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Patient Health > Final Exam > Flashcards

Final Exam Flashcards

1
Q

What are the phases of the Precede Proceed Model

A

1) Social Assessment 2) Epidemiological Assessment 3) Educational& ecological assessment 4a) Intervention Alignment 4b) Administrative & policy Assessment 5) Implementation 6) Process Evaluation 7) Impact & Outcome Evaluation

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2
Q

Social Assessment

A

health educators must determine the population’s idea of quality of life using discussion groups, nominal group process, Delphi technique, focus groups, surveys (Phase ONE)

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3
Q

Epidemiological Assessment

A

this phase identifies the health problems that are most prevalent in the population of interest

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4
Q

What are the two approaches to Epidemiological Assessment

A

Reductionist and Expansionist

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5
Q

Reductionist

A

looking at the big picture, QOL issue is ided and linked to the pic pic then you work backwards what is linked back and associated with that

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6
Q

Expansionist

A

start with health issue, how does it effect a bigger issue. how does flu affect things like productivity

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7
Q

Which approach of the epidemiological assessment is used more frequently

A

expansionist is used far more often than reductionist due to funding opportunities being more often associated with health problems among specific pop.

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8
Q

What two questions should epidemiological assessment

A

What is the problem

Who has the problem

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9
Q

What does the epidemiological assessment identify

A

the behavioral and environmental risk factors for the health problems that were identified earlier
make a list of behavioral factors that influence unhealthy behavior and rate it in terms of importance

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10
Q

Meta- evaluation

A

conducting methological quality study of past practice examples that have been implemented

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11
Q

Meta- analysis

A

recreating the statistics recreating data and results that have been gathered from numerious studies looking at the same thing so you can make definitive statements. looking at all studies talking collectively

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12
Q

Educational Assessment

A

identify the antecedents to behavior

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13
Q

What are the three general areas of factors that influence

A

predisposing, enabling, reinforcing

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14
Q

Predisposing

A

everything to do with the individual, attitudes, knowledge level, micro level, genetics, ed level, SES, gender, value, belief

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15
Q

Enabling

A

environment and personal resources that can affect behaviors skills, facilities, accessibility, economic, security

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16
Q

Reinforcing

A

peers, family, friends, law enforcement, how are they reinforcing behavior?

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17
Q

Intervention Alignment

A

Health program, educational strategies, policy regulations, organizational policies, theory application

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18
Q

Administrative and Policy Assessment

A

Id policies, resources, circumstances in the organization that could hinder or facilitate program implementation. assessments of availability of necessary time, staff, and resources is conducted, barriers to implementation are identified ( lack of time resources), org policies are addressed

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19
Q

Implementation

A

program is implemented according to the plans. important to evaluate that youre doing it appropriately

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20
Q

Process Evaluation

A

process of planning, implementing program, managerial side. are you staying in budget, utilizing resources. assess those things, figure out strengths/weaknesses using focus groups, surveys. do this from first day and make changes along the way

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21
Q

Impact Evaluation

A

short term effects what did you see immediately after program ended? changes in behavior? attitude? what immediate changes in constructs

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22
Q

Outcome Evaluation

A

(ten years down the road) long term affect. how did it affect big QOL issues we were focusing on in phase1

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23
Q

Why should evaluability assessment be conducted

A

to determine if a behavioral impact evaluation is feasible. budget, written program plan and objectives, specification of the type, frequency, and intensity methods, some agenices require evaluation for funding

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24
Q

What is formative evaluation

A

“pilot study” look at feasibility with small sample

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25
Q

R

A

random assignment of an evaluation study participant to a group

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26
Q

E

A

experimental group. intervention or treatment

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27
Q

C

A

Control (equivalent) group est only by random assignment , indicates no exposure to an intervention or exposure to a minimum or standard intervention procedures

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28
Q

C (underlined)

A

comparison group est through any method OTHER than randomization

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29
Q

X

A

intervention procedures applied to an E group

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30
Q

n

A

number of participants in the E, C, and underlined C group

31
Q

O

A

an observation or measurement to collect data, including tests, interviews, visual, or audio ratings or record reviews

32
Q

T

A

time when an observation, assignments to a group, or application of intervention procedures has occurred

33
Q

Nonexperimental Design

A

includes one experimental group (E) but no control group or comparison group

34
Q

Quasi experimental design

A

includes an experimental group (E) and a comparison group created by methods other than random assignment and includes observation of both groups, both prior to and after application of intervention procedures, It may yield interpretable and supportive evidence of behavioral impact asserting varying degrees of control over several biases, but usually not all that bias internal validity

35
Q

Experimental Design

A

includes random assign of experimental and a control group, and observations of both groups, prior to and after application of the intercention procedures. it yields the most interpretable and defensible evidence of behavioral impact asserting the greatest degree of control over the major factors that bias or compromise the internal validity of results

36
Q

Internal Validity

A

did a planned, replicable intervention produce that significant increase in the impact rate? Is the intervention the only or the most plausible explanation for the significant changes in impact rate, or can all or part of the observed change be attributed to other factors. are programs caused by your prog or something else. threats to internal validity

37
Q

External Validity

A

can the program and the results be generalized to other similar populations, supported by meta analysis. need to have good internal before you can make comments on external

38
Q

What are the 3 primary sources of bias

A
  • measurement bias
  • selection bias
  • historical bias
39
Q

Measurement bias

A

poor valididy, poor reliability, combines testing and instrumentation threats. pre-post test using the same instrument to do both learned from test not program

40
Q

Validity

A

accuracy

41
Q

Reliability

A

consistency

42
Q

what are two sources of selection bias

A

participation rate & attrition rate

43
Q

attrition rate

A

dropout rate

44
Q

What is the big question in selection bias

A

how representative of population at risk is the study sample

45
Q

Primary selection questions

A

how representative are the results and can the results of the evaluation be applied to the defined population in this setting

46
Q

What does historical bias combine

A

-history and maturation ( natural changes that occur just learning more through social environment seeing it effect others) threats to internal validity

47
Q

Internal Validity

A

an evaluation will not be able to attribute observed changes to an intervention unless measurement, selections, and historical biases are ruled out. an evaluation design does not always control for each of these biases. purpose of a design is to create experimental versus control group equivalence at baseline and follow up

48
Q

what is a common constraint that evaluation designs challenge to apply the experimental model

A

a randomized design with baseline and follow up measurement of the E and C group. Always start with most rigorous design and then modify it to setting

49
Q

One Group Pretest and Posttest

A

E1 or C(underlined) O X O most basic design. can be used for pilot testing, if the interval between O1 and O2 is short and if significant selection and measurement biases can be ruled out. maximum control over measurement reliability and validity and data collection methods and completeness should be asserted to control for bias, regardless or purpose of the evaluation

50
Q

What is the primary weakness of the one- group pretest and posttest

A

extent to which participants selected for the program are comparable to typical users of other clinic, school, worksite, and community settings in an HP program

51
Q

Nonequivalent Comparison Group

A

E1 O X1 O
C(underlined) O O
design 2 adds an experimental group
dashed line- confirms creation of the groups by method other than randomization. collecting data in same way, but comparison does not get intervention

52
Q

Time Series Design

A

est the pattern of the of the impact rate being examined for a well defined population at risk
observe at multiple monthly data points, typically 1-2 yrs before and 1 to 2 years after the new intervention was introduced. est the valididty, reliability, and completeness of measurement

53
Q

Time Series Design

A

EOOOOXOOOO
evaluation teams may use fewer than the recommended 50 data points, due to the complexity; however, more data points may increase the validity of results so that an evaluation makes stronger causal inferences

54
Q

Multiple Time Series

A

E OOOOXOOOO
COOOO OOOO
quasi- experimental design in which impact rates are studied at different times over several years for an E and C_ group. The addition of the C_ group may strengthen the programs control over the primary 3 biases

55
Q

When can multiple time series be applied

A

when retrospective and prospective databases exist and are accessible or where an organization can periodically observe rates for program participants for both E and C_ groups

56
Q

What are the primary methodological issues in multiple time series

A

comparability of E C_ group at baseline and at each follow up measurement: selection bias (difficult to match sites on all of the major predictor variables to reduce selection bias)
Barrier- need for the same multiple observations of the C group before during, and after the intervention programs begins

57
Q

Randomized Pretest and Posttest with an E and C Group

A

gold standard, experimental design with two groups, not significantly different at baseline for an independent or dependent variable that are predictors of impact, eligible participants are randomized within each/ all study sites.

58
Q

Common approach to randomized pretest and posttest with and and C group

A

evaluate existing program for a C group by comparing it to an E group that receives a hypothetically more effective. est through random assignment, you cant control the bias because of randomization

59
Q

quasi experimental design

A

does not control for all measurement selection historical biases. very hard to control what bias can occur

60
Q

What is the best method of establishing groups (e and c) for evaluation purposes and of asserting control over biases to internal validity

A

random assignment

61
Q

A Multiple- Component Program

A

ex- trying to get 2 groups to get the flu shot and using media campaigns, entire pop hears this but the experimental group will have additional info

62
Q

A new program

A

randomly assign half of participants to be exposed E1 to the standard program and half E2 to the new enriched program for purposes of comparison of impact

63
Q

How do we frame material

A

in the context of the patients thinking rather than professional thinking

64
Q

Whats the best way to find out if the patient understands the material

A

ask them

65
Q

Culture

A

shared set of beliefs, assumptions, values and practices

66
Q

Cultural identity

A

id of a group or culture or of an individual as far as she is influenced by her belonging or group or culture

67
Q

Cultural Diversity

A

result of interaction between different cultures

68
Q

Acculturation

A

willingness to modify one’s own culture as a result of contact with another culture

69
Q

Assimilation

A

extreme form of acculturation, willingness of a person settling in a new country to adopt characteristics of that new culture

70
Q

Cultural Sensitivity

A

begins with a recognition that there are differences between cultures

71
Q

Cultural and linguistic competance

A

set of congruent behavior attitudes and policies that come together in a system agency that enables effective work in cross cultural situations

72
Q

cultural humility

A

a ligelong process of self reflection and self critique which does not require mastery

73
Q

Smart technique

A

s- specific m-measurable a-attainable r- realistic t- time element

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