MOD 2. 16-18 Flashcards
Describe population mass strategy
- aims at everyone in the population
- aims to decrease health risk and improve health of all population
- aimed at common diseases or widespread cause
Describe High risk strategy
targets individuals who are high risk
intervention is matched to individuals concern
What are the advantages of population mass strategy
behaviorally appropriate
benefits whole population
addresses causes
what are the disadvantages of population mass strategy
poor motivation
small benefit to people
population are exposed to the downstream of the strategy
What is the advantages of the high risk strategy
appropriate to individual
individual motivation
cost effective
favorable benefit to risk ratio
Disadvantages of high risk strategy
cost of identifying individual, need to identify individuals
temporary effect
limited potential
behaviorally inappropriate
What is health promotion
act on determinants of wellbeing and health
enables and empowers individuals to control and improve their own health
Involves whole population in every day context
Describe what the Ottawa charter acknowledges for health promotion
health is a right for everyone
requires both individual and collective responsibility
opportunity should be equally available
what are the structures that are involved in the Ottawa charter
Enable/ Advocate/ Mediate
-strengthen community action/ develop personal skills
Create supportive environments
reorient health services
Building healthy public policy
State and Describe the 3 basic strategies
- ENABLe
Ottawa charter
- individual level strategy
- providing skills and supportive environment
State and Describe the 3 basic strategies
- Advocate
create favorable systems level strategy
promoting health focusing on achieving equity in health
State and Describe 3 basic strategies
- Mediate
bring people together a strategy that joins up individuals group and systems
describe disease prevention
disease focus
look at a disease and find ways to prevent it
Describe primary prevention strategies
limit the occurrence of the disease by controlling specific causes and risk factors- eg. immunisations
Describe secondary prevention strategies
reduce the more serious consequences of disease
eg: screening women age 45-69 for breast cancer
describe tertiary prevention of the disease
reduce the progress of complications of established disease
eg: burn patients
Describe Health protection
Focus on environmental hazard actions: rish/hazard management monitoring Risk communication occupational health eg safety regulation on work sites
Describe the focus and actions of disease prevention
focus: disease
action: prevents incidence, prevalence, risk factors or impact
eg: immunisation
Describe the focus and actions of health promotion
focus: health wellbeing
action: acts on the determinants of wellbeing
eg: push play 5+ a day
Is screening prevention strategy a Primary, secondary or tertiary prevention strategy
It can be all it depends on what is screened
What is the screening criteria
suitable disease
suitable test
suitable treatment
suitable screening programme
what is the objective of screening initiative
to improve health outcome (morbidity, mortality or disability)
What is a suitable disease
relatively common
relatively uncommon
early detection and intervention= better outcome Increased duration of preclinical phase
Knowledge of the natural history of the disease or relationship of risk factors to the condition
what is a suitable test
safe simple reliable acceptable accuracy- ability's of a test to indicate which individual have the disease and which do not - sensitivity, specificity
What is sensitivity
the liklihood of a positive test in those with the disease
the ability of to test to identify correctly those who have the disease (a) from all individuals with the disease (a+c)
What is specificity
The likelihood of the negative test in those without the disease
The ability for the test to identify correctly those who do not have the disease from all individuals free from the diesease
Describe the evaluating test accuracy
the sensitivity of a screening test is high the proportion of true positives is high
the specificity is high if the portion of true negatives is high
Sensitivity and specificity are a fixed characteristic of the test
DEscribe Positive predictive Value
The proportion who really have the disease of all people who test positive
the probability of having disease if the test is positive
Describe the Negative predictive Value
the proportion who are actually free of the disease of all people who test negative
the probability of not having the disease if the test is negative
n
n
Describe Suitable treatment overview
evidence of early treatment leading to better outcomes
effective acceptable and accessible treatment appropriate treatment to be offered
evidence-based policies covering who should be offered treatment
Describe suitable screening programme
Benefits must outweigh the harm
Rct evidence that screening programme will result in reduced mortality
increased survival time
Suitable screening programme Overview
Adequate resourcing, agreed policy for testing, diagnosis, treatment and programme management
cost effective
heath care system must be able to support all elements of the screening pathway
needs to reach all those who are likely to benefit from it ( specific initiatives for particular population groups)
Why do we need prioritizing in health
Limited funds to supply all the health problems
Where does the Nz health dollar go
Health administration and health insurance
services of curative and rehabilitative care
service of long term nursing care
ancillary services to health care
medical goods dispends to outpatients
prevention and public health services
What are some of the establishing population health priorities
evidence based measures
Community expectation and values
human rights and social justice
Evidence based measures can be categories into?
Descriptive
explanatory
evaluative
Describe descriptive based measure
in evidence based measure
who is the most/ least affected
where are we now
TRENDS?
- define the problem
Describe explanatory based measure
in evidence based measure
identify the risk and protective factors
equity?
What are epidemiological measures used in prioritization
age, death and premature mortality
time lived with disability
population attributable risk
What is the Attributable risk
the amount of extra disease attributable to a particular risk factor in the exposed group (RD)
Population attributable risk (PAR)
amount of extra disease attributable to a particular risk factor in a particular population
if association is causal- amount of disease we could prevent if we removed that particular risk factor from the population
How do you calculate PAR
Occurrence in total population- Occurrence in the unexposed group
What is evaluative evidence
what can improve health outcomes (and in whom)
Is the intervention improving health outcomes
economic feasibility
other factors that influence priortisation
community expectation and values
human rights an social justice
acceptability
Describe the flow diagram of screening for disease
Screening test- less expensive diagnosis
IF POSITIVE
Diagnostic test- gold standard
- often invasive and expensive
