Understanding ecological models - Assignment Example

HPRM3000: Portfolio Task 2 - Understanding Ecological Models 1. The ecological perpsective of health promotion is an approach that recognizes the interconnectedness of people with their physical and socio-cultural environments. 2.Ecological approaches are so effective because they involve the most factors and determinants of health. For example, anti-smoking campaigns aimed at teens in South African found that teen smoking rates were linked with a lack of recreational facilities and whether or not the teen's parents smoked. 2 3. Limitations of the ecological approach include: -Difficult to implement multi-level approaches (Salis & Owen, 369) -Health care professionals unfamilar with these - usually just individual approaches. -large amounts of enegry, creativity, and patience. -Challenging and expensive to changealready built enviornments, especially if those environments (i.e. buildings) are privately owned. -"Operationalizing the general princiapls of evological models for specific behaviours is a challenging but essential step." 4. The purpose of the paper by Elder et. Al (2007) is: to describe a framwork that would be used to guide an individual study. 5. The integration of a wide number of contributing theories into Elder et. al's ecological framework is valuable because Gathers a wider range and depth of knowledge to the framework. "Theories that helped guide and inform the TAAG SE model are operant conditioning, social cognitive theory (SCT) and organizational change theory, including diffusion of innovations. These theories are incorporated into the TAAG model (see Fig. 1), which serves to put all relevant theories into a unified whole. The model, then, informs the intervention development by providing its theoretical grounding." 6. Sallis and Owen (2002; p468) the components of the TAAG model fulfill the "principles of ecological approaches to health behaviour change" to the extent that contributing theories such as social cognative theory and organizational change theory are included within the model. HPRM3000: Portfolio Task 3 Health Priorities and the Importance of Populations 1. This kind of research so important for health promotion because demographic, and distribution information on health matters is vital for informed health policy creation and implementation. 2. The description, strengths and weaknesses of the DALY are: "Health loss expressed as disability-adjusted life years (DALYs) and presented as proportions of total DALYs and DALY rates (crude and agestandardised) per 1000 population." " One DALY is equivalent to one lost year of healthy life and represents the gap between current health status and an ideal situation" Links to a format used by The World Bank (allows for ease of international comparision of data). A disadvantage is that it is a "created" and not a "real" mesaurement. ii) In Australia, the progressive increase in body mass is strongly associated with an increase in Type II Diabetes. As these connected risk factors and issues have been getting worse, instead of better, new more effective strageties are required. Two other areas: women's mental health and Aboriginal peoples (especially those in the NT) require immediate, planned progressive health promotion action. 7. a) Stephen R Leeder, Susan U Raymond and Henry M Greenberg Poverty and Human Development The need for leadership in global health. The Medical Journal of Australia. MJA 2007; 187 (9): 532-535 b) Global Leadership in health is present in Australia. This has resulted in deeper and more informed ecological health policies that have lead to concrete action to prevent futher diseases from global climate change. (This is a topic that is just now recieving global attention as a health issue.) 8. International Health Risks In the early 1980s, London School of Tropical Medicine and Hygiene epidemiologist Geoffrey Rose suggested another reason why the intrapopulation studies might fail to detect benefits of salt reduction that could still have a significant public health impact. Rose speculated that if the entire developed world consumed too much salt, as ecologic studies suggested, then epidemiology would never be able to link salt to hypertension, regardless of how causal the relationship. Imagine, he wrote, if everyone smoked a pack of cigarettes daily; then any intrapopulation study "would lead us to conclude that lung cancer was a genetic disease ... since if everyone is exposed to the necessary agent, then the distribution of cases is wholly determined by individual susceptibility." Thus, as with salt and high blood pressure, the clues would have to be "sought from differences between populations or from changes within populations over time." By the same logic, cutting salt consumption a small amount might have little effect on a single individual--just as going from 20 cigarettes to 19 would--but a major impact on mortality across an entire population. 9.Rose G (1985). Sick individuals and sick populations. International Journal of Epidemiology, 14 (1), 32-38. Rose define "epidemiology" "Epidemiology is often defined in terms of study of the derminants of the distrubution of the disease; but we should not forget that the more widespread is a particular cause, the less it explains the distrubution of cases. The hardest cause to identify is the one that is universally present, for then it has no influence on the distrbution of the disease." 10. Exposure to health determinants depends on age, ethnicity, geographic and SES factors. For example the higher DALY rates in the NT - aboriginal people = high concentration. Gender is factor 11. The "High Risk" stragety is one where individuals are tested (screened)to determine if they are at high risk for one or more diseases. The focus in on the individual and not the population. Advantages include: interventions geared to the individual, both patient and doctor motivation, cost-effective use of limited resources and a high benfit to risk ratio. Disadvantages include: costs and challenges of screening, results are temporary and palliative, limited potential, and inappropriate for behaviour. 12. The population stragety is one that attempts to change the typical behaviour of a society or population. Advantages include:radical approach and results, appropriate to cehaviour and "large potential for population" scale. HPRM3000: Portfolio Task 4 Risks and Determinants of Health Behaviour Criticisms of the Ecological Perspective: Pg 1 Improving motivation to change "It's not my fault. It's just where I live/work" attitude. Pg 2 Improving opportunities to change A large amount of resources are required to change the environment so an individual's or a group's health behaviour may change. Pg 3 Improving ability to change The ability for an individual to change rests in their community and not within themselves. The subtitle of the article - "Carrots, sticks and promises" means Carrots represent rewards, sticks represent negative outcomes (such as cancer), and promises stands for the promise that the ecological perspective has to transform health care and health behaviours. HPRM3000: Portfolio Task 5 Individual 1 & 2)The individual approach to health promotion entails the individual developing and practicing healthy lifestyle practices. Such practices can include regular exercise, healthy eating, not smoking (or quitting smoking) and stress management.The individual approach is not as effective as the population and the ecological approach. The ecological approach takes more factors into account when explaining and desiging interventions for poor health practices. For example, if the goal is to decrease and eliminate ciggarette smoking, an individual approach would just focus on the individual and might include patches, gum, counselling, and behaviour modification. The ecological approach would work on sociocultural factors such as tobacco advertizing, and changing tobacco smoking into a socially unacceptable behaviour. 3&4)Patient education is important, because understanding is the key to implementing and maintaining healtly living practices (including taking medication correctly). A (true) example of a lack of patient education is a teenage girl who was not told to take her newly perscribed birth control pills in order. As the pills were in several colours (one for each week), the girl took what ever colour she felt like taking that day. The result was a great decline in the effectiveness of the pills and a mood swings and pain. The goal of perscribing the BC Pill to this newly sexually active teenager was to prevent pregnancy. The lack of effective patient education, not only ment that this goal was not effectively met, but the patient developed other health complications. 5) A family doctor's office is a common primary care facility. The strengths that this setting has in providing health education is the often long term relationship that doctors and their staff have with patients. The setting is limited from prodiving effective health education as such offices are frequently very busy, and thus do not have the time to spend with each patient. 6)Strategies for stopping Smoking http://www.quitcoach.org.au/Portals/2/docs/additionalresources/AS5.pdf This phamplet covers three strageties for stoppign smoking: quitting abruptly, continual postponement, and cutting down. It's strengths are the well organized relevant information. It's negatives are the emphasis on text and lack of cultural relevance factors (i.e. Aboriginal smokers, or smokers with low litteracy skills would be unlikely to derive maximum benefit from this resource.) 7) An individual approach to health promotion would be useful in my chosen career with children and youth as it teaches individual responsibility. HPRM 3000: Portfolio Tasks (Week's 7 and 8) Population Approaches: The Environment and Social Marketing/Mass Media 1. Population approaches are trying to achieve an overall healthier environment, though behaviour, environmental, and sociocultural methods. 2. Environmental change involves real, planned systematic changes in a subject's or group's environment that are designed to have a positive impact on health. Such changes could include: planting a community garden, having a drop-in "Early Years" centre for parents with infants and preschoolers, and installing brighter "vandalism resistant" street lighting in higher crime areas. They also include: Changes in public policy & legislation, Technological interventions, and Incentives/disincentives. 3-4The environmental approach has been applied in order to increase the physical fitness level of the general public by: having public advertising campaigns designed to improve the social view of exercise, by having inexpensive public recreational facilities, and by the improvement of technology in athletic equipement breaking down barriers to physical activity (such as sports specific wheel chairs, and a wide variety of athletic shoes for all sorts of injuries and conditions). 3. 5-8Social Marketing is the practice of applying traditional marketing concepts and practices in order to achieve some social common good. It can be part of a well planned health promotion stratgey. Some components include: "positioning, segmentation, creative strategy, message design and testing, media strategy and planning, and effective tracking"3 . The "five-Ps" of traditional marketing (which are also applied to social marketing) are: product, price, promotion, positioning, and place. HPRM 3000: Portfolio Tasks (Week's 9 and 10) 1.1."the process of enabling people to increase control over, and to improve, their health" (Ottawa Charter for Health Promotion, 1986). 2.1. Key Milestones in Health Promotion include: "The Lalonde Report: New Perspective on the Health of Canadians The Epp Report: Achieving Health for All: A Framework for Health Promotion The Ottawa Charter Knowledge Development for Health Promotion: A Call for Action The National Forum on Health" http://www.hc-sc.gc.ca/ewh-semt/pubs/occup-travail/healthy-settings_cadres-sains/intro_e.html 3.2 National public health priorities in Australia include: Strengthen communities and build social capital through consultation, participation and empowerment Promote, develop, support and initiate actions which ensure safe and healthy environment Promote, develop and support growth and development through all life stages Promote, develop and support actions to improve the health status of Aboriginal and Torres Strait Islander people and other vulnerable groups health.osf.lt/downloads/news/Sumskas-Kiev1-2004.ppt 4.3 Advantages of the individual approach: -It can be customized and tailored to an individual's needs. -rewarding for the health care professional as the development of one person is easy to see compared to a large group. -Client is empowered to make a difference in their own lives. -Less costly (in the short and medium term) than approaches involving groups (such as the ecological approach). 4.5 The population strategy approach: Positives: Radical Large impact potential Is geared appropriately to current behaviours Negatives: Individual receives small relative benefit Both participant and health professional have low motivation Low Benefit to risk ratio. 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