The document outlines a proposal for a system-wide prevention strategy across health and social care partners in Hertfordshire. It identifies the need to address rising avoidable healthcare costs through better prevention efforts. Key points discussed include: conducting gap analyses of current prevention activities; agreeing to work together on prevention; appointing senior leads from each partner; and developing a joint prevention strategy and governance structure to be approved by the Health and Wellbeing Board. Examples of potential high-impact prevention actions are provided for different partners to address primary, secondary, and tertiary prevention. The goal is to reduce unnecessary spending while improving health outcomes through more coordinated and systematic prevention efforts across the healthcare system.
Prevention programs should address risk and protective factors, tailor interventions to the specific risks and population, and enhance protective factors like family bonding. Effective programs provide parenting skills, teach families how to develop and enforce drug policies, and give parents drug education to discuss with their children. School-based programs can intervene early to address risk factors for drug abuse.
The document discusses drug abuse prevention and approaches, including how serious the problem of drug dependence is in the US with an estimated 20.6 million people classified with substance dependence or abuse. It covers goals and levels of prevention programs from primary to tertiary, as well as strategies, examples of programs, and ways to make drug education more effective, such as establishing links between messages and students' lives.
Accomodation and prevention substance abuse CG Hylton Inc.
This document provides an overview of a presentation on substance abuse and prevention in the workplace. The presentation covers key topics such as indicators of substance abuse, addictions, prevention strategies, return-to-work strategies, employee assistance programs, drug and alcohol testing, and maintaining positive workplace morale and mental health. Effective solutions involve screening, brief interventions, treatment referrals, and changing workplace policies and culture to promote wellness and prevent problems.
Substance Abuse Prevention Programs for Children and Adolescentsiretablog
The document discusses drug abuse prevention programs and interventions. It describes how successful programs use cognitive behavioral therapy and are tailored to the specific community. Interventions should involve multiple community sectors and aim to decrease risk factors while increasing protective factors. The document reviews several prevention programs and notes there is evidence they can have short-term positive effects, but more data is still needed on long-term health impacts.
- Prevention efforts for substance abuse traditionally focus on primary, secondary, and tertiary interventions. Primary prevention aims to prevent initial use, secondary focuses on early identification of problems, and tertiary refers to treatment for those with substance abuse issues or dependence.
- There are three major models of prevention: the sociocultural model aims to influence social norms, the distribution/consumption model focuses on restricting availability, and the proscriptive model prohibits availability and advocates total abstinence.
- Common prevention strategies include education programs in schools, mass media campaigns, and programs targeting at-risk groups like college students where binge drinking leads to health, academic, and legal problems for many.
The document discusses the roles of parents and teachers in preventing drug abuse. It notes that children progress from an intelligent, social pre-addiction stage to using drugs due to neglect of behavioral changes and risk factors like peer pressure. Parents and teachers can prevent drug abuse through open communication, involvement, clear rules, leading by positive example, helping children choose friends wisely, talking to children about drugs early and often, and establishing rules for parties.
This document discusses approaches to drug prevention and education. It notes that effective programs incorporate skills training to resist peer pressure, correct misperceptions about drug use norms, and emphasize short-term health consequences. School-based programs work best when they are interactive, developmentally appropriate, involve parents and community, and are part of a multi-year curriculum. While DARE had little impact, programs focusing on life skills and social resistance training can reduce drug use if adequately implemented and evaluated.
The document discusses approaches to drug prevention and education. It describes how most drug prevention funds in the US come from the federal government and are allocated to various agencies. Effective drug prevention programs are school-based, involve peers, emphasize social influences and life skills, aim to change social norms, and include parent and community involvement. While early efforts focused on supply reduction, the focus is now on prevention and underlying factors contributing to drug abuse. Successful programs provide skills training, social resistance training, and normative education in a culturally sensitive way over multiple years.
Prevention programs should address risk and protective factors, tailor interventions to the specific risks and population, and enhance protective factors like family bonding. Effective programs provide parenting skills, teach families how to develop and enforce drug policies, and give parents drug education to discuss with their children. School-based programs can intervene early to address risk factors for drug abuse.
The document discusses drug abuse prevention and approaches, including how serious the problem of drug dependence is in the US with an estimated 20.6 million people classified with substance dependence or abuse. It covers goals and levels of prevention programs from primary to tertiary, as well as strategies, examples of programs, and ways to make drug education more effective, such as establishing links between messages and students' lives.
Accomodation and prevention substance abuse CG Hylton Inc.
This document provides an overview of a presentation on substance abuse and prevention in the workplace. The presentation covers key topics such as indicators of substance abuse, addictions, prevention strategies, return-to-work strategies, employee assistance programs, drug and alcohol testing, and maintaining positive workplace morale and mental health. Effective solutions involve screening, brief interventions, treatment referrals, and changing workplace policies and culture to promote wellness and prevent problems.
Substance Abuse Prevention Programs for Children and Adolescentsiretablog
The document discusses drug abuse prevention programs and interventions. It describes how successful programs use cognitive behavioral therapy and are tailored to the specific community. Interventions should involve multiple community sectors and aim to decrease risk factors while increasing protective factors. The document reviews several prevention programs and notes there is evidence they can have short-term positive effects, but more data is still needed on long-term health impacts.
- Prevention efforts for substance abuse traditionally focus on primary, secondary, and tertiary interventions. Primary prevention aims to prevent initial use, secondary focuses on early identification of problems, and tertiary refers to treatment for those with substance abuse issues or dependence.
- There are three major models of prevention: the sociocultural model aims to influence social norms, the distribution/consumption model focuses on restricting availability, and the proscriptive model prohibits availability and advocates total abstinence.
- Common prevention strategies include education programs in schools, mass media campaigns, and programs targeting at-risk groups like college students where binge drinking leads to health, academic, and legal problems for many.
The document discusses the roles of parents and teachers in preventing drug abuse. It notes that children progress from an intelligent, social pre-addiction stage to using drugs due to neglect of behavioral changes and risk factors like peer pressure. Parents and teachers can prevent drug abuse through open communication, involvement, clear rules, leading by positive example, helping children choose friends wisely, talking to children about drugs early and often, and establishing rules for parties.
This document discusses approaches to drug prevention and education. It notes that effective programs incorporate skills training to resist peer pressure, correct misperceptions about drug use norms, and emphasize short-term health consequences. School-based programs work best when they are interactive, developmentally appropriate, involve parents and community, and are part of a multi-year curriculum. While DARE had little impact, programs focusing on life skills and social resistance training can reduce drug use if adequately implemented and evaluated.
The document discusses approaches to drug prevention and education. It describes how most drug prevention funds in the US come from the federal government and are allocated to various agencies. Effective drug prevention programs are school-based, involve peers, emphasize social influences and life skills, aim to change social norms, and include parent and community involvement. While early efforts focused on supply reduction, the focus is now on prevention and underlying factors contributing to drug abuse. Successful programs provide skills training, social resistance training, and normative education in a culturally sensitive way over multiple years.
This document discusses approaches to drug prevention and education. It covers topics like the goals of prevention, levels of prevention from primary to tertiary, risk factors for drug abuse, and the effectiveness of different prevention strategies. School-based drug education programs are most effective when they are developmentally appropriate, teach social resistance skills, involve normative education, and receive sufficient time and support. Peer-led and health education models can also be effective approaches.
School-based drug prevention programs aim to reduce substance use among children and adolescents. Most interventions target youth ages 10-16 when most begin experimenting. Programs should start in elementary school and continue with developmentally appropriate curricula. Effective programs provide medically accurate information using interactive methods to build social skills and resist peer pressure. While D.A.R.E. was widely used, research found it ineffective. Programs like Life Skills Training are evidence-based and teach drug resistance and self-management skills to reduce risk. Developing successful prevention requires assessing community needs, involving families and schools, and evaluating outcomes.
This document discusses approaches to drug education for young people. It finds that interactive "life skills" programs that build skills like assertiveness and managing social situations can be most effective at reducing drug and alcohol use, compared to simply providing facts or warnings. Effective programs take time for reflection and are taught consistently, rather than one-off sessions. While experts can contribute, the content and teaching method are more important than who teaches. Engaging disconnected youth may also help through programs that improve classroom behavior and education completion. The organization advocates bringing evidence-based life skills programs to UK schools.
Michigan Model Substance Abuse Conference 9 08Wendy Sellers
The document discusses the Michigan Model for Health, a comprehensive K-12 health education curriculum that aims to prevent drug abuse. It provides skills-based lessons addressing various health topics including social-emotional health, nutrition, safety, and alcohol/tobacco prevention. Research shows this approach is effective by building students' knowledge, self-efficacy, and skills to make healthy choices. The curriculum is implemented statewide with support from regional coordinators.
Improving Schools-Based Drug and Alcohol EducationMentor
This presentation was given at the Primary Care and Public Health 2016 Conference. It explores effective ways to improve school-based alcohol and drug education, ensuring the use and promotion of evidence based practice.
This document discusses approaches to drug prevention and education. It covers the goals of prevention, who is responsible, funding sources, and effectiveness of different programs. School-based programs that incorporate social skills training over multiple years with parent and community involvement have been shown to be most effective in preventing drug use. Effective drug education programs provide developmentally appropriate information, teach social resistance skills, address social norms, and involve interactive teaching techniques.
This document summarizes the findings of a survey of over 3,500 educators on drug and alcohol prevention education in America's schools. It identifies several key findings, including that the majority of teachers spend less than 5 hours per year on prevention education and feel ill-equipped to teach the subject. The document puts forth two recommendations: 1) that schools should not be the primary provider of prevention education and should work with parents and the community, and 2) that schools should reevaluate spending on ineffective programs and speakers and instead focus on strategies shown to be effective like skills-based training.
This document discusses the impact that a person's problematic substance use can have on their family members and friends. It notes that while interventions often focus on supporting the individual with the substance use problem, less attention is paid to the effects on family and friends. These effects can include physical and mental health problems, financial issues, relationship challenges, and domestic violence. The severity of impact depends on factors like whether family members live with the individual, provide their care, experience abuse, or use substances themselves. The document provides an overview of research demonstrating the stress, health problems, and emotional difficulties family members may face when a loved one has problematic substance use.
Session 3 role of school teachers and counsellorsDr Rajeev Kumar
Teachers play an important role in preventing drug abuse among students. They can act as role models for healthy behaviors and help students understand pressures related to experimentation. When planning prevention programs, teachers should conduct a situation analysis, needs assessment, and set clear goals and objectives. Signs of potential drug abuse include mood swings, declining academic performance, and changes in physical appearance. Younger students benefit from learning about decision making and healthy habits, while older students need information on peer pressure and health risks. Activities like art contests and role playing can effectively teach kids about drug prevention.
This document discusses the impact of parental substance use on children. It reports that millions of children globally are affected by a parent's alcohol or drug use, which can negatively impact children's development, well-being, and increase their risk of developing substance use problems themselves. Parental substance use is associated with issues like neglect, abuse, disrupted routines, and domestic violence. It outlines strategies to help protect children and the importance of support services for families struggling with addiction.
Understanding and Addressing Food Addiction: A Science-Based Approach to Poli...Center on Addiction
Public health concerns about the escalating obesity epidemic and its far-reaching health consequences, coupled with a growing understanding of the shared features of addiction across its myriad forms, have prompted some scientists to explore the possibility that certain eating behaviors might best be explained through the lens of addiction.
The interest in applying an addiction framework to understanding certain eating behaviors and food-related disorders has grown in recent years. This is a result of a large body of research highlighting the considerable overlap in the characterizing symptoms, risk factors and underlying neurobiological characteristics between substance addiction and what can be thought of as food addiction. It also arises from an attempt to explore how certain types of addictive-like eating might account for pathology that cannot be explained within the context of the currently recognized eating disorders of anorexia nervosa, bulimia nervosa and binge eating disorder. The growing interest in food addiction is also partially a result of an increasing awareness that lessons learned with regard to policy, prevention and clinical practice in relation to addictive substances might fruitfully be applied to the realm of food addiction.
Drugs & Society SOC 204
Drugs Across the Spectrum
By Raymond Goldberg
Chapter 2 Drugs in Contemporary Society
Chapter 3 Motivations for Drug Use
Chapter 4 Drugs & the Law
The chapter discusses drugs and delinquency among youth. It finds that most drug use is experimental and involves alcohol, tobacco, and marijuana. The relationship between drug use and delinquency is complex, with evidence that drug use can both cause and result from delinquency. Effective interventions include life skills training to prevent drug use and treatment programs that combine legal action with individualized treatment plans, such as drug courts.
Chronic harms of substance misuse. Effects of substances. A bio-psycho-social...Workingwithsubstanceabuse
This document discusses the bio-psychosocial model for understanding chronic harms of substance misuse. It uses alcohol as an example to show the interactions between biological, psychological, and social factors. The biological effects of substances like alcohol, opioids, stimulants are then outlined, including liver disease, addiction, overdose risk, and infections. Lastly, harm reduction strategies are proposed focusing on prevention, screening, and safer use.
EVERFI Webinar: Addressing Prescription Drug Abuse on CampusMichele Collu
This document discusses addressing prescription drug abuse on college campuses. It begins by outlining the scope of the problem, noting that while the US makes up 5% of the world's population, it consumes 75% of the world's prescription drugs. Contributing factors to misuse include easy access to medications, misperceptions about safety, and direct-to-consumer drug advertising. The document then defines misuse and outlines the most commonly abused drug types - opioids, stimulants, and depressants. It presents data on misuse rates among college students and 18-25 year olds. Finally, it discusses prevention strategies including information dissemination, skill building, problem identification and referral services, environmental approaches, and campus-
These slides provide an overview of the major elements required for effectively addressing addiction and risky use of addictive substances within the primary care setting. For more information, including a supplement guide with slide-by-slide background information, case studies and references please visit http://www.casacolumbia.org/health-care-providers/addiction-resources-tools
Drug abuse negatively impacts communities through increased family stress, crime, and health issues. It can cause marital and family problems as well as child neglect when parents are preoccupied with addiction. Users may commit crimes to fund drug habits, and drinking and driving contributes to many crashes. Treatment programs are costly and not always effective in reducing these negative effects of drug abuse on communities.
Adolescent Substance Use: America’s #1 Public Health ProblemCenter on Addiction
These slides accompany the CASAColumbia report, Adolescent Substance Use: America's #1 Public Health Problem (http://www.casacolumbia.org/addiction-research/reports/adolescent-substance-use), which reveals that adolescence is the critical period for the initiation of substance use and its consequences. The CASA report finds 1 in 4 Americans who began using any addictive substance before age 18 are addicted, compared to 1 in 25 Americans who started using at age 21 or older.
Protecting young people in the UK from designer drugs [UNODC expert panel, Ma...Mentor
Presentation by Emilio Torrini, Mentor research analyst.
"Designer drugs and Social Prevention" an event held as part of the 59th Session of the Commission on Narcotic Drugs
14-22 March 2016, organised by The Academic Council on the United Nations System (ACUNS).
The document outlines a proposal for partners in Hertfordshire to work more closely together on prevention initiatives. It discusses the need to scale up prevention efforts to make the NHS more sustainable and reduce costs across the health and social care system. The partners agree to conduct gap analyses on current prevention activities and develop a joint prevention strategy and governance structure to guide collaborative prevention programs going forward. The strategy will focus on high impact areas like musculoskeletal health, obesity, and long term condition management to help lower the projected cost curve.
Teaching slides from a University College London Partners and National Co-ordinating Centre for Mental Health Public Mental Health Course in February 2015. This session focuses on building local approaches to public mental health
This document discusses approaches to drug prevention and education. It covers topics like the goals of prevention, levels of prevention from primary to tertiary, risk factors for drug abuse, and the effectiveness of different prevention strategies. School-based drug education programs are most effective when they are developmentally appropriate, teach social resistance skills, involve normative education, and receive sufficient time and support. Peer-led and health education models can also be effective approaches.
School-based drug prevention programs aim to reduce substance use among children and adolescents. Most interventions target youth ages 10-16 when most begin experimenting. Programs should start in elementary school and continue with developmentally appropriate curricula. Effective programs provide medically accurate information using interactive methods to build social skills and resist peer pressure. While D.A.R.E. was widely used, research found it ineffective. Programs like Life Skills Training are evidence-based and teach drug resistance and self-management skills to reduce risk. Developing successful prevention requires assessing community needs, involving families and schools, and evaluating outcomes.
This document discusses approaches to drug education for young people. It finds that interactive "life skills" programs that build skills like assertiveness and managing social situations can be most effective at reducing drug and alcohol use, compared to simply providing facts or warnings. Effective programs take time for reflection and are taught consistently, rather than one-off sessions. While experts can contribute, the content and teaching method are more important than who teaches. Engaging disconnected youth may also help through programs that improve classroom behavior and education completion. The organization advocates bringing evidence-based life skills programs to UK schools.
Michigan Model Substance Abuse Conference 9 08Wendy Sellers
The document discusses the Michigan Model for Health, a comprehensive K-12 health education curriculum that aims to prevent drug abuse. It provides skills-based lessons addressing various health topics including social-emotional health, nutrition, safety, and alcohol/tobacco prevention. Research shows this approach is effective by building students' knowledge, self-efficacy, and skills to make healthy choices. The curriculum is implemented statewide with support from regional coordinators.
Improving Schools-Based Drug and Alcohol EducationMentor
This presentation was given at the Primary Care and Public Health 2016 Conference. It explores effective ways to improve school-based alcohol and drug education, ensuring the use and promotion of evidence based practice.
This document discusses approaches to drug prevention and education. It covers the goals of prevention, who is responsible, funding sources, and effectiveness of different programs. School-based programs that incorporate social skills training over multiple years with parent and community involvement have been shown to be most effective in preventing drug use. Effective drug education programs provide developmentally appropriate information, teach social resistance skills, address social norms, and involve interactive teaching techniques.
This document summarizes the findings of a survey of over 3,500 educators on drug and alcohol prevention education in America's schools. It identifies several key findings, including that the majority of teachers spend less than 5 hours per year on prevention education and feel ill-equipped to teach the subject. The document puts forth two recommendations: 1) that schools should not be the primary provider of prevention education and should work with parents and the community, and 2) that schools should reevaluate spending on ineffective programs and speakers and instead focus on strategies shown to be effective like skills-based training.
This document discusses the impact that a person's problematic substance use can have on their family members and friends. It notes that while interventions often focus on supporting the individual with the substance use problem, less attention is paid to the effects on family and friends. These effects can include physical and mental health problems, financial issues, relationship challenges, and domestic violence. The severity of impact depends on factors like whether family members live with the individual, provide their care, experience abuse, or use substances themselves. The document provides an overview of research demonstrating the stress, health problems, and emotional difficulties family members may face when a loved one has problematic substance use.
Session 3 role of school teachers and counsellorsDr Rajeev Kumar
Teachers play an important role in preventing drug abuse among students. They can act as role models for healthy behaviors and help students understand pressures related to experimentation. When planning prevention programs, teachers should conduct a situation analysis, needs assessment, and set clear goals and objectives. Signs of potential drug abuse include mood swings, declining academic performance, and changes in physical appearance. Younger students benefit from learning about decision making and healthy habits, while older students need information on peer pressure and health risks. Activities like art contests and role playing can effectively teach kids about drug prevention.
This document discusses the impact of parental substance use on children. It reports that millions of children globally are affected by a parent's alcohol or drug use, which can negatively impact children's development, well-being, and increase their risk of developing substance use problems themselves. Parental substance use is associated with issues like neglect, abuse, disrupted routines, and domestic violence. It outlines strategies to help protect children and the importance of support services for families struggling with addiction.
Understanding and Addressing Food Addiction: A Science-Based Approach to Poli...Center on Addiction
Public health concerns about the escalating obesity epidemic and its far-reaching health consequences, coupled with a growing understanding of the shared features of addiction across its myriad forms, have prompted some scientists to explore the possibility that certain eating behaviors might best be explained through the lens of addiction.
The interest in applying an addiction framework to understanding certain eating behaviors and food-related disorders has grown in recent years. This is a result of a large body of research highlighting the considerable overlap in the characterizing symptoms, risk factors and underlying neurobiological characteristics between substance addiction and what can be thought of as food addiction. It also arises from an attempt to explore how certain types of addictive-like eating might account for pathology that cannot be explained within the context of the currently recognized eating disorders of anorexia nervosa, bulimia nervosa and binge eating disorder. The growing interest in food addiction is also partially a result of an increasing awareness that lessons learned with regard to policy, prevention and clinical practice in relation to addictive substances might fruitfully be applied to the realm of food addiction.
Drugs & Society SOC 204
Drugs Across the Spectrum
By Raymond Goldberg
Chapter 2 Drugs in Contemporary Society
Chapter 3 Motivations for Drug Use
Chapter 4 Drugs & the Law
The chapter discusses drugs and delinquency among youth. It finds that most drug use is experimental and involves alcohol, tobacco, and marijuana. The relationship between drug use and delinquency is complex, with evidence that drug use can both cause and result from delinquency. Effective interventions include life skills training to prevent drug use and treatment programs that combine legal action with individualized treatment plans, such as drug courts.
Chronic harms of substance misuse. Effects of substances. A bio-psycho-social...Workingwithsubstanceabuse
This document discusses the bio-psychosocial model for understanding chronic harms of substance misuse. It uses alcohol as an example to show the interactions between biological, psychological, and social factors. The biological effects of substances like alcohol, opioids, stimulants are then outlined, including liver disease, addiction, overdose risk, and infections. Lastly, harm reduction strategies are proposed focusing on prevention, screening, and safer use.
EVERFI Webinar: Addressing Prescription Drug Abuse on CampusMichele Collu
This document discusses addressing prescription drug abuse on college campuses. It begins by outlining the scope of the problem, noting that while the US makes up 5% of the world's population, it consumes 75% of the world's prescription drugs. Contributing factors to misuse include easy access to medications, misperceptions about safety, and direct-to-consumer drug advertising. The document then defines misuse and outlines the most commonly abused drug types - opioids, stimulants, and depressants. It presents data on misuse rates among college students and 18-25 year olds. Finally, it discusses prevention strategies including information dissemination, skill building, problem identification and referral services, environmental approaches, and campus-
These slides provide an overview of the major elements required for effectively addressing addiction and risky use of addictive substances within the primary care setting. For more information, including a supplement guide with slide-by-slide background information, case studies and references please visit http://www.casacolumbia.org/health-care-providers/addiction-resources-tools
Drug abuse negatively impacts communities through increased family stress, crime, and health issues. It can cause marital and family problems as well as child neglect when parents are preoccupied with addiction. Users may commit crimes to fund drug habits, and drinking and driving contributes to many crashes. Treatment programs are costly and not always effective in reducing these negative effects of drug abuse on communities.
Adolescent Substance Use: America’s #1 Public Health ProblemCenter on Addiction
These slides accompany the CASAColumbia report, Adolescent Substance Use: America's #1 Public Health Problem (http://www.casacolumbia.org/addiction-research/reports/adolescent-substance-use), which reveals that adolescence is the critical period for the initiation of substance use and its consequences. The CASA report finds 1 in 4 Americans who began using any addictive substance before age 18 are addicted, compared to 1 in 25 Americans who started using at age 21 or older.
Protecting young people in the UK from designer drugs [UNODC expert panel, Ma...Mentor
Presentation by Emilio Torrini, Mentor research analyst.
"Designer drugs and Social Prevention" an event held as part of the 59th Session of the Commission on Narcotic Drugs
14-22 March 2016, organised by The Academic Council on the United Nations System (ACUNS).
The document outlines a proposal for partners in Hertfordshire to work more closely together on prevention initiatives. It discusses the need to scale up prevention efforts to make the NHS more sustainable and reduce costs across the health and social care system. The partners agree to conduct gap analyses on current prevention activities and develop a joint prevention strategy and governance structure to guide collaborative prevention programs going forward. The strategy will focus on high impact areas like musculoskeletal health, obesity, and long term condition management to help lower the projected cost curve.
Teaching slides from a University College London Partners and National Co-ordinating Centre for Mental Health Public Mental Health Course in February 2015. This session focuses on building local approaches to public mental health
The document discusses shifting to a prevention-focused approach to public health. It outlines 5 premises: (1) there is an epidemiological crisis with avoidable deaths and chronic disease; (2) policy context supports prevention; (3) clear roles and a nuanced understanding of behavior change are needed; (4) "big wins" include shifting clinical complexity and increasing prevention; (5) prevention efforts should be phased and layered across the lifecourse. Actions taken so far include new weight management and lifestyle services, and increasing health checks. A behavior change pathway is outlined moving from brief interventions to specialist support.
This document discusses approaches to addressing breathlessness from an integrated perspective across specialties and settings. It notes that breathlessness affects a large portion of the population but is underdiagnosed and inconsistently addressed. The working group recommends taking a systematic history, using various tests to assess underlying conditions, addressing mental health and obesity factors, and providing evidence-based treatments like rehabilitation and smoking cessation. Commissioners are urged to foster integration across specialties and providers to improve outcomes for those with breathlessness.
A presentation to start a workshop with community pharmacists on the contribution of pharmacy to the NHS Five Year Forward View, Health and Wellbeing Strategy and Sustainability and Transformation Plan
1) The document discusses innovative approaches to preventing and managing complex chronic diseases, including establishing centers of excellence through a partnership between UnitedHealth and the National Heart, Lung, and Blood Institute.
2) It outlines "Grand Challenges" to address chronic disease through public awareness, policies, risk factor modification, business engagement, and health system reorientation.
3) Prevention efforts for those with complex chronic conditions face conceptual difficulties and should be patient-centered rather than disease-focused.
This document provides an overview of public health services in Hertfordshire and discusses approaches to improving population health from a systems perspective. It outlines the various workstreams, budgets, and services provided by public health including health protection, improvement, screening programs, and sexual health services. It emphasizes the need to address the social determinants of health and take a systemic approach that considers health equity, prevention, and improving systems to better support overall wellness. The document advocates for public health leaders and elected members to think systematically and consider the health impacts of all policies across economic, effectiveness, efficiency, and equity domains to ultimately reverse trends of avoidable disease burden.
Η διαχείριση των μειζόνων συμπεριφορικών παραγόντων κινδύνου στην ΠΦΥEvangelos Fragkoulis
Παρουσίαση μου στα πλαίσια του Consensus Meeting: "Η διαχείριση και ο έλεγχος των Μείζονων Συμπεριφορικών Παραγόντων Κινδύνου για την Υγεία: η συμβολή νέων "εργαλείων" για την αντιμετώπιση τους", Ελληνική Επιστημονική Εταιρεία Οικονομίας και Πολιτικής της Υγείας, Ξυλόκαστρο 6-8 Ιουλίου 2018
Dr Aillen Keel CBE (Deputy CMO)'s keynote speech 'Better Health After Cancer,' at the SCPN's 'Be Active Against Cancer Conference,' Tuesday 4th February 2014.
Hugh Griffiths: Improving health outcomes for people with long-term conditionsThe King's Fund
Dr Hugh Griffiths, Acting National Clinical Director for Mental Health, Department of Health, outlines the key themes of the government’s mental health strategy for England and looks at how outcomes for people with physical and mental health conditions can be improved.
An analysis of the potential to achieve expected reductions in life expectancy from recommended interventions (reviewing the implications of a national modelling exercise)
Richard Mendelsohn- Beyond 2010: SMART Living Paneleventwithme
The document discusses a digitally enabled citizen program called Birmingham OwnHealth that aims to improve health outcomes for those with chronic diseases. The program provides personalized care plans, information prescriptions, and support for self-management through telehealth and care managers. Initial outcomes include reductions in avoidable hospitalizations and emergency visits, as well as improvements in clinical metrics like HbA1c and blood pressure. An independent university study found participants in the program experienced greater reductions in these measures compared to controls.
This presentation to a public health strategy workshop discussed how we could embed behaviour change at population level into our public health strategy
A presentation to a National Institute of Health Research consultation event on identifying priorities for public health research for the next five years
1) The document discusses using behavioral sciences strategically and contextually as part of an integrated public health strategy, rather than focusing solely on individual behavior change.
2) It notes there are many disciplines within behavioral sciences and provides examples of how different approaches could be applied, such as using behavioral economics for social marketing campaigns and health psychology in patient-clinician consultations.
3) The key points are that behavioral change strategies should be one part of a whole system public health approach, not seen as a magic bullet, and sometimes legislation and structural solutions are more effective.
The document proposes a new health plan focused on incentivizing healthy behaviors and reducing unnecessary healthcare costs. It notes that 50% of healthcare costs are due to preventable conditions and 35% of spending is wasteful. The plan would provide financial incentives for activities like health assessments, enrolling in coaching programs, and completing health education modules in order to encourage participation and healthy choices. The goals are to help people better understand and manage their health while saving on healthcare expenses over time.
Similar to systemic and system wide action on prevention : towards a strategy (20)
Prof Jim McManus discusses leadership models in public service and how they can fail or succeed across diverse communities. He reviews leadership approaches over the past 100 years, from the "great man" theory to more modern adaptive and transformational models. Effective leadership requires competence, strong culture, emotional intelligence, and a focus on justice. It also means fostering other leaders. Leadership should be inclusive and draw from diverse cultural worldviews rather than being based solely on white western men. Traditional virtues like justice, charity, fortitude, temperance and prudence can be recast through modern psychology to develop leaders.
A presentation to the SABRE Cymru conference (Social and Behavioural Science Rapid Response Network) on lessons for social and behavioural sciences in public health beyond Covid-19. https://sabrecymru.uk/
My presentation to the 175th anniversary conference of the Association of Directors of Public Health on lessons from the past and pointers for the future
This document discusses the impacts of poverty on health and wellbeing in the context of the COVID-19 pandemic and cost of living crisis. It notes increases in economic inactivity due to long-term illness, worsening life expectancy for some groups, and rising mental health issues like depression and anxiety. It emphasizes that poverty negatively impacts physical, emotional, psychological and social wellbeing. Addressing poverty requires a systems approach that considers socioeconomic factors like income, employment and social support, rather than just focusing on healthcare access. Key strategies discussed include addressing stigma, improving psychological flexibility, and taking a multi-pronged "Swiss cheese" approach similar to COVID-19 responses.
A presentation to the National Immunisation Conference on lessons learned for the future of public health response to Monkeypox and other novel infections
This is part 2 of a two part session deliver for a Common Awards (Theology, Ministry and Mission, University of Durham) course on health and the Church. The first part focuses on a theological perspective and the second part focuses on public health perspectives
This is part 1 of a two part session deliver for a Common Awards (Theology, Ministry and Mission, University of Durham) course on health and the Church. The first part focuses on a theological perspective and the second part focuses on public health perspectives
This presentation was given to a webinar on addressing poverty and also contains some suggested waymarkers for response. It is based on local experience and the lessons in the LGA/ADPH Annual Public Health Report 2023
An invited keynote to the St Vincent de Paul Society Conference 2022 on emerging from the Pandemic and tasks for the Church and associated organisations
1) The document discusses the importance of social and behavioral sciences in understanding and addressing complex public health problems like COVID-19. It argues these fields are needed to examine issues across multiple levels from biological to social and political.
2) It provides examples of how behavioral sciences have informed local COVID-19 responses in Hertfordshire, including around lockdowns, non-pharmaceutical interventions, vaccine confidence, and reopening plans.
3) Lessons from previous epidemics like HIV/AIDS are discussed, emphasizing the need to address psychological, social, and systemic factors for an effective response beyond just biomedical solutions. A multi-disciplinary approach is advocated.
This document provides a briefing for faith communities on responding to trauma in the wake of the COVID-19 pandemic. It discusses the impact of COVID-19 at the population, faith community, and ministry team levels. It emphasizes that COVID-19 has caused collective trauma and that faith communities need to ground their trauma response theologically and use evidence-based practices. The document provides frameworks and resources for faith communities to develop trauma-informed recovery plans, support self-care, and enable post-traumatic growth.
A briefing for Public Health teams on a public mental health approach resilience, trauma and coping beyond the pandemic, and addressing the needs of communities and workplaces
A publication for government on pandemic flu and faith communities. Prepared as a sister document to Key Communities, Key Resources, a report for government on faith communities and pandemic preparedness
More from Professor Jim McManus AFBPsS,FFPH,CSci, FRSB, CPsychol (20)
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2. www.hertsdirect.org
Outcomes we’d like from today
1. Agreement to do prevention together AS A
SYSTEM
2. A lead senior person from each partner
3. A gap analysis on prevention from each
partner
4. From gap analyses produce a strategy
5. A steer on governance of this from HWBB
3. www.hertsdirect.org
The big win
“The NHS needs a radical upgrade in
prevention if it is to be sustainable”
5 year Forward View 2014
Current Herts position
We are doing prevention, but lots of variation, not
systematic and lots of gaps
We could get more if we do it smarter
4. www.hertsdirect.org
Problem you asked us to look at
• Significant escalating and avoidable spend
across system
• Some efforts at preventing and reducing this
• Growth of avoidable cost to system and
avoidable health problems
• Growth of multimorbid health conditions
• System wide problem, little system wide
preventive pathways
5. www.hertsdirect.org
What do we mean by prevention?
Primary Prevention – ‘prevent’ harm
•Example: promoting health and active lifestyles
Secondary Prevention – ‘reverse’ harm
•Example: early detection and effective self management
of diabetes
Tertiary Prevention – ‘reduce’ harm
•Example: COPD + early stage heart failure + depression
6. www.hertsdirect.org
What Prevention are we doing
• Primary – increasing and needs to be done but
is a very slow upstream burn
• Secondary – we really need to do much more
here to prevent a 3-5 year cost curve increase
• Tertiary – Could have high impact within twelve
months. We need to do more.
Primary prevention alone, and tertiary prevention
alone not the answer.
Target all three for maximum impact
7. www.hertsdirect.org
Case study – Martha 69
• COPD
• Diabetes
• Early stage heart failure
• Smokes
Tertiary Prevention
Which bit of the system could do what for her?
What do we need to do better?
8. www.hertsdirect.org
Case Study – Joe, 58
• Stroke
• Poorly controlled blood pressure
• Coping poor
How do we prevent escalation? (secondary
prevention)
9. www.hertsdirect.org
Case Study – Joanne 39
• Very overweight
• Inactive
• Smokes
• Single parent
• Stressed
• Manual work
• Depressed
• Always asking for prescriptions
How do we stop this becoming a
major cost to the system?
10. www.hertsdirect.org
The Strategy
1. Reduce cost to the system by implementing high
impact actions system wide to prevent worsening of
health and management of cost
2. Improve quality of life by including clinical + lifestyle +
behavioural components
3. Make more use of services in the community including
pharmacy
4. Develop preventive pathways
5. Work across primary, secondary and tertiary
prevention to deliver this in tandem
6. Start with areas which will have highest impact
11. www.hertsdirect.org
Some early estimates
• Musculoskeletal health costs us
• Obesity costs us
• Poor management of long term conditions costs
us – including physical and mental health
• Multimorbidity costs us – 16% of NHS spend on
2% most complex patients
12. www.hertsdirect.org
Multimorbidity – evidence
• Definition - presence of two or more disorders
• 42% patients 1+ morbidities and 23% were multimorbid
• Prevalence increased with age and present in most 65
+
• BUT absolute number of people with multimorbidity
higher in those younger than 65 years
• Onset of multimorbidity occurred 10–15 years earlier in
people living in the most deprived areas
• Presence of a mental health disorder increased as the
number of physical morbidities increased and was
much greater in more deprived people
13. www.hertsdirect.org
Multimorbidity – implications for
practice?
• Is the single-disease framework fit for purpose?
– individual long term condition (LTC) services can be
duplicative and inefficient, and burdensome for
patients due to poor coordination and integration
• Is mental health a core component of LTC
pathways?
• Need to support generalist clinicians to provide
personalised continuity of care, especially in
deprived areas
14. www.hertsdirect.org
Example from the Commissioning for
Value CVD pathway
• HVCCG
– Hypertension ratio (-7.1 % lower) opportunity for
5,828 people
– % anti-coagulation drug therapy for those with
stroke risk >1 (using CHADS2 score) (-9.2 %
lower) opportunity for 361 people
– E&NHCCG
– % stroke patients blood pressure <150/90 (-2.6
% lower) opportunity for 200 people
– % stroke patients record of cholesterol (-4.6 %
lower) opportunity for 347 people
15. www.hertsdirect.org
Pharmacy
• We are not using pharmacy effectively
• High impact actions (Year 1 and 2)
– More uptake of medicine use reviews & new
medicine service
– More use of pharmacy based support for self
management in long term conditions
– Minor ailments schemes
– Healthy Living pharmacies in areas of highest need
• Develop further programmes in years 3 onwards
16. www.hertsdirect.org
The avoidable spend areas in the physical
health system, with poor health/quality of
life
Multi morbid
Repeat admission
Complex care
Existing disease
Managed sub-optimally
Sudden onset of acute
Avoidable events eg stroke
Volume of
spend
Severity
Existing curve
17. www.hertsdirect.org
Key actions to reduce this PH spend curve
Clinical + Lifestyle + Behavioural
Case management
Self management
Optimal assertive
Management of existing
disease
(lifestyle +
pharmacological)
Optimal
management of
high
Risk patients;
Volume of
spend
Severity
Existing curve
The Achievable
18. www.hertsdirect.org
The avoidable spend areas in the mental
health system, with poor health/quality of
life
Crisis pathways
And repeat
Admissions, dual
diagnoses
People with long term mental ill health
Whose physical health deteriorates due to
Sub-optimal management
Prescribing practice where
IAPT or CBT could resolve issues
Volume of
spend
Severity of condition
Existing curve
19. www.hertsdirect.org
Key actions to reduce this MH spend curve
Clinical + Lifestyle + Behavioural
Recovery focused
care
Channel shift:
Greater use of
online and
community groups;
less prescribing
Optimum
physical health
(eg quitting
smoking
reduces cost to
MH services)
Volume of
spend
Severity
Existing curve
The Achievable
20. www.hertsdirect.org
The Actions
• We’ve suggested the strategy
• What follows are the actions
Main message:
We need to reduce variation across the
healthcare system for these high
impact actions
21. www.hertsdirect.org
High Impact Actions by Partner 1
Who Primary Secondary Tertiary
Primary Care NHS Health Checks
Making Every Contact
Counts (MECC)
- Joint British Society
recommendations for prevention of
CVD (JBS3) - Blood pressure
- Weight
- Alcohol
- Diabetes – eight care processes
- Improved access to IAPT services
- Early identification of atrial
fibrillation and anticoagulation
therapy
Self-Management
Optimise referrals to
Pulmonary / Cardiac
rehabilitation
Pharmacy
Purple – contractual
Red – requires funding
Green – may need financial
support
Healthy Living Pharmacies
Public Health (PH) Pathway into PH Services
Minor ailments with pharmacy
Medicine Use Reviews / New Medicines Service
Healthy Lifestyle Advice
Home MURs
(Bright Ideas Project)
LTC Pathways
Repeat dispensingExpansion of PH services –
smoking, alcohol IBA, sexual health
Minor ailments
Healthy Living Pharmacies
22. www.hertsdirect.org
High Impact Actions by Partner 2
Partner
Primary Secondary Tertiary
HCS Promote a healthy workforce
Making Every Contact
Counts & brief interventions
Re-ablement
Public Health Continue to commission
services
Use expertise to support
prevention strategy
Enhance healthcare and social
care public health offer
Use expertise to support
prevention strategy
PH Pathway into PH Services
PH Pathway into PH Services
Community Wellbeing Services
Prevention Strategy for Older People
23. www.hertsdirect.org
High Impact Actions by Partner 3
Partner
Primary Secondary Tertiary
HCT
Promote a healthy workforce
Implement NICE guidance
-Smoking cessation in secondary
care: acute, maternity and
mental health services (PH48)
Brief Interventions /MECC
Alignment of physical health and
mental health / psychological
support pathways
Acute Promote a healthy workforce
Implement NICE guidance
-Smoking cessation in secondary
care: acute, maternity and
mental health services (PH48)
Brief Interventions /MECC
Referral pathways to community
prevention services
Rehabilitation
Reduce variations in length of
stay
Optimise Pulmonary / Cardiac Rehab Pathways
PH Pathway into PH Services
PH Pathway into PH Services
24. www.hertsdirect.org
High Impact Actions by Partner 4
Partner
Primary Secondary Tertiary
Voluntary Sector Making Every Contact Count
Deliver resilience and
psychosocial support
Programme delivery
providers
Programme delivery providers
HPFT Promote a healthy workforce
Implement NICE guidance
-Smoking cessation in secondary
care: acute, maternity and
mental health services (PH48)
MECC
Robust physical health pathways
for patients with serious mental
illness (SMI) and dementia
Recovery services
PH Pathway into PH Services
PH Pathway into PH Services
25. www.hertsdirect.org
High Impact Actions by Partner 5
Partner
Primary Secondary Tertiary
Childrens
Ensure universal public health
offer aligns well with children's
services
Schools mental health and
wellbeing
School health
Ensure early intervention
takes holistic approach
PH Pathway into PH Services
26. www.hertsdirect.org
Two things now...
How do we govern this?
• How do we make it happen
system wide?
• Which fora do we use?
• Who leads?
• Resource – within existing
resources but some
investment in programme
capacity and look at
prioritising?
Agreements we’d like today
1. Agreement to do
prevention together AS
A SYSTEM
2. A lead senior person
from each partner
3. A gap analysis on
prevention from each
partner
4. From gap analyses
produce a strategy for
HWBB
Editor's Notes
England faces an epidemic of largely preventable non-communicable diseases, such as heart disease, cancer, Type 2 diabetes and liver disease.
The WHO Global Burden of Disease Study shows us that the leading causes of premature mortality are tobacco, raised blood pressure, obesity, physical inactivity and poor diet. The radical upgrade in prevention needs population-level approaches. But it also needs ongoing behaviour change support and medical treatment for individuals during their repeated contacts with primary care.
Secondary prevention - interventions happen after an illness or serious risk factors have already been diagnosed. The goal is to halt or slow the progress of disease (if possible) in its earliest stages; in the case of injury, goals include limiting long-term disability and preventing re-injury.
Tertiary prevention - focuses on helping people manage complicated, long-term health problems such as diabetes, heart disease, cancer and chronic musculoskeletal pain. The goals include preventing further physical deterioration and maximizing quality of life.
Referral from GP to CP could result in
Education and counselling by CP can result in improvements to cardiovascular risk profile of patients with diabetes. (Manor Pharmacy/UoH pilot article attached)
MURs in pharmacy or patient’s home (Bright Ideas project – IM sponsoring) may prevent hospital admission, by ensuring prescribed medication compliance/concordance
Stroke/Coping poor
Referral to support services – detail needed on what they are? Community navigator role?
Why are bloods poorly controlled?
Provide community based anti-coag service? Could be in CP or other suitable venue? Could be nurse/CP lead?
Needs multi-disciplinary solution – HPs, social care, voluntary sector etc
CP could signpost, also offer SS service, Rx support – are meds being prescribed appropriately
Not addressing relationship between LTCs and mental health and its impact on self management
NHS England LTC Dashboard
1 LTC (31% EN; 31.7% HV)
2 LTCs (12.4% EN; 12.5% HV)
3 LTCs (9% EN; 8.1% HV)
Commissioning for Value (CfV) - 2% most complex patients of which 60% aged 65 years+
E&NH – 16% spend, 1497 patients, av. 2.8 conditions and 6.2 admissions per year – circulation, cancer and GI top 3 areas of spend
HV – 15.9% spend, 1530 patients, av. 2.91 conditions and 6.7 admissions per year– circulation, cancer and MSK top 3 areas of spend
Obesity associated with the four most prevalent disabling conditions in the UK: arthritis, back pain, mental health disorders and learning disabilities
1/3 obese adults have a limiting long term illness or disability compared to a quarter of adults in the general population
Multimorbidity is associated with high mortality, reduced functional status, and increased use of both inpatient and ambulatory health care
The Global Burden of Disease study (2010) - growing burden of disability, particularly from mental disorders, substance use, musculoskeletal disorders, and falls deserves an integrated and strategic response
314 GP practices in Scotland (2007)
Prevalence of both physical and mental health disorder 11%, in most deprived area vs 6% in least deprived
Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 2012;380(9836):37–43. CrossRefPubMed
cross-sectional study
data on 40 morbidities from a database of 1 751 841 people registered with 314 medical practices in Scotland as of March, 2007.
analysed the data according to the number of morbidities, disorder type (physical or mental), sex, age, and socioeconomic status. D
Defined multimorbidity as the presence of two or more disorders.
challenge the single-disease framework by which most health care, medical research, and medical education is configured
The CHADS2 score is a clinical prediction rule for estimating the risk of stroke in patients with non-rheumatic atrial fibrillation (AF), a common and serious heart arrhythmia associated with thromboembolic stroke. It is used to determine whether or not treatment is required with anticoagulation therapy or antiplatelet therapy,
& new medicine service (50% drugs stopped before end of first month without this and often GPs unaware)
The NHS Health Check is a systematic approach to identifying local people at high risk of CVD, offering behaviour change support and early detection of hypertension, CKD, diabetes and pre-diabetes. Modelling suggests that 75% uptake will lead to substantial reductions in premature mortality. What proportion of our local eligible population is receiving the NHS Health Check and how effective is their follow up risk factor management in primary care?
12.8% offered an NHS Health Check (18.4% in England). 65.3% of people received an NHS Health Check of those offered (49% in England).
http://www.guidelines.co.uk/cardiovascular_bmj_jbs3_jul14
Diabetes
Diabetes observed prevalence compared to expected prevalence ENH 82% & HV 73%
8 care processes – CfV data on pathways - Cardiovascular disease profile - Diabetes (March 2015)
ENH- People with diabetes who have had the eight recommended care processes = 42.4%
HV- People with diabetes who have had the eight recommended care processes = 63.2%
CVD pathway CfV - What questions should we ask in our CCG?
1.For each indicator how wide is the variation in achievement and exception reporting?
2.How many people would benefit if all practices performed as well as the best?
3.How can we support practices who are average or below average to perform as well as the best in:
•Identifying people who are obese, inactive or smokers
•Identifying and managing high CVD risk
•Identifying and managing high blood pressure
•Identifying and managing pre-diabetes
4.What is the quality of brief interventions we offer our patients?
5.How available are preventive services such as weight management and smoking cessation?
Stroke
Atrial fibrillation increases the risk of stroke by about 6 fold, and strokes caused by AF are often more severe with higher mortality and greater disability. Anticoagulation substantially reduces the risk of stroke in people with AF. Around 25-30% of people with AF are unaware they have the condition and less than a half of patients are adequately treated – many do not receive anticoagulants and of those who do, many are undertreated. Only 30% of people with known AF admitted with stroke are on anticoagulant treatment at the time of their stroke.
Secondary prevention of stroke For people who have had a stroke anti-platelet treatment and good control of blood pressure are key to reducing the risk of a further stroke
Pharmacy – Lisa
Healthy Lifestyle advice contractual and includes healthy eating, physical activity, smoking, alcohol etc. Advice given generally as well as during MURs and as part of contractual Health Promotion campaigns.
Medicines Use Review (MUR)/New Medicines Service (NMS) – contractually funded but need multidisciplinary buy in. Prioritise by specific target groups eg respiratory disease, recently discharged from hospital. Could also have local target groups eg: musculoskeletal conditions. Direct funding not required but knowledge of local pathways/training etc
Expansion of PH services – need to look at where GP/Pharmacy services are lacking and encourage contractors to become accredited. Referral process where GP or CP is not providing to ensure patient needs are met.
LTC Pathways – CP rarely included until issues arise or targets unmet eg: Under 65yrs target groups for flu vaccine. When are pathways reviewed? How can CP be involved?
Repeat dispensing – contractual service that CPs must promote but only GP can issue – need both to work together. Patient benefits as CP must assure that requested medication is required. Opportunity to discuss with patient on monthly basis. Potential to improve compliance/concordance and recognise problems at early stage.
Home (domicilary) MURs – project doc attached
Healthy Living pharmacy – expansion of current ohort (18) across Herts. Promotes PH interventions and proactive working with clients in pharmacy and as part of outreach
HCS
Levels and competencies from brief intervention onwards
Preventive services as part of commissioned services
Link up to community services (referral for leisure and behavioural interventions)
Culture change
Embedding good practice
Evidence on what is effective
Pulmonary / Cardiac Rehab Pathways - uptake/access and follow up