Con ten ts
01 1 - Introduction
02 Upstream determinants of lifestyle behaviors and chronic disease risk
03 Hearing impairments
04 Community action
05 Evaluation of health intervention programs
06 Quality of life
07 Green spaces
08 Sample size calculations and RCT
09 Economic evaluation
10 Implementation
11 Ethics
clinical immunology · study summary
, lecture 01
1 - Intr oduction
Health promotion & disease prevention
Example Case: VU Health Pack
Employees receive a step counter, fat-percentage calculator, and BP monitor.
Is this a health intervention program?
Is it theory- and evidence-based?
What is the population (VU staff)?
What is the setting (workplace/university)?
How to determine effect? → focus on the dependent variable (Y-axis).
Define primary (most important dependent outcome) and secondary outcomes before evaluating.
Key takeaway: every intervention requires a clearly defined target population, setting, dependent variable
(outcome), and evaluation method.
Types of prevention
Primary; prevent (the development) of disease.
E.g. seatbelt use, helmet, folic acid supplementation.
Secondary; screening of disease / early detection.
E.g. breast cancer screening, heel prick test.
Tertiary; prevent/reduce the seriousness or complications of diseases
E.g. everything a physiotherapist does.
Palliative care; end of life care, to relieve pain, mostly for terminally ill people.
E.g. hospice care.
Universal, Selective, and Indicated Prevention
Universal prevention = designed to reach the entire population, without regard to individual risk factors and are
intended to reach a very large audience.
Selective prevention = target subgroups of the general population that are determined to be at risk for a
disease. Subgroups may be distinguished by traits such as age, gender, family history, or economic status.
Indicated prevention = aims to identify individuals who exhibit early signs of a disease and other related
problem behaviors associated with a health problem and target them with special programs.
Levels of intervention
Societal; e.g. national tax on sugary drinks, anti-smoking laws.
Community; e.g. neighborhood exercise program.
Organization; e.g. workplace health policy (VU example).
Interpersonal; e.g. family or peer-group sessions.
Individual; e.g. personal coaching or counseling
The broader your level, the more precisely you must define the outcome.
Tools or instruments
Education: brochures, leaflets, websites, campaigns.
Facilities: providing means to act healthy (e.g. bicycle lanes, gyms).
Legislation/Law: bans, safety laws, smoking restrictions (needs enforcement).
Prizing: taxes on tobacco/alcohol, subsidies for healthy food.
Health behaviors
clinical immunology · study summary
, Many health problems are related to lifestyle factors, such as CVD, obesity, DT2, etc. Acronym for main modifiable
health behaviors:
Bewegen – physical activity
Roken – smoking
Alcohol – alcohol use
Voeding – nutrition
Veilig vrijen – safe sex
Ontspanning – stress/relaxation
Health behavior determinants
Behavior is not a simple “choice” — influenced by:
Perceived severity / risk perception
Attitude
Social influence
Self-efficacy (confidence in ability)
Habits
Definitions
Health promotion = maintain people’s current health status and ideally a shift towards better health.
Disease prevention = To prevent people getting a disease and prevent a shift
towards the seriousness of a disease.
Want to focus on health promotion, which has an effect on disease prevention.
clinical immunology · study summary
01 1 - Introduction
02 Upstream determinants of lifestyle behaviors and chronic disease risk
03 Hearing impairments
04 Community action
05 Evaluation of health intervention programs
06 Quality of life
07 Green spaces
08 Sample size calculations and RCT
09 Economic evaluation
10 Implementation
11 Ethics
clinical immunology · study summary
, lecture 01
1 - Intr oduction
Health promotion & disease prevention
Example Case: VU Health Pack
Employees receive a step counter, fat-percentage calculator, and BP monitor.
Is this a health intervention program?
Is it theory- and evidence-based?
What is the population (VU staff)?
What is the setting (workplace/university)?
How to determine effect? → focus on the dependent variable (Y-axis).
Define primary (most important dependent outcome) and secondary outcomes before evaluating.
Key takeaway: every intervention requires a clearly defined target population, setting, dependent variable
(outcome), and evaluation method.
Types of prevention
Primary; prevent (the development) of disease.
E.g. seatbelt use, helmet, folic acid supplementation.
Secondary; screening of disease / early detection.
E.g. breast cancer screening, heel prick test.
Tertiary; prevent/reduce the seriousness or complications of diseases
E.g. everything a physiotherapist does.
Palliative care; end of life care, to relieve pain, mostly for terminally ill people.
E.g. hospice care.
Universal, Selective, and Indicated Prevention
Universal prevention = designed to reach the entire population, without regard to individual risk factors and are
intended to reach a very large audience.
Selective prevention = target subgroups of the general population that are determined to be at risk for a
disease. Subgroups may be distinguished by traits such as age, gender, family history, or economic status.
Indicated prevention = aims to identify individuals who exhibit early signs of a disease and other related
problem behaviors associated with a health problem and target them with special programs.
Levels of intervention
Societal; e.g. national tax on sugary drinks, anti-smoking laws.
Community; e.g. neighborhood exercise program.
Organization; e.g. workplace health policy (VU example).
Interpersonal; e.g. family or peer-group sessions.
Individual; e.g. personal coaching or counseling
The broader your level, the more precisely you must define the outcome.
Tools or instruments
Education: brochures, leaflets, websites, campaigns.
Facilities: providing means to act healthy (e.g. bicycle lanes, gyms).
Legislation/Law: bans, safety laws, smoking restrictions (needs enforcement).
Prizing: taxes on tobacco/alcohol, subsidies for healthy food.
Health behaviors
clinical immunology · study summary
, Many health problems are related to lifestyle factors, such as CVD, obesity, DT2, etc. Acronym for main modifiable
health behaviors:
Bewegen – physical activity
Roken – smoking
Alcohol – alcohol use
Voeding – nutrition
Veilig vrijen – safe sex
Ontspanning – stress/relaxation
Health behavior determinants
Behavior is not a simple “choice” — influenced by:
Perceived severity / risk perception
Attitude
Social influence
Self-efficacy (confidence in ability)
Habits
Definitions
Health promotion = maintain people’s current health status and ideally a shift towards better health.
Disease prevention = To prevent people getting a disease and prevent a shift
towards the seriousness of a disease.
Want to focus on health promotion, which has an effect on disease prevention.
clinical immunology · study summary
