ESA 2 Health Promotion Flashcards
What are the 5 approaches to health promotion?
Much overlap
- Medical or preventive (e.g. Stop smoking services)
- Behavioural change (persuasive health promotion campaigns)
- Educational (providing info about e.g. Smoking and how to stop)
- Empowerment (patient-centred approach or directly from P, e.g. apps)
- Social change (e.g. No smoking in public places) - changing norms
Distinguish between the 3 levels of prevention.
Primary
- prevent onset of disease or injury, by reducing exposure to risk factors
Secondary
- detect and treat a disease (or its risk factors) at an early stage to prevent its progression/potential future complications and disabilities
- e.g. Screening for cervical cancer, monitoring and treating BP…
Tertiary
- minimise the effects of established disease
- e.g. Maximise remaining capabilities and functions of already disabled patient, steroids for asthma to prevent attacks
What are the 4 main approaches to primary prevention?
- immunisation (e.g. Measles, TB)
- Prevention of contact with environmental risk factors (e.g. Asbestos)
- Taking appropriate precautions re communicable disease
- Reducing risk factors from health related behaviours (e.g. Stop smoking)
Suggest dilemmas associated with health promotion.
- Ethics of interfering in people’s lives
- potential psychological impact of health promotion messages
- state intervention in individuals lives (“nanny state”) - Victim blaming
- focusing on individual behavioural change plays down impact of wider socioeconomic and environmental determinants of health
- e.g. Housing conditions - Fallacy of empowerment
- unhealthy lifestyles not necessarily due to ignorance but to adverse circumstances and wider socioeconomic determinants of health - Reinforcing of negative stereotypes
- health promotion messages have potential to reinforce negative stereotypes associated with a condition or group
- e.g. Leaflets aimed at HIV prevention and drug users - The prevention paradox
- interventions that make a difference at pop level might not have much effect on individual
- link with lay beliefs:- if people don’t see themselves as a candidate for a disease they might not listen to the message
- awareness of anomalies and randomness of a disease
What is the evaluation of health promotion?
The rigorous and systematic collection of data to assess the effectiveness of a programme in achieving predetermined objectives
Why should health promotion projects be evaluated?
- Need for evidence-based interventions
- Accountability: evidence gives legitimacy to interventions and political support
- Ethical obligation: imperative to ensure there is no direct or indirect harm
- Programme management and development
What are the 3 types of health promotion evaluation?
- Process: assess process of program implementation employing a wide range of qualitative methods
- Impact: assess immediate effects of intervention. More popular choice as easiest to do.
- Outcome: measures more long term consequences and what is achieved (e.g. QoL improvement, symptom reduction…).
Timing of evaluation can influence outcome. Delay: some interventions might take a long time to have an effect. Decay: some interventions wear of rapidly.
What are the difficulties involved in evaluation of health promotion?
Demonstrating an attributable effect is difficult because:
- Design of intervention
- Possible lag time to effect
- Many potential intervening or concurrent confounding factors
- High cost of evaluation research - studies are likely to be large scale and long term
What are determinants of health?
A range of factors that have a powerful and cumulative effect on the health of populations, communities and individuals.
- the physical environment
- the social and economic environment
- our individual genetics, characteristics and behaviours
What is health promotion?
Process of enabling people to increase control over and to improve their health. Is not just the responsibility of the health sector, but goes beyond healthy lifestyles to well-being.
What are the 7 principles of health promotion?
1- empowering: enabling individuals and communities to assume more power over the determinants of health
2- participatory: involving all concerned at all stages of the process
3- holistic: fostering physical, mental, social and spiritual health
4- intersectoral: involving the collaboration of agencies form relevant sectors
5- equitable: guided by a concern for equity and social justice
6- sustainable: bringing about changes that individuals and communities can maintain once funding has ended
7- multi-strategy: uses a wide variety of approaches - inc. policy dev., organisational change, community dev., legislation
What is the difference between health promotion and public health?
Public health : more emphasis on ends.
Health promotion: more emphasis on means of achieving ends.
Health promotion = health education x healthy public policy
Public health = health protection + health promotion
