Health Promotion

Question 1

Define health promotion.

Answer 1

“The process of enabling people to increase control over, and to improve, their health.” (WHO 1986)

Question 2

Define determinants of health.

Answer 2

Factors that determine the health status of individuals or populations. (WHO)

Question 3

Define health education.

Answer 3

“Any combination of learning experiences designed to help individuals and communities improve their health, by increasing their knowledge or influencing their attitudes.” (WHO 2015)

It is a voluntary process in which clients acquire health information skills and behaviours willingly. It empowers clients towards personal commitment and self-management of health.

Question 4

Define health inequities or inequalities.

Answer 4

Avoidable inequalities in health between groups of people within countries and between countries.

Question 5

Define Primary Health Care.

Answer 5

“Essential health care based on practical, scientifically sound and social acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of heir development in the spirit of self-reliance and self-determination.” (WHO 1978)

“It recognizes the broader determinants of health and includes coordinating, integrating, and expanding systems and services to provide more population health, sickness prevention, and health promotion, not necessarily just by doctors. It encourages the best use of all health providers to maximize the potential of all health resources.” (Mable and Marriot 2002)

Question 6

List the core principles of primary health care.

Answer 6

Accessibility

Health promotion and chronic disease prevention

Intersectoral collaboration

Appropriate technology and innovation

Public participation

Question 7

Explain the PHC principle of accessibility.

Answer 7

A continuing and organized supply of essential health services is available to all people with no unreasonable geographic or financial barriers.

Question 8

Explain the PHC principle of intersectoral collaboration.

Answer 8

Commitment from all sectors (government, community, and health) is essential for meaningful action on health determinants.

Question 9

Explain the PHC principle of appropriate technology and innovation.

Answer 9

Methods of care, service delivery, procedures, and equipment should be socially acceptable and affordable.

Question 10

Explain the PHC principle of public participation.

Answer 10

Individuals and communities have the right and responsibility to be active partners in making decisions about their health care and the health of their communities.

Question 11

Define the three levels of health promotion.

Answer 11

Primary: preventing onset of disease by reducing risk factors.

Secondary: detecting disease and treating to control disease progression.

Tertiary: enhancing quality of life for individuals with chronic disease by modifying risk factors and accommodating disability.

Question 12

Health behaviour is influenced by factors at multiple levels. Name these levels.

Answer 12

Individual (intrapersonal - biological, knowledge, skills, attitude)

Interpersonal (social)

Organizational (environment)

Community (culture)

Public policy

Question 13

List the social determinants of health in Canada. (13)

Answer 13

Income and income distribution
Education
Unemployment and job security
Employment and working conditions
Early childhood development
Food insecurity
Housing
Social exclusion
Social safety network
Health services
Aboriginal status
Gender
Race
Disability

Question 14

What is the focus of the Expanded Chronic Care Model?

Answer 14

The ECCM proposes a way to integrate population health promotion into the delivery of chronic disease prevention and management services.

It states that improved outcomes for disease management are the result of interactions between informed, active clients and a prepared and proactive team of clinicians and healthcare professionals.

Question 15

List the elements of the ECCM.

Answer 15

Build healthy public policy
Create supportive environments
Strengthen community action
Delivery system design / re-orient health services
Decision support
Information systems

Question 16

Explain the ECCM element “build healthy public policy.”

Answer 16

Policies should be developed and designed to improve population health, including legislation, fiscal measures, taxation and organizational change.

Question 17

Explain the ECCM element “create supportive environments.”

Answer 17

The health system can have a role in promoting living and employment conditions that are safe and engaging within the larger community.

Question 18

Explain the ECCM element “strengthen community action.”

Answer 18

Healthcare professionals and organizations should work with community groups to set priorities and achieve goals to improve the health of the community.

Question 19

Explain the ECCM element “delivery system design / re-orient health services.”

Answer 19

Health services need to move beyond focusing entirely on clinical and curative services to supporting individuals and communities in a more holistic way. Health, not illness, should underpin healthcare work and should involve facilitating connections between the social, political and medical fields.

Question 20

Explain the ECCM element “decision support.”

Answer 20

Evidence should be gathered and shared not just on disease and treatment but also on strategies for being well and staying healthy.

Question 21

Explain the ECCM element “information systems.”

Answer 21

Technologies and information systems can play a role in making cases for new programs, evaluate existing programs, or make improvements and create efficiencies.

Question 22

Name the guiding principle of the PRECEDE-PROCEED model.

Answer 22

Health practitioners should identify the expected outcomes they and their clients have and work backwards from those outcomes to determine the inputs required to achieve the outcomes.

Question 23

What basic assumption does the PRECEDE-PROCEED model make?

Answer 23

It assumes that clients will participate actively to define their problems, establish their goals, and develop their solutions.

Question 24

Define PRECEDE.

Answer 24

Predisposing, Reinforcing, Enabling Constructs in Educational and Environmental Diagnosis and Evaluation. An educational diagnosis must precede the intervention development and implementation.

Question 25

Define PROCEED.

Answer 25

Policy, Regulatory, Organizational Constructs in Educational and Environmental Development. It addresses the impact of environmental influences on health with regard to the implementation and evaluation of a program or intervention.

Question 26

Name and explain the three types of factors that can influence the learner according to the PRECEDE-PROCEED model.

Answer 26

Predisposing factors: occur before the behaviour, and facilitate or hinder the client’s motivation to change. e.g. knowledge, attitude, expectations, perceived needs, and confidence held by the client and the health professional

Enabling factors: conditions that allow positive or negative behaviours to occur. e.g. availability, accessibility, and affordability of health resources that make it necessary to motive the client to take action; personal skills and abilities to perform behaviour; and conditions of living like childcare and transportation that may act as a barrier or a facilitator to action

Reinforcing factors: consequences of the behaviour that determine whether the client receives positive or negative feedback and social support. e.g. attitude and climate of support from service providers, family, social network or community groups, and the observable benefits of making the change

Question 27

Define social support.

Answer 27

Social support refers to the positive health benefits that come from social relationships and interpersonal transactions.

Question 28

Name the types of social support.

Answer 28

Emotional: empathy, trust, love, caring

Instrumental: tangible assistance and services such as money, time, or labour that directly help the person in need

Informational: advice, suggestions, and information that the person in need can use to solve their problems

Appraisal: information such as constructive feedback that helps the person in need evaluate him/herself and his/her behaviour

Question 29

Define client-centred care.

Answer 29

Care that focuses on the individual (rather than statistical groups or populations). Health outcomes consider the client’s values and preferences.