L12- Social factors in health promotion

Question 1

examples of health promotion in the UK

Answer 1

• Change for life
• Start for life
• Couch to 5k
• Be clear on cancer

Question 2

5 types of health promotion in action

Answer 2

1. Medical or preventative
2. Behaviour change
3. Educational
4. Empowerment
5. Social change

Question 3

medical or preventative

Answer 3

• Clinical approach to promoting health

* E.g. giving advice on the benefits of stopping smoking

Question 4

behaviour change

Answer 4

.g. using shocking images and clever catch phrases
• Very brief advice on smoking (for doctors- so they can take part in the intervention)
• Motivational interviewing

Question 5

educational

Answer 5

Giving people the facts on the easiest way to give up an unhealthy behaviour

Question 6

empowerment

Answer 6

• Make people feel in control of stopping whatever unhealthy behaviour they want to quit
• E.g. smoke free app

Question 7

social change

Answer 7

• Not acceptable to smoke in many places- social sanction around smoking
• Seen less often- less socially acceptable

Question 8

sociological perspectives

Answer 8

structural

surveillance

consumption critiques

Question 9

structural critiques

Answer 9

material conditions that give rise to ill health are marginalised
o Focus on individual responsibility may miss the point

Question 10

surveillance critiques

Answer 10

monitoring and regulating population- is that okay??

Question 11

consumption critiques

Answer 11

lifestyle choices not just seen as health risks but also tied up with identity construction

Question 12

dilemas of health promotion

Answer 12

1) should we intervene in peoples lives?
2) Victim-blaming: whos fault is poor health?
3) Fallacy of empowerment
4) Reinforcing negative stereotypes
5) Unequal distribution of responsibility

Question 13

1) should we intervene in peoples lives?

Answer 13

• Potential psychological impact of health promotion messages.
• State intervention in individuals like ‘Nanny’ state —> rights and choice

Question 14

2) Victim-blaming: Who’s fault is poor health?

Answer 14

Health promotion often focuses on individual behavioural change

• Structural and socioeconomic changes are not often factored in
• Plays down the impact of wider socioeconomic an environmental determinant of health
• E.g. housing conditions, water and air quality, workplace conditions, roads, green spaces
• All of the above influence the perceptions individuals have on their health and the choices they make

Question 15

3) The fallacy of empowerment

Answer 15

• Giving people generic information about unhealthy behaviours will not necessarily make them do it
• Info does not give automatic power to act on healthier choices
  o e.g. cost of doing a healthy behaviour
  o e.g. join a gym if inactive
• Unhealthy lifestyles almost never due to ignorance, but due to adverse circumstances and wider socio-economic determinants of health
  o e.g. mums who don’t breast feed because they need to earn money and work

Question 16

4) Reinforcing negative stereotypes

Answer 16

• Health promotion can reinforce negative stereotypes associated with a condition or group
  o e.g. leaflets aimed at HIV prevention in drug users

Question 17

5) Unequal distribution of responsibility

Answer 17

• Implementing healthy behaviours in the family is often left up to the women
• Example: healthy eating advice and the responsibility to their family to eat more fresh fruit etc
• Women are often left to implement promotions that require work in the home as we know women still do

Question 18

the prevention paradox

Answer 18

Interventions that make a diff at population level might not have much effect on the individual

Question 19

lay beliefs and the prevention paradox

Answer 19

• 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 will also impact on views about candidacy
• Importance of health promoters engaging with lay beliefs
• e.g. anti-vaxxers do not understand why we vaccinate for diseases that don’t exist in the UK anymore- lack of understanding of heard immunity

Question 20

why evaluate health promotion

Answer 20

• We need 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 21

types of health promotion evaluation

Answer 21

process eval

impact

outcome

Question 22

process evaluation

Answer 22

• Assessing the process of programme implementation

* Employ wide range of mainly qualitative methods

Question 23

impact

Answer 23

• Assess the immediate effects of the intervention

* Popular choice- easiest to do

Question 24

Outcome

Answer 24

Measure more long-term consequences ◦Measures what is achieved:
• Improvement in clients lives
• Reduction of symptoms
• Level of harm reduction
• Timing of eval can influence outcome: delay- sometime interventions might take a long time to have an effect
• Decay: some interventions wear off rapidly

Question 25

difficulties with evaluation

Answer 25

Demonstrating an attributable effect is difficult because:

• Design of the intervention
• Lag time to effect
• Many potential intervening or concurrent confounding factors
• High cost of evaluation research-studies are likely to be large scale and long term