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INNOVATION IN RURAL HEALTH CARE DR. MEL BORINS Associate Professor Faculty of Medicine University of Toronto active staff ...
 
RURAL RISKS <ul><li>Self destructive/Risky behaviour </li></ul><ul><li>Adherence/Self-Management </li></ul><ul><li>Health ...
SELF DESTRUCTIVE <ul><li>CORE BELIEF </li></ul><ul><li>▼▼ </li></ul><ul><li>THOUGHTS </li></ul><ul><li>▼▼ </li></ul><ul><l...
 
 
Source: Prochaska & DiClemente Stages of change IDENTIFICATION
 
PROCESS OF CHANGE <ul><li>1. AWARENESS </li></ul><ul><li>2. WILLINGNESS </li></ul><ul><li>3. PREPARATION/DREAMING WITH OUR...
Causes of death in USA 2000 <ul><li>Tobacco 435,000 18 </li></ul><ul><li>Diet/activity 400,000 17 </li></ul><ul><li>Alcoho...
SELF DESTRUCTIVE  <ul><li>“ All of us at one time or another do things that aren’t good for us.  It might be something lik...
NON ADHERANT <ul><li>“ Most of us forget to take our medication or follow through with diet or exercise at some point or a...
HEALTH PROMOTION <ul><li>“ What are you doing these days that you believe is contributing to your health?” </li></ul>
 
CHOOSE ONE NEW BEHAVIOUR <ul><li>Write it down </li></ul><ul><li>Concrete, measurable, baby step </li></ul><ul><li>MEANS W...
 
PROCESS OF CHANGE <ul><li>1. AWARENESS </li></ul><ul><li>2. WILLINGNESS </li></ul><ul><li>3. PREPARATION/DREAMING WITH OUR...
ACCESSIBILITY IS A CHALLENGE 80% of the world's inhabitants still rely chiefly on traditional medicines for their primary ...
BRING HEALTH TO THE PEOPLE <ul><li>AUCTIONS </li></ul><ul><li>FAIRS </li></ul><ul><li>HOCKEY RINKS </li></ul><ul><li>SCHOO...
BRING HEALTH TO THE PEOPLE <ul><li>BP </li></ul><ul><li>GLUCOSE </li></ul><ul><li>CHOLESTEROL  </li></ul><ul><li>COOKING C...
THE BASICS <ul><li>CLEAN WATER </li></ul><ul><li>PROPER SEWAGE DISPOSAL </li></ul><ul><li>ENOUGH FOOD </li></ul><ul><li>SH...
 
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Dr. Mel Borins

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Dr. Mel Borins

  1. 1. INNOVATION IN RURAL HEALTH CARE DR. MEL BORINS Associate Professor Faculty of Medicine University of Toronto active staff St. Joseph’s Health Center www.melborins.com
  2. 3. RURAL RISKS <ul><li>Self destructive/Risky behaviour </li></ul><ul><li>Adherence/Self-Management </li></ul><ul><li>Health Promoting </li></ul>
  3. 4. SELF DESTRUCTIVE <ul><li>CORE BELIEF </li></ul><ul><li>▼▼ </li></ul><ul><li>THOUGHTS </li></ul><ul><li>▼▼ </li></ul><ul><li>FEELINGS </li></ul><ul><li>▼▼ </li></ul><ul><li>BEHAVIOUR </li></ul>
  4. 7. Source: Prochaska & DiClemente Stages of change IDENTIFICATION
  5. 9. PROCESS OF CHANGE <ul><li>1. AWARENESS </li></ul><ul><li>2. WILLINGNESS </li></ul><ul><li>3. PREPARATION/DREAMING WITH OUR SENSES </li></ul><ul><li>4. MAKING IT HAPPEN/TAKING THE STEPS </li></ul>
  6. 10. Causes of death in USA 2000 <ul><li>Tobacco 435,000 18 </li></ul><ul><li>Diet/activity 400,000 17 </li></ul><ul><li>Alcohol 85,000 4 </li></ul><ul><li>Microbial agents 75,000 3 </li></ul><ul><li>Toxic agents 55,000 2 </li></ul><ul><li>Motor Vehicles 43,000 2 </li></ul><ul><li>Firearms 29,000 1 </li></ul><ul><li>Sexual behavior 20,000 <1 </li></ul><ul><li>Illicit drug use 17,000 <1 </li></ul><ul><li>TOTAL 1,159,000 48 </li></ul><ul><li> </li></ul>% of Total Deaths Cause Estimated Number (Mokdad et al, JAMA, 2004)
  7. 11. SELF DESTRUCTIVE <ul><li>“ All of us at one time or another do things that aren’t good for us. It might be something like not wearing a seat belt or perhaps drinking more than we think we should. Are you doing anything right now that you would put into this category?” </li></ul>
  8. 12. NON ADHERANT <ul><li>“ Most of us forget to take our medication or follow through with diet or exercise at some point or another. What difficulties have you had with the treatment you are following?” </li></ul>
  9. 13. HEALTH PROMOTION <ul><li>“ What are you doing these days that you believe is contributing to your health?” </li></ul>
  10. 15. CHOOSE ONE NEW BEHAVIOUR <ul><li>Write it down </li></ul><ul><li>Concrete, measurable, baby step </li></ul><ul><li>MEANS WHEREBY </li></ul><ul><li>Share it with someone at your table </li></ul>
  11. 17. PROCESS OF CHANGE <ul><li>1. AWARENESS </li></ul><ul><li>2. WILLINGNESS </li></ul><ul><li>3. PREPARATION/DREAMING WITH OUR SENSES </li></ul><ul><li>4. MAKING IT HAPPEN/TAKING THE STEPS </li></ul>
  12. 18. ACCESSIBILITY IS A CHALLENGE 80% of the world's inhabitants still rely chiefly on traditional medicines for their primary health care needs . Akerele Olayiwola, Nature's medicinal bounty: don't throw it away. World Health Forum 1993;14:390-395
  13. 19. BRING HEALTH TO THE PEOPLE <ul><li>AUCTIONS </li></ul><ul><li>FAIRS </li></ul><ul><li>HOCKEY RINKS </li></ul><ul><li>SCHOOLS </li></ul><ul><li>BINGO HALLS </li></ul><ul><li>PLACES OF WORSHIP </li></ul>
  14. 20. BRING HEALTH TO THE PEOPLE <ul><li>BP </li></ul><ul><li>GLUCOSE </li></ul><ul><li>CHOLESTEROL </li></ul><ul><li>COOKING CLASSES </li></ul><ul><li>OCCULT BLOOD TESTING </li></ul><ul><li>USE OF CELL PHONES IN SMOKING CESSATION </li></ul><ul><li>INTERNET </li></ul>
  15. 21. THE BASICS <ul><li>CLEAN WATER </li></ul><ul><li>PROPER SEWAGE DISPOSAL </li></ul><ul><li>ENOUGH FOOD </li></ul><ul><li>SHELTER </li></ul>

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