Lecture 3: Thinking population vs. individuals

Question 1

What are the 3 levels of prevention to protect and promote health

Answer 1

1. Primary prevention
2. Secondary prevention
3. Tertiary prevention

Question 2

What is primary prevention

Answer 2

The maintenance of health through individual or community efforts so that the disease process never starts.
- Focus on prevention

Question 3

What is secondary prevention

Answer 3

• Focus on the reduction in expression and severity of disease
• Focus on individuals with the disease but are not presenting the signs and symptoms.
• Early detection will lead to prompt and effective inventions that will improve survival

Question 4

What is tertiary prevention

Answer 4

• Focus on slowing or blocking the progression of disease
• Focus on helping to manage the disease
• Reduces impairments and disabilities to improve quality of life and survival

Question 5

What is an example of primary prevention

Answer 5

Constructing bike lanes downtown to promote cycling among adults

Question 6

What is an example of secondary prevention

Answer 6

Mammography screening of all post-menopausal women

Question 7

What is an example of tertiary prevention

Answer 7

Patient exercise program for men with prostate cancer

Question 8

What are the two approaches to prevention

Answer 8

Individual-based (high-risk approach)

Population-based

Question 9

What is the individual-based approach

Answer 9

• traditional medical approach
• identify high-risk susceptible individuals and offer individual protection
• screening
• truncates the risk distribution
• Ex. having the people wear seatbelts who are at high risk of getting into a car accident

Question 10

What is the population-based approach

Answer 10

• control the causes of disease in the whole population
• shift the whole risk distribution
• Ex. having everyone wear seatbelts regardless of their risk factor of getting into an accident

Question 11

What is the Bell-Curve Shift in Populations

Answer 11

Population approach: encourages everyone to reduce their risk, shifting the entire distribution
Individual-based approach: Truncate the risk distribution - move the high risk to the normal range

Question 12

What is an advantage to the high-risk approach

Answer 12

• Subject has the motivation to change their behaviour
• Physician has the motivation to help individuals
• Cost-effective use of resources: focus limited services and time where there is need

Question 13

What is a disadvantage of the high-risk approach

Answer 13

• Difficulties and costs of screening
• Does not alter underlying cause of disease
• Weak ability to predict the future
• Behaviourally inappropriate: ex. doesn’t take into account a social circle that includes smoking

Question 14

What is an advantage of the population-based approach

Answer 14

• Takes into account the underlying causes of the disease
• Increased potential for the population
• Behaviourally appropriate: takes into account social norms and environment

Question 15

What is a disadvantage of the population-based approach

Answer 15

• Small benefit to individual
• Poor motivation for the subject to change
• Poor motivation for the physicians to help

Question 16

What do behaviour change theories/models do?

Answer 16

provide a synthetic framework for examining the factors that influence behaviour

Question 17

What are the levels of the ecological model for health promotion

Answer 17

1. Intrapersonal: knowledge, attitudes, skills
2. Interpersonal: social level, family influence, peers influence, teacher’s influence, partner’s influence
3. Institutional: work, school, daycare
4. Community: physical environment, social environment
5. Policy: National/provincial/local laws

Question 18

Give an example for each level of the ecological model for health promotion

Answer 18

For smoking:

1. Intrapersonal: person wants to quit smoking
2. Interpersonal: spouse supports them to quit
3. Institutional: their work has smoking breaks (social circles)
4. Community: Winter is cold, it’s hard to stand outside and smoke
5. Policy: Sin taxes on smoking are too expensive for the individual

Question 19

What are the 5 factors of the Socialization Model of Children’s Behaviour

Answer 19

1. Home and neighbour environment (number of parks and playgrounds or safety of neighbourhood)
2. Parental behaviour (modeling behaviour)
3. Parental cognition (intrapersonal)
4. Children’s behaviour
5. Children’s cognition/ personal attributes (intrapersonal)

Question 20

What is the Socialization Model of Children’s Behaviour

Answer 20

Factors that influence children’s behaviour directly and indirectly. Notice in the model that the arrow are double-sided. (this means that a parental behavious can affect child behaviour and vise versa)