Lecture_6_Behavior_change_to_prevent_chronic_diseases_through_population.pptx

Umm Al-Qura University Faculty of Public Health and Health Informatics Health Promotion and Education Department Health Behavior Change Course Lecture 6 Behavior Change to Prevent Chronic Diseases Through Population Presented by: Dr. Sallah Alawneh By the end of this lecture the students will be...

Umm Al-Qura University Faculty of Public Health and Health Informatics Health Promotion and Education Department Health Behavior Change Course Lecture 6 Behavior Change to Prevent Chronic Diseases Through Population Presented by: Dr. Sallah Alawneh By the end of this lecture the students will be able to: Identify various roles of behavior change to prevent chronic diseases through population. Contents of the Lecture Chronic diseases Burden of The Chronic Diseases Risk Factors Prevention Coaching and Motivational Interviewing Chronic diseases • They are medical conditions mainly of non-infectious etiology. • They are lifelong conditions (continuous for a long period of life more than one year). • They are the illness and impairments that limits daily activities and functioning. • They are generally progressive. Examples of The Common Chronic Diseases Addison's disease Asthma Bipolar Mood Disorder Bronchiectasis Cardiac failure Cardiomyopathy Chronic kidney disease Chronic obstructive pulmonary disease Chronic renal disease Coronary artery disease ‫مرض اديسون‬ ‫الربو‬ ‫اضطراب المزاج الثنائي‬ ‫القطب‬ ‫توسع القصبات الهوائية‬ ‫فشل القلب‬ ‫اعتالل عضلة القلب‬ ‫مرض الكلى المزمن‬ ‫مرض االنسداد الرئوي المزمن‬ ‫المرض الكلوي المزمن‬ ‫مرض الشريان التاجي‬ Examples of The Common Chronic Diseases Crohn's disease Diabetes insipidus Diabetes mellitus (type 1 and type 2) Dysrhythmia (irregular heartbeat) Epilepsy Glaucoma Haemophilia Hyperlipidaemia (high cholesterol) Hypertension (high blood pressure) ‫مرض كرون‬ ‫مرض السكري الكاذب‬ )2 ‫ ونوع‬1 ‫داء السكري (نوع‬ ‫خلل النظم (عدم انتظام ضربات‬ )‫القلب‬ ‫الصرع‬ )‫الزرق (المياه الزرقاء‬ ‫سيولة الدم‬ ‫ارتفاع نسبة الشحوم (الكوليسترول‬ )‫المرتفع‬ ‫ارتفاع ضغط الدم‬ Examples of The Common Chronic Diseases Hypothyroidism Hyperthyroidism Multiple sclerosis )‫خمول الغدة الدرقية (غير نشطه‬ ‫فرط نشاط الغدة الدرقية‬ ‫التصلب المتعدد‬ Parkinson's disease ‫مرض الشلل الرعاش‬ Pulmonary disorder ‫اضطراب رئوي‬ Rheumatoid arthritis Schizophrenia Systemic lupus erythematosus (SLE) Ulcerative colitis ‫التهاب المفاصل الروماتويدي‬ ‫انفصام في الشخصية‬ )SLE( ‫الذئبة الحمامية الجهازية‬ ‫التهاب القولون التقرحي‬ Burden of the Chronic Diseases • They are the major cause of disability and death globally. • They have a serious impact on individuals and on society in general. • They affect the quality of life of individuals. • They can be a financial burden on those who are affected. Burden of the Chronic Diseases • In USA, as of 2012, about half of all adults—117 million people— had one or more chronic health conditions. • One of four adults had two or more chronic health conditions. • Seven of the top 10 causes of death in 2010 were chronic diseases. • Heart disease and cancer—together accounted for nearly 48% of all deaths. Burden of the Chronic Diseases • Arthritis is the most common cause of disability accounting 53 million. • Diabetes is the leading cause of: • Kidney failure. • Lower-limb amputations other than those caused by injury. • New cases of blindness among adults. Number of Chronic Condition Chronic Diseases risk factors in Saudi Arabia • Elevated BMI (11.64%). • Dietary risks (9.68%). • Elevated blood glucose (9.53%). • Elevated blood pressure (7.83%). • Physical inactivity (5.33%). • Smoking (3.02%). Major Causes of Death in KSA • Cerebrovascular diseases (13.20%). • Ischemic heart diseases (6.23%). • Vehicle Motor injuries (11.75%). • Chronic kidney diseases (3.99%). • Diabetes mellitus (3.70%). • Hypertensive heart diseases (2.37%). Chronic Diseases Gene tic The development of chronic diseases is a combination of 3 factors: Beha vior Expo sure Risk Factors • A number of risk factors related to an individual's lifestyle can contribute to the development of chronic diseases. • Example: • Cardiovascular diseases. • Chronic respiratory conditions. • Diabetes. Modifiable Risk Factors Unhealthy Diet Physical Inactivity Smoking Healthy Lifestyle Practices • Adopting healthy lifestyle practices can prevent or control the onset of chronic diseases. • Healthy lifestyle practices can be obtained by changing the behavior: • A healthy diet. • Regular physical activity. • Avoiding tobacco use. Health Risk Behaviors • Health risk behaviors are unhealthy behaviors you can change. • Four of these health risk behaviors: • Lack of exercise or physical activity. • Poor nutrition. • Tobacco use. • Drinking too much alcohol and other drugs. Prevention • Prevention is effective in reducing the effect of chronic conditions. • Early detection results in less severe outcomes. • Clinical preventive services include: • Screening for the existence of the disease. • Counseling. • Immunizations against infectious agents. Primary Prevention • Primary prevention seeks to prevent the onset of specific diseases via risk reduction by: • Altering behaviors. • Exposures that can lead to disease. • Examples: • Include smoking cessation. • Vaccination. Secondary Prevention • It includes procedures that detect and treat pre-clinical pathological changes and thereby control disease progression. • Screening procedures (such as colonoscopy to detect early stage of colon cancer) are often the first step. • Leading to early interventions that are more cost effective than intervening once symptoms appear. Tertiary Prevention • Once a disease has developed and has been treated in its acute clinical phase, tertiary prevention seeks to reduce the impact caused by the disease on the patient’s function and quality of life. • Examples: • Include cardiac rehabilitation following a myocardial infarction. • Assisting a cardiac patient to lose weight. Positive Health Outcomes • Positive health outcomes for chronic illness require: • Effective treatments • Adherence to the treatments. Coaching In Health Behavior Change • Coaching in health behavior change is defined as: “A method of patient education that guides and prompts a patient to be an active participant in behavior change”. Coaching In Health Behavior Change • For example: coaching for patients with coronary disease includes: 1. Assessment of the patient’s knowledge and practice of lifestyle. 2. Drug treatments. 3. Education of the patient about how to take the treatment. 4. Encouragement for the patient to reach the target goals. Coaching In Health Behavior Change • Coaching used the theoretical frameworks of the Transtheoretical Model of Change (Five stages of change). Motivational Interviewing • It is a technique used in some self-management programs. • It identifies a client’s readiness to change and how barriers can be overcome. Motivational Interviewing • The professional-client relationship during motivational interviewing is a partnership rather than an expertrecipient relationship. • The counseling style is a quiet and eliciting one. The Principles of Motivational Interviewing Express Empathy Develop Discrepancy Avoid Argumentation Roll with Resistance Support Self-efficacy Characteristics of Motivational Interviewing 1. Client centered 7. Increasing discrepancy 2. Nonjudgmental 8. Exploring ambivalence 3. Expressing empathy 9. Reducing resistance 4. Building trust 10. Increasing readiness 5. Being collaborativ e 11. Eliciting change talk 6. Reflective listening 12. Increasing selfefficacy Examples of Prevention Interventions Intervent Disease ion level Primary Colorectal Cancer Individual Counselling on healthy lifestyles: dietary counselling for people at risk of colorectal cancer, etc. Secondary Hemoccult stool testing to detect colorectal cancer early. Tertiary Follow-up exams to identify recurrence or metastatic disease: physical examination, liver enzyme tests, chest x-rays, etc. Examples of Prevention Interventions Intervent Disease ion level Colorectal Cance Populatio n Primary Publicity campaigns alerting the public to the benefits of lifestyle changes in preventing colorectal cancers; promotion of high fiber diets; subsidies to help people access exercise programs; anti-smoking campaigns. Secondary Organized colonoscopy screening programs. Tertiary Implementation of health services organizational models that improve access to high-quality care. Examples of Prevention Interventions Intervent Disease ion level Primary Metabolic Syndrom Individ Nutrition and ual exercise counselling. Secondary Tertiary Screening for Referral to diabetes. cardiac rehabilitation clinics. Examples of Prevention Interventions Diseas Interventi e on level Primary Metabolic Syndrom Populati Community on level weight loss and exercise programs to control metabolic syndrome. Secondary Tertiary Implementati on of multidisciplin ary clinics. Built environment favorable for active transport (walking, bicycling rather than using a car).