SDOH (Pastakia)

Question 1

Cognitive Dissonance

Answer 1

mental discomfort that results from holding two conflicting beliefs, values, or attitudes

Question 2

Signs of Cognitive Dissonance

Answer 2

• feeling uncomfortable before making decision
• justify or rationalize decision
• embarrassed or ashamed of something you have done
• experiencing guilt or regret about something in the past
• doing things because of social pressure or fear of missing out

Question 3

Causes of Cognitive Dissonance

Answer 3

Forced compliance

New Information

Decisions

Question 4

Dealing with Cognitive Dissonance

Answer 4

adding more beliefs to outweigh dissonant beliefs

reducing importance of conflicting belief

changing beliefs

Question 5

Specific Example of Cognitive Dissonance in Class

Answer 5

Andrew Natsios, former USAID administrator, stating that Africans cannot tell time and that AIDS medications would be hard to use for them as they are taken multiple times each day

Question 6

What agreement did President Bush sign to help AIDs

Answer 6

PEPFAR

Question 7

Adherence to ART in Africa

Answer 7

the adherence rates in African compared to the US are very similar and actually statistically significant more in some aspects of Africa

Question 8

Equity vs Equality

Answer 8

Equity: each person has different circumstances and allocates the exact resources needed to receive equal outcome

Equality: each person is given the same resources

Question 9

Importance of Non Clinical Factors

Answer 9

40%: Socioeconomic Factors
30%: Choices + Behaviors
20%: Healthcare
10%: Physical environment

Example: In Marion county, IU Health Medical is present however the life expectancy is still very low (70)

Question 10

Poverty Levels in Kenya

Answer 10

79% of population is in poverty (< 2 $/day) in Western Kenya

Question 11

Life Expectancy of 10 yr old for Type 1 Diabetes

Answer 11

Africa has the lowest life expectancy of < 25

Question 12

Diabetes Care Cascade

Answer 12

only 11% would get the diabetes medications they need

Question 13

Guidance for HIV in African before Medications

Answer 13

Nutrition
- fruits, vegetables

Garlic

Shower after intercourse

Question 14

Outcomes based on Income Status

Answer 14

High-Income:
- greatest chance for success
- greatest protection from risk

Low-Income:
- minimum chance for success
- highest chance for risk

Question 15

Attempts to Provide Equity in Society

Answer 15

Unconditional Cash Transfers
Food Stamps
Unemployment benefits
Medicare & ACA

Question 16

SDOH Activities and Effects on A1c

Answer 16

when providing REFERRALS to resources/services for SDOH, each clinic showed significant drops in A1c

Question 17

A1c Changes by SDOH Needs

Answer 17

• those who have SDOH needs identified had a higher baseline A1c
• people with SDOH needs had less of a reduction in A1c than those without need

Question 18

Why did people without SDOH need have a better reduction in A1c after 60-119 days

Answer 18

• if you do not correct the SDOH need, you will not correct the A1c
• the study is limited in only assessing individuals over 60-119 days –> SDOH changes take much longer such as > 1 year to see impacts in health

Question 19

Standard Questionairre

Answer 19

Prapare tool

Question 20

Unconditional Cash Transfer

Answer 20

direct provisions of cash without any strings attached

Question 21

Did a lump sum or stable salary each month for UCT

Answer 21

lump sum as there is a deficit hole in money allowing the patients to dig themselves out of the hole