Module 2 Flashcards
What are entry points
- places to enter the field or to get started
- consider the issues (from monitoring surveys, epidemiology, CVD, diabetes, most at the individual levels), populations (target at risk), and settings (where people live and engage).
in health promotion, we focus on the populations and settings entry vs the issue
Settings-Based Health Promotion
“settings”= places, locations where the health promotion happens. ex: schools, workplaces, homes, cities, hospitals, neighborhoods, prisons. its about meeting people where they are
Reciprocal Causation
Theory that one’s behavior both influences and is influenced by personal-individual factors and the surrounding environment and that the environment is influenced by the individuals in it. so when we change an environment or its culture, that has an effect on those living in it and if we change the people, others in will be affected by that person in the environment
What are the 2 approaches to “settings”
easier 1- Captured audience: individual focused on health promotion, education, mass media, skill development (ex: stress reduction, lifting techniques, nutrition programs)
harder 2- Structure and Culture redesign: the individual is powerless, ecological model of health promotion (ex: individuals and structures interacting creating complexity, focus on changing the whole system to be more health-enhancing)
3 Health Promotion Models
Ecological Model (or social ecological model), Public Health Agency of Canada’s Public Health Promotion Model, The PRECEDE/PROCEED Model
Ecological Model of Health
- health and well-being are affected by a dynamic interaction between biology, behavior, and the environment
- this interaction changes over the life course of individuals, families, and communities
- considers environmental factors as they consider the individual to the public policy levels
- accounts for the social, cultural, and economic factors that affect health behavior
- the main focus is on how the environment shapes behavior and how there can be multiple levels of influence on a specific behavior
What are the levels of the Ecological Model
Proximal -> Distal
- Individual (knowledge and skills)
- Interpersonal (friends, family, social network)
- organizational (workplace, schools)
- Community (cultural values, norms, built environment)
- Public Policy
Ex behavior: mask-wearing- Individual Level of Ecological Model
- community knowledge, attitudes, and skills are the focus
- video from healthy Canadians, talks about how to wear a mask properly
- individual-level interventions because we want to only educate YOU about wearing a mask
Ex behavior: mask-wearing- Interpersonal Level of the ecological model
- our friends, family, and social network can make a difference in our attitudes towards things
- how our friends and family feel about something affects our behaviors
- if all our friends wear masks, we will likely too. all against, then likely wont
Ex behavior: mask-wearing- Organizational Level of the ecological model
- organizations can make decisions that affect our behavior
ex: SFU asks all visitors to wear a mask. UBC says masks will not be mandatory on campus.
if we want people to wear masks, educating them, getting their social circles on board, and their schools to require it will increase the chances they will wear a mask
Ex behavior: mask-wearing- Community Level of the ecological model
- our communities influence our behavior too
ex: people rally to protest mask rules in the newspaper. also in the newspaper is a group of healthcare workers advocating for BLM but are all masked. these images, events, headlines, etc affet behavior
Ex behavior: mask-wearing-Public Policy Level of the ecological model
- this sphere has a huge influence
- when you make something policy also need to enforce it
- people will follow along to avoid the consequences, others will resist being told what to do
- need a lot of social and political capital to make laws of things people may not like.
ex: mandating masks or Quarantine
PHACs Population Health Promotion Model
covers the who (various levels of action), what (full range of health determinants), and how (comprehensive action strategies) of health promotion. combines the ecological model, the ottawa charter, and determinants of health. To address an issue, select one level form each of the 3 sides
What is the “who” portion of the PHAC’s population health promotion model?
Various levels of action within:
- individual
- family
- community
- sector/system
- society
What is the “what” portion of the PHAC’s population health promotion model?
the full range of health determinants are:
- income and social status
- social support networks
- education
- working conditions
- physical environments
- biology and genetics
- personal health practices and coping skills
- health child development
- health services
What is the “how” portion of the PHAC’s population health promotion model?
the comprehensive action strategies are:
- strengthen community action
- build healthy public policy
- create supportive environments
- develop personal skills
- reorient health services
How are decisions made for the Population Health Promotion Model?
All of the levels on the cube are entry points. deciding is based on:
- consulting research
- leaning from what we have done before
- evaluation programs to see what is working and what is not
- consider the values and assumptions involved
Example of the PHAC model
Governments can assess the health impacts of income support policy options
- sector level
- income and social status topic
- healthy public policy area
Example of the PHAC model
support community action to establish needle exchange programs
- community level
- personal health practice topic
- strength community action area
Example of the PHAC Model
schools and workplaces can make nutritious foods available in their cafeterias
- society level
- personal health practices topic
- supportive environment area
The PRECEDE/PROCEED model
- more specific in the steps involved in creating a potential health promotion/public health intervention
- process for doing health and community work
- focuses on the community as the wellspring of health promotion
- participatory process
- 9 phases
Phase 1: Social Assessment and Situational Analysis
- what quality of life issues concerning the people to be served
- the very important first phase
- talk with the population and figure out what quality of life issues are they really facing
- consult and figure out the big-ticket items that are hindering their QOL
Phase 2: Epidemiological Assessment
- identify specific health problems linked to QOL issues in phase 1
- monitoring surveillance, mortality, morbidity, disability, genetics, behavior, environment and prioritizing
- assess what is affecting or causing the issue in phase 1
Phase 3: Behavioral and Lifestyle Assessment and Environment Assessment
- identify specific health behaviors that need to be changed
- be aware of environmental factors that already influence these behaviors
- how do these influence factors in the next stage
- find out more about what is blocking their ability to do the thing
