Chapter 9 (Building A Healthy City)

Question 1

Stages of Change Model

Answer 1

1. Pre-contemplation
   - People are yet to recognize that there is a problem in their behaviour that needs to be changed
2. Contemplation stage
   - have acknowledged that there is a problem
   - not yet ready or sure of wanting to make a change
3. Preparation/Determination stage
   - people are ready to change
   - have made some initial attempts
4. Action
   - people start practicing new behaviours
5. Maintenance
   - maintain the practice of new behaivour for a period of time

Question 2

Name the Ottawa Charter of health promotion

Answer 2

1. Building healthy public policy
   - Policy directing awareness of health consequences of decisions
   - Accept their responsibility for health
2. Create supportive environments
   - Generates living/working conditions are safe, stimulating, satisfying and enjoyable
   - Conservation of natural resources worldwide should be emphasized as a global responsibility
3. Strengthen community action
   - Enhance self-help and social support
   - Promote mutual help and establish the community bonds
   - Development draws on human and material resources in communities
4. Develop personal skills
   - Providing information, education for health
   - Enhancing life skills to control health
   - Make choices conducive to maintaining health
5. Re-orientate health services
   - No longer confined as clinical treatment
   - Extended to disease prevention and health promotion
   - Promotes holistic health

Question 3

Examples for building healthy public policy

Answer 3

• Legislation
• Government financial arrangements
• Taxation
• Programs and promotions

Question 4

Examples for create supportive environments

Answer 4

• To foster a safe, fulfilling and happy living environment
• To provide community support services

Question 5

Examples for strengthen community action

Answer 5

• To enhance public participation in health matters
• Support groups for people to express feelings, concerns, experiences

Question 6

Examples for develop personal skills

Answer 6

• Provide information, health education, training of life skills, positive thinking and community integration

Question 7

Examples for re-orientate health services

Answer 7

• Encourage health professionals to participate in the promotions
• Extended to disease prevention and health promotion

Question 8

Name the 3 levels for a “healthy city”

Answer 8

1. Community level
2. Society level
3. International level

Question 9

Guiding principles for community level

Answer 9

1.Community participation
- Encourage people to voice their opinions
- actively build a healthy community

2. Health promotion
   
   • Promote healthy living environment and lifestyle
   • Enhance health education that ‘prevention is better than cure’
3. Primary health care
   
   • To strengthen the network of community clinics
   • To reduce the need of hospital care

Question 10

Guiding principles for society level

Answer 10

1. Equity in health
   
   • Equal opportunity to attain full health potential for everyone regardless of age/gender
2. Inter-sectoral collaboration
   
   • Have collaboration across government departments and service organizations
   • For better services tailored to community needs
3. Evidence-based approach
   
   • To ensure optimum use of limited resources
   • To identify and meet real demands through validation measures
   • Have proper evaluation procedures

Question 11

Guiding principles for international levels

Answer 11

1. International cooperation
   
   • Share knowledge/experiences with other healthy cities around the world

Question 12

Name the process of risk assessment

Answer 12

1. Risk assessment
2. Improve health and safety
3. Changes in the environment
4. Monitor and review

Question 13

Name some of the risks

Answer 13

• Injuries
• Poisoning
• Physical illness
• Mental illness

Question 14

Name hazards for injuries

Answer 14

1. Mechanical hazard
   
   • Contact with moving parts of machinery or equipment
2. Physical hazard
   
   • Obstacles on the ground (wet or demaged flooring)
   • Poor visibility

Question 15

Name hazards for poisoning

Answer 15

1. Chemical hazard
   
   • Hazardous chemical substances

Question 16

Name hazards for physical illness

Answer 16

1. Biological hazard
   
   • Environmental conditions allow the rapid growth of micro-organisms
2. Lifestyle hazard
   
   • Risk behaviors (smoking, alcohol addiction, drug abuse, unprotected sex, unhygienic practices)

Question 17

Name hazard for mental illness

Answer 17

1. Stress hazard
   
   • Related to life events (work pressure, depression, etc)

Question 18

Consequences for injuries

Answer 18

1. Mechanical hazard
   
   • Cuts
   • Bruises
   • Punctured skin
   • Crushed limps
   • Amputation
   • Fatality
2. Physical hazard
   
   • Slips
   • Trips
   • Falls

Question 19

Consequences of poisoning

Answer 19

1. Chemical hazard
   
   • Skin or eye irritation
   • Respiratory problems (asthma, lung cancer)
   • Poisonings
   • Long term health problems (e.g. cancer)

Question 20

Consequences for physical illness

Answer 20

1. Biological hazard
   
   • Infectious diseases (bacteria, viruses, fungi or parasites)
2. Lifestyle hazard
   
   • Infectious and non infectious diseases (heart attacks, stroke, cancers, asthma, diabetes, cardiovascular diseases)

Question 21

Consequences for mental illness

Answer 21

1. Stress hazard
   
   • Insomnia
   • Depression
   • High blood pressure

Question 22

Name the risk management

Answer 22

1. Empowerment
   
   • Provide more occupational safety information
   • Provide informative nutritional labeling
   • Empowerment to deal with lifestyle hazard
2. Precautions
   
   • Individual level (wearing surgical masks, washing hands)
   • community level (attending prevention courses, reiterating government guidelines)
3. Monitoring
   
   • Controlling the hazardous exposure
   • Putting in-place measures
   • Like no smoking indoors etc

Question 23

Name the health belief model

Answer 23

1. Individual perceptions
2. Modifying factors
3. Likelihood of action

Question 24

What is individual perceptions

Answer 24

The higher perceive of threat, the more willing to take action

    1. Perceived severity 
      - Individuals assessment on severity of failure to treat the disease 
      - Including clinical consequences 
      - possible social consequences 

    2. Perceived susceptibility 
      - Individuals subjective assessment on risk of contracting a disease

Question 25

What is modifying factors

Answer 25

To feel more threatened by disease and trigger preventive action

  - demographic (age, gender)
  - cues to action (doctors advice, education, media information, symptoms, family)
  - socio-psychological (personality, social class)
  - structural factors (knowledge of disease, prior exposure to disease)

Question 26

What is likelihood of action

Answer 26

If “perceived benefit” outweighs “perceived barriers”, individuals will take action to prevent diseases

 1. Perceived benefits 
     - Individuals assessment on vaccination in reducing the threat of diseases

 2. Perceived barriers 
      Individuals assessment on the potential 
      - Negative impact of vaccination 
      - Risk (side effects)
      - Unpleasurable action(pain, distress)
      - Time-consuming 
      - Cost

Question 27

Types of bullying

Answer 27

• Physical assault
• Verbal harassment
• Exclusion from social situation
• Coercion