PBL Workshops Flashcards
Age standardisation: crude death rate
sum of all deaths/
total population/time
Age standardisation: age-specific death rate
no. of deaths for the age group/
pop size of age group/time
Age standardisation: expected deaths for age group
age specific death rate x
no of people in standard pop age group
Age standardisation: age-standardised death rate
sum of expected deaths/
standard pop/time
Treat of Waitangi: Languages
English and Maori
Treat of Waitangi: Which version sets precedence
Maori
Treat of Waitangi: Voluntary or involuntary
Voluntary
Treat of Waitangi: Maori population after signing
The proportion of Maori pop in NZ decreased rapidly after the signing of the Treaty
Treat of Waitangi: Hāpu
Most hāpu signed the Maori version of the Treaty
Is ethnicity always self-identified
Not always
In some cases, individuals (e.g. children) may not be able to identify it themselves
Ethnicity / race
Ethnicity is not the same as race
Newborn children and mother ethnicity
New born children don’t need to be recorded as same ethnicity as mother
How is consistency of ethnicity responses maintained
A standard ethnicity question is used for collecting ethnicity
Can ethnicity change over time
The ethnicity identified by individuals can be changed over time
Ethnicity coding: recording vs reporting
Must be recorded exactly how participants responded into a data warehouse
Can decide how to report individuals’ ethnicity
Main methods of reporting ethnicity
Prioritised output
Total response output
Sole/combination output
Ethnicity coding: different levels
Level 1: least detailed, 1 digit
Level 2: more detailed, 2 digits
Level 3: more detailed, 3 digits
Level 4: most detailed, 5 digits
Ethnicity codes: level 1 - code, ethnicity, priority
1: European (6)
2: Maori (1)
3: Pacific (2)
4: Asian (3)
5: Middle Eastern/Latin American/African - MELAA (4)
6: Other ethnicity (5)
9: Residual categories (9)
Ethnicity coding: minimum level recorded
Level 4
Numerator : denominator bias
A common error in health research where researchers need to adjust for the classification differences when 2 diff output methods are used
Numerator: prioritised output
Denominator: total response output
Ethnicity coding: repetitions in level 3, 2, 1
Don’t report repeated codes twice
Relative inequality and absolute inequality
Similar to RR and RD
Relative inequality: EGO/CGO
Absolute inequality: EGO - CGO
How to interpret relative inequality
e.g. relative inequality = 2
x are twice as likely to smoke as y
OR x are 2 times more likely to smoke as y
OR x are 100% more likely to smoke than y (RRI = (RR - 1) x 100%)
If result < 1, interpret it in %, e.g. relative inequality = 0.25
x are 75% less likely to to smoke than y (RRR = (1 - RR) x 100%)
How to interpret absolute inequality
e.g. absolute inequality = 10 per 100
There are 10 more smokers per 100 x than per 100 y
OR out of 100 x, there are 10 more smokers than out of 100 y
If result is negative, e.g. absolute inequality = -15 per 100
There are 15 fewer smokers per 100 x than per 100 y
OR out of 100 x, there are 15 fewer smokers than out of 100 y
What is the Haddon Matrix
A 3x3 brainstorming table/tool to help identify diff ways of intervening to address injury risks from multiple dimensions
Haddon Matrix: Columns
Host - the people at risk of experiencing an injury, or the caregiver of the at-risk person
Agent/Vehicle - the people or an object that causes an injury or accident
Environment - the contextual background (environmental determinant) associated with the injury, including aspects of the social/physical setting or health system
Haddon Matrix: Rows
Pre-event - anything that happened before the injury/accident
Event - the moment when an injury/accident takes place and and at the site of injury
Post-event - anything that happens after the injury/accident beyond the site of injury
Haddon Matrix - interventions
Interventions can either prevent injury occurring in the first place (pre-event), reduce the severity of injury at the time of accident (event) or reduce consequences of the injury after the event (post-event)
Haddon Matrix: Interventions focusing on host or humans in agent/vehicle column
Often have an educational orientation, e.g. training, advertising campaign
Haddon Matrix: Interventions focusing on inanimate objects in vehicle/agent column
Often have an engineering orientation
Haddon Matrix: Interventions in environment category
Often have either social, physical, or health system, e.g.
Social - financing, legislation, setting up / creating new programs
Physical - street design
Health system - availability of trauma and rehabilitation systems, social attitudes and health
3rd dimension of Haddon Matrix: Criteria that could influence likelihood of success of various injury prevention interventions
Effectiveness
Cost
Freedom
Equity
Haddon Matrix: 3rd dimension - effectiveness
Is there good evidence the intervention will work
Haddon Matrix: 3rd dimension - cost
What are the costs of implementing/enforcing the program/policy
May also be relevant to consider who bears this cost as there may be equity issues
Opportunity costs and cost-effectiveness included here
Haddon Matrix: 3rd dimension - freedom
Extent to which the freedom of a particular group is compromised can result in resistance to the intervention
Haddon Matrix: 3rd dimension - equity
Horizontal equity: an intervention that treats all people equally or in a universal way
Vertical equity: a strategy that results in unequal treatment of people based on their unequal risk of injury
Haddon Matrix: 3rd dimension - stigmatisation
Concept that a program of policy shouldn’t stigmatise people wherever possible
Haddon Matrix: 3rd dimension - preferences/acceptability
Of the proposed strategy to the affected community/individuals - importance of perceptions involved and socio-cultural context, norms and values
Haddon Matrix: 3rd dimension - feasibility
If effective, is it likely to be able to be implemented in the setting of relevance
Haddon Matrix: 3rd dimension - unforeseen adverse consequences
Relates to situations like fencing a property resulting in limited access to house from road and security concerns for vehicle or personal safety
