Summary Notes course 'Epidemiology and Public Health Policies' (CHL-33303)

‌



Notes‌‌course‌‌‘Epidemiology‌‌and‌‌Public‌‌
Health‌‌Policies’‌‌(CHL-33303)‌ ‌
‌
‌
‌
Content‌ ‌

Notes‌‌week‌‌1‌ 2‌ ‌
1.1‌‌The‌‌definition‌‌of‌‌public‌‌health‌ 2‌ ‌
1.2‌‌The‌‌Public‌‌Health‌‌Cycle‌ 2‌ ‌
1.3‌‌Needs‌‌assessment‌ 8‌ ‌
1.4‌‌Illustrations‌ 13‌ ‌
1.5‌‌Group‌‌Assignment‌ 13‌ ‌
Notes‌‌week‌‌2‌ 13‌ ‌
2.1‌‌Role‌‌of‌‌policy,‌‌Research‌‌&‌‌Practice‌ 14‌ ‌
2.2‌‌POL‌‌determinants‌ 17‌ ‌
2.3‌‌Formulate‌‌aims‌‌and‌‌objectives‌ 18‌ ‌
2.4‌‌Group‌‌Assignment‌ 21‌ ‌
Notes‌‌week‌‌3‌ 22‌ ‌
3.1‌‌Constructing‌‌a‌‌Logic‌‌Model‌ 22‌ ‌
3.2‌‌Policy‌‌Instruments‌‌and‌‌Health‌‌Promotion‌ 24‌ ‌
3.3‌‌Illustrations‌ 26‌ ‌
3.4‌‌Communication‌‌Essentials‌ 27‌ ‌
3.5‌‌Group‌‌Assignment‌ 28‌ ‌
Self-tests‌ 29‌ ‌
4.1‌‌Self-test‌‌1‌ 29‌ ‌
4.2‌‌Self-test‌‌2‌ 30‌ ‌
4.3‌‌Self-test‌‌3‌ 32‌ ‌
‌
‌
‌
Note:‌‌All‌‌reading‌‌chapters‌‌in‌‌this‌‌summary‌‌are‌‌derived‌‌from:‌ ‌
Haveman-Nies,‌‌A.,‌‌Jansen,‌‌S.,‌‌van‌‌Oers,‌‌H.,‌‌&‌‌van‌‌'t‌‌Veer,‌‌P.‌‌(Eds.)‌‌(2017).‌‌Epidemiology‌‌in‌‌
public‌‌health‌‌practice.‌‌Wageningen‌‌Academic‌‌Publishers.‌ ‌
Other‌‌information‌‌is‌‌derived‌‌from‌‌the‌‌Wageningen‌‌University‌‌and‌‌Research‌‌(WUR).‌ ‌‌




Epidemiology‌‌and‌‌Public‌‌Health‌‌Policies‌‌(CHL-33303)‌ 1‌ ‌

, ‌



Notes‌‌week‌‌1‌ ‌
‌
‌


1.1‌‌The‌‌definition‌‌of‌‌public‌‌health‌ ‌
‌
1.1‌‌Definition‌‌of‌‌public‌‌health‌ ‌
The‌‌definition‌‌of‌‌public‌‌health‌‌is:‌‌‘The‌s‌ cience‌‌and‌‌art‌‌‌of‌p ‌ reventing‌‌disease,‌‌prolonging‌‌life‌‌
and‌‌promoting‌‌health‌‌‌through‌‌the‌o ‌ rganized‌‌efforts‌‌of‌‌society‌’.‌‌You‌‌try‌‌to‌‌prevent‌‌disease,‌‌
prolong‌‌life‌‌and‌‌promote‌‌health.‌‌ ‌
‌
Health‌‌‌is‌‌defined‌‌as‌a ‌ bsence‌‌of‌‌illness‌.‌‌It‌‌also‌‌is‌‌a‌‌state‌‌of‌‌complete‌‌physical,‌‌mental‌‌and‌‌
social‌w ‌ ell-being‌‌‌(WHO,‌‌1948).‌‌Added‌‌later‌‌was‌‌also‌‌the‌a ‌ bility‌‌to‌‌adapt‌‌‌and‌s
‌ elf-manage‌‌
in‌‌the‌‌face‌‌of‌‌social,‌‌physical,‌‌and‌‌emotional‌‌challenges‌‌(Huber,‌‌2011).‌‌ ‌
‌
The‌o ‌ rganized‌‌efforts‌‌of‌‌society‌‌‌go‌‌through‌‌governmental‌‌organizations‌‌and‌‌
non-governmental‌‌organizations.‌‌They‌‌act‌‌on‌‌local,‌‌regional,‌‌national‌‌or‌‌international‌‌level.‌‌
For‌‌example:‌‌WHO,‌‌Ministry‌‌of‌‌Health,‌‌Public‌‌health‌‌or‌‌primary‌‌care‌‌organizations‌‌(GP,‌‌
social‌‌services,‌‌health‌‌insurance,‌‌nutrition‌‌centre),‌‌and‌‌the‌‌industry‌‌(food‌‌industry,‌‌retail).‌‌ ‌
‌
The‌a ‌ rt‌‌of‌‌science‌‌‌is‌‌described‌‌as‌‌‘The‌‌public‌‌health‌‌professional‌‌needs‌‌to‌‌work‌‌
academically,‌‌but‌‌needs‌‌to‌‌be‌‌a‌‌civil‌‌engineer’.‌‌This‌‌means‌‌that‌‌the‌‌professional‌‌always‌‌
combines‌‌the‌‌science,‌‌together‌‌with‌‌policy‌‌and‌‌the‌‌practice.‌ ‌
‌
‌
‌


1.2‌‌The‌‌Public‌‌Health‌‌Cycle‌ ‌
‌
1.2.1‌‌Chapter‌‌3‌‌&‌‌4‌‌reading‌ ‌
The‌P ‌ ublic‌‌Health‌‌Cycle‌‌‌is‌‌a‌‌framework‌‌for‌‌public‌‌health‌‌professionals.‌‌This‌‌is‌‌a‌‌tool,‌‌where‌‌
different‌‌work‌‌cycles‌‌(of‌‌research,‌‌practice‌‌and‌‌policy)‌‌come‌‌together.‌‌It‌‌emphasizes‌‌that‌‌
activities‌‌of‌‌policymakers,‌‌practitioners‌‌and‌‌researchers‌‌are‌‌related,‌‌and‌‌acknowledges‌‌that‌‌
they‌‌can‌‌work‌‌together‌‌on‌‌health‌‌promotion‌‌and‌‌disease‌‌prevention‌‌by‌‌using‌‌a‌‌shared‌‌
frame.‌‌The‌‌success‌‌of‌‌intervention‌‌programmes‌‌in‌‌public‌‌health‌‌strongly‌‌depends‌‌on‌‌proper‌‌
planning‌‌and‌‌good‌‌teamwork.‌‌Important‌‌key-points‌‌of‌‌the‌‌shared‌‌model‌‌are:‌‌ ‌
● A‌c ‌ ommon‌‌goal‌:‌‌improvement‌‌of‌‌the‌‌health‌‌and‌‌well-being‌‌of‌‌all‌‌people.‌ ‌
● Systematic‌‌approach‌:‌‌it’s‌‌a‌‌cyclical,‌‌and‌‌thus,‌‌ongoing‌‌process,‌‌with‌‌continuous‌‌
quality‌‌improvement.‌ ‌
● Transparency‌:‌‌shared‌‌information‌‌about‌‌facts,‌‌figures,‌‌evidence,‌‌motives,‌‌norms,‌‌
values‌‌and‌‌available‌‌budget.‌ ‌
● Open‌‌dialogue‌:‌‌mutual‌‌respect‌‌and‌‌recognition.‌ ‌
‌




Epidemiology‌‌and‌‌Public‌‌Health‌‌Policies‌‌(CHL-33303)‌ 2‌ ‌

, ‌




‌
Source:‌‌WUR‌ ‌
‌
The‌‌four‌‌stages‌‌of‌‌the‌‌Public‌‌Health‌‌Cycle‌ ‌
1. Agenda‌‌setting‌:‌‌problem‌‌recognition‌‌and‌‌development‌‌of‌‌broad‌‌goals‌‌to‌‌address‌‌it.‌‌
The‌‌health‌‌issues‌‌must‌‌compete‌‌against‌‌other‌‌policy‌‌issues‌‌(for‌‌example,‌‌safety‌‌or‌‌
education)‌‌to‌‌become‌‌a‌‌priority.‌‌Governments‌‌can‌‌only‌‌focus‌‌on‌‌a‌‌limited‌‌number‌‌of‌‌
health‌‌problems‌‌at‌‌a‌‌time.‌‌The‌‌government‌‌is‌‌often‌‌the‌‌most‌‌important‌‌and‌‌influential‌‌
agenda‌‌setter.‌‌Others‌‌are‌‌political‌‌parties,‌‌the‌‌media,‌‌interest‌‌groups‌‌and‌‌
practitioners.‌‌How‌‌issues‌‌reach‌‌the‌‌agenda‌‌is‌‌a‌‌complex‌‌process.‌‌If‌‌public‌‌health‌‌
issues‌‌are‌‌perceived‌‌to‌‌be‌‌socially,‌‌practically‌‌and‌‌scientifically‌‌relevant‌‌and‌‌have‌‌
public‌‌support,‌‌a‌‌win-win‌‌situation‌‌for‌‌all‌‌fields‌‌can‌‌occur.‌‌ ‌
a. Role‌‌of‌‌the‌e‌ pidemiologist‌:‌‌provide‌i‌nformation‌‌about‌‌population‌‌health‌‌‌with‌‌
policymakers,‌‌political‌‌parties,‌‌interest‌‌groups‌‌and‌‌the‌‌media.‌ ‌
b. Role‌‌of‌‌the‌r‌ esearcher‌‌‌and‌p ‌ ractitioner‌:‌‌provide‌i‌nform‌ation‌‌‌about‌‌the‌‌
magnitude‌‌and‌s‌ eriou‌sness‌‌‌of‌‌a‌‌health‌‌problem.‌ ‌
c. Role‌‌of‌‌the‌p‌ olicymaker‌:‌p ‌ riority‌‌setting‌.‌ ‌
2. Programme‌‌development‌:‌‌strategies‌‌to‌‌intervene‌‌at‌‌an‌‌individual,‌‌organizational‌‌
and‌‌policy‌‌level‌‌have‌‌to‌‌be‌‌formulated‌‌in‌‌a‌‌programme‌‌or‌‌intervention.‌‌This‌‌plan‌‌
could‌‌have‌‌different‌‌forms;‌‌implementation,‌‌adapting‌‌or‌‌developing.‌‌The‌‌choice‌‌
depends‌‌on‌‌the‌‌defined‌‌programme‌‌objectives,‌‌available‌‌strategy‌‌and‌‌responsible‌‌
authorities.‌‌Ideally,‌‌it‌‌contains‌‌a‌‌well-founded‌‌selection‌‌of‌‌target‌‌groups,‌‌activities,‌‌
and‌‌evaluation‌‌plan.‌ ‌
a. Role‌‌of‌‌the‌e‌ pidemiologist‌:‌‌develop‌‌SMART‌‌objectives,‌‌generate‌‌the‌‌
evidence-base‌‌‌for‌‌the‌‌programme‌‌and‌‌help‌‌develop‌‌the‌‌evaluation‌‌plan.‌ ‌
b. Role‌‌of‌‌the‌r‌ esearcher‌:‌‌arguments‌‌can‌‌be‌‌found‌‌in‌e ‌ vidence-based‌‌‌and‌‌
therapy-based‌‌approaches.‌‌ ‌
c. Role‌‌of‌‌the‌p‌ ractitioner‌:‌‌applicability‌‌and‌‌meeting‌‌the‌n ‌ eeds‌‌‌of‌‌individuals‌‌and‌‌
groups‌‌are‌‌the‌‌added‌‌decisive‌‌arguments‌‌for‌‌action.‌ ‌
d. Role‌‌of‌‌the‌p‌ olicymaker‌:‌‌important‌‌decisive‌‌arguments‌‌are‌‌public‌‌
acceptability,‌‌visibility‌‌and‌‌immediacy‌.‌ ‌



Epidemiology‌‌and‌‌Public‌‌Health‌‌Policies‌‌(CHL-33303)‌ 3‌ ‌

, ‌


3. Implementation‌:‌‌put‌‌the‌‌intervention‌‌plan‌‌into‌‌action;‌‌[1]‌‌research-driven‌‌approach‌‌
(translate‌‌research‌‌into‌‌practice),‌‌and‌‌[2]‌‌practice-drive‌‌approach‌‌(local‌‌initiatives‌‌and‌‌
no‌‌prespecified‌‌activities,‌‌development‌‌continues‌‌during‌‌the‌‌implementation).‌‌ ‌
a. Role‌‌of‌‌the‌e ‌ pidemiologist‌:‌r‌ egister‌‌and‌‌collect‌‌data‌,‌e
‌ valuate‌‌‌the‌‌
implementation‌‌process,‌‌and‌‌therewith‌‌improve‌‌the‌‌quality.‌‌ ‌
b. Role‌‌of‌‌the‌r‌ esearcher‌:‌g ‌ uiding‌‌‌the‌‌implementation‌‌process.‌ ‌
c. Role‌‌of‌‌the‌p ‌ ractitioner‌:‌o
‌ rganizing‌‌‌activities.‌ ‌
d. Role‌‌of‌‌the‌p ‌ olicymaker‌:‌c‌ oordination‌.‌ ‌
4. Evaluation‌:‌‌information‌‌about‌‌the‌‌process,‌‌costs‌‌and‌‌effects.‌‌With‌‌this,‌‌the‌‌
government‌‌can‌‌decide‌‌whether‌‌the‌‌programme‌‌should‌‌be‌‌maintained,‌‌expanded,‌‌
changed‌‌or‌‌terminated.‌‌ ‌
a. Role‌‌of‌‌the‌e ‌ pidemiologist‌:‌‌provide,‌‌analyse,‌‌interpret‌‌and‌‌integrate‌‌data‌‌on‌‌
the‌e‌ ffectiveness‌‌‌of‌‌the‌‌programs‌‌(in‌‌order‌‌to‌‌legitimate‌‌public‌‌funding).‌‌ ‌
b. Role‌‌of‌‌the‌r‌ esearcher‌,‌p ‌ ractitioner‌,‌‌and‌p
‌ olicymaker‌:‌‌reaching‌c‌ on‌sen‌sus‌‌
about‌‌weighting‌‌the‌‌different‌‌evaluation‌‌results‌‌relevant‌‌for‌‌policy,‌‌practice‌‌
and‌‌research.‌ ‌
‌
Plan‌‌public‌‌health‌‌policies‌‌and‌‌programs‌ ‌
There‌‌are‌‌three‌‌different‌‌models‌‌for‌‌planning‌‌public‌‌health‌‌policies‌‌and‌‌programs.‌‌Their‌‌aim‌‌
is‌‌to‌‌guide‌‌the‌‌process‌‌from‌‌the‌‌beginning‌‌to‌‌the‌‌end:‌ ‌
1. Precede-Proceed‌‌‌(Green‌‌and‌‌Kreuter,‌‌2005)‌:‌‌oldest‌‌model‌‌and‌‌adjusted‌‌over‌‌time.‌‌
The‌‌first‌‌steps‌‌are‌‌about‌‌setting‌‌priorities‌‌on‌‌the‌‌basis‌‌of‌‌causal‌‌importance,‌‌
prevalence‌‌and‌‌changeability.‌‌The‌‌last‌‌steps‌‌are‌‌about‌‌implementing‌‌and‌‌evaluating.‌‌
The‌‌quality‌‌of‌‌the‌‌total‌‌planning‌‌process‌‌largely‌‌depends‌‌on‌‌the‌‌evaluation.‌ ‌
Stage‌ ‌ Component‌ ‌ ‌

1‌ ‌ Precede‌ ‌ Social‌‌assessment‌‌and‌‌situational‌‌analysis‌:‌‌engage‌‌people‌‌in‌‌
defining‌‌their‌‌social‌‌conditions‌‌and‌‌quality‌‌of‌‌life‌‌concerns‌‌(community‌‌is‌‌
an‌‌active‌‌partner).‌ ‌

2‌ ‌ Epidemiological‌‌assessment‌:‌‌identify‌‌a‌‌health‌‌problem‌‌that‌‌may‌‌
interact‌‌with‌‌the‌‌social‌‌problem‌‌from‌‌stage‌‌1.‌‌Also,‌‌determinants‌‌are‌‌
identified‌‌and‌‌grouped‌‌into‌‌behavioural‌‌patterns,‌‌environmental‌‌
conditions‌‌and‌‌genetic‌‌components.‌ ‌

3‌ ‌ Educational‌‌and‌‌ecological‌‌assessment‌:‌‌identify,‌‌sort‌‌and‌‌select‌‌
predisposing,‌‌enabling,‌‌and‌‌reinforcing‌‌factors‌‌that‌‌seem‌‌to‌‌have‌‌
influence.‌ ‌

4‌ ‌ Administrative‌‌and‌‌policy‌‌assessment,‌‌and‌‌intervention‌‌alignment‌:‌‌
answer‌‌the‌‌question‌‌‘What‌‌programme‌‌components‌‌and‌‌interventions‌‌
are‌‌needed‌‌to‌‌affect‌‌the‌‌changes‌‌specified‌‌in‌‌previous‌‌stages?’‌ ‌

5‌ ‌ Proceed‌ ‌ Implementation‌:‌‌programme‌‌components‌‌are‌‌selected‌‌and‌‌aligned‌‌with‌‌
priority‌‌determinants‌‌of‌‌change.‌ ‌

6‌ ‌ Process‌‌evaluation‌:‌‌evaluate‌‌the‌‌implementation‌‌of‌‌the‌‌progress.‌ ‌

7‌ ‌ Impact‌‌evaluation‌:‌‌evaluate‌‌the‌‌immediate‌‌effects‌‌of‌‌the‌‌program.‌ ‌

8‌ ‌ Outcome‌‌evaluation‌:‌‌evaluate‌‌the‌‌program’s‌‌effect‌‌on‌‌the‌‌health‌‌and‌‌
social‌‌situation.‌ ‌
Source:‌‌Epidemiology‌‌in‌‌public‌‌health‌‌policy‌




Epidemiology‌‌and‌‌Public‌‌Health‌‌Policies‌‌(CHL-33303)‌ 4‌ ‌