Year 2 I&P

Question 1

First step on ladder of intervention

Answer 1

Do nothing, monitor the situation

Question 2

Give an example of ‘providing information’, the second step on the intervention ladder

Answer 2

5 a day campaign

Question 3

Give examples of:

3) Enable choice
4) Guide choice through changing default
5) Guide choice through incentive
6) Guide choice through decentives

Answer 3

3) free fruit in schools
4) salad becomes default side with meals, have to ask for chips
5) tax-free bike to work scheme
6) higher tax on cigarettes

Question 4

What are stages 7 and 8 on the intervention ladder?

Answer 4

7) Restrict choice e.g. remove unhealthy food items from shops
8) Eliminate choice e.g. isolate those with infectious disease

Question 5

What did the Marmot review find out about health inequalities?

Answer 5

Not inevitable, result from social inequalities.

Question 6

What is proportionate universalism?

Answer 6

Cannot focus solely on most disadvantaged

Question 7

According to the Marmot review, who should tackle health inequalities?

Answer 7

Government, not NHS

Question 8

What is a necessary cause?

Answer 8

Presence is required for an event to occur. Presence doesn’t always lead to event, but event cannot occur without it.

Question 9

What is a sufficient cause?

Answer 9

Presence always leads to an effect. Presence alone is enough, but is not the only cause of the effect.

Question 10

What are the 4 determinants of population health, ranked from most to least important?

Answer 10

1. Societal characteristics
2. Health behaviours
3. Medical care
4. Genes and biology

Question 11

What are the 5 steps on Maslow’s hierarchy of need?

Answer 11

Physiological
Safety
Love and belonging
Self-esteem
Self-actualisation

Question 12

What is a normative need?

Answer 12

Need identified according to a norm

Question 13

What is a comparative need?

Answer 13

Need stemming from a comparison to others who are not in need

Question 14

Cross-sectional study

Answer 14

Counts number of people with disease at 1 time
Pros: quick, good for prevalence
Cons: only measures 1 time, can’t measure incidence, sampling frame may lead to bias

Question 15

Ecological studies

Answer 15

Compare one group to another.
Pros: cheap, less bias, easy.
Cons: ‘ecological fallacy’ - assume population measures are true for individuals, assume average risk / incidence applies to all

Question 16

Case-control studies

Answer 16

Retrospective comparison for exposure as a potential cause. Diagnosed cases in exposed group compared to control.
Pros: Quick, good for rare disease
Cons: Selection / participation bias, difficult to find control

Question 17

Cohort study

Answer 17

Set population at risk of but free from disease and follow them through time.
Pros: Can measure many outcomes, low bias
Cons: expensive, time consuming

Question 18

Randomised controlled trial

Answer 18

Split population randomly into treatment and control groups and compare rates of outcome.
Pros: strongest evidence, no bias
Cons: Expensive, can be unethical

Question 19

Primary prevention

Answer 19

Preventing disease onset by removing cause

Question 20

Secondary prevention

Answer 20

Halt disease progression e.g. using screening programmes

Question 21

Teritary prevention

Answer 21

Treat disease to limit disability and complication

Question 22

What does Rose’s single population theory state?

Answer 22

Instead of only treating “high risk” groups, should shift mean to left and focus more on whole population.

Question 23

What is the Ottawa Charter?

Answer 23

International agreement organised by WHO aiming to achieve the goal of “health for all” by 2000 by improving health promotion

Question 24

What are the 5 actions set out by the Ottawa Charter?

Answer 24

1. Develop personal skills
2. Strengthen community
3. Create a supportive environment
4. Build healthy public policy
5. Re-orientate health services towards prevention of illness and promotion of health

Question 25

What are the 5 approaches to health promotion?

Answer 25

1. Medical: 3 levels of prevention
2. Behaviour change: focuses on individual attitudes
3. Educational: enables choice and avoids persuasion
4. Empowerment: gives people confidence and skills to address their concerns
5. Social: healthier choices normal in physical and social environment

Question 26

What is the social norms approach?

Answer 26

Addresses misperceptions of the norm by aiming to understand what the perceived norm is and challenge unhealthy aspects.

Question 27

Commissioning

Answer 27

Set of linked activities required to assess population needs and how to assess them

Question 28

What are the 3 steps of the commissioning cycle?

Answer 28

Planning –> procurement –> monitoring

Question 29

What is the King’s fund and what are their aims?

Answer 29

Charity working to improve health and care in England.
Integrated care methods
Promote health understanding
Invest in support
Link healthcare and government
Employ patients
Focus on multiple health behaviour
Population based commissioning
Care plans for elderly

Question 30

What is polypharmacy?

Answer 30

Cost-effective prescribing and reduction of medication errors

Question 31

Name some ways in which polypharmacy may be achieved

Answer 31

Pharmacist-led intervention
Pharmacy technicians
Benchmarked information on prescribing performance
IT decision support tools

Question 32

What are the 5 components of the voluntary sectors role in health promotion?

Answer 32

Peer support
Self-management education
Health coaching
Group activities
Asset-based approach

Question 33

Epidemic

Answer 33

Serious outbreak in single area

Question 34

Pandemic

Answer 34

Epidemic spreading to several areas of the world

Question 35

What is the heirarchy of studies?

Answer 35

1. Randomised controlled trial
2. Cohort study
3. Case-control study
4. Register / ecological studies
5. Cross-sectional studies
6. Anecdote