Promoting health and preventing illness

Question 1

Define prevention

Answer 1

Interventions aimed at eradicating, eliminating or minimising the impact of disease and disability. If none of these are possible, slowing the progression of disease and disability.

Question 2

What is health promotion?

Answer 2

The process of enabling people to increase control over their health and its determinants and thereby improve their health.

Question 3

What are Leavell and Clark’s different levels of disease prevention?

Answer 3

Primary prevention:

• Pre-disease stage
• Aim of avoiding development of a disease in the first place
• E.g immunisations, health education
• Public health and GP led.

Secondary prevention:

• Latent/early stage of disease
• Aim for early detection of disease and early treatment to slow/halt progression
• E.g. screening/case detection
• GP and hospitals

Tertiary prevention:

• Symptomatic disease stage
• Aim to limit damage from disease, to slow progression, reduce severity and maximise QoL.
• E.g. rehabilitation programmes, pain management
• Hospitals, rehabilitation programmes, palliative care.

Question 4

What is the individual approach to promoting health and preventing illness?

What are its strengths and weaknesses?

Answer 4

Aim preventative care at high risk individuals.

Strengths:

• High patient motivation and high doctor motivation

Weaknesses:

• High demand on resources to identify high risk patients
• Medicalises prevention
• May stigmatise patients
• Does not produce lasting change at population levels

Question 5

What is the population approach to promoting health and preventing illness?

What are its strengths and weaknesses?

Answer 5

Directed at the whole population, irrespective of risk. Directed towards socio-economic, behavioural and lifestyle changes.

Strengths:

• Benefit for population as a whole
• Attempts to control root causes of disease
• Shifts cultural norms
• Can work passively
• More permanent results

Weaknesses:

• Benefit is small for each individual
• Low subject motivation

Question 6

What are the models of entity and health promotion?

Answer 6

• Ewles and Simnett 5 approaches
• Beattie’s model of health promotion

Both suggest that to make health promotion effective, you need a multi-faceted approach.

Help select the most effective/acceptable strategies

Makes explicit our aims and choice of strategies

Question 7

Describe Ewle and Simnett’s 5 approaches to health promotion

Answer 7

• Medical: screening, immunisation
• Behaviour change: encourages healthier behaviours
• Educational: Provide information → informed choice
• Client centered: Health issues identified by client/community
• Societal change: Change physical, social and economic environment (e.g. policy, legislation) to make healthier choices easier.

Question 8

Describe Beattie’s 4 quadrants model of health promotion

Answer 8

• Authoritative ⇔ Negotiated
• Individual ⇔ Collective

Individual and negotiated:

• Personal counselling

Individual and authoritative:

• Health persuasion
• Behaviour change
• Education, advice

Collective and authoritative:

• Legislative action
• Health surveillance

Collective and negotiated:

• Community development
• Lobbying
• Action research
• Skill sharing

Question 9

What is Rose’s prevention paradox?

Answer 9

A preventative measure that brings large benefits to the community offers little to each participating individual