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What are the six components of the Chronic Care Model?
self-management support, clinic information systems, delivery system redesign, decision support, health care organization, community resources
Define self-management support
Construct of the CCM. Empowering and preparing patients to manage their health and health care. This includes emphasizing the patient's role in managing their health, setting goals, and organizing resources.
Define clinic information systems
Component of the CCM. Organization of patient and population data to facilitate efficient and effective care. This includes EMR, reminders, coordinating care through info sharing.
Define delivery systems design
Component of the CCM. Assuring the delivery of effective, efficient clinical care and self-mgmt support. This includes culturally sensitive care, case management, define roles among care team.
Define decision support
Component of the CCM. Promoting clinical care that is consistent with scientific evidence and patient preferences. This includes sharing evidence with patients, integrating specialist expertise with primary care, educational sessions for providers.
Define health care organization
Component of CCM. Creating a culture, organization and mechanisms that promote safe, high quality care. This involves promoting improvement in handling errors, incentives based on quality, and comprehensive support for improvement.
Component of CCM. Linking with collaborative resources such as education sites, promotores, etc.
Prior to engagement (CBPR)
Two principles: be clear about the goals of the engagement effort and population/communities you want to engage. Get knowledgeable about the community (power structures, norms/values, perceptions, experience w/ outside groups).
To ensure engagement occurs (CBPR)
Two principles: establish relationships w/ community and seek commitment. Self-determination of community (identifies w/ issues, has ownership of issue, has a contribution to make.
To ensure ongoing engagement (CBPR)
Five principles: Partner with the community (equitable power, equal responsibility). Resect the diversity of the community. Identify/mobilize community assets and develop capacity and resources. Release control and be flexible. Make a long-term commitment.
What are the core principles of CBPR?
Recognize identity; build on strengths; facilitates equal partnerships, empowerment; promotes learning, capacity building; integrate balance of research and action; emphases relevant issues/attends to multiple health determinants; development is cyclical/iterative; findings/knowledge go to all partners; long term commitment.
What is CBPR?
Community-Based Participatory Research. This is an approach to doing research that actively engages communities in the research process. Collaborations are equitable between community and university, and the community takes ownership of the problem and its continued solution.
What is community empowerment?
Enabling process by which individuals or a community take control over their lives/environment. This is a process where people gain mastery over their lives/community, and assume control to create desired changes.
What is capacity building?
Fostering community characteristics that can help bring about desired social and health changes. This includes improving knowledge, skills, resources, and autonomy.
What is culture?
System of meaning and symbols that frame the way people perceive, find meaning in, and locate themselves in the world.
Examples of health culture in U.S.
Healthy = absence of a disease; healthcare is a commodity, not a right; emphasis on treatment rather than prevention.
What are the 4 core principles of ecological theories?
There are multiple influences on health behaviors, with factors at each level (intra/inter/org/comm/policy). Influences on behaviors interact across these levels. Eco models are behavior-specific ID'ing most relevant influences at each level. Multi-level interventions should be most effective.
What is ecological psychology?
The study of the influence of the outside environment on the person.
What is environmental psychology?
Study of how social and physical situations predict behaviors. Concludes that behaviors are predicted more accurately from situations than from individual characteristics.
What is social ecology?
Study of social structure which organizes environment into four factors: (1) physical settings such as weather and built environment, (2) organizational settings such as school/worksites size and function, (3) the "human aggregate" such as the sociocultural characteristics of the ppl in the environment, (4) "social climate" which is the supportiveness of a particular behavior.
What is the Bronfenbrenner Systems Theory?
Study of social effect on behavior which delineates 3 environmental influences: (1) microsystem, the interaction between family and workgroups, (2) mesosystem is family, school, work settings, (3) ecosystem is the larger social system of economics, culture, and politics
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