Epidemiology Unit 3

Unit 3 Epidemiology

• Formative evaluation occurs before and during a program.

  • It involves evaluating planning and implementation.
  • A key question to ask is whether the new program is being implemented as planned.

• Differences between endemic, epidemic, and pandemic:

  • Endemic: Expected presence of a disease.
  • Epidemic: Presence of a disease that surpasses the expected level.
  • Pandemic: A widespread epidemic that has spread to a large scale, impacting many countries. COVID-19 is an example.

• Summative evaluation is conducted at the end of an established program.

  • It measures the overall outcomes of established programs.

• The epidemiological triangle includes agent, host, and environment:

  • Agent: Cause of a disease.
  • Host: The carrier of the disease.
  • Environment: Agent's surroundings.

• Natural history of disease:

  • Shows disease progression without intervention.
  • Stage of susceptibility is prior to exposure to the disease-causing agent (host).
  • Stages include exposure, pathologic changes, onset of symptoms, clinical disease, subclinical disease, recovery, disability, or death.

• Chain of infection:

  • Infectious agent: Pathogen capable of causing injury or disease.
  • Reservoir: Where the infectious agent lives, grows, and multiplies.
  • Portal of exit: Path by which the agent leaves the host.
  • Mode of transmission: Ways the agent spreads from a reservoir to a susceptible host.
  • Portal of entry: Path by which the agent enters the susceptible host.
  • Susceptible host: Individual who can become sick when exposed to an infectious agent.

Incidence

• Incidence: Number of new cases during a specific time period.
  • Only individuals at risk are included in the denominator.
  • Example: Only women with a uterus are counted when calculating the incidence of uterine cancer.

Mortality Measures

• Crude mortality rate: Total number of deaths divided by the total population during a certain time period.
• Age-specific mortality rate: Mortality rate data specific to an age range or group.
• Case fatality rate: The proportion of people with a disease who die from it.

Ethical Principle of Beneficence

• Beneficence: Providing benefit or doing good while balancing potential harms.

False Negative Screenings

• Implications of a false negative screening: Loss of opportunity for early intervention.

Unit 3 Evidence-Based Practice

• Focuses on community involvement when implementing a community program.
  • Involves community members' needs, values, and preferences.
  • Emphasizes long-term, sustainable processes.

County Health Rankings

• Public health data on health behaviors, social/economic factors in communities.
  • Used to guide change.

Health People 2030 Goals

• Overarching goals provide focused objectives for disease prevention.
  • Eradicating health disparities, improving health equity, promoting healthy behaviors.

Needs Assessment

• Needs assessment of a community: Starts with a thorough needs assessment of the community. Disseminating results to all residents.

Ethical Issues in Community-Engaged Research

• Confidentiality of private records and need for education.

Organizational Barriers to Evidence-Based Practice

• Decreased database access.
• Lack of time.
• High nurse workloads.
• Limited access to evidence-based practice (EBP) resources.
• Organizational cultures that don't support EBP.

Unit 3 Prevention of Diseases and Illnesses

• Antibiotic resistance contributes to the STI problem.
• Communicability/spreading of diseases: Ability of a virus to spread between individuals.
• Different levels of prevention: Primary (prevent occurrence), Secondary (detect and treat early), and Tertiary (reduce disease severity).
• Individual prevention: focuses on increasing awareness of modifiable risk factors.
• Community prevention: focuses on community-wide changes to decrease exposure risks.

Prevention Methods for Communicable Diseases

• Prevention methods include isolation and handwashing.

Risk Factors for Kidney Disease

• Chronic illnesses like hypertension, diabetes, and coronary heart disease are risk factors.
• Obesity can also contribute to this risk.

Environmental Persistence

• Persistence is an agent's ability to survive in the environment and retain its infectivity.
• Virulence, as an ability to cause severe disease, may increase when antibiotic resistance is present.

Ways to Block Transmission at the Portal of Exit

• Wash hands

Community Program Planning, Implementation, and Evaluation

• A shared vision helps overcome collaboration barriers.
• Characteristics of a community health worker are inclusive of any community member who has an impact on programs within the community (such as paid employees, volunteers, community leaders or members of the community).

Ethical Issues of Surveillance Systems

• Review local/state laws about sharing data from national notifiable disease surveillance systems.

Secondary Data Collection in Community Assessments

• Example: Census data, statistics, and rankings.

Ecological Model Levels

• Individual, relationships, community, and societal; levels are used to assess a community

Built Environment Assessment Tool Core Features

• Infrastructure, walkability, bikeability, recreational sites, and availability of food access points.

Simplex Method for Prioritization

• Stakeholders complete questionnaires where higher scores indicate higher priorities.

Community Diagnosis

• Analysis of data to create a community diagnosis, defining community issues, identifying resources, and prioritizing areas that need improvement.

Program Management

• Involves stakeholders and community members to create a thorough program.

Characteristics of a Community Leader

• Someone who influences community members with goals to improve the program that they're involved in.

Strategic Planning Framework

• Follows five steps to create and implement a community program: Assessment, capacity, planning, implementation, and evaluation.

Community Tool Kit

• A step by step approach with various evaluation examples.

Evaluation of Programs

• Evaluation of a program is done to measure performance by collecting data about the program and addressing predetermined goals.

Emergency Preparedness and Management

• Disaster prevention involves assessing hazards, preventing disaster occurrence, and mitigating effects that may occur from a disaster if it does occur. This assessment looks at what resources are present and how many are needed with a disaster preparation plan.

Disaster Management Cycle

• The third phase in a disaster management cycle is Disaster Response which consists of the actions that are performed during or immediately after a disaster event has occurred.

Disaster Nursing

• This domain involves activities like providing care based on the priority given, providing resources to those who need them, and managing large amounts of deceased.

NGOs in Disasters

• NGOs can offer help during and before a disaster.
  • Examples include places of worship, private businesses, schools, health services.
  • They provide necessities like food, water, shelter, and temporary housing.
  • These organizations are often made up of volunteers.

National Preparedness Goal

• This initiative aims for whole community readiness in case of a disaster and focuses on entire community preparedness for any type of disaster.

Disaster Events

• Disaster events that occur in a community are tracked through a plan that has specific first response steps that can be used.
  • Steps involve activating local government efforts, confirming if the state has enough resources, or requesting federal aid if necessary.

Disaster Preparedness Activities

• Activities that occur in the disaster preparedness phase, such as developing personal/family disaster plans, identifying shelter locations and evacuation routes, stockpiling emergency supplies, and recognizing which people need assistance or have a risk of vulnerability.

Disaster Management Cycle Phases

• Prevention/Mitigation: Identifies vulnerabilities and repairs/removes them.
• Preparation: Creates plans and strategies to help during and after.
• Response: Actions taken during and immediately afterward.

Core Competencies in Disaster Nursing

• Interventions: Providing care to those most in need, isolating, and securing resources; and prioritizing those with most immediate threat to life and well-being are necessary actions.
• Safety and Security: Identifying vulnerable populations, and using appropriate PPE.

Individual Learning Styles

• Important because each person learns differently.

Educator Related Barriers

• Educators may have low credibility, lack teaching experience, but these barriers can be overcome by doing research, preparing before education sessions, and admitting if don't know something, committing to finding the answer.

Cultural Care Theory

• Provides information used to deliver culturally congruent care.

Psychomotor Domain of Learning

• Covers using sensory-motor skills.

Low Health Literacy Issues

• Clients with low health literacy may have difficulty with health forms, managing chronic conditions, seeking preventive care, giving current medical history, and understanding impacts of unhealthy behaviors.

Unit 4 Health Education

• Affective Domain of Learning: Covers the learners' feelings, beliefs, and attitudes.
• Transformative learning theory: Learners gain a new way of thinking with new information.