“It is unreasonable to expect that people will change their behavior easily when so many forces in the social, cultural, and physical environment conspire against such change” (Kovner and Knickman, p. 139).
When seeking to lessen behavioral risk factors in different populations, one of the greatest challenges is addressing the systemic issues within the population that enable the risky behavior to occur in the first place. Consider the health risks of school-age children not being immunized or drug users sharing needles. These risky behaviours led to increases in individual and population health problems. Thus, when planning health prevention programs, it is important to consider how to effectively address risky behaviors at both the individual and the population level.
The Discussion focuses on the use of the Population-Based Intervention Model outlined in the course text Health Care Delivery in the United States, as well as how this model can be applied to strengthen advocacy programs.
To prepare:
Selected Behavioural risk factor:
Alcohol Misuse/Risky Drinking: Binge Drinking
Proportions of adults who exceed guidelines for low risk drinking baseline 72% women, 74% men, 2020 goals 50%.
Adults 18 years and older baseline 16.6%, 2020 Goals 6%.
Adolescents (12 to 17 years) baseline 7.7%, 2020 Goals 2%.
Deaths from Alcohol-Related Auto Crashes baseline 5.9%, 2020 Goals 4%.
Assignment:
Research how this risk factor is affecting your community or state (Texas). The Discussion focuses on the use of the Population-Based Intervention Model outlined, as well as how this model can be applied to strengthen advocacy programs.
With your selected risk factor in mind, review the information on the Population-Based Intervention Mode. In particular, focus on the concept of downstream, midstream, and upstream interventions. Consider at least one intervention that could be put into place at each stage.
Comprehensive Approach to changing provider Practice.
Paradigm for Changing Provider Practice.
Upstream: National/State/Local performance mandates, reimbursement and pay for performance policies.
Midstream: Health plan level; organizational mandates/incentives, clinical information systems, technical assistance, CQI.
DownStream: Individual provider level: CME strategies
Between Upstream and Midstream: Managed care regulatory standards, performance measurement/accreditation (e.g., NCQA/HEDIS)
Between Midstream and Down Stream: Office-Level reminder systems, detailing local opinion leaders.
Post a description of the behavioral risk factor you selected and how this factor is impacting your community or state. Using the Population-Based Intervention Model, suggest at least one intervention that could be put into place at each stage (downstream, midstream, and upstream) to ensure that a health prevention program addressing the behavioral risk factor would have a greater chance at succeeding. Justify why each intervention you identified would be effective.
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