Year 2 I&P Flashcards
First step on ladder of intervention
Do nothing, monitor the situation
Give an example of ‘providing information’, the second step on the intervention ladder
5 a day campaign
Give examples of:
3) Enable choice
4) Guide choice through changing default
5) Guide choice through incentive
6) Guide choice through decentives
3) free fruit in schools
4) salad becomes default side with meals, have to ask for chips
5) tax-free bike to work scheme
6) higher tax on cigarettes
What are stages 7 and 8 on the intervention ladder?
7) Restrict choice e.g. remove unhealthy food items from shops
8) Eliminate choice e.g. isolate those with infectious disease
What did the Marmot review find out about health inequalities?
Not inevitable, result from social inequalities.
What is proportionate universalism?
Cannot focus solely on most disadvantaged
According to the Marmot review, who should tackle health inequalities?
Government, not NHS
What is a necessary cause?
Presence is required for an event to occur. Presence doesn’t always lead to event, but event cannot occur without it.
What is a sufficient cause?
Presence always leads to an effect. Presence alone is enough, but is not the only cause of the effect.
What are the 4 determinants of population health, ranked from most to least important?
- Societal characteristics
- Health behaviours
- Medical care
- Genes and biology
What are the 5 steps on Maslow’s hierarchy of need?
Physiological Safety Love and belonging Self-esteem Self-actualisation
What is a normative need?
Need identified according to a norm
What is a comparative need?
Need stemming from a comparison to others who are not in need
Cross-sectional study
Counts number of people with disease at 1 time
Pros: quick, good for prevalence
Cons: only measures 1 time, can’t measure incidence, sampling frame may lead to bias
Ecological studies
Compare one group to another.
Pros: cheap, less bias, easy.
Cons: ‘ecological fallacy’ - assume population measures are true for individuals, assume average risk / incidence applies to all
Case-control studies
Retrospective comparison for exposure as a potential cause. Diagnosed cases in exposed group compared to control.
Pros: Quick, good for rare disease
Cons: Selection / participation bias, difficult to find control
Cohort study
Set population at risk of but free from disease and follow them through time.
Pros: Can measure many outcomes, low bias
Cons: expensive, time consuming
Randomised controlled trial
Split population randomly into treatment and control groups and compare rates of outcome.
Pros: strongest evidence, no bias
Cons: Expensive, can be unethical
Primary prevention
Preventing disease onset by removing cause
Secondary prevention
Halt disease progression e.g. using screening programmes
Teritary prevention
Treat disease to limit disability and complication
What does Rose’s single population theory state?
Instead of only treating “high risk” groups, should shift mean to left and focus more on whole population.
What is the Ottawa Charter?
International agreement organised by WHO aiming to achieve the goal of “health for all” by 2000 by improving health promotion
What are the 5 actions set out by the Ottawa Charter?
- Develop personal skills
- Strengthen community
- Create a supportive environment
- Build healthy public policy
- Re-orientate health services towards prevention of illness and promotion of health
What are the 5 approaches to health promotion?
- Medical: 3 levels of prevention
- Behaviour change: focuses on individual attitudes
- Educational: enables choice and avoids persuasion
- Empowerment: gives people confidence and skills to address their concerns
- Social: healthier choices normal in physical and social environment
What is the social norms approach?
Addresses misperceptions of the norm by aiming to understand what the perceived norm is and challenge unhealthy aspects.
Commissioning
Set of linked activities required to assess population needs and how to assess them
What are the 3 steps of the commissioning cycle?
Planning –> procurement –> monitoring
What is the King’s fund and what are their aims?
Charity working to improve health and care in England. Integrated care methods Promote health understanding Invest in support Link healthcare and government Employ patients Focus on multiple health behaviour Population based commissioning Care plans for elderly
What is polypharmacy?
Cost-effective prescribing and reduction of medication errors
Name some ways in which polypharmacy may be achieved
Pharmacist-led intervention
Pharmacy technicians
Benchmarked information on prescribing performance
IT decision support tools
What are the 5 components of the voluntary sectors role in health promotion?
Peer support Self-management education Health coaching Group activities Asset-based approach
Epidemic
Serious outbreak in single area
Pandemic
Epidemic spreading to several areas of the world
What is the heirarchy of studies?
- Randomised controlled trial
- Cohort study
- Case-control study
- Register / ecological studies
- Cross-sectional studies
- Anecdote
