CM1.1-10 | Foundations of Health, Disease and Prevention — Glossary

A deliberate communication skill involving attending, reflecting, paraphrasing, and summarising to demonstrate understanding and encourage the patient to share fully.

The process of dividing a target population into sub-groups with similar characteristics, needs, and barriers so that tailored messages can be designed for each sub-group.

Behaviour Change Communication — a framework for health communication that addresses deeper behavioural determinants (social norms, self-efficacy, perceived risk and benefits) through formative research, audience segmentation, and theory-based message design.

A structured framework for clinical consultations comprising 71 evidence-based communication skills organised across five phases: initiating, gathering information, physical examination, explanation and planning, and closing.

A question answered with yes/no or a specific fact; used to clarify specific details after open questioning has established the patient's narrative.

Total live births per 1,000 mid-year population per year; 'crude' because the denominator includes all ages and both sexes.

Total deaths from all causes per 1,000 mid-year population per year; influenced by the age structure of the population.

Disability-Adjusted Life Year — one year of healthy life lost; calculated as YLL (years of life lost to premature death) + YLD (years lived with disability, weighted by severity).

The economic growth potential that arises when the working-age population is proportionally large relative to dependents, creating a window of high productivity if health and education investments are adequate.

The historical shift from high birth rate + high death rate (pre-transition) through declining mortality + still-high fertility (rapid growth) to declining fertility + low mortality (slow growth) to low birth rate + low death rate (stability).

The broad range of social, economic, environmental, biological, and behavioural factors that influence the health of individuals and populations.

A mode of secondary prevention: treatment of established clinical disease to prevent further deterioration and transition to permanent disability.

The professional therapeutic bond between a doctor and patient, characterised by trust, confidentiality, and a commitment to the patient's health and well-being; structurally analysed using models from paternalistic to deliberative (Emanuel & Emanuel, 1992).

The ability to recognise and appropriately acknowledge a patient's emotional state without necessarily sharing it; communicated through both verbal statements and non-verbal behaviour.

The framework for disease causation comprising three interacting elements: agent, host, and environment; disease results from their combined interaction.

Qualitative and quantitative research conducted with the target audience BEFORE designing a communication campaign, to understand their knowledge, beliefs, barriers, and preferred channels.

Per WHO (1948): a state of complete physical, mental and social well-being, not merely the absence of disease or infirmity.

A psychological model (Rosenstock, 1966) predicting health behaviour based on perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy.

A component of health promotion aimed at voluntary behaviour change through improving knowledge, changing attitudes, and building health-related practices (KAP framework); delivered through individual, group, or mass methods.

The process of enabling people to increase control over, and to improve, their health, through five action areas: healthy public policy, supportive environments, community action, personal skills, and reorienting health services (Ottawa Charter, 1986).

A model of health that encompasses all dimensions of a person's well-being — physical, mental, social, and spiritual — rather than focusing only on the absence of physical disease.

Ideas, Concerns, and Expectations — a structured approach to exploring the patient's own beliefs, worries, and hopes about their condition.

The observation that the visible (diagnosed and symptomatic) portion of disease in a community is far smaller than the submerged sub-clinical and unrecognised portion — most disease is invisible to routine surveillance.

Information, Education and Communication — the systematic use of communication strategies and channels to disseminate health information and support behaviour change in health programmes.

The number of new cases of a disease arising in a defined population per unit time, expressed per 1,000 or 100,000 population at risk.

Deaths of infants aged less than 1 year per 1,000 live births in a given year; composed of NMR (deaths in first 28 days) + PNMR (deaths 29 days to <1 year).

Knowledge, Attitudes, and Practice — the triad targeted by health education and measured by KAP surveys to evaluate educational programme effectiveness.

The average number of years a newborn would live given current age-specific mortality rates; an integrated positive health indicator.

Maternal deaths (during pregnancy, childbirth, or within 42 days of termination) per 100,000 live births; technically a ratio (denominator = live births, not all pregnant women).

A patient-centred, non-confrontational communication method to resolve ambivalence about behaviour change, using four principles: express empathy, develop discrepancy, roll with resistance, support self-efficacy (Miller & Rollnick).

The concept that disease results from the simultaneous or sequential action of multiple causal factors, no single one of which is invariably necessary or sufficient.

A periodic national household survey (2019–21) providing data on fertility, child health, nutrition, and a range of health-related topics; conducted by IIPS, Mumbai.

The uninterrupted, unmodified course of a disease from the earliest ecological interaction between agent and host through to the final outcome of recovery, disability, or death.

A metric that measures the presence of disease, disability, or death (e.g., mortality rates, disease incidence/prevalence).

A question that cannot be answered yes/no, inviting the patient to describe their experience in their own words; used at the beginning of history-taking to gather breadth and perspective.

Objective Structured Clinical Examination — a standardised assessment format using simulated patient encounters, rated by trained observers using validated communication checklists.

The 1986 WHO document defining health promotion and articulating five action areas (healthy public policy, supportive environments, community action, personal skills, reorienting health services) and three strategies (advocate, enable, mediate).

A metric that measures wellness, functional capacity, or quality of life (e.g., life expectancy, disability-adjusted life years).

Patient-Reported Experience Measure — a standardised questionnaire completed by patients that measures their subjective experience of the quality of communication, involvement in decisions, and overall care.

The earliest stage of natural history in which the ecological interaction between agent, host, and environment exists but no pathological change has yet occurred in the host.

All existing cases of a disease (new + old) in a defined population at a point in time or over a period, expressed per 1,000 or 100,000 population.

Prevention during the prepathogenesis stage through two modes: health promotion (non-specific host resistance enhancement) and specific protection (disease-targeted immunisation or protection).

Prevention that targets the social, economic, and environmental conditions that allow risk factors to emerge in a population — acts before any individual risk factors have developed.

The science and art of preventing disease, prolonging life, and promoting health through organised community efforts (Winslow, 1920).

The sole mode of tertiary prevention: physical, vocational, social, and psychological interventions to restore function and social participation after established disability.

The principle that health status is not absolute but is shaped by an individual's age, culture, geographic context, and the era in which they live.

India's continuous demographic survey that provides annual estimates of vital statistics including crude birth rate, crude death rate, and infant mortality rate.

Prevention during early or established pathogenesis through early diagnosis and treatment (to limit spread and severity) and disability limitation (to halt progression to severe outcomes).

An individual's belief in their own ability to successfully perform a specific behaviour; a key predictor of health behaviour change (Bandura's Social Cognitive Theory).

Conditions in which people are born, grow, live, work, and age — including income, education, housing, and social support — that are the primary drivers of health inequities.

A six-step framework for breaking bad news (Setting, Perception, Invitation, Knowledge, Empathy, Strategy/Summary) developed by Baile et al. (2000).

The dimension of health relating to a sense of purpose, meaning, values, and inner peace; introduced by Halbert Dunn (1959) in the high-level wellness concept.

An evidence-based communication technique where the clinician asks the patient to explain back in their own words what they understood about their condition and treatment plan, to verify comprehension and identify gaps.

An evidence-based communication method where the clinician asks the patient to explain back in their own words what they understood, to verify comprehension and identify gaps.

Prevention at the stage of advanced disease or established disability, aimed at rehabilitation — restoring maximum function and quality of life.

The average number of children a woman would have if she experienced current age-specific fertility rates throughout her reproductive life (ages 15–49); replacement level ≈ 2.1.

Prochaska and DiClemente's stage-based model of behaviour change: precontemplation → contemplation → preparation → action → maintenance; BCC strategies should match the message to the individual's current stage.

Deaths of children aged less than 5 years per 1,000 live births per year; sensitive to child nutrition, immunisation, and illness management.

MacMahon's model of disease causation as an interconnected network of biological, behavioural, social, and environmental factors, each probabilistically linked to others.