Primary Prevention

Question 1

Define primary prevention.

Answer 1

Preventing disease / injury before it occurs.

Question 2

List 2 examples of primary prevention.

Answer 2

1 - Immunisation programmes.

2 - Laws enforcing safety equipment at work.

Question 3

Define secondary prevention.

Answer 3

Reducing the impact of disease / injury by preventing its development.

Question 4

List 2 examples of secondary prevention.

Answer 4

1 - Screening programmes.

2 - Diet / exercise programmes to reduce risk of further health problems.

Question 5

Define tertiary prevention.

Answer 5

Softening the impact of long term health effects.

Question 6

List 2 examples of tertiary prevention.

Answer 6

1 - Rehabilitation programmes.

2 - Support groups.

Question 7

Define health promotion.

Answer 7

• The process of enabling people to increase control over, and to improve, their health.
• Usually the same as primary prevention, but sometimes impacts secondary and tertiary prevention.

Question 8

List 3 differences between disease prevention and health promotion.

Answer 8

1 - Disease prevention uses a medical model, whereas health promotion uses a holistic model.

2 - Disease prevention targets specific diseases, whereas health promotion is more general, and the benefits are wider.

3 - Disease prevention only targets the groups at risk, whereas health promotion targets whole populations.

Question 9

List 7 examples of health promotion.

Answer 9

1 - Drink driving campaigns.

2 - Tobacco control.

3 - Immunisation programmes.

4 - Screening programmes.

5 - Water fluoridation.

6 - Self management of disease.

7 - Healthy eating campaigns.

Question 10

List 3 possible approaches to health promotion.

Answer 10

1 - Medical.

2 - Behavioural.

3 - Socio-environmental.

Question 11

For each of the 3 approaches to health promotion, list two examples of diseases for which that approach is suitable.

Answer 11

Medical:

1 - Cardiovascular disease.

2 - High blood pressure.

Behavioural:

1 - Smoking.

2 - Poor diet.

Socio-environmental:

1 - Poverty.

2 - Pollution.

Question 12

List 2 strategies that can be classified as behavioural health promotion.

Answer 12

1 - Health education.

2 - Public health policies (e.g. smoking ban).

Question 13

List 2 strategies that can be classified as socio-environmental health promotion.

Answer 13

1 - Community development.

2 - Political action for societal change.

Question 14

List 4 behaviour change theories / models that focus on individual behaviour.

Answer 14

1 - Health belief model.

2 - Stages of change model.

3 - Theory of planned behaviour.

4 - Precaution adoption process model.

Question 15

What is the focus of the health belief model?

Answer 15

How perceptions of threat, and benefits of avoiding threat, contribute to health actions.

Question 16

What is the focus of the stages of change model?

Answer 16

How various factors contribute to an individual’s readiness to change behaviour.

Question 17

What is the focus of the theory of planned behaviour?

Answer 17

How attitudes and perceived norms contribute to behaviour.

Question 18

What is the focus of the precaution adoption process model?

Answer 18

The journey from a lack of awareness to action and maintenance.

Question 19

Give an example of a behaviour change theory / model that focuses on interpersonal behaviour.

Answer 19

The social cognitive theory.

Question 20

What is the focus of the social cognitive theory?

Answer 20

How personal and environmental factors contribute to behaviour.

Question 21

List 3 personal and environmental factors that contribute to behaviour according to the social cognitive theory.

Answer 21

1 - Capacility.

2 - Expectations.

3 - Self-efficacy.

Question 22

List 5 factors that contribute to an individual’s perceptions of threat according to the health belief model.

Answer 22

1 - Perceived susceptibility.

2 - Severity.

3 - Benefits.

4 - Barriers.

5 - Self-efficacy.

Question 23

List 3 behaviour change theories / models that focus on community behaviour.

Answer 23

1 - Community organisation theory.

2 - Diffusion of innovation theory.

3 - Communication theory.

Question 24

What is the focus of the community organisation theory?

Answer 24

The practice of individuals and agencies collaborating and addressing issues deemed important and necessary within a given community.

Question 25

List the advantages of community collaboration according to the community organisation theory.

Answer 25

1 - Community empowerment.

2 - Increases community capacity.

Question 26

What is the focus of the diffusion of innovation theory?

Answer 26

How new ideas and practices spread within society.

Question 27

List the factors that affect how new ideas and practices spread within a society according to the diffusion of innovation theory.

Answer 27

1 - Compatibility.

2 - Complexity.

3 - Trialability.

4 - Observability.

Question 28

What is the focus of the communication theory?

Answer 28

How different types of communication affect behaviour.

Question 29

List the stages of the intervention ladder.

Answer 29

1 - Do nothing.

2 - Provide information.

3 - Enable choice.

4 - Guide choice through disincentives.

5 - Guide choice through incentives.

6 - Guide choice through policies.

7 - Restrict choice.

8 - Eliminate choice.

Question 30

List 5 health communication techniques to influence and promote conditions conducive to health.

Answer 30

1 - TV adverts.

2 - Billboards.

3 - Leaflets.

4 - Cigarette pack labels.

5 - Food labelling.

Question 31

Define mutual aid.

Answer 31

Opportunities where people who share common problems can support each other.

Question 32

List 3 examples of mutual aid.

Answer 32

1 - Alcoholics anonymous.

2 - Weight management.

3 - Cardiovascular rehabilitation.

Question 33

List 3 examples of organisational changes that create environments to better enable people to make healthy choices.

Answer 33

1 - School healthy eating policies.

2 - No smoking policies.

3 - Workplace exercise programmes.

Question 34

List the targets of each of the 3 approaches to medical health promotion.

Answer 34

1 - Medical: high risk individuals.

2 - Behavioural: High risk groups.

3 - Socio-environmental: High risk societal conditions.

Question 35

What is the major advantage of population approaches as compared to high risk individual / group approaches?

Answer 35

Although there are only small changes at the individual level, the population benefit is substantial.

Question 36

Give an example of a high risk individual / group approach to health promotion.

Give an example of a population approach to health promotion.

Answer 36

• High risk approach: cardiovascular risk screening.

- Population approach: North Karelia project.

Question 37

What was the North Karelia project?

Answer 37

A population approach of health promotion among men in North Karelia to reduce smoking, cholesterol and blood pressure.

Question 38

On a graph showing risk (x axis) and number of individuals in a population (y axis), how would the bell curve distribution be affected by:

1) A high risk approach?
2) A population approach?

Answer 38

1) A high risk approach would make the downward slope of the bell curve steeper / more concave.
2) A population approach would move the entire bell curve to the left.

Question 39

What is the healthy town programme?

What specific changes might be made under the healthy town programme?

Answer 39

• A population approach of health promotion that brings about environmental changes in towns and residential areas.
• Specific changes include cycle lanes, safer home designs for the elderly and fast-food free zones.

Question 40

Define choice architecture.

Answer 40

Any aspect of architecture that alters people’s behaviour in a way without eliminating any options or significantly changing their economic incentives.

Question 41

What is the difference between legislation and policy?

Answer 41

• Legislation is enforced by law.

- Policy is a plan of action to guide adherence to legislation.

Question 42

What is the difference between an interventionist and a libertarian?

Answer 42

• An interventionist would argue that the state should create freedom for individuals.
• A libertarian would argue that interventions by the state should be minimal.

Question 43

List 3 examples of health-promoting legislation that were initially met by controversy but are generally accepted today.

Answer 43

1 - 1st PH Act, 1848, which gave the government power over water and sewage systems.

2 - Licensing act, 1872, which restricted pub opening times and prohibited children from drinking spirits in a pub.

3 - Seatbelt wearing mandatory, 1983.

Question 44

Which groups of people respond more to price changes?

Answer 44

The poor and the young.

Question 45

Define social capital.

Answer 45

The factors of effectively functioning social groups for example:

• Interpersonal relationships,
• A shared sense of identity, and
• Shared norms.

Question 46

List 2 implementation issues of socio-environmental interventions.

Answer 46

1 - Generally more costly and difficult to implement than individual-level interventions.

2 - They are subject to shifting political / societal ideologies.

Question 47

List 4 actions that should be taken by a doctor to promote health.

Answer 47

1 - Ask about lifestyle.

2 - Offer advice.

3 - Refer if necessary.

4 - Empower patients to self-manage chronic disease.

5 - Undertake public health research.

6 - Contribute to national reports.

Question 48

What is a brief intervention?

Answer 48

A short, evidence-based, structured conversation about a patient’s behaviour.