Prevention and Health Promotion - Tutorial 2

Question 1

What is health promotion?

Answer 1

Health promotion is an over-arching principle/activity which enhances health and includes disease prevention, health education and health protection. It may be planned or opportunistic.

i.e. any planned activity designed to enhance health or prevent disease

Question 2

How does health promotion promote health?

Answer 2

Through a combination of legislation, the provision of preventative services such as immunisation and the development of activities to promote and maintain change to a healthier lifestyle

Question 3

What does health promotion vary with?

Answer 3

Population
Environment
Sex
Socioeconomic class

Question 4

What does health promotion in the UK look at?

Answer 4

Settings - e.g. workplace, school and hospital along with community development

Question 5

What is health affected by and which of these are affected by health promotion?

Answer 5

Genetics
Access
Environment
Lifestyle

Access, environment and lifestyle are affected by health promotion

Question 6

Attempts must be made to justify what in relation to health promotion?

Answer 6

Input of human and financial resources to health promotion

Question 7

Describe the theories of health promotion

Answer 7

Educational
Socioeconomic
Psychological

Educational - provides knowledge and education to enable necessary skills to make informed choices re health, may be one-to-one or group workshop e.g. smoking, diet, diabetes

Socioeconomic (Radical) - ‘makes healthy choice the easy choice’, national policies e.g. unemployment, redistribute income

Psychological - complex relationship between behaviour, knowledge, attitudes and beliefs. Activities start from an individual attitude to health and readiness to change. Emphasis on whether individual is ready to change

Question 8

What is health education?

Answer 8

An activity involving communication with individuals or groups aimed at changing knowledge, beliefs, attitudes and behaviour in a direction which is conductive to improvements in health

Question 9

What is health protection?

Answer 9

Involves collective activities directed at factors which are beyond the control of the individual. Health protection activities tend to be regulations or policies, or voluntary codes of practice aimed at the prevention of ill-health or the positive enhancement of well-being.

Question 10

Why is health promotion relevant?

Answer 10

Consider poor lifestyles, exercise, diet etc. and the burden of chronic disease and the ageing population on the NHS

Consider primary care system, health visitors, chronic disease clinics

Question 11

What is empowerment?

Answer 11

Empowerment refers to the generation of power in those individuals and groups which previously considered themselves to be unable to control situations nor act on the basis of their choices

Question 12

What are the benefits of empowerment?

Answer 12

An ability to resist social pressure
An ability to utilise effective coping strategies when faces by an unhealthy environment
A heightened consciousness of action

Question 13

What are the challenges to successful health promotion?

Answer 13

Some doctors are cynical about health promotion and question if the resources allocated to it are money well spent

Question 14

It is worth noting that the majority of health activities in secondary and primary care have never been adequately evaluated, what has been done in response to this?

Answer 14

In response, the UK government has set up the National Institute for Health and Clinical Excellence (NICE) to review evidence and develop appropriate guidelines to practice

Question 15

Catford (1993) has suggested that there should be a common set of criteria to assess the performance and quality of health promotion activities that he has called ‘vital signs of quality’, what do these include?

Answer 15

Does the activity understand and respond to people’s needs fairly?
Is it built upon an identifiable approach to health promotion?
Does it demonstrate a sense of direction and coherence?
Are connections made between settings, individual and community approaches?

Question 16

What are the stages of the cycle of change?

Answer 16

Precontemplation
Contemplation 
Action 
Maintenance 
Relapse

Question 17

What are examples of health promotion in primary care?

Answer 17

Planned - posters, chronic disease clinics, vaccinations

Opportunistic - advice within surgery, smoking, diet, taking BP

Question 18

What are examples of government health promotion?

Answer 18

Legislation - legal age limits, smoking ban, health and safety, clean air act, Highway Code
Economic - tax on cigarettes and alcohol
Education - HEBS

Question 19

What is primary prevention?

Answer 19

Measures taken to prevent onset of illness or injury
Reduces probability and/or severity of illness or injury
E.g. smoking cessation, immunisation

Question 20

What is secondary prevention?

Answer 20

Detection of a disease at an early (preclinical) stage in order to cure, prevent, or lessen symptomatology
Earliest opportunity is when a disease becomes evident or detectable
Ends when disease becomes symptomatic

Question 21

What are the Wilson and Junger (1968) criteria that need to be taken into consideration before setting up a screening programme?

Answer 21

Will the test detect the condition at an early pre-clinical stage?
Is the disease an important public health problem?
Is the natural history of the disease adequately understood?
Is a test available for the condition?
Is the test sensitive (low false negatives)?
Is the test specific (low false positives)?
Is the test safe?
Is the test acceptable to the public and professionals involved?
Is the cost of the test reasonable?
Does the overall cost-benefit analysis make it worthwhile e.g. number of tests required to save one life?
Is treatment for the conditions being screened for of proven effectiveness?
Is treatment for the condition being screened for safe?
Is treatment for the condition being screened for acceptable to public and professionals?
Are facilities for diagnosis and treatment available

Question 22

What is tertiary prevention?

Answer 22

Measures to limit distress or disability caused by disease e.g. osteoarthritis, motor neurone disease