In ethics and governance, accountability is answerability, blameworthiness, liability, and the expectation of account-giving. In leadership roles, accountability is the acknowledgement and assumption of responsibility for actions, products, decisions, and policies including the administration, governance, and implementation within the scope of the role and encompassing the obligation to report, explain and be answerable for resulting consequences.
The extent to which something is affordable, as measured by its cost relative to the amount that the purchaser is able to pay.
Capacity building is the development of knowledge, skills, commitment, structures, systems and leadership to enable effective health promotion. It involves actions to improve health at three levels: the advancement of knowledge and skills among practitioners; the expansion of support and infrastructure for health promotion in organizations; and the development of cohesiveness and partnerships for health in communities.
Caregiver – Carers:
Persons, often relatives, who provide assistance (in activities and interaction within the environment) to those who are dependent on others for such assistance.
Plans for the management of patient care that set goals for patients and provide the sequence of interventions that physicians, nurses and other professionals should carry out in order to reach the desired goals in a given time period.
Provision of continuous care across different services through the integration and coordination of needs and resources around the patient. The fundamental difference with disease management is that it focuses more on individual patients and their families than on the population of patients with a certain disease. This type of management is targeted at people with a high level of risk requiring expensive care, people who are vulnerable or have complex social and health needs. The case manager coordinates patient care throughout the entire continuum of care.
Chronic care practice:
CHRODIS takes practice in a broad sense, referring to interventions at micro level (clinical practice), meso level (management interventions, providers funding schemes, implementation of a clinical guideline in several providers, etc.) or macro level (health plans, insurance policies, etc.)
Community of Practice:
A community of practice (CoP) is a group of people who share a concern or a passion for something they do and learn how to do it better as they interact on a regular basis (Wenger E.). The group can evolve naturally because of the members' common interest in a particular domain or area, or it can be created specifically with the goal of gaining knowledge related to their field. It is through the process of sharing information and experiences with the group that the members learn from each other, and have an opportunity to develop themselves personally and professionally.
Any distinct additional entity that has existed or may occur during the clinical course of a patient who has the index disease under study.
Effective or productive in relation to its cost. Cost-effectiveness analysis is a decision-making assistance tool. It identifies the economically most efficient way to fulfill an objective. In an evaluation, the tool can be used to discuss the economic efficiency of a program or a project.
The extent to which an intervention (see below) is applied in terms of context, care-setting, target population, etc.
A Delphi consultation is a consensus technique widely used in health services and health policies research, particularly useful when evidence is uncertain (i.e. discretionary decisions are the rule) and stakeholders involved are heterogeneous.
It has been frequently used to decide on the appropriateness of the use of a diagnostic technique or a surgical procedure. CHRODIS opts for a modified technique with a two-round on-line consultation process and a face-to-face consensus meeting at the end of the two rounds.
Educational diabetes programs:
A structured patient education is an international accepted and vital intervention for people with diabetes with an evident effect on the therapy and prognosis of diabetes. Therefore it is labeled as education and care programs with a targeted structure of education. Usually, it means that the core contents, goals, methods, and didactics are described in a curriculum and materials or tools for the educators and participants are provided.
Educational strategies and interventions are considered in educational diabetes programs. Patient education is described as a complex intervention with special requirements on evidence and transparency regarding its rationale, methodology, performance and outcome representation. Appropriate educational interventions and self-management support strategies were defined as a standard.
The extent to which an intervention produces a beneficial result under ideal conditions.
A measure of how economically the resources/inputs (funds, expertise, time, etc) are converted into results.
The extent to which the intervention’s objectives were achieved, or are expected to be achieved, in real conditions, taking into account their relative importance (in contrast to efficiency, effectiveness is determined without reference to resources deployed or costs).
It is a process that helps people gain control over their own lives and increases their capacity to act on issues that they themselves define as important.
Equity in health:
Means fairness. Equity in health means that people’s needs guide the distribution of opportunities for well-being. Equity in health is not the same as equality in health status. Inequalities in health status between individuals and populations are inevitable consequences of genetic differences, of different social and economic conditions, or a result of personal lifestyle choices. Inequities occur as a consequence of differences in the opportunity which result, for example in unequal access to health services, to nutritious food, adequate housing and so on. In such cases, inequalities in health status arise as a consequence of inequities in opportunities in life.
The systematic and objective assessment of an on-going or completed project, program or policy, its design, implementation, and results. The aim is to determine the relevance and fulfillment of objectives, implementation efficiency, effectiveness, impact, and sustainability. An evaluation should provide information that is credible and useful, enabling the incorporation of lessons learned into the decision–making process.
Evidence-based health promotion:
The use of information derived from formal research and systematic investigation to identify causes and contributing factors to health needs and the most effective health promotion actions to address these in given contexts and populations.
A good practice would ideally refer to a practice able to improve the quality of life efficiently (particularly from a societal perspective) while preserving the values of the patient and the society where the practice is implemented. The difficulty is on objectively measuring those elements.
CHRODIS opts for a definition of good practice built upon the use of a set of criteria previously agreed in a consensus process with experts on chronic care. Consensus becomes a surrogate when making a positive statement is difficult, and normative (subjective) arguments might take place.
It is the kind of material that is not published in easily accessible journals or databases. It includes things like conference proceedings that include the abstracts of the research presented at conferences, unpublished theses, and so on.
Clinical practice guidelines (‘guidelines’) are systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances. In addition, guidelines can play an important role in health policy formation and have evolved to cover topics across the health care continuum (e.g. health promotion, screening, diagnosis).
A health indicator is a characteristic of an individual, population, or environment which is subject to measurement (directly or indirectly) and can be used to describe one or more aspects of the health of an individual or population (quality, quantity and time). Health indicators can be used to define public health problems at a particular point in time, to indicate change over time in the level of the health of a population or individual, to define differences in the health of populations, and to assess the extent to which the objectives of a program are being reached.
Differences in health status or in the distribution of health determinants between different population groups. For example, differences in mobility between elderly people and younger populations or differences in mortality rates between people from different social classes. It is important to distinguish between inequality in health and inequity. Some health inequalities are attributable to biological variations or free choice and others are attributable to the external environment and conditions mainly outside the control of the individuals concerned. In the first case it may be impossible or ethically or ideologically unacceptable to change the health determinants and so the health inequalities are unavoidable. In the second, the uneven distribution may be unnecessary and avoidable as well as unjust and unfair, so that the resulting health inequalities also lead to inequity in health.
Health literacy is linked to literacy and entails people’s knowledge, motivation and competence to access, understand, appraise, and apply health information in order to make judgments and take decisions in everyday life concerning healthcare, disease prevention and health promotion to maintain or improve a quality of life during the life course.
The process of enabling people to increase control over, and to improve, their health.
The process of optimizing opportunities for physical, social and mental health to enable older people to take an active part in society without discrimination and to enjoy an independent and good quality life.
Intended or unintended change due directly or indirectly to an intervention (Related terms: results, outcome. The change can be positive and negative, primary and secondary).
Indicators in the context of evaluation are simply one-dimensional measures that help to measure, to express, or at least to reflect and to simplify the most complex formulation of the objectives.
Information need is a recognition that your knowledge is inadequate to satisfy a goal that you have, within the context ⁄ situation that you find yourself at a specific point in time.
Those interventions which practice new solutions for certain problems and challenges or specific needs through the application of new ideas, concepts, process and techniques are innovative.
A recognized relationship between part or parts of different sectors of society which has been formed to take action on an issue to achieve health outcomes or intermediate health outcomes in a way which is more effective, efficient or sustainable than might be achieved by the health sector acting alone.
May refer to policies, programs as well as processes and practices.
Low threshold approach:
Refers to purposeful ways to connect with disadvantaged target group(s), e.g. facilitating access to services, providing non-stigmatizing offers, including mediators in certain setting approaches (e.g. different languages-speaking dieticians in schools).
The use of statistical techniques in a systematic review to integrate the results of included studies. Sometimes misused as a synonym for systematic reviews, where the review includes a meta-analysis.
A continuing function that uses a systematic collection of data on specified indicators to provide management, and the main stakeholders of an ongoing intervention, with indications of the extent of progress, and achievement of objectives and progress in the use of allocated funds.
Co-occurrence of two or more conditions in the same patient without identifying an index disease.
National diabetic plan:
Any systematic and coordinated approach to improve the organization, accessibility, and quality of diabetes prevention and care.
A systematic procedure for determining the nature and extent of health needs in a population, the causes and contributing factors to those needs and the human, organizational and community resources which are available to respond to these.
Ageing is multidimensional. Most developed world countries have accepted the chronological age of 65 years as a definition of 'elderly' or older person. While this definition is somewhat arbitrary, it is many times associated with the age at which one can begin to receive pension benefits. At the moment, there is no United Nations standard numerical criterion, but the UN agreed cutoff is 60+ years to refer to the older population. For the purposes of this work, older people refer to those 65 and above.
An immediate or direct effect of a program. Outcomes are frequently stated, for example: by a specified date, there will be a change (increase or decrease) in the target's behaviour, among the target population.
It relates the results of a project in the target group to its specific objectives (and the underlying working hypothesis).
The state, relation or facts of considering yourself as the owner of an intervention in which you participate somehow.
The individuals and/or organizations that collaborate to achieve mutually agreed upon objectives. The concept of partnership connotes shared goals, a common responsibility for outcomes, distinct accountabilities, and reciprocal obligations. Partners may include governments, civil society, non-governmental organizations, universities, professional and business associations, multilateral organizations, private companies, etc.
Patient centred care:
It is commonly understood as focusing on the individual seeking care—the patient. The care that is respectful of and responsive to individual patient preferences need, and values, and ensuring that patient values guide all clinical decisions.
Appraisal of an individual who is informed and knowledgeable about the probabilities and severity of the effects and risks of interventions, and about process and outcome aspects of healthcare.
Patients’ characteristics that could potentially lead to successful outcomes like motivation, self-direction, readiness for change, social and family support, etc.
The degree to which a development intervention or a development partner operates according to specific criteria/standards/guidelines or achieves results in accordance with stated goals or plans.
A continuous process of collecting and analyzing data to compare how well a project, program, or policy is being implemented against expected results.
A Policy is a principle or protocol to guide decisions and achieve rational outcomes. A policy is a statement of intent and is implemented as a procedure or protocol. Policies are generally adopted by a senior governance body or Board within an organization whereas procedures or protocols would be developed and adopted by senior executive officers. The term may apply to government, private sector organizations and groups, and individuals. Presidential executive orders, parliamentary rules of order and corporate privacy policies are all examples of policy. Policy differs from rules or law. While the law can compel or prohibit behaviours (e.g. a law requiring the payment of taxes on income), policy merely guides actions toward those that are most likely to achieve the desired outcome.
The use of multiple medications by a patient, generally older adults (those aged over 65 years). It is often defined as the use of five or more regular medication, but different cut-points have been proposed (including 8 or 10 medications.).
Prevention can be defined as an ‘action to reduce or eliminate the onset, causes, complications or recurrence of disease’. In general, the concept of prevention is characterized by activities that are designed to reduce the likelihood that something harmful will occur or to minimize that harm if it does occur.
There are several ways of categorizing preventive measures, according to the stage in the natural history of disease at which they are introduced; the determinants of disease which are being addressed; the target groups to which they are applied; and the setting or level of delivery of preventive measures.
Measures and interventions directed towards preventing the initial occurrence of a disorder. It reduces both the incidence and prevalence of a disease.
A plan of things that are done to achieve a specific result.
Public health is the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals.
Quality of life:
The quality of life is defined as individual’s perceptions of their position in life in the context of the culture and value system where they live, and in relation to their goals, expectations, standards, and concerns. It is a broad ranging concept, incorporating in a complex way a person’s physical health, psychological state, level of independence, social relationships, personal beliefs and relationship to salient features of the environment.
The extent to which the objectives of a development intervention are consistent with beneficiaries’ requirements, local needs and global priorities and policies.
The ability of the health system to meet the population's legitimate expectations regarding their interaction with the health system, apart from expectations for improvements in health or wealth.
A review article in the medical literature which summarizes a number of different studies and may draw conclusions about a particular intervention. Review articles are often not systematic. Review articles are also sometimes called overviews.
This is any attribute, characteristic or exposure of an individual that increases the likelihood of developing a disease or injury. A small set of common risk factors is responsible for most of the main chronic diseases. These risk factors are an unhealthy diet, physical inactivity, and tobacco use. In the context of this questionnaire the modifiable behavioural and social risk factors includes unhealthy diets, physical inactivity and tobacco use and the underlying socio-economic, cultural, political and environmental determinants of chronic diseases (including globalization, urbanization and population ageing). The majority of cardiovascular disease (CVD) for example, is caused by risk factors that can be controlled, treated or modified, such as high blood pressure, cholesterol, overweight/obesity, tobacco use, lack of physical activity and diabetes. However, there are also some major CVD risk factors that cannot be controlled (age and heredity). In terms of attributable deaths, the leading CVD risk factor is raised blood pressure (to which 13 per cent of global deaths is attributed), followed by tobacco use (9 percent), raised blood glucose (6 percent), physical inactivity (6 per cent) and overweight and obesity (5 percent).
Risk factors for diabetes depend on the type of diabetes. Weight (obesity and overweight, often linked to a diet over-reliant on processed foods) and inactivity are major risk factors for diabetes 2.
Socioeconomic status (SES) is associated with chronic disease in large part through modifiable risk factors such as obesity, tobacco use, and sedentary lifestyle. Several recent studies have explored the association between neighbourhood deprivation and risk factors and chronic disease incidence and mortality. Whereas prevention efforts that focus on individual characteristics that control behaviour are important, environmental and social elements also affect personal choices, are modifiable risk factors, and deserve attention.
A formal estimate of the probability of a person's succumbing to a disease or benefiting from a treatment for that disease.
The term describes an approach focusing on factors that support human health and well-being, rather than on factors that cause disease. More specifically, the "salutogenic model" is concerned with the relationship between health, stress, and coping.
Secondary prevention aims to reduce progression of the disease through early detection, usually by screening at an asymptomatic stage, and early intervention. Secondary prevention of diabetes relies on early detection of diabetes (e.g. through screening) and application of intervention strategies and disease management, respectively to prevent progression of the disease. Therefore all (primary) preventions of the secondary diseases (e.g. diabetes-specific complications and co-morbidities) of type 2 diabetes are involved.
A review of a clearly formulated question that uses systematic and explicit methods to identify, select, and critically appraise relevant research, and to collect and analyze data from the studies that are included in the review. Statistical methods (meta-analysis) may or may not be used to analyze and summarize the results of the included studies.
The activities and skills (e.g. goal setting, decision making, self-monitoring) individual learns and uses to improve their quality of life with one or more chronic conditions. Education and support from healthcare or other providers can enhance an individual’s self-confidence and self-management skills.
An endeavor in which the healthcare team partners with patients to improve their ability to manage their conditions day to day.
That assistance available to individuals and groups from within communities which can provide a buffer against adverse life events and living conditions, and can provide a positive resource for enhancing the quality of life.
Sustainable interventions are those that can maintain their benefits for communities and populations beyond their initial stage of implementation. Sustainable actions can continue to be delivered within the limits of finances, expertise, infrastructure, natural resources and participation by stakeholders.
Deliberate efforts to increase the impact of health service innovations successfully tested in pilot or experimental projects so as to benefit more people and to foster policy and program development on a lasting basis.
It is a collaborative process between patients and their providers whereby health care decisions are made together using both the best available scientific evidence and incorporation of patient’s values and preferences.
(Acronym) Specific/Measurable/Acceptable/Realistic/Time framed.
Agencies, organizations, groups or individuals who have a direct or indirect interest in the intervention or its evaluation
The specific individuals, groups or organizations for whose benefit the intervention is undertaken.
The goal of tertiary prevention is to improve function and includes minimisation of the impact of established disease, and prevention or delay of complications and subsequent events through effective management and rehabilitation.
The quality of being transferable to other context or exchangeable among different contexts.
The quality or degree of being tested or verified by means of a trial.
It is defined as the association between patients’ preferences concerning health outcomes and/or medical treatments, and treatment intention or treatment underwent.