CPH

• Community organization & health promotion


  A process by which community groups are helped to identify common problems or change targets, mobilize resources, and develop & implement strategies for reaching their collective goals
• Changes in community social structure has lead to loss in sense of community
• Advances in electronics, communications, and increased mobility have contributed to the loss in sense of community
• Community organizing skills extend beyond community health
• Community organizing methods

  • Locality development
  • Social planning
  • Social action
• Initial organizer


  Recognizes that a problem exists and decides to do something about it, gets things started, can be from within or outside of the community
• Gatekeepers


  Those who control, both formally and informally, the political climate of the community
• Criteria to consider when selecting priority issue

  • Problem must be winnable
  • Must be simple and specific
  • Must unite members of organizing group
  • Should affect many people
  • Should be part of a larger plan
• Final step in community organization & health promotion

  • Implementing
  • Evaluating
  • Maintaining
  • Looping back
• Health education


  Part of health promotion

  
• Health promotion


  More encompassing than health education

  
• Steps in creating a health promotion program

  • Assessing the need of the priority population
  • Setting appropriate goals and objectives
  • Creating an intervention
  • Implementing the intervention
  • Evaluating the results

  
• Goals


  More encompassing, written to cover all aspects of the program, provide overall program direction, are more general in nature, usually take longer to complete, are usually not observed but inferred, often not measured in exact terms
• Objectives


  More precise, steps to achieve the program goals, composed of who, what, when and how much
• Intervention considerations


  • Multiplicity
  • Dose
  • Best practices
  • Best experience
  • Best processes
• Types of evaluation


  • Formative evaluation
  • Summative evaluation
  • Impact evaluation
  • Outcome evaluation

  
• Determinants of health


  Various factors that influence a person's current state of health
• Environmental factors are one of the determinants of health
• Different sources of evidence are used in health impact assessments, including research, reviews, and local and expert knowledge
• The goal of health impact assessments is to identify and assess both positive and negative health impacts, as well as their magnitude and distribution among different population groups
• The evidence-based approach in health impact assessments helps to provide a comprehensive understanding of the potential health impacts and supports informed decision-making

  
• Infectivity


  Characteristics of the infectious agent that embodies its capability to enter, survive, and multiply in the host
• Pathogenicity


  Proportion of infected individuals who develop clinically apparent disease
• Virulence


  Proportion of clinically apparent cases that are severe or fatal
• Antigenicity or immunogenicity


  Ability of an agent to produce a systemic or local immunologic reaction in the host
• Host factors that influence exposure

  • Animal exposure, including pets
  • Behavioral factors related to age, drug use, alcohol consumption
  • Blood or blood product receipt
  • Child daycare attendance
  • Closed living quarters
  • Food and water consumption
  • Hospitalization or outpatient medical care
  • Hygienic practices, including toilet training and hand washing
  • Occupation
  • Recreational injection drug use
  • Sexual activity
  • School attendance
  • Socioeconomic status
  • Travel, especially to developing countries
  • Vector exposure
• Host factors that influence infection and the occurrence and severity of disease

  • Age
  • Alcoholism
  • Antibiotic resistance
  • Coexisting noninfectious diseases
  • Dosage: amount and virulence of the organism
  • Duration of exposure to the organism
  • Entry portal of the organism and presence of trauma
  • Genetic makeup
  • Immune state at the time of infection
  • Immunodeficiency
  • Mechanism of disease production
  • Nutritional status
  • Receptors for organism on cells
• Direct contact transmission


  Occurs in association with touching, kissing, or sexual intercourse or by the direct projection (droplet spread) of droplet spray from an infected host onto the conjunctiva or the mucous membranes of the nose or mouth of another host
• Indirect transmission of infectious agents

  Vehicle-borne transmission and vector-borne transmission
• Vehicle-borne transmission


  When any material serves as an intermediate means by which an infectious agent is transported or introduced into the susceptible host through a suitable portal of entry
• Vector-borne transmission


  May be mechanical or biologic
• Direct transmission


  Transmission through physical contact, sexual intercourse, or droplet spread
• Direct transmission


  • Droplet spread limited to 1m
  • Exposure to agent through bite of rabid animal
  • Transplacental transmission
• Indirect transmission


  Transmission through a vehicle or vector
• Vehicles for indirect transmission

  • Water
  • Food
  • Biological products (blood, serum, plasma, tissues, organs)
  • Objects (fomites) like toys, soiled clothing, bedding, surgical instruments
• Mechanical vector transmission


  Infectious agent carried by insect through soiling of feet/proboscis or gastrointestinal tract, without requiring multiplication or development
• Biologic vector-borne transmission


  Transmission requiring propagation, cyclic development, or a combination in the arthropod before it can transmit the infected form to humans
• Airborne transmission


  Dissemination of aerosols with infectious agents to a suitable portal of entry, usually the respiratory tract
• Airborne transmission does not include droplets and other large particles that promptly settle out, which result in direct transmission
• Portal of entry


  Manner in which a pathogen enters a susceptible host, providing access to tissues where it can multiply or a toxin can act