Health Promotion

Question 1

What are the 7 principles that should be included in health promotion?

Answer 1

-Empowering, participatory, holistic, inter-sectoral, equitable, sustainable, multi-strategy

Question 2

Difference between public health and health promotion

Answer 2

Public health: health protection and health promotion
Health promotion: health education and healthy public policy.
In England: want to shift previous agencies all back together into one umbrella thing

Question 3

Critiques of Health promotion

Answer 3

1. Structural critiques: neglect of the importance of the social-political environments and the constraints within which people are living and still too much emphasis on individual to chance their behaviour
2. Surveillance critiques: monitoring and regulating of the population –> criticism is that health promotion emphasises self surveillance
3. Consumption critiques: lifestyle choices not just seen as health ‘‘risks’’ but also tied up with identity construction –> privileges those who are better off over those we aren’t

Question 4

Describe primary prevention

Answer 4

• Aim: to prevent the onset of disease or injury - by reducing exposure to risk factors
• 4 main approaches:
– 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. quitting smoking)

Question 5

Describe secondary prevention

Answer 5

• Aim: to detect and treat a disease (or its risk factors) at an early stage (to prevent progression /potential future complications and disabilities from the disease) –> improves prospects of treatment/reduces prevalence
• Examples
– Screening for cervical cancer
– Monitoring and treating blood pressure
– Screening for glaucoma/atherosclerosis

Question 6

Describe tertiary prevention

Answer 6

• Aims to minimise the effects of established disease
• Examples
– To maximise the remaining capabilities and functions of an already disabled patient
– Renal transplants (to prevent someone dying of renal failure)
– Steroids for asthma (to prevent asthma attacks)

Question 7

Describe the ethical dilemma of interfering in peoples lives

Answer 7

• Potential psychological impact of health promotion messages –> people have the right of to live their individual/private lives
• State interventions in individuals’ lives
– “Nanny state”
– “Liberal do-gooders”
– Rights and choices

Question 8

Describe the dilemma of victim blaming

Answer 8

• Focusing on individual behavioural
change plays down the impact of wider socioeconomic & environmental determinants of health
• Examples
-Housing conditions, water and air quality, workplace
conditions, roads, green spaces…
-High perceived costs of ‘healthy living’

Question 9

Describe the dilemma around ‘‘fallacy of empowerment’’

Answer 9

• Does giving people the information give them the power? No
• ‘Unhealthy’ lifestyles are not due to ignorance but due to
adverse circumstances and wider socio-economic
determinants of health.

Question 10

Describe the dilemma of reinforcing negative stereotypes

Answer 10

• Health promotion messages have the potential to reinforce negative stereotypes associated with a condition or group
• Example:
– Leaflets aimed at HIV prevention in drug users can reinforce that drug users only have themselves to blame for their situation.

Question 11

Describe the dilemma of unequal distribution of responsibility

Answer 11

• Implementing healthy behaviours in the family is often left up to women.
• Example: Healthy eating advice and the responsibility / ‘unenviable’ task to get their family to eat more
fresh fruit, less processed food, etc.

Question 12

Describe the dilemma of the prevention paradox

Answer 12

-Do a health promotion campaign in order to shift the entire population’s BP down –> reduce amount of people in the risk group.
-There may be a difference at a population but not on the individual level
- Lay beliefs:
– If people don’t see themselves as a ‘candidate’ for a
disease they may not take on board the health promotion messages.
– Awareness of anomalies and randomness of a
disease (e.g. heart attacks) will also impact on views about candidacy

Question 13

Give a definition of evaluation (in contexts of health promotion campaigns)

Answer 13

The rigorous & systematic collection of data to assess the effectiveness of a programme in achieving predetermined objectives.

Question 14

Give 4 reasons why we should evaluate health promotion interventions

Answer 14

Need for evidence-based interventions Properly conducted evaluation studies can provide necessary evidence.
• Accountability- Evidence also gives legitimacy to interventions and political support.
• Ethical obligation -The imperative to ensure there is no direct or indirect harm
• Programme management and development

Question 15

What is process evaluation?

Answer 15

Focuses on assessing the process of programme
implementation. • Also referred to as ‘formative’ or ‘illuminative’ evaluation. • Employs a wide range of mainly qualitative methods.

Question 16

What is impact evaluation?

Answer 16

Assesses the immediate effects of the intervention. • Tends to be the more popular choice, as it is the easiest
to do.

Question 17

What is outcome evaluation?

Answer 17

Measures more long-term consequences.
• Measures what is achieved:
– For example: improvement in clients’ lives; reduction
of symptoms; level of harm reduction.
• Timing of evaluation can influence ‘outcome’:
– Delay: some interventions might take a long time to
have an effect;
– Decay: some interventions wear off rapidly.

Question 18

What are 4 possible evaluation difficulties?

Answer 18

1. Design of the intervention
2. Possible lag time to effect
3. Many potential intervening or concurrent confounding factors
4. High cost of evaluation research - studies are likely
   to be large scale and long term