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HAN 440: Intro to community health ed > midterm > Flashcards

midterm Flashcards

1
Q

How many phases are in the precede proceed model?

lecture 1

A

8 phases

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2
Q

What is the precede-proceed model?

lecture 1

A

health assessment and planning model

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3
Q

What does precede do?

Precede is phases 1-4

lecture 1

A

specify measurabe objectives and baselines

in other words: assessment

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4
Q

What does proceed do?

Proceed is phases 5-8

lecture 1

A

monitor and continue quality improvement

in other words: implementation and evaluation

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5
Q

Define intervention

lecture 1

A

an action/set of activities designed to positively influence health behavior, knowledge, and attitude within specific populations, aimed to prevent disease and improve health by targeting modifiable factors that contribute to health

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6
Q

What factors might affect community health?

lecture 1

A
  1. physical factors
  2. social factors
  3. individual behavior
  4. community organization
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7
Q

Define factors that might affect community health

physical factors

lecture 1

A
  • geography
  • environment
  • community size
  • industrial development
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8
Q

Define factors that might affect community health

social factors

lecture 1

A
  • community
  • economy
  • politics
  • social norms
  • socioeconomic status
  • culture
  • religion
  • beliefs, traditions, norms
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9
Q

Define factors that might affect community health

individual behavior

lecture 1

A

examples are the following:
- drinking while driving (affects community)
- not eating healthy –> fast food (affects individual)

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10
Q

Define factors that might affect community health

community organization

lecture 1

A

how a community can solve problems

helps us in implementing intervention by highlighting community assets and providing resources and not duplicating services

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11
Q

Phase 1 focuses on what?

lecture 1

A

social assessment
- quality of life indicators

bigger picture; emotions

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12
Q

Phase 2 focuses on what?

lecture 1

A

epidemiological assessment
- health issue (disease, illness, etc.)
- behavior
- environment
- genetic

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13
Q

Phase 1 - Social Assessment

What is the goal of a social assessment?

A

identify gaps between what exists and what ought to exist so that you can design a program to reduce those gaps

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14
Q

Phase 1 - Social Assessment

What do we do for a social assessment?

lecture 2

A

gauge needs, opinions, assumption, key issues and/or assets within a community

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15
Q

Phase 1 - Social Assessment

What are the need categories?

lecture 2

A
  • health
  • educational
  • resources
  • social
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16
Q

Phase 1 - Social Assessment

What are the two types of needs?

lecture 2

A
  • actual needs - what the community needs based on data
  • perceived needs - what the community wants (for this you can go to close ones of individuals to find out more info if needed)
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17
Q

Phase 1 - Social Assessment

What is primary data vs secondary data?

types of data

lecture 2

A

primary: going to the target population and finding information by self
secondary: viewing reports from organizations such as CDC, WHO, etc.

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18
Q

Phase 1 - Social Assessment

Define quality of life

Quality of Life

lecture 2

A

perception of an individual/group that their needs are being met

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19
Q

Phase 1 - Social Assessment

What are some quality of life indicators?

Quality of Life

lecture 2

A
  • safety
  • social belonging
  • governance
  • politics
  • income
  • employment
  • work-life balance
  • education
  • leisure
  • relationships
  • stress
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20
Q

Phase 1 - Social Assessment

What are some QOL tools?

Quality of Life

lecture 2

A
  • asset mapping and capacity analysis
  • social reconnaissance
  • forums and group discussion
  • individual data collection
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21
Q

Phase 1 - Social Assessment

asset mapping (1) and capacity analysis (2)

Quality of Life Tools

lecture 2

A

1) describing and literally mapping the assets in a given community

2) assessment of the capacities and skills of individuals
- primary building blocks: entities that exist by the community and in the community
- secondary building blocks: entities that exist in the community but are controlled outside of the community
- potential building blocks: resources that if they existed would solve an issue in the community

this promotes community empowerment

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22
Q

Phase 1 - Social Assessment

social reconnaissance

Quality of Life Tools

lecture 2

A

the use of community leaders to determine relevant aspects of social structure, processes, and the needs of community

they will do the following:
- identify perceived needs
- rank and prioritize needs/problems
- organize the community
- assist in the devlopment of the action plan

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23
Q

Phase 1 - Social Assessment

nominal group technique

Quality of Life Tools

lecture 2

A

small group consisting of 5-7 individuals

brainstorming method where individuals generate ideas independently, share them in a group, discuss for clarity, and then rank or vote to prioritize the best options

pros:
- equal participation
- reduces bias and groupthink (more anonymity)
- efficient prioritization
- structured and organized

cons:
- time consuming
- limited in-depth discussion
- potential for voting too quickly without properly analyzing
- less representative b/c of few people

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24
Q

Phase 1 - Social Assessment

focus group

Quality of Life Tools

lecture 2

A

medium group of community members 6-12

those involved are homogenous on relevant characteristics to help represent a larger group. unstructured interviews are done to discuss topic and share feelings, attitudes, and ideas. everything is then analyzed to draw conclusions about the attitudes and practices of the larger group the focus group represents

pros:
- low cost
- easy to arrange and doesn’t require too much time from participants
- rich in depth data

cons:
- moderator required so possible bias can stem and members are dependent on the moderator’s skill
- small so generalizing their interaction to larger groups are not easy
- yield data that are exclusively qualitative

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25
# Phase 1 - Social Assessment community forum | Quality of Life Tools ## Footnote lecture 2
an open meeting with all interested persons invited to attend/participate **pros:** - inclusive - encourages engagement - identifies local health issues - cost effective **cons:** - dominant voices - lack of depth - potential for conflict - limited representation
26
# Phase 1 - Social Assessment observation | Quality of Life Tools ## Footnote lecture 2
**pros**: - real world data - unbiased insights when unaware of being observed - useful for studying behavior - can be low cost **cons:** - privacy issues - observer bias - time consuming - limited control - not representative of whole
27
# Phase 1 - Social Assessment surveys | Quality of Life Tools ## Footnote lecture 2
- structured interview (face-to-face) - telephone surveys - mail-out questionnaires - delphi technique - traditional knowledge test
28
# Phase 1 - Social Assessment What characteristics must be kept in mind when choosing a QOL tool | Quality of Life Tools ## Footnote lecture 2
* **representativeness** of the sample * **reliable**: consistency of the answers * **valid**: accuracy of the measurement, aka, is the survey well designed
29
# Phase II What is Phase 2? ## Footnote lecture 2
epidemiologic assessment
30
# Phase II What is the 2 step process for this phase? ## Footnote lecture 2
1. Identify specific health issues or conditions that contribute to the social problem (the quality of life issue) 2. Select the health problems deserving the most attention - do this by: reviewing and analyzing epidemiological health related data
31
# Phase II What makes up phase 2? ## Footnote lecture 2
- health - genetic - behavior - environment
32
# Phase II What factors does *genetics* consist of? ## Footnote lecture 2
- age - gender - family history - race and ethnicity
33
# Phase II What factors does *behavior* consist of? ## Footnote lecture 2
- **compliance** - **consumption patterns** - **preventative actions** - coping - self-care - utilization
34
# Phase II What factors does *environment* consist of? ## Footnote lecture 2
- economic - **physical** - **services** - social
35
# Phase III What is Phase 3? ## Footnote lecture 3
educational & ecological assessment
36
# Phase III What are the influential factors of Phase 3 ? ## Footnote lecture 3
**PRE** - predisposing factors *(knowledge)* - reinforcing factors *(peers)* - enabling factors *(environment)* | has to do with behavior
37
# Phase III What is the goal for Phase 3? ## Footnote lecture 3
to identify the educational and ecological factors which have the greatest potential to promote behavioral and environmental change
38
# Phase III - **Predisposing** What are predisposing factors? ## Footnote lecture 3
knowledge, attitudes, beliefs, values, or self-efficacy that **exist prior** to the engagement of a health-related behavior | these factors predispose an individual to do/not do certain behaviors
39
# Phase III - **Reinforcing** What are reinforcing factors? ## Footnote lecture 3
physical, social and emotional responses of referent others (***those around us***) / institutions which reward the **continued engagement** in a behavior | engaging in a behavior bc it makes you feel good
40
# Phase III - **Enabling** What are enabling factors? ## Footnote lecture 3
internal and external conditions directly related to the issue that **help people adopt and maintain** healthy or unhealthy behavior and lifestyles | characteristics of the ***environment*** that facilitate action
41
# Phase IV What is Phase 4? ## Footnote lecture 4
administrative and policy assessment and intervention alignment
42
# Phase IV What are administrative objectives? ## Footnote lecture 4
used to help stay on track **SMART** - specific - measurable (documenting) - achievable - relevant - time bound
43
# Phase IV What is an intervention? ## Footnote lecture 4
how planners attempt to achieve the stated outcomes or goals - generally consisting of a combination of different activities **goal:** may be to increase knowledge, change behavior, influence or change policy, etc.
44
# Phase IV How do activities help? ## Footnote lecture 4
they are developed to help the target population achieve program objectives and ultimately the program goal
45
# Phase IV: **Activities** communication activities | define ## Footnote lecture 4
seek to convey message - handouts - brochures - media - ads
46
# Phase IV: **Activities** educational activities | define ## Footnote lecture 4
seek to increase knowledge
47
# Phase IV: **Activities** behavior modification activities | define ## Footnote lecture 4
seek to change behavior
48
# Phase IV: **Activities** environmental change activities | define ## Footnote lecture 4
seek to alter or change environment
49
# Phase IV: **Activities** regulatory activities | define ## Footnote lecture 4
implementing laws, policy, ordinances, regulations, etc.
50
# Phase IV: **Activities** community advocacy activities | define ## Footnote lecture 4
involving community members to influence social change
51
# Phase IV: **Activities** organization/culture activities | define ## Footnote lecture 4
changing environment inside an organization
52
# Phase IV: **Activities** incentive and disincentive activities | define ## Footnote lecture 4
seek to influence health outcomes
53
# Phase IV: **Activities** health status evaluation activities | define ## Footnote lecture 4
seek to increase awareness of individual's health
54
# Phase IV: **Activities** social activities | define ## Footnote lecture 4
seek to create social support systems for behavior change
55
# Phase IV: **Activities** technology-delivered activities | define ## Footnote lecture 4
using technology to deliver education
56
# Phase IV What are some strategies to increase knowledge? ## Footnote lecture 4
- chunking - advanced organizers - associated imagery - cues - tailoring - facilitated discussion - active learning
57
# Phase IV define chunking ## Footnote lecture 4
taking information and chunking them together to help remember better
58
# Phase IV define associated imagery ## Footnote lecture 4
mental pictures to connect with the information you are trying to learn
59
# Phase IV What are some strategies to change attitudes? ## Footnote lecture 4
**self-reevaluation**: urge them to think about how life can be improved if they change health behavior **environmental reevaluation**: how does the environment around the individual affect action **arguments**: promoting behavior change by highlighting the negatives and promoting the positives
60
# Phase IV What are some strategies to change social influence? ## Footnote lecture 4
- making peer expectations known to the target populaton - build resistance to the social pressure to engage in the risk behavior by increasing motivation to comply with positive social pressure - attempt to shift focus away from the risk behavior
61
# Phase IV What are some strategies to build skill and self-efficacy? ## Footnote lecture 4
- break behavior into a series of tasks - teach each task as a separate skill - take small steps in successive increments - include feedback, reinforcement and correction in each practice session
62
# Phase IV What should you keep in mind in regards to the activities, strategies and methods? ## Footnote lecture 4
- use existing material - tailor your intervention to the characteristics of your group (cultural appropiateness, translation of materials, etc.) - how? Gatekeepers (will increase acceptance of the intervention by target population and increase efficacy in intervention)
63
# Phase V What is Phase 5 ## Footnote lecture 4
Implementation
64
# Phase V What does implementation mean? ## Footnote lecture 4
acting on the plan! | just doing it!
65
# Goals and Objectives What is a goal? ## Footnote lecture 6
a future event toward which a commited endeavor is directed
66
# Goals and Objectives What makes up a goal? ## Footnote lecture 6
- provides *overall* direction for a program - is general in nature - usually takes longer to complete
67
# Goals and Objectives What are 3 components to consider for goals? ## Footnote lecture 6
1. Who will be affected? 2. What will change as a result of the program? 3. Where is the target population? | who, what , where
68
# Goals and Objectives What are some words that may be used to start off a goal? ## Footnote lecture 6
***"To..."*** - eliminate - improve - increase - promote - protect - minimize - prevent - reduce | this is the most formal part
69
# Goals and Objectives What are objectives? ## Footnote lecture 6
**more precise** than goals and represent **smaller steps** than program goals - the steps, if completed, will lead to reaching the program goal
70
# Goals and Objectives What should objectives be? ## Footnote lecture 9
- future oriented - SMART - measurable outcomes: who, what, where, when, how much - one should be able to ascertain the precede/proceed factor from a well-written objective (know which is being addressed)
71
# Goals and Objectives What are SMART objectives? ## Footnote lecture 6
- **specific**: concrete, using action verbs - **measurable**: numeric, descriptive, quantity - **achievable**: feasible in reference to goal - **realistic**: attainable in reference to resources - **time oriented**: indentifies target dates, includes interim steps to monitor progress
72
# Goals and Objectives What type of objectives go with what phase? ## Footnote lecture 6
- outcome/program objectives --> phase 1 or 2 - action/behavioral objectives --> phase 2 - environmental objectives --> phase 2 - learning objectives --> phase 3 - process objectives --> phase 4 or 5
73
# Goals and Objectives What are **outcome** objectives? ## Footnote lecture 6
the ultimate objective of the program - aimed at changes in *health or quality of life* **written in terms of:** - risk reduction - morbidity - mortality - disability - quality of life
74
# Goals and Objectives What are **action/behavioral** objectives? ## Footnote lecture 6
the *behaviors* or *actions* that the target population will engage in *to resolve the health problems* identified and move toward reaching the program goal **written in terms of:** - adherence - compliance - consumption patterns - coping - preventative actions - self-care - utilization
75
# Goals and Objectives What are **environmental** objectives? ## Footnote lecture 6
outlines *non-behavioral* causes of health problems that are *present in the environment* examples: - clean air - clean water - learning environment
76
# Goals and Objectives What are **learning** objectives? ## Footnote lecture 6
educational or learning tools needed to achieve desired behavior **consists of:** - awareness - knowledge - attitudes - skills | *predisposing, reinforcing, enabling*
77
# Goals and Objectives What are **process** objectives? ## Footnote lecture 6
day to day activities which occur to lead to the accomplishment of learning, action, environmental and outcome objectives **entails:** - program resources - intervention activities - attendance - participation - feedback
78
# Evaluation Why do we need to conduct an evaluation? ## Footnote lecture 9
- monitor objectives - identify program strengths and weaknesses - cost efficiency - funding source mandate
79
# Evaluation What are the levels of evaluation? ## Footnote lecture 9
1) **process: phase 6** - learning (*phase 3*) - administrative (*phase 4*) 2) **impact: phase 7** - behavior (*phase 2*) - environment (*phase 2*) 3) **outcome: phase 8** - health (*phase 2*) - quality of life (*phase 1)*
80
# Phase VI What is phase 6? ## Footnote lecture 9
**process evaluation: evaluating procedure** - are you actually doing (phase 5) what you planned (phase 4) --> *administrative and implementation*
81
# Phase VI Phase 6 is the assessment of... ## Footnote lecture 9
intermediate/learning objectives refers to aspects of health that *change more quickly*: - **predisposing factors** - **reinforcing factors** - **enabling factors** | ***also known as: evaluating phase 3!!!!!!***
82
# Phase VI When do you do process evaluation? ## Footnote lecture 9
**throughout the implementation process!!! (*phase 5*)** example: after each educational session to assess you can - take attendance - pre/post test results
83
# Phase VI Why do we do process evaluation during implementation? ## Footnote lecture 9
this helps to modify the intervention if needed
84
# Phase VII What is phase 7? ## Footnote lecture 9
**impact evaluation** factors we are evaluating: behavior and environment - what proportion of the participants changed or adopted **behavior**? - was there a change in the **environment**? | *takes longer to measure* + ***also known as evaluating phase 2!!!***
85
# Phase VIII What is phase 8? ## Footnote lecture 9
**outcome evaluation** factors we are evaluating: **health and quality of life** | ***also known as evaluating phase 1+2!!!***
86
# Evaluation What are some things to keep in mind during evaluation (phases 6-8)? ## Footnote lecture 9
- if you find a gap between your planning and reality (*the intervention is not achieving the results you wanted*), **go back to the assessment portion of the model** - determine what needs to be changed and adjust the plan accordingly - evaluation is **NOT** about "passing or failing", it is to ensure your intervention brings about the outcome in the community you wanted
87
# Overview of P/P model What is the goal of the precede proceed model? ## Footnote lecture 1-9
to plan, develop, implement and evaluate a program
88
# Overview of P/P model What phase/s entail planning? ## Footnote lecture 1-9
phases 1-4
89
# Overview of P/P model What phase/s entail developing? ## Footnote lecture 1-9
phase 4
90
# Overview of P/P model What phase/s entail implemention? ## Footnote lecture 1-9
phase 5
91
# Overview of P/P model What phase/s entail evaluation? ## Footnote lecture 1-9
phases 6-8
92
# Overview of P/P model What is the rule and exception to P/P model? ## Footnote lecture 1-9
**to start with phase 1 - social assessment!!!!!** exception: when you work with an organization with a predetermined health focus

HAN 440: Intro to community health ed (4 decks)

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