10-10-22 – Health promotion, behaviour, and improving CVS Flashcards
Learning outcomes
- Revise the definition and methods of health promotion from MD2001
- Apply health promotion methods to the prevention of cardiovascular disease
- Describe how personal attitudes and traits effect the response to health promotion initiatives
What is health promotion?
What 4 things does the Ottawa Charter state?
- Health promotion is the process of enabling people to increase control over, and to improve, their health.
- The 4 things the Ottawa Charter states:
1) ‘Health promotion is the process of enabling people to increase control over, and to improve, their health.
2) To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment.
3) Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.
4) Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy life-styles to well-being.’
What are 5 approaches to health promotion?
- 5 approaches to health promotion:
1) Medical / preventive approach - how we should be thinking about the reorientation of health services and realistic medicine
2) Behaviour Change approach – understanding and development of personal skills, can also be an educational approach
3) Educational approach – can include community actions
4) Empowerment approach – can include aspects of supportive environments and community actions and the reorientation of health services
5) Social change approach – includes healthy public policy and aspects of community action and supportive environments
What are social determinants of health?
What are 5 different types of factors of social determinants?
- Social health determinants of health are the economic and social conditions that influence individual and group differences in health status e.g education, family income, and housing
- Different types of factors of social determinants:
1) General socio-economic, cultural and environmental conditions
2) Living and working conditions e.g education, work environment, housing
3) Social and community networks
4) Individual lifestyle factors
5) Age, sex, and constitutional factors
What are the five waves of public health practise in the UK?
- Five waves of public health practise in the UK
1) Structural
* Clean water, sewers drainage
2) Biomedical
* Anti-biotics, early vaccines
* Refinement of scientific approach:
* Germ theory of disease, hospitals, health visitors
3) Clinical
* Life-style related diseases
* Restructure of institutions
* Welfare reforms
* New housing
* Social security
* NHS
4) Social
* Social determinants of health
* Focus on risk theory of disease
* Lifestyle issues e.g smoking, diet, and physical activity
5) Cultural
* A culture for health
* Shift in culture for health
What are the 5 layers of the health impact pyramid from top to bottom?
Which side greater increasing population impact?
Which side requires greater individual effort?
Which layer should we effect to have a greater impact on public health?
- 5 layers of the health impact pyramid from top to bottom
1) Counselling and education
2) Clinical interventions
3) Long-lasting protective interventions
4) Changing the context to make individuals’ default decisions healthy
5) Socioeconomic factors
- Going down the pyramid requires greater increasing population impact
- Going up the pyramid requires greater individual effort
- To have an impact on public health, it is more effective to have an impact on the socioeconomic level at the bottom of the pyramid
What does the Health Belief Model look at?
What are the 3 different sections of the Health Belief Model?
Describe the structure of the Health Belief Model
- The health belief model looks at why someone might start changing their behaviour in relation to their health
- It also looks at if the person has a personal sense of the risk of the disease to influence their behaviour
- 3 different sections of the Health Belief Model:
1) Individual perceptions
2) Modifying factors
3) Likelihood of action (behaviour)
What is the COM-B model?
What are the 3 components of the COM-B model?
What do they all influence?
- The COM-B model is the current health belief model
- Components of the COM-B model:
1) Capability – an individual’s psychological and physical capacity to engage in the activity concerned.
2) Motivation – all those brain processes that energize and direct behaviour, not just goals and conscious decision-making.
3) Opportunity – all the factors that lie outside the individual that make the behaviour possible or prompt it.
- All of these components influence behaviour
What are the 4 different preventions in the hierarchy of prevention?
How can CVD prevention be used as an example in this hierarchy?
- 4 different preventions in the hierarchy of prevention with CVD prevention as an example:
1) Primordial prevention
* Actions to affect the systems, which determine the risk factors of the disease
* E.e what can we do to change the system to reduce the risk of disease
* E.g sugar tax, smoking bans for CVD prevention
2) Primary prevention
* Detection and management of the risk factors for future disease
* E.g behaviour change
3) Secondary Prevention
* Screening for asymptomatic early disease
* What can we do to detect diseases as early as possible?
* E.g Abdominal aortic aneurysm (AAA) screening
4) Tertiary Prevention
* Improved management of patients with actual disease
* Reducing the risk of another event once one has already occurred
* E.g cardiac rehabilitation
What are 3 different Rose approaches to prevention?
Which one is better for the overall population?
- 3 different Rose approaches to prevention:
1) High risk approach only
2) Population approach
3) High risk and population approach - High risk and population approach is the best, as it benefits the overall population
What are 3 non-modifiable risk factors for CVD?
What are personal (6) / social / environmental (6) modifiable risk factors for CVD?
- Non-modifiable risk factors for CVD:
1) Age
2) Sex
3) Genetic factors - Personal modifiable factors for CVD:
1) Smoking
2) Diet
3) Physical activity
4) Obesity
5) High blood pressure
6) Diabetes - Social / environmental modifiable factors for CVD:
1) Deprivation
2) Income
3) Employment
4) Education
5) Housing
6) Air quality.
What 5 changes in diet do NICE guidelines recommend?
- Changes in diet NICE guidelines recommend:
1) Choose wholegrain varieties of starchy food
2) Reduce intake of sugar and food products containing refined sugars including fructose
3) Eat at least 5 portions of fruit and vegetables per day
4) Eat at least 2 portions of fish per week, including a portion of oily fish
5) Eat at least 4 to 5 portions of unsalted nuts, seeds and legumes per week
How can work affect food choices?
How does this tie in with social determinants?
- Spill over of work onto food choices and family roles in low and low - moderate - income urban households.
- Having a more demanding job that is limiting can lead to poorer choices being made e.g eating junk, quick meals, skipping meals
- In this case, it is not as simple as eat vegetables and that will solve the problem, there are far more socio-economic factors at play (social determinants of health)
- Social health determinants of health are the economic and social conditions that influence individual and group differences in health status e.g education, family income, and housing
What are 4 examples of CVD health promotion videos?
What is their target behaviour?
What technique do they use?
Is personality type related to incidence of CVD?
- Initially, it was found through studies that particular personality types were linked to higher prevalence of CVD
- It was later found to be false, as these studies were funded by tobacco companies in an attempt to move attention away from smoking causing CVD
