1. The Affordable Care Act (ACA) in the US has resulted in the adoption of Pay for Performance reimbursement arrangements by private and government insurance. Reimbursement to providers of health care will be partially related to patients' reported satisfaction with the care they receive. As the administrator of Prime Health, a major provider of health services with a system of primary health clinics, how would you attempt to maximize patient satisfaction by the following?
a. Recruiting doctors and nurses with particular backgrounds (e.g., race, gender specialty) to work at the primary care clinics-will it make a difference?
b. Orienting new and current primary care doctors in how to effectively interact with patients-what guidance would you provide?
2. Reflecting on Healthy People 2020, with the goal of reducing health disparities by race/ethnicity in the US, you observe that African-American men receive considerably fewer preventive health services.
a. To what extent would attitudes and expectations of medical care associated with race and gender account for lower utilization of preventive health services in African-American men?
b. Social Cognitive Theory addresses person and environmental factors in explaining health behaviors. How would constructs of person and environment suggest factors to consider in promoting greater use of preventive health services among African-American men?
c. How would community-based participatory research principles be reflected in the development of an intervention to promote the utilization of preventive health services by African-American men?
3. You are a member of the Board of Public Health of a major US metropolitan community. A recent PROCEED-PRECEDE assessment of community health needs by the Health Department showed that obesity is a major, changeable contributor to poor health. You observe that the Health Department's previous mass-media campaign focused on influencing people to make healthy (lower calorie) choices in dietary behavior resulted in only small changes in measured behavioral dietary behavior and no reduction in population obesity rates. So you propose taking bold steps by enacting a policy to ban the sale of sugared soft drinks in containers greater than 16 ounces to help prevent obesity.
a. Other Board members caution that widely held cultural values will lead to strong public resistance. What evidence might they cite to support their position?
b. What steps might you take to generate public support for your policy proposal?
c. Some say the impact evaluation of the prior mass-media campaign to prevent obesity by changing dietary behaviors might actually have been somewhat successful, even though there was only a small change in measured dietary behaviors and no change in the outcome of obesity prevalence. How might they support an argument that the campaign was a partial success?