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Phase 3A > Public health peer teaching > Flashcards

Public health peer teaching Flashcards

1
Q

What are the 4 perceptions that will affect likelihood of engaging in health promoting behaviour, according to the health belief model

A

Susceptibility to ill health
Severity of ill health
Benefits of behaviour change
Barriers to taking action

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2
Q

7 steps of change/ transtheoretical model

A 
Precontemplation
Contemplation
Preparation
Action
Maintenance
Relapse
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3
Q

Describe theory of planned behaviour

A

Attitudes, subjective norm and percieved behaviour control affect intention which affects behaviour

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4
Q

What are the three aspects of communicable disease control?

A

Surveillance
Prevention
Control

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5
Q

What makes a communicable disease important to public health authorities

A

High mortality and morbidity
Highly contagious
Expensive to treat
Effective interventions

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6
Q

When do you notify of notifiable disease and how

A

On clinical suspicion, name, NHS no, DOB, contact details. What disease, diagnosis, samples, outcome.
Written notification, can be telephone first but followed by written.

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7
Q

Notifiable diseases

A 
Acute encephalitis, infectious hepatitis, meningitis, polymyelitis. 
Anthrax
Botulism
Brucellosis
Cholera
Diptheria
Enteric fever
Food poisoning
Haemolytic uraemic syndrome
Infectious bloody diarrhoea
Invasive GABHS
Legionnaires
Leprosy
Malaria
Mumps
Measles
Meningococcal septicaemia
Rubella
Plague
Rabies
SARS
Scarlet fever
Small pox
Tetanus
TB
Typhus
Viral haemorrhagic fever
Whooping cough
Yellow fever
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8
Q

Is food poisoning a notifiable disease

A

Yes

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9
Q

Things other than diseases that are notifiable

A

Infection/ contamination which could be a signficant risk to human health (chichen pox in a healthcare worker), notification of suspected outbreaks/ clusters

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10
Q

Define a cluster (outbreak)

A

A aggregation of cases which may or may not be linked

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11
Q

Define a suspected outbreak

A

Occurence of more cases than normally expected within a specific group/ over a given period of time.
2+ cases linked through common exposure/ characteristic/ time/ location
Single case of rare/serious disease

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12
Q

Define confirmed outbreak

A

Link confirmed through epidemiological/ microbiological investigation

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13
Q

Define epidemic

A

Occurence within an area in excess of what is expected for a given time period

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14
Q

Define pandemic

A

Epidemic widespread over several countries

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15
Q

Define endemic

A

Persistent level of disease occurrence

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16
Q

Define hyperendemic

A

Persistently high level of disease occurrence

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17
Q

What is health

A

A state of complete physical, mental and social wellbeing; not merely the absence of disease

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18
Q

What are the three domains of public health

A

Health protection
Health improvement
Improving service

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19
Q

What does health protection mean

A

Measures to control infectious disease risk and environmental hazards

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20
Q

What does health improvement mean

A

Social interventions aimed at preventing disease, promoting health and reducing inequality

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21
Q

What does improving services health domain do

A

Organisation and delivery of safe, high quality services

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22
Q

What is the inverse care law

A

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

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23
Q

4 categories for the determinants of health

A

Genetic
Lifestyle
Environmental
Health care

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24
Q

What are genetic determinants of health

A

Age
Gender
Ethnicity

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25
Q

What are environmental determinants of health

A

Housing
Socioeconomic status
Access to education

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26
Q

What are lifestyle determinants of health

A

Smoking status
Wealth
Employment

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27
Q

What are healthcare determinants of health

A

Access
Quality
Economic factors

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28
Q

What is equity

A

What is fair and just

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29
Q

What is horizontal equity

A

Equal treatment for equal need

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30
Q

What is vertical equity

A

Unequal treatment for unequal need

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31
Q

Define health needs assessment

A

A systematic approach for reviewing the health issues affecting a population which leads to agreed priorities and resource allocation that will improve health and decrease inequalities

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32
Q

What is the health needs assessment cycle

A

Needs assessment
Planning
Implementation
Evaluation

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33
Q

Describe epidemiological health needs assessment

A

Defines problem and size of problem
Looks at current services
Recommends improvements

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34
Q

What are the limitations of epidemiological health needs assessment

A

Data available may be poor
May be inadequate evidence base
Doesnt consider felt need

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35
Q

Describe the comparative health needs assessment

A

Compares services recieved by one population to another

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36
Q

What are the limitations of a comparative health needs assessment

A

Data available may vary in quality. May be hard to find comparable population. Comparison may not be perfect

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37
Q

Describe corporate health needs assessment

A

Takes into account views of any groups that may have an interest e.g. patients, media, proffesionals, politicians

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38
Q

What are the limitations of corporate health needs assessment

A

May be hard to distinguish need from demand
Groups have vested interest leading to bias
Dominant individuals may have bias

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39
Q

Define health need

A

The ability to benefit from an intervention

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40
Q

Define supply

A

What is provided

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41
Q

Define demand

A

What people ask for

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42
Q

What are the four types of need

A

Felt need
Expressed need
Normative need
Comparative need

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43
Q

Define felt need

A

Individual perceptions of deviations from normal health

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44
Q

Define expressed need

A

Seeking help to overcome variation in normal health

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45
Q

Define normative need

A

Professional defines intervention for expressed need

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46
Q

Define comparative need

A

Comparison between severity, range of interventions and cost

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47
Q

What are the steps in maslows heirachy of needs

A 
Physiological
Safety
Love and belonging
Esteem
Self actualisation
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48
Q

What is the egalitarian approach to resource allocation

A

Provide all care that is necessary and required to everyone

49
Q

What are the pros and cons of egalitarian resource allocation

A

Equal for everyone but economically restricted

50
Q

What is the maximising approach to resource allocation

A

Based solely on consequence

51
Q

What are teh pros and cons of a maximising approach to resource allocation

A

Resources allocated to those likely to recieve most benefit but those with ‘less need’ receive nothing

52
Q

What is the libertarian approach to resource allocation

A

Each individual is responsible for their own health

53
Q

What are the pros and cons of libertarian approach to resource allocation

A

Leads to more patient engagement but not all diseases are self inflicted

54
Q

What are maxwells dimension to assessing the quality of service

A 
Access
Equity
Appropriate
Acceptable
Efficient
Effective
55
Q

Define health behaviour

A

Behaviour aimed at preventing disease

56
Q

Define illness behaviour

A

Behaviour seeking remedy

57
Q

Define sick role behaviour

A

Activity aimed at getting well

58
Q

Name 6 models of behaviour change

A 
Health belief model
Motivational interviewing
Transtheoretical model
Financial incentives
Theory of planned behaviours
Nudge theory
59
Q

Advantages of the transtheroetical model

A

Acknowledges individual stages of readiness
Accounts for relapse
Temporal element

60
Q

Disadvantages of transtheoretical model

A

Some individuals skip stages
Change may be continuous
Doesnt consider values

61
Q

What things affect intention of planned behaviour

A

Attitudes
Subjective norms
Perceived behvaiour control

62
Q

What factors influence relationship between intention and behaviour

A 
Prepatory actions
Percieved control
Anticipated regret
Implementation intentions
Relevance to self
63
Q

Advantages of theory of planned behaviours model

A

Very applicable
Useful for predicting intention
Takes importance of social pressures into account

64
Q

What are the disadvantages of theory of planned behaviours

A

No temporal element, direction or causality
Doesnt consider emotions
Assumes attitudes can be measured

65
Q

What are the 5 perceptions which are part of health belief model

A 
Susceptibility
Severity
Motivation
Benefits
Barriers
66
Q

Advantages of health belief model

A

Very applicable
Cues to action
Longest standing model

67
Q

What things affect action in health belief model

A

Health beliefs affect likelihood of action which affects action. Cues to action also affect action

68
Q

Disadvantages of health belief model

A

Other factors may influence outcome
Doesnt consider emotions
Doesnt differentiate first and repeated behaviours

69
Q

What is the bolam rule of medical negligence

A

Would a reasonable doctor do the same?

70
Q

What is the bolitho rule of medical negligence

A

Would that be reasonable?

71
Q

What are the four key questions when it comes to medical negligence

A

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

72
Q

Name some types of error

A 
Fixation and loss of perspective
Communication breakdown
Poor team working
Playing the odds
Bravado
Timidity
Ignorance
Mistriage
Lack of skill
System error
Sloth
73
Q

Explain how the swiss cheese model works

A

A series of latent failures and absent defenses lead to active failures and unsafe acts

74
Q

What is the three bucket model of error

A

Self
Context
Task
Error is due to interaction of personal, environemtnal and physical factors

75
Q

Define a never event

A

A serious, largely preventable patient safety incident that should not occur if available, preventative measures should have been implemented

76
Q

Examples of never events

A

Wrong route chemo
Wrong site surgery
Escape of mental health patient

77
Q

Consequences of never event

A

Financial penalties, CQC visit, reputation loss

78
Q

Define screening

A

Identifying apparently well individuals who have or at risk of having a particular disease

79
Q

Give four examples of screening

A

Newborn
Breast cancer
Cervical cancer
Bowel cancer

80
Q

What are wilsons criteria

A

Requirements that screening must fulfil for it to be effective

81
Q

Wilsons criteria: Disease

A

Important
Natural history known
Early treatment better than late

82
Q

Wilsons criteria: test

A

Acceptable for the population
Facilities available
Simple, safe, precise and validated

83
Q

Wilsons criteria: outcomes

A

Ongoing feasibility
Treatment available
Cost benefit analysis

84
Q

Ranking of study designs

A 
Systematic review/ meta analysis
RCT
Cohort
Case control
Cross sectional
Case series
Case report/anecdote
85
Q

Describe cross sectional study design

A

Snapshot data of those with and without disease to find associations at a single point in time

86
Q

Pros and cons of cross sectional studies

A

Quick, cheap, few ethical issues but prone to bias and no time reference

87
Q

Describe case control studies

A

RETROSPECTIVE observational study which looks at a certain exposure and compares similar participants without the disease

88
Q

Pros and cons of case control (patients notes)

A

Good for rare diseases, inexpensive but it can only show association and is unreliable due to recall bias

89
Q

Describe cohort studies

A

Longitudinal PROSPECTIVE study which takes a population of people recording their exposures and conditions

90
Q

Pros and cons of cohort studies

A

Can show causation and have less chance of bias but large amount lost to follow up and they are expensive

91
Q

Describe randomised control trial

A

Similar participants randomly controlled to intervention or control groups to study the effect of the intervention

92
Q

Pros and cons of RCTs

A

Can infer causality and have less bias but time consuming, expensive and ethical issues can interfere

93
Q

Factors to assess causality (bradford hill criteria)

A 
Biological plausability
Temporal relationship
Dose response relationship
Strength of association
Specificity
Consistency
Altered by experimentation
Coherence with existing themes
Consider reverse causality
94
Q

Define confounder

A

Risk factors, other than those being studied that influence the outcome

95
Q

Do confounders affect the exposure or outcome

A

Both

96
Q

Define bias

A

A systematic error that results in a deviation from the true effect of an exposure on an outcome

97
Q

Describe selection bias

A

Discrepancy of who is involved

98
Q

Describe publication bias

A

Some trials are more likely to be published than others

99
Q

Name four types of information bias

A

Measurement bias
Observer bias
Recall bias
Reporting bias

100
Q

What is measurement bias

A

Different equipment may give different values

101
Q

Describe recall bias

A

Past events incorrectly remembered

102
Q

Describe reporting bias

A

Responder doesnt tell the truth

103
Q

Define incidence

A

Number of new cases in a population during a specific time period

104
Q

Define prevalence

A

Number of existing cases at a specific point in time

105
Q

What is attributable risk

A

Number of cases that are specifically due to one risk factor.
Total - Number of cases that would have happened anyway

106
Q

How are the attrituble risk and number needed to treat related

A

NNT=1/attributable risk

107
Q

Define sensitivity

A

% correctly identified with the disease

108
Q

Define specificity

A

% correctly excluded as disease free

109
Q

Define positive predictive value

A

% of those with a positive test that actually have the disase

110
Q

Define negative predictive value

A

% of those with a negative test who are actually disease free

111
Q

Define chance

A

Possibility that there is a random error

112
Q

Define reverse causality

A

Outcome results in exposure

113
Q

Name 5 factors that can cause association

A 
Bias
Chance
Confounding
Reverse causality
True association
114
Q

What is lead time bias

A

Early identification doesnt alter outcome but appears to increase survival

115
Q

What is length time bias

A

Disease that progresses more slowly is more likely to be picked up by screening, whih makes it appear that screening prolongs life

116
Q

Name the 9 bradford hill criteria for causation

A 
Temporality
Dose response
Strength
Reversibility
Consistency
Plausability
Coherence
Analogy
Specificity
117
Q

What is the planning cycle for health services

A

Needs assessment
Planning
Evaluation
implementation

118
Q

What are bradshaws needs

A

Felt need
Expressed need
Normative need
Comparative need

Phase 3A (25 decks)

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