COMMEDRecon_Evals6

COMMED EVALS 6 (November 17, 2010) Topics Covered:  Health Education  Dr. Hipol  The Philippine Cancer Control Program  ISP; Dr. Carnat e  The Philippine CVD Prevention and Control Program  ISP; Dr. Carnate  Public Health Administration 3  Dr. Carnate

Set A: Identify the strategies strategies which which could be used in the following objectives/conditions: objectives/conditions: A. Lecture B. Media C. Demonstration D. Individual Instructions 1.

To

increase the awareness of mothers all over the Philippines regarding the importance of immunization. B - Media Mass Media (TV, Radio, Newspaper, Outdoor and Transit Ads, Direct Mail) Large number of people can be reached  Message has to be simple This is best because your target group is mothers all over the Philippines.

2.

To

improve the reading skills of 10 grade 2 children with varied levels le vels of intelligence. D  Individual Instructions Individual Instruction One-on-one Most personalized Inefficient from the P OV of the teacher; Efficient for the learner Learners progress at their own rates Best use when the range of individual differences within the target group is great  -

3.

To

improve the skills of BHWs in determining the vital signs. C  Demonstration Demonstration (with a small group) Participants can be active and learn by doing Convinces the audience that things can easily be done -

Set B. A. Programmed learning B. Mass Media C. Audio-visual D. A and B 4. When content is of confidential or embarrassing nature A  Programmed Learning Programmed Learning Brought about by means of teaching machines, programmed tests and computers programmed to present materials in a carefully organized sequential system Teacher not needed  Appropriate when the subject matter is relatively unambiguous, repetitive and straightforward W hen hen content is of confidential or embarrassing nature -

5.

Intended only to supplement and reinforce other educational methods C  Audio-Visual Audio-Visual Compared to mass media, audience reached is more limited  Intended only to supplement and reinforce other educational methods Effective in conveying conveying factual  factual information -

For Sets C & D; # 6-11:

STAGES OF CHANGE MODEL STAGE PRE-CONTEMPLATION

CONTEMPLATION

PREPARATION / DECISION

ACTION

MAINTENANCE

DEFINITI ON DEFINITION - unaware or under aware of their problem - no intention to take action/change behavior in 6mos - aware that problem exists - intends to take action in 6 mos; mos; seriously thinking about overcoming it - no commitment made commitment made to take action - combines intention and behavioral criteria - intends to take action in 30 days - committed to committed to take action - no action taken in the past year - modify their behavior, experiences, or environment in order to overcome their problems - involves the most overt behavioral changes - requires commitment of time and energy - has changed behavior for behavior for less than 6mos -  prevent relapse and consolidate the gains attained - has changed behavior for more than 6 mos

POTENTIAL STAGE STRATEGIES - increase awareness of need for change - personalize information about risks and benefits - motivate - encourage making specific plans - assist with developing and implementing concrete action plans - help set gradual set gradual goals

- assist with feedback, with  feedback, problem solving, social  support, reinforcement  - assist with assist  with coping, reminders, finding alternatives, avoiding slips/relapses

In short,

STAGE PRE-CONTEMPLATION CONTEMPLATION PREPARATION ACTION

Set C (#6-8):

AWARENESS

INTENTION INTENT ION

COMMITMENT

















ACTION



Identify the stage of change being described below: A. Pre-contemplation B. Contemplation C. Decision D. Action E. Maintenance

Set D (#9-11): Identify the potential change strategy strategy for for the following: A. Personalize information about risks and benefi ts B. Encourage making specific plans C. Help set gradual goals D. Assist with feedback and reinforcements E. Assist with coping, reminders, avoid relapses 6. (& 9.) Fatty, 34-year-old female attended a short lecture on how to become more fit. Although she has started with her exercise regimen last week, she felt she still needed to attend the said lecture. D  Action  Assist with feedback feedba ck and reinforcements She has started with her exercise regiment last week = (+) action, changed behavior for less than 6 mos. mos.

7. (& 10). Marta is a 34-year-old employee who one week ago has been diagnosed to be suffering from hypertension. Yesterday, she went back to her doctor because her doctor told her that she needed to diet and exercise. B B  Contemplation  Encourage making specific plans Though

it wasnt specifically mentioned that she already has the intention to take action, I guess the answer is B because having been diagnosed, she is already aware of her condition, thus putting her past the Pre-contemplation stage.

8.

(& 11). Sarah, while jogging inside the campus, felt some knee pains. Her friend said that most likely she is suffering from some kind of arthritis which she was not aware of. A  Pre-contempation  Personalize information about risks and benefits Clue: which she was not aware of 

12. In developing a session plan, the percentage of tim e which should be allotted for introduction should be: a. 20% b. 15% c. 10% d. 5% SESSION PLAN Introduction (15% of class time) time) Provide an overview of the session (Agenda) Link to previous session What is your main point? Why is it important? Body (70%)

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Break up into segments/different activities (that help you make your main point) Cue students that you are moving from one segment to the next Be clear with instructions

Conclusion (15%) R estate your main point Show the links between the main point and what you have done in class Link to next session

13. The main difference between a session plan from a curriculum is: a. Objectives b. Teaching methods c. Assessment method d. Duration of teaching CURRICULUM written description of  what happens throughout the duration of the course

SESSION PLAN a small curriculum a tool to organize a shorter period of teaching

INCLUDES:

of the course general 

Objectives Teaching Methods Time/Place where students will learn Methods of assessment

of the session in detail 

14. What should be the best arrangement of the following essentials of a session plan when tabulated from the first to the last column: a. Learning objectives, content, teaching method, resources, time, evaluation b. Learning objectives, content, resources, teaching method, time, evaluation c. Learning objectives, content, resources, teaching method, evaluation, time d. Learning objectives, teaching method, content, resources, time, evaluation SESSION PLAN Session Title / Topic: Participants: Venue of Learning: Time and Time Allotment: LEARNING CONTENT OBJECTIVES

TEACHING METHOD

RESOURCES

TIME

EVALUATION

15. To determine if there would be more mothers who would bring their child for immunization would fall under: a. Outcome b. Impact c. Process d. A,B e. A, B,C

16. To determine whether the resources were enough after a health education activity would fall under a. Outcome b. Impact c. Process d. A,B e. A,B,C For # 15 & 16

TYPES OF EVALUATION Process measures the strategies and activities of the project,  project quality including quality  including quality of resources, and whom it is reaching st 1 level Impact -

measures the immediate effects of the project and whether the objectives are being met  conducted after Process Evaluation

Outcome measures the long-term effects and whether the project is achieving achieving its goal  Done after Impact Evaluation

15. It is an Impact evaluation because it measures the immediate effect of the project, which is whether more mothers would bring their child for immunization 16. P rocess rocess evaluation measures project quality, including quality of resources.

For # 17-20: 17-20: Identify the theory which which was used / or could be applied applied by the program implementor. A. Community Mobilization Theory B. Social Learning Theory C. Health Belief Model D. Stages of Change Model E. B,C COMMUNITY MOBILIZATION THEORY Community members assess health risks, take action Encourages empowerment, building on cultural strengths, and involving disenfranchised groups Emphasizes active participation participation and development of the communities that can better evaluate and solve health and social problems SOCIAL LEARNING THEORY Explains behavior via a three-way, dynamic reciprocal theory in which  personal factors,  personal factors, environmental influences environmental  influences and behavior continually behavior  continually interact HEALT H BELIEF

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MODEL Assesses persons perception of the threat of a health problem and the appraisal of recommended behavior (s) for preventing or managing the problem

17. At the end of the program, health workers of the community should be able to plan a program to alleviate the problem of malnutrition in the area. A  Community Mobilization Theory 18. Each of the patients was shown their laboratory examination results and were made aware of their risk of having a heart disease. E  Social Learning Theory & Health Belief Model 19. Patients with increased blood sugar levels were shown that they could do something about their problem, that they were capable of lowering their blood sugar levels. E  Social Learning Theory & Health Belief Model 20. The lecture which was prepared was enough for them to realize that there are several factors which interact to have caused the disease. B  Social Learning Theory

For # 21-25: Which level of health service service delivery is responsible for the implementation implementation of the CVD Program activities listed below? A. Central Office B. Regional Hospital C. Provincial Health Office D. Municipal Health Office E. None of the above For # 21-25:

RESPONSIBILITY OF EACH LEVEL OF HEALTH SERVICE DELIVERY IN PROGRAM IMPLEMENTATION Central Office Formulates issues/policies/guidelines for program implementation Develops/issues relevant treatment guidelines/standards for care of cardiovascular patients Provides technical assistance to Centers for Health Development and other stakeholders on matters pertaining to C prevention and control programs Provides strategic logistic support for program implementation

V

Centers for Health Development Provides technical assistance to LGUs in matters pertinent to implementation Monitors/evaluates the implementation Provides strategic logistic support for implementation Regional Hospital / Medical Centers Provides all possible cardiology services except cardiac surgery Provides training on cardiology for lower level hospitals Provincial Health Office Convenes the Provincial Inter-sectoral C VD Task Force composed of various stakeholders based on the province which would be tasked to: Plan and oversee the implementation of the C VD program in the province Network with other stakeholders on matters pertaining to the program Supervision, monitoring and evaluation of the program Conducts training on matters pertaining to the program Provides logistical support to program implementation y y y y y

Provincial Hospital Serves as referral center for the province on C VD management Municipal Health Office Plan/implement CVD program for the municipality Conduct ca se-finding se-finding activities Manage patients properly Refer patients properly Do health education, advocacy and patient education Train BHWs on program -

21. Conducts case finding activities D  Municipal Health Office 22. Formulates and issues policies and guidelines for program implementation A  Central Office 23. Provides all possible cardiology services except cardiac surgery B  Regional Hospital 24. Develops treatment guidelines and standards of care for cardiovascular patients A  Central Office 25. Provides training for Barangay Health Workers D  Municipal Health Office 26. The risk factor for C VD which has the highest prevalence in the population: a. High cholesterol level b. Hypertension c. Smoking d. Family history of hypertension e. Age

Smoking Hypertension High cholesterol Family hx of HPN  Age

46% (of population) 22% (of population) population) 37% (of hypertensive patients)

was not mentioned as a risk factor for C VD

27. DOH Administrative Order 2010-0013 which proposes the labeling of cigarette packs with graphic pictures of the (ill) health effects of smoking will serve the purposes of this program of the C VD Program: a. Training b. Research c. Environmental Support System Development d. Public information and education e. Legislation For # 27-28  , the exact strategies are mentioned in the handout The Philippine CVD Prevention and Control Program given by Dra. Carnate. Theres a L ONG list of specific strategies/activities listed under each program, if youre up to studying it @_@

The Legislative

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Program aims to: Enact laws and ordinances, and to use ad mi nistrative orders to: Promote healthy lifestyles Control CVD risk factors Oppose pro-tobacco legislation and other similar efforts R epel laws obstructing the achievement of the vision of the program y y

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*The legislative agenda is the responsibility of the Department of Health. ealth. The given strategy addresses the first objective.

28. Creation of policies and guidelines regarding labeling of canned, boxed and packaged foods and food products to include information like caloric content are examples of the activities of this C VD Program Sub-program: a. Public Information and Education b. Training c. Legislation d. Environmental Support System Development e. None of the Above The Environmental

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Support System Development Program aims to: Institute support for proper nutrition and diet patterns Develop an environment conducive to non-smoking and smoking cessation

The given strategy addresses the first objective.

For # 29-33: Choose from the following cancer types/sites: types/sites: A. Breast B. Lung C. Colon D. Leukemia E. Cervix The

cancer type/site has the highest: (according to the materials distributed in class)

29. Rate of occurrence among children 30. Rate of occurrence among  f emales 31. Rate of occurrence when both sexes are taken into consideration 32. 5-year observed survival rate among males 33. 5-year observed survival rate when both sexes are taken into consideration These

are facts. Digest. 

D  Leukemia A  Breast B  Lung C - Colon A - Breast

For # 34-37:

CANCER SITE LUNG CERVIX LIVER

COLON & RECTUM

MOUT H

BREAST

SKIN PROSTATE

CANCER PREVENTION AND EARLY DETECTION PRIMARY PREVENTION SECONDARY PREVENTION Do not smoke NONE Having one sexual partner Regular pap smear Clean, safe sex Vaccination vs. Hepatitis B Minimal alcohol intake NONE Avoid moldy food Regular medical check-up Occult blood test Diet of high fiber, low fat DRE Sigmoidoscopy Avoid smoking tobacco Avoid betel nut chewing Thorough dental check-up Modify alcohol consumption Dental hygiene Self Breast Exam NONE Breast Exam by physician Mammography Avoid excessive sun exposure Skin self exam NONE DRE

34. The main strategy recommended by the Lung Cancer Control Program of the Philippines for secondary prevention of lung cancer includes: a. Diagnostic chest x-ray every 3 years starting age 40 b. Diagnostic chest x-ray annually for smokers c. Anti-smoking campaign: public information, health education and legislative measure s d. A and B only e. None of the above There is N O SECONDARY

cancer. PREVENTION MEASURE for lung cancer.

Remember,

PRIMARY PREVENT  RY  PREVENT IO ION  is for risk reduction SE C  CO   N D ARY PREVENT  RY  PREVENT IO ION  is for early detection

35. The main strategy recommended by the Breast Cancer Control Program of the Philippines for the control of breast cancer is: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. A and B only Secondary Prevention of Breast Cancer Self Breast Exam Breast Exam by physician Mammography There is N O PRIMARY

PREVENTION MEASURE for breast cancer.

36. The primary prevention measures recommended by the Philippine Cancer Control Program to control liver cancer include: a. Vaccination against hepatitis B b. Avoidance of multiple syringe use c. Proper screening of the blood for transfusion t ransfusion d. A and B only e. All of the above 37. The Philippine Cancer Control Program recommends the following for primary prevention of colorectal cancer: a. Sigmoidoscopy b. Fecal occult blood test c. High fiber diet d. Digital Rectal Exam e. All of the above

38. The Philippine Cancer Control Program recommends regular pap smears: a. Starting age 35 b. Starting age 25 until 50 c. Starting with sexual activity until 65 years d. Starting age 15 to 65 The Philippine Cervical Cancer Control Program recommends regular pap smears for all women who are or have been sexually active and who have a cervix. Regular testing can be discontinued after age 6 5 in women who have had regular previous screening in which smears have been consistently normal.

For # 39-43: Suppose a non-government organization, Maunlad Health Development Foundation (MHDF), working in Barangay Maunlad identified the priority problem in the barangay to be the high mortality rate due to rabies. Several factors were found to contribute to the problem: High proportion of households have unleashed dogs Low proportion of vaccinated dogs Limited supply of free anti-rabies vaccines for dogs High cost of the dog vaccine that is available from the local drugstore The Rural Health Unity (RHU) has inadequate therapeutic capability: anti-rabies vaccines are not available and the midwives do not know the early management of dog bites 90% of the population believe that a dog that has bitten a person should be killed y y y y y

y

All the above factors were deemed to be amenable to change. The

MHDF formulated the objectives below. C lassify them into the following types of objectives: A. Health Status B. Risk Reduction C. Service and Protection D. Problem Investigation E. Session For # 39  43: HEALT H STATUS Objectives Pertains to changes in s peci  f ic ic health conditio ns  mortality rates  morbidity rates  prevalence rates

SERVICE AND PROTECTION Objectives Pertains to changes in the health sector   services  health human resource  facilities RISK REDUCTION Objectives Pertains to changes in behavior and k nowled ge  population engaging in healthy behavior  population with appropriate knowledge

39. To increase the proportion of households which practice responsible pet ownership in Barangay Maunlad B  Risk Reduction ( population engaging in healty behavior = responsible pet ownership) 40. To be able to describe the pathophysiology of rabies in Barangay Maunlad E  Session (This would be part of the project implementation itself) 41. To reduce the number of deaths from r abies in Barangay Maunlad A  Health Status ( mortality rates) 42. To determine the proportion of household which have vaccinated dogs D  Problem Investigation 43. To increase the number of midwives capable of giving early management of dog bites in Baragngay Maunlad C  Service and Protection ( services; health human resource)

44. The above objectives satisfy the following criteria for formulation of good objectives: a. Specific b. Measurable c. Time-bound d. All of the above e. A and B only Good objectives have to be SMA RT  Specific, Measurable, Attainable, Realistic & Time-bound.

45. If MHDF decides to conduct a program in Barang ay Maunlad, this is the appropriate objective: a. To increase the proportion of households which practice responsible pet ownership in Bgy. Maulad b. To be able to describe the pathophysiology of rabies in Bgy. Maunlad c. To reduce the number of deaths from rabies in Bgy. Maunlad d. To determine the proportion of households which have vaccinated dogs e. To increase the number of midwives capable of giving early management for dog bites in Bgy. Maunlad 46. The people of Bgy. Maunlad prefer to conduct all activities within the confines of the barangay. This information will be needed when prioritizing strategies for their: a. Potential impact b. Potential scope c. Social concern d. Feasibility e. Social acceptability

For # 47-49: MHDF decided to work on the objective of increasing the number of midwives capable of providing early management for dog bites. The suggested strategies to attain the objective were as follows: Strategy 1: Strategy 2: Strategy 3:

Sending one of the midwives to the Research Institute on Tropical Medicine (RITM) in Manila for training. She will then conduct echo seminars with the other m idwives. Sending all 3 midwives to the RITM for 1 week to be trained. Sending for a doctor from RITM to teach the 3 mi dwives in Barangay Maunlad.

47. This strategy will have the lowest priority score in terms of potential impact a. Strategy 1 b. Strategy 2 c. Strategy 3 d. Strategies 1 and 2 e. Strategies 2 and 3 48. Strategies 2 and 3 will have the same priority scores in terms of: a. Potential impact b. Potential scope c. Social concern d. Feasibility e. Social acceptability 49. Strategy 2 will have a lower priority score than Strategy 3 in terms of: a. Potential impact b. Potential scope c. Social concern d. Feasibility e. Social acceptability Because of # 46.

For # 50-53: The MHDF decided to request the RITM to send a doctor to Bgy. Maunlad to train the 3 midwives for 1 week. Some of the expected expenses are the following: Honorarium for the doctor PhP 15,000 Boat fare (2-way trip) for the doctor 10,000 Hotel accommodation for the doctor 5,000 Computer, LCD 25,000 Office supplies, communication expenses, 30,000 expenses for printing of training materials 50. This amount represents personnel cost: a. 5,000 b. 10,000 c. 15,000 d. 25,000 e. 30,000 Personnel Cost Salaries/honoraries Allowances In

this case, Honorarium for the doctor = PhP 1 5,000

51. This amount represents operating expenses: a. 5,000 b. 10,000 c. 15,000 d. 25,000 e. 30,000 Maintenance and Operating Expenses (MOOE) Communication Water and power Rent Travel expenses Maintenance of vehicles, equipment, facilities Materials and supplies

In

this case, supplies, Communication expenses, Expenses for printing of the training materials = PhP 30,000

Office

52. This amount represents capital outlay: a. 5,000 b. 10,000 c. 15,000 d. 25,000 e. 30,000 Capital Outlay Major repair Renovation Construction Equipment Outlay Replace Repair Acquire

53. The MHDF formulated a figure that detailed the listing of activities and included the date of accomplishment. The figure is called: a. Activity Table b. Gantt Chart c. Organizational Chart d. Activity Chart

For # 54-58 : MHDF set the following indicators for evaluation of the project: A. The number of midwives capable of providing initial dog bite management B. The number of training kits printed C. The decrease in the number of new case s of rabies D. All of the above E. A and B only 54. Indicator(s) that measure(s) the effect of the project A  The number of midwives capable of providing initial dog bite management 55. Indicator(s) that measure(s) the impact of the project C  The decrease in the number of new cases of rabies 56. Process indicator(s) B  The number of training kits printed 57. If MHDF will evaluate the projects efficiency, this information will be needed: a. Planned and actual dates of accomplishment of activities b. Planned and actual cost of activities c. Number of midwives capable of giving initial dog bite management d. Decrease in the number of rabies mortality e. A and B only Recall : EFFICIENCY is concerned with the relationship between the results attained  and the efforts (in terms of money, human nputs and  as quickly as resource, equipment and time) expended. It is getting the work done with the mi ni mum o f  f   f  f i  in   ancial i np  possible.

58. This will be an evaluation indicator if MHDF will do a formative evaluation of the project: a. Dates of accomplishment of activities b. Cost of activities c. Number of midwives capable of giving initial dog bit management d. Decrease in the number of rabies mortality e. A and B only In

the above case, efficiency is evaluated. See # 57.

Formative Evaluation Progress Efficiency Summative Evaluation Effect Impact