Definition of Risk Assessment Definition of Risk Assessment - PDF Document

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  1. Definition of Risk Assessment Definition of Risk Assessment • • A scientific process of evaluating the A scientific process of evaluating the adverse effects caused by a substance, adverse effects caused by a substance, activity, lifestyle, or natural phenomenon. activity, lifestyle, or natural phenomenon. Risk Assessment Risk Assessment • • Characterized by uncertainty Characterized by uncertainty • • Establishes a range of probability Establishes a range of probability Definition of Risk Factor Definition of Risk Factor Healthy People Healthy People • • Disease prevention and health promotion Disease prevention and health promotion instead of only finding the cure instead of only finding the cure (since 1979) (since 1979) • • Risk Factors increase the probability of Risk Factors increase the probability of disease, injury, or death. disease, injury, or death. • • Studying the risk factors for Studying the risk factors for getting a disease disease became increasingly important. became increasingly important. getting a (McKenzie, Pinger and Kotecki, 2002) (McKenzie, Pinger and Kotecki, 2002) Types of Disease Types of Disease Examples of Risk Factors Examples of Risk Factors • • Communicable (infectious) Communicable (infectious) • • Non Non- -communicable communicable • • Obesity Obesity • • Alcoholism Alcoholism • • Poverty Poverty • • No helmet No helmet • • Tobacco use Tobacco use • • Environment Environment • • Acute Acute • • Chronic Chronic 1

  2. Establishing Risk Factors Establishing Risk Factors Analytical Studies Analytical Studies • • Retrospective Retrospective • • Case Case • • Control Control • • Prospective Prospective • • Cohort Cohort How do we know How do we know what the risk factors are? what the risk factors are? Resource Theory Resource Theory Considerations of Risk Assessment Considerations of Risk Assessment • • Culture Culture • • Religion Religion • • Age Age • • Socioeconomics Socioeconomics • • Environment Environment • • Physical Biology Physical Biology • • Behavior/attitude Behavior/attitude • • Resources Resources • • Define the resource reservoir Define the resource reservoir • • Pathways to obtain resources? Pathways to obtain resources? • • Status to obtain resources? Status to obtain resources? • • Recognize the lack of resources Recognize the lack of resources • • Women’s HIV prevention example Women’s HIV prevention example (DiClemente, Crosby & Kegler, 2002) (DiClemente, Crosby & Kegler, 2002) “ “Ownership” is crucial Ownership” is crucial Risk Vs Resource Risk Vs Resource Need Vs Strength Need Vs Strength • • Needs should be prioritized using the availability Needs should be prioritized using the availability of resources. of resources. There is no point in intervening if the There is no point in intervening if the community does not feel that they own community does not feel that they own the problem! the problem! “Giving people medicine for TB and not giving them food is like “Giving people medicine for TB and not giving them food is like washing your hands and drying them in the dirt.” hands and drying them in the dirt.” “You want to stop HIV in women? Give them jobs.” “You want to stop HIV in women? Give them jobs.” washing your • • Resources can be determined by “mapping” a Resources can be determined by “mapping” a community. community. Kidder, Tracey, Mountains Beyond Kidder, Tracey, Mountains Beyond Mountains. (2003) Mountains. (2003) (McKenzie, Pinger & Kotecki 2002) (McKenzie, Pinger & Kotecki 2002) 2

  3. Prevention Marketing Theory Prevention Marketing Theory Examples of Prevention Marketing Examples of Prevention Marketing • • Step 1: Communitywide risk assessment Step 1: Communitywide risk assessment • • Who is doing what, with whom, where, when, Who is doing what, with whom, where, when, how and how often how and how often • • Adolescents: “Brain on Drugs” Adolescents: “Brain on Drugs” • • Children and Adolescents: Vaccines Children and Adolescents: Vaccines • • All ages: Santa Claus eating cheese All ages: Santa Claus eating cheese • • All ages: “Got Milk” All ages: “Got Milk” • • Children and Parents: Bill Cosby Children and Parents: Bill Cosby • • Step 2: Social Marketing Step 2: Social Marketing • • Commercial marketing principles and Commercial marketing principles and techniques achieve socially beneficial goals techniques achieve socially beneficial goals (Kotler & Zaltman, 1971) (Kotler & Zaltman, 1971) (DiClemente, Crosby & Kegler, 2002) (DiClemente, Crosby & Kegler, 2002) Exemplary Tools of Risk Exemplary Tools of Risk Assessment Assessment National Reports National Reports • • Monthly Vital Statistics Monthly Vital Statistics • • Morbidity and Mortality Weekly Report Morbidity and Mortality Weekly Report (MMWR) (MMWR) • • Includes outbreaks, environmental hazards Includes outbreaks, environmental hazards • • Individual Individual • • Community/population Community/population Examples of Risk Assessment on Examples of Risk Assessment on the Web the Web • • Harvard Center for Cancer Prevention Harvard Center for Cancer Prevention www.yourcancerrisk.harvard.edu www.yourcancerrisk.harvard.edu • • Breast, Prostate, Lung, Colon, etc. Breast, Prostate, Lung, Colon, etc. Classifying BMI Classifying BMI • • Underweight Underweight • • BMI < 5 BMI < 5th thpercentile percentile • • Healthy weight Healthy weight • • 5th > BMI < 85 5th > BMI < 85th thpercentile • • National Institutes of Health National Institutes of Health www.nih.gov www.nih.gov • • 10 year risk of heart attack 10 year risk of heart attack percentile • • At Risk of Being Overweight At Risk of Being Overweight • • 85 85th th> > BMI > 95 BMI > 95th thpercentile percentile • • Memorial Slone Kettering Cancer Center Memorial Slone Kettering Cancer Center www.mskcc.org www.mskcc.org • • Lung cancer, etc. Lung cancer, etc. • • Overweight Overweight • • BMI BMI > > 95 95th thpercentile percentile Dennison, Barbara A., MD, Risk Dennison, Barbara A., MD, Risk Evaluation in Pediatric Practice, Evaluation in Pediatric Practice, Pediatric Annals (Jan 2004) Pediatric Annals (Jan 2004) 3

  4. Comorbidity Comorbidity! ! National Health Surveys National Health Surveys • • National Health Care Survey National Health Care Survey • • Behavioral Risk Factor Surveillance Behavioral Risk Factor Surveillance System System • • Your Risk Behavior Surveillance System Your Risk Behavior Surveillance System • • National Health and Nutrition Examination National Health and Nutrition Examination Survey Survey • • National Minority Substance Abuse and National Minority Substance Abuse and HIV Prevention Initiatives Survey HIV Prevention Initiatives Survey [SAMHSA] [SAMHSA] • • One risk factor is never enough One risk factor is never enough • • A good Risk Assessment identifies all the A good Risk Assessment identifies all the risks! risks! In Conclusion In Conclusion Nurses don’t necessarily need to know Nurses don’t necessarily need to know 1. 1. The cure The cure 2. 2. The causative agent The causative agent But we can’t prevent the disease from But we can’t prevent the disease from occurring without knowing the occurring without knowing the RISK RISK 4