WEEK 11 Flashcards
Give five examples of health behaviours
1) Exercise
2) Diet
3) Smoking
4) Taking medications
5) Unprotected sexual intercourse
Define non-adherence
The failure of a patient to follow recommended health behaviours and treatment advice given by a clinician
What is the difference between non-adherence and non-compliance?
Non-adherence focuses on the collaborative Dr-Pt relationship
What is a good predictor of long-term adherence?
Adherence at entry
What is the effect of complex medication regimens?
Low adherence
What is the result of intrusive/expensive treatments?
Lower adherence
What is the result of asymptomatic conditions on adherence?
Lower
Give six reasons patients don’t comply?
1) Fear of side effects
2) Forgetfulness
3) Expense
4) Feeling well (no need to keep with treatment)
5) Dr fails to communicate adequately
6) Travel away from home
Describe Ley’s Model of Compliance
Understanding and Memory results in Satisfaction=COMPLIANCE
Describe Stanton’s Model of Adherence
Doctor communication/Increased knowledge and satisfaction (aided by Dr communication)/Patient’s beliefs, locus of control, perceived social support=ADHERENCE
What are the three components of the Information-Motivation-Strategy model?
Information: Pts don’t understand what they’re supposed to do
Motivation: Pts aren’t motivated to carry out their treatment recommendations
Strategy: Pts don’t have a workable strategy for following treatment recommendations
Give four ways to improve information to aid in patient compliance?
Communicate information effectively
Build trust and encourage patient participation in their care
Have patients share why and how they are to carry out the recommended treatment
Listen to patients’ concerns
Give three ways to improve motivation to aid in patient compliance?
Help patients believe in the treatment efficacy
Elicit, listen to and discuss negative attitudes towards treatment
Determine the role of patient’s social system in supporting or contradicting elements of the regimen
Give four ways to improve strategy to aid in patient compliance?
Assist in overcoming practical barriers
Identify individuals who can provide concrete assistance
Provide written instructions/reminders
Link to support groups
How do you improve adherence?
1) Stress importance of what you’re about to say
2) Primacy effect (ie. first thing more likely to be remembered)
3) Repeat instructions/information
4) Keep to salient information
5) Negotiate regimens suiting patient routine
6) Encourage note taking
7) Use simple words to describe the body/treatment
What is the aim of health promotion?
Prevent/reduce unhealthy behaviours and increase healthy behaviours
Summarise the Health Action Model
Self->Behavioural intention->Health Action->Routine
What three factors influence whether behavioural intention results in health action in the Health Action Model?
Environment, Skills and Knowledge
What four factors influence ‘self’ in the Health Action Model?
Personality, belief system, motivation system and normative system
What two opposing factors influence behavioural intention following routine in the Health Action Model?
Confirmation or relapse
What is the CALO-RE taxonomy?
A taxonomy unpicking and describing all the individual components of behavioural change interventions
What are some examples of behavioural change techniques?
Goal setting (behaviour) eg. more exercise
Providing information on consequences of behaviour to individual
Relapse prevention/coping planning
Barrier identification/problem solving
What are change determinants of behaviour?
Promote/sustain desirable beliefs
Infrastructure (eg. food provision/education)
Economic incentives
Regulatory change to reinforce behaviour
What is the impact of change determinants of behaviour?
Expensive/difficult to implement, large no. of people influenced
What are the ways to change behaviour focusing on individuals at risk?
Education/motivational strategies
What is the impact of behavioural change focusing on individuals at risk?
Some success, not good at sustained long term change
What three things constitute the generic model of health promotion?
1) Health education
2) Environmental change
3) Legal change/make unhealthy behaviours expensive
Give three examples where health promotion has influenced health behaviour
1) Smoking
2) Alcohol
3) Physical activity
How is health promotion used to influence smoking?
Large scale public health changes as a result of Royal College of Physician’s recommendations=increase in cigarette smokers quiting, decrease in current smokers
Give three examples of the recommendations made by the Royal College of Physicians
1) Stop smoking indoors
2) Reduce smoking advertising
3) Taxation on cigarettes
What are the least effective methods of health promotion influencing alcohol use?
Provision of educational or public information
What had moderate effectiveness on influencing alcohol use?
Advertising controls
What are the most effective methods of health promotion influencing alcohol use?
Minimum purchase age laws
Alcohol-specific age laws
Drink-driving countermeasures
What are some of the benefits of physical activity on children?
Bone health Cognitive function CV fitness Muscle fitness Weight status Depression
What are some of the benefits of physical activity on adults?
All-cause mortality Stoke and heart disease Hypertension T2 diabetes Depression Cognitive function
What are some of the benefits of physical activity on older adults?
Falls
Frailty
Physical function
How can we address physical inactivity?
Interventions within the NHS
Community-based interventions
National/Governmental actions
Give three NHS interventions used to promote physical activity
1) GPs/practice nurses identifying people who are inactive and encourage activity
2) Provision of supervised exercise for people who have heart disease
3) Provision of facilities for NHS staff to exercise
Give four examples of community interventions used to promote physical activity
1) School PSHE lessons
2) More pedestrian crossings/lollipop people
3) Cycle lanes/pavements
4) Subsidise leisure centres
Give two examples of facilitative governmental actions to promote physical activity
1) Allow councils to spend money on road safety schemes
2) Provide resources in councils budgets for leisure centres
Give two examples of taxation done by government to promote physical activity
1) Tax workplace car parking spaces/petrol/road use
2) Make gym membership tax free
What are three factors making it difficult to sustain change in physical activity?
1) Environmental issues
2) Cultural issues
3) Temptation to slip up
Give the three types of prevention
Primary, Secondary and Tertiary prevention
What is the aim of primary prevention?
To prevent disease onset
What is the aim of secondary prevention?
To minimise the consequences of disease after it has arisen by detection and treatment to prevent worsening
What is the aim of tertiary prevention?
To prevent death or permanent disability once a disease has become established
What is the difficulty faced with health promotion in diverse communities?
Generic campaigns may have different effects on different societal sectors which may result in unexpected negative consequences
