Health Promotion

Question 1

What is Health Promotion?

Answer 1

Any planned activity designed to enhance health or prevent disease.

Definition = overarching principle/activity that enhances health & incl. disease prevention, health education, health protection - may be planned/opportunistic

Health is affected by: Genetics, Access, Environment, Lifestyle

Access, Environment, Lifestyle = can be targeted by health promotion

Question 2

3 Theories of Health Promotion

Answer 2

Educational = provides knowledge & education to enable necessary skills to rate informed choices about health; 1 - 1/group workshop e.g. smoking, diet, diabetes

Socioeconomic = makes healthy choice the easy choice using national policies e.g. unemployment, redistribute income, taxation of commodities to move people to make healthy choice

Psychological = complex behaviour, knowledge, attitudes, beliefs - activities start from individual attitude to health & readiness to change (pt. must be ready to change) e.g. smoking, alcohol

Question 3

Health Education Definition

Answer 3

activity involving communication w/ individuals/groups aimed at changing knowledge, beliefs, attitudes, behaviour in direction conducive to health improvement

Question 4

Health Protection Definition

Answer 4

collective activities directed at factors beyond control of individual - activities tend to be regulations/policies/voluntary codes of practice aimed at preventing ill health/+ve enhancement of well-being

Question 5

Benefits & Disadvantages of Health Promotion

Answer 5

Benefits = prevent disease rather than having to treat established disease, anyone can provide health promotion, media can be used + national programmes can be organised & advertised

Disadvantages = medicalising healthy individuals, poss. increased worry, may not effectively target most at risk groups e.g. those in deprived areas (may not respond unless healthy promotion meaningful/accessible to them) - can widen care gap, may not deliver req. benefits - further increased cost, difficult to assess impact

Question 6

Challenges to Successful Health Promotion

Answer 6

Many doctors cynical about planned health promotion + question if resources allocated to it are money well spent

Majority of healthy activities in secondary & primary care have never been evaluated (NICE set up to review evidence & develop appropriate guidelines to practice)

Question 7

Empowerment

Answer 7

Generation of power in individuals & groups that previously considered themselves to be unable to control situations/act on basis of their choices

Provides numerous benefits:

Ability to resist social pressure
Ability to utilise effective coping strategies when faced by unhealthy environment
Heightened consciousness of action

Question 8

Cycle of Change

Answer 8

Precontemplation - Contemplation - Action - Regression./Maintenance of Action - Regression/Maintaining healthier lifestyle

essentially, advice best given when pt. is ready to change (contemplation)

Question 9

Examples of Health Promotion

Answer 9

Primary Care

Planned = posters, chronic disease clinics, vaccinations, QOF, travel clinic, disease prevention measures e.g. smears, bowel screening

Opportunistic = advice w/I consultation e.g. smoking, diet, taking BP, alcohol brief intervention; delivered by GP & also increasingly by practice nursing team

Government

Legislation = legal age limits, smoking ban, health & safety, clean air act, highway code

Economic = tax on cigarettes & alcohol

Education = adverts

Question 10

Primary Prevention

Answer 10

Measure taken to prevent onset of illness/injury

Reduced probability &/or severity of illness/injury

e.g. smoking cessation/immunisation

Question 11

Secondary Prevention

Answer 11

Detection of a disease at early (preclinical) stage in order to cure, prevent, or lessen symptomatology

Earliest opportunity = disease becomes evident/detectable + ends when becomes symptomatic

Question 12

Wilson’s Criteria (3 main categories)

Answer 12

Knowledge of disease: imp. public health concern, recognisable latent/early symptomatic stage, natural course of condition (incl. from development from latent - declared disease) should be adequately understood)

Knowledge of test: suitable test/examination, test acceptable to population, cost-effective, sensitive + specific test, continuous case finding

Treatment for disease: accepted treatment for pt. w/ recognised disease, facilities for diagnosis & treatment available, agreed policy concerning who to treat as pt., cost-effective

Cost-considerations: costs of case finding economically balances in relation to poss. expenditures on medical care as a whole i.e. diagnosis + treatment of early disease should be cheaper than diagnosing + treating late disease

Question 13

Screening in Scotland

Answer 13

Cancers = breasts, bowel, cervical

AAA

Diabetic Retinopathy

Pregnnacy Screening = pre-eclampsia & diabetes, Down’s syndrome & other chromosomal conditions, NTDs, Viral infections (HIV, Hep B, Syphilis, Rubella), Anaemia & isoimmunisation, Baby & placental position

Newborn screening incl. hearing, cataracts, congenital heart disease, hip dysplasia, undescended testes

Guthrie test = PKU, hypothyroidism, sickle cell, CF

No screening for everything (whole body scans) = lots of measurement & some people will have measurements outwith normal range - but this is their normal (i.e. little chance of having no abnormalities)

Question 14

Tertiary Prevention

Answer 14

Measures to limit distress or disability
caused by disease

any intervention after disease onset that limits effect of it e.g. secondary prevention for stroke/MI, analgesia & physio for OA, OT for pt. w/ MND, providing care support

Question 15

Early Effects on Lifelong Health

Answer 15

Establishing of healthy lifestyle = growth & development fuelled by food

Role of Parenting = habits & lifestyles established in adolescence, 2x more likely to smoke if parents do, neglect & abuse recur

Question 16

Presentation of Children in Primary Care

Answer 16

Common Reasons for appt. = feeding problems (esp. new babies), pyrexia, URTI, coughs/colds, rashes, otalgia, sore throat, vomiting +/- diarrhoea, abdo pain, behavioural problems (older infants + depend on area/parents situation)

What to do = listen, watch, observe, examine properly, put child & parent/guardian at ease, consider seriously, parental understanding - explain thoughts & plans clearly, ethnic issues, language issues, refer & report if necessary, open door policy

Sometimes parents bring children in, stating they are unwell + child is clinically fine = parenting difficulty manifesting as chil illess, parent depression/anxiety, social issues, child presenting w/ difficult symptoms to interpret, child abuse by partner, single parent w/ no support, inexperience, anxiety about normal illness

Question 17

Health Advice for Children

Answer 17

Diet = NHS choices, 5 portion of fruit and veg a day
Exercise = at least 60mins of moderate - vigorous exercise daily for teens
Sleep = 8 - 10hrs per night
Screen-time = limit screen-time esp. before bedtime