Test 1 Study Guide for Determinants of Health Behavior
Test 1 Study Guide for Determinants of Health Behavior HLTH 2400_002
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This 10 page Study Guide was uploaded by Grace Stewart on Sunday March 20, 2016. The Study Guide belongs to HLTH 2400_002 at 1 MDSS-SGSLM-Langley AFB Advanced Education in General Dentistry 12 Months taught by Mrs. Amelia Clinkscales in Spring 2016. Since its upload, it has received 25 views. For similar materials see Determinants of Health Behaviors in Health Sciences at 1 MDSS-SGSLM-Langley AFB Advanced Education in General Dentistry 12 Months.
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Date Created: 03/20/16
HLTH 2400 – Determinants of Health Behavior/Test One Study Guide Test Structure • 11 true false – 1 point each (11 points) • 13 multiple choice – 3 points each (39 points) • 4 short answer – 12.5 points each (50) Test Content • Health o World Health Organization (WHO): Complete state of physical, mental, and social well being; not merely the absence of disease or infirmity • Dimensions of health and healthy communities-how the dimensions of health are interconnected o Physical: health status ▪ Host-Agent-Environment (EPI triangle) • host- individual or population at risk • Agent(s)- Pathogen • Environment- Brings host and agent together • EXAMPLES: Common cold, chronic disease, Haddon Matrix o Mental: mood-related (anxiety, depression, bipolar disorders, dementia) ▪ among most prevalent and costly of health concerns ▪ standard diagnostic criteria established in past few decades ▪ continue stigma ▪ strong risk factor for many other problems including job loss, suicide, drug dependency, relationship difficulties and more o Social: Connectedness; social interaction ▪ we are social creatures ▪ currently experience rapid shifts in how we connect ▪ clear relationships between social capitol and health - Healthy communities population statistics - - open spaces public transportation - - medical resources - climate - air quality - rates of crime - homelessness - employment • Measuring physical, mental and social well being/Health Indices o quantifiable characteristics of a population which researchers use as supporting evidence for describing the health of a population ^^^^ o Mortality incidence- # of deaths in a population within a prescribed period of time o crude mortality rate- number of deaths/year/1000 population o cause-specific mortality rate- # of deaths/specific cause/100,000 population o Life expectancy- Average number of years of life remaining o Longevity- Average length of life o Morbidity- Measure of disease incidence or prevalence in a given population o Disease Incidence Rate- Number of new cases/specific disease/year/1,000 population at risk o Disease Prevalence Rate- # of existing cases/specific disease/year/1,000 population • Leading causes of death o 1900- Infectious diseases ▪ Pneumonia ▪ Tuberculosis ▪ Diarrhea and enteritis ▪ Heart Disease ▪ Stroke ▪ Liver Disease ▪ Injuries ▪ Cancer ▪ Senility ▪ Diphtheria - 2007- chronic diseases - Heart Disease - Cancer Stroke - - Chronic respiratory disease Injuries - - Alzheimer ’s disease - Diabetes - Influenza and pneumonia - Nephritis - Septicemia • Epidemiologic transition o shift in major causes of death o dramatic increases in ▪ population size ▪ average age of population o contributing factors ▪ see “rise in life expectancy” slide • Measuring health and health behaviors o Measurement: “The assignment of numerals to aspects of objects or events according to rule.” o Behaviors, attitudes, cultural norms, policies, access to care can all be measured o The rule needs to be standardized and clear o Height, weight, BMI, social norms for development (ex. easier to measure weight than behavior) o Why measure health behaviors? Planning and Evaluation ▪ set priorities and compare rates ▪ determine success or determine health status ▪ data needs for evaluation are different than surveillance needs - What to measure - Behavior - related concepts - psychological - psychosocial - environment Measurement Variables (slide #5) - - How to measure behavior self-report - - Interviews - varying level of structure - often used to gather in-depth information about a phenomenon - conducted by a skilled interviewer - Questionnaires/Surveys - vary in level of structure - BRFSS- Behacior Risk Factor Surveillance System - NHNES- National Health and Nutrition Examination Survey YRBSS- Youth Risk Behavior Surveillance System - - NSDH- National Survey on Drug Use and Health - Journals - events, feelings, emotions and beliefs are categorized to general themes - takes a lot of processing time - Self-report levels of measurement - nominal - data into categories; mutually exclusive; categories are exhaustive; no meaningful order (example: male/female, what country you're from) ordinal - - data into categories; mutually exclusive and exhaustive; but also rank ordered; can’t measure distance between categories; - interval - data into categories; mutually exclusive and exhaustive; rank orders; can measure distance between 2 categories; no absolute zero (ex. temperature) - Ratio- data into categories; mutually exclusive and exhaustive; rank orders; CAN measure distance between categories; there is an absolute zero observations - - Purpose- to identify clear patterns of expressed needs from visual and auditory cues - The Process - determine what to look for and used a standard method for observing and recording - select and train observers - gain access - work to be unobtrusive - limit note taking - recall after observation in detail - biobehavioral - physiological measures - ex. measurements of total cholesterol, RBC count - anthropometric measures - height, weight, etc. - electronic - augment self-report - augment means support - wearing a heart rate monitor- heart rate and intensity go together - augment observation • Healthy People 2020 o Overarching Goals: ▪ Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death ▪ achieve health equity, eliminate disparities, and improve the health of all groups ▪ create social and physical environments that promote good health for all ▪ promote quality of life, healthy development, and healthy behaviors across all life stages o mission: ▪ healthy people 2020 strives to: ▪ Identify nationwide health improvement priorities ▪ increase public awareness and understanding of the determinants of health, disease, and disability and the opportunities for progress ▪ Provide measurable objectives and goals that are applicable at the national, state, and local levels ▪ engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the best available evidence and knowledge ▪ identify critical research, evaluation, and data collection needs o healthy people provides science-based, 10-year national objectives for improving the health of all americans. for 3 decades, healthy people has established benchmarks and monitored progress over time in order to: ▪ encourage collaborations across communities and sectors ▪ empower individuals toward making informed health decisions ▪ measure the impact of prevention activities • Health behavior o an action that helps prevent illness and promote health o behavior that affects one’s health status and/or quality of life o often established well before effects are experienced o however, it is still beneficial to change behaviors after onset of disease/condition. Helps with disease management and minimizing negative effects o CDC estimates that 50% to 80% of diseases are linked to behavior o Daily habits contribute to development of virtually all major sources of Mortality and Morbidity o multidimensional (complex)- with determinants at all levels ▪ person ▪ social ▪ environment/policy o dimensions overlap o personal health behavior ▪ behavior that primarily affect the individuals own health o health related behavior ▪ behavior that affects both behaviors that affect one’s health (personal health behavior) and the health of others (parenting, regulatory behaviors) o health protective behavior ▪ behavior undertaken specifically out of a concern for one’s own health or for the health of others (ex. policy, programs) o socially-oriented health protective behavior ▪ undertaken to improve the social conditions that contribute to health • Why do we research health behavior o Prevention Research ▪ prevalence ▪ determinants of health ▪ mediators of health behavior ▪ efficacy and effectiveness • Categories of prevention o Primordial ▪ Goal: prevent the development of risk factors ▪ Population Targets: General population ▪ examples: healthful diet, physical activity, sexual behavior, hygiene, injury prevention o Primary ▪ Goal: prevent onset of disease ▪ Population targets: at risk ▪ examples: diet, physical activity, sexual behavior, injury prevention o Secondary ▪ goal: early detection ▪ population targets: high risk ▪ examples: hypertension, hypercholesterolemia ▪ goal: adherence ▪ population targets: afflicted ▪ examples: HIV+ o Tertiary ▪ Goal: rehabilitation, reduce consequences, prevent recurrence ▪ population targets: afflicted ▪ Examples: Cancer, CVD, Diabetes, aids, injury, surgery • Change processes used in prevention o Teaching ▪ processes of facilitating change in knowledge, beliefs, attitudes, skills, and behaviors through information and learning activities with one individual or in a small group o Counseling ▪ processes of facilitating change in knowledge, beliefs, attitudes, skills, and behaviors through information and learning activities with one individual or in a small group o Communication ▪ process of developing and delivering information and persuasive messages o Social Marketing ▪ the application of marketing principles to achieve specific behavioral goals for a social good o Organizational Change ▪ the process by which desired goals of organizations are reached o Community Development and Social Capital ▪ actions designed to improve community involvement, resources, programs, policies, and functioning; social support; social capital o Advocacy ▪ actions designed to gain political commitment, policy support, and social acceptance for goal, program, policy, or practice. Advocacy actions include lobbying, organizing, and activism • Social Ecological model o multi-level health promotion ▪ individual level ▪ interpersonal level ▪ community level ▪ societal level • Health disparities o “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion. - Healthy People 2020 o the differences (gaps) in health that are not only avoidable but are unjust and unfair • Intrinsic and extrinsic motivation o Intrinsic ▪ motivation from within self ▪ usually refers to psychological motives • inherent pleasure, enjoyment, sense of positive identity associated with behavior o Extrinsic ▪ motivation from environmental incentives/consequences ▪ behavior is not inherently enjoyable ▪ behavior is done because of anticipated consequences (ex. money, food, social rewards…) o Behaviors ▪ same behavior might be driven by different motives in different people • example: eating fruits and veggies o intrinsic motivation- enjoy the taste, enjoys cooking, etc o extrinsic motivation- social knowledge of accomplishment ▪ implications of intrinsic vs. extrinsic motivation • maintaining extrinsic depends on reward • intrinsic motivation more likely to persist o Push and Pull Relationship ▪ often start with extrinsic to introduce/start a new behavior ▪ extrinsic can not overpower the behavior itself ▪ intrinsic motivation leads to maintained/sustained behavior change • Know the definitions for the desirable characteristics of data o psychometric qualities: ▪ reliability • consistency in the measurement process; the degree to which a measure is free from errors of measurement; obtained score=true score+error score • types: o internal-consistency reliability o rater reliability o parallel forms (2 different tests but they measure the same thing and are getting the same data) o test-retest reliability ▪ validity • measures what it is intended to measure; correctly measuring concepts under investigation • types: o construct- degree to which a measure correlates with other measures is theoretically expected to correlate with; convergent validity (should correlate with) and discriminant validity (should not correlate with) ▪ fairness • “is appropriate for the individuals or various ethnic groups with different backgrounds, gender, educational levels, etc.” • culture plays a part • culturally competent o sensitivity ▪ Sensitivity (those with) ▪ Specificity (those without) ▪ a sensitive test helps rule out disease. If highly sensitive and test is negative then one can rule out that disease o unbiased ▪ biased data are distorted data; often caused by the way they are collected; ex. response bias • Levels of measurement - nominal - data into categories; mutually exclusive; categories are exhaustive; no meaningful order (example: male/female, what country you're from) - ordinal - data into categories; mutually exclusive and exhaustive; but also rank ordered; can’t measure distance between categories; - interval - data into categories; mutually exclusive and exhaustive; rank orders; can measure distance between 2 categories; no absolute zero (ex. temperature) - Ratio- data into categories; mutually exclusive and exhaustive; rank orders; CAN measure distance between categories; there is an absolute zero What is theory? (explanatory and change theory) o Theory is a hypothesis supported by data ▪ understanding health and behavior ▪ needs assessment ▪ intervention development ▪ interpretation of results • Behavioral theory o behavior- observable and its frequency, amount and intensity can be objectively measured o behavioral theories are theories about what motivates behavior o common themes: ▪ environmental factors ▪ behavioral experience ▪ individual factors - Operant Conditioning emphasis on observable factors - - it ignores all factors that can ’t be observed - classical conditioning- conditioned responses or automatic responses to stimuli - antecedent- a stimulus when it alters the frequency of a response - operant- responses controlled by consequences - response- the action taken as result of stimuli - reinforcement- a consequence that increases the frequency of a behavior - types: - material - ex. offering money back on insurance - praise - ex. someone telling you you look good if you have been working out; you ’ll keep doing what you're doing attention - - ex. making excuses and receiving attention self-reward - - ex. rewarding yourself - accordingly, the frequency of a behavior will increase when properly or sufficiently reinforced - Behavior Modification - Grounded in Operant Conditioning - Goals of: - modify behavior - enable self management - Use of Applied Behavior Analysis - Assess behavior frequency and antecedents and consequences - self-management - Freud Primary Motivators of Behavior: - - Desire for pleasure Fear of pain - - Inevitability of death • Good theory o generalizability- applicable across diverse venues, populations and social environments o testability- open to falsification through directly derived testable hypotheses. o if you prove it wrong, its okay because you can just tweak it a little • How has western traditions, psychology, sociology, ecology and anthropology contributed to current behavior theories? o Order and regularity ▪ that the universe is ordered and regular, which has practical applications for technology o Predictability ▪ if there is order and regularity, the rules or “laws” can be learned, and used to predict o Primacy of Empirical Data ▪ the positivist epistemology associated with the Western tradition holds that what we know comes from our senses— observable, tangible evidence o Progress and Perfectability ▪ that there is an inexorable movement towards more knowledge, better understanding, higher complexity, etc. • Personality theory o Personality Types and Traits ▪ Extraverted versus introverted ▪ Neuroticism ▪ Agreeableness ▪ Conscientiousness ▪ Openness to experience o Theorists agree that personality is: ▪ relatively stable over time ▪ differs among people ▪ influences behavior o Theorists disagree about personality being: ▪ innate ▪ environmental • The readings from BB
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