Final: Adult Health Promotion Screening

Question 1

What are the 3 components of Health Promotion?

Answer 1

Heath Education
Health Screening
Disease Prevention

Question 2

What agency oversees preventative services?

Answer 2

USPSTF
United States Preventative Services Task Force

Question 3

Health screenings are important tools to

Answer 3

detect disease at early stages

Question 4

Health education about screening is

Answer 4

Primary Prevention

Question 5

Actual screening process is

Answer 5

Secondary prevention

Question 6

What are the next steps after detecting the disease in its early stage?

Answer 6

-treat disease
-stop the disease from progressing

Question 7

What is the financial benefit of early detection?

Answer 7

Reduce cost of disease management by avoiding costly interventions required at later stages

Question 8

Some diseases proceed by period of

Answer 8

asymptomatic pathogenesis or latency

Question 9

Individual screening

Answer 9

• 1 person tested
  -Often chosen based on risk factors
  -Sometimes chased based on universal screening

Question 10

Example of individual screening

Answer 10

Mammogram for a young adult with a family history of breast cancer

Question 11

Group or mass screening

Answer 11

target populations selected on basis of increased risk

Question 12

Example of group or mass screening

Answer 12

-Vision test in school children
-Testing for Phenylketonuria (PKU) in neonates

Question 13

One-test disease specific screening

Answer 13

-Single test
-Detects characteristics indicating high risk

Question 14

Example of one-test disease specific screening

Answer 14

-Hemoglobin A1C and diabetes
-Cholesterol levels and hypercholesterolemia

Question 15

Multiple test screening

Answer 15

2 or more test to detect one disease

Question 16

Example of multiple test screening

Answer 16

Tuberculosis screening (Tuberculin skin test, interferon gamma-realase assay blood test, chest x-ray, sputum cultures)

Question 17

Screening Criteria: Detection

Answer 17

-Are there well-documented diagnostic criteria?
-Resources/treatment available to support screening?

Question 18

Screening Criteria: Diagnostic Criteria

Answer 18

-Disease should have early asymptomatic state
-Risk factors: Who should be screened?

Question 19

Screening Criteria: Screening Measures

Answer 19

-Must be safe, cost effective, accurate
-Screening tool must accurately distinguish those with and those without disease

Question 20

Advantages of screening

Answer 20

-Cost effective
-Applied to individual and larger populations
-Some screenings mandated by law
-Can be one test specific or multiple test screening
-creates opportunity for health teaching

Question 21

Example of individual screening

Answer 21

Blood pressure check in primary care

Question 22

Example of large population screening

Answer 22

Community blood pressure screening fair

Question 23

Disadvantages of screening

Answer 23

-Uncertainty in scientific evidence (possibility for error)
-False positives: anxiety, unnecessary interventions
-False negatives: disease is overlooked, missed opportunity for early intervention, false assurance
-Ex. Microcalcification can be false positive which results in invasive breast biopsy

Question 24

Selection of a “screenable” disease Questions to ask

Answer 24

-Just because we can, does it mean we should?
-Does its significance warrant its consideration as a community problem?
-Can the disease be detected by screening?
-Can it be treated?
-Tangible and intangible (emotional, financial) costs

No clear answer

Question 25

Screening: Quality of life is

Answer 25

subjective, difficult to assess, individualized

Question 26

Epidemiology

Answer 26

-Method used to find cause of disease (and outcomes) in populations. -How different risk factors go together and influence disease

Question 27

Morbidity

Answer 27

Amount of Disease or disability from any cause in a population

Question 28

Mortality

Answer 28

Deaths in a given population as a result of a specific disease/illness/event

Question 29

Significance

Answer 29

Level of priority of disease as public health concern

Question 30

Incidence

Answer 30

-Rate of a new population problem and estimate RISK of individual developing disease -Measures new cases -Acute (IN= Incidence New)

Question 31

Prevalence

Answer 31

-Proportion of the population WITH disease at any one point in time -Measures all cases within a set period -Chronic (CP= Current Prevelance)

Question 32

Reliability

Answer 32

Exact same results every time

Question 33

Inter-observer

Answer 33

same results when two persons do test

Question 34

Intra-observer

Answer 34

Same person able to reproduce results

Question 35

Validity

Answer 35

Measuring what you actually want to measure

Question 36

Test Sensitivity

Answer 36

the ability of a test to correctly identify those WITH the disease (true positive rates)

Question 37

Test Specificity

Answer 37

The ability of a test to correctly identify those without the disease (true negative rate)

Question 38

If you do have a disease, you would have a true positive. So you would say that the test has a

Answer 38

High level of Sensitivity

Question 39

If you don't have a disease, you would want a true negative. So you would say that the test has a

Answer 39

High level of Specificity

Question 40

Can the test correctly identify if a person has diabetes or not? =

Answer 40

Validity

Question 41

Are the guidelines put forth by the USPSTF set?

Answer 41

No they can change over time Ex. Mammography guidelines several times over past decade (false positives) Ex. PSA no longer recommended: treatment harm> benefits early diagnosis

Question 42

Ethical considerations for Screening?

Answer 42

-Request for participation implies a health benefit -Need to clarify issues: What are cost to patient? (Financial, emotional, physical) -Controversies of screening results: False positives, false negatives, duty to inform, cutoff point, borderlines cases

Question 43

What is the economic cost dilemma?

Answer 43

-Do costs result in improved health? -Are benefits of screening worth the expenditures required? Goal: determine optimal use of resources to achieve desired outcome

Question 44

Three approaches to evaluate economic cost?

Answer 44

1. Cost-benefit ratio 2. Cost effectiveness 3. Cost efficiency analysis

Question 45

Clinical preventive screenings...

Answer 45

1. Save years of life and help people live better during those years 2. Save Money 3. Provide quality care 4. Reduce death, disability, and disease

Question 46

Who makes up the USPSTF and what do they do?

Answer 46

A panel of experts in primary care and prevention who review the evidence of effectiveness and develops recommendations for clinical preventive services

Question 47

What is the USPSTF grading recommendations like?

Answer 47

ABCDI A & B is High recommendation C is moderate recommendation D is Discouraged I is Insufficient, poor evidence

Question 48

The nursing role in screening

Answer 48

-Development and implementation of screening programs -Decision maker -Planner -Education and counseling -Follow-up -Collaborate -Focus on primary and secondary prevention