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EPHE 142: Midterm 1 Study Guide Notes
1. Define Health: A person's physical, mental and social well-being The sate of being free
from illness or injury A passive state of homeostatic or balance
2. Define Wellness: More than freedom from disease. Talking steps to prevent illness. Purposeful, enjoying
living. A deliberate lifestyle choice characterized by per- sonal responsibility. Optimal enhancement of physical, mental, and spiritual health. Wellness is more than being free from illness, it is a dynamic process of change and growth. Perception of wellness may differ depending on your age, gender, culture, and environment. Multiple dimensions to wellness and they are interconnected.
3. Illness-Wellness Contunuum: Pre-Mature Death:
Treatment Paradigm:
1. Disability
2. Symptoms
3. Signs
NEUTRAL POINT: (No discernable illness or wellness)
4. Awareness
5. Education
6. Growth
High-Level Wellness
4. Factors Influencing our society's ideas and beliefs of health and wellness-
: Culture Research Life Experience Friends/Family Media
5. Health Vs. Wellness: Health is a passive state of homeostasis or balance, where as wellness was a dynamic
process of continually moving toward one's potential for optimal functioning. Wellness emphasized a positive state, one that is beyond simply non-sickness.
6. WHO: Define Health: is a state of complete physical, mental, and social well-be- ing and not merely the
absence of disease or infirmity.
7. National Wellness Institute: Define Wellness: is an active process of becoming aware of and making choices
towards a more successful existence. -Process means we never arrive at a point where there is no possibility of improving. -Aware means that we are by nature continuously seeking more info about how we can improve.
- Choices means that we have considered a variety of options and select those that seem to be in our best interest.
8. The history of wellness: Ayurveda: 3000-1500 B.C.
A holistic system that strived to create harmony between body, mind and spirit. Yoga and mediation are critical to the tradition.
9. The history of wellness:
Kindness, honesty, sharing and strength
16. Dr. Halbert Dunn (1977): emphasized wellness as a positive state, one that is beyond simply non-sickness,
elaborating on the WHO definition by emphasizing the varying degrees of wellness and its interrelated, ever changing aspects
17. First Wellness Resource Center: founded in the U.S. in 1975 by Dr. John Travis
18. Who developed the six dimensions of the wellness model: Dr. Bill Hettler in the 1970s
19. Hettler Six Dimensions of Wellness: (hexagon)
- occupational
- physical
- social
- intellectual
- spiritual
- emotional
20. Hettler's Six Dimensions of Wellness: Physical Wellness: The ability to rec- ognize that our behaviours
have a significant impact on our wellness and adopting healthful habits while avoiding destructive habits -being physically active/ avoid harmful substances
21. Hettler's Six Dimensions of Wellness: Emotional/Psychological Wellness-
: -Emotional Wellness means
1. understand and accept your feelings
2. learn to express and cope with your emotions in a respectful and productive manner
22. Hettler's Six Dimensions of Wellness: Intellectual Wellness: the degree to which one engages in creative
and stimulating activities, as well as the use of resources to expand knowledge and focus on the acquisition, develeopment, ap- plication, and articulation of critical thinking. Intellectual wellness refers to active participation in scholastic, cultural and commu- nity activities
23. Hettler's Six Dimensions of Wellness: Spiritual Wellness: personal matter involving values and beliefs
that provide a purpose in our lives -it is generally considered to be the search for meaning and purpose in human existence, leading one to strive for a state of harmony with oneself and others while working to balance inner needs with the rest of the world.
24. Hettler's Six Dimensions of Wellness: Social Wellness: ability to build per- sonal connections with others,
deal with conflict, and to be apart of a positive social network. Social wellness is getting along with others and willing to express one's feelings, needs, opinions
25. Hettler's Six Dimensions of Wellness: Occupational Wellness: Finding en- richment through our work can
enhance our well-being
- a "well" occupation is consistent with personal values, interests, and beliefs
26. Emotional Wellness: Seeking happiness vs. self realization: Emotional well- ness is not all about achieving
the outcome (i.e. happiness) but also about the process of self-realization (the realization of valued human potentials)
27. How to engage in the process of intellectual wellness?: -Find out your interests.
-Be open to new ideas -Seek personal growth by learning new skills -Look for ways to be creative
32. Health Promotion: the process of enabling people to increase control over and to improve their health
-Must be able to identify and realize aspirations -Health is seen asa resource for everyday living
33. Achieving Health for All: A framework for Health Promotion: -Follow up report
Identified 3 national health challenged
1. Reducing inequities
2. Increasing the prevention effort
3. Enhancing people's capacity to cope
34. Dr. Jon Snow: (1854): Father of modern day epidemiology
epidemiology- study of how often diseases occur in different groups of people and why? Also stopped the spread of Cholera
35. Epidemiology Data: Environmental, clinical, genetics, molecular, social
36. Epidemiology Info can be used to...: -Evaluate Health strategies
-Prevent Illness -Methods to allocate health resources
37. Limitation of Survey Data: -Time Lag
-Resource intensive -Incomplete Responses
38. Observational Studies: the researcher observes and systematically collects info, but does not try to change
the people (or animals or reagents) being observed. No intervention.
39. Experimental Studies: the researcher intervenes to change something (i.e. gives some patients a drug)
and the observes what happens
40. Randomized Controlled Trial:: Experimental Studies
Allocate one group of people to receive an intervention and compare to a group without the intervention (control) Pros: mini bias. evaluating intervention effectiveness Cons: use selected population, ethical concern, time consuming
41. Quasi Experimental Design:: Experimental Studies Similar to RCT but
without randomization Pros: natural experiments, overcome challenges of RCT Cons: intervention group allocation bias
42. Cross Sectional Study: Observational Studies Compare different population
groups at a single point in time Pros: Quick Cons: self report/bias
43. Cohort (longitudinal) Study: Observational Studies Study changes in
outcome variables over time Pro: establish causal sequences Cons: Time consuming/costly/ drop outs
44. Case Control Studies: Observational Studies
Looking back retrospectively in patients those with a disease (or outcome) and compare to those without disease Pros: Cost Effective Cons: not
5. Food Insecurity
6. Housing
7. Social Exclusion
8. Health Services
9. Social Safety Net
10. Aboriginal Status
11. Gender
12. Race
13. Disability
14. Health Services
51. Positive Change in Health Behaviour Incorporates...: Predisposing Factors: knowledge attitude, beliefs,
values, and perceptions Enabling Factors: Skills, resources, accessible facilities, physical capabilities mental capabilities Reinforcing Factors: Praise from others, rewards, encouragement, recognition and sense of achievement
52. Classifications of current Behaviour Change Models/Theories: Intraperson- al Level: based on knowledge,
motivation, intention, perception of threat, outcome expectancy, perceived behavioural control and social pressure- which shape indi- vidual behaviour. -Health Belief Model, Stages of Change Model
Interpersonal Level: people learn and behave not only their own experiences but also by observing other's actions and through role modeling -Theory of Planned Behaviour Community and Social Levels: human behaviour both influences and is influence by the social environment -Theory of Ecological Perspective
53. The Health Belief Model (HBM): A psychological model that attempts to explain and predicts health
behaviours -Focusing on the attitudes and beliefs of individiuals -First developed in the 50s by social psychologists Hochbaum, Rosenstock, and Kegels working in the U.S. Public Health Services to tackle tuberculosis (TB) health screening program
54. HBM Core Assumptions: Assumes that people make rational health choices Behaviour Change is a product
of an individual's health beliefs which are based on the perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. Change is undertaken when the pros or benefits of new behaviour outweigh the cons or barriers to the behaviour
55. HBM Concept: Perceived Susceptibility: One's opinion of chances of getting condition
56. HBM Concept: Perceived Severity: One's opinion of how serious a condition and its consequences are
57. HBM Concept: Perceived Benefits: One's belief in the efficacy of the advised action to reduce risk or
seriousness of impact
58. HBM Concept: Perceived Barriers: One's opinion of the tangible and psycho- logical costs of the advised
action
59. HBM Concept: Cues to Action: Strategies to activate "readiness"
P=0.01= 1% chance Accept null Hypothesis if P-value greater than or equal to .05 Reject null Hypothesis if P-value is less than or equal to.
64. What is the Trans-Theoretical Model? (TTM): The TTM of behaviour change assesses an individual's
readiness to act on a new healthy behaviour, and provides strategies (processes of change) to guide the individual through the stages of change. -Developed by Prochaska and colleagues: -model inspired by smoking cessation studies -draws on fields of psychotherapy and behaviour change
65. Why is TTM important?: -Successful behaviour change needs to be tailored to the person's
motivation/readiness level -The model has been applied to a wide range of health behaviours: addiction bullying eating disorder etc -TTM can be effective to help you and your future "clients" change their behaviour to achieve a higher level of wellness
66. TTM: Consists of Four Core Constructs:: 1: Stages of Change(6 stages) 2: Processes of Change (
processes)
3. Decisional Balance (pro/cons)
4. Self Efficacy (confidence/Temptation)
67. Stages of Change: ONLY TALK ABOUT 5 Precontemplation: Blissful
Ignorance (in the next 6 months) Contemplation: Fence Sitting (within the next 6 months) Preparation: Getting Ready to Try (next four weeks) Action: Going for it (within the past 6 months) Maintenance: Steady as she goes (doing it more than 6 months)
68. Process of Change: Consciousness Rasing: Finding and learning new facts, ideas and tips that support the
recommended behaviour change. -increasing awareness via information, education, and personal feedback about the healthy behaviour GET THE FACTS
69. Process of Change: Dramatic Relief: -Experiencing negative emotions in as- sociation with the unhealthy
behaviour -Feeling fear, anxiety, or worry because of the unhealthy behaviour, or feeling inspiration and hope when hearing about how people are able to change to healthy behaviours. PAY ATTENTION TO FEELINGS
70. Process of Change: Environment Re-evaluation: Realizing how the presence or absence of a personal
behaviour can affect one's social environment -It can also include the awareness that one can serve as a positive or negative role model for others. NOTICE YOUR EFFECT ON OTHERS
71. Process of Change: Self Re-evaluation: Realizing that the behaviour change is an important part of one's
identity as a person -Assessments of one's self image with and without a particular unhealthy habit. Values clarification, identify healthy role models, and imagery are techniques that programs can use to move people toward self re-evaluation. ("imagine you were free of smoking? how would you feel about yourself?") CREATE A NEW SELF IMAGINE
80. Process of Change: Counter Conditioning: requires learning healthy behav- iours as substitutes for
problem behaviours USE SUBSTITUTE
81. Process of Change: Helping Relationships: Helping Relationships combine caring, trust, openness, and
acceptance, as well as support for healthy behaviour change. Rapport building, a therapeutic alliance, supportive calls, and buddy systems can be sources of social support USE SUPPORT
82. Process of Change: Stimulus Control: Stimulus Control removes cues for unhealthy habits and adds
prompts for healthier alternatives. In this process TTM programs can recommend revolving all the ashtrays from the house and car or removing high-fat foods that are tempting cues for unhealthy eating. -Journal Entry can be helpful in identifying cues to your unwanted actions MANAGE YOUR ENVIRONMENT
83. Process of Change: Reinforcement Management: Increasing the Rewards for the healthy behaviour and
decreasing the rewards for the unhealthy behaviour USE REWARDS
84. Intrinsic rewards: is an intangible award of recognition, a sense of achieve- ment, or a conscious
satisfaction
85. Extrinsic rewards: is a tangible or physically given to you for accomplishing something
86. TTM Assumptions: -No single theory can account for all the complexities of behaviour change
-Behaviour change is a process that unfolds over time through a sequence of stages -Stages are both stable and open to change -The majority of at-risk populations are not prepared for action -Specific processes and principles of change should be emphasized at specific stages to maximize efficacy -Stage-matches interventions have been designed primarily to enhance self-control
87. Limitations of TTM: When behaviour are associated with socioeconomic and education status is may also
be important to address the behaviour's role in the broader social and physical context. -Model may be of limitated use in populations where behaviours are contingent on several external restrictions -The lines between the stages can arbitrary with no set criteria of how to determine a person's stage of change. -There is no clear sense for how much time is needed for each stage, or how long a person can remain in a stage.
88. Define Physical Activity: All leisure and non-leisure body movement produce by the skeletal muscles and
results in an increase in energy expenditure
89. Define Exercise: Physical activity that you plan, structure and repeat for the purpose of conditioning
your body
90. Canadian Physical Activity Guidelines: -18-64 years
-an accumulation of at least 150 minutes of moderate to vigourous-intensity aerobic physical activity (MVPA) per week -it bouts of 10 minutes or more
91. What percent of Canadian Adults were meeting the 150 minute per week of Moderate to Vigorous
intensity physical activity: 15.4 percent -Discrepancy between self-reporting versus accelerometer monitoring
92. Sedentary Behaviour: Postures or activities that require little movement
-Prolonged sedentary time was independently associated with deleterious health outcomes regardless of physical activity
93. Physical Fitness: Ability to respond to routine physical demands with enough reserve energy to cope with
a sudden challenge
99. Flexibility: range of motion around specific joints
depends on age, gender, posture, bone spurs, how fat/muscular
100. Body Composition: Refers to amount of fat and lean tissue in body
-high proportion of fat tissue has serious health implications, high blood pressure, diabetes, stroke, gall bladder problems, back and joint problems, cancer
101. Skill Related Fitness: agility, balance, coordination, and power
102. Agility: is the ability to change your body position and direction quickly and efficiently
103. Balance: the body's ability to maintain proper equilibrium
104. Coordination: the integration of the nervous and muscular systems
105. Power: the ability to produce maximum force in the shortest time, has two components -speed and
force
106. How do you improve your physical fitness?: Physical Conditioning and Functional Fitness
107. What is functional fitness: performance of daily activities
exercises that mimic job tasks or everyday movements can improve an individual's balance, coordination, strength and endurance
108. What is Physical Conditioning: refers to the gradual building up of the body to enhance
cardiorespiratory, or aerobic fitness, muscular strength and endurance and flexibility
109. Health Benefits for Physical activity: better bones better mental health
bright mood less stress enhanced immunity healthier heart and lungs longer and more active life lower risk of cancer lower risk of Type 2 diabetes lower weight
110. Aerobic Energy System: body uses oxygen Low to moderate
intensity The body uses oxygen to break down carbs fat to met the demand of the activity
111. Anaerobic Energy System: without oxygen fuels high
intensity, short duration activities When the amount of oxygen taken in by the body cannot meet the demands of the activity it results in an oxygen deficit -sprinting, weight lifting, running for bus
112. Principles of Exercise:: Overload Principle:
-me must exercise our body at a level of activity greater than to which it is accus- tomed Progressive Overload: -Gradually increases physical challenged and provided benefits without risks -Graduate increase in Exercise FREQUENCY, INTENSITY, TIME Reversibility: -use it or lose it, usually no major loss of cardiovascular exercise benefits for the first 5-7 days of missed physical activity
