7) Health Promotion

Question 1

What is health?

Answer 1

WHO 48: a state of complex physical, mental and social well being and not merely the absence of disease of infirmity.
WHO 84: the extent to which an individual or group is able to realise aspirations and satisfy needs and to change or cope with the environment (resilience)

Question 2

What is health promotion?

Answer 2

The process of enabling people to increase control over and to improve their health.

Health promotion is not just the responsibility of the health sector, but goes beyond healthy lifestyles to wellbeing.

Question 3

Outline the concepts of the Ottawa Charter- WHO 1986

Answer 3

• building healthy public policy= working across sectors, recognition of role of policy
• creating supportive environments= role of work and leisure, protecting natural/built environment (green spaces, schools)
• strengthening community actions= empowering communities, strengthening participation and access to opportunities
• developing personal skills= access to info/education for health-enabling informed choice
• re-orientating health services= wider and holistic view

Question 4

Outline determinants of health

Hint=rainbow

Answer 4

At the centre= age, sex, constitutional factors
Individual lifestyle factors
Social and community networks
Living and working conditions (education, employment, environment, food, housing)
General socio-economic, cultural and environmental conditions

Question 5

Outline some initiatives of health improvement (domain of public health)

Answer 5

• smoking cessation
• public mental health
• sexual health services
• substance misuse services
• NHS health checks
• weight management
• public health nursing

Question 6

Outline the different levels of prevention- why are there different levels?

Answer 6

Different levels of prevention implemented at different stages of an illness

• primary= prevent the onset of illness (vaccination, infection control, diet, exercise)
• secondary= early diagnosis, to prevent the progression of the disease (screening, monitoring/treating blood pressure)
• tertiary= to minimise the effects of established diseases/prevent further complications (steroids for asthma, diabetic eye tests)

Question 7

Identify the 2 broad approaches to health promotion

Answer 7

Targeted promotion

Universal promotion

Question 8

Describe, with an example, targeted health promotion

Answer 8

Aims to identify those most at risk of a condition/disease and tailor messages to that group/s
For example-breast feeding initiatives in young mums

Question 9

Describe, using an example, universal health promotion

Answer 9

Aims to reduce the risk of disease across the whole population (equally accessible and relevant to every member of the population)
For example- sugar tax or the introduction of seat belts

Question 10

Outline the concept of ‘Making Every Contact Count’

Answer 10

Using brief opportunistic advice to patients to enable them to change their lifestyle.
Involves discussions about wider/general health (not always in relation to the topic of the consultation)
Topics discussed could include: smoking cessation, exercise, diet, weight loss.
And providing additional resources/referrals if appropriate.

Question 11

What does MECC/BOA relate to?

Answer 11

Prochaska/DiClemente’s Cycle of Change:

• pre-contemplation
• contemplation
• preparation
• action
• maintenance (if implemented and long term)
• relapse (commonly occurs and cycle starts again)

Question 12

Outline some features of a good health promoting setting

Answer 12

• create a health supporting environment
• achieve a good quality of life
• provide basic sanitation and hygiene needs
• supply access to healthcare

Question 13

Evaluation health promotion activities

Answer 13

• need for evidence-based interventions
• accountability (evidence gives legitimacy to interventions and political support)
• ethical obligation (ensures that interventions cause no direct or indirect harm)
• programme management and development