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Its the final countdown > public health > Flashcards

public health Flashcards

1
Q

what are the 3 domains of public health

A

health improvement (social interventions to promote health & reduce inequalities)

health protection ( disease control measures & environmental hazards)

health care ( health service delivery & quality)

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2
Q

what are the social determinants of health (x8)

A

PROGRESS
P- place of residence ( rural, urban etc)
R - race/ethnicity
O-occupation
G-gender
R- religion
E- education
S- socioeconomic status
S - social capital or resources

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3
Q

give an example of horizontal equity

A

every pneumonia pt deserves equal treatment

horizontal equity - equal treatment for equal need

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4
Q

give an example of vertical equity

A

areas with poorer health care need higher expenditure on health service /// those with pneumonia deserve different treatment to those with a common cold

vertical equity = unequal treatment for unequal need

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5
Q

what are the 9 sections for the Bradford hill criteria for causation

A

DR B.C. STACS

D- dose -response
R- reversibility

B- biological plausibility
C - consistency

S - strength of association
T - temporality most important
A- analogy (analogous to other similar research)
C- coherence ( coherent to other information)
S- specificity

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6
Q

associations found in research may be due to a variety of reasons, what re the 5 causes of association

A

bias
confounding fctors
chance
reverse causality
true association

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7
Q

give an example of information bias

A

information bias - systematic error in measurement / classification of exposure/outcome

e.g. observer - knows controls/cases
participant - recall bis, reporting bias etc
instrument/ measurement - wrongly calibrated/ diff instruments used etc

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8
Q

define lead time bias

A

early identification appears to increase survival but doesn’t actually alter outcomes they have a lead on the condition

e.g. pt diagnosed earlier, so “lives longer”

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9
Q

define length time bias

A

slowly progressing diseases are more likely to be picked up by screening, so screening appears to prolong life

Screening tends to detect disease that is less aggressive (slow growing cancers) because they may remain asymptomatic for longer

More aggressive disease becomes symptomatic more quickly, so breast cancer detected because the patient found a lump is more likely to be a more aggressive type of cancer, which is likely to have a poorer outcome.

so length time bias may falsely suggest that those who have been screened have a better prognosis (rather than because they have a less aggressive form of the disease)

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10
Q

give 2 examples of prospective studies

A

randomised control trial

cohort studies

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11
Q

give 4 types of retrospective studies

A

case- control
cross-sectional
case series (multiple cases)
case report / anecdote (1 case)

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12
Q

cross-sectional study
advantages (*3)
disadvantages (x3)

A

cross-sectional - snap shot

adv
- larger sample size
- rapid
- repeated studies = show change over time

disadv
- risk reverse causality
- disease length bias ( excludes people who recover quickly/ conditions with short recovery
- sample size too small for rarer outcomes

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13
Q

case-control studies
advantages (x2)
disadvantages (x2)

A

adv
- good for rare outcomes
- rapid

disadv
- selection & information bias
- finding well-matched controls is resource consuming

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14
Q

cohort study

advantages (x3)
disadvantages (x4

A

prospective longitudinal study ( looks at population w/o a disease, splits group into exposed /not-exposed, observes disease/no disease outcome in both groups)

adv
- can establish causal factors ( reverse causality eliminated as disease not happened yet)
- can follow rare exposures
- data on confounders can be collected prospectively

disadv
- difficult in rare outcomes ( conditions may not develop)
- drop outs
- large sample size required (Expensive & time consuming)

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15
Q

RCT disadvantages (x3)

A
  • ethical - is the exposure/ non-exposure ethical?
  • drop outs
  • expensive & time consuming
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16
Q

how do cross-sectional and ecological studies differ

A

cross-sectional - prevalence in one area
ecological - compares areas/ time periods / levels of exposure

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17
Q

health needs assessment. when is it needed?

A

assessment should be conducted before health intervention is done - systematic method to review health issues facing population

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18
Q

what are the 3 sections of a health needs assessment

A

Need - ability to benefit from an intervention

demand

supply

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19
Q

give the 4 Bradshaw’s needs

A

FENC

Felt need (individual perceptions of variation from normal health e.g. can’t walk as far)
Expressed need ( individual seeks help to overcome variation form normal health)
Normative need ( professional defines appropriate intervention for expressed need)
Comparative need (comparison between severity, range of interventions & cost (e.g. pt with worse sx are prioritised for oversubscribed service)

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20
Q

what are the 4 stages of the planning cycle of health needs assessments

A

needs assessment ( assessing pt)
planning( make plan to improve)
implementation (implement new service )
evaluation (evaluate effect on wellbeing)

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21
Q

health needs assessment - advantages ( x3) and disadvantages (x4) to the epidemiological approach

A

epidemiological approach = top down

adv
- uses existing data
- provides data (incidence, mortality, morbidity etc)
- can evaluate services by trends over time

disadv
- data quality variable
- data collected may not be that required
- does not consider felt needs/ opinions/experiences of those affected
- reinforces purely biomedical approach

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22
Q

health needs assessment - advantages ( x2) and disadvantages (x4) to the comparative approach

A

(compares services between sub-groups) - e.g. spacial ( MS pts in north vs south yorkshire) vs social ( MS pts >30 vs <30)

adv
- quick & cheap ( if data available)
- gives measure of relative performance

disadv
- may be difficult to find comparable population
- data may not be available/ high quality
- may not yield what the most appropriate level (e.g. of provision/ utilisation) should be
- may be comparing 2 poor quality services

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23
Q

health needs assessment - advantages ( x3) and disadvantages (x4) to the corporate approach

A

incorporates views from pts, politicians, press, professionals, commissioners etc (e.g. service may be requested but politicians lower its priority due to costs)

adv
- based on felt & expressed needs of population
- recognises detailed knowledge & experience of those working with the popultion
- wide range of views considered

disadv
- difficult to distinguish need from demand
- groups considered may have vested interests
- may be influenced by political agendas

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24
Q

what are the 3 categories in Donabedian approach to evaluating clinical services

A

structure (What there is)
process ( what is done)
outcome - the 5 Ds ( death, disease, disability, discomfort, dissatisfaction)

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25
Q

what are the 6 categories to Maxwell’s Dimensions for evaluating clinical services

A

3Es and 3As
Effectiveness
Efficiency
Equity
Acceptability (e.g. OPs happen@ accetable time of day)
Accessibility
Appropriateness ( given to those who need it )

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26
Q

what is Wrights matrix

A

the combination of Donabedian’s approach and Maxwell’s dimensions for evaluating clinical services

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27
Q

define incidence

A

number of new cases during a specific time period divided by the size of the population

(Number of new cases during time period/ Population size) x 100%

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28
Q

define prevalence

A

number of existing cases in a population at a specific point in time

(Number of existing cases/Population size x 100% )

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29
Q

define relative risk

A
  • Risk in one category relative to another
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30
Q

define relative risk

A

risk in one category relative to another

relative risk = absolute risk in exposed group/ absolute risk in unexposed group

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31
Q

define absolute risk

A

proportion of a disease which is specifically due to the exposure

In Crookes (population of 1000), 300 people smoke. 45 of the smokers developed lung cancer. 5 of the non-smokers developed lung cancer
* What is the absolute risk of lung cancer in smokers?
* 45 in 300 = 0.15 = 15% = 15 per 100

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32
Q

define absolute risk difference

A

aka attributable risk
to find the risk specifically attributable to an outcome: difference between the “naturally occurring” cases and cases in exposed group.

  • Risk of lung cancer in smokers = 45/300 = 15%
  • Risk of lung cancer in non-smokers = 5/700 = 0.7%
  • Attributable risk (risk difference) = (15/100) – (0.7/100) = 14.3/100 = 14.3%
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33
Q

how to calculate NTT

A

1/attributable risk

  • always round up NNT, as a fraction of a person cant be treated

300 people smoke. 45 of the smokers developed lung cancer. 5 of the non-smokers developed lung cancer
* Attributable risk = 14.3%
* NNT = 1/attributable risk = 1/0.143 = 6.99
* So, if 7 people gave up smoking in this population, you would prevent one person getting lung cancer

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34
Q

define point prevalence

A

no. cases @one time/ total population @same time

period prevalence = no. cases in a period / total no. people in population @same time

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35
Q

cumulative incidence calculation

A

no. new events or cases of disease/ total no. individuals in the population at risk for a specific time interval.

e.g. proportion of patients who develop postoperative complications within one month of surgery

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36
Q

define cumulative incidence

A

aka incidence proportion

estimate of the risk that an individual will experience an event or develop a disease during a specified period of time.

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37
Q

calculation for Rate ratio

A

incidence rate in exposed group/ incidence rate in unexposed group

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38
Q

odds ratio

A

odds of disease in exposed group/ odds disease in unexposed group

with odds being: probability of getting disease / probability of not getting disease

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39
Q

give 3 disadvantages of screening

A
  • distress/ harm in well individuals
  • Detection and treatment of sub-clinical disease
  • Preventative interventions that may cause harm to the individual or population
  • e.g Increased antibiotic resistance if all moms screened for GBS during pregnancy
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40
Q

define tertiary prevention

A

trying to slow down the progression of the disease

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41
Q

define the prevention paradox

A

seatbelts

preventative measure which brings much benefit to the population but offers little to the individual

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42
Q

define sensitivity

A

proportion of people with the disease who are correctly identified

(true positive)/(true positive +false negative)

aka true positive/ total diseased

sensitivity - correct selection (inclusion)

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43
Q

define specificity

A

proportion without the disease who are correctly excluded

(true negative)/ (true negative/false positive)

aka true negative / total disease free

specificity - correct exclusion

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44
Q

positive predictive value

A

proportion of +ve results who actually have disease

(true positive)/ (true positive +false positive)

aka (those who actually have disease)/ (all who received positive result)

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45
Q

negative predictive value

A

proportion with -ve result who don’t have the disease

(true negative)/(true negative +false negative)

(people w/o disease)/ (people told they don’t have disease)

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46
Q

what are the 4 components of Wilson and Junger’s criteria for a screening programme

A

the condition (serious, well understood, detectable at early stage)

the treatment (accepted tx, facilities for dx &tx vailable, w/ extreme extra workload)

the test ( suitable, acceptable for pts, establish intervals to repeat it)

the benefits ( policy on who to tx, benefit > cost)

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47
Q

health psychology - define health behaviour

A

preventing disease ( e.g. going for run)

48
Q

health psychology - define illness behaviour

A

seeking remedy - e.g going to GP for Sx

49
Q

health psychology - define sick role behaviour

A

aim: to get well - taking antibiotics

50
Q

how are risk behaviours & protective behaviours seen in social norms theory

A

often overestimate the risk behaviour and underestimate the protective behaviours

social norms theory:
* Social norms are behaviours and attitudes that are most common in groups
* belief of norms is different to actual norms and people often misperceive the peer norms
* Often overestimate the risk behaviour and underestimate the protective behaviours
* Does not work when the risk behaviour is the social norm

51
Q

define nudge theory

A

Changing the environment to make the best option the easiest

52
Q

give an example of transition points in life which can influence behaviour change

A

any of:

  • Leaving school
  • Starting work/new job
  • Becoming a parent
  • Becoming unemployed
  • Retirement
  • Bereavement
53
Q

Health intervention can be conducted at an: individual, community and population level.
Give an example of health intervention at an individual level (alcohol)

A

reducing level of alcohol consumption

54
Q

Health intervention can be conducted at an: individual, community and population level.
Give an example of health intervention at a community level (alcohol)

A

improved alcohol referrals/ support in A&E

55
Q

Health intervention can be conducted at an: individual, community and population level.
Give an example of health intervention at a population level (alcohol)

A

nationally increased tax on alcohol sales

56
Q

what are the 4 aspects of the health belief model?

A

that individuals will change their health behaviour if
- belief of susceptibility
- belief consequences are serious
- belief action reduces susceptibility
- belief benefits of action outweigh cost

57
Q

what are the advantages ( x3) and disadvantages (x3) of the Health belief model (A model of behaviour change)

A

adv
- applicable to variety of health behaviours
- cues to action are unique component
- longest standing model

disadv
- other factors may influence the outcome
- doesnt consider emotions
- doesnt differentiate between first time & repeated behaviours

58
Q

what are the 5 stages of the transtheoretical model

A

precontemplation, contemplating, preparation, action, maintenance ( with relapse possible at each stage)

59
Q

what are the advantages ( x3) and disadvantages (x3) of the transtheoretical model (A model of behaviour change)

A

adv
- acknowledges individual stages of readiness
- accounts for relapse
- gives temporal element

disadv
- not everyone goes through it stage
- change may be a continuum, not discrete phases
- doesn’t incorporate values/habits/ cultes/ SEC factors

60
Q

what are facets of the Theory of planned behaviour

A

attitudes/subjective norm/ perceived behavioural control –> intentions –> behaviours

  • Attitude – smoking is bad
  • Subjective norm – most people around me want me to give up smoking
  • Perceived behavioural control – I believe I have the ability to give up smoking
  • THEN intention – I intend to give up smoking
  • THEN Behaviour – Giving up smoking
61
Q

what are the advantages ( x3) and disadvantages (x3) of the theory of planned behaviour (A model of behaviour change)

A

adv
- applicable to variety of health behaviours
- useful for predicting intentions
- considers importance of social pressures

disadv
- no temporal element, direction, or causality
- doesn’t consider emotions
- assumes attitudes, subjective norms & percieved behaviour control can be measured
- relies on self-reported behaviour

62
Q

what are the 5 aspects of the Bridging the intention-behaviour gap model

A
  • Perceived control - individual’s felt capability
  • Preparatory actions = sub-goals increases self-efficacy and satisfaction
  • Anticipated regret = reflection on feelings if they fail
  • Implementation intentions = “if-then” plans and is the biggest one
  • Relevance to self = can they relate to the behaviour
63
Q

how many grams of alcohol are in 1 unit

A

8g

64
Q

calculation for units of alcohol

A

BV% x vol (mls) / 1000

65
Q

7 factors that lead to error

A

sloth (lazy = e.g. inadequate documetntion)
system error ( e.g. inadequate built in safeguards)
lack of skill
fixation (focussed on one dx)
bravado - working beyong compltency
playing odds - deciding its a common disease but its actually rare
poor team working

66
Q

what 2 outcomes may result from an error

A

adverse even
near miss

67
Q

what are the 3 aspects in the 3bucket model ( situations leading to error)

A

self
- poor knowledge, fatigue, inexpereinced, feeling ill

context
- distraction, inadequate handover, production pressure, equipment failure

task
- variation from normal, omission errors, unfamiliar equipment

68
Q

in managing error in never events, what does the anticipation of blame promote?

A

it promotes cover ups

69
Q

what are the 4 spects of the PDSA model of quality improvement

A

PDSA
plan , Do, study (analyse the data collected from running the test in “do” stage, act (action plan to change and start new cycle)

70
Q

how does unrealistic optimism lead to health damaging behaviours

A

innaccurate perceptions of risk & susceptibility –> continue practicing health damaging behaviour

71
Q

perceptions of risk is influenced by…

A
  1. lack of personal experience with problem
  2. Belief that its preventable by personal action
  3. belief that if it hasn’t happened by now, it’s unlikely to happen
  4. belief that problem is infrequent
72
Q

what are the notifiable diseases

A
  • Acute encephalitis
  • Acute meningitis/ Meningococcal septicaemia
  • Cholera
  • COVID-19
  • Diphtheria, Tetanus, Pertussis
  • Food poisoning
  • Haemolytic uraemic syndrome (HUS)
  • Invasive group A streptococcal disease
  • Legionnaires’ disease
  • Malaria
  • MMR
  • Rabies
  • Scarlet fever
  • Tuberculosis
73
Q

2 base aspects of capacity

A

assume person has capacity unless proven otherwise

if a pt does not have capacity, decisions must be made in their best interest and in the least restrictive way possible

74
Q

4 aspects of assessing capacity

A

1, can they understand
2. retain -long enough to make a decision
3. weigh up
4. communicate

75
Q

what is gillick competency

A

assessment of capacity in <16 yo. if deemed competent, parents do not need to be notified of decision making

BUT
<13 cannot legally consent to sexual intercourse
children cannot refuse life saving treatment

76
Q

what is the fraser guidelines

A

assessing <16 for contraceptives ( fraser = contraceptives alone)

77
Q

what are the 5 facets if fraser guidelines which allow advice to be given for contraceptives

A
  1. can understand the nature & implications of proposed tx
  2. cannot be persuaded to inform parents
  3. very likely to begin/ continue sexual intercourse
  4. physical/mental health is likely to suffer w/o tx
  5. advice/ tx is in the young person’s best interest
78
Q

what is stigma

A

negative response to a label
biological reductionism = dx is a social label w/ -ve social, moral, financial consequences

79
Q

who understood stigma and normal to be opposites of a continuum of identity which exist relative to one another

A

Goffman

(stigma is spoiled identity)

80
Q

what is a potential political consequence of stigma

A

citizenship & (lack of ) entitlement

81
Q

where does Goffman argue that stigma resides

A

in the r/ship between the attribute & audience

82
Q

Give 3 types of stigma, according to Goffman

A

abominations of the body ( bemish/deformities)

character defects ( mentally ill, criminal)

tribal stigma (social collective)

83
Q

what is the difference between Felt and Enacted stigma

A

felt stigma - people feel stigma by comparing themselves to ‘normal’ attributes, doesn’t actually mean they’re being discriminated against

enacted stigma - overt discrimination

84
Q

what does Scrambler (2004s) hidden distress model of epilepsy in Britten show

A

felt stigma is more disruptive than enacted stigma

85
Q

what is the difference between discredited and discreditable people

A

discreditable - vulnerable to being discredited but can hide the characteristic ( mastectomy, alcoholic)

discredited - unable to conceal discreditable characteristic (Eg. amputee in a wheelchair)

86
Q

how does using people first language avoid stigma?

A

labelling people by their disease –> reinforced stigma

people first langue (people with obesity) ,rather than “obese people” avoids discrimination

87
Q

give examples of people most at risk of malnutrition in the aging population (>60s)

A

Poor dental health/lacking own teeth, living in institutions, 85+yo, low SEC environments.

88
Q

what are the current nutritional requirements for older adults

A

0.75g/Kg body/day

but complex because:

Lower lean mass in older adults = ?lower requirements

Argued: that increased protein intake = ?renal damage / more needed to replace what is lost

“anorexia of aging”  reduced appetite & earlier satiety ( reduced hunger hormones and slowed gastric emptying)

89
Q

what are common causes of Fe deficiency in older age

A

GI bleed (chronic disease e.g. colorectal cancer, NSAIDs)
regular bloods taken
reduction in global food intake

90
Q

describe malnutrition

A

state of nutritional deficiency or excess which causes measurable adverse effects on tissue/body function and clinical outcome.

91
Q

what GI changes in elderly affect nutritional intake

A

taste
hormone - CCK/Ghrelin
Gut motility
atrophic gastritis

92
Q

what are the direct implications of malnourishment on healthcare (X3)

A
  • More likely to be admitted.
  • Require lengthier stays
  • Higher morbidity/mortality risks
93
Q

what screening tools are used to assess nutritional status in older adults

A

MUST ( Malnutrition universal screening too)

MNA ( mini nutritional assessment

94
Q

give examples of anthropometric measures in assessing nutritional status in older adults

A
  • BMI (inaccuracies: if pt unable to stand, oedema etc)
  • Demi span- Distance between the midpoint of the sternal notch to the finger tips – with arms outstretched laterally)
  • Waist circumference
  • Skinfold thickness
  • Bioelectrical impedance analysis ( for bodyfat %)
95
Q

give 3 tests which can be used to assess frailty

A
  • Handgrip strength
  • Timed ‘up and go ( Time taken to stand up from a chair, walk 3 metres, turn and sit back down)
  • 30 second chair stand test
    (Leg and strength endurance - Postural hypotension ( falls risk) , How many times someone can stand and sit down in a chair )
96
Q

what are the 2 types of harm in medication abuse

A

physiological harm
social harm

97
Q

what are the harms in abuse of

benzos/ opiates
alcohol/illicit drugs
laxatives
SSRIs
Chlorphenamine antihistamines

A

benzos/ opiates - addiction, gateway effects
alcohol/illicit drugs - gateway effects
laxatives - electrolyte imbalances
SSRIs - withdrawal syndromes
Chlorphenamine antihistamines - convulsions, acidosis
ibuprofen - indigestion, bleed, hypokalaemia, acidosis
paracetamol - hepatotoxicity, rebound headache

98
Q

what are the 3 social harms of medication abuse

A

economic consts
accidents
effects on jobs & r/ships

99
Q

give risk factors for abuse of OTC meds/opiates

A

older female
genetic
(F)Hx addiction/psych disorders
high pain level
self-reported craving
concurrent use of tobacco/alcohol/benzos

100
Q

what are the competing identities in OTC misuse

A

perceived stereotypical addict identity

addict identity

professional idenitiy

101
Q

what are the 3 types of OTC medicine addiction

A

1: never exceeded a max dose
2: slightly exceeded a max dose
3: grossly exceeded a max dose

102
Q

changes made to reduce medication abuse
- pharmacy (x3)
- training
- tx (x2)
- support groups

A

o Pharmacy
 Large packs of analgesics (e.g., 100 packs of co-codamol) now given as prescription only
 Changed the indications – e.g., only for pain, not cold or flu
 Pack warning: ‘can cause addiction. For 3 days use only’
o Increased training for professionals; information given to patients
o Treatments
 Substitution treatments, tapering off
 Regular reviews
o Internet support groups

103
Q

in patient safety, there are hard and soft defences in system design to minimise risk. what is a Hard defence
what is a soft defence

A

hard defence - engineering safety features
soft defence - people & systems

104
Q

Give 7 system defences intended to minimise risk

A
  • System design ( hard & soft defences)
  • Patient safety alerts
  • Simplification and standardisation of clinical processes (e.g. SBAR)
  • Checklists and aide memoires
    (E.g. Standardised observations through NEWS)
  • Information technology (reduces adverse effects & medication errors esp. in elderly & polypharmacy )
  • Tools to improve uptake of evidence based treatment ( e.g. C. diff care bundle)
  • Supporting better team working (training, simulations, safety huddles)
105
Q

in system defences to minimise risk, what is the benefit of checklists and aide memoires?

A

allow for immediate structured action in a situation where there is little time to think
e.g. surgical safety checklists / NEWS

106
Q

n system defences to minimise risk, Care bundles are an example of tools to improve uptake of evidence based Tx. Define && gve examples of care bundles

A

Care bundles – contain 3-5 evidence informed practices which need to be delviered collectively and consistently
 E.g., C. diff care bundle, sepsis care

107
Q

how is foresight important in pt safety

A

watchfulness and foresight –> preventing &recovering incidents
.

108
Q

how can the 3 bucket model be used for assessing risky situations

A

self, context, task

the fuller the bucket, the more likely something will go wrong

109
Q

An academic core trainee in rheumatology wants to investigate whether there is any
association between the use of antihypertensive drugs and gout. What would be the
most appropriate study design, given that she has relatively little time in which to
conduct the research?

Cohort study
Retrospective case-control study
Audit of anti-hypertensive prescribing
Randomised controlled trial
Population-based cross-sectional study

A

Retrospective case-control study

cohort & RCT - long duration of study ( e.g. cohort, have to develop disease etc etc, and gout very uncommon compared to no. people on anti-HTN, so large group needed)

case-control. starts w/ group w/ and w/o condition, and info on anti-HTN intake can be taken

  • Case-control study – split into “case” and “control” and looks at exposures in each
110
Q

A GP practice sets up a diabetes clinic to try to improve the glucose control of its
patients with diabetes. Patients are provided with education and support, along with
lifestyle advice and regular screening of their eyes, kidneys and feet. What type of
prevention is this?

A

tertiary prevention

the disease (in this case diabetes) is already present and the patient
may be symptomatic. The aim is to reduce complications or the impact of complications on the
patient.

secondary preventions are screening programmes: * Secondary prevention – detection of early disease in order to alter the course of the disease and maximise the chances of a complete recovery e.g. screening programmes

111
Q

An elderly man asks his GP why all men do not get screened for prostate cancer
using PSA tests. The GP replies that few patients with high PSA turn out to have
prostate cancer. What does this suggest about PSA as a screening test for prostate
cancer?

The sensitivity is high
There is a low disease prevalence
The specificity is high
The positive predictive value is low
The positive predictive value is high

A

A: PPV is low

The GP has explained that many people with a high PSA (a positive screening test) do not
have prostate cancer. This means the positive predictive value (the proportion of those with a
positive screening test result who truly have the disease) is low.

112
Q

what is the epidemiological approach to health needs assessment

A

essentially epidemiological data collection

  • disease incidence & prevalence
  • morbidity & mortality
  • life expectancy
  • services available ( location, cost, utilisation, effectiveness)

sources of data: disease registry, hospital admissions, GP databases, mortality data, primary data collection (
postal/patient survey)

113
Q

what is the comparative approach to health needs assessment

A
  • compares health/healthcare provision of 1 sub-group tgo another
  • spatial ( e.g. different towns) / social ( e.g. age, social class etc)
  • can compare health, service provision/ utilisation, health outcomes
  • means of evaluating variation in performace/ cost of service
114
Q

what is the comparative approach to health needs assessment

A
  • asks the local pop what their health needs are
  • use of focus groups, interviews, public meetings etc
  • wide variety of stakeholders: e.g. teachers, healthcare professionals, social workers, charity workers, local businesses, council workers, politicians etc
115
Q

According to the theory of planned behaviour, what is the greatest predictor oh health behaviours?

A

intention

which is determined by their attitude to the behaviour, subjective norms, and perceived behavioural control over the behaviour

116
Q
A
117
Q
A

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