modul 6 - social diagnosis assessing quality of life concerns

SOCIAL DIAGNOSIS: ASSESSING QUALITY OF LIFE

CONCERNSModule 5

HEALTH PROMOTION & EDUCATION (DEMA 3253)DIPLOMA IN ENVIRONMENTAL HEALTHVICTORIA INTERNATIONAL COLLEGE

PREPARED BY: MR KHAIRUL NIZAM MOHD ISA

THE 7 PHASES OF PRECEDE

Health education components of health program

Predisposing factors: knowledge, attitudes, values, perceptions

Enabling factors: Availability of resources, accessibility, referrals, skills

Reinforcing factors: Attitudes and behavior of health and other personnel, peers, parents, employers, ect.

Nonbehavioral causes

Behavioral causesBehavioral indicators: utilization, preventive actions, consumption patterns, compliance, self-care

Indirect communication: staff development, training, supervision, consultation, feedback

Direct communication: public, patients Nonhealth

factors

Health problems

Vital indicators: Morbidity, Mortality, fertility, disability

Dimensions: incidence, prevalence, distribution, intensity, duration

Quality of life

Subjectively defined problems of individuals or communities

Social indicators: illegitimacy, population, welfare, unemployment, absenteeism, alienation, hostility, discrimination, votes, riots, crime, crowding

Dimensions: Earliness, frequency, quality, range, persistence

Phase 6Administrative diagnosis

Phase 4-5Educational diagnosis

Phase 3Behavioral diagnosis

Phase 1-2Epidemiological & social diagnosis

OBJECTIVE IN PHASE 1

1. To determine the subjective concern with quality of life in the target population

2. To verify and clarify these concerns with analysis of existing social indicators and data available from newspaper files, census reports and vital records and special surveys conducted by radio and television stations and marketing and social agencies

3. To document the status of the target community in relation to those priority concerns for which there is a health components or cause

4. To make explicit the rationale of the selection of priority problems5. To use the documentation and rationale to justify the further

expenditure of health education resources on the selected social problems

6. To use the documentation and rationale as the bases on which to evaluate the program in cost-benefit terms

RELATIONSHIP BETWEEN HEALTH AND SOCIAL PROBLEMS

Health Problems Quality of Life

Social policy/Social condition

Health interventions

STRATEGIES FOR IDENTIFYING SOCIAL PROBLEMS

1. Reviewing the literature▫ Biomedical, health education and behavioral science literature

should be the first resources.

▫ Data from previous study provide insight into aspect of a social problem that directly can be focused on.

2. The nominal group process▫ Participants that knowledgeable and representative about the question

are Arranged into groups of six to seven members.▫ Asked a single question regard to quality of life▫ Get the response from each group. The answer can be written in a

paper or flipchart, whiteboard or OHP.▫ Then, a single response from each participant is elicited. No

discussion permitted at this time.▫ Clarify the meaning of the response▫ After that, a preliminary vote is conducted to rank the response by all

participants▫ The result is discussed the voting patterns.▫ Then the final vote is carried out to rank again the most important

items and rate them.▫ Finally the grand total of vote are calculated and the items are rank

base don the priority.


3. The Delphi method▫ Series of questionnaires are mailed to a small number of

expert, opinion leaders or informants when face-to-face meeting are impractical.

▫ Start with definition of issue, selection of participants and then development of 1st questionnaire (open-ended question).

▫ Then, voting or comment format is used in the 2nd question set that based on the result obtained from 1st questionnaire set.

▫ Develop 3rd questionnaire that require a final vote.▫ Finalize the result.▫ Advantages:

Researchers are able to work with a variety of target group representatives.

Wide geographical outreach. Participants remain anonymous


4. The continuum approach▫ Participants are asked to indicate the level of quality of life for

themselves or their community by placing a ‘X’ on the quality of life continuum with the value ranging from ‘poor’ to ‘optimum’.

▫ They are asked to list several condition that they believe stand as barriers to an improvement in the quality of life.

▫ Advantage: Appropriate for use in small and large groups as well as in one-to-one settings.

2 3 4 5 6 7 8 9 101Poor Optimum

X

Area for potential improvement


5. Using public service data▫ Data taken from National Center for Health

Statistics, Department of Health, Education and Welfare, local and state health departments, WHO, professional journals and state planning agencies.


EPIDEMIOLOGICAL DIAGNOSIS: ASSESSING OF

ETIOLOGIES

HEALTH PROMOTION & EDUCATION (DEMA 3253)DIPLOMA IN ENVIRONMENTAL HEALTHVICTORIA INTERNATIONAL COLLEGE

PREPARED BY: MR KHAIRUL NIZAM MOHD ISA

INTRO

• Epidemiology has been defined as: ▫ “The study of the distribution and determinants of health

related states or events in specified population, and the application of this study to control of health problems.” (Last, 1988)

▫Distribution – frequency and pattern of health events in a population

▫Determinants – causes and other factors that influence the occurrence of health related events

IDENTIFYING HEALTH PROBLEMS

1. The Reductionist Approach▫ Assessing the relative importance of various cause or etiology.▫ Epidemiologic knowledge and method can be used to

recommend the priorities program directed for both : health problems and other program that due to non-health factors which contributed to

social problems

▫ Source of references are: Scientific and professional data/study

Non-health factors

Health factors

Social problem or quality of life concern: Poverty

OverpopulationPoor infant healthMental illnessParasitesAlcoholismMalnutrition

UnemploymentEducationLack of industryRace, age, genderGeographyTransportation

IDENTIFYING HEALTH PROBLEMS

2. The Expansionist Approach▫ Use when the assigned problem has been oversimplified▫ This approach can determine easily the relationship of health

problems to quality of life.▫ Vital in developing of data for significant subgroup (ie. without

such data it would be impossible for the professional to know which subpopulations should receive special attention and which health problem deserve higher priority)

DESCRIBING HEALTH PROBLEMS• Function of this process:

1. Help to establish relationship between the health problem, other health conditions and quality of life Epidemiological and medical data can provide an indication

for couching program objectives. Sources like National Center for Health Statistics, Department

of Health, Education and Welfare, local and state health departments, WHO, professional journals and state planning agencies.

2. It lead to fuller understanding of the various dimensions of the health problems setting priority and serve as a guide for concentrating the problems development and resources. Help the planner get a clear focus on the problems and the

strategies to be used in attacking them. Whether a program is to be preventive, curative, rehabilitative

or some combination of these perspective.

DESCRIBING HEALTH PROBLEMS

3. It can make possible a clear allocation of responsibilities among collaborating professionals, agencies or departments.

DEVELOPING PROGRAM OBJECTIVES

• Setting an objectives is crucial to convert diagnostic data into program direction.

• Objective should used epidemiological and medical term/language.• Who, What, How much, When• The objectives can be:▫ Measured using a parameter▫ Individual objectives are based on relevant, seasonably accurate data▫ Objectives are in harmony across topics (dealing with various aspect of

health problem) as well as across level (success in all levels and more refine)

•Project:▫Select one significance environmental health topic

that really you can work out inline with health education and promotion.

▫Apply this lecture to accomplish your project.

Thank you for your attention

modul 6 - social diagnosis assessing quality of life concerns

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