PUblic Health Flashcards
(25 cards)
What is health promotion?
process of enabling ppl to increase control over, and to improve their health. Moves beyond individual behaviour towards a wide range of social and environmental interventions
- giving ppl the info or resources they need to improve their health
Who are behaviour change interventions aimed at?
3 main grps:
- those who are healthy benefit from reducing behavioural risk factors for ill health and increasing protective behaviours (eg engage w/ screening)
- those who are ill benefit from adjusting their behaviour to their circumstances (eg keeping active while suffering from back pain) or following behavioural advice to prevent deterioration (eg taking meds as prescribed)
- health professionals and others responsible for delivering effective, evidence based health care
What is the Health Belief Model?
Becker, 1974
Individuals will change if they:
- believe they are susceptible to condition in question
- believe it has serious consequences
- believe that taking action reduces susceptibility
- believe that the benefits of taking action outweighs the cost
Health Belief Model critique
- alternative factors may predict health behaviour, eg outcome expectancy and self-efficacy
- as a cognitively based model, HBM doesn’t consider the influence of emotions on behaviour
- HBM doesn’t differentiate between first time and repeat behaviour
- cues to action are often missing in HBM research
What is the theory of planned behaviour?
Ajzen, 1988
expansion of earlier Theory of Reasoned Action, proposes best predictor of behaviour is intention
Intention determined by:
- person’s attitude to the behaviour
- perceived social pressure to undertake behaviour, or subjective norm
- person’s appraisal of their ability to perform their behaviour, or their perceived behavioural control
Theory of Planned Behaviour critique
lack of temporal element, lack of direction or causality
‘rational choice model’ - doesn’t consider emotions eg fear, threat, +ve effect, might disrupt ‘rational’ decision making
model doesn’t explain how attitudes, intentions and perceived behavioural control intact
habits and routines - bypass cognitive deliberation and undermine key assumption of model
assumes attitudes, subjective norms and PBC can be measured
relies on self-reported behaviour
Transtheoretical / Stages of change model
Precontemplation
Contemplation
Preparation
Action
Maintenance
Transtheoretical / Stages of change model critique
+ves = acknowledges individual stages of readiness, accounts for relapse, temporal element
-ves = not all ppl move through every stage, some move backwards and forwards or miss some stages, change might operate on continuum rather than discrete stages, doesn’t take into account values, habits, emotions, culture, social and eco factors, ppl change behaviour in absence of planning / intentions can change over short period
COM-B model / framework
Capability - psychological or physical
Opportunity - physical or social
Motivation - reflective or automatic
COM-B model critique
+ves = analysis beyond description of basic factors, clear framework for organising data, consideration of context, can be used to develop interventions
-ves = v. broad, difficult to falsify, may stifle creativity in those developing interventions, little longitudinal evidence of practical application in intervention, limited consideration of meaning
What are behavioural change techniques?
an observable, replicable and irreducible component of an intervention designed to alter or redirect causal processes that regulate behaviour
goal planning, feedback and monitoring, social support, natural consequences, comparison behaviour
What is intersectionality?
concept for understanding how aspects of a person’s identities combine to create different and multiple discrimination and privilege
What is the inverse care law?
availability of good medical care tends to vary inversely with the need for it in the population served
Need, Supply and Demand
need = ability to benefit from an intervention
demand = what ppl ask for
supply = what we actually provide
we may supply what is demanded but not needed and not supply what is needed but not demanded
Donabedian’s 3-stage model of evaluating the quality of health
Structure - physical and organisational characteristics where healthcare occurs
Process - focus on care delivered to pts
Outcome - effect of healthcare on status of pts and populations
Maxwell’s Dimensions of Quality
Acceptability
Accessibility
Appropriateness
Effectiveness
Efficiency
Equity
Qualitative evaluation methods of healthcare
consult relevant stakeholders where appropriate
methods - observations, interviews, focus grps, review of documents
Quantitative evaluation methods of healthcare
- routinely collected data eg hospital admissions, mortality
- review of records eg med, administrative
- surveys
- other special studies eg using epidemiological methods
What are healthcare inequalities?
unfair and unavoidable differences in health across the population, and between different grps w/in society
arise because of conditions in which we are born, grow, live, work and age
influence our opportunities for good health, and how we think, feel and act, and this shapes our mental health as well as our physical health and wellbeing
What are the barriers to patients tackling their health and lifestyle issues?
mixed feelings, anxious or fearful
feel settles in existing routines and habits
low motivation or feelings
don’t like being told what to do
engage in self-sabotage or sabotaged by others
confusion or misunderstanding
social circumstances
What is the domestic abuse act (2011)?
behaviour of a person towards another person is domestic abuse if individuals are 16 or over and are ‘personally connected’ to each other and the behaviour is abusive
Domestic abuse risk levels
Standard - current evidence doesn’t indicate likelihood of serious harm
Medium - identifiable indicators of serious harm risk. Offender has potential to cause serious harm but unlikely unless change in circumstance
High - identifiable indicators of imminent risk of serious harm. Dynamic - could happen at any time and impact would be serious
Domestic abuse services
give details for DA services
MARAC / IDVAS
HARK assessment
Use Sheffield dash risk assessment
