Introduction to Health Promotion

Health Promotion Defined

• WHO defined health promotion in 1986 as enabling people to increase control over their health
• Health promotion is based on prevention rather than just cure
• Health promotion aims to prevent morbidity and mortality
• Health promotion aims to achieve the best possible health for everyone

Shared Responsibility for Health Promotion

• Health promotion isn't just for the health sector
• Individuals have responsibility for their health
• Communities and schools play an important role
• Non-government and professional organizations contribute
• All levels of government participate
• International organizations are involved

Individual Health

• Health is created and experienced by individuals in their daily lives - learn, work, play and love
• Individual responsibility and action are encouraged

Community/School Health

• Health promotion involves health education and personal development

Non-Government and Professional Organizations

• These organizations play an important role in community education
• They provide health services, research, workforce development and political advocacy

Government's Role

• All levels of government play a part in health promotion: local and national

International Organizations

• Organizations like the United Nations, WHO and UNICEF are vital

Health Promotion Model Focus

• Health promotion is a counterpart to health protection models
• It increases a client's level of well-being
• It explains why clients participate in health-promotion behaviors

Key Functions of the Model

• Identifies demographic and social factors enhancing or decreasing participation in health promotion
• Organizes cues to explain the likelihood of a client's participation in health-promotion behaviors
• Explains why individuals engage in health activities

Differences Between Health Promotion and Prevention

• Health promotion is not disease-oriented, whereas prevention/protection is specific to illness or injury
• Health promotion uses a positive "approach" to wellness
• Prevention/protection focuses on "avoidance" of illness with negative connotations
• Health promotion seeks to expand positive potential for health
• Prevention/protection seeks to thwart insults to health and well being

Disease Prevention Defined

• Involves activities to protect patients and the public from potential health threats and their harmful consequences
• Disease prevention includes measures to prevent disease occurrence and to arrest its progress/reduce its consequences once established

Primary Prevention

• Action taken before disease onset to remove the possibility of it occurring
• Intervention occurs during the pre-pathogenesis stage
• Modes of intervention include health education and specific protection like immunization
• Generalized health promotion and specific protection against disease precedes disease or dysfunction
• It applies to generally healthy individuals or groups

Health Promotion Model Strategies

• Health Education
• Good standard nutrition adjusted to developmental phases of life
• Attention to personality development
• Provision of adequate housing, recreation and agreeable working conditions
• Genetic screening
• Periodic selective examination
• Health education about accident and poisoning prevention, standards of nutrition and growth/development for each life stage or appropriate exercises
• Stress management and protection against occupational hazards
• Immunizations
• Risk assessment for specific diseases
• Family planning services and marriage counseling
• Environmental sanitation

Primary Level Disease Prevention (Strategies)

• Through persons: immunization, nutrition, chemoprophylaxis, personal hygiene, fertility regulation, and avoidance of allergens, poisons and carcinogens
• Through environmental control: safe water, food hygiene, safe excreta disposal, proper refuse management, safe home environment, and safe workplace

Secondary Prevention

• Action which halts disease progression at its beginning stage and prevents complications
• Intervention occurs during the early pathogenesis stage Emphasizes early disease detection, prompt intervention, and health maintenance, including prevention of complications and disabilities, for individuals experiencing health problems.

Secondary Prevention - Early Diagnosis and Prompt Treatment

• Case-finding measures (individual, mass and selective examinations)
• Cure and prevention of disease processes to prevent spread of communicable diseases, prevent complications, and shorten disability
• Screening surveys and procedures
• Encouraging regular medical and dental checkups
• Teaching self-examination for breast and testicular cancer
• Assessing the growth and development of children
• Nursing assessments and care provided in various settings to prevent complications

Secondary Prevention - Disability Limitations

• Adequate treatment to arrest disease process and prevent further complications.
• Provision of facilities to limit disability and prevent death

Secondary Prevention - Facilities

• Hospitals: emergency departments, urgent care centers, critical care units, and medical-surgical units
• Intensive Care Units (ICUs): close monitoring and advanced technologies
• Psychiatric Facilities: counseling and treatment for emotional and behavioral problems

Tertiary Prevention Defined

• Measures available to reduce or limit impairments and disabilities
• Measures available to minimize suffering caused by existing departures from good health
• Measures available to promote patient adjustment to irremediable conditions
• Intervention occurs during the late pathogenesis stage
• Modes of intervention is disability limitation and rehabilitation
• Restoration and Rehabilitation, a process that aims to help people return to an optimum level of functioning within the constraints of a disability where a defect or disability is fixed/stabilized

Tertiary Prevention Strategies

• Diagnosis
• Treatment
• Management
• Rehabilitation

Restorative Care

• Restorative care is for patients recovering from acute/chronic illness or disability who require added services to return to their previous level of function or a new one
• Home care provides medical and paraprofessional services/equipment to the patient and their families
• Health maintenance, education, illness prevention, diagnosis/treatment of disease, palliation and rehabilitation are all components of care
• Rehabilitation restores a person to the fullest physical, mental, social, vocational, and economic potential possible
• Patients require rehabilitation after a physical/mental illness, injury, or chemical reaction Special Rehabilitation services include:cardiovascular, neurological, musculoskeletal, pulmonary, and mental health

Extended Care Facilites

• Provide intermediate medical, nursing, or custodial care
• Suited to patients recovering from an acute illness or those with chronic illnesses/disabilities
• Skilled nursing facility - an intermediate care that offers care from licensed nurses. This can include IV fluids, wound care, ventilator management and physical rehabilitation

Primordial Prevention

• Preventing the emergence/development of risk factors in countries or populations where they haven't appeared
• Intervention: Individual and mass education
• Modes of intervention - National programs and policies for food/nutrition, and against smoking/alcohol

Quaternary Prevention

• Health activities to mitigate/avoid consequences of unnecessary or excessive intervention of the health system

Types of Rehabilitation

• Medical: restoration of function
• Vocational: restoration of capacity to earn a livelihood
• Social: restoration of family and social relationships
• Psychological: restoration of personal dignity

Stages of Wellness

• Stage 1: Exposure to positive health influences.
• Stage 2: Adoption of positive health practices (healthy diet, exercise, recreation, adequate sleep, etc.).
• Stage 3: Increase in health and wellness indicators due to healthy practices.
• Stage 4: Achievement of specific defined health and wellness goals.
• Subjective (well-being, energy, fulfilling social relationships)
• Objective (high cognitive function, productivity, capacity for role fulfillment)