Process to provide the framework for integrating SDOH into patient care
Collaborative Practice
Be an active member of the interdisciplinary team