Midterm Flashcards

Question

What did John Snow do which was the basis of public health?

Answer 1

He mapped the cholera cases in East London and connected them to a single well on Broad Street that was contaminated by sewage.

Answer 2

He identified the bacteria as the cause of infection which led to the development of vaccination

Answer 3

1. Health Protection (antiquity - 1830s) 2. Miasma control (1840s - 1870s) 3. Contagion control (1880s - 1930s) 4. Preventive Medicine (1940s - 1960s) 5. Primary health care (1970s-1980s) 6. Health Promotion (1990s - now)

Answer 4

Went from antiquity to 1830s Thought diseases might be prevented by enforced regulation of human behaviours through societies' social structures There were religious and cultural rules that were thought to protect the health of individuals (e.g. quarantine for epidemics, sexual relations and alcohol drinking)

Answer 5

Quarantine of illegal migrants; enforcement of some environmental protection laws; aspects of spirituality in prevention and coping with disease; some occupational and transport safety laws.

Answer 6

From the 1840s to the 1870s. Wanted to address unsanitary environmental conditions to prevent diseases (they demonstrated that poor health and epidemics resulted from unsanitary physical and social environments) --> started minimum standards of drainage, sewage and refuse disposal

Answer 7

Healthy cities initiatives such as potable water and sanitation programs, foundations of modern epidemiology and surveillance. Public health included in legal framework.

Answer 8

Lasted from the 1880s to the 1930s. Germ theory: Positivist approach to demonstration of infectious origins of disease. Demonstrated presence of micro-organisms that cause disease in infected media. Led to improved water filtration processes, vaccination, and standardized disease outbreak control measures.

Answer 9

Evidence-based PH practice, ethical vaccination practice, foundations of international cooperation in health, foundations of modern chemotherapy.

Answer 10

From the 1940s to the 1960s. Improvements in PH through focus on the prevention and cure of diseases in high-risk groups Based on analysis of definition and interventions for disease transmission. Also treatment of communicable diseases and primary care of special populations (pregnant women, factory workers...) Did environmental interventions to target disease vectors (e.g. mosquitoes), identification and use of useful microbes, enhanced medical care for high-risk groups, foundations of modern clinical pathology

Answer 11

Focus on "high-risk" groups in the planning and implementation of PH programs Improved understanding of pathogenesis of communicable and non-communicable diseases

Answer 12

From the 1970s to the 1980s Focuses on health for all: HC geared toward the community, for the community and by the community. Preventative approach which emphasizes on equity, community participation, accessibility of services and social determinants of health. Emphasizes on global cooperation, adapting health services to countries and communities, link between HC and socioeconomic development, intersectoral cooperation in health promotion and disease prevention and equity in health care

Answer 13

Concepts underpinning multicultural health and Healthy Cities initiatives, health inequalities, and community participation in health promotion activities.

Answer 14

From the 1990s to now. Advocacy for health: Enabling individuals and communities to attain optimal health. Individuals and communities may be assisted by educational, economic, and political actions to increase control over, and improve, their health through attitudinal, behavioral, social, and environmental changes. Encapsulated by the key action areas of the Ottawa Charter: build healthy public policy; create supportive environments; strengthen community action; develop personal skills; and reorient health services.

Answer 15

The traditional view saw the art or science of medicine as the fount from which all improvements in health have flowed, and popular belief equates the level of health with the quality of medicine. The consequence of the traditional view is that most direct expenditures on health are physician-centered, including medical care, hospital care, laboratory tests and prescription drugs. A view mainly oriented to treating existing illness. Marc Lalonde brought the term "health promotion" in 1974 and attempted to tackle wider determinants of health, and suggested that health care services were not the most important determinants of health. Health field concept: The 4 health fields are: Lifestyle, environment, health care organization and human biology. He said that major improvements in health would result primarily from improvements in lifestyle, environment and our knowledge of human biology (not only by health care) --> the promotion of health in future depends more on the pattern of living adopted by the individual than on technical or allied procedures...

Answer 16

- Build healthy public policy - Strengthen community action - Develop personal skills - Create supportive environment - Reorient health services

Answer 17

An international agreement signed at the first international conference of health promotion, organized by the WHO in 1986 Preceded by the Lalonde's report.

Answer 18

Advocate: Health is a resource for social and developmental means, thus the dimensions that affect these factors must be changed to encourage health. Enable: Individuals must become empowered to control the determinants that affect their health. Mediate: Health promotion's success will depend on the collaboration of all sectors of government (social, economic, etc.) as well as independent organizations (media, industry, etc.).

Answer 19

o Put health on the agenda of policy makers in all sectors and at all levels, directing them to be aware of the health consequences of their decisions and to accept their responsibilities for health. o Combine diverse but complementary approaches including legislation, fiscal measures, taxation and organizational change. It is coordinated action that leads to health, income and social policies that foster greater equity. o Joint action contributes to ensuring safer and healthier goods and services, healthier public services, and cleaner, more enjoyable environments. Health promotion policy requires the identification of obstacles to the adoption of healthy public policies in non-health sectors, and ways of removing them. The aim must be to make the healthier choice the easier choice for policy makers as well.

Answer 20

o Concrete and effective community action in setting priorities, making decisions, planning strategies and implementing them to achieve better health. At the heart of this process is the empowerment of communities, their ownership and control of their own endeavours and destinies. o Community development draws on existing human and material resources in the community to enhance self-help and social support, and to develop flexible systems for strengthening public participation and direction of health matters. This requires full and continuous access to information, learning opportunities for health, as well as funding support.

Answer 21

Personal and social development through providing information, education for health and enhancing life skills --> increases the options available to people to exercise more control over their own health and over their environments, and to make choices conducive to health. Enabling people to learn throughout life, to prepare themselves for all of its stages and to cope with chronic illness and injuries is essential. This has to be facilitated in school, home, work and community settings. Action is required through educational, professional, commercial and voluntary bodies, and within the institutions themselves.

Answer 22

o The inextricable links between people and their environment constitutes the basis for a socioecological approach to health. Need to encourage reciprocal maintenance – to take care of each other, our communities and our natural environment. The conservation of natural resources throughout the world should be emphasized as a global responsibility. o Work and leisure should be a source of health for people. The way society organizes work should help create a healthy society. Generate living and working conditions that are safe, stimulating, satisfying and enjoyable. o Systematic assessment of the health impact of a rapidly changing environment – particularly in areas of technology, work, energy production and urbanization – is essential and must be followed by action to ensure positive benefit to the health of the public. The protection of the natural and built environments and the conservation of natural resources must be addressed in any health promotion strategy.

Answer 23

The responsibility for health promotion in health services is shared among individuals, community groups, health professionals, health service institutions and governments. The role of the health sector must move increasingly in a health promotion direction, beyond its responsibility for providing clinical and curative services. Reorienting health services also requires stronger attention to health research as well as changes in professional education and training. This must lead to a change of attitude and organization of health services, which refocuses on the total needs of the individual as a whole person

Answer 24

Health promotion is the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs and to change or cope with the environment. Health is therefore seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy lifestyles to well-being.

Answer 25

A part of the world where people live much longer than average.

Answer 26

It promotes a desocialized discourse about creating healthy communities. The BZP avoids contemplation of structural determinants of health, such as income and wealth, educational attainment, employment status, or race and ethnicity. These social factors may play a large role in the US health outcomes disadvantage vis-a-vis other high-income countries. While it has been shown possible to organize place-based, community health improvement efforts using a framework that foregrounds such social determinants, the BZP discourse almost completely ignores them, and its praxis has no remedy for these structural and persistent causes of health inequality. Also problematic: Due to Buettner's (Author and founder of BZ,) holistic, place-based, and community-centered assessment of what accounts for long and healthy lives, in practice the BZP relies on modifying the built and social environment to facilitate personal practices of healthy living. In that sense, the BZP reflects the ethos of libertarian paternalism, where targeted but subtle “nudges” provoke people to adopt healthy habits and, in the process, engage in creating “healthy places”. Whatever its other effects, one consequence of the BZP is to sidestep systematic analysis of socio-structural causes of health disparities.

Answer 27

1. Move naturally (their environments constantly nudges them into moving w/o thinking about it) 2. Purpose (knowing your sense of purpose) 3. Down shift (even if they do experience stress, they have routines to shed stress, e.g. pray, nap, happy hour) 4. 80% rule (Stop eating when stomach is 80% full) 5. Plant slant (Meat (mainly pork) = 5x/mo. Beans and pulses are the cornerstone of most centenarian diets. Portion sizes are 3-4 oz) 6. Wine at 5 (moderate and regular alcohol intake - 1 to 2 glasses per day) 7. Belong (must feel like a part of something - faith based services 4x/mo increases life expectancy) 8. Loved ones first (Families first, keep aging parents or grandparents nearby or in the home, commit to a partner and invest in their children with time and love) 9. Right tribe (social circles that promote healthy behaviours - smoking, obesity, happiness and loneliness are contagious)

Answer 28

* Looking at how the community can enable the individual * We want communities and individuals to promote health by economic and political actions * Focus on educational, economic and political actions * Federal, provincial, regional policies

Answer 29

- Graphed all-cause and CHD mortality by grades of employment - Examined mortality rates over 10 years among male british servants aged 20-64 - Found an inverse association between grade of employment and mortality from CHD and all-cause. Men in the lowest grade has 3x higher mortality rate than in the highest grade - Low status was associated with other specific causes of death, (such as obesity, smoking, less PA, higher BP, shorter height...) but even controlling for those accounted for only 40% of the grade difference in CHD mortality (the risk of CHD mortality was still 2.1x higher)

Answer 30

May be d/t grade differences in job control and job support. BP at work was associated with job stress, lack of skill utilization, tension and lack of clarity in tasks The rise in blood pressure from the lowest to the highest job stress score was much larger among low grade men than among upper grade men (although home BP was not related to job stress levels. --> The structure of society may get into our skin… Still looking for mechanisms that explain it.

Answer 31

1. Age, sex and hereditary factors (cannot change) 2. Individual lifestyle factors: What we do every day that contributes to our health 3. Social and community networks 4. Living and working conditions (Agriculture and food production, education, work environment, unemployment, water and sanitation, Health care services, housing) 5. General socio-economic, cultural and environmental conditions

Answer 32

It explains that disease is quantitative and not categorical (whole spectrum) If people do not feel well or are impaired in daily living, they are not healthy, but may not be identified as sick based on standards, which may cause them to develop a preventable disease. Do not only focus on the tip of the iceberg. Shift focus from treatment to prevention

Answer 33

Most clinical decisions are dichotomous (either you are treated or not) Diagnosis is based with the intent to treat and does not identify the disease entity Diseases come in all grades of severity, which makes preventive medicine much broader Inadvertently encourages the belief that those who are not high risk are normal and have no cause for concern. "We can’t properly address the tip of the iceberg if we understand the tip of the iceberg to be the whole problem of disease."

Answer 34

A large number of people must participate in a preventive strategy for direct benefit to relatively few (e.g. vaccination, seatbelts) - Unless we focus on people who have low to moderate risk, we will miss out on the major part of the people who will develop disease + Those people will moderate to low risk will replenish those with high risk once those with high risk are treated Also, more people at low to moderate risk will end up developing the disease although a lower %.

Answer 35

The impact of acting on a whole population is not immediate and won't happen for everyone who seek it. People are motivated by benefits that are visible, early and likely (Small changes, for example, doing more PA, losing some weight will only make a small difference in a person’s health prospects in the next few years) Focusing on the health benefits of an action is not enough to "shift the curve"

Answer 36

To shift the curve, do not focus on education on health benefits but to change attitudes towards a certain behaviour - -> motivation becomes more psychological and social than medical; effect is positive and immediate (e. g. Smoking carries a distant and small risk to health but immediate damage to self-respect)

Answer 37

The population strategy of prevention

Answer 38

Immunization, seatbelt use, water fluoridation, clean air

Answer 39

A population strategy of medicine is needed wherever risk is widely diffuse in the whole population - shifting the whole population into a lower risk category benefits more individuals than shifting high risk individuals into a lower risk category Red zone = line is an arbitrarily set criteria (e.g. BP > 140/90) High risk approach will only focus on people at HR, although some people at normal risk will also develop the disease. Population approach wants to tend everyone to change so the curve shifts and the mean shifts; the average is now lower and thus high-risk group becomes in a lower range of ex. BP - everyone benefits from this small change = delayed onset of disease for everyone.

Answer 40

If we want to reduce HTN in the population, may focus on reducing sodium in processed foods, for example.

Answer 41

Linear and exponential

Answer 42

Is there an identifyable group where high exposure carries high personal risk? Is there an exposure treshold below which we can ignore the risk, risk is negligible? If so, use HR approach

Answer 43

* Intervention is appropriate to the individual * Avoids interfering with those not at special risk * It fits readily with the character of medical care * It offers cost-effective use of resources * Selectivity improve benefit to cost ratio

Answer 44

1. Prevention becomes medicalized 2. Success is only palliative and temporary (helping with the damages of the exposure but not acting to diminish the exposure. It does not attempt to change the exposure or the hazard, which continues to exist.) 3. The strategy is behaviorally inadequate (lifestyle is pattern of behaviour and shaped by strong social and cultural norms; if not changing those, we are just equipping people to cope with disease) 4. It is limited by the poor ability to predict the future (we know it works on a population scale but cannot predict on individual level. If you have normal cholesterol you don’t think you will develop heart disease) - -> If we focus only on high risk, we are only addressing ≈12% of all the MI that occur in a whole group of men. Poor predictive quality. - -> If you define high risk broadly for a high-risk approach, most who qualify as high risk will not be affected (in the case shown, 5 years later). If you use a narrow approach, then it only prevents a small amount of burden of the disease. Not easy to sell this – what is best for the individual is worse for the community. 5. Problems of feasibility and cost 6. The contribution to overall control of the disease is disappointingly small

Answer 45

- Effectiveness and safety of interventions - Acceptability, response and compliance - Total cost of preventing one critical event (for patient and medical services)

Answer 46

- Control the determinants of incidence - Lower the mean level of risk factors - Shift the whole population exposure into a favorable direction Asks questions such as: "Why do some people get HTN and others do not?" "What is about this culture/place so that the whole population has lower risks of HD?

Answer 47

• Behaviourally appropriate • If it becomes normal to quit smoking, or eat a more plant-based diet, then it will be less necessary to keep persuading individuals • If the social norms support the behaviour (e.g. diet), and the food industry adapt themselves, the change no longer requires individual effort This strategy focuses on the upstream determinants of health (things that are far from us but will affect us over the long-term)

Answer 48

* People are motivated by benefits that are visible, early and likely * Small changes, for example, taking more exercise, losing a bit of weight will only make a small difference in a person health prospect in the next few years * Health benefits may be real, but are delayed and may come to only a few who seek them * Health education must seek other ways than health benefits to be attractive

Answer 49

Health behavior theories | Even + if you combine parts of different theories

Answer 50

1. Individual 2. Interpersonal (family, friends, social network) 3. Organizational (within own community; school, place…) 4. Community (social support) 5. Public policies

Answer 51

* Theories and models help explain behavior (what influences it) * Guide how to develop more effective ways to influence and change behaviors * Tools to facilitate our practice of planning and evaluating health interventions

Answer 52

Health belief model Social cognitive theory Transtheoretical model/stages of change Social Ecological level

Answer 53

Individual focused model It theorizes that people’s beliefs about whether they are at risk for a disease or health problem, and their perceptions of the benefits of taking action to avoid it, influence their readiness to take action.

Answer 54

Personal characteristics, such as age, gender, and ethnicity modify individual perceptions, such as perceived susceptibility, severity, self-efficacy, and benefits & barriers.

Answer 55

He demonstrated that violent behaviors that were modelled by adults on a Bobo doll were imitated by children. This effect was repeated when children observed the same behavior on the television. Important effect of role modeling on one’s behavior.

Answer 56

Interpersonal level theory developed by Albert Bandura that emphasizes the dynamic interaction between people (personal factors), their behavior, and their environments.

Answer 57

Theory developed by Bandura explaining that a person's behavior both influences and is influenced by personal factors and the social environment

Answer 58

HBM is not acknowledging interrelation between behavior, environment and individual. The SCT tends to have a focus on an interpersonal level (impact of a person on another person's behavior)

Answer 59

- Self-Efficacy (confidence in one's ability to perform a given behavior - task-specific) - Self-regulation/control (controlling oneself through self-monitoring, goal-setting, feedback, self-reward, self-instruction and enlistment of social support) - Observational learning (role-models) - Reinforcement (Internal or external responses to a behavior that will affect the likelihood of continuing or d/c the behaviour. - reciprocal relationship between behavior and environment)

Answer 60

Theory on how behavior CHANGES. Change process (vs other ones explain behaviours) Stages of Change is best thought of as a cyclical and recycling process where individuals progress in order of stage but can relapse and recycle through stages several times; they may or may not ever reach the last stage.

Answer 61

* Precontemplation: unawareness or denial of problem. No intention to change behavior in the next 6 months. Not aware of or deny issue. * Contemplation: considering behavior change, with no preparation, in the next 6 months but not within next 30 days. * Preparation: taking initial steps to change behavior in the next 30 days * Action: actively engaged in behavior change in next 30 days but not 6 months * Maintenance: sustaining behavior change that occurred in the last 6 months * OR Relapse: Can cycle through stages

Answer 62

If you want to change behaviour, target strategies to change people’s readiness to change so they can enter the cycle. Work on INTENTION.

Answer 63

There are many levels of influence on people’s behaviour. If we’re not using them and focusing on individual level: will only be equipping people to cope with environments that make it difficult to be healthy. Influences are on many levels --> addressing all of them gives better chance of having an impact on the whole population and act on things that are beyond an individual’s ability to control. Behaviours both shape and are shaped by the environment

Answer 64

Agency is always constrained by social structures (e.g. sit on chair and not floor because there is an expectation that this is the right thing to do). We have a choice, but those choices are constrained by social norms, rules, regulations and resources. This idea is a part of the SEM.

Answer 65

* Choosing a suitable theory should begin with identifying the problem, goal, and units of practice (who are we focusing on? e.g. children, schools, health providers) not with selecting a theoretical framework because it is intriguing, familiar, or in vogue. * Ideally one should start with a logic model of the problem and work backward to identify potential solutions.

Answer 66

1. Incentives (e.g. healthier food at lower price) 2. Mappings 3. Defaults 4. Feedbacks (e.g. car beeps when you forget to put your seatbelt 5. Expect error (??) 6. Structure complex choices (e.g. facilitate food label reading)

Answer 67

o “Nudge” people of all ages to make healthier choices o Implement low/no-cost changes o Increase assess, selection/sales of healthy choices o Create healthier eating environments o Reduce chronic disease, healthcare costs, etc. Mindless eating: We make more than 200 decisions about food every day! Most of which we don’t realize we’re making… Your surroundings matter.

Answer 68

1. Place 2. Profile 3. Portion 4. Pricing (increase sales for healthy choices) 5. Promotion 6. Picks 7. Priming or prompting 8. Proximity (healthy choices at eye level)

Answer 69

The continuous, systematic collection, analysis and interpretation of health-related data need for the planning, implementation and evaluation of public health practice. Surveillance directly measures what is happening in the population, it allows both determining the interventions necessary and the effects of such interventions. Surveillance aims to allow decision-makers to oversee and manage more effectively by providing them with useful evidence-based date, in a timely manner

Answer 70

* Serve as an early warning system for impending public health emergencies (e.g. obesity) * Document the impact of an intervention, or track progress towards specified goals * Monitor and clarify the epidemiology of health problems, to allow priorities to be set and to inform public health policies and strategies * Dissemination of information to decision-makers

Answer 71

Help making informed decisions in the health and social services sector as well as in other sectors of activity that affect health, by addressing the need for further information in the health status and its determinants, as well as by informing the population about its health status

Answer 72

- An overall picture of the health status of the population - The observation of temporal and spatial trends and variations - The detection of emerging problems - The recognition of priority problems - The development of projection scenarios with regard to the health status of the population - A f/u of the evolution of specific health problems and their determinants - The dissemination of information to decision-makers

Answer 73

1970-1972 The Nutrition Canada survey (was never repeated)

Answer 74

* Statistics Canada * Canadian Community Health Survey (CCHS) * Canadian Health Measures Survey (CHMD) (Includes blood, urine samples and direct measurements of height, weight which is not included in CCHS) * National Population Health Survey (NPHS) (Education, different determinants of health and social well-being) * Institut de la statistique du Québec (ISQ) (High school students, Breastfeeding, 4 years old) * Institut national de la santé publique du Québec (INSPQ) * Nunavik Regional Board of Health and Social Services (NRBHSS) (2007 and repeated recently; Many national health surveys exclude populations living on reserves (may be d/t sampling strategies))

Answer 75

Food security exists when all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life (FAO, 1996)

Answer 76

HHFSM (household food security survey module)

Answer 77

HFSSM was core content in 2007-2008; 2011-2012 (next core data is 2017-2018) Optional in 2005, 2009-2010; 2013-2014

Answer 78

There was a redesign of the sampling methods.

Answer 79

- Prison populations - First nations on reserves - People in the military

Answer 80

Around double the rate of FI (25% vs. 12%) in 2014

Answer 81

``` 88% of the population is food secure 12% is food insecure o Marginal FI 3.7% o Moderate FI 5.5% o Severe FI 2.7% ```

Answer 82

Nunavut, NWT, Atlantic provinces (NB, NS, PEI)

Answer 83

Mainly indigenous populations High cost of important foods High rate of poverty Other social issues

Answer 84

Goes from worrying about running out of food to children not eating for a whole day. Each question specifies a lack of money or the ability to afford food as the reason for the condition or behaviour

Answer 85

10 for households with only adults | 18 for households with children

Answer 86

Based on the number of affirmed response in the category (e.g. adults, children). Need less affirmative responses in the child part since there are less questions.

Answer 87

They usually report multiple indications of problems with food access among adults and/or children, but typically have reported few, or no, indications of reduced food intake (e.g. inadequacy in household food supplies or adjustments to the quality of food consumed)

Answer 88

Disrupted eating patterns and reduced food intake among adults and/or children in addition to the conditions reported by moderately food insecure households.

Answer 89

Households with children.

Answer 90

Marginal food insecurity: Worry about food running out and/or limit selection of food because of lack of money Moderate food insecurity: Compromise in quality and/or quantity of food due to a lack of money for food Severe food insecurity: Miss meals; reduce food intake and at the most extreme go day(s) without food

Answer 91

Wages/salaries This means that 2/3 of food insecure households have a job and are working. They are making money but cannot afford good food for their family, Second highest: Social assistance (15.7%); Senior’s income (13.3%); others or none; employment insurance or worker’s compensation (2.5%)

Answer 92

INEQUALITY is about difference of health outcome between groups > implies there is difference. INEQUITY is about systematic differences which can be changed with collective action, or are not natural, but social in nature>implies potential actions to alleviate the inequity.

Answer 93

• Many INEQUALITIES are the result of individual’s and groups’ relative social, political and economic disadvantages • These inequalities affect people’s chances of achieving and maintaining good health over their lifetimes • Inequalities in health outcomes, or in access to the resources that support health… Are systematic (i.e. the patterns of differences are consistently observable between population groups – not random) And can plausibly be avoided or ameliorated by collective action • They may be deemed UNJUST and INEQUITABLE

Answer 94

Socioeconomic and political context | Socio-economic position

Answer 95

It highlights the critical roles that broad social, economic, and political factors (e.g. systems of governance; macroeconomic, social, and public policies; and culture and societal values and norms) play in generating and reinforcing societal hierarchies (social gradients of health). (e.g. minimal wage, etc.) Mediated through socio-economic position

Answer 96

These differences in socioeconomic positions shape the health influencing social and physical conditions in which individuals are born, grow, live, work, and age. (gender, ethnicity (racism has an impact), sexual orientation…)

Answer 97

These conditions include material circumstances (e.g. living and housing standards, workplace conditions, neighbourhood amenities and safety); psychosocial factors (e.g. job strain, social connectedness or isolation, access to social support); health behaviours (e.g. diet, physical activity, tobacco and alcohol consumption); and biological (including genetic) factors. The interactions between these various domains are the means by which inequitable social processes are translated into inequities in health and well-being outcomes

Answer 98

5.1x more risk of FI

Answer 99

Non indigenous people < metis < first nations off reserves < inuits < first nations on reserves

Answer 100

Social policies

Answer 101

Most people who rely on social assistance in Canada are food insecure --> programs are not designed in ways that enable recipients to meet basic household needs. Other studies link FI to energy cost subsidies, housing subsidies and agricultural subsidies related to milk

Answer 102

There are none. | Action plan is dated (1998) - food policy under development

Answer 103

None. Some have enacted poverty reduction strategies, but FS is not the explicit focus of these

Answer 104

there is little evidence that community-based initiatives that are largely reliant on donated food and labour have the capacity to effectively address the very serious food problems facing the nearly one million households in Canada who struggle with food insecurity

Answer 105

Charitable food programs and food banks - limited evidence these are the solution alone Rely on donations and volunteer labor May even perpetuate the problem by abdicating the government of their responsibility

Answer 106

Objectives: Improve diet, PA and promote positive attitudes Target risk factors for DM: Obesity and PA Used HBT and SCT - impact self-efficacy and knowledge How? - Parental support healthy eating - School food environment - School program (delivered through grades 1-6) - Community PA program - Parental support PA (interpersonal impact, relationship with family – increases SE for PA and healthy eating)

Answer 107

1. Identify the ultimate desired result 2. Identifying and setting priorities among health or community issues and their behavioral and environmental determinants that stand in the way of achieving that result, or conditions that have to be attained to achieve that result; and identifying the behaviors, lifestyles, and/or environmental factors that affect those issues or conditions. Phase 3: Identifying the predisposing, enabling, and reinforcing factors that can affect the behaviors, attitudes, and environmental factors given priority in Phase 2. Phase 4: Identifying the administrative and policy factors that influence what can be implemented.

Answer 108

Another premise behind PRECEDE-PROCEED is that a change process should focus initially on the outcome, not on the activity. (Many organizations set out to create community change without stopping to consider either what effect their actions are likely to have, or whether the change they’re aiming at is one the community wants and needs.) PRECEDE’s four phases, therefore, move logically backward from the desired result, to where and how you might intervene to bring about that result, to the administrative and policy issues that need to be addressed in order to mount that intervention successfully. All of these phases can be thought of as formative.

Answer 109

1. Consciousness-raising - gathering information (e.g. I recall information people had given me on how to stop smoking) --> means an impact was made 2. Self-evaluation - reconsidering consequences on oneself (e.g. My dependency on cigarettes makes me feel disappointed in myself) 3. Dramatic relief - experiencing and expressing affect (e.g. react emotionally to warnings about smoking cigarettes) 4. Environmental evaluation - considering consequences on others – (e.g. I consider the view that smoking can be harmful to the environment) 5. Social liberation - attending to changing social norms (e.g. I find society changing in ways that make it easier for the nonsmoker)

Answer 110

1. Counterconditioning - Substituting new behavior (e.g. I find that doing other things with my hands is a good substitute for smoking) 2. Stimulus control - Controlling environmental cues (e.g. I remove things from my home that remind me of smoking) 3. Reinforcement management - being rewarded by self or others (e.g. I reward myself when I don’t smoke) 4. Helping relationships - using social support (e.g. I have someone who listens when I need to talk about my smoking) 5. Self-liberation - committing to change (e.g. I make commitments not to smoke)

Midterm Flashcards

(137 cards)