w2 Flashcards
________ approaches to promoting nutrition:
Assessment
- Dietary assessment
- Determine dietary needs
- Explore family and culture influences on food choice
- Investigate accessibility of healthy food
Program planning or policy development
- Provide education on healthy diets and portions
- Reading labels
Individual
Individuals focused (microscopic theories)
- ________ = abilities and belief that they can change
- _________ = important, worth the effort, interested
- __+___ = motivation
expectancy
value
Value expectancy theory
Examples of health disparities
Differences in
- Length of life
- Quality of life
- Rates of disease, disability, death
- Severity of disease
- Access to treatment
Community focused (macroscopic theories)
- Impact - systemic change that you expect to see in the long-term
- Outcomes - intended and unintended changes that your stakeholders are experiencing or might experience with your intervention
- Outputs - immediate results of activities or products
- Activities – what activities need to take place for each output to happen?
- Inputs – resources or investments needed to ensure activities take place
Theory of change
implicit bias in health care
- People with minoritized racial and ethnic identities often receive lower quality health care compared to white patients
- Unconscious biases can lead to different treatment of patients by race, gender, weight, age, language, income, and insurance status.
- Different treatment = different outcomes
_______scopic – focus is on the individual or family
________scopic – ex: school, workplace
_________scopic – focus is on the broader community, subpopulation, and population
Microscopic – focus is on the individual or family
Mesoscopic – ex: school, workplace
Macroscopic – focus is on the broader community, subpopulation, and population
Community focused (macroscopic theories)
- Focused on achieving goals by leveraging community strengths and resources
- Process includes examining social structures and factors:
- Gender disparities
- Racism
- Ethnocentrism
- Education
- Health literacy
- Class disparities
Ex: women’s empowerment model
Empowerment theories
Individuals focused (microscopic theories)
- Help examine individuals health behaviors and what influences those behaviors
- Variables provide cues to explain health behaviors
- Guide strategies to support individual to achieve health behaviors
- Based on value expectancy
- Addresses individual perceptions, modifying factors, likelihood of action
- Does not address social, political, community structural, or environmental factors
Health behavior theories
Addressing health disparities
Success = every person can attain their _________, no one is disadvantaged from achieving this potential because of social position or other social circumstance.
Addressing health disparities
Success = every person can attain their full health potential, no one is disadvantaged from achieving this potential because of social position or other social circumstance.
Social determinants and physical activity
Access to opportunities for physical activity
- Sidewalks
- Parks
- Bike lanes
- Rec facilities
- Neighborhood safety
- Work schedule
- Cost of physical activities
Opportunities accessible for all people
- Disabilities
- Cost
- Location
________ approaches to promoting physical activity:
- Employ natural helpers or early adopters from community
- Walkable and bikeable communities – walkscore
- Address barriers – safety, greenspace
- Community Events – walks, runs
- Programs for physical activity at businesses and organizations
- Educational campaigns – “lets move” campaign
Population
Selecting a focus
__________ (microscopic)
- Health belief model
- Transtheoretical model
__________ (macroscopic)
- Empowerment theories
- Theory of change
________ AND _______ (micro and macro)
- Ecological model
- Diffusion of innovation
Selecting a focus
Individuals (microscopic)
- Health belief model
- Transtheoretical model
Community or society (macroscopic)
- Empowerment theories
- Theory of change
Individual/family AND community/society (micro and macro)
- Ecological model
- Diffusion of innovation
Micro and macro theories
- Used to better understand human behavior
- Researchers use this to assess when individual level interventions/behaviors aren’t changing
- Interventions that take place on multiple levels are more effective
Ex: violence prevention
Individual – age, income, education, SUD, abuse
Relationship – peers, partners, family
Community – schools, neighborhoods, work
Societal – cultural norms, policies and laws, social inequalities
Ecological or socio-ecological model
Individuals focused (microscopic theories)
- Precontemplation – no intention to change behavior
- Contemplation – committed to take action within 6 months
- Prepartation or determination – seriously considering changing behavior, taken some steps
- Action – consistently changing behavior for <6 months
- Maintenance – consistently changing behavior for >6 months
- (can exit and re-enter at any stage)
Transtheoretical model
Individuals focused (microscopic theories): Transtheoretical model
- _______ – no intention to change behavior
- _________ – committed to take action within 6 months
- ________ – seriously considering changing behavior, taken some steps
- ______– consistently changing behavior for <6 months
- _________ – consistently changing behavior for >6 months
- (can exit and re-enter at any stage)
Action
Precontemplation
Prepartation or determination
Contemplation
Maintenance
- Precontemplation – no intention to change behavior
- Contemplation – committed to take action within 6 months
- Prepartation or determination – seriously considering changing behavior, taken some steps
- Action – consistently changing behavior for <6 months
- Maintenance – consistently changing behavior for >6 months
- (can exit and re-enter at any stage)
Micro and macro theories
- An idea of product gains momentum and diffuses through a specific population over time
- Adoption – person/population does something differently than what they had previously
- person/population must perceive the idea, behavior, or product as new
- first to adopt – innovators
- 2nd to adopt – early adopters
- 3rd to adopt – early majority
- 4th to adopt – late majority
- 5th and last to adopt – leggards
Diffusion of innovation
____________
particular type of health difference that is closely linked with social, economic, or environmental disadvantage
- Preventable differences r/t disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations
- Directly r/t historical and current differences in social, political, economic, and environmental resources
Health disparity
________ approaches to promoting physical activity:
Educate about benefits of regular physical activity
- Weight control
- Reduce risk of CVD, T2DM, cancer, hip fx
- Reduce pain and improve mobility
- Pts with arthritis benefit from low impact aerobic activity
- Mental health improves
- Reduce risk of falls
- Improve quality of life and increase lifespan
Educate about supportive and protective factors
- Initiate physical activity slowly to reduce risk of injury or heart attack
- Pts with chronic health issues or OA must be eval by HCP before beginning
- Consider activities the family can do together
- Approachable tasks – brisk walk
- Identify community resources with no/low cost
Individual
_________ approaches to promoting nutrition:
Increase population accessibility to healthy foods
- Local grocers must sell fruit, vegs, low fat, low sodium food
- Farmers markets
- Community gardens
- School lunches serve healthy foods from local producers
Increase population’s ability to make healthy food choices
- Restaurants label food nutrition
- Simplify food labels
- Restaurants serve healthy options
- Truthful advertising
Respect social/cultural aspects of food preparation
- Create culturally acceptable healthy alternatives to typical foods
Population
Public health ________
Health belief model
Transtheoretical model
Public Health ________
- Help organize information
- Provide direction with information
Public health models
Health belief model
Transtheoretical model
Public Health Theories
- Help organize information
- Provide direction with information
System 1 thinking vs system 2 thinking
System __ thinking
- Fast, autonomic
- Susceptible to environmental influences
System __ thinking
- Slow, reflective
- Considers goals and intentions
System 1 thinking vs system 2 thinking
System 1
- Fast, autonomic
- Susceptible to environmental influences
System 2 thinking
- Slow, reflective
- Considers goals and intentions
Individuals focused (microscopic theories)
- Considers individual perceptions, modifying factors, and likelihood of action
- Perceived susceptibility – ones opinion of chances of getting condition
- Perceived severity – one’s opinion of how serious condition and consequences are
- Perceived benefits – one’s belief in the value of the advised action to reduce risk of condition
- Perceived barriers – one’s opinion of the tangible and psychological costs of the advised action
- Cues to action – strategies to activate readiness
- Self-efficacy – confidence in one’s ability to take action
Health belief model
Individuals focused (microscopic theories):Health belief model
- Considers individual perceptions, modifying factors, and likelihood of action
- __________ – ones opinion of chances of getting condition
- __________ – one’s opinion of how serious condition and consequences are
- __________– one’s belief in the value of the advised action to reduce risk of condition
- ___________ – one’s opinion of the tangible and psychological costs of the advised action
- _________– strategies to activate readiness
- __________ – confidence in one’s ability to take action
Perceived susceptibility
Cues to action
Perceived benefits
Self-efficacy
Perceived severity
Perceived barriers
- Perceived susceptibility – ones opinion of chances of getting condition
- Perceived severity – one’s opinion of how serious condition and consequences are
- Perceived benefits – one’s belief in the value of the advised action to reduce risk of condition
- Perceived barriers – one’s opinion of the tangible and psychological costs of the advised action
- Cues to action – strategies to activate readiness
- Self-efficacy – confidence in one’s ability to take action
Implicit bias
- Unconscious bias, activated involuntarily without individuals _________
- Can cause us to have _________ about other people based on race, ethnicity, sexual orientation, gender identity, age, and appearance
- Both favorable and unfavorable assessments
- Implicit biases are pervasive
- Implicit and explicit biases are related by distinct mental constructs
- Implicit biases don’t necessarily align with out declared __________ beliefs
- We tend to hold implicit biases that favor________
- Implicit biases are malleable
Implicit bias
- Unconscious bias, activated involuntarily without individuals awareness or control
- Can cause us to have feelings/attitudes about other people based on race,ethnicity, sexual orientation, gender identity, age, and appearance
- Both favorable and unfavorable assessments
- Implicit biases are pervasive
- Implicit and explicit biases are related by distinct mental constructs
- Implicit biases don’t necessarily align with out declared personal beliefs
- We tend to hold implicit biases that favor our own ingroup
- Implicit biases are malleable
_________
Attitudes or stereotypes that affect our understanding, actions, and decisions, in an unconscious manner
Implicit bias
Addressing ________
Robert wood johnson foundation
- Creates fair and just opportunities to be healthier
- Removes obstacles to health
American public health association
- Providing everyone with the opportunity to attain their highest level of health
CDC
- Healthy People 2030
- Research funding
Addressing health disparities
Public health models and theories
- Support health promotion and disease prevention
- Help to explain complex ideas
- Explain relationships between concepts related to health and illness, and impact on outcome
Individuals focused (microscopic theories) (4)
vs
Community focused (macroscopic theories) (2)
vs
Micro and macro theories (2)
- Health behavior theories
- Empowerment theories
- Value expectancy theory
- Theory of change
- Health belief model
- Transtheoretical model
- Ecological or socio-ecological model
- Diffusion of innovation
I - Health behavior theories
C - Empowerment theories
I - Value expectancy theory
C - Theory of change
I - Health belief model
I - Transtheoretical model
B - Ecological or socio-ecological model
B - Diffusion of innovation
_________ approaches: sleep
- Sleep disturbances in hospitals
- Policies to reduce nighttime noise and light pollution
- Increase greenspace = increased daytime activity
- Decrease air pollution = increased daytime sun exposure
Population
__________ approaches: obesity
- Safe places for physical activity
- Policies influencing work schedules/commutes
- Reduce oversized food portions
- Educate about calorie content
- Address physical accessibility and cost of healthy foods
- Policies to address food advertising – unhealthy foods targeting kids
Population
Populations with health disparities
- LGBTQ
- Racial/ethnic
- Religion
- Gender
- Age
- Disability
- Geographical location
Approaches to promoting physical activity
Physical activity guidelines per US dept of health (for overall CV health)
- 30 mins of moderate aerobic activity for 5 days a week
OR
- 25 mins vigorous aerobic activity for 3 days a week
OR
- A combination of moderate and vigorous aerobic activity
AND
- Moderate to high muscle strengthen activity 2 days a week
Adolescents need 60 mins+ of physical activity per day and muscle strength training 3 days a week
