PHYSICIAN
ASSISTANT
PROGRAM

CLINICAL YEAR 2005-2006
STUDY GUIDES

Community Medicine Rotation

Use this list of study topics along with the syllabus, required texts, article readings, and lecture notes from Behavioral Medicine I and II to get the most out of the rotation and to prepare for the end-of-rotation exam.

Community Health Assessment and Program Planning

• Purpose of a community health needs assessment

• Steps in a community health needs assessment

• PRECEDE-PROCEED Planning Model: Five phases of PRECEDE

• Methods of gathering primary health data

• Sources of secondary health data

• Identifying a target or priority population

• Social Ecological Perspective: Planning interventions at levels of influence

• Determinants of health at various levels of influence

• Information sources needed for building an effective program rationale

• Healthy People for Healthy Communities and Healthy People 2010

• Mission statement, elements of goals, and different types of objectives

 Health Behavior Change Theories

• Health Belief Model

• Transtheoretical Model (stages of change and processes of change)

• Social Cognitive Theory

• Freeing Theory and its use in community building

• Matching theories with interventions at specific levels of influence

• Examples of primary, secondary and tertiary prevention

• Group roles

• Strategies to engage and motivate patients and the community for therapeutic lifestyle change (TLC)

 Program Implementation

• Gaining entry into the community

• Identifying potential community partners

• Working with volunteers (community group leaders and lay leaders)

• Using the four “p’s” for developing a marketing-mix strategic plan

• Social marketing

• Market segmentation

• Intervention tailoring

• Diffusion theory

• General principles of learning (Chapter 5: Community Health Manual)

• PRECEDE-PROCEED Planning model: Four phases of PROCEED

• Legal and ethical concerns related to intervention programs

• Resources

• Interventions: strategies and examples

Program Evaluation

• Types of evaluation (formative, process, outcome, and impact)

• Internal versus external evaluation

• Evaluation process

• Practical problems or barriers in evaluation

• Writing an evaluation report (Chapter 8: Community Health Manual)

 Chronic Disease Management and Patient-Self Management

• Why chronic disease management should be a high priority—number of Americans with chronic disease, causes of death, costs, areas for improvement

• Definition of disease management and patient self management

• Elements of the chronic care model

• Five A’s: Role of the provider in patient self-management

• Self-management tasks

• Components of successful action plan

• Problem-solving steps

• Strategies for fatigue management, stress management, pain management

• Examples of internal and external factors that can have a negative impact on chronic care management in primary care

• Diabetic management tests that can be included on a patient chart reminder sheet

• Tasks a support staff in a primary care office can be trained to do to assist with disease management

 Cultural Competence

• Definition of culture, ethnicity, bicultural, cross-cultural, acculturation, assimilation, cultural relativity, ethnocentrism

• Sociocultural issues for African Americans, Asian and Pacific Americans, Hispanic/Latin Americans, Native Americans, and the elderly

• Strategies for overcoming language barriers and other barriers to care

• Patient-centered, cross-cultural care approach

  • Motivational interviewing
  • Engaging
  • Empathizing
  • Educating
  • Enlisting

• Effective use of an interpreter

 Patient Education

• Teach-back/show-me techniques

• Patient-friendly written material guidelines

• Brown-bag medication review

• Smoking cessation

• Physical activity recommendations

• Healthy eating guidelines and food pyramid