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Foundations of Public Health > Ch. 2: Evidence-Based Public Health > Flashcards

Ch. 2: Evidence-Based Public Health Flashcards

1
Q

5 Basic Questions / P.E.R.I.E Process

A
  1. Problem: What is the health problem?
  2. Etiology: What is/are the contributory causes?
  3. Recommendations: What works to reduce the health impacts?
  4. Implementation: How can we get the job done?
  5. Evaluation: How well does/do the intervention(s) work in practice?
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2
Q

The P.E.R.I.E approach is what?

A

circular

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3
Q

If evaluation suggests that more needs to be done, the cycle what

A

repeat

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4
Q

occurrence of disability and death due to disease

A

Burden of disease

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5
Q

frequency of disability/symptoms

A

Morbidity

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6
Q

frequency of deaths

A

Mortality

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7
Q

how often the disease occurs, how likely it is to be present, and what happens once it occurs

A

Course of disease

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8
Q

Who gets the disease? Where are they located? When does the disease occur?

A

Distribution of disease

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9
Q

What percentage of individuals have the disease at a specific time point?

A

Prevalence

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10
Q

what is the calculation for Prevalence

A

of people living with the disease /
total # of people in the population

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11
Q

In 2020 how many of the us population contract Covid

A

33%

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12
Q

what is this an example of

In 2020 how many of the us population contract Covid

A

Prevalence

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13
Q

How many new cases developed during a specific time period?

A

Incidence

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14
Q

how to calculate incidence

A

𝑜𝑓 𝑝𝑒𝑜𝑝𝑙𝑒 𝑖𝑛 𝑡h𝑒 𝑎𝑡 𝑟𝑖𝑠𝑘 𝑝𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛

new cases of disease /
# of people in the at risk population

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15
Q

what is this an example of

From 2019 to 2021 there were 114,044 deaths due to COVID-19 with nearly 1 in 4 U.S. adults and older teens who had still not contracted COVID-19 the end 2022

A

Incidence

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16
Q

Chances of dying from the disease

A

Case-Fatality Rate
or
Case-Fatality Risk
or
Case-Fatality Ratio

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17
Q

how to calculate Case-Fatality Rate

A

of cases of disease

of deaths /
# of cases of diseases

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18
Q

what is this an example of

among a total of 200 patients with disease A, 20 of them died from the
disease within 30 days; the 30-day case fatality rate = 20/200 * 100 = 10%.

A

Case-Fatality Rate

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19
Q

When pregnant women drink alcohol what happens?

A

preterm labor of birth defects

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20
Q

Three reasons why changes in disease rates may be artifactual rather than real:

A
  1. Differences in the interest in identifying the disease
  2. Differences in the ability to identify the disease
  3. Differences in the definition of the disease
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21
Q

investigate factors known as “person” and “place” to find patterns or associations in the frequency of a disease

A

Epidemiologists

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22
Q

take a scientific approach to addressing public health issues

A

Epidemiologists

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23
Q

what does Descriptive Epidemiology look at

A

Person: demographic characteristics such as age, gender, race, socioeconomic factors, behaviors, and exposures

Place: geographic location or other non-physical connections

Time: disease onset, disease duration, time of exposure, length of exposure, time of day, year, season

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24
Q

A characteristic of individuals or an exposure that increases the probability of developing a disease

Does not imply that a contributory cause has been established

A

Risk Factor

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25
Q

is associated with the “effect” at the individual level

A

“Cause”

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26
Q

occur more frequently at the
individual level than would be expected by chance

A

The potential “cause” and the potential “effect”

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27
Q

The “cause” precedes the what in time

A

“effect”

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28
Q

Altering the “cause” alters the “effect”

A
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29
Q

a third variable/factor that distorts the association between exposure and outcome

A

Confounder

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30
Q

Individuals are selected to be in the study based on disease status

A

Case-Control Study

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31
Q

those with the disease

A

Cases

32
Q

those without the disease

A

Controls

33
Q

Asked about their past exposures

A

retrospective analysis

34
Q

case-control study are Useful for establishing

A

individual association

35
Q

Individuals are disease-free at the start of the study and identified by their exposure status (exposed or unexposed) and followed over time to determine the probability of developing the disease

A

Cohort Study

36
Q

Most useful for determining that the “cause” precedes the “effect”

A

Cohort Study

37
Q

Randomization

  • Individuals are randomly assigned to an exposed or nonexposed “cause”
  • Altering or removing the “cause” alters the “effect”

*(intervention works)

  • Ethical issues e.g., cannot assign non-smoking individuals to a smoking group
A

Randomized Controlled Trials (RCTs)

38
Q

individuals are randomly assigned to an intervention (treatment) or control group

A

Randomization

39
Q

intervention works

A

efficacy

40
Q
  • Population comparison study
  • Group association
  • Hypothesis generating
A

Ecological studies

41
Q

Requirement for Case-control studies

A

Individual association

42
Q

Requirement for Cohort Studies

A

“Cause” precedes “effect”

43
Q

Requirement for Randomized controlled trials or natural experiments

A

Altering the “cause” alters the “effect”

44
Q

refers to the degree to which action(s) produce a clinically measurable effect under ideal conditions

A

efficacy

45
Q

refers to the degree to which actions achieves the intended health result under normal or usual circumstances

A

effectiveness

46
Q

-refers to how the vaccine performs in ideal conditions

-controlled clinical trials

A

vaccine efficacy

47
Q

refers to how the vaccine performs in the wider populations

A

vaccine effectiveness

48
Q

How closely related the risk factor is to the disease

A

Strength of Association

49
Q

Higher levels of exposure and/or longer duration of exposure to the “cause” are associated with increased probability of the “effect”

A

Dose-Response Relationship

50
Q

Studies at the individual level produce similar results in multiple locations among populations of varying socioeconomic and cultural backgrounds

A

Consistency of the Relationship

51
Q

Known biological mechanisms can convincingly explain a cause-and- effect relationship

A

Biological Plausibility

52
Q

an increased of something because of the same thing

A

Strength of Association

53
Q

The average smoker has more than what the probability of developing lung cancer compared to nonsmokers

A

10 times

54
Q

Used to measure strength of an association between an exposure and a disease

A

Relative Risk (Strength of Association)

55
Q

how to calculate Relative Risk (Strength of Association)

A

probability of disease among those with exposure/

probability of disease among those without the exposure

56
Q

Evidence-Based Recommendations

A

Quality of Evidence
Magnitude of Impact

57
Q

scoring recommendations

A
58
Q

Smoking examples of grades A or B (strong evidence and magnitude of impact)

A
  • Clean Indoor Air legislation: prohibits smoking in indoor public places
  • Federal and State tax increases on tobacco products
  • Long-term high-intensity mass media campaigns
  • Reminders for health providers to reinforce importance of smoking cessation
  • Reducing tobacco availability to youth
59
Q

When-Who-How Approach

A

Intervention Implementation

60
Q

When?

A

Primary Interventions:
Secondary Interventions
Tertiary Interventions:

61
Q
  • before the onset of disease
  • avoid development of a disease
  • remove risk factor
A

Primary Interventions

62
Q
  • after initial detection of disease but before symptoms
  • early detection treatment
  • prevent progression
A

Secondary Interventions

63
Q
  • after development of disease, but before irreversible disability
  • reduce complications of established disease
A

Tertiary Interventions:

64
Q

Who?

A
  • To whom should we direct the intervention?
  • Should it be directed at individuals one at a time as part of clinical care?
  • Should it be directed at groups of people, such as vulnerable populations?
  • Should it be directed to everyone in the community or population (improving the average approach)?
65
Q

How?

A
  • Information = Education
  • Motivation = Incentives
  • Obligation = Requirements
66
Q

Efforts to communicate information and change behavior on basis of
information

A

Information = Education

67
Q

Rewards to encourage or discourage behavior without legal requirement

A

Motivation = Incentives

68
Q

Required by law or institutional sanction

A

Obligation = Requirements

69
Q

How do we evaluate an intervention’s results

A

The RE-AIM framework is increasingly being used to evaluate how well specific interventions work and are accepted in practice

70
Q

RE-AIM Approach

A

Reach
Effectiveness
Adoption
Implementation
Maintenance

71
Q

Who is the intervention being offered to in practice

A

Reach

72
Q

What is the impact in practice on the intended or target population?

A

Effectiveness

73
Q

How well is the intervention accepted by individuals and providers?

A

Adoption

74
Q

How should the intervention be modified to reach the target population and providers?

A

Implementation

75
Q

How can we ensure the long-term continuation of use and success of the intervention?

A

Maintenance

Foundations of Public Health (9 decks)

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