Disease Prevention Levels and Strategies

Question 1

what is an exmaple of primordial prevention?

Answer 1

aims to minimize future hazards to health, inhibit the establishment of factors known to increase risk

(environmental, economic, social, behavioural, cultural).

Question 2

What is secondary prevention?

Answer 2

Secondary prevention aims at

early diagnosis and treatment in its

early stages before it results in morbidity

(e.g. screening, medication for osteoporosis), or to prevent recurrence (e.g. treatment to reduce risk of recurrence of a heart attack)

Question 3

what is tertiary prevention?

Answer 3

Tertiary prevention aims to reduce the negative impact of existing disease and reduce complications (e.g. blindness from diabetes, rehabilitation after spinal injury or amputation

Question 4

What kind of prevention is the following example?

“Fluoridination of water?”

Answer 4

Primary prevention to prevent tooth decay

Question 5

What is primary prevention

Answer 5

Primary prevention aims at lowering the occurrence of disease (i.e. preventing new cases of disease, e.g. immunisation)

Question 6

describe the differeneces between individual level, environmental and societal level prevention programs

Answer 6

ACTIONS Reducing childhood poisoning

Individual level: Education and public awareness

Environmental level: Development of childproof containers e.g. for medicines, household cleaners

Societal level: Legal requirement for childproof packaging of medicines

Question 7

give examples of passive/active strategies at prevention

Answer 7

Question 8

what is the differnece betwen passive and active interventions?

Answer 8

passive= protect everyone, require little or no cooperation or action on part of individuals

active = interventions that require individual action for the intervention to be effective

Question 9

what is the rationale for population strategy?

Answer 9

• The higher the level of cholesterol or of blood pressure or of the total estimated risk, the higher the risk of an event
• Only a small proportion of the population are in highest risk group. Treating them is important clinically but will make little impact on population burden of disease
• Each individual benefits to small extent but adds to large benefit for the population

Analogy of larger profits in high turnover, fast food restaurant vs. expensive restaurant – latter has larger profit / customer but fewer clients, so lower total profit

Question 10

what are the advantages and disadvantages for using primary prevention and a population strategy?

Answer 10

Advantages

• Radical
• Large potential for population
• Behaviourally appropriate

Disadvantages

• Small benefits to individuals
• Poor motivation of subject & of health professionals

Question 11

what are the advantages and disadvantages of using a high risk strategey and primary prevention?

Answer 11

Advantages

• Tailored to the individual, with high professional & patient motivation
• Benefit-to-risk ratio is favourable i.e. potential for benefit outweighs risk of adverse events

Disadvantages

• High screening costs to identify those at high risk
• Effects are temporary and limited

Behaviourally inappropriate i.e. the person is asked to behave differently to most people in that society

Question 12

which levels of prevention contribute the most to health and wellbeing of the whole population?

Answer 12

primordial and primary prevention

Question 13

What type of prevention is the following example?

“detection and treatment of blood pressure”

Answer 13

secondary prevention -