Behavior change to prevent chronic diseases through population.
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Transcript of Behavior change to prevent chronic diseases through population.
Health Education and Promotion Department
Umm Al-Qura UniversityFaculty of Public Health and Health Informatics
By: Dr. Ahmed Abdullah
Behavior change to prevent chronic diseases through
population
Chronic diseases
Burden of The Chronic Diseases
Risk Factors
Prevention
Coaching and Motivational Interviewing
Contents of the Lecture
Chronic diseases• They are medical conditions mainly of non
infectious etiology, and 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 اديسون مرضAsthma الربو
Bipolar Mood Disorder الثنائي المزاج اضطراب
القطب
Bronchiectasis الهوائية القصبات توسع
Cardiac failure القلب فشل
Cardiomyopathy القلب عضلة اعتالل
Chronic kidney disease المزمن الكلى مرض
Chronic obstructive pulmonary disease الرئوي االنسداد مرض
المزمن
Chronic renal disease المزمن الكلوي المرض
Coronary artery disease التاجي الشريان مرض
Examples of The Common Chronic Diseases
Crohn's disease كرون مرض
Diabetes insipidus الكاذب السكري مرض
Diabetes mellitus (type 1 and type 2) نوع ) السكري (2ونوع 1داء
Dysrhythmia (irregular heartbeat) انتظام ) عدم النظم خلل) القلب ضربات
Epilepsy الصرع
Glaucoma ) الزرقاء ) المياه الزرق
Haemophilia الدم سيولة
Hyperlipidaemia (high cholesterol) الشحوم نسبة ارتفاع) المرتفع) الكوليسترول
Hypertension (high blood pressure) الدم ضغط ارتفاع
Examples of The Common Chronic Diseases
Hypothyroidism غير ) الدرقية الغدة خمولنشطه(
Hyperthyroidism الدرقية الغدة نشاط فرط
Multiple sclerosis المتعدد التصلب
Parkinson's disease الرعاش الشلل مرض
Pulmonary disorder رئوي اضطراب
Rheumatoid arthritis الروماتويدي المفاصل التهاب
Schizophrenia الشخصية في انفصام
Systemic lupus erythematosus (SLE) الجهازية ) الحمامية (SLEالذئبة
Ulcerative colitis التقرحي القولون التهاب
Chronic Diseases
Genetic
ExposureBehavior
The development of chronic diseases is a combination of 3 factors:
Burden of The Chronic Diseases• Now, the chronic diseases are the major
cause of disability and death globally.• Chronic illnesses have a serious impact on
individuals and on society in general. They affect the quality of life of individuals and 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. Two of these 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, 53 million adults with a doctor diagnosis of arthritis.
• Diabetes is the leading cause of kidney failure, lower-limb amputations other than those caused by injury, and new cases of blindness among adults.
Chronic Diseases Prevalence in Saudi Arabia
• Elevated BMI (11.64%)• Dietary risks (9.68%)• Elevated FPG (9.53%)• Elevated blood pressure (7.83%)• Physical inactivity (5.33%)• Smoking (3.02%)
Major Causes of Death in KSA• Cerebrovascular disease (13.20%)• Ischemic heart disease (6.23%)• Road traffic injury (11.75%)• Chronic kidney diseases (3.99%)• Diabetes mellitus (3.70%)• Hypertensive heart disease (2.37%)
Risk Factors• A number of risk factors related to an
individual's lifestyle can contribute to the development of chronic diseases (e.g. cardiovascular diseases, chronic respiratory conditions and 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 and 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 or exposures that can lead to disease.
• Examples include smoking cessation and 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• Motivational interviewing is a technique
used in some self-management programs to identify a client’s readiness to change and how barriers can be overcome.
• The professional-client relationship during motivational interviewing is a partnership rather than an expert-recipient relationship and 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 centered2. Non-judgmental3. Expressing empathy4. Building trust5. Being collaborative6. Reflective listening
Characteristics of Motivational Interviewing
7. Increasing discrepancy8. Exploring ambivalence9. Reducing resistance10. Increasing readiness11. Eliciting change talk 12. Increasing self-efficacy
Examples of Prevention Interventions
Disease Intervention level
Primary Secondary Tertiary
Colorectal Cancer
Individual
Counselling on healthy lifestyles: dietary counselling for people at risk of colorectal cancer, etc.
Hemoccult stool testing to detect colorectal cancer early
Follow-up exams to identify recurrence or metastatic disease: physical examination, liver enzyme tests, chest x-rays, etc.
Examples of Prevention Interventions
Disease Intervention level
Primary Secondary Tertiary
Colorectal Cancer
Population Publicity campaigns alerting the public to the benefits of lifestyle changes in preventing colorectal cancers; promotion of high fibre diets; subsidies to help people access exercise programmes; anti-smoking campaigns
Organized colonoscopy screening programs
Implementation of health services organizational models that improve access to high-quality care
Examples of Prevention Interventions
Disease Intervention level
Primary Secondary Tertiary
Metabol
ic Syndrome
Individual Nutrition and exercise counselling
Screening for diabetes
Referral to cardiac rehabilitation clinics
Examples of Prevention Interventions
Disease Intervention level
Primary Secondary Tertiary
Metabol
ic Syndrome
Built environment favorable for active transport (walking, bicycling rather than using a car)
Community level weight loss and exercise programs to control metabolic syndrome
Implementation of multidisciplinary clinics
Built environment favorable for active transport (walking, bicycling rather than using a car)
Questions? Comments?