preventions and interventions

still on step 3 of the Public Health Approach: develop and test prevention strategies

General Concepts of Prevention

Addressing risk factor is one of two ways of thinking about preveting diseases and injuries. The second way is to interrupt the prgression of a disease or injury. There are phases at which you can intervene. (the earlier the better).

Injury

The conceptual model for injury; at some point the injury occurs. We want to prevent that so we need to look at what happened before- an "event" (car crash) that caused the injury (fractured legs) has to have happened.

Recall that the agent of the injury is energy, so the event would have to be an incident in which energy is released suddenly.

The time you spend being in a situation in which it is possible to be involved in a car crash is called "exposure" (driving around). More exposure = more risk.

The worst possible outcome of an injury is death

At each point in this model is the opportunity to stop the worst possible outcome from happening.

Ideally, the event doesnt happen at all (no crash = no injury = no death). This is called "primary prevention" (preferred). We prevent the event by reducing the person's exposure to happen. Or we make the event less likely to occur by lowering the risk of the exposure.

another possible intervention point is to prevent injury from occuring during the crash, this point is called "secondary prevention", where we do somethign that will protect you if you do crash (airbags, saftey seat, etc.)

The worst case is that the injury occurs, then we need to medically treat the injury to prevent death and provide care to restore functioning as much as possible. This is called "tertiary prevention" and is the last resort because the person has suffered and medical care is expensive. This prevention always includes some kind of medical care.

Definitions are:

• Primary prevention: prevent an "event" with injury- causing potential from occuring, generally by limiting human exposure to hazardous energy or making the event less likely to occur.
• Secondary prevention: prevent an injury from occuring during an event.
• Tertiary preventiion: provide medical treatment to prevent death or complications and to restore functioning.

Communicable Disease

The conceptual model for the progression of a communicable disease differs in what happens after the exposure but before someone is symptomatic. In this case, it is when the pathogen is transmitted to teh host. The time between transmission of the infectious agent to the host and sympoms appearing in the host is called the "incubation period"

• primary prevention is preventing transmission after exposure to pathogens.
• secondary prevention is preventing disease/symptoms after transmission. Use screening and contact tracing to identify these individuals who may have contracted disease but are in incubation period. If you intervene early, you can prevent more advanced disease
  • This is why most HIV-positive individuals can live normal lives if we start treating before it progresses to AIDs.
• tertiary prevention recovery after getting disease to prevent death. E.g., getting rabies shot (post-exposure prophylaxis.)

Non-Commuicable diseas

The "latency periode" is a long period of time during which the host is repeatedly exposed to the agent. The damage accumulates gradually and eventually cause symptoms.

• primary: prevent development of disease in helathy indivduals by limiting exposure to harmful agents
• screen to detect disease process in early stages to intervene to prevent advanced disease
• tertiary: provide medical treatments to prevent death/complication adn maintain best health

Generalized

• primary: prevent disease/injury process from starting by limiting exposure to harmful factors
• secondary prevention: prevent full-blown disease/injury after disease/injury proces has already started. done through early detection/secreening and early intervention
• tertiary prevention: medical treatment and rehabilitation.