public health Flashcards
What is health psychology
role of psychological factors in cause, progression and consequence of health and illness
aims to put theory into practice by promoting health bahvaiours and preventing illness
what are the 3 main categories of behaviours related to health
helath behaviour
illness behaviour
sick role behaviour
What is health behaviour
behaviour aimed to prevent disease e.g eating healthy
What is illness behaviour ?
behaviour aimed to seek remedy e.g seeing a doctor
What is sick role behaviour
any activity aimed at getting better e.g taking medications
Whats health damaging behaviours
smoking, alcohol and substance abuse, risky sexual behaviour
Whats health promoting behaviours
exercise, healthy eating, attending health check s
What is population level intervention at health promotion
process of enabling people to exert control over their determinants of health and improving health
public health england
What is individual level intervention
patient centred approach
Examples of health promotion
healthier you - diabetes
change 4 life campaign
Examples of promoting screening and immunisations
cervical smear screening
MMR vaccinen
What is unrealistic optimism?
individuals continue to practice health damaging behaviours due to inaccurate perceptions of risk and susceptibiliy
- lack of personal experience with problem
- belief problem preventable
- belief that if not happened by now it wont
- belief that problem is infrequent
What is the health belief model?
Becker 1974
individuals will change if they:
believe they are susceptible to the condition in question
believe it has serious consequences
beleieve that taking action reduces susceptibility
beleieve that the benefits of taking action outweight the costs
Critique of health behaviour model (Becker 1974) `
does not consider influence of emotions on behaviour
does not differentiate between first time and repeat behaviour
What is the theory of planned behaviour?
Ajzen 1988
proposes best predictor of behaviour is intention
intention determined by:
person’s attitude
perceieved social pressure to undertake behaviour / social norm
persons appraisal of ability to perform behaviour (perceived behaviour control)
Theory of planned behaviour critique
lack of temporal element and lack of direction or causality
doesnt take into account emotions
doesnt explain attitudes, intentions and perecived behavioural control intereact
relies on self reported behaviour
What is stage models of health behaviour
transthorectical model - Prochaska and DiClemente 1984
5 stages;
precontemplation
contemplation
preparation
action
maintanence
Advantages of transthoretical model
acknowledges individual stages of readiness
accounts for relapse
temporal element
Disadvantages / critique for the transtheoretical model
not everyone goes through every stage in order
change may be continuum rather than discrete stages
doesnt take into account values, habits, culture, social or economic factors
Other factors to consider in changing behaviour?
impact of personality traits on health behaviou r
assessment of risk assessment
impact of past behaviour/habit
automatic influences on health behaviour
predictors of maintenance of health behaviours
social environment
What are typical transition points in which interventions likely to be most effective
leaving school
entering workplace
becoming a parent
becoming unemployed
retirement and bereavement
What are examples of early influences on feeding behaviour
maternal diet and taste preference and development
role of breastfeeding
parenting practices
age of introduction of solid foods, types of foods
Positive parental feeding practices
modeling healthful eating behaviours
responsive feeding; recognising hunger and fullness cues
providing variety of foods
avoiding pressure to eat
not using food as a reward
Eating disorders definition?
eating disorders: clinically meaningful behavioural or psychological pattern having to do with eating or weight that is associated with distress, disability or with substantially increased risk of morbidity or mortality
Disordered eating definition
restraint, strict dieting, disinhibition, emotional eating, binge-eating, night eating, weight and shape concerns, inappropiate compensatory behaviours that don’t warrant a clinical dx
3 basic forms of diet associated with restriciton of food intake?
restriction total amount of food eaten
don’t eat certain types of food
avoid eating for long periods of time
Challenge with dieting?
risk factor for developing ED in some individuals
dieting results in loss of lean body mass, not just fat mass
slows metabolic rate and energy expenditure
chronic dieting may disrupt normal appetite responses and increase subjective sensations of hunger
Advantages of cohort studies
can follow a group with a rare exposure
good for common and multiple outcomes
less risk of selection and recall bias
Disadvantages for cohort studies
takes long time
loss to follow up (people drop out)
need large sample size
Advantages of cross-sectional studies
relatively quick and cheap
provide data on prevalence at single point in time
large sample size
good for surveillance and public health planning
Disadvantages for cross-sectional studies
risk of reverse causalitiy
cannot measure incidence
risk recall bias and non-response
advantages of RCTs
low risk bias and confounding
can infer causality
Disadvantages of RCTs
time consuming
expensive
specific inclusion/exclusion criteria may mean study population is different from main population
reasons a study may have associated between exposure and outcome
chance
bias
confounding
reverse causality
true causal association
What is selection bias
systemic error in:
selection of study participants
allocation of participants to different study groups
non response
loss to follow up
What is information bias
measurement - different equipment used
observer -
recall - events happened in past aren’t remembered or reported accurately
reporting - report inaccurate info - embarrassed or feel judges
What is confounding factor
situation between exposure and outcome has also been impacted by another factor
what is reverse causality
refers to a situation where an association between exposure and an outcome could be due to outcome rather than exposure
disadvantages to screening
exposure of well individuals to distressing or harmful diagnostic tests
detection and treatment of subclinical disease that never would have caused problems
preventative interventions that may cause harm to individual or population
what is sensitivity
a/a+c
proportion of those with disease who are correctly identified by screening test
3 approaches to health needs assessment
epidemiological approach
corporate
comparative
