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. What would you like to do?
What are the committees for the health fair?
- Door prize
- Facilities management
What are the seven responsibilities of a health care educator?
- Assess: plan an assessment, collect health related data
- Plan health education:develope goals and objectives,select or design strategies for intervention
- Implement:impelement a plan of action,monitor impelementaition
- Evaluate: develop plan for evaluation, design data collection intstruments
- Administer: manage resources, obtain accptance(door prizes and facility)
- Serve as a resource:disseminate health related information
- Advocate:assess and prioritize health information, deliver messages using variaty of methods.
What is healthy people 2020 based on ?
- It is based on the accomplishments of the 4 previous HP
- 1979-the surgon general
- 1990- promoting health/preventing disease
- 2000-national health promotion
- 2010-improving health
What is the key component of healthy people 2020?
What are the goals of HP2020?
- Attain a high quality longer lives
- Achieve health equity and eliminate health disparities
- Create social and physical environment that promotes good health
- Promote QOL
What are determinants of health?
- Biology &genetics
- Health care delivery
Health field concept?
suggests that there are four concepts that make up the health field and contribute to health and wellness or diease
What are two skills that are important to the health educatiors?
- Community organizing/building
- Health promotion programing
What is a key factor in establishing relationship between researchers and the community?
What is community organizing?
Process through which communities are helped to ID common problems or goals, moblize their resources(vendors),develope and implement strategies for reaching goals(posters) these goals are collectively set.
What are assumptions used for community organizing?
- Communities can develop the capacity to deal with their own problems
- People want to change and can change
- People should participate in making, adjusting or controlling major changes taking place
- Change that is self imposed has meaning and permanance
- A holistic approach is better then fragmented
- Democracy needs cooperative participation
- People must learn necessary skills,communities may need help organizing to address their needs.
what are different methods of community organizing?
- Locality development-self help method, process oriented,consensus building, build group ID and sense of community
- Social planning: may people are involved, needs skilled volunteers,focus on problem solving(rational,empirical,task oriented)
- Social action: involves redistribution of power and resorces, tas and process oriented allows community change
What are the ten step approaches to the community organizing?
- Recoganize the issue(topic)-a problem exists and something must be done. Organized bottom up/grass root or top down
- Gain entry to the community: learn about community before approaching the gate keepers
- Organize the people: obtain support from who are interested, those affected by the problem, ID a leader, recruit additional community memebers.
- Assess the community
- Determine priorities and set goals
- Arrive at solution and select intervention strategy
- Evaluate the outcomes
- Maintain outcomes over time
- Loop back and modify plans as required
What is community building?
- It is strenght based rather than need based
- It involves mapping communities capacity(ID communities assets)
- Difference between this and CO is the different type of assessment used
What are different types of intervention strategies?
- Health communication
- Health education
- Health policy
- Health engineering
- Health related community services
What is the generic approach to community organizing?(IEML)
- The last four steps
What are other methods used for community organizing?
- Healthy cities and communities
- PATCH(moblizing the community,collecting data,choosing health priorities, intervention plan,evaluating)
- It has p steps the first five fall under precede and the last four are proceed.
- PRECEDE-predisposem reinforce,enable,construct,ecosystem diagnosis and evaluation
What are the five phases of precede?(SEBEA)
- Social assessment
- Administration and policy assessment
What is social assessment? (Topic Committee)
- It asess quality of life
- Use multiple source of information
- Purpose is to understand how people percieve their own quality of life and understand their aspirations
- engenders community participation
- Sets priorities and cannot only look at health data
What does social assessment bring together?
- Public's percieved needs
- Actual needs based on scientific data
- Resources, feasabilities and policy
What are different methods of data collection?
- Community forums
- Focus groups
- Retrive existing data
Quality of life?
perception of individuals or groups that their needs are being satisfied and they are not denied opportunities
process and condition among people and organizations that lead to accomplishing a goal of mutual social benefit
assessment of the capacities and skills of individuals and existing assets in the community
What is epidemiological assessment?
- establishes relative importance of various health problems
- provides basis for setting program priorities
- helps in allocationg responsibilities
What is behavioral and environmental assessment?
- Behavioral: analysis of behavioral links to the goals or problems ID in the previous stage
- Environmental:analysis of factors in the immediate social and physical environment that could casually be linked to the behavior
What is educational and ecological assessment?
- ID program objectives by looking at the causal factors of the behavior(predisposing,enabling,reinforcing)
- Sort, categorize and select the factors that seem to have direct impact on the behavioral and environmental targets
What is Administrative policy?
- Assess readiness of the organization
- Develope timetable and budget
- Assign resources
- ID specific settings
What are the four steps of PRCEED(IPIO)
- Process evaluation
- Impact evaluation
- Outcome evaluation
What are the three steps of implelementation?
- Assessment of resources
- Assessment of available resources
- Assessment of factors influencing impelementation(evaluation committee)
What is process evaluation?
- Day to day activities
- Provides documentation on what is going on in the program
- Describes actul program activities
What is impact evaluation?
Assess the overall effectiveness and effect of program activities on the client
What is outcome evaluation?
assess changes or improvement over time, morbidity and mortality and other health status indicatrs are examined.
What are the functions of needs and strength assessment?(UGOD)
- Used as a way to allocate resources
- Generate support for already established needs
- Organize community to develp its potential to solve problems
- Document the existance of a community health problem
What is the purpose of need assessment?
- ID the needs of a target population
- ID existing resources
- Determine whether needs are being met
- Create a useful program
What are different levels of assessing needs?
- Macro-societal or state
What are different steps taken for needs assessment?
- Decide to conduct one
- Involve the community
- Specify the purpose
- Assess obstacles
- ID approperiate needs
- Gather data
- Summerize and interpert
What are the different strategies used?
- Old-focus on needs, deficiencies and problems
- New-discover the community capacity
Why is the old strategy is used more often?
- Researchers like to study problems
- Funding sources base grants on needs
- A need orentation is used by media
- Wall is built in a desire to help
What are the consequances of the focus on needs for the community?
- People start thinking of themselves as deficient
- Think of themselves as victims
- Not empowering
- Leads to fragmented solutions
- Directs funding to service providers
- Negatively affects local community leadership
- Encourages cycle of dependancy
- Leads to sense of hopelessness
What are community assets?
What are different approaches?
- Asset based-starts with what is present in the community
- Internally focused-agenda building and problem solving capacities of local residance and others involved
- Relationship driven-constantly build and rebuild relationships among locan residents
What is the definition of the CBPR?
Approach that entailes incolcing all potential users of the research and other stakeholders in the application of the research (green and mercer)
What are the guiding principles of CBPR?(BBCDFDIPS)
- The community is the unit of ID
- Build on community assets
- Develop a collaborative partnership
- Co-learning and capacity building among all partners(most important component)
- Balance between knowledge and intervention for mutual benefit
- Focus on local relevance of public health problems
- Systems development is key
- Disseminates results to all partners
- A long term process with commitment to sustainability(Israel)
What are the attributes of the CBPR approach?
- The community is a unit of identity
- The community is a co-equal entity
- Community does not perceive it as university
- Use multiple methods of data collection
- Emphasis on long term commitment
- Emphasis on co learning
- Collective visioning
- Innovative problem solving
What caused the building of CBPR?
- Health behavior change programs are not successful
- Universities needed to get out
How does the CBPR process start?
- Best if researchers are approached by community
- Many approach for assistance
What are challanges associated with CBPR?
- Takes time and effort to buid trust
- It is more likely capacity building
- Sometimes hard to develop a common purpose
- Working with partners with different backgrounds
- Differences between academic and the community
What is the difference between the university and community culture?
- University people care about outocme professionally and they are outcome oriented. Research is the priority
- Community people care about outcome personally, process oriented, research is extra work.
What are necessary skills needed for CBPR?
- Team building
- Group process
- Interpersonal communication
- Political acument
What are the benefits of CBPR?
- Meet many wonderful people
- Improvement in knowledge
- Provide needed service while empowering communities
- Impact policy
- Involved in applied research
- Improve research
- Learn about other cultures
- Help communities
- Contribute to social justice
Awerness of our own cultural views and attitudes toward different cultures and cross cultural skills
What is the purpose of using age-related profiles?
It helps ID the risks and target interventions
What is MIC?
It incompassees health of women of chilbearing age from prepregnancy through pregnancy labor /delivery and the postportumand health of the health of a child prior to birth through adolescence
What is the importance of MIC statistics?
It is an important indicator of effectiveness of disease prevention and health promotion services in the community.
What Race/ethnicity has the highest infant mortality rate?
- Non.hispanic blacks
- The lowest belongs to Cubans
What country has the lowest mortality?
What is the definition of family?
It is a primary unit in which infants and children are nurtured and supported regarding healthy development
What is the family definition according to US census bureau?
A group of two people or more related by birth, marriage or adoption and residing together
What is the importance of a family for children?
It is important for child's well being
What are the affects of being raised in a single parent household?
- adverse birth outcomes
- low birth weight
- higher mortality
- more likely to be in poverty
What is the difference between married and unmarried mothers?
- They tend to have lower education
- Lower income
- Greater dependence on welfare
What are the negative outcomes associated with teen pregnancy?
- Drop out of school
- Not getting married
- Rely on public assistance
- Live in poverty
- **substantial economic consequances for the society
- They are less likely to recieve early prenatal care
- they are more likely to smoke, have LBW babies, have pregnancy complications
What are the negative health behavior associated with unintended pregnancies?
- Delayed prenatal care
- Inadequate weight gain
- Alcohol and other drug use
What is the community involvement when it comes to family planning?
governmental and nongovernmental organizations
What is title X
- This is a family planning act which is a federal program that provides funds for family planning services for low income people
- ** Major program to reduce unintended pregnancies
- **supports 61% of family planning cliniques
- **over 5M women receive care
What are some services provided by FPCS?
- nutrition counsling
- immunization care
- well baby care
Roe Vs. Wade
Abortion is legal in early stages of pregnancy
Who contributes to majority of abortions?
- Unmarried women
- 55% white
- 52% under age 25
What are the three components of the prenatal health care?
- Risk assessment
- Treatment of medical conditions
Who faces the highest racial disparitiy in prenatal care?
- American indians/Alaskan natives-this is due to their culture, health care and their access and the transportation
- Non.hispanic black
What are some factors contrinuting to infants health?
- Mother's health and behavior
- Levels of prenatal care
- Quality of delivery
- Infants environment after birth
What is infant mortality?
Death of a baby before the age of one and it is considered the measure of nation's health
What are the factors contributiong to decrease in mortality rate?
- Improved disease survalliance
- Advanced clinical care
- Improved access to health care
- Better nutrition
- Increased education
What are leading causes of infant death?
- Congenital abnormalities
- Preterm,low birth weight
Chid mortality is?
most severe measure of health in children
What is the leading cause of death in children?
Unintentional injury specifically motor vehichle death
What are the causes of child morbidity?
- Unintentional injury
- Child maltreatment-community response needed
- Infectious disease-importance of immunization
What is title V?
It is the only federal legislation dedicated to promoting and improving health of mothers and children
What is MCHB?(IPED)
- This established in 1990 to administer title V funding
- Accomplishes goals through 4 core public health services
- Infrastructure building,population based,enabling and direct health care services
What is WIC?
This is a special supplement food program for women, infants and children sponsered by USDA started in 1974
What are the eligibility requirements for WIC?
Residency in application state and income requirements
Who are WIC enrollees?
- Infants 25.5%
- 1 years of age
- 2 years of age
What is CHIP?
this targets uninsured children whose families don't qualify for Medicaid
What is FMLA?
Grants 12 weeks of unpaid protected leave to men or women after birth of a child, adoption or illness in immidiate family
What are some organizations advocating for children?
- Children's defense fund
- American academy of pediatrics
What is the make up of US population?
66% white non.hispanic
What is Race and what are the categories?
- Race is grouping people together based on the phenotypical or georgraphical ansectery. The four racial groups which in 1997 became 5 include:
- American Indians/Alaskan native
- Pacefic islanders
- ** race is more social then biological
What is ethnicity and what are the categories?
- Grouping people toghether through a common such as common language or culture.
- Non hispanic origin
- hispanic origin
To define health disparities what are the factors that needs to be distinguished?
- Health status
- Health care access
- Quality of health care
- Health care outcomes
What are some factors contributiong to health disparities?
- Health care provider
What is the largest minority group?
- Lation/Hispanic origin
- These are people of mexican,Puerto Rican, Cuban,Central American or south american descent or some other spanish origin
- 95% of hispanics in US are classified as white
- They have less high school education so this relates to their income
- Health beliefes is the role of God
What What is the origin of black american?
- These people have origins in any of the black racial groups from africa
- More then half live in the south
- Their income is ranked below all racial groups
- Due to roots in slavary they use traditional methods for achieving better health
What is the racial group with highest poverty rate?
What is Indian health services responsible for?
- Assist tribes in developing health program
- Facilitate and assist indians in coordination health programs
- Provide comperehensive health care
- Serve as principle health advocate
What is the definition of refugee,immigrants,alines,illigal aliens?
- person who flees an area or country to seek shelter from danger.
- individual who migrates from one country to another for ourpose of seeking permanent residance
- Someone who is not born here(college studnents)
- these enter the country illigally
What are the 6 categories that needs elemination of disparities in minority population?
- Infant mortality
What minority group has the highest rate of diabetes?
American indian alaskan native
What are the factors contributing to health disparities?
- Legal and political
What is the single most influential contributor to premature morbidity and mortality?
What are three kinds of power associated with empowerment?
- Social: access to bases needed to gain political power
- Political:power of voice and action
- Psychological:indicidual sense of potency
What age is considered adolesents?
What is the source of threat for the adolesence?
Behavior rather than disease
What are the leading causes of death in this age group?
- Unintentional injury( 1/4 car crash involving alcohol)
What are the 2 common STDs and who has it in higher rate?
Chlymedia and gonnorhea females contract chlymedia at a higher rate between ages of 15-19
What are the major causes of motor vehichle crash injury?
- Not wearing seat belt
- Being drunk
- being an aggressive driver
What is the leading cause of death among A.A adolesence?
- This is the 2 lead for Hispanic and 3 for Native americans
What are risk factors associated with violance?
- Poor supervision
- Exposure to violence
- Poor emotional attatchemet
- Friends engage in high risk
- Low commitment to school
- Academic failure
What are life style choices of High school students?
- Unintentional injury
- Physical activities
- Over weight and weight control
What are life style choices of college students?
- Unintentional injury
What are characteristics of adolescents?
- Risk takers
- Believe they know everything
- Don't want to be told what to do
- Believe they are invincible
- Live in the moment
- Don't consider consequenses
What community programs can prevent injury?
- School lock down on prom night
- Reduce the BAC (.8)
What is the age group for adults?
What is the cause of mortality among adults?
It is mostly chronic diseases which is associated with unhealthy behavior and poor life style choices
What are leading causes of death among 25-44?
- Unintentional injuries
- Heart disease
What is the leading causes of death among 45-64?
- Heart disease
- Unintentional injuries
What are the leading cause of cancer death for man and women?
- for man- prostate,lung,colorectal
- for women-breast,lung,colorectal
What are some risk factors associated with chronic disease?
- Lack of exercise
What are risk factors associated with personal injury?
What are different categories of aging?
- Elders-65 amd p;der
- young olds-65-74
- mid old-74-85
- old old-85 and older this is the fastest growing population
Aged is defined as:
state of being old when one reaches a specific age
Aging is defined as:
changes that occur normally in plants and animals as they grow
study of aging , including chemical, biological, psychological, economic and historic
Medical practice specializing in treatment of the aged
What are the 3 defining points associated with the population and demography?
- Birth rate
- Death rate
What are the factors contributing to population size and age?
- Fertility rate-# of births/1000
- Mortality rate-Death rate/100000
- Migration -movement of people
What demographic variables affect community health programs for older americans?
- Marital status (3/4 of men and half of women, women are more likely to be widowed)
- Living arrangements( closely linked to income, health status and availability of caregivers)
- Racial and ethnic composition
- Geographic distribution
- Economic status
What is the state with the greatest elder population?
What are some reasons that states ages?
- Inward immigration
- Leaving of young people
- Decreased fertility
What is the income resource for the elderly?
- Social security
What are top causes of death for elders?
- Heart disease
What are different types of imparements for older adults?
What are some instrumental needs for elders?
- Personal care
- Health care
- Community facilities
Among elders what groups have the highest poverty?
non married women and minorities
What are major needs associated with housing for the elders?
When it comes to personal care of elders what are the for levels of taks that may need assistance?(IECT)
- Instrumental- house keeping, transportation,maintanance
- Expressive-emotional support,socializing
- Cognitive task-scheduling appointments
- Task of daily living-eating, bathing
What is a primary source of payment for health care services for elders?
What are some services provided to protect rights of elders?
- Older american act of 1965
- National nutrition program for elders
- State and area agencies on aging
What is the leading cause of disability in north america?
Mental illness (26% diagnosable mental disorder, 6% serious mental illness)
What are the causes of disability for all ages?
- Mental illness
- Alcohol and drug
What is mental health?
Emotional and social well being
Mental disorder is?
Health condition characterized by alteration in thinking, mood, behavior associated with distress or impared functioning
all diagnosable mental disorder
What are characteristics of good mental health?
- Functioning under adversity
- Change or adapt to changes around them
- Maintain control over their tension
- Find more satisfaction in giving
- show consideration for others
- curb hate
- Love others
What is the most influential book in mental health?
Diagnostic and statistical manual of mental disorders
What are causes of mental disorder?
- Poor prenatal care
- Postnatal environment
- Brain function imparement
- Substance abuse
- family functioning
- Major Depression
Stress is considered to be what kind of disease?
Disease of adaption
In colonial american how were the mentally ill cared for?
Families or private care takers
When was first institutionalized appeard?
When did the moral treatment era begin?
1792, they believed that environmental changes can affect the mind and alter behavior
Who advocated for public hospitals?
Dorothea Dix , for providing decent care for indigents with mental illness
What practices where started being used 1939?
- ECT (shock therapy. insulin therapy)
What mental health care was established after WW2?
When did deinstituonalization become common?
it was common in 1950 because of new drungs and concern about patient rights
What year was CMHCA?
What are the consequances of deinstitutionalization?
- Financial instability
- Comprise 1/3 of our homeless
- Greater burden on communities
- Mental health dollars spent on acute care
What is the composition of the homeless population?
2.1 M adults, 80% temporary, 10% esporadically,10% chronically
What are treatment approaches for mental illness?
- self help
- ** prevention is considered to be more cost effective
What is coordinates school health program?
- Organized set of policies , procedures and activities designe to protect,promote and improve the health and well being of students and staff
- Health education
- physical education
- health services
- healthy environment
- health promotion
- family community involvement
What are the parts of school health council? and what is the primary role?
- students , parents, teachers, medical personnel, mantenance workers,social workers,counseling, food service workers
- Primary role is to provide coordiation of the various components of CSHP
What are the foundations of the school health program?
- Support of school administration
- Written school health policies
- Well organized school health council
What are the steps for creating local health related policies?
- ID the policy development team
- Assess the districts needs
- Prioritize needs and develop an action plan
- Draft policy
- Build awareness and support
- Adopt and impelement policy
- Maintain measure and evalute
What are the components of the school health program?
- Administration-supportive adminstration, school health coordinator
- School health services- health services provided by school health workers to protect and promote health
- Healthy environment- safe surroundings, physical, psuchosocial
- Health education-develop and deliver and evaluate planned curriculum
- Counsling-individual and group assessment
- Physical education-providing cognitive contents and experiences in variety of activity areas
- School nutrition services-nutritious and appealing meals
- Family involvement for school health-integrated school, parent and community approach
- School-site health promotion for staff-opportunity for staff to improve their health
What are the concerns of school health program?
- Lack of support-policy constraints,lack of administrative support, focus on subjects included on tests
- School health curriculum challanges-based on differing values
- School-based health centers-met resistance in certain communities
- Violence in schools-risk factors need to be ID
What is the policy development associated with CSHP?
- Should be executed by the school health council
- Should cover all facets of school health program
- Gain approval from key stakeholders
What is the definition of injury?
It is kind of damage to the body that is produced by energy exchange that are manifested within 48 hours
Who are individuals contributing to injury prevention research?
- Dehaven- WW1 studied ways to reduce force of impact
- Gordon-Used epidemiology to analyze risk factors
- Haddon-used epidemiology to study highway safety
What is the difference between intentional and unintentional injury?
- Unintentional injury occurs without anyone intending harm
- Intentional injury is purposely inflicted by self or other
What are negative factors associated with disabling injuries:
- Great human burden attributed to injuries
- significant econocmic costs
- Greatly contribute to premature death
What are community health problems associated with unintentional injury? and what percentage contributes to death?
- Motor vehichle crashes( leading cause of unintentional injury death and nonfatal unintentional injury)
- Poisoning( most occurs at home)
- Falls ( leading cause of injury related ED visits and affects elders)
- account for 2/3 of all injury related deaths
What are the ways we look at when we want to define injury?
- Person (Age,Gender,Minority status)
- Place(home,highway, sports areas, work place)
- ** most injuries occur at home
- Time( days of the week, time of the day, month of the year)
What is the most contributing factor to injuries?
What are methods of prevention through epidemiology?
- Prevention through epidemiology-host, energy-environment
- Control tactics based upon transmission
- A) prevent accumulation of energy-reduce speed limit
- B)prevent inappropriate release of energy-flame retardant fabric, safety belt
- C)place barrier between host and agent-inclusion around electric wire
- D) separate host from source of energy-locked gates
What are sources of injury?
- Physical energy: mechanical, thermal , radiant, chemical
- Agents that interfere with normal body energy exchange: water, carbon monoxide
What are means of transmission of energy?
- Vehicles- electric lines, hot rivets, poison containers, moving objects
- Vectors-plants, animals
What are community approches to preventing injury?
- Automatic protection-modify products
- Litigation-removing unsafe tires
What are the componets of circle of violence?
- Stress period
- Crisis state
What unhealthy behavir leads to highest number of death?
What are different costs associated with Drug problem?
- Direct cost-health care, premature death,impared productivity
- Indirect cost-crime , court, jails, social work
- Any substance other than food or vitamins that alters physical, mental or emotional state
- Drug taking behavior
- Inapproperiate use of legally purchased prescriotion or non prescription
- Use of prescription or nonprescription for non medical purpose
What are environmental risk factors associated with drug and alcohol use?
- Personal factors
- Home and family
- School and peers
What are the prevention methods associated with drug and alcohol?
- Primary- aimed at those who have never used drugs
- Secondary -those who have used but not chronic users
- tertiary-treatment and aftercare
What are elements of prevention ?
- public policy
- law enforcement
- poblic policy
Federal agancies and programs associated to reduce drug and alcohol use?
- Office of national drug control policy
- Department of HHS
- Sebstance abuse and mental health services
- National institute on drug abuse
What is health disparity?
Difference in the incidence, prevalence and mortality and burden of disease and other health conditions that exist amon specific population groups in the USA> closely linked with socioeconomic status
What is health equity?
Effort on fairness, entail special effort to improve the health of those who have experienced social or economic disadvantage.
What are the three basic ethical principles? (RBJ)
- Respect for others- people should be treated as autonomous agens, people with diminished autonomy are entitled to protection these include, prisoners,children, prisoners, students
- Beneficience-do no har, and maximize the benefit
- Justice- fair distribution of burden and benefit, equal treatment, this is the informed consent process
What is social justice?
The application of the concept of justice on social scale
What is the definition of health according to WHO?
State of compelete physical, mental and social well being and not merely absence of disease
What is the key code of ethic and essence of community?
What are the 12 principles of public health code of ethic?
- Address-disease aiming to prevent adverse health outcome
- Achive- health by respecting the rights of others
- Advocate-empower disenfranchised community memebers
- Seek-information needed to implement that promote and protect health
- Provide-communities with information
- Act- in timely manner
- P/P incorporate variety of approches
What are the principles of ethical practive of public health related too?
- Healthy people
- Community organizing
- Basic ethical principles
- Health education responsibilities
- Coordinated school health program
What would you like to do?
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