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63 Cards in this Set

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What are some of the events that helped to shape our understanding of ethical research? 3
1.The Nuremberg War Crimes
2.Human Radiation Studies
3.US Public Health Service Syphillis Study at Tuskegee
The Tuskegee Study.
Facts: date, who told of it, person, how many years
1972
Newspaper Article
NY Times
Jean Heller
40 years
Tuskegee Study was held in which 6 locations
1.mississippi
2.tennessee
3.georgia
4.North Carolina
5.Virginia
6.Alabama
What nurse was appointed the liaison for the Tuskegee study?
Eunice Rivers
What was the project length For Tuskegee and men with positive results lasted how long before treated?
6-8 Months
Actually lasted 5 years
Declaration of Helsinki
Stringent provisions regarding informed consent for Tuskegee Study
Government settles in court over Tuskegee Study how much?
.suvivors
.heirs of subjects
.living controls
.deceased control
10 mill
37,000
15,000
16,000
5,000
Tuskegee study lasted from what dates?
1932-1972
Who broke the story for Tuskegee?
Jean Heller
Who brought the trial for Tuskegee and how much? What happened
Fred Gray
Nothing happened. didnt go
1.8 bill
What is the most important predictor of the quality of healthcare across racial and ethnic groups?
access
What are potential sources of disparities in care? 3
1.health systems level factors- cultural and linguistic barriers, finance
2.patient level factores- patient preferences, refusal of treatment
3. disparities arising from the clinical encounter
Stereotyping
the process by which people use social categories in acquiring, processing, and recalling informaiton about others.
Stereotyping riskes. 3
1. can exert powerful effectrs on thinking and actions at an implicit, unconscious level, even among well meaning, well educated persons who are not overtly biased
2.can influence how info is processed and recalled
3.can exert "self fulfilling" effects, as patients behavior may be affected by providers overt or subtle attitudes and behaviors
What are some recommendations to stop health care disparities. 6
1. General Recommendations
2. Legal, regulatory and policy rcommendations
3.Health system interventions
4.education
5.data collection and monitoring
6.research
Do critical periods exist in which SES may have significant impact upon subsequent health or, vice versa, when health may impact upon the various compontents on SES?
Recent research sugests over the long term SES affects health, but over the short term the relationship may be reversed.
What is Socioeconomic status?
an attribute of an individual or the person's family or household that consists of different dimentions.
What dimentions are involved In SES?
Educational attainment
occupational status
wealth
prestige
Educational attainment is positively correlated with? 3
1. health and funcioning
2. absence of disability
3. lower incidence of some illnesses
Types of data that will help with SES and health.
5
1.cross section data
2.lifetime and intergenerational data
3.longitudinal data sets
4.need for new data sets
5.cross national data and data from other countries
Multidiciplinary work involving SES and health.
5 fields
1.epidemiology
2.economics
3.demography
4.sociology
5.psychology
NIH initiative in SES and health is what?
Inclusion of minorities in research so that we can have representativeness.
Shavers et al categorized the potential barriers to seeking healthcare in three categories. what are they?
1.patient factors
2.clinical factors
3.structural barriers
What are some patient factors?
socioeconomic status
patiernt preferences
cost
transportation
time required for treatment
family and other support
What are some clinical factors?
physician recommendations
clinical indicators
comorbidity- 2 diseases at time
pain assesment
physician perceptions/bias
What are some stuctural bias?
health insurance status
type of health insurance
type of institution where care
is recieved
geographic region where recieved
commonwealth fund conducted study?
survey in 2001
cited ethnic minorities as being less satisfied with the quality of health care services.
What are barriers to healthcare? 2
1.cultural barriers
2.language barriers.
Language barriers
ability to speak a certain language, such as english. Intonation, pronunciation, volume and word choice can drastically change the meaning of communication, as can nonverbal cues
Literacy
according to the partnership for clear health communication, health literacy is the ability to read, understand and act on info.
what directly inpacts access to care?
involvement
Health communications
the art and technique of informing, influencing, and motivating individual, institutional, and public audiences about inportant health issues.
What is the scope of health communication? 4
1 disease prevention
2 health promotion
3 health care policy
4 business of health care
what are some methods of communication? 5
1 interpersonal
2 small groups
3 organization
4 community
5 mass media
what is challange #1 in health communication
to design an effective health communication program that identifies the optimal contexts, channels, context and reasons in which people will be motivated to pay better attention to and utilize health information.
Challenge #2 in health communication.
the protection of privacy and confidentiality of personal health information.
often people with the greatest health burdens have the least access to? 4 things
1 information
2 communication technologies
3 health care
4 supporting social services
Digital divide?
lack of technology
Objective 11-1
increase household without internet access
Objective 11-2
improve health literacy of person with inadequate or marginal literacy skills
Objective 11-3
increase the proportion of health communication activities that include research and evaluation.
Objective 11-4
Increase the proportion of health related world wide web sites that disclose info that can be used to assess the quility of the site
Objective 11-5
increase the number of centers for excellence that seek to advance the research and pratice of health communication.
research and training infrastructure needed
Objective 11-6
increase the proportion of persons who report that their health care providers have satisfactory communication skills
Center for study of health disparities was established when and where by whom?
march 28 2003 by the texas A&M board of regents
What does the center for the study of health disparities do for students?
enriches the minds of students
what is the key for the center for the study of health disparities?
collaboration- with other org.s
what are the three key terms to cultural differences?
1 culture
2 cultural awareness/ sensitivity
3 cultural competence
What health promotions strategies seem to have promise in working with racial and ethnic groups?
effective health education and promotion efforts must begin with a clear understanding of the cultural influences on health
What are the key concepts of health promotion stategies? 4 things
1 get to know your audience
2 cooperative relationships
3 accepting cultural differences
4 express interest and respect for different cultures
RECENT health promotion strategies for racial and ethnic populations. 6 things
1 increase accessability and quality of health care service
2 launch targeted public health programs
3 offer comprehensive and integrated health and social services
4 provide funds to community based org.
5 support community economic development
6 engage community residents in planning services and programs
EFFECTIVE strategies for racial and ethnically diverse populations. 7 things
1 educate in a style and pattern which they are accustomed to
2 locate programs and services near prominent intitutions
3 increase diversity in health personnel
4 using local residents in different capacities
5 promote events though traditional media sources
6 address health and social needs
7 involve/ organize community
Community organization
process by which a community identifies it needs or objectives, ranks these needs, developes the confidence and will to work at these objectives, finds the resources and in so doing, extends and develops cooperative and collaborative attitudes and practices in the community
community competence
community's ability to engage in effective problem solving
participation in health promotion is two pronged
1 participation of community organ.
2 participation of community members
partnering with texas cooperative extension on two community education programs.
1 do well be well with diabetes (6 week program)
2 diabetes cooking school (4 week program)
community health center currently implementing collaboratives on which diseases?
diabetes
cardio vascular
depression
cancer
asthma
redesign system to improve chronic illness care for patients with a specific condition. which models show that?
1 chronic care model
2 improvement model
3 learning model
what is self management
the individuals ability to manage the symptoms, treatment, physical and social consequences, and lifestyle changes inherent in living with a chronic condition
self management support use effective self management support strategies that include what? 5 things
1 assessment
2 goal setting
3 action plan
4 problem solving
5 follow up
self management in office practice... 5 A's
1 arrange
2 assess
3 advise
4 assist
5 agree
Personal action plan in self management in office practice includes what 4 things?
1 list specific goals in behavioral terms
2 list barriers and strategies to address barriers
3 specify follow up plan
4 share plan with practice team and patients social support
health education staff provide three specific services for patients with diabetes.
1 individual diabetes self management educations
2 group self management education and goal setting
3 group nutrition education classes