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.)
My outcome of interest is a positive change in the knowledge, attitudes, and perceived barriers to lifestyle modification (diet and exercise) of patients with fatty liver disease after attending a free fatty liver education course. While diet, exercise, and alcohol consumption are key behaviors for the health outcome of fatty liver disease, two key behaviors important to the outcome listed above (change in knowledge, attitudes, barriers) are 1) attendance of the fatty liver class requiring travel to and from clinic, and 2) understanding the information presented in the fatty liver class.
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.
We have created a survey with questions addressing knowledge of fatty liver disease, attitudes toward the diagnosis and healthcare in general, and perceived barriers to recommended lifestyle modification. We are comparing the pre-education survey to the post-education survey of patients able to attend the fatty liver education course. In this study, we are looking at several social factors including race/ethnicity, income, education, employment, location/neighborhood (including availability of healthy food and areas to walk exercise), impact of family/culture on diet and activity level, support system.
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?
Yes, I think that we need to continue to study how these behaviors influence health outcomes, as well as how social factors influence these behaviors. Although these relationships have previously been demonstrated, these factors and behaviors are not being effectively addressed at every opportunity in the healthcare system. Although these relationships may be known and accepted by some providers, they are not incorporated into practice in a systems-based approach, and therefore are not effectively addressed on a large scale, as they should be.