Use prevention Flashcards
What does prevention focus on?
- Identifying conditions that contribute to problems
2. Taking action before problems develop or become serious
What does prevention in addiction consist of?
Preventing people from using or misusing substances
-> avoid negative health and social consequences
Why is prevention important?
> Reduce the need of treatment resources
> Reduce stress on treatment system
What are the two types of prevention strategies introduced by Geoffrey Rose (1950s)?
- High risk strategy
- preventing disease in individuals - Population strategy
- preventing disease in populations
Applies to all types of disease
What characterises the high risk prevention strategy?
> Traditional approach to prevention
> Reduce risk of disease amongst those at highest risk
> Cut off risk distribution
What characterises the population prevention strategy?
> Control the cause of disease
> Reduce risk factors
> Shift distribution in favourable direction
- towards low likelihood of disease
What are the advantages of the high risk prevention strategy?
> 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
What are the disadvantages of the high risk prevention strategy?
> 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
What are the aims of the population prevention strategy?
Attempt to
- shift the whole curve of disease distribution
- remove underlying root causes of disease
- > large potential for population as whole
What is the prevention paradox in the population strategy?
- Most of the harm arises from people at lower risk level
- Occurs due to increased numbers of lower risk individuals
What are the advantages of the population prevention strategy?
> 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
What are the disadvantages of the population prevention strategy?
> 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
What are the three prevention classes presented by Geoffrey Rose?
- Primary prevention
- Secondary prevention
- Tertiary prevention
What is primary prevention about?
Avoids onset of disease
-> reduce incidence
What is secondary prevention about?
Detect disease in its earlier stages to slow/stop progression
- before symptoms appear
What is tertiary prevention about?
- Arrests the progression of an established disease
- Controls negative consequences
What are the two issues Robert Gordon raised in Geoffrey Rose’s prevention classification?
> 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
What are Robert Gordon’s prevention classification?
> Universal prevention
> Selective/targeted prevention
> Indicated prevention
What does universal prevention consist of?
- Desirable for everyone
- Easy to implement
e. g. “wear seatbelt”, “give up smoking”
What does selective (targeted) prevention consist of?
- 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
What does indicated prevention consist of?
- For individuals with high risk factor
- Presence of risks
- Can be expensive
What does the prevention matrix of David Foxcroft consist of?
> Form of intervention
- universal
- selective
- indicated
> Function and purpose of preventive strategy
- environmental
- developmental
- information
According to David Foxcroft’s prevention matrix, what is environmental purpose of a preventive strategy?
Reduce availability of opportunities to engage in high risk behaviours
According to David Foxcroft’s prevention matrix, what is developmental purpose of a preventive strategy?
Shape socialising and development of young people
-> less susceptible to opportunities to engage in risk behaviour
