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3a > Public Health > Flashcards

Public Health Flashcards

1
Q

3 domains of public health

A

Health improvement
health protection
improving services

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2
Q

What is health improvement?

A

social interventions aimed at preventing disease, promoting health + reducing inequalities
e.g. education, employment, housing

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3
Q

What is health protection?

A

measures to control infectious disease risks + environmental hazard
e.g. infectious disease, radiation, chemicals + poisons, environmental hazards

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4
Q

What is improving services?

A

organisation + delivery of safe, high quality services for prevention, treatment + care
e.g. clinical effectiveness, efficiency, service planning, audits, clinical governance

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5
Q

What are the determinants of health?

A

genetic, environmental, healthcare, lifestyle

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6
Q

inverse care law

A

availability of medical or social care tends to vary inversely with need of population served

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7
Q

equality

A

treating everyone the same, giving equal shares

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8
Q

equity

A

being fair, giving what they need to be successful

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9
Q

PROGRESS

A

place of residence
race or ethnicity
occupation
gender
religion
education
socio economic status
social capital or resources

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10
Q

horizontal equity

A

equal treatment for equal need

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11
Q

vertical equity

A

unequal treatment for unequal need

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12
Q

Bradford-Hill criteria

A

DR BC ST
dose-response
reversibility
biological plausibility
consistency
strength
temporality

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13
Q

bias

A

systematic error that results in deviation from true effect of exposure on outcome

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14
Q

confounding factors

A

factor is associated with exposure of interest + independently influences outcome

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15
Q

selection bias

A

systematic error in selection of study participants or allocation of participants to different study groups

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16
Q

information bias

A

systematic error in measurement or classification of exposure or outcome

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17
Q

public bias

A

studies with negative results less likely to be published

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18
Q

health definition

A

state of complete physical, mental + social wellbeing, not merely the absence of disease

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19
Q

3 types of health needs assessment

A

epidemiological, comparative, corporate

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20
Q

need definition

A

ability to benefit from an intervention

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21
Q

felt need

A

individual perceptions of deviation from normal health

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22
Q

expressed need

A

seeking help to overcome variation in normal health

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23
Q

normative

A

professional defines intervention for expressed need

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24
Q

comparative need

A

comparison between severity, range of interventions + cost

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25
Q

Maxwell’s dimensions

A

3 As + Es
access
appropriate, relevant to need
acceptability
equity
efficient
effective

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26
Q

health behaviour

A

aimed at preventing disease e.g. going for a run

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27
Q

illness behaviour

A

seeking remedy e.g. going to GP

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28
Q

sick role behaviour

A

activity aimed at getting better e.g. taking abx

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29
Q

transtheoretical model stages

A

PC PAM
pre contemplation
contemplation
preparation
action
maintenance

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30
Q

medical negligence

A

was there a duty of care?
was there a breach in that duty?
was patient harmed?
was harm due to breach in care?

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31
Q

Bolam rule

A

would reasonable doctor do the same?

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32
Q

Bolitho rule

A

would that be reasonable?

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33
Q

sloth error

A

lazy e.g. inadequate documentation

34
Q

system error

A

inadequate built in safeguards

35
Q

lack of skill

A

not having appropriate training

36
Q

fixation

A

focus on 1 Dx only

37
Q

bravado

A

working beyond competency

38
Q

playing odds

A

deciding it’s common disease + turns out to be rare disease

39
Q

poor team working

A

communication breakdown

40
Q

ignorance

A

unconscious incompetence

41
Q

screening

A

identifying apparently well individuals who have or are at risk of having particular disease

42
Q

primary prevention

A

prevent disease from occurring

43
Q

secondary prevention

A

detection of early disease to alter chances + improve outcomes (screening)

44
Q

tertiary prevention

A

slow down progression of disease

45
Q

Wilson-Junger criteria

A

condition should be important health problem
accepted Tx
facilities for Dx + Tx available
recognisable latent or early stage
suitable test or exam
test acceptable to population
natural Hx understood
agreed who to treat
cost-benefit balance
case finding continuous process

46
Q

sensitivity

A

people with disease correctly identified

47
Q

specificity

A

people without disease correctly excluded

48
Q

PPV

A

people who test positive who have disease

49
Q

NPV

A

people who test negative without disease

50
Q

cross-sectional study

A

snapshot of those with + without disease to find associations at single point in time
+ cheap + quick
+ few ethical issues
- prone to bias
- no time reference

51
Q

case-control

A

retrospective observational study looks at certain exposure + compares similar participants with + without disease
+ good for rare diseases
+ inexpensive
- only show association (not causation)
- unreliable due to recall bias

52
Q

cohort

A

longitudinal prospective study which takes population of people recording their exposures + conditions they develop
+ can show causation
+ less chance of bias
- large amount lost to follow up
- expensive

53
Q

RCT

A

similar participants randomly controlled to intervention or control groups to study effect of intervention
+ can infer causality
+ less risk of bias/confounders
- time consuming + expensive
- ethical issues can interfere

54
Q

health needs assessment cycle

A

planning
implementation
evaluation

55
Q

seedhouse ethical grid layers

A

4 layers
core rationale
deontological layer
consequential layer
external considerations

56
Q

4 quadrants

A

medical indications
patient preferences
quality of life
contextual features

57
Q

virtue ethics

A

virtuous habits, live life of moral character

58
Q

consequentialism

A

whether action is right by judging consequences

59
Q

utilitarianism

A

greatest good for greatest number

60
Q

hedonism

A

it’s good if consequence produces pleasure or avoids pain

61
Q

deontology

A

follow rules + do duty

62
Q

satiation

A

bring eating occasion to end - control meal size

63
Q

satiety

A

suppresses hunger after eating occasion - control snacking between meals

64
Q

health equity

A

equal expenditure for equal need
equal access for equal need
equal utilisation for equal need
equal healthcare outcome for equal need
equal health

65
Q

dimensions of health equity

A

spatial - geographical
social - age, gender, socioeconomic class, ethnicity

66
Q

perceptions of risk

A

no personal experience with problem
belief that preventable by personal action
belief that if not happened by now, it won’t happen
belief that problem infrequent

67
Q

health needs assessment - epidemiological approach

A

looks at evidence base, defines problem + size of problem, looks at current services, recommends improvements
+ provide info on incidence + prevalence of disease + existence + utilisation of services
- data available may be poor
- may be inadequate evidence base
- doesn’t consider felt need

68
Q

health needs assessment - comparative approach

A

compares services received by 1 population to another (spatial/social)
- data available may vary in quality or unavailable
- may be hard to find comparable population
- comparison may not be perfect

69
Q

health needs assessment - corporate approach

A

takes into account views of any group that may have an interest e.g. patients, doctors, media, politicians
interviews, focus groups, meetings
- may be hard to distinguish need from demand
- groups have vested interest - leads to bias
- dominant individuals may have undue influence
- may be influenced by political agendas

70
Q

lead time bias

A

early identification appears to prolong survival time

71
Q

length time bias

A

less aggressive cancers more likely to be identified by screening - makes it appear screening prolongs life

72
Q

theory of planned behaviours - what determines intention?

A

ASP
attitudes to behaviour
subjective norms
perceived control over behaviour

73
Q

theory of planned behaviours - what bridges the gap between intention + behaviour

A

P-PAIR
preparatory actions
perceived control
anticipated regret
implementation intentions
relevance to self

74
Q

theory of planned behaviour advantages

A

can be applied to wide variety of health behaviours
useful for predicting intention
takes into account importance of social pressures

75
Q

theory of planned behaviour disadvantages

A

no temporal element, direction or causality
doesn’t consider emotions
assumes attitudes can be measured
relies on self-reported behaviour

76
Q

transtheoretical model advantages

A

acknowledges individual stages of readiness
accounts for relapse
temporal element

77
Q

transtheoretical model disadvantages

A

some individuals skip stages or move backwards
change may be continuous or not discrete
doesn’t consider values e.g. cultural + social factors

78
Q

health belief model - what determines likelihood of action?

A

perceived susceptibility
perceived severity
health motivation
perceived benefits
perceived barriers

79
Q

health belief model advantages

A

can be applied to wide variety of health behaviours
cues to action unique component
longest standing model

80
Q

health belief model disadvantages

A

other factors may influence outcome
doesn’t consider emotions
doesn’t differentiate between 1st time + repeated behaviours
cues to action often missing in HBM research

81
Q

nudge theory

A

changing environment to make preferred option easiest
- weak evidence to support this

82
Q

motivational interviewing

A

counselling approach for initiating behaviour change by resolving ambivalence

3a (4 decks)

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