Wrap Up

IKM 1

Semester 3 - 2017
This is the last lecture in IKM1

Remember you will have a UTS in 3 weeks. Be prepared!

2
 Materials

Concept of Prevention Epidemiology 1

01 04
DR. dr. Tita Hariyanti, M.Kes DR. dr. Siswanto, MSc

Theory of Behaviour Epidemiology 2

02 05
dr. Arief Alamsyah, MARS DR. dr. Siswanto, MSc

Health Promotion Group Presentations

03 06
dr. Harun Al Rasyid, MPH

3
Concept of prevention
There are levels of prevention in public
health. Each level has a specific target and
activities. The combination of actions from
these levels is required to manage public
health issue comprehensively.
 What you have learned

Definition of Determinants of
health & illness health

Epidemiological Natural history

triangle of disease

Levels of
prevention

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 Epidemiological Triangle

Environment

vector

Agent Host
Five levels prevention of disease (Leavell & Clark 1965)

Primary Secondary Tertiary

prevention prevention prevention
3. Early
1. Health diagnosis and 5.
Promotion prompt Rehabilitation
treatment

2. Specific 4. Disability
Protection limitation
The linkage of natural history of disease and level of prevention
Theory of human behavior
Health Behavior Theories and Models

Models of Individual Health Behavior

Health Belief Model (HBM)
Theory of Reasoned Action and Theory of Planned Behavior
Transtheoritical Model

Models of Interpersonal Health Behavior

Social Learning Theory
Social Cognitive Theory

Community and Group Models of Behavior

Change
Diffusion on Innovations
PRECEDE-PROCEED Model

Glanz et.al (2008)

 Modifying Individual
Action
factors belief Perceived
threat

Perceived susceptibility to
and severity of disease

Age
Gender
Ethnicity
Personality Perceived benefits
Individual
Socioeconomics
Knowledge
behaviors
Perceived barriers

Perceived self efficacy

Cues to
HBM action
Social Cognitive Theory
Type of adopter according to Diffusion of Innovation Theory
Health Promotion
 Health Promotion

health education
- behavioural
- structural
attitudinal
-------------------------
behavioural
organisational
environmental
actions Improved
and
------------------------- Health
social
economic status
changes
actions
conducive
-------------------------
to health
political actions
Including advocacy
 Predisposing factors

RISK Enabling factors

FACTORS

Reinforcing factors
STRATEGI
PROMOSI
KESEHATAN
DI
INDONESIA

Pemberdayaan Bina Suasana

Advokasi Kemitraan
 Health Promotion Method

Individual Group

Patient Education Didactic

Guidence & Counseling Experential Group Learning

Programmed learning

Self-help materials

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Epidemiology
 Sub Topics

Definition Causation in epidemiology

01 04 Sufficient/necessary, plausibility, reversibility, OR, RR
Distribution of disease is not equal

Case Definition Epidemiological measures

02 05 Prevalence, Incidence, mortality rate, fatality rate
Suspected, Probable, Confirmed

Study Design
03
Cross-sectional, Case control, cohort

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 RESEARCH DESIGN
THE
RESEARCH

INTERVENTIONAL STUDIES
OBSERVATIONAL STUDY (INVESTIGATOR DETERMINE
(NO CONTROL OVER EXPOSURE) WHO EXPOSED OR NOT
EXPOSED)

NON COMPARRISONS COMPARISONS

GROUP GROUP
(Descriptive) (Analytic)

CROS
CASE
SURVEILLANC SEC COHORT
CASE- SURVEY CONTROL
E TIONAL STUDY
STUDY STUDY
STUDY
Contoh soal ujian
 1

Seorang penderita diabetes mellitus harus menyuntikkan insulin setiap hari untuk menurunkan
kadar gula darahnya yang sangat tinggi. Hal ini termasuk kegiatan apa?

A. Health Promotion

B. Specific protection

C. Primordial prevention

D. Secondary prevention

E. Tertiary prevention
 2

Seorang lelaki berusia 60 tahun mengikuti kegiatan pemeriksaan kesehatan gratis yang
diselenggarakan di posyandu lansia. Lelaki ini merasa sehat. Namun, ternyata ia mempunyai
tekanan darah 180/100 mmHg. Di dalam Natural History of Disease, lelaki ini berada dalam fase
apa?

A. Stage of susceptibility

B. Stage of subclinical disease

C. Stage of clinical disease

D. Stage of recovery, disability or death

E. Point of no return

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 3

Manakah contoh berikut yang sesuai dengan penerapan building healthy public policy?

A. Menerapkan kebijakan imunisasi dasar untuk semua anak

B. Menerapkan kebijakan larangan merokok di lingkungan Puskesmas dan rumah

C. Menerapkan kebijakan menyelenggarakan posyandu di setiap

D. Penempatan traffic light di pusat kemacetan lalu lintas

E. Pembangunan rumah sakit dengan kapasitas tempat tidur lebih banyak

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 4

Subyek adalah anak sekolah yang menderita diare dan teman sekolahnya yang tidak sakit diare
yang datang ke Puskesmas. Kedua kelompok didata untuk mengetahui jenis jajanan yang
dikonsumsi dua hari yang lalu. Bila ingin mengetahui hubungan antara konsumsi jajanan dan
kejadian diare, desain penelitian apa yang paling cocok?

A. Case-control study

B. Cohort study

C. Cross sectional study

D. Descriptive study

E. Experimental study

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 5

Seorang penderita Chronic Obstructive Pulmonary Disease (COPD) berusia 50 tahun diberi advis
oleh dokter untuk meninggalkan kebiasaan merokoknya. Pasien mengatakan bahwa ia sudah
memahami dampak merokok dan ingin berhenti tetapi menunggu saat yang tepat. Saat ditanya
kapan waktu yang tepat, pasien hanya menggelengkan kepala dan tidak bisa menjawab. Pasien
diatas berada pada fase perubahan perilaku yang mana?

A. Precontemplation

B. Contemplation

C. Preparation

D. Action

E. Maintanance

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Thank you
Good luck!