WEEK 11

Question 1

Give five examples of health behaviours

Answer 1

1) Exercise
2) Diet
3) Smoking
4) Taking medications
5) Unprotected sexual intercourse

Question 2

Define non-adherence

Answer 2

The failure of a patient to follow recommended health behaviours and treatment advice given by a clinician

Question 3

What is the difference between non-adherence and non-compliance?

Answer 3

Non-adherence focuses on the collaborative Dr-Pt relationship

Question 4

What is a good predictor of long-term adherence?

Answer 4

Adherence at entry

Question 5

What is the effect of complex medication regimens?

Answer 5

Low adherence

Question 6

What is the result of intrusive/expensive treatments?

Answer 6

Lower adherence

Question 7

What is the result of asymptomatic conditions on adherence?

Answer 7

Lower

Question 8

Give six reasons patients don’t comply?

Answer 8

1) Fear of side effects
2) Forgetfulness
3) Expense
4) Feeling well (no need to keep with treatment)
5) Dr fails to communicate adequately
6) Travel away from home

Question 9

Describe Ley’s Model of Compliance

Answer 9

Understanding and Memory results in Satisfaction=COMPLIANCE

Question 10

Describe Stanton’s Model of Adherence

Answer 10

Doctor communication/Increased knowledge and satisfaction (aided by Dr communication)/Patient’s beliefs, locus of control, perceived social support=ADHERENCE

Question 11

What are the three components of the Information-Motivation-Strategy model?

Answer 11

Information: Pts don’t understand what they’re supposed to do
Motivation: Pts aren’t motivated to carry out their treatment recommendations
Strategy: Pts don’t have a workable strategy for following treatment recommendations

Question 12

Give four ways to improve information to aid in patient compliance?

Answer 12

Communicate information effectively
Build trust and encourage patient participation in their care
Have patients share why and how they are to carry out the recommended treatment
Listen to patients’ concerns

Question 13

Give three ways to improve motivation to aid in patient compliance?

Answer 13

Help patients believe in the treatment efficacy
Elicit, listen to and discuss negative attitudes towards treatment
Determine the role of patient’s social system in supporting or contradicting elements of the regimen

Question 14

Give four ways to improve strategy to aid in patient compliance?

Answer 14

Assist in overcoming practical barriers
Identify individuals who can provide concrete assistance
Provide written instructions/reminders
Link to support groups

Question 15

How do you improve adherence?

Answer 15

1) Stress importance of what you’re about to say
2) Primacy effect (ie. first thing more likely to be remembered)
3) Repeat instructions/information
4) Keep to salient information
5) Negotiate regimens suiting patient routine
6) Encourage note taking
7) Use simple words to describe the body/treatment

Question 16

What is the aim of health promotion?

Answer 16

Prevent/reduce unhealthy behaviours and increase healthy behaviours

Question 17

Summarise the Health Action Model

Answer 17

Self->Behavioural intention->Health Action->Routine

Question 18

What three factors influence whether behavioural intention results in health action in the Health Action Model?

Answer 18

Environment, Skills and Knowledge

Question 19

What four factors influence ‘self’ in the Health Action Model?

Answer 19

Personality, belief system, motivation system and normative system

Question 20

What two opposing factors influence behavioural intention following routine in the Health Action Model?

Answer 20

Confirmation or relapse

Question 21

What is the CALO-RE taxonomy?

Answer 21

A taxonomy unpicking and describing all the individual components of behavioural change interventions

Question 22

What are some examples of behavioural change techniques?

Answer 22

Goal setting (behaviour) eg. more exercise
Providing information on consequences of behaviour to individual
Relapse prevention/coping planning
Barrier identification/problem solving

Question 23

What are change determinants of behaviour?

Answer 23

Promote/sustain desirable beliefs
Infrastructure (eg. food provision/education)
Economic incentives
Regulatory change to reinforce behaviour

Question 24

What is the impact of change determinants of behaviour?

Answer 24

Expensive/difficult to implement, large no. of people influenced

Question 25

What are the ways to change behaviour focusing on individuals at risk?

Answer 25

Education/motivational strategies

Question 26

What is the impact of behavioural change focusing on individuals at risk?

Answer 26

Some success, not good at sustained long term change

Question 27

What three things constitute the generic model of health promotion?

Answer 27

1) Health education 2) Environmental change 3) Legal change/make unhealthy behaviours expensive

Question 28

Give three examples where health promotion has influenced health behaviour

Answer 28

1) Smoking 2) Alcohol 3) Physical activity

Question 29

How is health promotion used to influence smoking?

Answer 29

Large scale public health changes as a result of Royal College of Physician's recommendations=increase in cigarette smokers quiting, decrease in current smokers

Question 30

Give three examples of the recommendations made by the Royal College of Physicians

Answer 30

1) Stop smoking indoors 2) Reduce smoking advertising 3) Taxation on cigarettes

Question 31

What are the least effective methods of health promotion influencing alcohol use?

Answer 31

Provision of educational or public information

Question 32

What had moderate effectiveness on influencing alcohol use?

Answer 32

Advertising controls

Question 33

What are the most effective methods of health promotion influencing alcohol use?

Answer 33

Minimum purchase age laws Alcohol-specific age laws Drink-driving countermeasures

Question 34

What are some of the benefits of physical activity on children?

Answer 34

``` Bone health Cognitive function CV fitness Muscle fitness Weight status Depression ```

Question 35

What are some of the benefits of physical activity on adults?

Answer 35

``` All-cause mortality Stoke and heart disease Hypertension T2 diabetes Depression Cognitive function ```

Question 36

What are some of the benefits of physical activity on older adults?

Answer 36

Falls Frailty Physical function

Question 37

How can we address physical inactivity?

Answer 37

Interventions within the NHS Community-based interventions National/Governmental actions

Question 38

Give three NHS interventions used to promote physical activity

Answer 38

1) GPs/practice nurses identifying people who are inactive and encourage activity 2) Provision of supervised exercise for people who have heart disease 3) Provision of facilities for NHS staff to exercise

Question 39

Give four examples of community interventions used to promote physical activity

Answer 39

1) School PSHE lessons 2) More pedestrian crossings/lollipop people 3) Cycle lanes/pavements 4) Subsidise leisure centres

Question 40

Give two examples of facilitative governmental actions to promote physical activity

Answer 40

1) Allow councils to spend money on road safety schemes | 2) Provide resources in councils budgets for leisure centres

Question 41

Give two examples of taxation done by government to promote physical activity

Answer 41

1) Tax workplace car parking spaces/petrol/road use | 2) Make gym membership tax free

Question 42

What are three factors making it difficult to sustain change in physical activity?

Answer 42

1) Environmental issues 2) Cultural issues 3) Temptation to slip up

Question 43

Give the three types of prevention

Answer 43

Primary, Secondary and Tertiary prevention

Question 44

What is the aim of primary prevention?

Answer 44

To prevent disease onset

Question 45

What is the aim of secondary prevention?

Answer 45

To minimise the consequences of disease after it has arisen by detection and treatment to prevent worsening

Question 46

What is the aim of tertiary prevention?

Answer 46

To prevent death or permanent disability once a disease has become established

Question 47

What is the difficulty faced with health promotion in diverse communities?

Answer 47

Generic campaigns may have different effects on different societal sectors which may result in unexpected negative consequences