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220 Cards in this Set
- Front
- Back
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What is covered by the BRFSS?
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*Tobacco use
*Physical activity* Dietary choices: Fruit, vegetables, fat * Height/Weight *Mammography *Blood stool testing *Proctoscopy *Health insurance |
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What is the youth Behavior Risk Factor System?
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*School-administered
*Surveys prevalence of health-related practices in students grades 9-12 * Smoking * Dietary choices * Participation in physical education classes |
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What agency administers NHANES?
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National Center for Health Statistics
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What are the assumptions of the Health Belief Model?
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* Assumes people fear disease
* Addresses readiness and non-adherence * Health actions are variably determined by degree of fear vs. barriers to action |
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In the health belief model, what is the concept of perceived susceptibility?
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Subjective perception of risk of contracting disease
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In the health belief model, what is the concept of perceived severity?
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Feelings about the seriousness of getting the disease (or leaving it untreated)
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In the health belief model, what is the concept of perceived benefit?
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Beliefs about the effectiveness of options available to reduce the disease threat
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In the health belief model, what is the concept of perceived barriers?
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Negative aspects of a health action that impede adopting the recommended behavior changes
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In the health belief model, what is the concept of Cues to action?
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Events or stimuli to “trigger” one’s “readiness” to change
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In the health belief model, what is the concept of Self-Efficacy?
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Confidence in one’s ability to take action and succeed
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The group with the highest suicide rates?
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25 to 64
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Health belief model chart
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In the this model, the most important determinant of behavior is a person’s intent
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Theory of Reasoned Action
https://www.youtube.com/watch?v=_LfGXgJMLlE |
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In the Theory of Reasoned Action , behavioral intent is determined by?
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*Positive or negative attitudes towards performing the behavior
*One’s normative beliefs about whether influential others approve or disapprove of performing the behavior |
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Theory of Planned Behavior
https://www.youtube.com/watch?v=DFn-IOcpd8A |
An extension of the theory of reasoned action
adds perceived behavioral control to account for factors outside of one’s control that might influence behavioral intention A person will expend greater efforts to perform a behavior when the perception of behavioral control is high |
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What is reciprocal determinism (social determinism?)
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Behavior is explained in terms of a dynamic interaction of personal, environmental and behavior influences.
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Observational learning (social learning [cognative learning] )theory
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People learn not only via their own interactions with the environment, but from observing others
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What behavioral theory best describes this statement: People can shape, and change their environment to better suit their needs?
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social learning [cognative learning] theory
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What are the stages of change and time frames? (=transtheorectical model)
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1) Precontemplation-no intent for 6 mo
2) Contemplation-intent in 6 mo 3) Preparation-one month, some initial efforts being made 4) Action-sustained changes less than 6 mo 5) Maintenance- changes > 6 mo = PCP AM |
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Transtheorectical model example
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What is the Fogg Behavior model?
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Motivation
Trigger Ability Work together to create action. Applied to computer technology http://www.behaviormodel.org/ https://www.youtube.com/watch?v=jsbF9z6adAo |
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A, B, or D rec for adults: smoking
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A
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A, B, or D rec for adults: Physical Activity/healthy diet for those at risk of CVD?
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B
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A, B, or D rec for adults: Alcohol Misuse
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B
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A, B, or D rec for adults: depression
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B
when resources are available to f/u |
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What best describes Rothman’s Typology?
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3 intertwined models: * Locality Development * Social Planning * Social Action |
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Read about Rothman's typology
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http://www.calgary.ca/CSPS/CNS/Pages/Publications-guides-and-directories/Community-Assessment-Handbook/Rothman%27s-Three-Models-of-Community-Organizing.aspx
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In Rothman's Typology, what is the Locality Development Model?
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This model of community practice is based on the belief that in order to effect change, a wide variety of community people should be involved in planning, implementation, and evaluation.
Key themes include the use of democratic procedures, voluntary cooperation, self-help, the development of local leadership, and educational objectives. |
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In Rothman's Typology, what is the Social Planning Model?
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A rational, deliberately planned, technical process of problem-solving with regard to substantive social problems
* W/ variable community participation *Building community capacity or fostering radical or fundamental social change is not a major goal of this model of community practice. |
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In Rothman's Typology, what is the Social action model?
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Assume that a disadvantaged segment of the population needs to be organized in order to make demands on the larger community for increased resources or improved treatment. *Key themes in this model are social justice, democracy, and the redistribution of power, resources, and decision making |
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In Rothman's Typology, what is the concept of participation and relevance?
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Community creates own agenda of needs, resources and obstacles
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In Rothman's Typology, what is the concept of empowerment?
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Members assume and expand power
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What is Pablo Freire's concept of Critical Consciousness?
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Members engage in dialogue that links rootcauses and community actions
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Breaking through prevailing mythologies to reach new levels of awareness—in particular, awareness of oppression, being an "object" of others’ will rather than a self-determining "subject."
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Critical consciousness
http://en.wikipedia.org/wiki/Critical_consciousness |
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What is Community Competence?
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Members identify specific problems, gain consensus, and agree on change strategies to reach goals
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What is Issue Selection?
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Members identify specific problems, gain consensus, and agree on change strategies to reach goals
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What community development theory posits that change is best promoted by intervening at several levels in the hierarchy
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Organizational Change Theory (multiple models)
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What are the components of stage theory theory?
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Four parts of the Stage theory theory?
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1) Awareness of a problem and possible solutions
2) Decision to adopt the innovation 3) Implementation that includes redefining the innovation and modifying organizational structures to accommodate it 4) Institutionalization or making the innovation part of the organization's ongoing activities |
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What is Relative Advantage?
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Is the innovation better than what it will replace?
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What is Compatibility?
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Does innovation fit with the intended audience?
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What is Complexity?
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Is the innovation easy to use?
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What is Trialability?
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Can the innovation be used on a trial basis?
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What is Observability?
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Are results of use observable and easy to measure?
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Impact on Social Relations
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Does innovation impact/disrupt social environment?
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Reversibility
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Can effect be reversed or discontinued easily?
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Communicability
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Can the innovation be easily understood by users?
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Time Required
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Can innovation be adopted with minimal time expense?
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Risk and Uncertainty Level
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Can it be adopted with minimal risk and uncertainty?
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Commitment required
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Can innovation be used effectively with only modest commitment by person or organization?
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Modifiability
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Can innovation be adapted/modified over time?
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Rate of Adoption (D of I)Earliest to Latest
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What is the purpose behind PRECEDE/PROCEED?
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Intended to predict or explain the relationship among factors thought to influence an outcome of interest
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Provides a structure for applying multiple theories so that most appropriate strategies ares elected and implemented.
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PRECEDE/PROCEED ("Road Map for Theories to find their avenue.")
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PRECEDE/PROCEED
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What is the life time prevalence of ANY mental illness?
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approx 60%
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Top three mental illnesses?
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1) Substance use disorder
2) Anxiety 3) Impulse control disorder (depression is 4th) |
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What portion of mental illness begins in adolescents? Adults?
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Half of all lifetime cases begin by age 14; three quarters have begun by age 24. Thus, mental disorders are really the chronic diseases of the young.
http://www.nimh.nih.gov/news/science-news/2005/mental-illness-exacts-heavy-toll-beginning-in-youth.shtml |
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Top 3 mental illnesses, 3-17
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1) ADD/ADHD 6.8%
2) Behavioral or conduct disorders 3.5% 3) Anxiety 3.0% 4th= depression Note that despite the hype, autism is rare =1.1% |
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The National Institute of Mental Health Collaborative Psychiatric Epidemiologic Surveys combines?
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*National Comorbidity Survey Replication (1st study to use interviewer for describe the burden of mental illness)
*National Survey of American Life (_->racial/ethnic variations in mental health) *National Latino and Asian American Study |
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What is the QALY equivalent for Major Depression?
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paraplegia, blindness
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What is the QALY equivalent for Schizophrenia (Psychosis)
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quadriplegia
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Age group with highest suicide rate.
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25 to 64 (no longer >65) |
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Suicide facts (read)
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http://www.cdc.gov/violenceprevention/pdf/Suicide-DataSheet-a.pdf
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Racial disparities in suicide rates
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Top three groups who commit suicide:
1) American Indians/Alaskan Nativies 2) Whites 3) Hispanics |
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Methods of suicide.
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What is the leading cause of disability world-wide?
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Depression
ref: http://www.who.int/mediacentre/factsheets/fs369/en/ |
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Efficacy def?
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What is found statistically in the artificial environment of clinical trials.
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Effectiveness def?
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How the intervention works in the "real world."
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Top 3 illicit substances abused/misused?
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1) Marijuana~18%
2) Prescription drugs ~ 6 % 3) Cocaine ~ 1.5% Most abused licit substance = ETOH |
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What % of MVA fatalities were related by ETOH?
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~40%
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What are the leading health indicators according to Healthy People 2020? |
* Access to health services * Clinical Preventive services * Environmental quality * Injury and violence * Maternal, infant and child health * Mental Health * Nutrition, Physical Activity, and Obesity * Oral health * Reproductive and sexual health * Social determinants * Tobacco * Substance abuse |
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What are the components of the 6-step method for behavior change? |
1. Appraise risk 2. Explicitly state problem 3. Increase patient self-awareness 4. Develop and implement the action plan 5. Evaluate the action plan 6. Maintain change |
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What is the model of motivation interviewing? |
Used to determine discrepancies between the patients goals and actions, respond to resistance to behavior change, and build self-efficacy. |
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What are the 4 principles of motivational interviewing? |
*Show empathy * Develop patient's awareness of discrepancy * Respond to resistance * Support self-efficacy |
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What behavior change model is best for assessing motivation to change? |
The health belief model |
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What percent of adults reported drinking in the last month? |
56% |
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What percent of adults report binge drinking in the last month? |
24.6 percent |
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What is the leading cause of mental retardation? |
Fetal Alcohol syndrome |
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What is a limitation of the CAGE questionnaire? |
It is less sensitive for women and non white patients. |
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What does a AUDIT score > 5 mean |
Further questions are needed to determine alcohol misuse and dependence |
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What does a AUDIT score > 8 mean |
There is a concern about alcohol use and dependence |
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What is AL-Anon? |
An support group for family members of alcoholics |
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What questions are asked by the Adolescent Substance abuse Questionnaire? (CRAFFT)
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1) Have you ever ridden in a CAR driven by someone (including yourself) who was ‘‘high’’ or had been using alcohol or other drugs? 2) Do you ever use alcohol or other drugs to RELAX, feel better about yourself, or fit in? 3) Do you ever use alcohol or other drugs while you are ALONE? 4) Do you ever FORGET things you did while using alcohol or other drugs? 5) Do your family or FRIENDS ever tell you that you should cut down on your drinking or drug use? 6) Have you ever gotten into TROUBLE while you were using alcohol or other drugs? |
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What is a behavioral pathogen? |
A health-compromising behavior or habitsmoking, excessive eating, substance abuse, dangerous driving, risky sexual behavior |
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What is a behavioral Immunogen? |
A health-enhancing behavior or habitexercising regularly, using sunscreen, healthy eating, practicing safe sex, wearing seat belts |
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What is optimistic bias? |
The tendency of most people to believe that they are less likely to become ill than others |
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What is the number 1 cause of premature death for persons 15-19? |
Alcohol use |
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Def of high risk drinking for a man? |
more than 14 drinks in a typical weekmore than 4 drinks on any day |
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Def of high risk drinking for a woman? |
more than 7 drinks in a typical weekmore than 3 drinks on any day |
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True or false: antidepressants are effective for treating alcohol dependence? |
False |
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What are the FDA approved medications for treating alcohol abuse? |
* Disulfiram * Def of high risk drinking for a man? * Acamprosate * Naltrexone Depot |
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Rank these groups in terms of HCV prevalence: IV drug user, dialysis patients, Hemophiliacs |
1) Hemophiliacs 2) IV drug users 3) hemodialysis pts |
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The legal drinking age was raised to 21 years. Which of the following changes in the rate of alcohol-related motor vehicle crashes occured? A) 15% decrease in overall rate.B) 15% decrease in rate among persons under 21 years of age. C) 15% increase in rate among persons under 21 years of age. D) No significant change in the rate. |
Answer: B. 15% decrease in the rate of alcohol-related MVA in persons under age 21 years was demonstrated after the legal drinking age was raised to 21 years of age. |
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Approximately what percent of motor vehicle crashes in the United States are alcohol-related (driver or non-occupant, e.g. pedestrian)? A) 10% B) 20%C) 40% D) 60% |
c |
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Which of the following is NOT routinely addressed in the Behavioral Risk Factor Surveillance System (BRFSS)? A) Blood stool testingB) Fruits and vegetable intakeC) Health insuranceD) Substance and marijuana use |
Answer: D. |
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Which of the following best describes the factors involved in the Health Belief Model? A) Perceived barriers to and benefits of action B) Perceived barriers to and benefits of action, self-efficacy, and cues to action C) Perceived barriers to action, self-efficacy, and cues to action |
B. |
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The CDC estimated that in 2012 approximately how many Americans were binge drinkers? A) 1 in 10 B) 1 in 25 C) 1 in 6 D) 1 in 8 |
Answer : C. Binge drinking is defined as having 5 or more drinks on one occasion for a man or four or more drinks on one an occasion for a women. Facts: The largest number of drinks at a single binge is on average 8 Binge drinkers binge on average 4 times a month |
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Approximately what percent of motor vehicle fatalities in the United States in 2010 involved a drunk driver?A) 10%B) 20%C) 30%D) 60% |
C. 1/3 fatal MVA crashes involves a drunk driver. |
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True or false? In 2013, an estimated 24.6 million Americans aged 12 or older were current (past month) illicit drug users, meaning they had used an illicit drug during the month prior to the survey interview. This estimate represents 9.4 percent of the population aged 12 or older. Illicit drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics (pain relievers, tranquilizers, stimulants, and sedatives) used nonmedically |
True |
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True or false? In 2013, an estimated 24.6 million Americans aged 12 or older were current (past month) illicit drug users, meaning they had used an illicit drug during the month prior to the survey interview. This estimate represents 9.4 percent of the population aged 12 or older. Illicit drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics (pain relievers, tranquilizers, stimulants, and sedatives) used nonmedically |
True |
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True or false? |
The rate of current illicit drug use among persons aged 12 or older in 2013 (9.4 percent) was similar to the rates in 2010 (8.9 percent) and 2012 (9.2 percent), but it was higher than the rates in 2002 to 2009 and in 2011 (ranging from 7.9 to 8.7 percent? |
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True or false? In 2013, an estimated 24.6 million Americans aged 12 or older were current (past month) illicit drug users, meaning they had used an illicit drug during the month prior to the survey interview. This estimate represents 9.4 percent of the population aged 12 or older. Illicit drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics (pain relievers, tranquilizers, stimulants, and sedatives) used nonmedically |
True |
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True or false? |
The rate of current illicit drug use among persons aged 12 or older in 2013 (9.4 percent) was similar to the rates in 2010 (8.9 percent) and 2012 (9.2 percent), but it was higher than the rates in 2002 to 2009 and in 2011 (ranging from 7.9 to 8.7 percent? |
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True or false? The percentage of persons aged 12 or older who used prescription-type psychotherapeutic drugs nonmedically in the past month in 2013 (2.5 percent) was similar to the percentages in 2010 to 2012 (ranging from 2.4 to 2.7 percent |
True |
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True or false? The number and percentage of past month methamphetamine users in 2013 (595,000 or 0.2 percent) were similar to those in 2012 (440,000 or 0.2 percent) and 2011 (439,000 or 0.2 percent), but they were higher than the estimates in 2010 (353,000 or 0.1 percent |
True |
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True or false? Among unemployed adults aged 18 or older in 2013, 18.2 percent were current illicit drug users, which was higher than the rates of 9.1 percent for those who were employed full time and 13.7 percent for those who were employed part time. However, most illicit drug users were employed. Of the 22.4 million current illicit drug users aged 18 or older in 2013,15.4 million (68.9 percent) were employed either full or part time |
True |
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True or false? Among persons aged 12 or older in 2012-2013 who used pain relievers nonmedically in the past 12 months, 53.0 percent got the drug they used most recently from a friend or relative for free, and 10.6 percent bought the drug from a friend or relative. Another 21.2 percent reported that they got the drug through a prescription from one doctor. An annual average of 4.3 percent got pain relievers from a drug dealer or other stranger, and 0.1 percent bought them on the Internet |
True |
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True or false? Slightly more than half (52.2 percent) of Americans aged 12 or older reported being current drinkers of alcohol in the 2013 survey, which was similar to the rate in 2012 (52.1 percent). This translates to an estimated 136.9 million current drinkers in 2013 |
True |
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True or false? In 2013, 9.4 percent of the population aged 12 or older were current drug users |
True |
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True or false? |
The rate of current illicit drug use among persons aged 12 or older in 2013 (9.4 percent) was similar to the rates in 2010 (8.9 percent) and 2012 (9.2 percent), but it was higher than the rates in 2002 to 2009 and in 2011 (ranging from 7.9 to 8.7 percent? |
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True or false? The percentage of persons aged 12 or older who used prescription-type psychotherapeutic drugs nonmedically in the past month in 2013 (2.5 percent) was similar to the percentages in 2010 to 2012 (ranging from 2.4 to 2.7 percent |
True |
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True or false? The number and percentage of past month methamphetamine users in 2013 (595,000 or 0.2 percent) were similar to those in 2012 (440,000 or 0.2 percent) and 2011 (439,000 or 0.2 percent), but they were higher than the estimates in 2010 (353,000 or 0.1 percent |
True |
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True or false? Among unemployed adults aged 18 or older in 2013, 18.2 percent were Of the 22.4 million current illicit drug users aged 18 or older in 2013,15.4 million (68.9 percent) were employed either full or part time |
True |
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True or false? Among persons aged 12 or older in 2012-2013 who used pain relievers nonmedically in the past 12 months, 53.0 percent got the drug they used most recently from a friend or relative for free, and 10.6 percent bought the drug from a friend or relative. Another 21.2 percent reported that they got the drug through a prescription from one doctor. An annual average of 4.3 percent got pain relievers from a drug dealer or other stranger, and 0.1 percent bought them on the Internet |
True |
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True or false? Slightly more than half (52.2 percent) of Americans aged 12 or older reported being current drinkers of alcohol in the 2013 survey, which was similar to the rate in 2012 (52.1 percent). This translates to an estimated 136.9 million current drinkers in 2013 |
True |
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True or false? In 2013, nearly one quarter (22.9 percent) of persons aged 12 or older were binge alcohol users in the past 30 days. This translates to about 60.1 million people. The rate in 2013 was similar to the estimate in 2012 (23.0 percent). Binge drinking is defined as having five or more drinks on the same occasion on at least 1 day in the 30 days prior to the survey |
True |
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True or false? In 2013, heavy drinking was reported by 6.3 percent of the population aged 12 or older. Heavy drinking is defined as binge drinking on at least 5 days in the past 30 days |
True |
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True or false? In 2013, an estimated 10.9 percent of persons aged 12 or older drove under the influence of alcohol at least once in the past year. This percentage was lower than in 2002 (14.2 percent), but it was similar to the rate in 2012 (11.2 percent). The rate was highest among persons aged 21 to 25 and persons aged 26 to 29 (19.7 and 20.7 percent, respectively). |
True |
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True or false? Underage binge and heavy drinking are declining? |
True: • Past month, binge, and heavy drinking rates among underage persons declined between 2002 and 2013. Past month alcohol use declined from 28.8 to 22.7 percent, binge drinking declined from 19.3 to 14.2 percent, and heavy drinking declined from 6.2 to 3.7 percent. |
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True or false? In 2013, 18% of adults tobacco users? |
False? 25.5 percent of the population in that age range. 21% smk cigs, 4.7 % cigars, 3.4% smk less tobacco, 0.9% pipes. |
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True or false? Youth smoking is increasing? |
False: The rate of past month tobacco use among 12 to 17 year olds declined from 15.2 percent in 2002 to 7.8 percent in 2013. |
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True or false? Teens who smoke are much more likely to use illicit substances |
Among youths aged 12 to 17 who smoked cigarettes in the past month, 53.9 percent also used an illicit drug compared with only 6.1 percent of youths who did not smoke cigarettes |
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True or false? Teens who smoke are much more likely to use illicit substances |
Among youths aged 12 to 17 who smoked cigarettes in the past month, 53.9 percent also used an illicit drug compared with only 6.1 percent of youths who did not smoke cigarettes |
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True or false? Prescription drugs are a common entry into drug abuse? |
True: In 2013, an estimated 2.8 million persons aged 12 or older used an illicit drug for the first time within the past 12 months. This averages to about 7,800 initiates per day and was similar to the estimate for 2012 (2.9 million). A majority of these past year illicit drug initiates reported that their first drug was marijuana (70.3 percent). About 1 in 5 initiated with nonmedical use of prescription drugs (20.6 percent, including 12.5 percent with pain relievers, 5.2 percent with tranquilizers, 2.7 percent with stimulants, and 0.2 percent with sedatives |
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True or false? About half of new smokers in 2013 were younger than 18 when they first smoked cigarettes (50.5 percent |
True |
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True or false? In 2013, an estimated 21.6 million persons aged 12 or older (8.2 percent) were classified with substance dependence or abuse in the past year based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). Of these, 2.6 million were classified with dependence or abuse of both alcohol and illicit drugs, 4.3 million had dependence or abuse of illicit drugs but not alcohol, and 14.7 million had dependence or abuse of alcohol but not illicit drugs |
True |
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What is the order of the top three most abused illicit substances? |
The specific illicit drugs with the largest numbers of persons with past year dependence or abuse in 2013 were marijuana (4.2 million), pain relievers (1.9 million), and cocaine (855,000) |
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Name this psychotherapy technique: anticipating likely problems and enhancing patients’ self-control by helping them develop effective coping strategies. Specific techniques include exploring the positive and negative consequences of continued drug use, self-monitoring to recognize cravings early and identify situations that might put one at risk for use, and developing strategies for coping with cravings and avoiding those high-risk situations. |
Cognitive based therapy (effective for most substances) |
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Name this substance abuse treatment approach: Patients attend one or two individual counseling sessions each week, where they focus on improving family relations, learn a variety of skills to minimize drug use, receive vocational counseling, and develop new recreational activities and social networks. Those who also abuse alcohol receive clinic-monitored disulfiram (Antabuse) therapy. Patients submit urine samples two or three times each week and receive vouchers for cocaine-negative samples. As in VBR, the value of the vouchers increases with consecutive clean samples, and the vouchers may be exchanged for retail goods that are consistent with a drug-free lifestyle |
Community Reinforcement Approach Plus Vouchers (effective for: Alcohol, Cocaine, Opioids) |
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Name this drug abuse counseling technique. a counseling approach that helps individuals resolve their ambivalence about engaging in treatment and stopping their drug use. This approach aims to evoke rapid and internally motivated change, rather than guide the patient stepwise through the recovery process. This therapy consists of an initial assessment battery session, followed by two to four individual treatment sessions with a therapist. In the first treatment session, the therapist provides feedback to the initial assessment, stimulating discussion about personal substance use and eliciting self-motivational statements. Motivational interviewing principles are used to strengthen motivation and build a plan for change. Coping strategies for high-risk situations are suggested and discussed with the patient. In subsequent sessions, the therapist monitors change, reviews cessation strategies being used, and continues to encourage commitment to change or sustained abstinence. Patients sometimes are encouraged to bring a significant other to sessions. |
Motivation enhancement therapy. Effective to keep pt enganged in treatment but not to help quit. |
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Name this substance abuse strategy: stimulant (e.g., methamphetamine and cocaine) abusers in treatment and helping them achieve abstinence. Patients learn about issues critical to addiction and relapse, receive direction and support from a trained therapist, and become familiar with self-help programs. Patients are monitored for drug use through urine testing. |
Matrix model (borrows heavily from other counseling techniques) |
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What are the essential tenets of a three step program? |
(1) acceptance, which includes the realization that drug addiction is a chronic, progressive disease over which one has no control, that life has become unmanageable because of drugs, that willpower alone is insufficient to overcome the problem, and that abstinence is the only alternative; (2) surrender, which involves giving oneself over to a higher power, accepting the fellowship and support structure of other recovering addicted individuals, and following the recovery activities laid out by the 12-step program; and (3) active involvement in 12-step meetings and related activities |
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Phase 1: PRECEED/PROCEED |
Community organizing theories and principles are relevant.
Community Organization: Community groups are helped to identify common problems or goals, mobilize resources, and develop and implement strategies for reaching those goals Community Mobilization: Community members define prevention needs (problem identification, needs assessment, program design) and obtain community program support |
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Phase 1: PRECEED/PROCEED |
Planners expand their understanding of the community with the following methods.
Social Assessment: The application of objective and subjective sources of information designed to expand the mutual understanding of people regarding their aspirations for the common good (Green and Kreuter, 2005, p.31). Concept Mapping: A structured group activity where participant generated ideas are subjected to quantitative analysis resulting in cluster maps. Final agreement is reached those maps that best reflect the participants' views. |
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Phase 2 (PRECEED/PROCEED) Epidemiological Assessment, Behavioral Determinants, and Environmental Determinants |
Epidemiological Assessment
Identifies the health problems, issues, or aspirations upon which the program will focus. Uncovers the behavioral and environmental factors most likely to influence the identified priority health issues. Translates priorities into measurable objectives for the program being developed (Green and Kreuter, 2005).
Behavioral Determinants
Behaviors or lifestyles that contribute to the occurrence and severity of a health problem. The behavior of others who can directly affect the behavior of the individuals at risk. The action of decision makers whose decisions affect the social or physical environment that influences the individuals at risk.
Environmental Determinants
Those social and physical factors external to the individual, often beyond his or her personal control, that can be modified to support the behavior or influence the health outcome.
At this phase in the program planning process, community organizing theories and principles are still relevant, as are interpersonal and individual theories of behavior change such as Social Cognitive Theory. |
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Phase 4, PRECEED/PROCEED: Administrative and Policy Assessment and Intervention Alignment |
The planner selects and aligns the program's components with priority determinants of change previously identified to discover resources, organizational barriers and facilitators, and policies needed for implementation and sustainability.
The planner must look at macro and micro levels of alignment between the assessment of determinants and the selection of interventions (Green and Kreuter, 2005, p.196)
Macro level - Consider the organizational and environmental systems that can affect the desired outcomes. Micro level - Focus on individual, peer, family, and others who can influence the intended audience's health behaviors more directly.
Methods for building a comprehensive program (Simons-Morton, Greene, and Gottlieb, 1995; D'Onofrio, 2001):
Matching the ecological levels to broad program components. Mapping specific interventions based on theory and prior research and practice to specific predisposing, enabling, and reinforcing factors. Pooling prior interventions and community-preferred interventions that might have less evidence to support them. Patching those interventions to fill gaps in the evidence-based best practices. The mapping of interventions to predisposing, reinforcing, and enabling factors is mainly influenced by community-level theories. |
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PRECEED/PROCEED Phases 5 to 8 - Implementation and Evaluation |
Data collection plans should be in place for evaluating the process, impact, and outcome of the program.
Process Evaluation: determines the extent to which the program was implemented according to protocol. Impact Evaluation: assesses change in predisposing, reinforcing, and enabling factors, as well as in the behavioral and environmental factors. Outcome Evaluation: determines the effect of the program on health and quality of life indicators. |
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What is the relationship between cigarette tax and youth smoking? |
For every ten percent increase in the price of a pack of cigarettes, youth smoking rates overall drop about seven percent |
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Phase 1: PRECEED/PROCEED |
Community organizing theories and principles are relevant.
Community Organization: Community groups are helped to identify common problems or goals, mobilize resources, and develop and implement strategies for reaching those goals Community Mobilization: Community members define prevention needs (problem identification, needs assessment, program design) and obtain community program support |
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Phase 1: PRECEED/PROCEED |
Planners expand their understanding of the community with the following methods.
Social Assessment: The application of objective and subjective sources of information designed to expand the mutual understanding of people regarding their aspirations for the common good (Green and Kreuter, 2005, p.31). Concept Mapping: A structured group activity where participant generated ideas are subjected to quantitative analysis resulting in cluster maps. Final agreement is reached those maps that best reflect the participants' views. |
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Phase 2 (PRECEED/PROCEED) Epidemiological Assessment, Behavioral Determinants, and Environmental Determinants |
Epidemiological Assessment
Identifies the health problems, issues, or aspirations upon which the program will focus. Uncovers the behavioral and environmental factors most likely to influence the identified priority health issues. Translates priorities into measurable objectives for the program being developed (Green and Kreuter, 2005).
Behavioral Determinants
Behaviors or lifestyles that contribute to the occurrence and severity of a health problem. The behavior of others who can directly affect the behavior of the individuals at risk. The action of decision makers whose decisions affect the social or physical environment that influences the individuals at risk.
Environmental Determinants
Those social and physical factors external to the individual, often beyond his or her personal control, that can be modified to support the behavior or influence the health outcome.
At this phase in the program planning process, community organizing theories and principles are still relevant, as are interpersonal and individual theories of behavior change such as Social Cognitive Theory. |
|
|
Phase 4, PRECEED/PROCEED: Administrative and Policy Assessment and Intervention Alignment |
The planner selects and aligns the program's components with priority determinants of change previously identified to discover resources, organizational barriers and facilitators, and policies needed for implementation and sustainability.
The planner must look at macro and micro levels of alignment between the assessment of determinants and the selection of interventions (Green and Kreuter, 2005, p.196)
Macro level - Consider the organizational and environmental systems that can affect the desired outcomes. Micro level - Focus on individual, peer, family, and others who can influence the intended audience's health behaviors more directly.
Methods for building a comprehensive program (Simons-Morton, Greene, and Gottlieb, 1995; D'Onofrio, 2001):
Matching the ecological levels to broad program components. Mapping specific interventions based on theory and prior research and practice to specific predisposing, enabling, and reinforcing factors. Pooling prior interventions and community-preferred interventions that might have less evidence to support them. Patching those interventions to fill gaps in the evidence-based best practices. The mapping of interventions to predisposing, reinforcing, and enabling factors is mainly influenced by community-level theories. |
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|
PRECEED/PROCEED Phases 5 to 8 - Implementation and Evaluation |
Data collection plans should be in place for evaluating the process, impact, and outcome of the program.
Process Evaluation: determines the extent to which the program was implemented according to protocol. Impact Evaluation: assesses change in predisposing, reinforcing, and enabling factors, as well as in the behavioral and environmental factors. Outcome Evaluation: determines the effect of the program on health and quality of life indicators. |
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What is the relationship between cigarette tax and youth smoking? |
For every ten percent increase in the price of a pack of cigarettes, youth smoking rates overall drop about seven percent |
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What is the genetic contribution (%) to anxiety and depression? |
30-40% |
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What is the genetic contribution (%) to substance abuse? |
%50-60 |
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What is the one year prevalence of any mental illness? |
1 in 5 |
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True or false: compared to women: men use substance earlier, more intensely, and more often than women. |
True. Except tobacco use is similar. Note that men commit suicide more often than women |
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True or false: substance abuse occurs later in AM and hispanics compared to whites? |
True |
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What is the IOM frame work for mental health? |
Universal screening-whole population Targeted screening composed of: *Selective: those with risk factors, e.g., childhood trauma *Indicated screening, e.g., those who have a subclinical disease, e.g symptoms but no DSM dx NB: Universal = primary prevention whereas targeted=secondary preventtion. |
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What are some screening test for alcohol abuse/dependance? |
CAGE Audit Mast (Michigan Alcoholism Screening test) 24 items RAPI, Rutgers Alcohol problem index. Used for consequences of drinking |
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What is the genetic contribution (%) to anxiety and depression? |
30-40% |
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|
What is the genetic contribution (%) to substance abuse? |
%50-60 |
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|
What is the one year prevalence of any mental illness? |
1 in 5 |
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|
True or false: compared to women: men use substance earlier, more intensely, and more often than women. |
True. Except tobacco use is similar. Note that men commit suicide more often than women |
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|
True or false: substance abuse occurs later in AM and hispanics compared to whites? |
True |
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What is the IOM frame work for mental health? |
Universal screening-whole population Targeted screening composed of: *Selective: those with risk factors, e.g., childhood trauma *Indicated screening, e.g., those who have a subclinical disease, e.g symptoms but no DSM dx NB: Universal = primary prevention whereas targeted=secondary preventtion. |
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What are some screening test for alcohol abuse/dependance? |
CAGE Audit Mast (Michigan Alcoholism Screening test) 24 items RAPI, Rutgers Alcohol problem index. Used for consequences of drinking |
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What are some screening test for illicit s abuse/dependance? |
DAST for those who are current users or at risk Addiction severity index (seven domains covering medical, employment, family/social, psychiatric Smoking: Fagerstons (6 items) and heaviness of smoking incidence |
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What is the genetic contribution (%) to anxiety and depression? |
30-40% |
|
|
What is the genetic contribution (%) to substance abuse? |
%50-60 |
|
|
What is the one year prevalence of any mental illness? |
1 in 5 |
|
|
True or false: compared to women: men use substance earlier, more intensely, and more often than women. |
True. Except tobacco use is similar. Note that men commit suicide more often than women |
|
|
True or false: substance abuse occurs later in AM and hispanics compared to whites? |
True |
|
|
What is the IOM frame work for mental health? |
Universal screening-whole population Targeted screening composed of: *Selective: those with risk factors, e.g., childhood trauma *Indicated screening, e.g., those who have a subclinical disease, e.g symptoms but no DSM dx NB: Universal = primary prevention whereas targeted=secondary preventtion. |
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What are some screening test for alcohol abuse/dependance? |
CAGE Audit Mast (Michigan Alcoholism Screening test) 24 items RAPI, Rutgers Alcohol problem index. Used for consequences of drinking |
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|
What are some screening test for illicit s abuse/dependance? |
DAST for those who are current users or at risk Addiction severity index (seven domains covering medical, employment, family/social, psychiatric Smoking: Fagerstons (6 items) and heaviness of smoking incidence |
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name a suicide screening test |
Depressive symptoms index suicidality. Score of 3 is posivite |
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What is the genetic contribution (%) to anxiety and depression? |
30-40% |
|
|
What is the genetic contribution (%) to substance abuse? |
%50-60 |
|
|
What is the one year prevalence of any mental illness? |
1 in 5 |
|
|
True or false: compared to women: men use substance earlier, more intensely, and more often than women. |
True. Except tobacco use is similar. Note that men commit suicide more often than women |
|
|
True or false: substance abuse occurs later in AM and hispanics compared to whites? |
True |
|
|
What is the IOM frame work for mental health? |
Universal screening-whole population Targeted screening composed of: *Selective: those with risk factors, e.g., childhood trauma *Indicated screening, e.g., those who have a subclinical disease, e.g symptoms but no DSM dx NB: Universal = primary prevention whereas targeted=secondary preventtion. |
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What are some screening test for alcohol abuse/dependance? |
CAGE Audit Mast (Michigan Alcoholism Screening test) 24 items RAPI, Rutgers Alcohol problem index. Used for consequences of drinking |
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|
What are some screening test for illicit s abuse/dependance? |
DAST for those who are current users or at risk Addiction severity index (seven domains covering medical, employment, family/social, psychiatric Smoking: Fagerstons (6 items) and heaviness of smoking incidence |
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name a suicide screening test |
Depressive symptoms index suicidality. Score of 3 is posivite |
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What interventions are effective and not effective for preventing drug use in school? |
school based programs that teach refusal skills Minimum drinking age (community guide (CG)) DARE program-ineffectivve |
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What is the genetic contribution (%) to anxiety and depression? |
30-40% |
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Effective suicide prevention interventions? |
Gate Keeper training (recognize warning signs) Hotlines and criss centers-inconclusive Post-suicide debriefing-could be harmful |
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What is the genetic contribution (%) to substance abuse? |
%50-60 |
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|
What is the one year prevalence of any mental illness? |
1 in 5 |
|
|
True or false: compared to women: men use substance earlier, more intensely, and more often than women. |
True. Except tobacco use is similar. Note that men commit suicide more often than women |
|
|
True or false: substance abuse occurs later in AM and hispanics compared to whites? |
True |
|
|
What is the IOM frame work for mental health? |
Universal screening-whole population Targeted screening composed of: *Selective: those with risk factors, e.g., childhood trauma *Indicated screening, e.g., those who have a subclinical disease, e.g symptoms but no DSM dx NB: Universal = primary prevention whereas targeted=secondary preventtion. |
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What are some screening test for alcohol abuse/dependance? |
CAGE Audit Mast (Michigan Alcoholism Screening test) 24 items RAPI, Rutgers Alcohol problem index. Used for consequences of drinking |
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|
What are some screening test for illicit s abuse/dependance? |
DAST for those who are current users or at risk Addiction severity index (seven domains covering medical, employment, family/social, psychiatric Smoking: Fagerstons (6 items) and heaviness of smoking incidence |
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name a suicide screening test |
Depressive symptoms index suicidality. Score of 3 is posivite |
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What interventions are effective and not effective for preventing drug use in school? |
school based programs that teach refusal skills Minimum drinking age (community guide (CG)) DARE program-ineffectivve |
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What is the genetic contribution (%) to anxiety and depression? |
30-40% |
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Effective suicide prevention interventions? |
Gate Keeper training (recognize warning signs) Hotlines and criss centers-inconclusive Post-suicide debriefing-could be harmful |
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What is CBT and what are some benefits? |
Restructure malaadapative cognitions. Identify triggers and learn how to cope with triggers. May involve exposure. Effective; decrease substance abuse after 1 year; for anxiety, more effective than pharmacotherapy for symptoms and preventing relapses; effective for PTSD Combing CBT + Pills for substance is no better than mono therapy and offers no advantage Adding CBT to SSRI rx slightly offsets increase risk of suicide. |
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Drugs used for ETOH abuse? |
*Naltrexone: opiate antagonist, discourages drinking *Acamprostate: modulates glutamee recepter activity; reduces distress w/t withdrawl; promotes maintenance of abstaince *Buprenorphine: partial opioid aganonist; lowers isk of overdose compared to methodone *Naltrexone: opiod antagonist; used for reversal; pt must be detoxified before giving |
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What is the genetic contribution (%) to substance abuse? |
%50-60 |
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|
What is the one year prevalence of any mental illness? |
1 in 5 |
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|
True or false: compared to women: men use substance earlier, more intensely, and more often than women. |
True. Except tobacco use is similar. Note that men commit suicide more often than women |
|
|
True or false: substance abuse occurs later in AM and hispanics compared to whites? |
True |
|
|
What is the IOM frame work for mental health? |
Universal screening-whole population Targeted screening composed of: *Selective: those with risk factors, e.g., childhood trauma *Indicated screening, e.g., those who have a subclinical disease, e.g symptoms but no DSM dx NB: Universal = primary prevention whereas targeted=secondary preventtion. |
|
|
What are some screening test for alcohol abuse/dependance? |
CAGE Audit Mast (Michigan Alcoholism Screening test) 24 items RAPI, Rutgers Alcohol problem index. Used for consequences of drinking |
|
|
What are some screening test for illicit s abuse/dependance? |
DAST for those who are current users or at risk Addiction severity index (seven domains covering medical, employment, family/social, psychiatric Smoking: Fagerstons (6 items) and heaviness of smoking incidence |
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|
name a suicide screening test |
Depressive symptoms index suicidality. Score of 3 is posivite |
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|
What interventions are effective and not effective for preventing drug use in school? |
school based programs that teach refusal skills Minimum drinking age (community guide (CG)) DARE program-ineffectivve |
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True or false: The majority of USPSTF recommendations focus on behavioral modification |
True |
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Which of the following best describes the factors involved in the Health Belief Model A) Perceived barriers to and benefits of action Correct answerB) Perceived barriers to and benefits of action, self-efficacy, and cues to action C) Perceived barriers to action, self-efficacy, and cues to action D) Perceived self-efficacy and cues to action |
Answer : B. The Health Belief Model incorporates six key constructs in behavior change: perceived susceptibility (subjective perception of risk of contracting disease), perceived severity (feelings about the seriousness of getting the disease--or leaving it untreated), perceived benefit (beliefs about the effectiveness of options available to reduce the disease threat), perceived barriers (negative aspects of a health action that impede adopting the recommended behavior changes), cues to action (events or stimuli to “trigger” one’s “readiness” to change), and self-efficacy (confidence in one’s ability to take action and succeed |
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What percent of the National Survey of Drug Use and Health respondents are current binge drinkers? A) 7% Correct answerB) 23% C) 44% D) 57% |
Answer : B. 23% of those responding to the survey reported binge drinking, defined as having 5 or more drinks on one occasion. 46% of adults >21 years reported drinking no alcohol, 26% report drinking less than 1 drink per week, 13% report having approx. 1 drink/day, 9% approx. 2 drinks/day and 6% report drinking more than 2 drinks/day. |
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All of the following have been shown to be effective strategies for reducing risky alcohol drinking EXCEPT: A) Alcohol pricing and taxation Missed correct answerB) Controls on media advertising Incorrect answerC) Health warning labels on packaging of alcohol products D) Penalties for drinking and driving |
Answer: B. Alcohol pricing and taxation, health warnings on alcohol product packaging, and penalties for drinking and driving have been shown to reduce alcohol drinking Community guide recommends: dram shop liability, electronic screening and brief intervention, inc etoh tax, limit days and hrs of sale, privatization of ETOH sales, Reg ETOH outlet density, enhanced enforcement of sales to minors, Insufficient: overservice law enforcement initiatives (Overservice law enforcement initiatives are proactive community efforts to increase the enforcement of laws that prohibit the service of alcoholic beverages to intoxicated customers. Alcohol Beverage Control personnel or plainclothes or uniformed police carry out enforcement, which may include fines or licensing actions) responsible beverage training |
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37. Which of the following models of health behavior includes belief about whether influential others approve or disapprove of the behavioral change being considered A) Health Belief Model B) Social Learning Theory Correct answerC) Theory of Reasoned Action D) Transtheoretical Model |
Answer: C. The Theory of Reasoned Action emphasizes a person’s behavioral intention. Behavioral intention is determined by positive or negative attitudes towards performing the behavior and one’s normative beliefs about whether influential others approve or disapprove of performing the behavior. The Health Belief Model incorporates several key constructs in behavior change: one’s perception of barriers to and benefits of taking an action, level of self-efficacy to conduct the action, and cues to action. The Social Learning Theory says that behavior is explained in terms of a dynamic interaction of personal, environmental and behavior influences (reciprocal determinism). People learn not only via their own interactions with the environment, but from observing others (observational learning). The other constructs in this theory include behavioral capability, expectations, and self-reinforcement. The Transtheoretical Model addresses the stages of behavior change: pre-contemplation, contemplation, preparation, action, maintenance, and termination. |
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In applying the Stages of Change Model to smoking cessation, which of the following actions would be most appropriate for smokers in the preparation phase A) Discussing health risks of smoking B) Personalizing health risks/benefits C) Prescribing medication Correct answerD) Setting a quit date |
Answer: D. For the precontemplation stage, the appropriate action is discussing the risks of an unhealthy behavior. For the contemplation stage, the appropriate response is to offer personalized assessment of the patient’s risk. For the preparation stage, patients are ready to develop an action plan. Specifically for smoking cessation, the action plan should include a quit date. During preparation they also need additional information and resources to assist them in making the change. For the action and maintenance stages, encouragement for sustaining the behavior is appropriate, as well as relapse prevention planning. |
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Which of the following is NOT a part of Rothman’s typology of community organization A) Locality Development Correct answerB) Locus of Control C) Social Action D) Social Planning |
Answer: B. The Rothman typology incorporates social planning, social action and locality development. Rothman identifies a category of community practice which he calls social action which organizes groups of people to influence political processes. These actions are designed to change the balance of power between one group and their opposition. Social planning refers to the role that policy planners and analysts play in social change. Locality development describes community development in which residents develop and manage social and physical service delivery within their own community. According to Rothman, locality development also includes the repair of social relations and the development of consensus-building decision- making processes |
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Which of the following DSM-IV disorders has the highest lifetime prevalence in the United States Correct answerA) Anxiety Disorders B) Depression/Mood Disorders C) Impulse Control Disorders D) Substance Abuse Disorders |
Answer: A. According to the National Comorbidity Survey Replication, which is conducted via face-to-face household interviews of US adults over the age of 18, 28.8% will meet criteria for anxiety disorders, 20.8% for depression/mood disorders, 24.8% for impulse control disorders, and 14.6% for substance use disorders during their lifetime |
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Key tenets of organizational development? |
1. Organizational climate: leadership, openness of communication, leader support, leader control 2. Organization culture: norms, beliefs, assumptions, artifacts 3. Organizational strategies: *Action planning (see if feasible to implement), *Implement *Evaluation |
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What is the organization stage theory? |
After stages are recognized, steps to promote change can be matached to various points in the process Adoption of innovation in an organization goes through several stages: 1. Awareness of a problem and possible solution 2. Decision to adopt innovation 3. Implementation that includes redefining the innovation and modifying the organization to accomodate it 3) institutionalization of the innovation |
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Calorie recommendations for weightloss? |
Not less than 800 cals WomenL 1,000-1,200 Men: 1,200-1,600 |
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Community Guide recommends which of the following intervetions for obesity prevention (more than can true) A) reduced screen time B) Worksite programs C) Technology supported counselling/coaching D) School based programs E) Provider based programs |
A-C are recommended. D-E are insufficient evidence |
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Community Guide recommends which of the following intervetions for obesity prevention (more than can true) A) reduced screen time B) Worksite programs C) Technology supported counselling/coaching D) School based programs E) Provider based programs |
A-C are recommended. D-E are insufficient evidence |
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The community guide recommends all of the following EXCEPT for increasing physical activity (more than one may be false) A) Enhanced school based PE B) College based PE and edu C)Community wide campaigns E) Travel and transportation policies encouraging walking and bicycling |
B and E have insufficient evidence. A, C, D are recommended as well as sign prompts to take the stairs |
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What are the four fundamental indicators in healthy people 2020? |
General health status Health related quality of life and well being Disparities Determinates of health |
