Use prevention Flashcards

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1
Q

What does prevention focus on?

A
  1. Identifying conditions that contribute to problems

2. Taking action before problems develop or become serious

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2
Q

What does prevention in addiction consist of?

A

Preventing people from using or misusing substances

-> avoid negative health and social consequences

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3
Q

Why is prevention important?

A

> Reduce the need of treatment resources

> Reduce stress on treatment system

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4
Q

What are the two types of prevention strategies introduced by Geoffrey Rose (1950s)?

A
  1. High risk strategy
    - preventing disease in individuals
  2. Population strategy
    - preventing disease in populations

Applies to all types of disease

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5
Q

What characterises the high risk prevention strategy?

A

> Traditional approach to prevention

> Reduce risk of disease amongst those at highest risk

> Cut off risk distribution

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6
Q

What characterises the population prevention strategy?

A

> Control the cause of disease

> Reduce risk factors

> Shift distribution in favourable direction
- towards low likelihood of disease

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7
Q

What are the advantages of the high risk prevention strategy?

A

> Appropriate interventions

> Patient motivation to make changes (problem already exists)

> Doctor motivation
(there’s justification for intervention)

> Cost-effective
- specific groups of people are targeted

> Favourable benefit:risk ratio
- problem exists -> benefits from intervention are often greater than risks

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8
Q

What are the disadvantages of the high risk prevention strategy?

A

> Difficulty and cost of screening
- tendency of response to screening to be greater among people who have the least need or risk of disease

> Those not “high risk” are overlooked
- those borderline in screening outcome but still at increased risk level

> Palliative and temperate: not addressing root cause

> Limited potential:

  • difficult to predict future diseases
  • low risk individuals are not effectively addressed and may become high risk later

> Behaviourally inappropriate:
- clashes with patient lifestyle and social norms

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9
Q

What are the aims of the population prevention strategy?

A

Attempt to
- shift the whole curve of disease distribution

  • remove underlying root causes of disease
  • > large potential for population as whole
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10
Q

What is the prevention paradox in the population strategy?

A
  • Most of the harm arises from people at lower risk level

- Occurs due to increased numbers of lower risk individuals

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11
Q

What are the advantages of the population prevention strategy?

A

> Radical

> Large potential benefit for whole population

> Small individual changes can result in large overall changes in population

> Behaviourally appropriate

  • e.g. not smoking can be made the norm
  • > it’ll be easier to get people to quit
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12
Q

What are the disadvantages of the population prevention strategy?

A

> Only small benefit to individual, but large benefit to overall population
-> prevention paradox

> Poor motivation for individual
- small benefits, especially at initial term

> Poor doctor motivation

> Unfavourable benefit:risk ratio
- the few benefits can be easily outweighed by small risks

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13
Q

What are the three prevention classes presented by Geoffrey Rose?

A
  1. Primary prevention
  2. Secondary prevention
  3. Tertiary prevention
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14
Q

What is primary prevention about?

A

Avoids onset of disease

-> reduce incidence

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15
Q

What is secondary prevention about?

A

Detect disease in its earlier stages to slow/stop progression
- before symptoms appear

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16
Q

What is tertiary prevention about?

A
  • Arrests the progression of an established disease

- Controls negative consequences

17
Q

What are the two issues Robert Gordon raised in Geoffrey Rose’s prevention classification?

A

> Issue 1: origin
- distinction between primary and secondary depends on what the origin of disease is

  • e.g. education on smoking is primary to general population BUT secondary if directed to those with smokers cough or early stage lung disease

> Issue 2: ordinal value

  • terms of primary and secondary suggest an ordinal value
  • “primary is best” is not always the case
18
Q

What are Robert Gordon’s prevention classification?

A

> Universal prevention

> Selective/targeted prevention

> Indicated prevention

19
Q

What does universal prevention consist of?

A
  • Desirable for everyone
  • Easy to implement
    e. g. “wear seatbelt”, “give up smoking”
20
Q

What does selective (targeted) prevention consist of?

A
  • Recommended to a subgroup of the population
    e. g. age, gender, occupation
  • to whom the risk of becoming ill is higher than average
    e. g. flu immunisation for elderly
21
Q

What does indicated prevention consist of?

A
  • For individuals with high risk factor
  • Presence of risks
  • Can be expensive
22
Q

What does the prevention matrix of David Foxcroft consist of?

A

> Form of intervention

  • universal
  • selective
  • indicated

> Function and purpose of preventive strategy

  • environmental
  • developmental
  • information
23
Q

According to David Foxcroft’s prevention matrix, what is environmental purpose of a preventive strategy?

A

Reduce availability of opportunities to engage in high risk behaviours

24
Q

According to David Foxcroft’s prevention matrix, what is developmental purpose of a preventive strategy?

A

Shape socialising and development of young people

-> less susceptible to opportunities to engage in risk behaviour

25
Q

According to David Foxcroft’s prevention matrix, what is informational purpose of a preventive strategy?

A

Improving knowledge and awareness by challenging pre-existing beliefs and providing information

26
Q

How does prevention work (probabilistic model)?

A

By reducing the occurence of new cases by

  • decreasing vulnerability and risk factors
  • increasing resilience and protective factors

-> might not work the same for everybody

27
Q

What are the intrinsic factors of prevention?

A

Vulnerability and Resilience

due to:

  • genetics
  • learning experiences
  • behaviours
  • personality
28
Q

What are the extrinsic factors in prevention?

A

> Risk factors:

  • economic deprivation
  • lack of education
  • substance availability

> Protective factors:

  • social support
  • education
  • judicial policy
29
Q

What characterises the probabilistic model of prevention?

A

> More risk and vulnerability factors -> more likely the individual is to experience problems (e.g. substance use)

However

> High risk + High vulnerability does not mean problems are inevitable

> High protective factors + high resilience does not mean absence of problems

=> not deterministic