Introduction to levels of prevention, and health promotion Flashcards
What is the aim of preventive medicine?
The aim of preventive medicine is the absence of disease, either by:
a)preventing the occurrence of a disease; or
b)halting disease progression; or
c)averting complications after its onset.
Preventive medicine can be practised by governmental agencies, primary care physicians and the individual himself.
Disease prevention is everyone’s business.
List some agencies tasked with health prevention
- WHO
- UN agencies e.g. UNICEF, UNFPA, UNDP…
- Word Bank
- OECD
- Bilateral agencies
- International Philanthropy e.g. Red Cross, MSF
List and briefly describe the levels of health prevention
- primary
- preventing disease before it happens
- modifying existing risk factors e.g. bike helmets, tobacco cessation
- preventing development of risk factors e.g. boke trails located away from vehicles and policies limiting youth from purchasing tobacco - secondary
- identifying disease before problem becomes serious e.g. NBS, mammography, BMI screening, BP measurement, regular check ups for smokers
- tertiary
- preventing complications of disease e.g. post-stroke rehabilitation, blood sugar-lowering medications for diabetes, physical therapy for back injury
Primordial prevention targets social and economic policies affecting health.
It is to prevent the emergence of predisposing social and environmental conditions that can lead to causation of disease.
It is often beyond the control of clinicians as it requires policy-level interventions.
But clinicians can be advocates for change.
quaternary prevention
- action taken to protect individuals from medical interventions that are likely to cause more harm than good
- the goal is to reduce overmedicalisation and iatrogenic harm
Describe the components of health promotion
The key principles of health improvement include:
- a broad and positive concept of health
- participant involvement
- action, and competencies for action
- a settings perspective
- equity in health
Health promotion is defined as the process of enabling people to increase control over, and to improve their health, through a) Building Healthy Public Policy; b) Creating Supportive Environments; c) Strengthening Community Action; d) Developing Personal Skills; and e) Reorienting Health Services.
Describe the links between health promotion and prevention and SDH
Health promotion is defined as the process of enabling people to increase control over, and to improve their health, through a) Building Healthy Public Policy; b) Creating Supportive Environments; c) Strengthening Community Action; d) Developing Personal Skills; and e) Reorienting Health Services.
Disease or health prevention is defined as measures not only to prevent the occurrence of disease, such as risk factor reduction, but also to arrest its progress and reduce its consequences once established.
Equity means fairness. Equity in health means that people’s needs guide the distribution of opportunities for well-being. (This also applies to health services access & availability).
Individuals live behave and are influenced by various factors operating at different levels e.g. individual, interpersonal, organisational, community and public policy levels.
When considering the “three” levels of prevention do not forget the context, and person, place and time.
These levels, above, are also where SDH strategies are targeted e.g. a multi-level approach.
List and briefly describe the stages of health behaviour change
Stages include:
- 1: precontemplation and ignoring problems
- 2: contemplation, and weighing up the pros and cons of the problem
- 3: preparation, and planning behaviour changes
- 4: action and performing the behaviour
- 5: maintenance, and integration of new behaviours in daily life
e.g. IHD, asthma, pre-diabetic (T2D)
The missing element from this model is that relapse is not an exception but a normal part of human behaviour.
Doctors need to assist individuals to get back on course as part of a health promotion and prevention strategy.
