Lecture 33: Prevention

Question 1

What part of the definition of epidemiology related to prevention?

Answer 1

… the application of this knowledge to control relevant health problems

Question 2

Define public health

Answer 2

the science and art of preventing disease, prolonging life and promoting health through organised efforts of society

Question 3

What are the three levels of prevention?

Answer 3

• primary
• secondary
• tertiary

Question 4

What is meant by a primary level intervention?

Answer 4

Interventions that attempt to prevent disease from occurring ie. they reduce the incidence of disease

Question 5

What is meant by secondary level of prevention?

Answer 5

reducing the impact of disease by shortening its duration, reducing severity or preventing recurrence for people who already have the disease

Question 6

What is meant by tertiary level prevention?

Answer 6

reducing the number of impact of complications; improve rehabilitation

Question 7

Give three examples of primary prevention

Answer 7

1. sleeping babies on their backs to prevent SIDS
2. immunisation to prevent measles
3. excise tax on alcohol to reduce the incidence of cancer, domestic violence, liver disease

Question 8

What does secondary prevention cure or stop, and what may it involve?

Answer 8

• it cures or stops progression once the condition has been initiated
• it may involve an earlier diagnosis and treatment

Question 9

Give two examples of tertiary stroke rehabilitation

Answer 9

• specialist stroke rehabilitation

- diabetes monitoring and treatment programs

Question 10

What could be a primary prevention for myocardial infarction?

Answer 10

education and opportunities to exercise more and eat less salt and saturated fat

Question 11

What could be a secondary prevention for myocardial infarction?

Answer 11

treatment of blood pressure, lipids and clotting in people who have had a heart attack

Question 12

What could be a tertiary prevention for myocardial infarction?

Answer 12

assistance with getting back to work

Question 13

What could be some factors to address primary prevention of car crash injuries? Give examples of preventions to do with each of these factors

Answer 13

• alcohol related factors such as lowering the legal blood alcohol concentration
• the roads themselves as a factor such as improving the road engineering
• seatbelt laws
• rules about new drivers

Question 14

What could be a secondary prevention for car crash injuries?

Answer 14

compulsory alcohol treatment after drink driving crash

Question 15

What could be a tertiary prevention of car crash injuries?

Answer 15

psychological support

Question 16

What are the two strategies for primary prevention?

Answer 16

• high risk/individual strategy

- population/mass strategy

Question 17

What is the difference between individual and mass strategies?

Answer 17

individual strategy identifies individuals who are at risk then the prevention intervention is applied to them whereas mass strategy aims to reduce risks of the entire population

Question 18

What would be a population approach to prevent myocardial infarction?

Answer 18

increasing the price of tobacco

Question 19

What would be a population approach to prevent car crash injuries?

Answer 19

lowering the legal blood alcohol concentration limit

Question 20

What would be an individual approach to prevent myocardial infarction?

Answer 20

targeted education and opportunities to exercise more eat less salt and saturated fat

Question 21

What would be an individual approach to prevent car crash injuries?

Answer 21

loss of licence for speeding/drink driving

Question 22

What are some advantages of mass strategy?

Answer 22

• radical
• large potential for whole population
• behaviourally appropriate

Question 23

What are some disadvantages of mass strategy?

Answer 23

• small benefit to individuals
• poor motivation of subject
• benefit-to-risk ratio may be low for individuals

Question 24

What are some advantages of individual strategy?

Answer 24

• appropriate to individuals
• subject motivation
• clinician motivation
• favourable benefit-risk ratio for individuals

Question 25

What are some disadvantages of individual strategy?

Answer 25

• need to identify individuals
• might be against population norms
• can be hard to sustain behavioural change

Question 26

Define prevention paradox

Answer 26

A large number of people at small risk may give more rise to more cases of the disease than the small number of people who are at high risk. This means a preventive measure that brings large benefit to the community may offer little to each individual