HLTB16 FINAL STUDY GUIDE
Primary Prevention - Answer -- Goal: prevent onset of disease (stop the disease from
happening in the first place)
- Approach: reduce risk by altering behaviours (like stop people from smoking and stuff)
or exposures that lead to disease or enhance resistance to exposures
- Can be active (e.g., individual behaviour change) or passive (e.g., policies)
Secondary Prevention - Answer -- Goal: control disease (to identify and then treat the
detected disease)
- Approach: detect and treat pre-clinical pathological changes
- Often undertaken by health care professionals or in specific public health programs
- Good example: cancer screening. People who don't think they're sick but are showing
symptoms so that we can detect early and treat early
- Another example: STI screening
Tertiary Prevention - Answer -- Goal: reduce impact caused by disease on quality or
length of life (people have full blown symptoms, they know they're sick. We try to stop
the disease from lowering their life satisfaction and lowering their lifespan)
- Approach: treat symptoms of disease, modify risk factors for further complications (ex.
Stroke: we can provide someone with rehabilitation)
- Will reduce or increase prevalence of disease, depending on whether it is reversible
(HIV never goes away but you're just trying to help them live longer with the disease.
That means the prevalence is still high and continues to be high but mortality isn't)
Canadian Task Force on Preventive Health Care - Answer -- Began as "Task Force on
the Periodic Health Examination" (1976); charged with evaluating what services and
tests should be provided in annual check-ups
- Establishes rules for searching evidence, assessing quality, and creating simple
recommendations
- Produces evidence-based guidelines for disease prevention and treatment (e.g.,
screening, vaccination, vitamin supplementation)
- When not enough evidence is available, is a catalyst for research
,Hierarchy of Evidence - Answer -I, II-1, II-2, II-3, III
Level I - Answer -- At least 1 properly designed RCT
- most effective evidence. (like we have the most confidence that the effectiveness is
due to the treatment and not some other factor)
Level II-1 - Answer -Well-designed trials without randomization
Level II-2 - Answer -Well-designed cohort studies and case-control studies from
multiple research groups
Level II-3 - Answer -Multiple time series studies or dramatic results from uncontrolled
experiments
III - Answer -Descriptive studies, opinions from respected authorities, reports of expert
committees, consensus conferences
Intervening on individuals - Answer -- Identify high-risk individuals and intervene (only
targeting high risk individuals and then trying to make things better for them so they
don't get the disease. Ex. high-cholesterol)
- Generally used in clinical medicine
- E.g., disease screening, counseling on diet
Intervening on the population - Answer -- Reduce average risk of entire population
- Some individuals stay at higher risk than average in population, but overall burden of
disease is decreased
- E.g., adding nutrients to food (we have like policies on what goes into the food and
stuff), policies
Health Promotion - Answer -Definition
- Also called primordial prevention (with the idea that it comes before primary
prevention)
- Actions to help people maximize control over and improve health
Focus
- Usually aimed at enhancing resistance to adverse effects of physical and social
environment
- Includes individual and population-level approaches
Integrated Model of Health - Answer -- Who and what the intervention should target
, - And how can health be achieved
- Health promotion doesn't just approach individual or population, it approaches both
- All of these decisions on what programs and policies should be placed for people
should be based on evidence.
Transtheoretical Model - Answer -Stages of thinking about health change up to actually
taking action
Role of Education - Answer -Provides information about unhealthy and healthy
behaviours in school and other contexts (ex. In elementary they teach you the basics on
how to be healthy and stuff like how to wash your hands, etc)
Limits to Role of Education - Answer -- Change in knowledge does not = change in
behaviour (impacts knowledge but not necessarily behaviour)
- Messages sometimes influenced by ideology (there are biases that needs to be
considered and taken into account)
- Resistance from industry invested in unhealthy behaviour (ex. tobacco companies and
vaping industry. Should these companies be allowed to advertise?)
Educating Alternatives - Answer -1. Advertising
2. Social norms approach
3. Medical advice
Advertising - Answer -provide advertising to reinforce public health messages and
counter negative messages usually seen in media
Social norms approach - Answer -counters "everyone is doing it" notion by providing
information on actual rates of high risk behaviours
Medical advice - Answer -health education messages delivered by physicians during
office visits
Harm Reduction - Answer -Definition:
- "Reducing the negative consequence of risk behaviours, rather than trying to eliminate
the behaviours themselves"
- (extremely controversial. I.e., safe injection sites)
Example:
- Safe injection sites aka (we can't stop substance use so let's just put safe injection
sites so we can make sure that people at least don't overdose and share dirty needles
to prevent hepatitis and stuff)
Primary Prevention - Answer -- Goal: prevent onset of disease (stop the disease from
happening in the first place)
- Approach: reduce risk by altering behaviours (like stop people from smoking and stuff)
or exposures that lead to disease or enhance resistance to exposures
- Can be active (e.g., individual behaviour change) or passive (e.g., policies)
Secondary Prevention - Answer -- Goal: control disease (to identify and then treat the
detected disease)
- Approach: detect and treat pre-clinical pathological changes
- Often undertaken by health care professionals or in specific public health programs
- Good example: cancer screening. People who don't think they're sick but are showing
symptoms so that we can detect early and treat early
- Another example: STI screening
Tertiary Prevention - Answer -- Goal: reduce impact caused by disease on quality or
length of life (people have full blown symptoms, they know they're sick. We try to stop
the disease from lowering their life satisfaction and lowering their lifespan)
- Approach: treat symptoms of disease, modify risk factors for further complications (ex.
Stroke: we can provide someone with rehabilitation)
- Will reduce or increase prevalence of disease, depending on whether it is reversible
(HIV never goes away but you're just trying to help them live longer with the disease.
That means the prevalence is still high and continues to be high but mortality isn't)
Canadian Task Force on Preventive Health Care - Answer -- Began as "Task Force on
the Periodic Health Examination" (1976); charged with evaluating what services and
tests should be provided in annual check-ups
- Establishes rules for searching evidence, assessing quality, and creating simple
recommendations
- Produces evidence-based guidelines for disease prevention and treatment (e.g.,
screening, vaccination, vitamin supplementation)
- When not enough evidence is available, is a catalyst for research
,Hierarchy of Evidence - Answer -I, II-1, II-2, II-3, III
Level I - Answer -- At least 1 properly designed RCT
- most effective evidence. (like we have the most confidence that the effectiveness is
due to the treatment and not some other factor)
Level II-1 - Answer -Well-designed trials without randomization
Level II-2 - Answer -Well-designed cohort studies and case-control studies from
multiple research groups
Level II-3 - Answer -Multiple time series studies or dramatic results from uncontrolled
experiments
III - Answer -Descriptive studies, opinions from respected authorities, reports of expert
committees, consensus conferences
Intervening on individuals - Answer -- Identify high-risk individuals and intervene (only
targeting high risk individuals and then trying to make things better for them so they
don't get the disease. Ex. high-cholesterol)
- Generally used in clinical medicine
- E.g., disease screening, counseling on diet
Intervening on the population - Answer -- Reduce average risk of entire population
- Some individuals stay at higher risk than average in population, but overall burden of
disease is decreased
- E.g., adding nutrients to food (we have like policies on what goes into the food and
stuff), policies
Health Promotion - Answer -Definition
- Also called primordial prevention (with the idea that it comes before primary
prevention)
- Actions to help people maximize control over and improve health
Focus
- Usually aimed at enhancing resistance to adverse effects of physical and social
environment
- Includes individual and population-level approaches
Integrated Model of Health - Answer -- Who and what the intervention should target
, - And how can health be achieved
- Health promotion doesn't just approach individual or population, it approaches both
- All of these decisions on what programs and policies should be placed for people
should be based on evidence.
Transtheoretical Model - Answer -Stages of thinking about health change up to actually
taking action
Role of Education - Answer -Provides information about unhealthy and healthy
behaviours in school and other contexts (ex. In elementary they teach you the basics on
how to be healthy and stuff like how to wash your hands, etc)
Limits to Role of Education - Answer -- Change in knowledge does not = change in
behaviour (impacts knowledge but not necessarily behaviour)
- Messages sometimes influenced by ideology (there are biases that needs to be
considered and taken into account)
- Resistance from industry invested in unhealthy behaviour (ex. tobacco companies and
vaping industry. Should these companies be allowed to advertise?)
Educating Alternatives - Answer -1. Advertising
2. Social norms approach
3. Medical advice
Advertising - Answer -provide advertising to reinforce public health messages and
counter negative messages usually seen in media
Social norms approach - Answer -counters "everyone is doing it" notion by providing
information on actual rates of high risk behaviours
Medical advice - Answer -health education messages delivered by physicians during
office visits
Harm Reduction - Answer -Definition:
- "Reducing the negative consequence of risk behaviours, rather than trying to eliminate
the behaviours themselves"
- (extremely controversial. I.e., safe injection sites)
Example:
- Safe injection sites aka (we can't stop substance use so let's just put safe injection
sites so we can make sure that people at least don't overdose and share dirty needles
to prevent hepatitis and stuff)
