Public health Flashcards
What are the determinants of health
P- place of residence
R- race
O- occupation
G- gender
R- religion
E- education
S- socio-economic
S- social capital
5 stages of the transtheoretical model
Pre-contemplation
Contemplation
Preparation
Action
Maintenance
Name the 4 beliefs individuals must have if they are to change their behaviour according to the health belief model
- susceptible to the condition
- serious consequences
- taking action reduces susceptibility
- benefits of action outweigh the cost
State the 3 perspectives of a health needs assessment
- Epidemiological perspective
- Comparative perspective
- Corporate perspective
Describe the Epidemiological perspective of a health needs assessment
Looks at:
* Size of population - incidence/ prevalence
* Services available - prevention/ treatment / care
* Evidence base - effectiveness/ cost effectiveness
Sources: disease registry, admissions,GP databases
Pros and Cons of the Epidemiological perspective of a health needs assessment
Pros:
* Uses existing data
* Provides data on disease incidence/mortality/morbidity
Cons:
* Quality of data is variable
* Data collected may not be data required
* Does not consider felt needs/ opinions of patients
Describe the comparative perspective of a health needs assessment
- Compares services/ outcomes received by a population with others
- Could compare different areas or patients of different ages etc
- Looks at: health status, service provision, outcomes
Pros and Cons of the comparative perspective of a health needs assessment
Pros:
* Quick and cheap if data available
* indicates whether health or services provision
is better/worse than comparable areas
Cons:
* Can be difficult to find comparable population
* Data may not be available/ high quality
Describe the corporate perspective of a health needs assessment
- Ask local population what their health needs are
- Use focus groups, interviews, public meetings
- Wide variety of stakeholders
Advantages of the corporate approach of a health needs assessment
- Based on the felt and expressed needs of the
population - Recognises the detailed knowledge and
experience of those working within the population - Takes into account wide range of views
Disadvantages of the corporate approach of a health needs assessment
- Difficult to distinguish ‘need’ from ‘demand’
- Groups may have vested interests
- May be influenced by political agendas
3 disadvantages of screening
- Exposure of well individuals to distressing or harmful diagnostic tests
- Detection and treatment of sub-clinical disease that would never cause any problems
- Preventative interventions that may cause harm to the individual or population
What screening is offered during pregnancy
- Infectious diseases in Pregnancy Screening Programme (hep B, syphilis, HIV)
- Sickle Cell and Thalassaemia Screening
- Fetal Anomaly Screening Programme (Down’s syndrome, Edwards’ syndrome and Patau’s syndrome)
What screening programmes are available for young people and adults
- AAA screening programme
- Bowel Cancer Screning
- Breast Cancer Screening
- Cervical Screening
- Diabetic Eye Screening
Define sensitivity
proportion of those with disease who are correctly identified
Define specificity
proportion of people without disease who are correctly excluded by screening test
Define positive predictive value
proportion of people with a positive test result who actually have the disease
Define negative predictive value
proportion of people with a negative test result who do not have the disease
What is case-control study
- retrospective, observational study looking at cause of disease.
- Compares similar participants with disease to controls without.
advantages of case control studies
- Good for rare outcomes
- Quicker than cohort or intervention studies (outcome already happened)
- Can investigate multiple exposures
disadvantages of case-control studies
- Difficulties finding controls to match with case
- Prone to selection and information bias
What is a cross-sectional study
Retrospective observational study that collects data from a population at a specific point in time ‘snapshot’.
advantages of a cross-sectional study
- Relatively quick and cheap
- Provide data on prevalence at single point in time
- Good for surveillance and PH planning
disadvantages of cross-sectional studies
- Risk of reverse causality (did outcome or exposure come first?)
- Cannot measure incidence
- Recall and response bias risk (may miss quick recoveries)
What is a cohort study
Prospective longitudinal study looking at separate cohorts with different treatments or exposures. Wait to see if disease occurs
advantages of cohort study
- Can follow-up group with a rare exposure
- Good for common and multiple outcomes -> establish disease risk and confounders
- Less risk of selection and recall bias
disadvantages of cohort studies
- Takes a long time
- People drop out
- Need large sample size, expensive and time consuming
What is a randomised control trial
Prospective study, all participants randomly assigned exposure or control intervention
Advantages of randomised control trials
- Low risk of bias and confounding
- Can infer causality ( X intervention causes Y outcome)
disadvantages of randomised control trials
- Time consuming, expensive
- Drop outs
- Inclusion criteria may exclude some populations
Give 5 models of behaviour change
- health belief model
- theory of planned behaviour
- transtheoretical model
- social norms theory
- motivational interviewing
- Social marketing
- Nudging (choice architecture)
- Financial incentives
According to the theory of planned behaviour, what 3 factors determine an individual’s health behaviour
- behavioural beliefs: attitude towards the behaviour
- normative beliefs: subjective norm
- control beliefs: perceived behavioural control
4 dimensions of food insecurity
- availability
- access
- utilisation
- stability of the three dimensions over time
