Health promotion Flashcards
What are the differences between health prevention vs promotion?
Disease prevention
- medical model
- tends to focus on specific disease
- target at risk groups
Health promotion
- positive holistic model
- general, and benefits are wider
- whole population approach
Most interventions target both - ie. prevent disease and promote health
Most health promotion interventions are the same as primary prevention
What are some examples of health promotion?
Drink driving campaigns Tobacco control Immunisation programmes Screening programmes Water fluoridation Self management of disease Healthy eating campaigns
Define: health promotion
process of enabling people to increase control over and to improve their health
Combination of educational and environmental supports for actions and conditions of living conducive health
With the medical model what are the target group, general approach, strategy and actors in health promotion?
Example condition: CVD, High BP Target: high risk individuals General approach: individual Strategy: surgical/medical therapy/ medically manage behaviour change Actor: doctors, HCPs
With the behavioural model what are the target group, general approach, strategy and actors in health promotion?
Example condition: smoking, poor diet, alcohol abuse
Target: high risk groups
General approach: individual/population
Strategy: health education, public health policies (e.g. smoking ban)
Actor: public health, patient groups, government
With the socio-environmental model what are the target group, general approach, strategy and actors in health promotion?
Example condition: poverty, isolation, loneliness, pollution
Target: High risk societal conditions
General approach: communities
Strategy: community development, political action for societal change
Actor: citizens, social organisation, political movements
What is the high risk approach?
Identify few at "high risk" target interventions on these large benefit to individuals at greatest risk limited benefit at population level Example: CVD risk screening in PC
Issue with this approach is that the majority of major diseases are found throughout the population
What is the population approach?
target whole population for intervention
modify risk in whole community
small changes at individual level but affecting large numbers = substantial population benefit
What % of the population report no negative health behaviours and how many report 2 and 3 ?
29% report none
71% report one
28% report two
What is the impact of obesity in the UK?
extensive list of comorbidities - reduces life expectancy by 3-13 years
What is the impact of smoking in the UK?
1 in 4 deaths
What is the impact of physical activity in the UK?
1/3 of all deaths due to illness whose prevalence could have been partly reduced by increased physical activity
What is the impact of alcohol in the UK?
estimated to factor in about 20-30% of all road accidents
What is the impact of sexual health in the UK?
10% sexually active women infected with chlamydia - pelvic inflammatory disease and infertility
What are some examples of behavioural change theories at an individual level?
Health belief model
Stages of change model
Theory of planned behaviour
Precaution adoption process model
What is the focus and key concepts of the health belief model?
focus: perceptions of threat, benefits of avoiding the threat
Key concepts: perceived susceptibility, severity, benefits, barriers, self-efficacy
What is the focus and key concepts of the stages of change model?
Focus: readiness to change behaviour
Key concepts: precontemplation, contemplation, action, decision, maintenance
What is the focus and key concepts of the theory of planned behaviour?
Focus: attitudes, norms
Key concepts: Intention, attitude, subjective norm, behaviour control
What is the focus and key concepts of the precaution adoption model?
Focus: journey from lack of awareness to action and maintenance
Key concepts: unaware, unengaged, deciding about acting, acting and maintenance
What is an example of behavioural change theory at an interpersonal level?
social cognitive theory
Focus: personal, environmental factors and behaviour
Key concepts: capability, expectations, self-efficacy, reinforcements
What are some examples of behavioural change theory at a community level?
Community organisation
diffusion of innovations
communication theory
What is the focus and key concepts of community organsation?
Focus: community driven
Key concepts: empowerment, community capacity
What is the focus and key concepts of the diffusions of innovations?
Focus: how new ideas and practices spread within society
Key concepts: compatibility, complexity, triability, observability
What is the focus and key concepts of the communication theory?
Focus: how different types of communication affect behaviour
Key concepts: agenda setting, problem identification
What are some health promotion strategies?
health communication health education self-help/mutual aid organisational change community development and mobilisation policy/legislation political action
Research suggests using multiple strategies is the most effective method
What does health communication do and what approaches are there?
technique to positively influence and promote conditions conducive to health approaches - tv ads - billboards - leaflets - food labelling
Usually address large audiences
What is the purpose of health education?
provides opportunities for learning to individuals or community groups
- improve knowledge /develop skills conducive with health - managing a disease, school based education, support available
More intensive than communication
What is encompassed in self-help/mutual aid?
opportunities where people who share common experiences / problems can support each other
- alcoholic anonymous
- weight management
- CV rehabilitation
What is encompassed in organisational change?
Creating supportive environments that better enable people to make healthy life choices in a variety of settings
- school healthy eating policy
- no smoking policy in hospitals
- workplace exercise programmes
What is encompassed in policy/legisaltion?
Legislation = law enforced
Policy = plan of action to guide adherence to legislation
State interventions are often controversial and met with resistance but can be successful given time
What are the interventionists arguments for introducing policies/legislations?
State should create freedom for individuals
create opportunities
level out inequalities
What are the libertarians arguments against introducing policies/legislations?
interventions should be minimal
individual freedom is important
What are some examples of policies/legislations introduced which were controversial?
1st PH act (1848) - local government powers over water and sewage systems - opposed as paternalistic
Licensing act 1872 - restricted pub opening times and prohibited children
Seatbelt wearing mandatory 1983
What are the arguments for taxing unhealthy foods?
Fatty food consumption related to obesity
Unhealthy diets are low cost whereas recommended health diets cost more
price elasticity of high fat foods - responsiveness of quantity demanded related to price
Could generate funds for other obesity prevention measure
What are the arguments agaisnt taxing unhealthy foods?
Evidence inconsistent: what should be taxed?
Powerful interest groups lobby government
Lack of evidence of taxation policy affecting obesity
Taxation could penalise the poor
May lead to unintended consequences
What is the doctors role in health promotion?
Consider health promotion in all consultations
Ask about lifestyle - smoking
Offer advice and appropriate referral if necessary - dietician, smoking cessation service
Empower patients to manage chronic disease and offer appropriate support
Could undertake public health research, contribute to national reports and advocacy and lobbying
