AOR 8 Ethics & Professionalism Flashcards
Adaptation
Making changes to health education messages, materials, or programs to make them more suitable for a population of interest
Cultural Competence
A person’s ability to understand and respect attitudes and values of various cultures & to address these differences in planning, implementing, & evaluating health education and promotion programs
Cultural Humility
Ongoing process of self-exploration for HES in which they honor the beliefs, customs, culture, & values of people with whom they work in communities
Health Disparities
Differences in incidence, prevalence, mortality, and//or burden of disease that exist among specific population groups
Online Database
Any systematically organized information accessible on the internet
- used by HES to obtain health knowledge and/or resources for health education process
What does online database include?
text documents, citations, abstracts, images, audios, videos, and/or web links
Policies
Sets of rules and objectives to guide activities
Professional Development Plan (PDP)
Career document in which short-term and long-term goals and objectives for a professional person are outlined
Social Determinants of Health (SDOH)
Factors that could lead to health inequities and influence an individual’s or community’s health
SDOH barriers to health
- Race or ethnic status
- Gender
- Mental Health
- Disabilities
- Location
Technical Assistance
Dynamic, capacity building process for designing or improving the quality, effectiveness, & efficiency of specific programs, research, products, or systems
Theory
Set of interrelated concepts and definitions that present a systematic view of events
- used to describe a relationship among variables to explain or predict events
Workforce Development Plan (WDP)
Same as PDP, however it is used for teams or organizations in an agency or system
Ethics
Principles or rules that provide guidance for behaviors that may be classified as right or wrong
- Delinated in Code of Ethics
What organization approved Code of Ethics that HES are expected to follow?
CNHEO
Ethical Dilemmas
Issues with 2 sides and involves a judgement of right or wrong
What does the CNHEO Code of Ethics tell the public?
What to expect from the practitioner
What articles are included in HES Code of Ethics?
- Responsibility to the Public
- Responsibility to the Profession
- Responsibility to Employers
- Responsibility in the Delivery of health education/Promotion
- Responsibility in Research & Continuing Education
- Responsibility to Professional Preparation & Continuing Education
6 frequently used ethical frameworks applied to planning programs (including needs assessment)
- AUTONOMY - personal right to self-determination & choice
- CRITICALITY - worst off benefit the most
- EGALITARIAN - all personal of equal value; minimize disparities
- NEEDS BASED - equal opportunity to meet own needs (e.g. healthy life)
- RESOURCE SENSITIVE - resources are scarce
- UTILITARIAN - greatest good for the greatest number; end justifies the means
Why should IRB be consulted to review research and/or evaluation protocols?
To help identify and avoid any possible & unforeseen risks to which participants may be subject
What does IRB support? What are they responsible for?
SUPPORT the worth, dignity, potential & uniqueness of all people
RESPONSIBLE FOR upholding integrity & ethics of the profession
What is HES responsible for when it comes to ethical principles?
- Respect for autonomy
- Promotion of social justice
- Active promotion of good
- Avoidance of harm
What does the Belmont Report summarize?
Basic ethical principles & guidelines for the protection of human subjects of research
HES should recognize 3 concepts of human subject’s protection (regardless of whether they are doing research). What are they?
- RESPECT FOR PERSONS - people have right to choose whether to participant in research; some groups are unable to determine this on their own and need to be protected (such as prisoners & children)
- BENEFICENCE - do no harm & maximize benefits of research
- JUSTICE - address fairness in distribution of benefits of research and selection into research projects
What information does informed consent include?
- Nature and purpose of the program
- Any risks or dangers associated with participation in the program
- Any possible discomfort that may be experienced
- Expected benefits of participation
- Alternative programs or procedures in which the same results would be accomplished
- Option of discontinuing participation at any time
Health Insurance Portability and Accountability Act (HIPPA)
Legislation in which rules around data privacy, integrity, & availability
What does HIPPA statement include?
what types of personal identifiers or personal health information (PHI) is collected, how it is protected, & who has access to the data
What is included in PHI?
- Demographics
- Medical history or diagnoses
- Test results
- Medical records
- Insurance status
Types of Research Misconduct
- PLAGIARISM - using other people’s words, thoughts, or results without offering them credit through appropriate citations
- FABRICATION - making up results & reporting them
- FALSIFICATION - changing or omitting data or manipulating results or processes so that research is not truthfully presented
When should level of significance be determined? what value is generally used in health education/promotion research?
During planning stage of data analysis (before implementation begins)
0.05
What should be planned during initial planning stages of research planning? Why?
- value of significance
- Authorship - how it will be granted; order on subsequent publications
- Least publishable units
- How to present findings - whether in least publishable units OR minimal amt of information that can generate peer-reviewed publication (AKA salami publishing)
Salami Publishing
Occurs when data are published incrementally as opposed to simultaneously
- can fragment literature & compromise legitimacy of significance testing
Ethical Guidelines to consider when working with organizations
- Do no harm to client
- Keep client information private or confidential unless the client or law requests otherwise
- Avoid conflicts of interest
- Do not act in official capacity as an advocate for the client
- Do not go beyond expertise/qualifications
- Respect others
- Ensure all participation in research and data collection is voluntary
- Represent accurately potential services & outcomes to their employers
- Maintain competence in their field of practice
Lobbying
Any attempt to influence specific legislation according to federal law
- Federal, State, & organizational laws/policies affect HES ability to participate in certain types of advocacy while on “organizational time”
- Private citizens can participate in any level of advocacy or lobbying
- No resources that belong to employer can be used when acting as private citizen
What responsibilities do HES have according to Code of Ethics?
Promote, maintain, & improve individual, family, & community health
** MUST always consider actions & social policies that support and facilitate the best balance of benefits over harm for all affected parties
When is IRB required?
- when research requires human subjects
- evaluations prior to data collection
What is an IRB sometimes referred to as?
Independent ethics committee or committee that has been formally designated to approve, monitor, & review biomedical and behavioral research involving humans
IRB performs critical ________________________
oversight functions for research conducted on human subjects that are scientific, ethical, & regulatory
What type of legal issues should HES pay special attention to?
Those that affect data sharing with regard to HIPPA laws, informed consent, and confidentiality
HIPPA Privacy Rule
Conditions established regarding when protected health information may be used for research or program evaluation
** HES or researchers are permitted information with individual authorization or for limited circumstances without authorization
Steps to reduce risk of legal liability
- Ensure all informed consent procedures are implemented
- Maintain privacy of participants’ PHI
- Choose currently certified instructors to teach classes
- Ask program participants to be cleared by medical professionals before modifying their diet or engaging in strenuous activity
- Provide written guidelines for emergency medial procedures for participants
- Make sure classrooms/facilities comply with building codes and are regularly maintained
Paperwork Reduction Act
information collection review helps reduce paperwork burden & maximize information collection
Rehabilitation Act
Federal agencies are required to make websites, electronic materials, & other information technology accessible to people with disabilities
Plain Writing Act
Stipulations that federal agencies use plain language that general population/public can understand
- includes websites, printed and electronic materials, social media, etc.
Negligence
Failure to act in a careful or reasonable manner
Negligence can be the result of ____________ or ___________
OMISSION - not doing something that should have been done
COMMISSION - doing something that should NOT have been done
How to reduce likelihood of legal improprieties
- Be aware of legal liabilities
- Use only professionals or experts in areas being presented
- Require medical clearance for participation (when appropriate)
- Instruct staff not to practice outside their area of expertise
- Follow building codes and regulations
Why can’t gov’t employees advocate?
It may appear that federal or state government agency has biases
What can HES provide even if they cant advocate themselves?
- Education
- Data
- Information to local community organizing or formal advocacy efforts
Federal laws, regulations, and policies for Statutes Prohibiting Discrimination in Employment
- Civil Rights Act
- Age Discrimination in Employment Act
- American with Disabilities Act
- Rehabilitation Act
- Pregnancy Discrimination Act
- Fair Credit Reporting and Disclosure Act
- Immigration Reform and Control Act
Federal laws, regulations, and policies for Employment Rights
Family Medical Leave Act
Federal laws, regulations, and policies for Employee Benefits & Compensation
- Fair Labor Act
- Employee Retirement Standards Act
- Consolidated Omnibus Budget Reconciliation Act (COBRA)
- Federal Unemployment Compensation Act
- Equal Pay Act
- Lily Ledbetter Fair Pay Act
Health Equity
Achievement of highest level of health for everyone
Health Inequities
Differences in health due to social, economic, and/or environmental disadvantages or injustices
SDOH can lead to differences in ______________
incidence, prevalence, mortality, and burden of disease among specific groups or HEALTH DISPARITIES
Healthy People 2030 has organized SDOH into how many # of categories
5
Those who are minority and have lower incomes are more likely to be _____________________-
uninsured, face barriers to accessing care, & have higher incidence rates of diseases compared to whites and those who have higher incomes
Those with higher education have ________________ compared to lower education
lower incidence of some diseases & better health outcomes
Types of SDOH (according to Healthy People 2030)
- ECONOMIC STABILITY
- EDUCATION
- SOCIAL & COMMUNITY CONTEXT
- NEIGHBORHOOD & BUILT ENVIRONMENT
- HEALTH & HEALTH CARE
Strategies that can be used to address inequities
COLLECTION OF DATA - helps HES to understand, investigate, & spread awareness about causes of inequities
ADVOCACY can ensure creation of policies, regulations, or rules that can impact behaviors & environmental conditions
HEALTH IN ALL POLICIES - identify multi sectorial opportunities for advancing equity in all areas of social, economic, & health policies within community
COMPREHENSIVE APPROACHES - intervening at multiple levels can increase reach of program or intervention
ADDRESSING ROOT CAUSES OF HEALTH DISPARITIES - useful to address upstream issues leading to health disparities
SPECIFIC INITIATIVES - specific programming to reach group or place that is underserved (compared to community-wide or population approaches
Steps in CDC health equity checklist aimed to reduce health inequities
- Identify
- Engage
- Analyze
- Review
Theories & models are used to ________________
- Identify targets for change in health promotion effort
- Select strategies for implementation based on known influences on behavior & design interventions
- Specify potential outcomes to be monitored, measured, or compared in a program evaluation for an intervention
What are the 6 phases of MAPP?
- Organizing for success & partnership development
- Visioning: Gathering collective vision of what community should be
- Conduct 4 assessments: Community themes & strengths assessment, Local public health system assessment, Community health status assessment, Forces of change
- Identifying strategic issues: Using gathered information from assessments to discern strategic health & other issues that community must address
- Formulation of goals & strategies: specifying goals & activities in community health improvement plan
- Action cycle: Continuing with planning, implementation, & evaluation of community plan
What is the Community Themes & Strengths Assessment?
Assessment of qualitative data on how communities perceive their health & QOL
What is the Local Public Health System Assessment?
Measurement of how well public health system partners collectively offer health services through analysis of national public health performance standards
What is the Community Health Status Assessment?
Analyses of health indicators about the population
What is the Forces of Change Assessment?
Assessment of positive & negative external forces that impact health promotion
What types of models do HES need to identify when deciding what types of data need to be collected to fully understand the complex influences on health?
Planning Model & Implementation Model
How can Transtheoretical Model help HES ensure impact on health?
TTM identifies readiness for change & meets people where they are in their motivation for changing a particular behavior
What are the constructs for TTM?
- stages of change
- processes of change
- decisional balance
- self-efficacy
What are the levels of stages of change according to TTM?
- Precontemplation - no interest in addressing problem; unaware of or in denial of problem
- Contemplation - aware of problem and intends to do something in the next 6 months
- Preparation - taken steps to address problem within the next month
- Action - taken action to change behavior within past 6 months
- Maintenance - maintained behavior change for more than 6 months
- Termination - No attempt to return to old behavior
What are the major constructs of the Health Belief Model?
- Perceived Susceptibility: Risk of disease
- Perceived Severity: there are serious consequences to developing disease
- Perceived Benefits: Benefits of taking action to prevent/control disease
- Perceived Barriers: Consequences to taking action against the disease
- Cues to Action: Cues/Triggers that encourage person to take action
- Self-efficacy: Confidence in taking action against the disease
What are the assumptions of TRA/TPB?
- Behavioral intention is key in determining behavior
- Attitude toward behavior change affects outcome of whether they act
- Social/Subjective norms of important people in their life affects whether they take action
What is the main difference of TRA & TPB?
TPB adds behavioral control construct to TRA
When examining potential use of TRA/TPB, HES should examine _________________
- individual’s motivation to perform behavior
- what peers think of the behavior
- assess difficulty in performing behavior
Learning is an interaction between person, environment, cognitive processes, & behavior is based on what theory?
Social Cognitive Theory
What are the major constructs of SCT?
- Behavior capability (knowledge & skills)
- Outcome expectations
- Expectancies
- Reciprocal determinism
- Self-efficacy
What are the different types of social support?
- Tangible - offering material assistance
- Emotional - Provision of caring/comfort
- Informational - Offering advice or information
- Appraisal - Support of self evaluation/assessment
What is community organizing?
Process in which community groups identify problems or goals for change, mobilize internal & external resources, & deliver strategies to reach goals
What strategies can be used in community organizing?
Form basis of policy & organizational change
- Organizing coalitions
- Grassroots organizing
- Leadership development
- building community identity
- Legislative actions
What is the Guide to Community Preventative Services?
- Free resource to help practitioners choose programs & policies to improve health & prevent disease at the community level
- Provides information on public health interventions & policies that have been shown to be effective
What are Cochrane Reviews? What do they aim to determine?
- Provide systematic reviews of health care interventions & policy
- Determines if there is/is not conclusive evidence for recommended policy or intervention
What topics do CLAS standards cover?
- Principle standard
- Governance, Leadership, & Workforce
- Communication & Language Assistance
- Engagement, Continuous Improvement, & Accountability
Culturally & Linguistically competent HES
- Value Diversity
- Develop capacity for self-assessment
- Raise awareness of dynamics when cultures interact
- Use organizational processes to institutionalize cultural knowledge
- Strive to develop individual & organizational adaptations to diversity (i.e. materials that consider cultural attitudes, practices, & experiences)
What are benefits of getting involved with coalitions, collaborative partnerships, and other networks?
- Creating common ground & identify among interdisciplinary and/or mutli-sector partners
- Facilitating ownership and trust among collaborators & organizations
- Enhancing learning by bringing together stakeholders with varied experiences
- Building capacity & competence among members & organizations to address community issues
- Advancing public health practice initiatives through tangible partnerships with shared knowledge/experience
What are sources of Continuing Education Training?
Training Finder Real-time Affiliate Integrated Network (TRAIN), CDC learning connection, Public health learning network (PHLN), public health learning navigator, Center for Online Resources & Education (CORE)
What should HES consider when selecting potential training resources?
Learning needs to match with modalities, delivery methods, & complexity of training needed (i.e. simple, complicated, and/or complex learning)
What may be asked of HES when acting as liaison/consultant?
- Facilitate relationships across different groups
- Coordinate communication
- Enhance linkages with other agencies
- Analyze/Synthesize information about problem & interpret for stakeholders
- Assess quality & appropriateness of materials
- Develop data-driven reports that provide recommendations
What does promoting health education profession entail?
- Explaining responsibilities of HES
- Explaining history of profession
- Explaining role of professional organizations & credentialing in advancing professional practice
What is ACHA’s mission?
To advocate & offer leadership organization for college & university health
What is Publication of ACHA?
Journal of American College Health
Mission of APHA
- To be strong advocate for health education, disease prevention, & health promotion
- To set, maintain, & exemplify highest ethical principles & standards of practice
APHA publication
American Journal of Public Health (The Nation’s Health)
ASHA mission
To protect & promote health of children & youth by supporting coordinated school health programs as a foundation for school success
ASHA publication
Journal of School Health (Health in Action)
ESG mission
To foster professional competence & dedication of members in the health education profession
ESG publication
The Health Educator Eta Sigma Gamma Student Monograph
IUHPE mission
To promote global health & wellbeing & to contribute to achievement of equity in health between & within countries
IUHPE publication
Global Health Promotion
NCHEC mission
To enhance professional practice of Health Education by promoting & sustaining a credentialed body of HES
SOPHE mission
To provide leadership in facilitating & promoting initiatives to achieve national health & education goals & objectives
What does SOPHE promote?
Effective school programs & practices that involve collaboration with parents and community groups to positively impact healthy & active lifestyles
SOPHE publication
- Health Promotion
Practice, - Health Education & Behavior
- Pedagogy in Health Promotion
SSLHPE mission
To utilize advocacy, partnerships, professional development, & resources to build the capacity of school health leaders to implement effective health/physical education policies and practices
