HP Midterm #3

Planning models serve as

frames from which to build

When analyzing planning models, what 3 impacts to consider?

individual, neighborhood, community

What are priority populations?

population groups of interest

Examples of priority populations

low income, racial/ethnic minorities, women, children/adolescents, elderly, individuals with special healthcare needs

Upstream vs downstream

downstream focuses on individual vs upstream looks at policies impacting the community as a whole

Precede-Proceed Model has how many phases

8

Precede

Predisposing, Reinforcing, and Enabling Constructs in Education/Ecological Diagnosis and Evaluation

Proceed

Policy, Regulatory, and Organizational Constructs in Educational & Environmental Development

In considering desired outcomes for precede-proceed, ____ is not the main outcome

Health

For the precede-proceed model, how to consider the outcome

social assessment

What does MATCH stand for?

Multilevel Approach to CommunityHealth

MATCH focuses on ____ health, _____ intervention

community, multilevel

MATCH is applied when ____ are known & ____ are determined

behavioral & environmental risk/protective factors for disease/injury are known & general priorities determined

How many phases in MATCH?

5

Phases of MATCH

health goals section, intervention planning, development, implementation, evaluation

What is MATCH recognized for?

emphasizing program implementation

MATCH is a ______ planning approach

socio-ecological

Intervention mapping

evidence-based, matrix of change objectives

Intervention Mapping focuses on

planning programs that are based on theory & evidence

How many steps of intervention mapping

6

Steps of intervention mapping

needs assessment, program outcome and objectives, program design, program production, adoption/implementation/maintenance, evaluation plans

CDCynergy is a ______ planning model

Health communication

Why was CDCynergy initially developed?

for public health professionals at CDC with responsibilites for health communication

SWOT, part of CDCynergy, stands for

strengths, weaknesses, opportunities, threats

SMART stands for

Social Marketing Assessment and Response Tool

SMART

Application of commercial marketing technologies to the analysis, planning, and execution, and evaluation of programs designed to influence the voluntary behavior of target audiences in order to improve personal welfare and that of their society

SMART offers ____, reduces ____, uses

benefits the audience wants, reduces barriers the audience faces, uses persuasion to influence intentions to act favorably

How many phases of SMART

7

Priority population of SMART

consumers

MAPP stands for

Mobilizing for Action through Planning and Partnerships

MAPP focuses on

city or county level planning ; mobilizing partnerships

MAPP has how many phases

3

MAPP may also be called

Community Health Action Mobilization partnership

Phases of MAPP

build community health improvement foundation, tell the community story, continuously improve the community

GMPP stands for

Generalized Model of Program Planning

Generalized Model of Program Planning has how many tasks

5

Steps of Generalized Model

assessing needs, setting goals and objectives, developing an intervention, implementing the intervention, evaluating the results

Plumpy nut

nutrient, calorie dense food to help combat malnutrition

Global health

area of study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide

Global health emphasizes (3)

transnational health issues, determinants, and solutions

Social determinants of health

health care, education, neighborhood and environment, social and community context, economic stability

4 main responsibilities in global health

ethical, equitable, appropriate, sustainable

Example of development malpractice with water purification

Company comes in with new water purification system, did not consider sustainable aspect or that there already was a system in place - resulted in real deaths as when systems broke, kids got disease

Global health is a multidisciplinary field, involving

medicine, public health, epidemiology, sociology & anthropology, economics, environmental sciences, law & politics, engineering

Tropical Medicine

colonial health - largely driven by need to keep colonizers and labor force alive

International health

people from high income countries helping people in low/middle income countries

Global health

people from high income countries leading health programs in LMICS

What is the issue with global health now

The priorities of where the money is coming from drives what happens

Systems thinking

a holistic approach that conceptualizes a system by its complex relationships and their underlying characteristics

Systems thinking can be used to

explore and develop effective actions in complex contexts

Systems thinking acknowledges that

systems are constantly changing and that a change to one part of the system will cause changes elsewhere

How did Dr.Burkholder adjust the WHO health system building blocks

less building blocks and more cross-cutting ; can’t have first four without financing and governance

WHO Health System Framework (6 components)

service delivery, health workforce, information, medical products/vaccines/technologies, financing, leadership/governance

Elements of the emergency care system framework (3)

scene, transport, facility

Low-resource countries bear

the disproportionate burden of deaths and disabilities due to health emergencies

What was developed in response to emergency care in Zambia

WHO Emergency Care Toolkit

Elements of WHO Emergency Care Toolkit

triage tool, checklists, resuscitation area, clinical forms, basic emergency care course

Triage tool

know how to use resources and for who

Checklists used for

traumatic injuries or medical resuscitations

What is the problem with emergency care in Zambia

we currently lack an understanding of the optimal approach to implementation of the WHO Emergency Care toolkit

KNOW-DO Gap

figure out barriers and facilitators - measure aspects of how well we are implementing

Zambia is currently piloting the toolkit in

8 hospitals

Guatemala Inoculation Experiments

1500 people enrolled w/o consent in unethical studies related to testing and treatment of STIs (prisoners, children, psychiatric patients)

In the Guatemala Inoculation Experiments, people were intentionally

infected with disease through sexual contact or inserting it in eyes, cuts

How did the military play a role in Guatemala Inoculation Experiments

need to control Venereal Disease within the military

What was the justification for inoculation experiments

link between national security and STIs

Initial promise/goal of inoculation experiments

provoke infection to test effectiveness of prophylactic treatments

Main areas of philosophy (3)

ethics, epistemology, metaphysics

Ethics

study of morality

Epistemology

study of human knowledge

Metaphysics

study of the nature of reality

Ethics defines

(un)acceptable behavior within the norms of a particular group

Morality sets

standards for right and wrong in human behavior

Why should people act ethnically (personal reason)

tends to lead healthier, more emotionally satisfying lives

Why should people act ethically (professional reasons)

sense of trust, moral credibility and leadership, make programs more effective

Professional ethics

actions that are right or wrong in the workplace and are of public matter

Research ethics

computes principles and standards that guide appropriate conduct relevant to research decisions

2 main ethical theories

teleology and deontology

Teleology

consequentialism - the end does justify the means

In teleology, you evaluate the moral status of an act by

the goodness of the consequences

Deontology

formalism or non-consequentalism - the end does not justify the means

In deontology, certain actions are

inherently right or wrong, or good and bad, withotu regard for their consequences

when analyzing an ethical problem, people need to depend more on

thinking than feeling

5 basic principles for common moral ground

value of life, goodness, justice, truth telling, individual freedom

Value of life

no life should be ended without strong justification

Implications for value of life

abortion, suicide, euthanasia, capital punishment

2 principles of goodness/rightness

nonmaleficence (non-infliction of harm to others) and beneficience (principle of doing good)

What ratio do you consider for goodness/rightness

benefit-to-harm ratio

Justice (fairness)

people treating other people fairly and justly in distributing goodness and badness

2 types of justice

procedural and distributive

Procedural justice

fair procedure in place and procedures were followed

Distributive justice

allocation of resources

Truth telling (honesty)

Moral relationship → meaningful communication → telling the truth

Individual freedom

equity principle or principle of autonomy

What is the most difficult principle to live by

truth telling

When making ethical decisions,

define the problem, identify who will be affected by decisions, contemplate ultimate goals of a moral person, identify alternatives, consider probable consequences of each alternative, consider the nature of the alternatives, reflect on yourself, reflect on society and environment, apply categorical imperative, choose and act on your choice

What is the categorical imperative?

commands or moral laws all persons must follow, regardless of their desires or extenuating circumstances

Ethical issues and health education/promotion obligations (5)

obligations and availability of services, obligations between professionals and clients, obligations to third parties, obligations between professionals and employers, obligations to the profession

Obligation and availability of services

equality of opportunity for making professional services available to all citizens

Obligations between professionals and clients

Fiduciary model - healthcare providers prioritize patients’ interests above their own