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GLPH 271 > Module 5 > Flashcards

Module 5 Flashcards

Levels of Health Prevention

1
Q

disease prevention

A

non-communicable diseases account for 70% of deaths globally
there is a greater need to focus on disease first rather than treatment because most of the burden of non communicable diseases is preventable

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2
Q

disease prevention stages

A
  1. Primordial prevention: prevents the development of risk factors by targeting underlying social and environmental conditions
  2. primary prevention: identification and modification of risk factors to prevent disease onset
  3. secondary prevention: early detection and treatment of disease before symptoms appear
  4. tertiary prevention: treatment of disease to stop its progression and control its negative consequences
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3
Q

primordial prevention on the disease progression pathway

A

used when there is no disease

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4
Q

primary prevention on the disease progression pathway

A

used when there is no disease
ex: getting vaccinated

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5
Q

secondary prevention on the disease progression pathway

A

occurs after the disease onset, but the disease is asymptomatic
ex: regular mammograms and Pap smears

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6
Q

tertiary prevention on the disease progression pathway

A

clinical onset of disease
ex: cardiac rehabilitation for people with myocardial infarction

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7
Q

health promotion

A

Primordial prevention is often considered synonymous with health promotion, but that is not entirely accurate. Primordial prevention consists of risk factor prevention/reduction through social and environmental changes for the entire population. These changes tend to be accomplished through policy and law changes. In addition, health promotion helps individuals increase their control over their health, by promoting skills development and healthy habits.

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8
Q

2 approaches to effective health promotion

A
  1. identification risk: identify susceptible individuals to a risk factor and intervening to reduce the development of risk
  2. reducing average risk: reducing risk level for the whole population, usually through legislative/policy changes
    ex: mandating all companies display nutritional facts on their food products to promote healthier eating
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9
Q

Ottawa Charter of Health Promotion

A

developed after the International Conference on Health Promotion was held in 1986
it called for several important actions to facilitate health promotion, including:
- building healthy public policy
- creating supportive environments
- strengthening community actions
- developing personal skills
- reorienting health services

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10
Q

health promotion and the SDHs

A

Health promotion at the individual and population levels targets the behaviours, environmental conditions, social conditions, and any other factors that could lead to the development of risk factors. These factors are often grouped into three categories: environmental, social, and other factors.

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11
Q

health promotion: environmental factors

A

occupation
housing/living conditions
school or work

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12
Q

health promotion: social factors

A

education
family
SES
war/conflict
culture
race/racism

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13
Q

health promotion: other factors

A

internal/external factors that impact health
healthy/unhealthy behaviours
availability of quality services

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14
Q

the need for behaviour change

A

the healthy behaviours one chooses to engage in are arguably the most significant factors in determining an individual’s health. The behaviours we choose to engage in also happen to be the most easily modifiable SDH, as the remaining ones we are either born into, or they are beyond our immediate control.
Given that personal health behaviours are a critical aspect of one’s health, modifying such behaviours (tobacco use, diet, physical activity) is a large and effective component of health promotion.
Yet, behavioural change tends to be a difficult aspect of health promotion as there is often a disconnect between knowledge and behaviour.

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15
Q

barriers to changing healthy behaviours: intrapersonal

A

Mostly situated within the control of an individual. Some of these factors related to this level include knowledge, attitude, skills, self-efficacy, motivation, age, and socioeconomic status
Examples of barriers:
- Lack of knowledge about safe sexual practices, dental hygiene, etc.
- Flawed risk perception of unhealthy eating, drinking habits, and sleeping habits
- Cost (time or money) of switching to healthy foods, joining a gym, getting proper medical advice, etc.

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16
Q

barriers to changing healthy behaviours: interpersonal

A

Involve social relationships, including those with friends, family, peers, partners, and coworkers
Any one of these relationships may influence an individual’s behaviour positively or negatively
Ex:
-Lack of connection and social integration with peers
- Unsupportive family or peer environment
- Social norms within the peer group that promote negative behaviours like smoking

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17
Q

barriers to changing healthy behaviours: community/institutional barriers

A

Includes the social and physical environments and setting individuals engage with daily, including schools, workplaces, neighbourhoods, and healthcare facilities
Encompasses social and gender norms, a sense of empowerment within the community, and the policies that influence the social environment of schools and workplaces
Ex:
- Lack of economic and housing opportunities
- Inflexible work environment
- Lack of healthy food options at school
- Inaccessible parks and other recreational areas

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18
Q

barriers to changing healthy behaviours: public policy barrier

A

Involves the broad, structural factors such as local, state, and federal policies, that either enable or hinder an individual’s ability to take control over their health
Ex:
- Unfair trade and labour laws that increase prices and access to care products and services
- Lack of funding to the healthcare system and other social services
- Punitive drug policies
- Lack of a comprehensive health curriculum at school

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19
Q

the health belief model

A

Is one of the best known and most widely used theories about health behaviour change. It was first developed by a group of social psychologists in the 1950s, who were trying to understand the widespread failure of TB screening programs. It involves modifying factors (age, gender, ethnicity, personality, SES, and knowledge), individual beliefs, and action

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20
Q

HBM: individual beliefs

A

includes perceived seriousness, perceived susceptibility, perceived benefits, and perceived burdens, and self efficacy (person’s confidence in their ability to change successfully)

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21
Q

HBM: action

A

cues to action include specific triggers needed to prompt the decision making process to engage in a health behavioural change
ex: pre-existence of a health condition, physician recommendation, or the illness of a family member

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22
Q

trans-theoretical model of a health behaviour change (TTM)

A

Outlines the process of intentional behaviour change
Understanding this process can facilitate the development of successful interventions. The TTM posits that individuals move through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and relapse

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23
Q

TTM: precontemplation

A

individuals in this stage are unaware of the need to change
they are often uninformed about the consequences of their behaviour
ex: a person is smoking

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24
Q

TTM: contemplation

A

the getting ready stage, individuals are often ambivalent or behavioural procrastinators
ex: smoker thinking about quitting, but has not made plans to do so

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25
Q

TTM: preparation

A

individuals have motivation and a plan of action, some steps have been made to change their behaviour
ex: a smoker has set a quit date

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26
Q

TTM: action

A

individuals are actively trying to modify their behaviour and lifestyle

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27
Q

TTM: maintenance

A

individuals have sustained their behavioural change for at least 6 months and work towards preventing relapse

28
Q

TTM: relapse

A

individuals have abandoned the idea of changing due to difficulty in maintaining their new behaviour

29
Q

health promotion levels: individual

A

happens through one-on-one interactions and is suitable when there is a lot of individualized information and knowledge to be transferred
These interactions provide an opportunity for personal clarification and adaptation, however, individual level health promotion can be labour intensive and costly
ex: discussing strategies for smoking cessation

30
Q

health promotion levels: peer or group

A

this level can include small groups, institutions, or entire communities, and can occur in many spaces (classrooms, field trips, etc.)
This interaction is suitable when social interaction is helpful and may be a more efficient method to transfer information because one individual can teach a large group of people
ex: prenatal class

31
Q

health promotion level: population

A

there are 2 main types at this level: legislation and policy, and social marketing

32
Q

population health promotion: legislation and policy

A

promotion is effective but often an overlooked approach as it requires political will and public support
This type of promotion helps change environments and sets the community standard for behaviour
Since individuals are forced to change, this can cause a massive shift in attitude and behaviour

33
Q

population level health promotion: social marketing

A

relies on ‘selling’ health like businesses that sell products
This approach leverages a target niche market. Often this approach can influence acceptability of social norms and attitudes

34
Q

need for Indigenous voices in Health Promotion

A

Many Indigenous communities are disproportionately affected by health related issues compared to non-Indigenous populations. A space needs to be created for Indigenous voices to be heard when developing Indigenous health promotion strategies.
When Indigenous voices are not heard, colonial health promotion strategies are left unchecked and can result in the continuous and damaging perpetuation of neocolonialism.

35
Q

need for Indigenous voices in Health Promotion: researcher perspective

A

Many Indigenous health researchers and practitioners do not come from an Indigenous background, or do not identify as Indigenous
This can be problematic and oftentimes results in a contradiction between the Indigenous community’s priorities and common goals and researcher’s perspectives in how they identify and address these issues

36
Q

need for Indigenous voices in Health Promotion: intervention evaluation

A

There is an evident lack of research on evaluating the effectiveness of health promotion interventions for Indigenous Peoples. Even when research is conducted, program effectiveness is regularly measured based on westernized individualistic methods that do not align with Indigenous holistic community measures.

37
Q

BC Cancer Prince George Centre for the Northern

A

has taken on various initiatives that are aimed at improving the healthcare and experiences of Indigenous Peoples
they have implemented strategies to combine Western and Traditional medicines, like having an Aboriginal Case Coordinator and a Healing Garden

38
Q

amplifying Indigenous Voices in Health Promotion

A

researchers must genuinely collaborate with, and work alongside chiefs, elders, and leaders
By creating a safe space for Indigenous voices to be heard, health promotion strategies can be developed that reflect Indigenous cultures, values, and traditional knowledge

39
Q

Indigenous health promotion factors:

A
  • Protective Factors: self government, land control, and control over cultural activities
    • Prevention: community based approaches, gatekeeper training, and peer support groups
    • Spirituality: using Indigenous concepts of well-being and spiritual practices: pow-wows, sweetgrass ceremonies, and sweat lodges
40
Q

Indigenous Suicide Prevention: successful program

A

Focus on community and family connectedness, community empowerment, and Indigenous cultural affinity. Programs developed with these components in mind have been proven to be effective in lowering rates of suicide
- Ex: to treat substance abuse issues, a treatment would involve community healers utilizing spiritual practices, dances, and ceremonies
In many Indigenous communities, culture is viewed as treatment and it is understood that all healing is spiritual

41
Q

Indigenous Suicide prevention: unsuccessful

A

There have been cases where westernized suicide prevention programs and strategies have failed in Indigenous communities
As the programs lacked Indigenous perspective, they created incongruences in culture and resulted in further disruption of Indigenous communities
In some situations, the implementation of these suicide prevention programs has actually resulted in higher rates of suicide

42
Q

health promotion in practice

A

As a whole, health promotion focuses on encouraging people to improve their health in one of two ways: either by increasing their frequency of healthy behaviours, or by reducing or eliminating their unhealthy behaviours

43
Q

increasing frequency of healthy behaviours

A

One practice focuses on increasing the frequency of healthy behaviours by identifying healthy behaviours and implementing programs to make these behaviours easier to achieve
ex: OMama for pregnancy healthcare

44
Q

eliminating unhealthy behaviours

A

Health promotion also focuses on empowering the population to identify and reduce behaviours that are detrimental to a healthy lifestyle, and designed interventions which will effectively alter those behaviours
ex: smoking cessation programs

45
Q

Indigenous considerations with smoking cessation: First Nations

A

Have traditionally used tobacco for prayer, purifying the body and mind, providing spiritual strength, guidance, and as a symbol of respect in First Nations gatherings
However, most practices do not include inhaling tobacco directly

46
Q

Indigenous considerations with smoking cessation: Metis

A

Metis use of tobacco has historically been influenced by First Nations as a medicinal plant and for social uses. Early Metis were known for being voyageurs, and during long canoe journeys they would frequently stop for rest and to pipe
Eventually, this way of life became so important they would measure their distance travelled by the number of pipes smoked

47
Q

Indigenous considerations with smoking cessation: Inuit

A

From a traditional perspective, Inuit typically do not use tobacco for ceremonial or other practices because tobacco could not grow in the colder climate of traditional land

48
Q

Sacred Smoke Program

A

an initiative that was developed to support and promote being tobacco wise in two communities: Batchewana First Nation and Garden River First Nation. The program was based on traditional Anishinaabe practices and shares smoking cessation information in a culturally respective manner
This cessation program involved both western medicine nicotine replacement therapies and support groups in conjunction with traditional Anishinaabe medicines and cultural resources

49
Q

Sacred Smoke Program: elders and coping strategies

A

Elders:
Led by elders, participants were shown how to make kinikinik (traditional tobacco) and taught traditional methods for smoking cessation, such as tobacco offerings, quitting on a new moon, and selecting traditional medicines

Coping Strategies:
Participants were shown how to incorporate adaptive coping strategies into their daily routines to help distract from cravings and avoid relapse
Some strategies were exercise, drumming, crafts, and cultural ceremonies.

50
Q

primary prevention information

A

Strategy: the identification and modification of risk factors for disease

Aim: to prevent occurrences of disease

Disease stage: there is no disease present, but the individual is susceptible to the disease due to risk factors

Ex: quitting smoking

51
Q

secondary prevention information

A

Strategy: the early detection and treatment of diseases

Aim: to stop the progression of the disease, or to either cure, prevent complications, and death, or to stop or limit its spread

Disease stage: subclinical or early clinical, pathological changes but no signs or symptoms

Ex: regularly schedules mammograms

52
Q

tertiary prevention information

A

Strategy: the treatment and rehabilitation of the person with the disease

Aim: to limit disability, prevent relapse, and restore function

Disease Stage: signs and symptoms of the disease, potential complications/disabilities

Ex: early rehabilitation for people who suffered a stroke

53
Q

primary prevention of HPV related cancers

A

Aims to reduce the occurrence of a disease by identifying and modifying risk factors. Globally, HPV infections are the most common sexually transmitted infections and can lead to 6 types of cancer. Without vaccination, it is estimated that 75% of sexually active Canadians will have an HPV infection in their life
HPV vaccination is most effective when administered before becoming sexually active. HPV vaccines are federally funded and administered in schools.

54
Q

secondary prevention of cervical cancer

A

Screening plays a critical roe in secondary prevention because it enables early detection and treatment of disease. One example of effective secondary prevention is the screening for cervical cancer
Although highly curable, cervical cancer kills thousands of women annually, especially in low income countries

55
Q

tertiary prevention for PD

A

Tertiary prevention involves the treatment and control of disease. PD is a progressive disease of the NS. This diseases usually effects adults ages 50-60, and is 50% more common in men than women. The cause of PD is attributed to a combination of genetic mutations, which can be hereditary, and environmental factors

56
Q

health interventions

A

Aim to address a health need or gap within a given population. Often, interventions are developed around 3 main criteria: the target (entity on which the action is carried out), the action (a deed done by an actor to a target), and the means (the processes and methods by which the action is carried out)

57
Q

developing an intervention step 1

A

identify and assess the level of the problem
This can be done using a needs assessment
Common needs assessments include questions like:
- What is the extent of the problem
- What are potential root causes for the health problem
- What are barriers and enablers to addressing the root cause through intervention

58
Q

developing an intervention step 2

A

develop a solution to the problem
After identification and assessment of the problem, a solution is developed. Solutions can be built upon existing interventions/best practices

59
Q

developing an intervention step 3

A

describe the action plan for the intervention
This step involves determining the details of the implementation of the proposed solution. Questions that are addressed at this stage include:
- What specific change or aspect of the intervention will occur?
- Which groups will benefit from this intervention?
- Who will carry it out?
- When will the intervention be implemented? How long will it be maintained?
- What resources are needed, what resources are available?
- What is the feasibility of the plan?

60
Q

developing an intervention step 4

A

assess the potential impact
Once the action plan has been described, the potential impact must be assessed.
Questions asked:
- What are the intended and unintended outcomes of this intervention?
- How will ‘success’ be measured? Will the impact be positive or negative?

61
Q

interventions: from theory to practice

A

despite rigorous planning that occurs in developing an intervention, it is important to understand that once implemented in reality, the intervention might now always be as effective as anticipated.
Therefore, it is important for researchers to investigate any intended or unintended consequences of their proposed intervention plan.

62
Q

quaternary prevention

A

Quaternary prevention is defined as “action taken to identify patients at risk of overmedicalization, to protect them from new medical invasion, and to suggest to them interventions which are ethically acceptable”.
This type of prevention is important so that doctors are conscious of the harm they may cause to their patients, even unintentionally. One relevant example involves the current opioid crisis, which was initially caused by the over-prescription of opioids for patients with chronic pain. The opioid crisis has historically burdened marginalized and racialized people disproportionately, including Indigenous people.

63
Q

community input in needs assessment

A

Conducting a needs assessment of the community is the most critical component developing an intervention. It informs health promoters of the most pressing needs within a community, as described by its own members, and it also ensures that the intervention being planned is aligned with the needs that are perceived by the community.
One of the biggest benefits of involving community members throughout this process is a higher likelihood that the community will support the process and engage with the intervention, resulting in improved chances of a successful intervention.

64
Q

the importance of consultation and practice

A

Community input and participation during a needs assessment is central to the success of an intervention. However, if this step is not taken into consideration, the intervention might be unsuccessful at best, and at worst, have unintended consequences within the community.

65
Q

curating an intervention

A

Successful interventions are often the result of effective collaboration between people, departments, and disciplines.

66
Q

problematic attitudes when providing aid

A

Paternalistic and patronizing attitudes when carrying out an intervention can be extremely dangerous, as they may be disguised as a well-intentioned approach to take while it is actually doing harm. These complexes are often found in the white saviour complex, and it serves to build a helpless and demeaning image of marginalized and vulnerable communities, which further disempowers them.

GLPH 271 (4 decks)

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