PASS Semester 4 - health improvement

Question 1

What are the three domains of public health?

Answer 1

1. Health improvement
2. Health protection
3. Healthcare public health

HI, HP, PH

Question 2

What is involved in health improvement?

Answer 2

• Adressing inequalitiies
• Education
• Housing
• employment
• Family/community
• Lifestyles
• Surveillance and monitoring of specific diseases and risk factors

Question 3

What is the virtuous cycle of public health?

Answer 3

• Health improvement and early intervention in publick health
• = improved health and and health equality
• = greater personal and population wellbeing
• = reduced pressure on health and social care by more competent public
• = money saved to invest in prevention and health improvement

Question 4

What is the Rose bell curve shift in populations?

Answer 4

Shifting of whole population into a lower risk category benefits more individuals than shifting high risk into lower risk
Target full population = more beneficial

Question 5

What model shows different determinants of health?

Answer 5

Dalgren and Whitehead - individual, social, environmental and cultural parts of health

Question 6

Different levels of intervention for public health

Answer 6

• Personal - eg stopping smoking interventions, advice, nictotine replacement therapy, self-help
• Community - media campaigns on tobacco related harm, school based interventions, warnings on packets
• Supportive environments - no smoking public transport, public buildings, smoke free homes and cars, restricted tobacco sale points, prevent sale to children
• Healthy public policy - high tax, smoking bans, advert bans
• Reorient health services - preventitive and intensive support services eg group therapy, counselling, targeted at particular groups eg pregnant women

Question 7

Why is Leicester a place where Covid rates were very high?

Answer 7

Diverse city:
* Overcrowding and multigenerational households
* High contact occupations - eg manufaturing, were not isolating
* Higher levels of financial insecurity - more likley to attend work when +ve
* Use of public transport high
* International travel - from 50 different countries

Question 8

What is involved in health needs assessment?

Answer 8

• Incidence, Prevalence
• Effectiveness/cost effectiveness of intervention
• What current services exist

Question 9

What model is used for change cycle?

Answer 9

Prochaska and Diclemente cycle of change

Question 10

What are the stages of Prochaska and Diclemente cycle of change?

Answer 10

• Precontemplation
• Contemplation
• Preparation
• Action
• Maintenece
• Relapse

Question 11

What is the diffusion of innovation theory?

Answer 11

Maps how new ideas/things in society are taken up and adopted by people

Question 12

Stages of diffusion of innovation theory

Answer 12

1. Innovators eg first person to have covid vaccine
2. Early adopters eg healthcare workers/vulnerable
3. Early majority those keen to get vaccine
4. Late majority those a bit hesitant
5. Laggards those who do not want vaccine, haven’t had

Question 13

4 types of prevention and what they target with examples

Answer 13

Primordial - general population, try to eliminate risk factors, eg immunisation, health promotion
Primary - suceptible population, try to reduce risk of disease, eg immunisation
Secondary - asymptomatic population, slow down disease progression/catch early, eg screening/start treatments
Tertiary - symptomatic population, minimise consequences of disease and treat

Question 14

Two types of biases that affect screening

Answer 14

Lead time bias - screening program does not actually prolong life, just know you have the disease for a longer amount of time
Length time bias - screening more likely to pick up slower growing cancers rather than fast ones