PHC6410 Exam 1

primordial prevention

-general population

-injury prevention, promote a healthy diet, physical activity, no substance use

prevents the development of risk factors

primary prevention

-at risk 

-reduces incidence rate of a disease

--examples: wearing face masks, handwashing,improving diet

prevents the onset of disease through risk reduction

secondary prevention

-high risk and confirmed cases

-prevent more serious disease/reduce severity, limit disability

-screening for cdv risk, enhance adherence to medical recommendations like medication/low fat diet 

early detection and treatment

tertiary prevention

-cancer, AIDS

-disease management/ CVD patient

rehab, reduces consequences, prevents recurrence

how do we develop theory 

precise about wording and measure what we are testing 

constructs

conceptual components, building blocks, or primary elements of a theory

variables

operational definitions of constructs or how the constructs are measured/implemented 

how is theory used in health promotion?

Provides conceptual context for understanding behavior, guides research that seeks to identify determinants of health-related behavior, and guides program planning methods can be incorporated into health promotion practice 

mediators

actors associated with outcome of interest and when changed can increase the likelihood of beahavior change

change processes

health promotion professionals make changes in individuals, organizations with whom they work to accomplish specific outcomes

program development functions

Identifying a need for a program, developing components and plans, implementing interventions, conducting evaluation 

what are health promotion’s goals

• Providing services and activities that improve behavior and health

• Strengthen the environment to support personal health behavior

• Facilitate healthful behavior

health related behavior

-everyone , managers, public officials

-engage in behaviors that expose others to possible infection, congregating in large groups

affects health and health behavior of other people and not the person who engages in the behavior

health protective behavior

-everyone, public health profesisonals

-wearing face masks, testing for disease, vaccines 

out of concern for one’s own health or the health of others

prevention

makes changes to the environment, behaviors, or other risk factors to prevent or mitigate impacts of health conditions

primary prevention for checking and controlling blood pressure

reduction in heart attack incidence

secondary prevention of controlling blood pressure

screening people with a family history of hypertension

tertiary prevention of checking/controlling blood pressure

trying to prevent the recurrence of a heart attack

How do you develop hypotheses?

be precise and measure ideas that you are testing

what is a model

representation of a behavior that may or may not be testable and is an application of a theory

evaluation

assessing the strengths and weaknesses of programs, policies, personnel, products, and organizations to improve their effectiveness

Do we need a program, policy, product, or service first before we consider evaluation?

no

role of evaluation in public health

developing, improving, and identifying quality health programs and interventions; before, during, and after your program

evaluation research

-perfect world research

-determine cause and effect

-internal validity

impact of a new intervention among a defined population, generating new knowledge, establishes the feasibility, efficacy, and costs of an intervention

program evaluation

-practice based, does the program work when delivered under normal conditions?

-external validity and generalizability

-EFFECTIVENESS

produces valid evidence that a tailored, replicable program is accepted and delivered

efficacy

-behavioral impact/research

did the new intervention produce changes among a population sample under optimal program practice conditions

effectiveness

-program evaluation/existing programs

-real world setting

did the established intervention produce a significant change in a large sample population under normal program practice conditions

formative evaluation

-forming the program

-creates rapid feedback before widespread implementation

-improve the way a program is delivered

provides quantitative and qualitative insight during the developmental and early implementation phases

summative evaluation

• to understand the end products. how did behavior change?

  • summing up the program

draw conclusions and make decisions about impact, outcomes, or other benefits of a health program

process evaluation

-ongoing check on a plan’s implementation and documentation of the process

-compares the actual implementation components of a solution with the intended

documents the degree to which the program was implemented as planned

implementation fidelity

degree to which an intervention was delivered as intended

quality assurance

systematically monitoring to ensure an intervention meets predefined standards

short term evaluaition

-up to 1 or 2 years

immediate effects and behavior

intermediate evaluation

-1 or 2 years, up to 5 years

what short term effects lead to such as health status

long term evaluation

longer than intermediate and measures overall morbidity/mortality and changes in conditions

what makes up the CDC’s social ecological model

individual, relationship, community, social

prevention strategies at individual social ecological model

-conflict resolution, life skills training, social emotional learning

promote attitudes beliefs and behaviors

prevention strategies at relationship social ecological mdoel

family focused prevention programs, mentoring, peer

prevention strategies at community social ecological model

improve social environment and address social conditions

prevention strategies at societal social ecological model

prevent societal norms and strengthen structural determinats of health

intrapersonal factors

-interventions are education, training, skills

-harm reduction education, safety info, peer led

knowledge, behaviors, attitudes, self concept

intrapersonal factors

-interventions are education/training to those who interact and modifying home and family environments

-campaigns to change social norms, increase accessibility to sex worker led groups

social network with family, group, and friendships; expectations of how one should behave

Institution/organizational levels (school/work) 

-modifications to environments, policies, or services

-workplace policies, connection to support services

rules, regulations, policies, and informal structures

community factors

-coalition building, sex worker organizations’ community building efforts

relationships among orgs, institutions, and informal networks

public policy

-decriminalization of sex work, improved law enforcement

state, local laws, and regulations

health program

-has educational services, prevention and populaiton focused

organized set of activities to provide a health focus intervention for a specific audience

health service

organizational structure through which providers interact w clients or patients to meet their health needs

project

time limited effort to provide a specified set of organized services or interventions

policy

decisions, plans, and actions achieve specific healthcare goals

product

-food, drugs, assistive tech, med devices or imaging, ppe

refer to a program

What is the public health impact pyramid levels from most individual effort needed to increasing population impact

counseling, clinical interventions, long lasting protective intervention, changing the context, and socioeconomic factors

critiques of social ecological models

complex for bringing up many protective/risk factors, resource-intensive unclear which factors are at each level

What is behavior mediated by?

-Knowledge isn’t sufficient for behavior change

-perceptions, motivation, emotions, skills, and factors

cognitions since your thoughts and knowledge affect actions

Health Believe Model (HBM)

-an expectancy-value theory

-people expect that working out will prevent them from getting heart disease

people behave in ways they expect will maximize the likelihood of achieving something they value

assumptions of health belief model

desire to avoid illness or get well; a specific health action available will prevent illness

constructs of HBM

perceived susceptibility, seriousness, benefits, barriers

percieved susceptibility

how likely do you think you are to have a health issue

perceived severity/ seriousness

how serious a problem do you believe a health issue is

perceived threat

susceptibility and severity/seriousness

perceived benefits

how well does the recommended behavior reduce the risks associate with a health issue

perceived barriers

potential negative aspects of doing a recommended behavior

cues to action (HBM)

-media, education, person’s symptoms

-essentially a catalyst

factors that cause you to change or want to change

self efficacy

one’s confidence that can successfully execute the behavior required to produce outcomes

Increased perceived threat means there also needs to be a high

self efficacy

what is the strongest association with lack of protective behavior?

-percieved susceptibility has some association

perceived barriers

when is HBM most useful for?

-specific threat associated with a health behavior

-ex. getting a vaccine

-not for something we do regularly

predict preventive health behaviors that are short term , examining specific constructs across studies

theory of reasoned action

individual will perform a behavior based on their intent to perform the behavior, attitude, and subjective norms

beliefs about a behavior (TRA)

what the person thinks the consequence of a behavior will be

evaluation of a behavior (TRA)

value attached to the outcome and judgements on whether it is positive or negative

what two factors influence subjective norms

-acceptable to their friends (opinions of others), perception of their beliefs

normative beliefs and motivation to comply

Theory of Planned Behavior

adds the factor of perceived behavior control like the ability to engage or have control over a behavior

perceived control

facilitating control beliefs; factors making it easier or harder to participate in a behavior

integrative model of behavior

adds self-efficacy, environmental factors, and skills/abilities

intervention

organized set of activities designed for a specific audience targeting behavioral or health changes

method

technique or process of influencing changes in determinants of behaviors and conditions

anticipated regret

stimulating people to focus on how they may fell after engaging in an unintended risky behavior

information about other’s approval

provide info about what others think about the person’s behavior and whether they will approve or disapprove

guided practice

prompting people to rehearse and repeat the behavior various times to discuss the experience and provide feedback

precontemplation stage

-may have wanted to change but have been demoralized

-Disadvantages are greater than advantages

-consciousness raising, dramatic relief

have no interest in changing their behavior or have no awareness

contemplation

-be open to information and may actively seek information about it

-long periods of time in this stage

-self reevaluation, environmental reevaluation

people are ware that change might be beneficial and are considering it

preparation for action

efforts to change have not been recent or sustained

-often lack the skill and resources needed to establish change

-social liberations, self liberation

have a plan to take action in the future 

action

-stopping smoking for all

substantial behavior change that can reduce risk of disease and promotes health

maintenance

>6 months

helping relationships, reinforcement management, stimulus control

prevent relapse and keep the gains they have made

how do people move from one stage to another?

advantages of changing outweigh the disadvantages

interventions for precontemplation > contemplation

consciousness raising, dramatic relief, environmental reevaluation

dramatic relief

experiencing and expressing feelings about one’s problems and solutions

contemplation > preparation interventions

self reevaluation

self reevaluation

looking at life with and without the healthy risk behavior 

preparation > action intervention

self liberation (choosing and committing to act in ability to change)

action > maintenance intervention methods

reinforcement management, helping relationships, counter conditioning, stimulus control 

critiques of TTM

unclear stages, stage progression doesn’t always lead to behavior change, doesn’t consider external factors, may not capture complexities of behaviors

what were the bobo doll experiment replications

observational learning through recordings/tv and impact of observed rewards/punishments

social learning theory

behavioral + cognitive

vicarious learning

observing the behaviors of others

vicarious reinforcement

engage in behavior we’ve seen others being rewarded for

social cognitive theory

association between personal factors, environmental factors, and human behavior

behavioral capability

whether one has the skills necessary to perform a behavior

self efficacy

person’s belief in their ability to engage and maintain a behavior

outcome expectations

regarding the outcomes of a behavior

how to build behavioral capability

education, modeling, skills training, skills practice, role playing