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Public Health Exam 2

Terms in this set (36)

Primary Prevention
Interventions are conducted to prevent development of disease or injury in those who are currently healthy (Vax admin)
Secondary Prevention
interventions include those aimed at early detection and initiation of treatment for disease, this reducing disease associated morbidity and mortality (breast, cervical, prostate screening)
Tertiary prevention
prevention of disability and premature death and when indicated, the initiation of rehab for those diagnosed with disease. Helping clients navigate their chronic disease. (You have a heart attack, let's get you into cardiac rehab)
Social Marketing
The intervention use to influence knowledge, attitudes, values, beliefs, behaviors, and practices of a community. (Ads, billboards, etc.)
Upstream approach
focuses on eliminating the factors that increase risk to a population's health (like SDoH)

Ex: obesity- restricting TV ad's for childrens foods, creating national nutrition standards for meals served in schools)

Includes determinants of health
Downstream approach
represents actions taken after disease or injury has occurred

Ex: obesity- nutritional health teaching based on nutritional patterns, portions, and choice within an individual who is already obese or to prevent their obesity

More individual level behavioral approaches for prevention and disease management
Phases of Epidemiology
Sanitary: cleanliness
Infectious: illness only caused by pathogens
Risk factor phase: where we are now, we understand that illness is not only pathogen related but also involves a person's risk factors, and is more all encompassing
Epi Framework: Epidemiological triangle
Agent, host, and environment
Epi Framework: Epidemiologic constants
Person, place and time
Web of Causation
illustrates the complexity of the multiple factors of illness/disease, which is caused by multiple causes and affected by the complex interaction between biological and socio-behavioral determinants of health. Take into account the multiple risk factors of disease.
Prevalence
statistic that describes the probability that someone selected at random from the population will have a disease of condition. (# of of sick/total # of at risk population})
Incidence
number of new cases of a disease of illness at a specific time or over a specific period of time
Odds/risk ratio
The statistic that describes the excess in risk associated with an exposure in relative terms. When the value is 1, there is no association, and no associated risk.
Prevalence pot
Depicts total number of current cases. Way of depicting the total number of cases of a disease at all stages of the disease in a population, and takes into account issues related to duration of the disease and the incidence of the disease.
Surveillance
Establishes expected levels of disease and illness in a population. We want to know if there is a rise in numbers. It also includes the collection, analysis and dissemination of information to help guide public health decision making ( to help on a larger scale, no the individual person)
Screening

How to screen for alcohol use disorder?
Want to identify those with the disease and those who are at risk for developing it. Screen for quantity, frequency, duration, and pattern of use.

Alcohol use disorder screening: We can review alcohol-related injury admissions, check the current screening system for successes and flaws, review current screening techniques used in other hospitals

●Evaluation of screening
○Reliability
○Feasibility
○Validity, which encompasses:
■Sensitivity: probability to test + when truly affected
●Low sensitivity = many false negatives
■Specificity: probability to test - among truly unaffected
●Low specificity = many false positives
Modes of transmission
Vertical: parent to offspring
Horizontal: person to person
- Direct: skin to skin contact
- Indirect: shared objects, common vehicle, vector borne
Know what is and isn't included in the chain of infection
Infectious agent, Reservoir, Portal of Exit, Mode of transmission, Portal of Entry, Susceptible Host
Genomics
The field of genetic epidemiology that seeks to understand the inheritability of factors that have an impact on the development of illness is called
GINA (Genetic Information Nondiscrimination Act)
prohibits covered employers from firing, refusing to hire, or otherwise discriminating against individuals on the basis of their genetic information, and from discriminating against employees and applicants on the basis of a family member's genetic information. Protects against health insurance and employment discrimination
Health literacy
is the capacity to obtain, process and understand basic health information and services, and to make appropriate health care decisions based on information provided, as well as the ability to access/navigate the healthcare system
Best way to asses a patient's health literacy?
How confident are you at filling out medical forms?
Education strategies
Teach back method, return demonstration, be direct and concrete
Chronic Care Model
Focuses on long term treatment of a chronic disease.

Hale: average number of years that person can expect to live in good health by adjusting for disease and/or injury

Daly: a measurement of the gap that exists between the ideal health status of a disease- and disability- free population that lives to an advanced age

Chronic disease is usually d/t modifiable risk factors
National Prevention Council
authorized by ACA with goal of keeping every american healthy at every stage of life, has these goals.
- Build healthy and safe community
- Expanding quality preventative services in both clinical and community settings
- Empowering people to make healthy choices
- Eliminating health disparities
Harm Reduction
The harm reduction approach to alcohol, tobacco, and other drug problems focuses on health promotion and disease prevention. Primary prevention for SUD problems includes the promotion of healthy lifestyles and resiliency factors, and education about drugs and guidelines for their use. Nurses are ideally prepared to use health promotion strategies such as encouraging healthy alternatives to indiscriminate, careless, and often dangerous drug use practices and providing education about drugs to decrease harm from irresponsible or unsafe drug use.
The number of new cases that occur within a specific population within a defined time interval is:
A. Point Prevalence
B. Incidence
C. Period prevalence
D. Lifetime Prevalence
B. Incidence
A systematic method for continuous monitoring of diseases in a population, in order to be able to detect changes in disease patterns and then to control them is:
A. Conditional probability

B. Screening

C. Prevalence

D. Surveillance
D. Surveillance
A nurse is concerned about the accuracy of the PPD test in identifying cases of TB exposure for follow-up chest x-ray. The nurse's concern is addressing the validity measure of:
A.reliability.
B.sensitivity
.C.specificity.
D.variation.
B. Sensitivity
Nurses in community health often use epidemiology because in the community it is often difficult to control the environment. Which of the following statements demonstrates an epidemiologic strategy for monitoring disease trends?

A. A nurse in community health conducts an education class for clients newly diagnosed with diabetes.

B. A nurse in community health investigates a breakout of whooping cough in a local middle school

.C. A nurse in community health organizes a health fair at the community health center.

D. A nurse in community health participates on a county school board that addresses student health issues.
B. A nurse in community health investigates a breakout of whooping cough in a local middle school
Disease prevention activities protect people from disease and the effects of disease. An example of primary disease prevention is:

A. teaching people with diabetes how to prevent complications.

B. administering vaccines to children before kindergarten.

C. checking the skin of farm workers for signs of skin cancer.

D. identifying and testing individuals exposed to someone with tuberculosis.
B. administering vaccines to children before kindergarten.
A home health nurse is charged with identifying opportunities for health promotion and illness primary prevention. The activity that demonstrate this focus is:

a. collaborating with the chaplain to address the spiritual needs of a hospice patient.

b. educating a school nurse on the care regime of a returning student newly diagnosed with asthma.

c. referring a newly diagnosed diabetic patient to the nutritionist for dietary teaching.

d. tracking the immunization status of patients.
d. tracking the immunization status of patients.

Immunizations prevent disease, a function of primary prevention. Patients requiring home health care may be more at risk of complications of diseases like influenza and pneumonia. Keeping immunizations current is a critical aspect of health promotion and illness primary prevention for these patients. Home health nursing involves the same primary prevention focus in the care of aggregates as does other community-oriented nursing. It also requires a focus on secondary and tertiary prevention in the care of individuals in collaboration with the family and other caregivers.
Name the level of prevention.

a.Childhood immunizations.

b.Self empowerment after an HIV/AIDs diagnosis

c.General health promotion education, i.e., seat belts.

d.BSE, TSE, mammography, colonoscopy.

e.Physical therapy after a stroke
A.Primary
B.Tertiary
C.primary
D.Secondary
E.Tertiary
Sputum examination is the major screening tool for pulmonary tuberculosis. Clients would sometimes get false negative results in this exam. This means that the test is not perfect in terms of which characteristic of a diagnostic examination?

A. Effectiveness
B. Efficacy
C. Specificity
D. Sensitivity
D. Sensitivity

Sensitivity is the capacity of a diagnostic examination to detect cases of the disease. If a test is 100% sensitive, all the cases tested will have a positive result, i.e., there will be no false negative results
A student athlete receives a screening examination before being active in school sports. Which of the following levels of prevention is being used?

a. Health prevention

b. Primary prevention

c. Secondary prevention

d. Tertiary prevention
C. Secondary prevention

Screening, because it may result in early diagnosis and treatment, is secondary prevention. Primary prevention refers to interventions that occur before the disease develops. Tertiary prevention focuses on limitation of disability and the rehabilitation of those with irreversible disease. Health prevention is not considered to be a level of prevention.
Which of the following best describes the advantage of the web of causation model in comparison with the epidemiological triangle model?

a. The web of causation model is easier to understand and use

b. The web of causation model is more widely known and publicized.

c. The web of causation model is more recent and current.

d. The web of causation model shows the relationships among variables.
D. The web of causation model shows the relationships among variables.

Although it is a more recently created model, the web of causation model is more useful because it illustrates the complexity of relationships among causable variables. It is not easier to understand and use as it has more variables than the three (agent, host, and environment) in the epidemiological model.
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