Week 4 Flashcards
1
Q
define: community
A
- a group of people who live, learn, work, worship, and play in an enviro at a given trend
- persons who interact & have similar goals or interests & share common social supports
- people & relationships who share agencies & a physical enviro
- a locality-based entity composed of systems of formal organizations reflecting society’s institutions, informal groups, and aggregates (groups within a population)
2
Q
people in a community may or may not…
A
- come from within the same geographic boundaries
3
Q
people in a community…
A
- share common characteristics and interests
- function within a larger social system such as an organization, region, province, or nation
4
Q
what is the core of any community
A
- its people, who are characterized by age, gender, socioeconomic status, education lvl, occupation, ethnitcity, and religion
5
Q
most definitions of a community include the following thee dimesions/components:
A
- people
- place
- function
6
Q
describe the relationship between the components of community
A
- interdependent (ie. they are mutually reliant upon each other)
7
Q
describe the function component of community
A
- to meet a wide variety of collective needs
- the aims & activities of the community
8
Q
describe the people component of community
A
- the community residents
9
Q
describe the place component of community
A
- refers to both geographic and time dimensions
10
Q
define: community health… this definition emphasizes…
A
- the process of involving the community in maintaining, improving, promoting, and protecting its own health & wellbeing
- this definition emphasizes the process dimension but also includes the dimensions of status and structure
11
Q
the concept of community health has 3 common dimensions…
A
- status
- structure
- process
12
Q
describe the community health dimension “status”
A
- includes physical, emotional, and social components
13
Q
the physical component of “status” is often measured by…
A
- often measured by traditional morbidity and mortality rates, life expectancy indices, and risk factor profiles
14
Q
the emotional component of “status” can be measured by…
A
- can be measured by client satisfaction and mental health indices
15
Q
the social component of status is reflected by…
A
- reflected in crime rates and individual & family lvls
16
Q
describe the community health dimension “structure” (3)
A
includes:
- community health services and resources
- attributes of the community structure itself
- commonly identified as social indicators or correlates of health
17
Q
describe the community health dimension “process”
A
- community health is the process of effective community functioning or problem solving
18
Q
define: healthy community
A
- a health community is one where people, organizations, and local institutions work together to improve the social, economic, and environmental conditions that make people healthy –> the DOH
19
Q
what are characteristics of healthy community:
A
- equitable community engagement
- intersectoral partnerships
- political commitment
- healthy public policy
- asset-based community development
- clean & safe physical enviro
- peace, equity, and social justice
- adequate access to food, clean water, shelter, income, safety, work, and recreation for all
- strong, mutually supportive relationships and networks
- wide participation of residents in decision making
- strong cultural and spiritual heritage
- diverse & robust economy
- opportunities for learning & skill development
- access to health services, including public health & preventive programs
20
Q
define: community development
A
- building communities from the inside out
21
Q
community development occurs when…
A
- a community is engaged in a dynamic, continuous process of social change that can lead to permanent enhancement in people’s lives
22
Q
define: asset mapping
A
- identifying community-based initiatives such as community development, strategic planning, and organizational development
- outline the assets and capacity of the community
- identifying strengths and potential resources for program planning & interventions
23
Q
define: sustainability
A
- the maintenance and continuation of established community programs
24
Q
asset mapping & sustainability is more likely to occur when…
A
- members of the community are involved as partners in the community development process
25
define: community health assessment
-ongoing systematic appraisal of the community
- a dynamic, ongoing process undertaken
- the process of thinking critically about the community
- involves getting to know & understand the community client as partner
26
community health assessment helps to (8)
- identify the needs, resources, assets, capacities, opportunities, and strengths of the community
- clarify health concerns
- identify community constraints
- identify the economic, political, and social factors affecting the community
- identify the DOH affecting community health
- address the challenges to reduce inequalities, increase prevention, and enhance community coping
- enable the community-wide establishment of health profiles
- and facilitate collaborative action planning
27
CHA is directed at...
- improving community health status and QOL
28
community health assessment includes.. (4)
- environmental scan
- needs assessment
- problem investigation
- resource evaluation
29
an environmental scan includes...
- a windshield survey
30
describe: needs assessment
- consider what appropriate and cost-effective services is the community missing to meet its health needs
- identify the need, resources present, and missing services
31
what is problem investigation
- investigating occurrence and distribution of a problem
- explore the roots or causes & their effects
- develop a response plan
32
what is resource eval
- assessment and evaluation of existing community resources and services
33
resource evaluation must be.. (2)
- purposeful
- evidence based
34
community assessment starts with a ____ statement
PISO --> Population, Intervention, Setting, Outcome
35
community health assessment is successful when the community is..
- fully engaged and empowered thru the nursing process
36
components in community assessment include... (16)
- community history and perception
- population
- boundaries
- enviros
- socioeconomic enviro
- income and social status
- employment and working conditions
- social supports and networks
- diversity and social inclusion
- recreation
- education and healthy child development
- culture and religion
- health and social services
- transportation
- communication
- gvmts and policies
37
what are 3 types of population categories
- target population
- population at risk
- priority or vulnerable population
38
define: target population
- population for whom nursing intervention is intended for
39
define: population at risk
- group of individuals who have a high probability of developing illness
40
define: priority or vulnerable population
- people who are disadvantaged, susceptible, or vulnerable to health inequity, injury, disease, or premature death
41
define: boundaries r/t CHA. are they permeable?
- where the target population lives, works, worships, plays, and learns
- they are permeable
42
define: physical boundaries
- geographic boundaries such as mountains, valleys, roads, or oceans
43
what are 2 types of artificial boundaries
- political (townships, countries)
- situational (school zones, traffic patters)
44
what are 2 categories of environments r/t CHA
- biological & chemical
- physical
45
what are biological & chemical characteristics of enviros (6)
- vegetation
- animals
- food
- water
- chemicals
- toxins
46
what are physical characteristics of enviro
- road design
- mountains
- geography
- climate
47
what are socioeconomic enviros
- the interaction between social and economic conditions of the community
ex, new housing, business developments, employment rates
48
what are the most important DOH (2)
- income
- social status
49
what are the 4 phases of CHA
- assessment
- planning
- implementation
- evlaluation
50
define: health program planning process
- the organized approach to identifying and choosing interventions to meet specific goals and objectives that address client health concerns
51
what is the goal of the health program planning process
- to ensure that healthcare services are acceptable, equitable, efficient, and effective
52
what are the 3 steps to the health program planning process
1. assessment of health concern
2. identification and formulation of goals and objectives
3. identify activities or alternatives
53
what is involved in the assessment of health concern in the health program planning process (70
- identify target population and involve them in designing the program
- the interdisciplinary planning team must verify that a health concern exists
- health education may be necessary to alert the population to the health concern
- determine the size and location of the population
- determine boundaries (to stipulate who is included or excluded)
- identify available resources
- use all relevant assessment data
54
what is involved in the identification & formulation of goals & objectives in the health program planning process
- create goals
- create SMART objectives
- several objectives (short, intermediate, and long term) are needed to meet each goal
55
what is involved in identifying activities or alternatives in the health program planning process (3)
- working with client
- consider the possibility of solving a health concern using the various solutions identified
- for each alternative, list the resources required to implement each activity
56
data collection & interpretation in CHA includes... (4)
- gathering or compiling existing data
- generating missing data
- interpreting data
- identifying community abilities and health concerns
57
what are 7 key data-collection methods
- participant observation
- informant interviews
- focus groups
- windshield survey
- community forums
- secondary analysis of existing data
- surveys
58
what is the benefit and con of community surveys
- benefit: provides a snapshot of the population being studied at that particular time
- con: may be generalized to describe the larger population
59
what are community forums
- public meetings in which community members discuss issues of concern and share their experiences and opinion w their community leaders or decision makers
60
what are focus groups
- small group discussions conducted by trained facilitators with an average of 8-12 people that usually last 1-2 hours
61
what are sources of community data (5)
- participant observation (windshield survey, walking tours)
- literature review
- demographic and epidemiologic data
- national and local policy data
- community surveys (key informant surveys, Canadian community health surveys)
62
what are examples of national and local policy data (3)
- PHAC
- CHI
- local, provincial, federal health department
- etc.
63
what are examples of demographic and epidemiologic data used for community data (3)
- census data
- trends
- vital statistics
64
what are assessment issues with CHA (2)
- gaining entry or acceptance can be a major hurdle to assessment
- confidentiality is important but is affected by the legal requirement to disclose info in some cases (ex. child abuse)
65
how can we gain trust for CHAs (8)
- taking part in community events
- looking & listening w interests
- visiting people in formal leadership positions
- using an assessment guide
- using a peer group for support
- keeping appts
- clarifying community members' perceptions of health needs
- respecting an individual's right to choose whether he or she will work w the CHN
66
define: population health
- an approach to health that aims to improve the health of the entire population & reduce health inequities among population groups
- it acts upon the broad range of factors and conditions that have a strong influence in our health
67
what are 10 aspects of population health
- focus on the health of population
- address the DOH and their interactions
- base decisions on evidence
- increase upstream investments
- apply multiple strategies
- collaborate across sectors and lvls
- employ mechanisms for public involvement
- demonstrate accountability for health outcomes
- focus on inequities & determinants
- identify community strengths and problems
68
describe: risk assessment
- assessing the risks and benefits to the entire population or to its significant aggregates
- then delivering health services to individuals who are at risk to reduce health inequity caused by various SDoH
69
what is a community nursing diagnosis
- inferences made from data collected and analysed for actual and potential strength and needs, the social determinants interaction and impact on community health, functions, and dynamics
70
community nursing diagnosis consists of the following components: (4)
- target group
- actual or potential unhealth or healthy response
- etiology or cause: related to...
- characteristics: as evidenced by...
71
what are the 4 steps of planning for community health
1. analyze health concerns
2. setting health concern priorities
3. establishing goals and objectives
4. identifying intervention activities
72
what is involved in the planning for community health step "analyzing health concerns"
- the CHN seeks to clarify the nature of the concern, the points at which intervention might be undertaken, and the parties that have an interest in the health concern and its solution
73
helpful ranking criteria for setting health concern priorities when planning for community health include... (6)
1. how aware is the community of the health concerns?
- is the community motivated to resolve or better manage the health concern?
- is the CHN able to influence a solution for the health concern?
- are experts available to solve the health concern?
- how severe are the outcomes if the health concern is unresolved?
- how quickly can the health concern be solved?
74
what is the difference between goals and objectives
- goals = broad statements of desired outcomes
- objectives = precise statements indicating the means of achieving the desired outcomes
75
what does SMART objectives stand for
Specific
Measurable
Achievable
Realistic
Timely
76
define: intervention activities
- the strategies used to meet the objectives, the ways in which change will be effected, and the ways in which the health concern cycle will be broken
77
intervention activities must be _____ because ______
- must be identified and evaluated because alternative intervention activities exist
78
what are community participatory tools for community planning (4)
- community needs matrix
- community mapping
- present-future drawing
- community governance and engagement
79
what is the community needs matrix tool
- a tool used to discuss, identify, rate, or explain what they perceive to be the most important health problems or the most feasible intervention in their community
80
what is community mapping
- distribution and occurrence of illness, disease, and health
81
community governance and engagement is pivotal in... (3)
- achieving program sustainability and accountability
- building community capacity
- building social equity
82
what is community governance
- decision making process where mngmt and leadership are usually undertaken by a group of community stakeholders to meet the health needs and priorities of the community thru community engagement and empowerment
83
what is community engagement
- process involving citizens at various lvls of participation based on interpersonal communication and trust & a common understanding & purpose
84
what is community development
- process of involving a community in the identification and strengthening those aspects of daily life, culture life, and political life
85
what is community mobilization
- taking collective action to generate solutions to common problems
86
define the health program implementation process
- putting the health program planned activities into action
87
what are factors influencing implementing in community health (3)
- the CHNs role
- the community health concern, CHNs role, and personal choices
- the social change process and how receptive the community is to innovation
88
define: change agent
- stresses gathering and analyzing facts & implementing programs
89
define: change partner
- includes enabler-catalyst, teacher of problem solving skills to address health concern, and activist advocate
90
the CHNs role in implementation depends on... (3)
- the nature of the health problem
- the community's decision making ability
- and professional
91
define evaluation of the intervention for community health
- the appraisal of the effects of some organized activity or program
- the systematic process of appraising all aspects of a program to determine its impact
92
when does evaluation of interventions begin
- in the planning phase of community action, when goals and measurable objectives are established and goal-attaining activities are identified
- needs to start early & should therefore be designed at the same time as the health program planning process
93
what is the major benefit of program evaluation
- it shows whether the program is fulfilling its purpose
94
community program evaluation includes...
1. determining what needs to be evaluated based on the evaluation criteria
- engaging stakeholders throughout the process
- determining the appropriate methods of measurement
- developing data collection instruments, budget, and timeline for evaluation
- collecting & analyzing data
- reporting and disseminating the results
- making decisions for actions
95
describe the role of outcomes in evaluation
- outcome measures answer questions about results of the intervention
96
what questions should you ask about results of the intervention in the evaluation phase (5)
- which interventions have been effective, and why?
- which interventions were ineffective and why?
- has the health concern been resolved or the risk reduced?
- what lessons have been learned?
- what changes are needed?
97
what are the major sources of info with program evaluation
- program records
98
what are the 2 lvls of program evaluation
- formative eval
- summative eval
99
what are the steps for evaluating public health programs (5)
- focus on determining exactly what needs to be known about the health program
- choose suitable strategies to answer the eval questions
- design or revise data collection tools
- collect and analyze the data
- make decisions about the health program based on responses to the eval questions
100
what are sources of health program eval (3)
- program clients
- program record (clinical records)
- community indicators (mortality and morbidity data)
101
what is included in health program eval criteria (7)
- relevance
- adequacy
- progress
- efficiency
- effectiveness
- impact
- sustainability
102
describe relevance r/t health program eval criteria
- the need for the program
103
describe adequacy r/t health program eval criteria
- the extent to which the program addresses the entire problem defined in assessment
104
describe progress r/t health program eval criteria
- the tracking of program activities to meet objectives
105
describe efficiency r/t health program eval criteria
- the relationship between program outcomes and costs
106
describe effectiveness r/t health program eval criteria
- the ability to meet program objectives and the results of program efforts
107
describe impact r/t health program eval criteria
- long term changes in the client population
108
describe sustainability r/t health program eval criteria
- enough resources to continue the program
109
what are community planning tools
- program logic model (PLM)
- precede-proceed model
110
what is the program logic model (PLM)
- a communication tool that depicts the process and components of planning in a diagrammatic form
- depicts a cause-and-effect sequence or path toward a stated outcome
111
the PLM clarifies...
- logical linkages of program inputs, outputs, and outcomes related to a specific health concern or situation
112
what are the benefits of the PLM (4)
- provides a coherent structure for complex health programs
- helps expose gaps
- yields an overview of program with appealing visual clarity
- provides a means of documenting what the program is supposed to do, with who, and why
113
PLM
114
what does CAT stand for
Components
Activities
Target groups
115
describe the Component aspect of CAT
- clusters of related activities
ex. risk assessment, crisis intervention, peer support
116
describe the Activities component of CAT
- specific intervention strategies to be used for each component
ex. training
117
describe the target component of CAT
- target groups are the intended recipients of the program
118
what does SOLO stand for? what is it?
Short-term
Outcomes and
Long-term
Outcomes
- the ultimate goal of the program
119
what is the program evaluation tool kit
- the use of a logic model and identifies which evaluation processes may be used to inform decision making during program planning and implementation
- evaluation is an ongoing process
120
what is the precede-proceed model
- a complex, but comprehensive, planning model
- involves thinking logically about the desired end point and work backwards to achieve that goal
121
how many phases are in the precede-proceed model
9
122
describe the precede aspect of the precede-proceed model, which phases does it involve?
- phases 1-5
- set the direction and objectives for the ensuing phases
123
describe the proceed aspect of the precede-proceed model, which phases does it involve?
- address the need for health promotion interventions and approaches used to change unhealthy behavior
- phases 6-9
124
the precede-proceed model emphasizes 2 basic assumptions:
- health and health risks are caused by multiple factors (DOH)
- efforts to effect behavioral, enviro, and social change must be multidimensional or multisectoral and participatory in the target audience is actively involved in the model
125
precede-proceed model
126
planning-implementation-evaluation cycle
127
community health promotion model
128
public health agency of canada tool kit: decision-oriented model for program eval
129
what are 3 aspects of community dyanmics
- effective communication
- leadership
- decision-making
130
what are 3 types of effective communication
- vertical
- horizontal
- diagnoal
131
what is vertical communication
- links communities to large communities or those w higher decision-making power
132
what is horizontal communication
- connects community to work collaboratively with its own members, enviro , and other service systems
133
what is diagonal communication
- reinforced the cohesiveness of both horizontal and vertical communication
134
describe leadership r/t community dynamics
- lead their members by influencing the decision-making process using their status and position in the community
135
describe decision making r/t community dynamics
- formal leaders use governmental policies
- informal leaders use status
- effective leaders collaborate with community groups to advocate for optimal change
136
what is the epidemiological triangle
- host -- environment -- agent
137
what is the epidemiological triangle used for?
- to examine the freq of a disease or health & social conditions
138
define: host
- who is affected
- human being in which the disease occurs
139
define: enviro r/t the epidemiological triangle
- where and when the condition occurred
- the context that promotes the exposure of the host to the agenct
140
define: agent r/t epidemiological triangle
- why and how it occurred
- the contagious or non-contagious force that can begin or prolong a health problem
141
define: web of causation
- chains of causations and their effects on health problems
142
epidemiological triangle model
143
epidemiology triangle as a venn diagram
144
define: epidemiology
- the study of the occurrence and distribution of health-related states or events in specified populations, including the study of the determinants influencing such states and the application of this knowledge to control the health problem
145
epidemiology is the study of populations in order to... (3)
1. monitor the health of the population
2. identify the DOH and disease in communities
3. investigate and evaluate interventions to prevent disease and maintain health
146
what is descriptive epidemiology (3)
- the study of the distribution of disease
- looking at health outcomes and seeking to answer the questions "what, who, where, and when?"
- discusses a disease in terms of person, place, and time
147
what is analytical (or applied?) epidemiology (2)
- looks at the etiology (origins and casual factors) of the disease (how and why)
- deals with DOH and disease
148
what are examples of DOH and disease (5)
- individual
- relational
- social (income, married, single, etc.)
- communal
- environmental (ex. do diseases happen more in summer vs winter?)
149
describe relational DOH
- how are two factors r/t one another (correlation vs causation)
150
describe communal DOH
- what community they live
ex. small vs large
151
describe the role of Florence Nightingale r/t epidemiology
- mid 19th centruy
- contributed to the development of epidemiology in her work w British soldiers during the Crimean War
- looked at the relationship between environmental conditions and the recovery of the soldiers
- encouraged accurate recording of deaths and causes
- was able to decrease mortality rates by improving enviro conditions and adding nursing care (ex. washing hands)
152
describe multiple agents
- during the 12th century
- shift from looking for single agents (host agent) as the cause of diseases to seeking combos of factors that contribute to disease
- shift in focus from infectious diseases, which were now controllable, to chronic diseases such as cancer and diabetes
153
epidemiology triangle as a venn diagram
154
describe the role of Hippocrates in epidemiology
- 400 BC
- first saw relationships between enviro and health
- he suggested physicians study who eats and drink to excess, and who prefers exercise and labor
155
describe the role of John Graut in epidemiology
- 1600s
- recording gender differences, deathrates, levels of infant death
156
describe the role of dr. john snow in epidemiology
- linked cholera deaths to sources of drink water
157
why is epidemiology once again at the center of public planning? (3)
- threats of biological terrorism (ex. anthrax mailed packages)
- the appearance of new infectious diseases (ex. COVID)
- the recurrence of drug-resistant strains of older diseases (no longer have effective tx for an old disease ex. TB)
158
define: epidemiological variables
- to describe the patterns of health challenges
159
what are examples of person variables (6)
- age
- sex
- ethnicity
- education lvl
- socioeconomics
- diets
- etc.
160
what are time variables
- cyclic or seasonal variations of a health event
- health challenges following an event (ex. post partum depression)
- time trends (increase in chronic disease over time)
161
what are place variables
- variation between regions, countries, continents, population density, rural/urban
162
sustainability and risk can also be described as...
- vulnerability which determines the individual host response
163
what are examples of modes of transmission
- direct
- indirect
164
what is direct transmission
- involves direct contact between individuals
165
what is indirect transmission
- involves a vehicle or vector that moves disease between hosts
ex. contaminated water supply, moquito
166
what are examples of indirect transmission (4)
- airborne
- water born
- vector borne
- vehicle borne (utensils, clothing, hygiene articles)
167
define: endemic
- the rate of a disease, injury, or other condition is the rate of occurrence that is usual in a population
ex. headlice in schools
168
define: epidemic
- occurs when the rate of a disease, injury, or condition clearly exceeds the usual lvl for that condition
ex. the incidence of the disease has increased
169
define: pandemic
- rate of a disease, injury, or other condition is the rate of its occurrence in geographically widespread populations
ie. not just in canada
170
define: health surveillance
- the tracking and forecasting of any health event of health determinant thru the collection of data; its integration, analysis, and interpretation into surveillance products , and the dissemination of those surveillance products to those who need to know (how much RSV or influenza is out there)
- an important aspect of public health
171
define: surveillance products
- everybody comes to an emergency room to be swabbed looking for the disease indicator, gather info and then decide what public health needs to do to address the concern
172
define: morbidity rate
- measures of illness
- the amt of people have a/the disease
- how many people are ill with condition x
173
define: incidence rate
- newly diagnosed in a period of time
ex. 5 cases
174
define: prevalence rate
- newly diagnosed cases and alreadt existing cases
ex. 5 new cases + existing cases
175
prevalence rate is affected by.. (2)
- how effective treatment is
- how fast people die
176
prevalence rate might be lower when..
- it is hard to diagnose
177
define: mortality rate
- how many people die from condition
- death rate
178
define: comorbidity
- looking at 2 illnesses
179
define: survival rate
- the % or persons with the disease who are alive 5 years after diagnosis
180
define: case-fatality rate
- dividing the number of people who die from a disease by the number of people who have the disease
181
define: relative risk
- divides the incidence of a given problem or disease in a population exposed to a given risk factor, by the incidence of the same problem in a population not exposed to the same risk
182
define: point prevalence
- do you smoke?
- time is now
183
define period prevalence
- have you ever smoked in the last 6 months?
184
define: cumulative or lifetime incidence
"have you ever smoked?"
185
define: potential years of life lost
(PYLL)
- assumption that a person who dies early in life has lost greater potential than has a person who dies much later in life
186
how is PYLL calculated
75 (average age) - age of death = # of years lost
187
define: natural history of disease
- refers to the progression of the disease process from onset to recovery
188
define: prepathogenesis
- susceptibility to disease
189
define: pathogenesis
- from the preclinical stage of death, disability, or recovery
190
the natural history of disease is related to...
3 levels of prevention
191
which 3 lvls of prevention are related to the natural history of disease
- primary
- secondary
- tertiary
192
natural history of disease
193
194
what are 5 types of epidemiological studies
1. descriptive
2. analytical
3. ecological
4. experimental or observational studies
5. community trials
195
describe: descriptive studies
- outcomes person, place, time
196
what are types of descriptive studies (2)
- case series studies
- cross sectional studies/prevalence studies
197
describe: case series studies
- counts of selected variables within a specific population
- researchers determine morbidity and mortality rates and thru analysis of factors look for evidence of association and causality
ex. are mortality rates for cardiac disease higher for men or women?
198
what are cross sectional/prevalence studies
- snapshots of the present
ex. anonymous survey to ask about smoking behaviors to inform when to start health education
199
cross sectional/prevalence studies are collected as...
- a baseline for planning & implementing interventions or to measure change
- can also be used to assess effectiveness of an intervention
200
analytical studies focus on..
- how and why
201
what are types of analytical studies
- case-control studies
- cohort studies
202
describe case control studies
- individual in the group w a disease are matched w similar individuals who do not have the disease
- these individuals are compared to find common factors and differences between the two populations
203
what is the odds ratio
- (exposed person with the disease/ unexposed person with the disease) / (exposed person without the disease/unexposed persons without the disease)
204
describe cohort studies
- examine individual histories of a group of people manifesting a certain disease to find out what factors they share and what differences can be discerned
205
what are 2 types of cohort studies
- retrospective
- prospective
206
what are retrospective studies
- begin in the present and search the past for info that explain the present
207
what are prospective studies/longitudinal studies
- begin in the present and follow the subjects into the future or make predictions about the future that can be tested at a later date
ex. group of people w high exposure to a stressor
208
what do ecological studies focus on
- relationships
209
what are types of experimental or observational studies
- randomized controlled trial
210
what are community trials
- similar to clinical trials, but usually study health promotion and disease prevention, rather than treatment of existing disease
211
with community trials, intervention happens...
- on a large scale
- unit of treatment allocation is a community, region, or group, rather than individuals (trying out approaches that work w groups)
212
community trials often involve.. (3)
- educational
- programmatical
- or policy interventions
213
data for epidemiological studies commonly come from 3 categories:
1. routinely collected data such as census data, vital records, and surveillance data
2. data collected for other purposed, such as medical, health department, and insurance records
3. original data collected for specific epidemiological studies
214
what governmental agencies are used as sources of data (6)
- health canada/provincial health departments
- public health statistics
- health surveys
- statistics canada
- provincial vital statistics
- census data
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what non-governmental agencies are sources of data (4)
- canadian cancer society
- heart & stroke foundation
- social planning councils
- canadian institute of health info
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what are other sources of data
- employee health
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describe screening
- the testing of groups of individuals who are at risk for a certain condition but do not manifest any symptoms , in order to determine the likelihood that these individuals will develop the disease
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screening is a key component of...
- many secondary prevention interventions (key component of finding a disease early)
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what are considerations specific to screening tests (3)
- reliability
- validity
- ethical concerns
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define: reliability
- measurement devices always produce the same result
- would you get the same result if it was repeated?
- consistent in results over time & population
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define: validity
- does it measure what it need to measure?
- includes sensitivity and specificity
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define: sensitivity
- the ability to correctly identify individuals who have the disease
- that is to identify a true positive
- a test w high sensitivity has few false negatives
- how well can we identify that someone has the disease
- not highly sensitive = more false positives
- want this to be high
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define: specificity
- the ability to correctly identify individuals who do not have the disease or to call a true negative "negative"
- high specificity = few false positives
- want this to be high
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define surveillance
- constant watching or monitoring of diseases to assess patterns and quickly identify events that do not fit the pattern
- gathering and analyzing data
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define: association
- reasonable evidence that a connection exists between a stressor or environmental factor and a disease or health challenge
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define: causation
- when an association has been confirmed beyond doubt
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how do CHNs use epidemiology
- CHNs are involved in surveillance and monitoring of disease trends and can identify patterns of disease in a group
- nursing documentation on client records is an important source of data for epidemiological reviews (ex. client demographics, health histories)
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what is the ethical concern w screening
- it is unethical to collect data that will not be used to plan interventions
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define: capacity building
- process to strengthen the ability of an individual, organization, community, or a health system to develop & implement health promotion initiatives and sustain positive health outcomes over time
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what is the goal of the community health promotion model
- apply community health promotion strategies to achieve collaborative community actions & to improve sustainable health outcomes for the community
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what is SWOT
Strengths
Weaknesses
Opportunities
Threats analysis
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what is the multiple intervention program (MIP) framework
- shift to a focus on programs that target multiple layers of the system
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what is included in the MIP framework
- identify health issue, burden of illness, and inequity gaps
- describe sociostructural features
- consider intervention options
- maximize intervention impact
- assess implementation, impact, and consequences
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multiple intervention program framework
