Lecture 1: Introduction to Health Improvement

Question 1

Give the 8 steps of the Nuffield Ladder in order of increasing levels of interventions:

Answer 1

1) do nothing and monitor the situation

2) provide information

3) enable choice to make change

4) guide people through changing the default

5) guide people through incentives

6) guide people through disinscentives

7) restrict choice

8) eliminate choice

Question 2

What is the Nuffield Ladder?

Answer 2

a model that describes intervention types from least to most intrusive on personal choice

Question 3

What are the four features of health improvement?

Answer 3

1) action aimed at improving health

2) prevention of clinical conditions

3) mitigation of impact

4) reducing inequalities

Question 4

What is the relative contribution of genes and biology to population health?

Answer 4

10%

Question 5

What is the relative contribution of physical environment to population health?

Answer 5

10%

Question 6

What is the relative contribution of clinical care to population health?

Answer 6

10%

Question 7

What is the relative contribution of health behaviours to population health?

Answer 7

30%

Question 8

What is the relative contribution of health behaviours to social and economic factors?

Answer 8

40%

Question 9

Give the definition of health improvement:

Answer 9

the action on modifiable causes of disease to prevent and mitigate unwell people

Question 10

Give two types of health improvement approaches:

Answer 10

1) high risk approaches

2) population approaches

Question 11

What are high risk approaches to health improvement?

Answer 11

identifying and acting on the ‘top end’ of the population distribution via screening and by targeting preventative measures

Question 12

What are population approaches to health improvement?

Answer 12

identifying important risk factors for the entire community using policy irrespective of individual risk, shifting the mean of the entire population distribution

Question 13

Give the high risk prevention paradox:

Answer 13

a large number of people at small risk may give rise to more cases of disease than a small number of people at high risk

Question 14

What is the COM-B model used for?

Answer 14

gaining insight into the components involved in changing behaviours

Question 15

What are the three components of the COM-B model?

Answer 15

1) capability

2) opportunity

3) motivation

Question 16

What does ‘capacity’ refer to in the COM-B model?

Answer 16

whether we have the knowledge, skills and abilities required to engage in a particular behaviour

Question 17

What subcategories is ‘capacity’ split into in the COM-B model?

Answer 17

1) psychological

2) physical

Question 18

What does ‘opportunity’ refer to in the COM-B model?

Answer 18

the external factors which make the execution of a particular behaviour possible

Question 19

What subcategories is ‘opportunity’ split into in the COM-B model?

Answer 19

1) physical

2) social

Question 20

What does ‘motivation’ refer to in the COM-B model?

Answer 20

the internal processes which influence our behaviours

Question 21

What subcategories is ‘motivation’ split into in the COM-B model?

Answer 21

1) automatic

2) reflective

Question 22

What is reflective motivation?

Answer 22

making plans and evaluating things that have happened

Question 23

What is automatic motivation?

Answer 23

desires, impulses and inhibition