Modul 6 - Social Diagnosis Assessing Quality Of Life Concerns

SOCIAL DIAGNOSIS: ASSESSING QUALITY OF LIFE CONCERNS Module 5

HEALTH PROMOTION & EDUCATION (DEMA 3253) DIPLOMA IN ENVIRONMENTAL HEALTH VICTORIA INTERNATIONAL COLLEGE PREPARED BY: MR KHAIRUL NIZAM MOHD ISA

THE 7 PHASES OF PRECEDE Phase 6 Administrative diagnosis

Direct communication: public, patients

Phase 4-5 Educational diagnosis

Phase 3 Behavioral diagnosis

Predisposing factors: knowledge, attitudes, values, perceptions

Phase 1-2 Epidemiological & social diagnosis

Nonhealth factors Quality of life

Nonbehavioral causes Health education components of health program

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

Enabling factors: Availability of resources, accessibility, referrals, skills Reinforcing factors: Attitudes and behavior of health and other personnel, peers, parents, employers, ect.

Behavioral causes Behavioral indicators: utilization, preventive actions, consumption patterns, compliance, selfcare Dimensions: Earliness, frequency, quality, range, persistence

Health problems

Vital indicators: Morbidity, Mortality, fertility, disability Dimensions: incidence, prevalence, distribution, intensity, duration

Subjectively defined problems of individuals or communities Social indicators: illegitimacy, population, welfare, unemployment, absenteeism, alienation, hostility, discrimination, votes, riots, crime, crowding

OBJECTIVE IN PHASE 1 • •

•

• •

•

To determine the subjective concern with quality of life in the target population 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 To document the status of the target community in relation to those priority concerns for which there is a health components or cause To make explicit the rationale of the selection of priority problems To use the documentation and rationale to justify the further expenditure of health education resources on the selected social problems 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 Social policy/ Social condition

Health Problems

Quality of Life

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.

STRATEGIES FOR IDENTIFYING SOCIAL PROBLEMS 1. 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.

STRATEGIES FOR IDENTIFYING SOCIAL PROBLEMS 1. 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

STRATEGIES FOR IDENTIFYING SOCIAL PROBLEMS 1. 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. Optimum

Poor 1

2

3

4

5

6

7

8

9

10

X

Area for potential improvement

STRATEGIES FOR IDENTIFYING SOCIAL PROBLEMS 1. 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 HEALTH VICTORIA 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

Unemployment Education Lack of industry Race, age, gender Geography Transportation Social problem or quality of life concern: Poverty

Health factors Overpopulation Poor infant health Mental illness Parasites Alcoholism Malnutrition

IDENTIFYING HEALTH PROBLEMS 1. 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. ▫ 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 1. 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