Interventions at the population level

Rationale

Many interventions at the individual level must be supported by actions at the community level. Physicians will be expected to advocate for community wide interventions and to address issues that occur to many patients across their practice.

Key Objectives

1. Understand the three levels of prevention (primary, secondary and tertiary).
2. Describe strategies for community needs assessments, health education, community engagement and health promotion.
3. Appreciate the role that physicians can play in promoting health and preventing diseases at the individual and community level (e.g. prevention of low birth weight, immunization, obesity prevention, smoking cessation, cancer screening, etc.).
4. Understand how public policy can influence population-wide patterns of behaviour and affect the health of a population.

Enabling Objectives

1. Be able to both define the concept of levels of prevention at the individual (clinical) and population levels, as well as formulate preventive measures into their clinical management strategies.
2. Name and describe the common methods of health protection (such as agent-host-environment approach for communicable diseases, and source-path-receiver approach for occupational/environmental health).
3. Describe the importance and impact of good, culturally-appropriate communication with the patient, the patient’s family and, if necessary, the community as a whole with regard to risk factors and their modification.
4. Apply the principles of screening and be able to evaluate the utility of a proposed screening intervention, including being able to discuss the potential for lead-time bias and length-prevalence bias.
5. Understand the importance of disease surveillance in maintaining population health and be aware of approaches to surveillance.
6. Identify ethical issues with the restricting of individual freedoms and rights for the benefit of the population as a whole (e.g., issues in designating non-smoking areas or restricting movements of person with active tuberculosis).
7. Describe the advantages and disadvantages of identifying and treating individuals versus implementing population-level approaches to prevention.
8. Describe the five strategies of health promotion as defined in the Ottawa Charter and apply them to relevant situations.
9. Describe one or more models of behavior change, including predisposing, enabling and re-enforcing factors.
10. Identify the potential community, social, physical, environmental factors and work practices that might promote healthy behaviors, as well as ways to assist communities and others to address these factors.
11. Be aware of the role of, and work collaboratively with, community and social service agencies (e.g., schools, occupational therapists, municipalities, non-governmental and other agencies).
12. Demonstrate awareness of the contribution of allied professionals such as social workers in addressing population health issues.
13. Be able to describe the health impact of community-level interventions to promote health and prevent disease.
14. Describe examples of public policies which have had an effect on population health.