Assignment_2_Barrie
Please post to the forum by 1pm on the day of class
1. State your health outcome of interest. (It could be the one you used for week #2 or another one.) Pick two key behaviors that are important factors leading to your health outcome. Explain the importance of these behaviors either for etiology, prevention, or intervention. (If none of the behaviors in the readings are important for your health outcome, suggest another behavior that is.)
Answer:
I am interested in the social determinant of health which influence access to maternal and child health care in Sierra Leone. In April 2010, Sierra Leone launched a free health care initiative providing free healthcare to Pregnant women, lactating mothers and children under the age of five years. Despite the removal of user fees for these categories of patients, facility attendance did not improve. My outcome of interest is health clinics attendance by tribes, household income, and education level. The behaviors of interest are related to health seeking behaviors by patients and health service provision by healthcare workers. With the health seeking behaviors, I will like to look at which factors influences patients’ decisions to seek health care at a health facility, factors such as their education level, the tribe they belong to, income of the patient’s household, trust in the public health facilities. For the health service provision, I will want to look at the behavior of health care providers to patients, such as do they discriminate patients based on their income, their tribes or education level. And then I will look at the relationships between these behaviors and the trust in the health care systems.
2. Describe how you would study the role of one of the behaviors described for question #1 and your health outcome of interest. Incorporate a social factor (e.g. race/ethnicity, social exclusion, stress) in the study approach.
Answer:
I will conduct a mixed method study design to understand why patients refuse to attend public health clinics. I will design a survey questionnaire where I will elicit, educations level, household income and tribes. Also, in the questionnaire I will ask questions like when you get ill where you sought care, and why they did not seek care in the public facility even though it is free for them, if they answered that they seek care somewhere else. Then a I will administer a semi-structured interview to a sub-set of those who answered the surveys to learn the reasons why they chose not to attend public clinics. Then I will analyze both the surveys and interviews then use the interview answers to explain my finding in the surveys. Then I will aggregate the data by tribe, household income and education level to see if there is a relationship between these indicators and my outcome indicator which is clinic attendance.
3. If key health behaviors (e.g. smoking, exercise, nutritious diet) are strongly influenced by neighborhood, income, and/or education, do we need to continue to study how these behaviors influence health outcomes? Why or why not?
Answer:
I think we should still continue to study how these behaviors influence health outcomes, because even though they strongly influence neighborhood income and education the way they influence health outcomes may be different. You can look at neighborhood in terms of clusters of 1 mile, 2 miles etc, which will give you different income and education levels. There are also many other factors which can influence income and education in a neighborhood such as well as influence health outcomes such as distance to restaurants, highways, noise etc so yes we should continue to study how these behaviors influence health outcomes.