Week 6 (new content) Flashcards
List, describe, and give examples of the 3 approaches to population health
1) Health care: one-on-one individual health services
-ex: clinical services, counseling, screenings
2) Traditional public health: Group and community-based interventions
-ex: food and drug safety, disease control, environmental hazards
3) Public policy interventions: Interventions with another non-health-related purpose which have secondary impacts on health
-ex: increase education, address socioeconomic disparities, mobility of goods
What are Social Determinants of Health?
Non-medical factors that affect health outcomes, health behavior and decision making
What are the 5 domains of the social determinants of health?
1) Economic stability
2) Neighborhood and built environment
3) Education access and quality
4) Social and community context
5) Healthcare access and quality
What is Health Belief Model?
Classic frame of reference for understanding health behavior that assumes people act rationally
-There are several factors that determine whether a person is likely to change behavior when faced with a health threat
Several factors that determine whether a person is likely to change behavior when faced with a health threat; list 4
1) The extent to which the individual feels vulnerable to the threat
2) The perceived severity to the threat
3) Perceived barriers to taking action to reduce the risk
4) The perceived effectiveness of taking an action to prevent or minimize the problem
What is the transtheoretical model?
The stages of change: precontemplation, contemplation, preparation, action, maintenance, behavior.
Give 3 examples of decision making attitudes
1) Risk-taking attitudes
2) Certainty effect
3) Long-shot effect
1) What are Risk-taking attitudes?
2) When do ppl tend to be risk takers?
Risk-taking attitudes
Attitude toward risk which influences choices regarding prevention and treatment of disease
2) When conditions are intolerable; risk avoiders when conditions are tolerable.
1) What is the certainty effect?
2) What is the long-shot effect?
1) A guarantee of the better outcome and not willing to take any risk of a less desirable outcome.
2) Patients in poor health taking the risk of a slight worsening vs. a chance for a major improvement.
Give examples of Social/Behavioral Science and Public Health interacting
1) Psychology
2) Sociology
3) Communications
4) Demography
5) Geography
Inform of decision:
1) What is it?
2) What is an advantage?
3) What are 2 disadvantages?
1) Clinician has all the information and makes decision in patient’s best interest; requires element of trust between patient and provider.
2) Efficient, helpful if patient not good at decision making.
3) Patient may not fully understand and therefore not fully participate.
-Patient doesn’t always accept responsibility.
Informed Consent:
1) What is it?
2) What is the disadvantage?
1) Patients are informed of and make a decision to proceed based on the following info…
what intervention is recommended
why it is needed
risks and benefits
alternative treatments
2) Time consuming, lots of paperwork
List different approaches to clinical decision making
1) Inform of decision
2) Informed consent
3) Shared decision making
Shared Decision Making:
1) What is it?
2) Advantage?
3) Disadvantage?
1) Clinician provides patient with information and patient decides.
2) Patient can ask questions and dialogue about solutions-more “buy-in” and can include cost, timing, side effects in decision.
3) Time consuming, may increase stress on patient, clinician may hand off responsibility to the patient and not be as thorough.
List and describe 5 psychosocial factors that affect health behavior
1) Shapes norms: Behaviors accepted among social groups; “everyone else is doing it”
2) Enforcing patterns of control: Rules and regulations in place to create structure
3) Opportunities or lack of opportunities: Opportunities to engage in healthy behaviors
4) Coping strategies: Encouraging health behaviors as a coping strategy
5) Self-efficacy: The sense of having control over one’s life
Social and Behavioral Sciences + Public health:
1) How do these fit together?
2) What is a big part of that?
1) Organization and motivation behind social forces + the behavior of individuals
2) Addressing social and economic inequalities help provide fair treatment and equal division of societal benefits amongst individuals in a population (Social Justice)
Describe how each of the following blends social/ behavioral science and public health:
1) Psychology
2) Sociology
3) Communications
4) Demography
5) Geography
1) Theories of behaviors, behavior modification and risk-taking tendencies
2) Social impacts on individual and group behaviors
3) Mass personal communication and the role of media in health information
4) How global aging, changes in birth rates and migration impact the health of a society
5) Locations of disease occurrence and geographic impact of disease
1) What are screenings?
2) What can they allow for?
3) What can this cause?
1) Tests for asymptomatic persons
2) Early Detection: Breast cancer and colon cancer
3) Lead-time bias
What are the 4 criteria for an ideal screening process?
1) Disease produces substantial death and/or disability
2) Early detection is possible and improves outcome
3) Feasibility and acceptable accuracy of testing
4) Low risk of screening harm, costs and patient acceptance
1) What does screening identify?
2) What does it ideally require?
1) High-risk population
2) Two or more tests
Define the following:
1) False positive
2) False negative
3) Sensitivity
4) Specificity
1) Test positive, Disease negative
2) Test negative, Disease positive
3) Probably the test will be positive in the presence of the disease
4) Probability the test will be negative in the absence of disease
1) What are some coronary artery disease risk factors?
2) What are some sexually transmitted disease risk factors?
3) Cancer Risk Factors?
1) HTN
2) Unprotected sex, risky behaviors in general
3) Depends on cancer type (alcohol, smoking, etc)
Give 2 examples of multiple risk factor reduction
1) Obesity AND exercise
2) High blood pressure AND Cholesterol
Cost Effective Interventions; define the following:
1) Cost-benefit analysis
2) Net-effectiveness
3) Cost-effectiveness
1) Weighs the estimated cost of implementing a policy against the estimated benefit
2) Benefits are substantially greater than the harm
3) Net-effectiveness worth the additional cost
Genetic interventions:
1) List 3 pre-pregnancy/ carrier tests
2) List 2 during-pregnancy tests
1) Tay-Sachs Disease, sickle-cell anemia, cystic fibrosis
2) Down Syndrome + phenylketonuria (PKU
1) What test can predict risk of disease?
2) True or false: pharmacogenetics is an example of genetic interventions
1) BRCA 1
2) True
Compare/ contrast Population vs Individual interventions using the example of alcohol abuse (liver disease, fetal alcohol syndrome, MVC, etc)
1) Population: Taxation, MADD, Laws
2) Individual: Provider screening, therapy, AA
1) What is the goal of Tx?
2) What can be the downside to reducing pain?
3) What can be a downside of suppressing autoimmune disease?
4) What two things should you monitor?
1) Prevent long-term mortality and morbidity from our treatments
2) Narcotics addiction
3) Increased risk of cancer
4) Kidney + liver function
