S7- Health Promotion Flashcards
Outline the parts of the socio-ecological model of prevention
- Individual: individual attitudes, beliefs, knowledge + behaviour
- Interpersonal: relationships, support groups, social networks, cultural context
- Institutions and organisations: schools, health care administration, business, faith based organisations,
- Community: between organisations and institutions
- Structures and systems: Federal state, local regulations, laws, built environment (public works, infrastructure etc)
What is primordial prevention?
- Concerned with avoiding the emergence and establishment of social, economic + cultural patterns of living that contribute to risk of disease
- involved interventions that are applied at population level
Distinguish between the following and give examples;
a) Primary prevention
b) Secondary prevention
c) Tertiary prevention
a) - concerned with preventing the onset of pathological changes
- involves interventions that are applied before there is any pathology
- e.g. vaccination, smoking cessation, physical fitness and road safety
b) - concerned with detecting disease in earliest stage before symptoms and intervening to slow or stop its progression
- e.g. cervical screening + risk prediction
c) - concerned with arresting the progress of an established disease and to control its negative consequences
- e.g. lessen impairment + reccurence, reduce disability + handicap, minimise suffering, promote adjustment
a) What is health promotion?
b) What are the two approaches of health promotion?
C) pros and cons?
a) The process of enabling people to increase control over, and to improve, their health
b) 1. Universal approach: aim to reduce risk across whole population e.g. sugar tax
2. Targeted approach: aims identify those most at risk and then tailor messages and approaches to that group e.g. breast feeding initiatives in young mums
c)
1. Universal
- big impact if there is a common risk factor
- harm paradox is an issue: affects percieved credibility
- targeted
- can be tailored to need and to specific communities
- but it can assume that groups are homogenous, can lead to culture blaming and broader health issues might be neglected
What are the 3 levels of strategies for health promotion?
- Policy, legislation and systems change
- Community development
- Health communication: information communication and health education
What are some of the policy, legislation and system health promotion strategies?
- Social policy: local, national or international culture and policy e.g. smoking ban in public places
- Fiscal approaches: taxation or other approaches to discourage health harming behaviours e.g. tax on cigarettes
- Bans and restrictions: reducing availability, using legal powers e.g. illicit substances, restricting sales of alcohol and cigs
What are some of the community development health promotion strategies?
- Community participation and action
- Facilitation: statutory services support community activites e.g. space for meetings
- Interface: statutory services working with communities e.g. consultation with faith leaders
- Strategy: strategic support from local or national initatives e.g. national funding streams
What are some of the health communication promotion strategies?
- For health information to be understood it needs to be: received, understood, change attitudes and beliefs and stimulate behavioural change
What are some of the problems with health promotion activities?
- Are we allowed to intervene in peoples lives?
- Health promotion often focuses on individual behavioural change and doesn’t factor in wider socioeconomic + environmental determinants e.g. housing conditions
- fallacy of empowerment: information doesn’t give people power to act on healthier choices
- can reinforce negative stereotypes associated with a condition or group
What is the prevention paradox?
- interventions that make a difference at population level might not have much effect on the individual
- there are lay beliefs associated with this: if people dont see themselves as a candidate for a disease then they may not take onboard health promotion messages
Why do we need to evaluate health promotion?
- need for evidence-based interventions
- properly conducted evaluated studies provide evidence
- accountability
- gives legitimacy to interventions
- ethical obligation
- ensure there is no direct or indirect harm
- management and development
What are the 3 types of health promotion evaluations?
- Process evaluation:
- focusses on assessing the process of programme implementation
- formative/illuminative
- employs mainly qualitative methods - Impact evaluation:
- assesses the immediate effects of the intervention
- more popular, as easiest - Outcome evaluation:
- measures long term consequences
- measures what is achieved e.g. improvement, reduction of symptoms, level of harm reduction
- timing can influence outcome i.e. some interventions may take a long time to have an effect and decay- some interventions wear off rapidly
What are some of the difficulties associated with evaluation?
- demonstrating an attributable effect is difficult because:
- design of the intervention
- possible lag time to effect
- many potential intervening or concurrent confounding factors
- high cost of evaluation research
