Unit 5: Week 10

Question 1

Where do we spend most of our health care dollars?

Answer 1

It is mostly spent on the clinical strategy which means on treatment and search for cures

Question 2

what does the current strategy for prevention of ill-health place the blame on? Who should be held accountable

Answer 2

the blame is placed on the individuals themselves for “unhealthy behaviours”. we fail to recognize the industries that promote these unhealthy behaviours. For example, junk food commercials being aimed at kids is not the kids fault, it is the company

Question 3

T/F: our medical system falls under the population strategy

Answer 3

F. it falls under the clinical strategy

Question 4

why must we focus on people who are at low or moderate risk of ill-health issues?

Answer 4

if we only focus on those who are at high risk, we fail to prevent new cases. The people from the low risk groups will continuously replenish the high risk groups.

Question 5

what is the prevention paradox?

Answer 5

states that unless we focus on the low risk groups as well as the high risk, we will fail to reach the majority of people who ultimately develop a disease like obesity, diabetes and cancer. People from low risk groups continuously replenish people from the high risk groups

Question 6

what are 5 ways to solve the prevention paradox?

Answer 6

1. EXPAND investments in population strategies
2. DESIGN communities to make it harder to become sick
3. Make it EASIER to walk and cycle/take public transit
4. increase HEALTHY FOODS by banning the marketing of unhealthy products to children
5. POPULATION strategies are more cost effective than those benefitting solely one individual

Question 7

only ___/____ years of life expectancy has been gained in the past century due to medical care. Therefore, the ultimate goal should be to ________ disease

Answer 7

5/30, prevent

Question 8

what are the 2 strategies for curbing disease? Explain both

Answer 8

1. clinical strategy = where medical systems treats individual patients
2. population strategy = where we tackle risk factors that make us sick in the first place.

Question 9

1. For too long we have put _______ above people’s health
2. majority of death, diseases and disability occur among those at ______ risk. This phenomenon is the _________ ____________

Answer 9

1. profit
2. low/moderate, prevention paradox

Question 10

what is the clinical strategy also called? (2)

Answer 10

• micro approach = not the big picture
• high risk strategy = addresses those at high risk

Question 11

what is the population strategy also called? (2)

Answer 11

• maco approach = the big picture by looking at the determinants leading to ill-health
• low risk

Question 12

give an example of a situation from the clinical strategy vs the population strategy perspectives

Answer 12

Examining incidences of obesity.
clinical = examining those who are overweight or who have obesity instead of those at low risk for it
population = why people have obesity. maybe they do not have access to healthy food options/recreational services, history of it in family etc.

Question 13

what are benefits to the micro approach (clinical)?

Answer 13

benefits =
- appropriate to the individual receiving treatment and who is at high risk
- motivation to receive/grant treatment increases with those at high risk
- decreases waste of resources because you are only treating those at high risk
- ratio of costs to benefits are better

Question 14

what are the drawbacks to the micro approach (clinical)?

Answer 14

drawbacks =
- medicalization of prevention
-challenges and costs of interventions
- results palliative and temporary
- limited potential for individuals and the population
- behavioural insufficiencies

Question 15

explain each drawback to the high risk strategy approach:
a) medicalization of prevention
b) challenges and costs of interventions
c) results palliative and temporary
d) limited potential for individuals and the population
e) behavioural insufficiencies

Answer 15

medicalization of prevention = how the patient feels about being treated and why they couldn’t prevent the sickness
challenges and costs of interventions = very difficult and should start in early life
results palliative and temporary = the focus is to prevent further sickness not to identify the root cause
limited potential for individuals and the population = difficult to predict disease unless previous related morbidities exist
behavioural insufficiencies = high risk requires behavioural patterns that may deviate from social normals

Question 16

large numbers of people at minimal risk for a disease can produce ________ incidence rates than a small number of people at highest risk for the disease

Answer 16

higher

Question 17

the high risk strategy has the ability to prevent disease in a _____ number of highly susceptible individuals but no ability to prevent disease in ______ numbers of individuals at relatively low risk for disease

Answer 17

small, large

Question 18

a _______ number of people at low risk may give rise to ______ cases of disease than the _____ number who are at high risk

Answer 18

large, more, small

Question 19

what are advantages of macro (population based) strategies?

Answer 19

1. radical = attempts to find the root cause of the disease and get rid of it to make it less common in the population
2. powerful = changing the exposure risk for the population creates powerful potential for health gains
3. behaviourally appropriate = working with rather than against social normals. changing what is considered socially acceptable

Question 20

what are disadvantages of macro (population based) strategies?

Answer 20

• benefits are outstanding
• might have lack of motivation between population and the practitioner
• minimal benefit experienced by each individual may not outweigh the small risk (benefits may outweigh the risks)

Question 21

what are the circumstances for adopting population based intervention strategies?

Answer 21

• when health risk has permeated the entire population
• on a population scale, benefits are outstanding, but on an individual bases, benefits are minimal
• when the only way to deliver an intervention to individuals at risk is through a population based approach
• when we need to impact as many people as possible in the population with minimal adverse effects

Question 22

T/F: eventually macro population based approaches will completely eliminate the need for micro population based approaches

Answer 22

F. both are used at times to address different things, so neither will completely get rid of the other

Question 23

1. what is motivational interviewing?
2. who created MI?
3. MI involves having __________ where people can talk themselves into ______ based on their own ________ and _________

Answer 23

1. client centred counselling style to help people explore and resolve their ambivalence regarding behaviour change
2. Miller and Rollnick
3. conversations, change, values interests

Question 24

the counselling style was ____________ because health care professionals are not necessarily trained in counselling

Answer 24

intimidating

Question 25

how does MI relate to HP?

Answer 25

MI is a way to make people reflect on their health and resolve their own health issues. HP is based on this where we encourage people to have control over their health

Question 26

1. MI puts HP into _______
2. MI _______ and ________ people to enhance their health and lives:
   a) directs and pushes
   b) enables and empowers
   c) forces and drives
   d) facilitates and moves

Answer 26

1. action
   2, b)

Question 27

MI taps into the _________, ________ and _______ of clients otherwise behaviour change will not be meaningful to them

Answer 27

preferences, values and rights

Question 28

1. the power for client behaviour change comes from _________ between them and their practitioner
2. ___% of behaviour change comes from clients relationship with practitioner
3. ___% likelihood that a practitioner can influence behaviour change

Answer 28

1. engagement
2. 30%
3. 60%

Question 29

1. what is ambivalence?
2. We are (more/less) inclined to continue what we are doing?
3. MI builds _______ motivation
4. goal of MI is to….

Answer 29

1. contrasting desires
2. more
3. intrinsic
4. close the behaviour gap between our current behaviour and broader values and goals

Question 30

what are the rules as the interviewer in MI?

Answer 30

drop assumptions, get curious and ask questions without assumptions, acknowledge experiences of the client

Question 31

1. what are open ended questions?
2. most open ended questions begin with the word ____
3. using the word ____ can make people defensive
4. T/F: open ended questions are more likely to make behaviour change temporary and not long lasting

Answer 31

1. broad questions that help reduce judgement, not heavy on knowledge
2. what
3. why
4. F. they are more likley to make behaviour change long lasting

Question 32

T/F: in open ended questions, it’s better to ask why instead of what.

Answer 32

F. we should ask what

Question 33

why ask “what’s important to you about….”

Answer 33

• plays into client values
• does not centre around why WE want them to change
• shifts responsibility from practitioner to client

Question 34

reflective listening = _______ and _______ your client

Answer 34

empathy and mirroring your client

Question 35

1. empathy _______ ___________, sympathy _______ __________
2. what are the 4 components of empathy?
3. why are the words “at least” important?
4. _________ make something better. __________ rarely make something better

Answer 35

1. fuels connection, drives disconnection
2. perspective taking, staying out of judgement, recognizing emotions, communicating that
3. silver linings
4. connections, responses

Question 36

what is the Michelangelo belief?

Answer 36

lens we use when we are engaged with a client. the belief that there is a masterpiece within all of us and that we are all capable of change and adherence

Question 37

the michelangelo belief allows us to take a _______ world view instead of a ______ world view

Answer 37

competence, deficit