 Introduce new project at PSHMC Discuss ethnography and field site projects Review and discuss assignment 3
– Significant socio-economic barriers– Lowest level of socio-economic barriers
USDA Food Desert Locatorhttp://www.ers.usda.gov/data-products/food-desert-locator/go-to-the-locator.aspx
   How do we work with community    organizations to improve access to healthy    foods and education/information?
   An empirical research    method for learning    about cultural    phenomena and    discovering the nature    of peoples
Learning the culture of the group                                 under study before deriving                             ...
 Historical research Active field notes Participant observation Interviews Questionnaires Geography/topography
 Build a rich history of your site Develop relationships & trust Identify key informants Take rigorous notes & cross-c...
Assignment 3Final assignment
   Give voice to an underserved population   Contextualize your observations   Identify themes and patterns that can in...
 You are not a consultant, you are a learner We are not expecting you to ‘save’ the  organization or its clients Think ...
 Goals:  › Eliminate preventable disease, disability, injury,    and premature death  › Achieve health equity, eliminate ...
 Models serve as frames from which to  build; Provide structure & organization  for the planning process Many different ...
    Biology/    Genetics    Behaviors    Social     Environment    Physical     Environment    Policies and     Inter...
   Assessments                                              Summary (III)                • Social                       ...
?29
30
   Radiation Exposure      Infectious Agents   Workplace Hazards       Auto/Road Design   Home Hazards            Sp...
   Geography         Discrimination   Age               Residence   Race              Literacy   Education        ...
   Access to care   Quality of care   Access to interventions   Representativeness in    policy development   Equity ...
Hi! I’m theLiterature!              34
35
 Behavior = What people do or don’t do Factors = influence behaviorAn analysis of the determining (predisposing[facilita...
37
 Awareness and Knowledge Beliefs, Values, and Attitudes Perceptions of Susceptibility,  Seriousness, Benefits, & Cost ...
39
   Health Care Environment.    › Facilities, clinics, providers, etc.    › Cost, distance, transportation, hours, etc.  ...
 Social Support Family and Peer Influences Advise/Feedback from Providers Benefits of the Treatment/Action Social and...
 Theory - “a set of interrelated concepts,  definitions, and propositions that present a  systematic view of events or si...
   “A theory based approach provides direction and    justification for program activities and serves as    the basis for...
   Perceived Susceptibility – is he/she    vulnerable to health problem?   Perceived Seriousness – how serious is    the...
   Stages of Changes    ›   Precontemplation.    ›   Contemplation.    ›   Preparation.    ›   Action.    ›   Maintenance...
 Attitudes – toward performing the behavior. Subjective Norm – influence of other people  (i.e., parents, friends). Int...
Plenary 10 18-12 final
Plenary 10 18-12 final
Plenary 10 18-12 final
Plenary 10 18-12 final
Plenary 10 18-12 final
Plenary 10 18-12 final
Plenary 10 18-12 final
Plenary 10 18-12 final
Plenary 10 18-12 final
Plenary 10 18-12 final
Plenary 10 18-12 final
Plenary 10 18-12 final
Plenary 10 18-12 final
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Plenary 10 18-12 final

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  • 1. Introduce new project at PSHMC (Relevance to your field site intervention and to you personally) 2. Discuss ethnography and field site projects (3. Review and discuss assignment 3 (Date change to next Weds, Oct 24th)
  • The charge of the garden is to participate in community outreach in underserved areas in the community – help people stay healthy rather than just treating illness
  • USDA food desert map – many of your field sites are located within these areas
  • Mike – potentially drive into food deserts and deliver produce, health screenings, etc
  • Pilot program – giving prescriptions to patients for produce at farmers markets, and then tracking blood pressure, weight, BMI, weight gain in pregnant women, etc . Will serve 100 families and six farmers markets during 2010 season with plans to expand. “Maine, Massachusetts tackle healthy eating.” The Nation’s Health. Oct 2010: 9.
  • “Let thy food be thy medicine” – Hippocrates
  • Just some ideas to consider given recent changes at PSHMC. Bridge to your field experience / most have been good, almost ¾ plan on visiting again. This is encouraging because, as you know, we don’t want you to see your role as being a consultant
  • http://www.youtube.com/watch?v=2SoWNMNKNeM
  • Your role is more of an ethnographer
  • Med anthro – applying ethnographic principles and practices to medicine. Diseases are social with a biological aspect
  • What’s interesting is that this list is equally applicable to your clinical practice
  • As you go about this process, without the shackles of anatomy, you’ll understand the value of this approach
  • If this isn’t inspiring or momentus that’s fine. This is a learning experience rooted in the community – for some it may be more but if not, it’s ok. Questions/concerns. Please feel free to email me or meet in my office
  • Plenary 10 18-12 final

    1. 1.  Introduce new project at PSHMC Discuss ethnography and field site projects Review and discuss assignment 3
    2. 2. – Significant socio-economic barriers– Lowest level of socio-economic barriers
    3. 3. USDA Food Desert Locatorhttp://www.ers.usda.gov/data-products/food-desert-locator/go-to-the-locator.aspx
    4. 4.  How do we work with community organizations to improve access to healthy foods and education/information?
    5. 5.  An empirical research method for learning about cultural phenomena and discovering the nature of peoples
    6. 6. Learning the culture of the group under study before deriving explanations of their attitudes/behaviorPhysical geography and climate
    7. 7.  Historical research Active field notes Participant observation Interviews Questionnaires Geography/topography
    8. 8.  Build a rich history of your site Develop relationships & trust Identify key informants Take rigorous notes & cross-check with informants › Quote your informants Understand your biases and assumptions Keep an open mind
    9. 9. Assignment 3Final assignment
    10. 10.  Give voice to an underserved population Contextualize your observations Identify themes and patterns that can inform effective intervention strategies Determine variables for future research and develop a testable hypothesis Propose more culturally-sensitive plans for project implementation Identify key questions about existing programs and policies
    11. 11.  You are not a consultant, you are a learner We are not expecting you to ‘save’ the organization or its clients Think long-term about your involvement with the organization There will be many opportunities for leadership/action in medical schoolQuestions or concerns? dgeorge1@hmc.psu.edu C1747 – Diversity Office
    12. 12.  Goals: › Eliminate preventable disease, disability, injury, and premature death › Achieve health equity, eliminate disparities, and improve the health of all groups › Create social and physical environments that promote good health for all. Goals (cont.) › Promote healthy development and healthy behaviors across every stage of life. Objectives › 37 focus areas
    13. 13.  Models serve as frames from which to build; Provide structure & organization for the planning process Many different models, common elements, but different labels. A Generalized Model for Program Planning 26
    14. 14.  Biology/ Genetics Behaviors Social Environment Physical Environment Policies and Interventions Access to Quality Health Care/ Services 27
    15. 15.  Assessments  Summary (III) • Social • Justify need for an • Environmental intervention/programThe way • Behavioral • Identify possible solutions it is… What are the behaviors (interventions) to healthDescribe that impact health problem I problem?  Next Paper: The Program/Intervention • Risk and ProtectiveAnalyzing Factors Associated Itargeted with/Influence IIbehavior Behaviors II III 28
    16. 16. ?29
    17. 17. 30
    18. 18.  Radiation Exposure  Infectious Agents Workplace Hazards  Auto/Road Design Home Hazards  Speed Limits Contaminants  Medical Care Access Media  Product Design (e.g., handgun) Political Systems  Noise Migration  War/Civil Conflict Global Warming  Deforestation Recreational space  Adequate Surveillance Systems 31
    19. 19.  Geography  Discrimination Age  Residence Race  Literacy Education  Isolation Crime  Family Composition Income  Faith/Spirituality Unemployment  Culture Roles  Gender 32
    20. 20.  Access to care Quality of care Access to interventions Representativeness in policy development Equity and justice 33
    21. 21. Hi! I’m theLiterature! 34
    22. 22. 35
    23. 23.  Behavior = What people do or don’t do Factors = influence behaviorAn analysis of the determining (predisposing[facilitate or hinder person’s motivation to change,e.g., knowledge, attitudes, beliefs, etc.], enabling[barriers or vehicles created by society or system,e.g., access to hl, resources, rules, etc.], andreinforcing [feedbacks & rewards by peers, relatives,employers, etc.]) factors that influence the chosenbehavior and health problem.
    24. 24. 37
    25. 25.  Awareness and Knowledge Beliefs, Values, and Attitudes Perceptions of Susceptibility, Seriousness, Benefits, & Cost Personal Histories Behavioral Intentions Existing Skills 38
    26. 26. 39
    27. 27.  Health Care Environment. › Facilities, clinics, providers, etc. › Cost, distance, transportation, hours, etc. Other Environmental Conditions. › Availability of fast food, cigarettes, billboard, alcohol , sports, laws, etc. Skills – ability to perform task. 40
    28. 28.  Social Support Family and Peer Influences Advise/Feedback from Providers Benefits of the Treatment/Action Social and Economical Benefits Adverse Consequences 41
    29. 29.  Theory - “a set of interrelated concepts, definitions, and propositions that present a systematic view of events or situations by specifying relations among variables in order to explain and predict the events of the situations” (Glanz, Lewis, & Rimer, 2002, p. 25) Concept - primary elements of theories or building blocks of theory (Glanz et al., 2002)
    30. 30.  “A theory based approach provides direction and justification for program activities and serves as the basis for processes that are to be incorporated into an intervention/program (Cowdery et al., 1995, p. 248) “Theories can provide answers to program developers’ questions regarding why people aren’t engaging in a desirable behavior of interest, how to go about changing their behaviors, and what factors to look at when evaluating a program’s focus” (van Ryn & Heaney, 1992, p. 326).
    31. 31.  Perceived Susceptibility – is he/she vulnerable to health problem? Perceived Seriousness – how serious is the the illness/problem? Perceived Benefits – anticipated value of the recommended action. Perceived Barriers – cost involved in taking a particular action. Motivation/Cues to Action & Self-efficacy.
    32. 32.  Stages of Changes › Precontemplation. › Contemplation. › Preparation. › Action. › Maintenance. › Termination. *Relapse Decisional Balance – pros vs. cons.
    33. 33.  Attitudes – toward performing the behavior. Subjective Norm – influence of other people (i.e., parents, friends). Intentions – probability of performing. Behavior – the actual action.

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