SOCIAL DIAGNOSIS:

ASSESSING QUALITY OF LIFE

CONCERNS
Module 5

HEALTH PROMOTION & EDUCATION (DEMA 3253)

DIPLOMA IN ENVIRONMENTAL HEALTH
VICTORIA INTERNATIONAL COLLEGE

PREPARED BY: MR KHAIRUL NIZAM MOHD ISA

 THE 7 PHASES OF PRECEDE
Phase 6 Phase 4-5 Phase 3 Phase 1-2
Administrative diagnosis Educational diagnosis Behavioral diagnosis Epidemiological & social diagnosis

Predisposing
Direct factors:
communication: knowledge,
public, patients attitudes, values, Nonhealth
perceptions factors
Nonbehavioral Quality of life
causes
Health education Enabling factors:
Availability of Health problems Subjectively
components of Behavioral causes defined problems
health program resources,
accessibility, of individuals or
referrals, skills Behavioral Vital indicators: communities
indicators: Morbidity,
utilization, Mortality, fertility, Social indicators:
Indirect Reinforcing preventive actions, disability illegitimacy,
communication: factors: Attitudes consumption population,
staff and behavior of patterns, welfare,
development, health and other compliance, self- Dimensions: unemployment,
training, personnel, care incidence, absenteeism,
supervision, peers, parents, prevalence, alienation,
consultation, employers, ect. distribution, hostility,
Dimensions:
feedback intensity, discrimination,
Earliness,
duration votes, riots,
frequency, quality,
crime, crowding
range, persistence
OBJECTIVE IN PHASE 1
• To determine the subjective concern with quality of life in the
target population
• To verify and clarify these concerns with analysis of existing social
indicators and data available from newspaper files, census reports
and vital records and special surveys conducted by radio and
television stations and marketing and social agencies
• To document the status of the target community in relation to
those priority concerns for which there is a health components or
cause
• To make explicit the rationale of the selection of priority problems
• To use the documentation and rationale to justify the further
expenditure of health education resources on the selected social
problems
• To use the documentation and rationale as the bases on which to
evaluate the program in cost-benefit terms
RELATIONSHIP BETWEEN HEALTH AND
SOCIAL PROBLEMS

Social policy/
Social condition

Health Problems Quality of Life

Health interventions
STRATEGIES FOR IDENTIFYING SOCIAL
PROBLEMS

1. Reviewing the literature

▫ Biomedical, health education and behavioral science literature
should be the first resources.

▫ Data from previous study provide insight into aspect of a social

problem that directly can be focused on.
STRATEGIES FOR IDENTIFYING SOCIAL
PROBLEMS
1. The nominal group process
▫ Participants that knowledgeable and representative about the question
are Arranged into groups of six to seven members.
▫ Asked a single question regard to quality of life
▫ Get the response from each group. The answer can be written in a
paper or flipchart, whiteboard or OHP.
▫ Then, a single response from each participant is elicited. No
discussion permitted at this time.
▫ Clarify the meaning of the response
▫ After that, a preliminary vote is conducted to rank the response by all
participants
▫ The result is discussed the voting patterns.
▫ Then the final vote is carried out to rank again the most important
items and rate them.
▫ Finally the grand total of vote are calculated and the items are rank
base don the priority.
STRATEGIES FOR IDENTIFYING SOCIAL
PROBLEMS
1. The Delphi method
▫ Series of questionnaires are mailed to a small number of
expert, opinion leaders or informants when face-to-face
meeting are impractical.
▫ Start with definition of issue, selection of participants and then
development of 1st questionnaire (open-ended question).
▫ Then, voting or comment format is used in the 2nd question set
that based on the result obtained from 1st questionnaire set.
▫ Develop 3rd questionnaire that require a final vote.
▫ Finalize the result.
▫ Advantages:
Researchers are able to work with a variety of target group
representatives.
Wide geographical outreach.
Participants remain anonymous
STRATEGIES FOR IDENTIFYING SOCIAL
PROBLEMS
1. The continuum approach
▫ Participants are asked to indicate the level of quality of life for
themselves or their community by placing a ‘X’ on the quality of
life continuum with the value ranging from ‘poor’ to ‘optimum’.
▫ They are asked to list several condition that they believe stand
as barriers to an improvement in the quality of life.
▫ Advantage: Appropriate for use in small and large groups as
well as in one-to-one settings.

Poor Optimum
1 2 3 4 5 6 7 8 9 10
X

Area for potential improvement

STRATEGIES FOR IDENTIFYING SOCIAL
PROBLEMS

1. Using public service data

▫ Data taken from National Center for Health
Statistics, Department of Health, Education and
Welfare, local and state health departments, WHO,
professional journals and state planning agencies.
 EPIDEMIOLOGICAL
DIAGNOSIS: ASSESSING OF
ETIOLOGIES

HEALTH PROMOTION & EDUCATION (DEMA 3253)

DIPLOMA IN ENVIRONMENTAL HEALTH
VICTORIA INTERNATIONAL COLLEGE

PREPARED BY: MR KHAIRUL NIZAM MOHD ISA

INTRO
• Epidemiology has been defined as:
▫ “The study of the distribution and determinants of health
related states or events in specified population, and the
application of this study to control of health problems.”
(Last, 1988)

▫ Distribution – frequency and pattern of health events in a

population
▫ Determinants – causes and other factors that influence the
occurrence of health related events
IDENTIFYING HEALTH PROBLEMS

1. The Reductionist Approach

▫ Assessing the relative importance of various cause or etiology.
▫ Epidemiologic knowledge and method can be used to
recommend the priorities program directed for both :
health problems and
other program that due to non-health factors which contributed to
social problems
▫ Source of references are:
Scientific and professional data/study
 Unemployment
Education
Lack of industry
Race, age, gender
Geography
Transportation
Non-health factors
Social problem or
quality of life
concern: Poverty
Health factors
Overpopulation
Poor infant health
Mental illness
Parasites
Alcoholism
Malnutrition
IDENTIFYING HEALTH PROBLEMS

1. The Expansionist Approach

▫ Use when the assigned problem has been oversimplified
▫ This approach can determine easily the relationship of health
problems to quality of life.
▫ Vital in developing of data for significant subgroup (ie. without
such data it would be impossible for the professional to know
which subpopulations should receive special attention and which
health problem deserve higher priority)
DESCRIBING HEALTH PROBLEMS
• Function of this process:
1. Help to establish relationship between the health problem, other
health conditions and quality of life
Epidemiological and medical data can provide an indication
for couching program objectives.
Sources like National Center for Health Statistics, Department
of Health, Education and Welfare, local and state health
departments, WHO, professional journals and state planning
agencies.

▫ It lead to fuller understanding of the various dimensions of the

health problems  setting priority and serve as a guide for
concentrating the problems development and resources.
Help the planner get a clear focus on the problems and the
strategies to be used in attacking them.
Whether a program is to be preventive, curative, rehabilitative
or some combination of these perspective.
DESCRIBING HEALTH PROBLEMS

1. It can make possible a clear allocation of responsibilities among

collaborating professionals, agencies or departments.
DEVELOPING PROGRAM OBJECTIVES
• Setting an objectives is crucial to convert diagnostic data into program
direction.
• Objective should used epidemiological and medical term/language.
• Who, What, How much, When
• The objectives can be:
▫ Measured using a parameter
▫ Individual objectives are based on relevant, seasonably accurate data
▫ Objectives are in harmony across topics (dealing with various aspect of
health problem) as well as across level (success in all levels and more
refine)
• Project:
▫ Select one significance environmental health topic
that really you can work out inline with health
education and promotion.
▫ Apply this lecture to accomplish your project.
Thank you for your attention