prevention and health promotion final study guide.pdf

DH 284 Disease Prevention and Health Promotion FINAL EXAM REVIEW Prevention and Health Promotion Health promotion & prevention → It is important for the oral health professional to understand risk factors for oral disease, health behaviors, determinant...

DH 284 Disease Prevention and Health Promotion FINAL EXAM REVIEW Prevention and Health Promotion Health promotion & prevention → It is important for the oral health professional to understand risk factors for oral disease, health behaviors, determinants, and disparities in oral health so they can change the health behavior → When health promotion efforts are effective, disease is prevented → Example of successful health promotion is water fluoridation → Oral health promotion intervention is considered as one of the greatest public health measures in the past century → Example of health promotion activity or model oral hygiene promotion intervention is the local dental hygiene organization working to change policy, to eliminate sugary drinks and snacks from school vending machines → Purpose of prevention is to ensure that a disease process never starts or is curtailed and limited at an early stage 3 Levels of Prevention, oral disease → Primary prevention : before disease occurs → Example of primary prevention is fluoridated water, fluoride mouth rinse for a caries free child, fabrication delivery for sports mouth guard → Secondary prevention : early treatment / control of disease → Example of secondary prevention is fluoride to re-mineralize demineralized tooth surfaces, periodontal debridement to reduce pocket depths, class I restoration, amalgam restoration restoring tooth to form/function → Tertiary prevention : limiting the disability as a result of disease process → Example of tertiary prevention is periodontal surgery, bridge, and implant, dentures, periodontal maintenance, oral cancer rehabilitation Health education, literacy, status → Health habits can influence health either positively or negatively → Factors related to the incidence of oral disease are geographic location, transportation, values, manual dexterity → Oral health promotion is aimed to reduce the incidence of the 4 preventable diseases → Dental caries : #1 most common chronic childhood disease → Disease of supporting structures → Oral pharyngeal cancers → Craniofacial injuries → Health literacy : the ability of an individual to read, understand, apply and act on health information and advice → Factors that affect health literacy → Education, culture language, characteristics of health settings and ability to read → More than just reading skills, health literacy includes abilities such as understanding instructions on prescriptions, asking pertinent questions to health care providers, and relaying symptoms → Low health literacy is linked to  → Medication and treatment errors → High rates of hospitalization, disease (morbidity), and death (mortality) → Use of emergency room as primary care → Failure to seek preventive care → A person's reading ability has more to do with their health status than race, age, and educational level Behavior, learning, motivation → Adherence : behavior change that is patient driven Communication & messages → Two types of communication : verbal and nonverbal → Tone of voice → Gestures → Facial expressions and head movements → Posture → Touching → Proximity to others → Physical personal space → The primary function of communication is to establish trust and understanding between patient and the provider → Personal filters : distort the messages being sent and received → Factors that affect our personal filters → Life experiences → Age → Gender → Culture → Messages sent and received is distorted by the clinician's own life experiences, gender, age, culture, beliefs, etc. → Acquiring knowledge through study, instruction, and experience → True learning means knowledge is applied to everyday living → Motivation : the inner driving force that prompts an individual to act to satisfy a need, desire or to accomplish a particular goal → Motivation is internal/intrinsic and or external/extrinsic → Intrinsic/ internal motivation is more powerful than extrinsic/external motivation, because intrinsic motivation is within a person → Traditional cognitive approach merely supplies facts → Historically centered on avoidance behaviors → Traditional approach to oral health education includes → Dispensing advise → Authoritarian → Persuasion → NOT collaboration → Evidence has shown that a patient centered approach to health education yields the most profound results → Many people have trouble understanding the words used in health care, even people with high education and high health literacy levels  → A school based program includes sealants and fluoride varnish applications and referrals for restoration of dental caries. What level of preventive services are represented in this program? Fluoride varnish and sealants are primary; restorations are secondary → Identify the preventive service represented by the following procedures : fluoride mouth rinse for a caries free seven year old, fabrication and delivery of a full mouth set of dentures, and fabrication and delivery of a sports mouth guard → Children benefit from both topical fluoride and systemic fluoride → Community water fluoridation is especially beneficial for those of low socioeconomic status (SES) → Community profile : used to describe the demographics of a community, including gender, age, and socioeconomic status Motivation and Learning #1 Health Belief Model → Motivation : inner driving force that prompts an individual to act to satisfy a need, a desire, or to accomplish a particular goal → Health belief model : the most useful in predicating the likelihood of a patient's compliance/adherence with professional recommendations for preventive health behaviors → Health belief model is based on the theory that behaviors are directed by and depend on a person's perception and beliefs → The belief components are susceptibility, severity, beneficial, and benefits outweighs barriers to action → Susceptibility : individual beliefs or perceives that they are susceptible to get a given disease or condition → Severity : individual must believe or perceive that the disease will have an impact of at least moderate severity or seriousness in life → Beneficial : Individual must believe or perceive that there are effective actions that can be taken to reduce the risk of or control the disease → Benefits outweigh barriers to action : individual must believe or perceive the benefits of taking the recommended action outweigh the barriers or any difficulties they might encounter → The focus of health belief model theory is a persons perceives or beliefs of the threat of a health problem and appraisal of recommended behaviors for preventing or managing the problem Stages of Change → Stages of change model / theory : primary concept is that people cycle through different stages of readiness and can be in any stage at any given time → The stages of change are precontemplation, contemplation, preparation, determination / decision, action, maintenance, and relapse → Precontemplation : no intention of changing a behavior or are unaware of problem behavior → Contemplation : aware of problem and thinking about the possibility of making a change in 6 months → Preparation : making a plan for change in the next 30 days → Determination / decision : determined to make a change → Action : a change in behavior or lifestyle has occurred within the past 6 months → Maintenance : continuing desired behavior now part of daily routine → Relapse : resumption of old undesired behavior  → Movement within the stages of change model is influenced by confident in the ability to change → Contemplators are thinking about a change intending to change within 6 months → Awareness of the pros and cons of making a change Maslow’s Hierarchy of Needs → Suggest that inner needs or forces drive a person to action → Some needs take precedence over others → A person can become concerned about higher level needs only when lower-level needs are met → Once needs for a level are satisfied, they are no longer motivators Learning Ladder → Learning ladder : unawareness, awareness, self-interest involvement, action, and habit → Unawareness : many patients have no to little concept of the new information about periodontal disease and prevention → Awareness : patients may have a good knowledge of the scientific facts and knows about the problem, but they do not apply the information personally or to their present behavior → Self interest : information is relevant to self and an inclination to act → Involvement : with the awareness and application to self, the response to action is forthcoming when attitude is influenced ** → Involvement is characterized by desire to action, values are inconsistent with actions, value of action is strong but behavior is missing → Action : moves to act to test the new knowledge and the beginning of change in behavior → Habit : self satisfaction in the comfort and value of sound teeth, healthy periodontal → Behavior change is a process not an event Motivation, motivational interviewing, empathy → Motivational interviewing is a patient centered method or approach to elicit (encourage) behavior change → There are 3 elements / components of MI : collaboration, evocative, and patient autonomy → Collaboration : partnership, shared decision making between patient and clinician → Evocative : understand patient goals, connecting behavior with patients beliefs, values, and concerns → Patient autonomy : patient ultimately decides what to do → 7 guiding principles of motivational interviewing → Resist the righting reflex → Understand and explore patients motivations → Listen with empathy to the patient, to empower the patient → Establish rapport → Explore ambivalence → Allow patient autonomy in decision making → Not employing avoidance behaviors Open-ended questions & closed questions, listen, paraphrase  → Empathy : the ability to identify with and understand another person's feelings or difficulties → Empathy is perceiving others as they see themselves, sensing their hurt or pleasure as they see it, accepting their hurt feelings and communicating this understanding of their reality → Open ended questions and reflecting listening are two ways to express empathy → Open ended questions require more than one words answers, allows patients to express ideas, feelings, opinions and to elaborate, leads patient in a specific direction → When confronted with resistance to change you should emphasize with patients struggle and wait for patient to be ready → MI involves asking permission before offering advice / information → Ask permission to talk about oral self care before offering advice or information → Open ended questions → Lead patient in a specific direction → Allow patient to elaborate and show their feelings → Requires narrow answers to specific questions → Examples of an open ended question → Do you understand ? → Do you have any questions ? → What questions have I not answered ? → Do any of your teeth hurt ? → Patients receives the signal → Message is received → Message is understood → Message to continue the conversation → Stages of change theory is constructs of the theory and stages, strategies for progress to next stage, limitations → Limitations : focus is on strategies rather than information; should combined with a cognitive approach → Social learning theory can be combined with health belief model to focus on information → Internal : persons beliefs about impact of their actions on health outcomes → External : focus is on influence of other important people or fate on their own health outcomes → Community organization theory incorporates concept of empowerment and provides grassroots Motivation and Learning #2 Learning principles, styles → Repetition, review and reinforcement enhance learning → Learning is most effective when many channels of information or senses are stimulated → People learn by doing and learners need to be actively involved → Learner responses should be immediately reinforced → For best transfer of learning between settings and situations, behaviors should be learned in the way they will be used → Learning styles → Visual (spatial) : you prefer using pictures, images, and spatial understanding → Aural (auditory-musical) : you prefer using sound and music → Verbal (linguistic) : you prefer using words, both in speech and writing → Physical (kinesthetic) : you prefer using your body, hands, and sense of touch  → Logical (mathematical) : you prefer using logic, reasoning, and systems → Social (interpersonal) : you prefer to learn in groups or with other people → Solitary (intrapersonal) : you prefer to work alone and use self study → Ripple effect : spreading series of effects or consequences caused by a single event Communication Function, factors, techniques, skills → Primary function of communication in the dental setting is to establish trust and understanding between patient and dental health provider → Intimate zone : 1 – 18 inches → Personal zone : 1.5 ft - 4 ft → Our personal filters distort messages → Communication = environmental factors / physical surroundings, perceptions, values, and emotions → Active listening : communication technique that focuses on the speaker → Active listening requires the listener to understand, interpret, and evaluate what they hear → 3 main degrees of active listening : → Repeating : use the exact same words used by the speaker → Paraphrasing : use similar words and phrase arrangment as the ones used by speaker → Reflecting : understanding speakers emotions and perspective Verbal & nonverbal → 2 major forms of communications → Verbal : written words → Nonverbal : tone of voice/touch, gestures, proximity to others/personal space, NOT WRITTEN WORDS → Good communication skills are associated with an increase in patient trust and confidence → We all interpret messages based on our personal filters which include → Life experiences → Age → Gender → Culture Cross Culture Communications Culture influence, communication → Culture : a learned set of beliefs, values, attitudes, convictions, and behaviors that are common to a group of people and usually passed down from generation to generation → Culture shapes the way a person responds to dental providers and to dental care → Cultural relativism : the view that all beliefs, customs, and ethics are relative to the individual within his own social context  → In other words “right” and “wrong” are culture specific; what is considered moral in one society may be conisdered immoral in another → There is an association between health interventions that ignore the influence of culture and positive health consequences and good clinical outcomes → Culture shapes the way that a person responds to dental health providers and dental care → Understanding differences help communication and improves patient care Ethnocentrism → Ethnocentrism : defined as the tendency to consider one's own culture as superior to others Cultural competence continuum → Cultural competency : understanding that culture shapes an individual's experiences, perceptions, decisions, interpersonal relationships and the way he/she responds to dental health care providers/dental care → Recognize your assumptions/biases → Value diversity → Show empathy → Cultural blindness : believe that color or culture make no difference, and that people are all the same → Cultural competence accepts and respects differences, expands cultural knowledge, and resources, engages in continuous self assessment → High contrast cultures are Arab and Latin American → The intimate zone (1-18 inches) and personal zone (1.5ft - 4ft) → Speak slowly and not loudly → Let patients answer questions one at a time, NOT use of a string of several questions at a rapid pace Instructional Strategies Instructional planning → When assessing a target audience for instructional planning, it is important to consider and identify population demographics aka the community profile → Age/ gender → Educational levels → Socioeconomic status (SES) → Cultural background / ethnicity → NOT dental insurance coverage → All instructional planning includes → Diagnosis or analysis of target audience → Identification of learning objectives → Identifaction of specfic content to meet those needs and objectives → Selection of methods to achieve the objectives Lesson plan, components → Components of a lesson plan include  → Objective → Instructional materials / methods → Body → Closure → Planning / educational goal is a broad general, nonspecific statement at the beginning of the lesson plan, that describes the overall purpose of the block of instruction → Identify the behavior by name, accepted as evidence of learning (what) → Should contain action verbs → Should contain specific conditions under which the behavior will occur (how) → Should contain a measurable standard that must be met for behavior to be considered acceptable (how well) → Upon completion of the learning experience, the learner should be able to → Appreciate the value of good oral hygiene → Know the 4 tooth brushing methods → Demonstrate the bass tooth brushing technique → Understand why toothbrushing and flossing are important → Psychomotor domain : concerned with technical or motor skills → Affective domain : concerned with attitudes, interests, appreciation, and modes of interest → Lecture instruction method → Leader centered → Allows for presenting many facts in a short time → Most effective in large groups when time is limited → Lecture : formal active delivery of information → Poster presentation : allows for the most interaction with the largest number of health care professionals at health promotion meetings → What type of media would you use in a 30 minute presentation to adolescents ? Brochures → What is the most effective instruction method to use in a 30 minute presentation to adolescents ? Discussion / demonstration → Advantages of using print media to support learning objectives → Easy to use → Useful in many locations → Some commercially available at low/no cost → Disadvantages of using print media to support learning objectives → Reading skills / language are a concern → Instructional set of presentation should create interest in the use and value of the new information → Instructional set does NOT → Set a measurable objective for the presentation → Contain the main focus of the lesson plan → Serve as a written guide for the presentation → Learning principles → Repetition, review, and reinforcement enhance learning → Learning is most effective when many channels of information or sense are stimulated, NOT just 1 channel → People learn by doing; learners need to be actively involved → Learners responses should be immediately reinforced → Principles of teaching → Teach the way skills are to be used  → Establish goals and objectives → Formed delivery (active) : lecture, demonstration, discussion, etc. → Informal delivery (passive) : brochures, pamphlets, billboards, videos, etc. → Interactive, participatory learning experiences result in better learning → Teach the way skills are to be used → Select activities or procedures that have been successful in the past – no need to invent the wheel