Final Exam Flashcards
Social Ecological Model
Intrapersonal –> Interpersonal –> Community level (institution & community factors)
Health Belief Model
Perceived susceptibility –> Perceived severity –> Perceived benefits –> Perceived barriers
Social Cognitive Theory
Personal Behavior Environmental all interact together
Reciprocal determinism
Behavior results from the interaction and influence of the three factors of the Social Cognitive Theory
Theory of Reasoned Action
Assumes that people are rational and behavior is under our voluntary control; Intention to act is the strongest determinant of behavior
Theory of Planned Behavior
A person’s intention is greater if they perceive they have greater control; Focus on beliefs that affect intention through altering attitudes
Transtheoretical Model
Precontemplation –> Contemplation –> Preparation/Determination –> Action –> Maintenance –> Termination
High self-efficacy
Individual has strong belief that they can complete a task
Low self-efficacy
Individual has not strong belief that they can complete a task
DNA Linkage
Study how DNA markers and disease move together through families
DNA Association
Study how DNA markers and disease move together through a population study of unrelated individuals with disease vs/ matched controls
Adoption studies
Compare risk in adoptees and biologic vs. adoptive parents
Genotype Scoring (for addiction)
Can predict ability to quit a substance
DNA Methylation
The repression of certain parts of the genetic sequence
Epigenetics
Our experiences/environment can change our DNA by switching on and off genes that influence health behaviors
High Patient; High Physician
Mutuality
High Patient; Low Physician
Consumerism
Low Patient; High Physician
Paternalism
Low Patient; Low Physician
Default
Male calories required to maintain weight
~2400
Female calories required to maintain weight
~1800
Calorie deficit to loose weight
500 cal. daily
METS
Physical activity spectrum (kcal/g)
Moderate intensity activity
3-6 METS
Vigorous intensity activity
6+ METS
Agonist Substance
Substance that initiates a physiological response when combined with a receptor
Antagonist Substance
Substance that interferes with or inhibits physiological action of another
Delay discounting
Preference for a smaller reward now rather than a large one later
CAGE screening
Did you ever feel you had to cut down?
Did you ever feel annoyed?
Did you ever feel guilty about behavior?
Did you ever need a drink as an eye-opener?
eHealth
Intersection of medical informatics, public health, and business
Consumer Health Informatics
Any electronic tool, technology, or application that is designed to interact with consumers without the presence of a healthcare professional and provides health information
Consumer Clinician
Empowers consumer to make more individually informed health decisions
Self-monitering
Ask the individual to “track” the behavior they wish to change
SMART goals
Specific Measurable Actionable Relavent Time-sensitive
Stimulus Control
Identify stimuli that the person associates with the behavior and make a plan to manage them
Cognitive Restructuring
Identify negative self-talk, thought stopping, and though replacing
Motivational Interviewing
Focus on exploring and resolving ambivalence though collaboration and evocation
Weight Classification: Underweight
<18.5
Weight Classification: Normal range
18.5 - 24.9
Weight Classification: Pre-obese (overweight)
25 - 29.9
Weight Classification: Obese class I (mild)
30 - 34.9
Weight Classification: Obese class II (moderate)
35 - 39.9
Weight Classification: Obese class III (morbid/severe/extreme)
> 40
Obesity comorbidities
CHD, diabetes, cancer, hypertension
Metabolic Syndrome
Group of risk factors that occur together and increase the risk for CHD, stroke, and type 2 diabetes
Urban health
Health of densely populated areas
Faith Based Organizations
Health programs designed, connected, or supported by groups affiliated or based in a nonsecular setting
Health-Smart Church Program
Goal to increase health promoting behaviors among at risk African-American women and their families
Health Empowerment Coaches
Serve as role models to provide support in FBO
Polygenetic phenomenon
Several genes controlling one trait (ex. obesity, addiction, mood)
Taq1 A1 Allele significance
Major candidate gene that regulates dopamine neurochemistry and is associated with obesity and compulsive overeating; Associated with decreased dopamine D2 receptors
Eating high fat, high sugar foods stimulates dopamine in the _______ in a way similar to taking illicit drugs
Striatum
YALE food addiction scale
Identifies those most likely to exhibit markers of substance dependence with the consumption of high fat, high sugar foods
Needs Planning
Initial process to understand the health behavior and its influences
Environmental Imperative
Social environments can reinforce positive behavior and punish negative behavior
Goals
Broad statements of direction
Objectives
Precise statements of intended targets of change that are specified in measurable terms
Precede framework
Predisposing, reinforcing, and enabling constructs in diagnosis and evaluation
Proceed framework
Policy, regulatory, and organizational constructs in development
Social assessment
Define health behaviors and consider how they affect long-term desired outcomes
Epidemiological assessment
Data gathering step on health behavior
Educational and ecological assessment
Identifies factors that have the potential to influence health behavior change
Administrative and policy assessment
Aligns appropriate intervention strategies to address targeted goals and objectives
Outcome evaluation
End result of the program and is generally measured by improvements in overall morbidity
Binge drinking
5 or more drinks in 2 hours for men
4 or more drinks in 2 hours for women
Heavy drinking
15 or more drinks per week for men
8 or more drinks per week for women
AUDIT scoring system
Developed by the WHO and is valid across cultures and genders
AUDIT Zone I
(0-7) –> Alcohol education
AUDIT Zone II
(8-15) –> Simple advice
AUDIT Zone III
(16-19) –> Advice and counseling
AUDIT Zone IV
(20-40) –> Referral to specialist
Segregation
Refers to the compositional and spatial distribution of two or more groups among a given geographical area
1890 - 1940 Segregation
Result of large scale migration from the south to urban areas in the northeast
1940 - 1970 Segregation
Continued migration towards the north;
Defined by collective action racism through housing discrimination
1970 - present Segregation
Segregation has coined modestly;
Poor black families have become isolated in resource poor areas
Risk exposure theory for segregation
Segregation creates race differences in the health risk profiles of communities in which minorities often live;
Leads to greater exposure to toxins, target availability of hazardous products; high crime
Resource deprivation theory for segregation
Segregation creates differential access to health-supporting services
Anorexia Nervosa
Restriction of energy intake relative to requirements
Bulimia Nervosa
Recurrent episodes of binge eating and inappropriate compensatory behaviors
Binge-Eating Disorder
Recurrent episodes of binge eating
Avoidant/Restrictive Food Intake Disorder
Eating or feeding disturbance manifested by persistent failure to meet appropriate nutritional or energy needs
Predisposing factors for an eating disorder
Genetics, personality
Precipitating factors for an eating disorder
Life stressors, sociocultural
Perpetuation factors for an eating disorder
Habit, physiology, reward
Levels of treatment for an eating disorder
Outpatient –> Intensive outpatient –> Partial hospitalization –> Residential treatment center –> Inpatient hospitalization
Seropositivity
AIDS test which shows the antibody has been present in the blood
2015 NHAS AIDS goal
Lower the annual number of new infections by 25%
Proposed 2020 HIV/AIDS goals
Reduce HIV incidence by at least 45% Reduce transmission rate by at least 20% Increase access to care Reduce HIV-related disparities Achieve a more coordinated national response
5 Tier Framework for Public Health Interventions
Socioeconomic factors (bottom tier) Changing the context of to make default decisions healthy Long-lasting protective interventions Clinical interventions Counseling and education (top tier)
Structural Intervention
Interventions that change behavior by changing conditions beyond individual control such as the social and physical environments
When to use structural intervention
If the behavior falls within two standard deviations of the mean, it is a “common behavior” and deserves a structural intervention
Geoffrey Rose
Determinants of individual cases of disease vs. determinants of the cause of disease incidence
High Risk Strategy - Rose
Target most at risk but don’t address incidence
Population Strategy - Rose
Control determinants of incidence in the population
Prevention Paradox
A preventative measure which brings much benefit to the population offers little to each participating individual
Nancy Milio
To support health promoting choices, broaden the range of options and make health-promoting choices easier and/or make health-damaging options more difficult
Rudolf Virchow
Medicine as a social science has the obligation to point out problems and attempt their theoretical solution
Policy instruments
The methods used y decision making bodies to achieve a desired effect
Policy process
Problem identification –> Policy formulation –> Policy adoption –> Policy implementation –> Policy evaluation
John W. Kingdon
Multiple streams model
Multiple Streams Model
Problem stream, policy stream, and political stream must converge in time in order to get the political attention to sue an available solution to solve an existing problem
Policy window
Policy windows open when the multiple streams converge
