Exam 2

Question 1

Not a science, but an art of consensus building
The process of people coming together to:
• Identify common problems or goals
• Mobilize resources
• Develop and implement community intervention programs/ strategies for reaching the goals they have collectively set

Answer 1

Community organizing/ building:

Question 2

“a process in which an intervention is planned to help meet the needs of a specific groups of people”
• The process of enabling people to increase control over their health and its determinants, and thereby improve their health
• It may take a community organizing/building effort to be able to plan such an intervention.

Answer 2

Program planning:

Question 3

“any planned combination of educational, political, environmental, regulatory, or organizational mechanisms that designed to benefit and protect individual’s health and quality of life by addressing and preventing the root causes of illness”

• Much more encompassing term than health education

Answer 3

Health promotion

Question 4

Refers to an individual who recognizes that a problem exists in a community and decides to do something about it
• First recognize a problem in the community
• Get things started
• Can be from within or outside of the community

Answer 4

Initial organizer

Question 5

those who are already interested in the problem solving, best to organize them first e.g. law enforcement personnel, former victims of violence and their families, public health officials

Answer 5

Executive participant:

Question 6

Trial run – implementation to a small group, determine problems and fix before full implementation

Answer 6

Pilot study/test

Question 7

Refers to a step-by-step implementation with small group
• Example- Instead of initiating one big intervention for all, planners could divide the priority population by residence location (e.g., south side of town first)

Answer 7

Phasing in

Question 8

relationships and structures within a community that promote cooperation for mutual benefits (e.g social trust or norms)

Answer 8

Social capital

Question 9

ability of communities (organized action of people) to come together to make changes

Answer 9

Community competence

Question 10

enabling process through which individuals (individual empowerment) or communities (collective empowerment) take control of their lives and their environment

Answer 10

Empowerment

Question 11

determine the needs and wants of the priority population - The assessment is focused on the needs of the community (e.g., traditional needs assesment.) Problem-based perspective

Answer 11

Needs assessment

Question 12

Struggling or having a challenge with mental well-being

Answer 12

Mental disorder:

Question 13

Health (medical)conditions characterized by alterations in thinking, mood, or behavior associated with distress and/or impaired functioning (e.g. diabetes = a disorder of the pancreas)
• Refers collectively all diagnosable mental disorders
• Many people with mental illness can be treated successfully with medications and are thus able to live successfully in our community

Answer 13

Mental illness:

Question 14

Emotional and social well-being; “State of successful performance of mental function”

Answer 14

Mental health

Question 15

can be expressed as emotional maturity
• Adults with good mental health are able to:
o Function under adversity
o Adapt to changes around them
o Maintain control over their tension and anxiety
o Find more satisfaction in giving than receiving
o Show consideration for others
o Curb hate and guilt
o Love others

Answer 15

Good mental health

Question 16

1. Determining the purpose and scope of the needs assessment
   • What is the goal of the needs assessment?
   • What do the planners hope to gain from the needs assessment?
   • How extensive will the assessment be?
   • What kind of resources will be available to conduct the needs assessment
2. Gathering data
   • Primary data – those that are collected specifically for use in this process (e.g., conducting a questionnaire about their health behavior)
   • Secondary data – data that have already been collected for some other purposes (e.g., health insurance claims records, HNANES, BRFSS, etc.)
3. Analyzing the data
   • Formal analysis – some type of statistical analysis assuming that the appropriate statistical criteria have been met
   • Informal analysis – referred to as “eyeballing the data”; look for the obvious differences in the health status or conditions
4. Identifying risk factors linked to health problem
   • Need to identify and prioritize the risk factors (e.g., health behaviors and environments) that are associated with the health problem (e.g., smoking cigarettes, physical inactivity, alcohol intake, obesity, diabetes, etc., for heart disease)
5. Identifying program focus
   Need to identify those predisposing, enabling, and reinforcing factors that seem to have a direct impact of the targeted risk factors
   Predisposing factors – provide motivation and rationale for the behavior including knowledge, attitudes, beliefs, personal preferences, etc.
   Enabling factors – refer to pre-existing conditions that allow a motivation to be realized including availability of resources, accessibility of services, government laws, policies, etc.
   Reinforcing factors – refer to continuing reward/incentive or the influence of significant others to encourage the behavior
6. Validating the prioritized need
   • Double-check or confirm that the identified need are fully addressed in the priority population

Answer 16

Understand the six-step approach for a needs assessment:

Question 17

• Goal – “a future event toward which a committed endeavor is directed”
o Provide overall direction for the program
o Are more general in nature
o Do not have a specific deadline
o Usually take longer to complete
o Include two basic components – who will be affected and what will be changed because of the program
Examples
1. To reduce the number of teenage pregnancies in the community
2. To help cardiac patients and their families deal with the lifestyle changes that occur after a heart attack
3. To improve student’s health, fitness, and quality of life through daily physical activity.

Objectives – “the steps taken in pursuit of a goal”
• More precise/specific than goals
• Steps to achieve the program goals
• The more complex a program, the more objectives needed
• Composed of who, what, when, and how much
• Examples
o During a telephone interview, 35% of the residents will report having had their blood cholesterol checked in the last six months
o By 2020,the proportion of adults who meet the current government physical activity guidelines will be increased by 55% (currently from 48%)
o By the end of this semester, when asked in class, 80% of the students will be able to differentiate between goals and objectives

Answer 17

Understand goals and objectives

Question 18

• Formal analysis – some type of statistical analysis assuming that the appropriate statistical criteria have been met
• Informal analysis – referred to as “eyeballing the data”; look for the obvious differences in the health status or conditions

Answer 18

Understand the types of evaluation of program results

Question 19

1. Problems must be able to solved
2. Must be simple and specific
3. Must unite members of organizing group
4. Should affect many people
5. Should be part of larger plan

Answer 19

What are the criteria that should be considered when prioritizing identified community problems?

Question 20

1. Recognizing the Issue
2. Gaining Entry into the Community
3. Organizing the People
4. Assessing the Community
5. Determining the Priorities and Setting Goals
6. Arriving at a Solution and Selecting Intervention Strategies

Answer 20

Understand the process of community organizing/building:

Question 21

1. Biology/ Genetics
2. Individual/ Behavior
3. Social environment
4. Living/ Working conditions
5. Physical environment

Answer 21

Understand the determinants of health:

Question 22

• Health disparities are differences in the burden of disease, injury, violence, or opportunities to achieve optional health that are experienced by socially disadvantaged populations..”
• Health Inequality are differences (e.g., unequal or uneven) in health status or in the distribution or opportunity of health determinants between different population groups
• Health Inequity unfairly addressing avoidable inequalities in health between groups of people within countries and between countries

Answer 22

Understand the differences between health disparity/ health inequity/ health inequality

Question 23

• Poverty
• Environmental threats
• Inadequate access to health care
• Individual and behavioral factors
• Education inequalities

Answer 23

What are the factors causing health disparities?

Question 24

o Socioeconomic status (SES) considered the most influential single contributor to premature morbidity and mortality
• Association between SES and race/ethnicity is complicated and cannot fully explain all disparity

Answer 24

What are the influences of SES to the community health?

Question 25

Goal to eliminate disparities among racial and ethnic minority populations in six areas of health while maintaining progress of overall health of American people
• Infant mortality:
o Serious disparity in U.S. among racial and ethnic minorities
o Black Americans infant death rate more than two times that of white Americans
o Lack of prenatal care and low-birth-weight babies
• Cancer screening and management:
o Incidence and death rates highest among black Americans for various types of cancer
 Many disparities attributed to lifestyle factors, late diagnosis, access to health care
o Less primary and secondary prevention in various minority groups
• Cardiovascular disease:
o Death rates vary widely among racial and ethnic groups
 Black Americans have higher rates from CHD and stroke
o Hypertension prevalence as a risk factor varies according to race/ethnicity
 Black Americans tend to develop hypertension earlier in life than whites; unknown reason
• Diabetes:
o Overall prevalence has risen in U.S. in recent years
 Prevalence in those 20 and older varies in minority groups
 Increase in age-adjusted death rates in all racial and ethnic groups
• Significantly higher in minority groups
• HIV/AIDS:
o Proportional distribution of AIDS cases has increased in Black Americans and Hispanics and decreased in white Americans
o Attributed to higher prevalence of unsafe or risky health behaviors, and lack of access to health care to provide early diagnosis and treatment
• Adult and child immunization:
o Early childhood immunizations do not vary significantly by race or ethnicity
o Older adult immunization rates are substantially lower in minority groups, even though an overall increase has occurred

Answer 25

Understand racial health disparities

Question 26

•	Mental illness can occur when  the brain (or part of the brain) is not working well or is working in the wrong way
•	Inherited traits
•	Negative life experiences (traumatic)
•	Environmental exposures before birth
o	Viruses, toxins, alcohol or drugs
•	Brain chemistry
o	Hormonal imbalances

Answer 26

Determine the causes of mental illness:

Question 27

o Depression:
o is the most common (e.g., more than 3 million US cases per year)but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working
o Obsessive/Compulsive Disorder (OCD):
o OCD is a common (e.g., more than 200,000 US cases per year), chronic and long-lasting disorder in which a person has uncontrollable, repetitive thoughts (obsessions) and behaviors (compulsions)
o Schizophrenia:
o A condition of losing touch with reality accompanied by reduced ability to function (aka: Split Mind)
o Loses abilities to distinguish fantasy from reality
o Signs of tissue shrinkage in brain
o Early psychological trauma:
o violence, sexual abuse, death, divorce, or other stressors of childhood
o 1.2% of Americans (3.2 million) have the disorder
o Social Anxiety Disorder (SAD):
o The 4th most common mental health condition (about 1 in 8 people (12.1%) have suffered from SAD at some time in their life
o It is an intense, persistent fear of being watched and judged by others
o This fear is more than just shyness and can affect work, school, and your other day-to-day activities
o Attention Deficit Hyperactivity Disorder (ADHD):
o 6.4 million children (11% of age group 4-17 years) have ever been diagnosed in U.S.
o Combination of problems such as inattention, hyperactivity, and impulsive behavior
o Chronic interference in more than 1 setting
o Home life, school work, sports/activities
o Addiction:
o An overwhelming desire to continue taking the drug that leads to bodily harm, social maladjustment, or economic hardship
o Approximately 20.6 million people in the U.S over the age of 12
o 100 people die every day from drug overdoses
o 6.8 million people with addiction have a mental illness
o Anorexia Nervosa:
o A disorder in which the irrational fear for becoming obese results in severe weight loss from self-imposed starvation
o The cause is not known, but there appear to be some genetic components and/or cultural factors
o 7 million women and 1 million men and children suffer with an eating disorder. Up to 22% will die!
o Post Traumatic Stress Disorder (PTSD):
o Mental health condition that is triggered by a traumatic event – either experiencing it or witnessing it
o The traumatic events causing PTSD can include:
o Military combat
o Accident
o Rape
o Assault
o Torture
o Sever burns
o Etc.
o 7.8% in the general population (women (10.4%) were more than twice as likely as men (5%) to have PTSD)

Answer 27

Understand common types of mental disorders:

Question 28

• Thinking
• Perception
• Emotion
• Signaling Physical Behavior
• SYMPTOMS CAN INCLUDE THINKING/FOCUSING PROBLEMS, EXTREME EMOTIONAL HIGHS AND LOWS, SLEEP PROBLEMS

Answer 28

Understand the body functions that will be disrupted by mental illness:

Question 29

• Primary – reduces incidence of mental illness and related problems (e.g., meditation, exercise, relaxation, etc.)
• Secondary – reduces prevalence by shortening duration of episodes (e.g., stress reduction, therapies, social supports, etc.)
• Tertiary – treatment and rehabilitation (e.g., medication, counseling, etc.)

Answer 29

What are the primary, secondary, and tertiary prevention for mental disorders?