Introduction to preventative medicine

Question 1

What is health promotion?

Answer 1

The process of enabling people to increase control over and improve and maintain their health.

Question 2

What are the concepts enshrined in the Ottawa Charter?

Answer 2

1. Developing personal skills
   
   • provision of information and enhancement of lifeskills
2. Strengthening community action
   
   • providing information, motivating, consulting the public (view and feedback, involving in research), empowerment
3. Creating supportive environments
   
   • promoting health eating etc…
4. Building healthy public policy

Question 3

What are the 5 key approaches to health promotion?

Answer 3

Medical
Behavioural change 
Educational
Empowerment
Social change

Question 4

What is the medical approach?

Answer 4

Primary - Preventing onset of diseases
Secondary - Detecting and treating pre-symptomatic diseases
Tertiary - Minimising effects of a disease

Question 5

What is the behavioural change approach?

Answer 5

Focuses on individuals
-> attitudes -> behaviour -> responsibility -> choice

Success dependent on individual
Ignores the social determinants of health

Question 6

What is the educational approach?

Answer 6

Enables individuals to make informed choices - Avoids persuasion
-> Information -> knowledge -> skills

Relies on individual to make right choice
Little on the social determinants of health

Question 7

What is the empowerment approach?

Answer 7

Empowerment is the process of enhancing the capacity of individuals/populations to identify and address their concerns.

Recognises the social determinants of health.

Question 8

What is the social change approach?

Answer 8

Change society, not individuals

Physical & social environment -> Healthier choices

Question 9

What are the key objectives of health promotion?

Answer 9

• To prevent disease (Medical or Preventive)
• To ensure people are well informed and able to make “healthy” choices (Behaviour Change and Educational)
• To help people to acquire the skills and confidence to take greater control over their health (Education and Empowerment)
• To change policies and environments in order to facilitate healthy choices (Empowerment and Social Change).

Question 10

What are the phases of the PRECEDE-PROCEED model?

Answer 10

Phase 1 - Social assessment
Phase 2 - Epidemiological assessment
Phase 3 - Educational and ecological assessment
Phase 4 - Administrative and policy assessment and intervention alignment 
Phase 5 - Implementation
Phase 6 - Process evaluation 
Phase 7 - Impact evaluation
Phase 8 - Outcome evaluation

Question 11

What are the problems in evaluating health intervention programs?

Answer 11

• May involve very long-term social, behavioural or environmental changes
• Outcomes not easily measured or defined
• Different stakeholders and staff members may have different goals (not always shared)
• Evaluation can be expensive (costs often out of proportion with cost of the intervention) and resource consuming (time and personnel)
• Difficult to control external influences