Health Promotion Theory And Practice PDF

HEALTH PROMOTION Theory And Practice Population Health and Healthcare Delivery (PHHD) Dr. Nitya Kumar PHHD Lead vha.org.au  Learning outcomes You will be able to:  Explain what is meant by health promotion and health education from a health ser...

HEALTH PROMOTION Theory And Practice Population Health and Healthcare Delivery (PHHD) Dr. Nitya Kumar PHHD Lead vha.org.au  Learning outcomes You will be able to:  Explain what is meant by health promotion and health education from a health service perspective  Apply the theory of action for health promotion to the reduction of tobacco-related ill- health  Apply the theory of action for health promotion to other health topics  Utilize a population health framework such as the Ottawa Charter to identify evidence-based interventions for a health problem 2 Behavior Change can assist professionals to support patients to adopt and maintain new habits Theoretical Models that predict health behavior  WHY SHOULD PHYSICIANS LEARN BEHAVIOR CHANGE? Can you think of health conditions that require behavior change as key part of therapy and prevention? Which health conditions require behavior change as a key intervention? Infections Hypercholesterolemi a (hand washing, (limiting high fat Diabetes mellitus foods) among others) (limiting high glycemic index foods) Obesity Multiple Sclerosis (regular physical (Avoiding heat and activity and stress and limiting caloric smoking) intake)  Social Determinants of Health Many factors outside the control of individuals, especially low income and/or low educational attainment  Factors Influencing Behaviors are heterogenous and interlinked Baum FE. More than the tip of the iceberg: health policies and research that go below the surface. Journal of Epidemiology & Community Health 2009;63:957. External factors Influence Behaviors Food economics Brand Marketing strategies Infrastructure Media / pop culture http://www.unce.unr.edu/publications/files/hn/2010/fs1011.pdf Free will versus structured choices? Conditions that mediate initiation prevention? Promoting health Promoting ill-health Personal factors Is the hill steeper for matter but some individuals and should health be an groups than for  Health Education Definition: Communication which seeks to influence health behaviour so as to maintain health …. Seeks to influence » Knowledge » Attitudes » Behaviour  Health Promotion Definition Activities of government and other agencies, including health services, to enable communities and individuals to increase control over and to improve their health – Includes but is broader than health education International Institute of Action is needed at a number of levels to support healthy lifestyles ‘to make the healthier choice the easier choice’ The Ottawa Charter (1986) defined health promotion and set out its key action areas The Charter was adopted at an international conference organised by WHO Ottawa Charter: 5 action areas for Health Promotion and Injury Prevention 1. Build healthy public policy e.g. include ‘health impact assessment’ when developing transport policy 2. Create supportive environments e.g. road design, cycle lanes, footpaths (sidewalks)  Ottawa Charter: 5 action areas for Health Promotion 3. Strengthen community action Collaboration between statutory & voluntary organizations e.g. advocacy for speed ramps 4. Support the development of personal skills traffic school for kids, driving tests, mass media campaigns  Ottawa Charter: 5 action areas for Health Promotion 5. Reorientation of the health services (1) Analyze health problems (2) Recognize and address barriers to change (3) Planning strategies to solve problems downstream action e.g. trauma networks – 15-25% reduction in mortality  Ottawa Charter: 5 action areas for health promotion and youth smoking prevention - QUIZ A. Build healthy public 1. Social, personal and policy health education in schools B. Create supportive environments 2. Smoke free playgrounds C. Strengthen community and cars action 3. Increase the number of D. Support the smoking cessation clinics development of personal skills 4. Bahrain Cancer Society, E. Reorientation of the Anti-smoking society health services 5. Advertising restriction, point of sale regulation  Ottawa Charter: 5 action areas for health promotion and youth smoking initiation 1. Build healthy public policy e.g. advertising restriction, point of sale regulation 2. Create supportive environments e.g. smoke free playgrounds and cars 3. Strengthen community action e.g. Bahrain Cancer Society, Anti-Smoking Society  Ottawa Charter: 5 action areas for health promotion 4. Support the development of personal skills Social, personal and health education in schools 5. Reorientation of the health services Increase the number of smoking cessation clinics  Influences on Policy Development  Non-governmental organisations can advocate for health but opposition from vested interests  Potential conflict of interest for governments & the European Union (EU)  Higher consumption of tobacco and alcohol = higher tax revenue  Government & tourist sector keen to keep down costs for visitors  EU wants to promote industry, including alcohol, and can consider high taxes as barrier to trade. Example of Lobbying against public health policy Introduction of plain packaging of tobacco products in Ireland: JTI (a tobacco trade association in Ireland) involved in lobbying. – Sophisticated website: http://www.theplainfacts.ie/the-impact/impact-retailers/ Pressure on Irish government by US trade organisations – Argued that plain packaging interferes with rights of companies to use the intellectual property of their brands and interferes with international trade Tobacco industry concerned that if introduced in Ireland, other governments will follow…. “nanny state” – Other industries e.g. sugar producers, chocolate manufacturers Example of lobbying against public health policy https://www.youtube.com/watch?v=s3eeTjK0q ZY  Role and Challenges in health promotion in health services Roles: Advocate for changes to policy as described Contribute to improvements in health service settings; e.g. CT Surgeon and Cardiologist drives Tobacco Free Campus in University Teaching Hospital Challenges: Competing roles - care of the sick consumes much of the time and resources of health professionals Health sector has limited resources compared to other sectors e.g. commercial organisations  Conclusions (1) Behaviours which affect health are influenced by a person’s economic, physical and social environment, as well as by genetic factors, as also demonstrated in Health Behaviour course Actions outside the control of the individual are required to maintain healthy lifestyles or to change behaviour to improve health outcomes requires  Conclusions (2) To maintain health or reduce risk of illness requires intervention across the five action areas for health promotion: – Policy, environment, community, education, health services Health promotion proposals can be subject to strong lobbying by industry To be effective, health promotion programmes require planning, to identify the topic & messages, target population groups & settings Evaluation provides information for planning Health professionals can be advocates and lead change There are however challenges for health professionals in balancing their time and other resources between clinical and advocacy roles  Additional Resources Tobacco Control History in Bahrain https://applications.emro.who.int/emhj/1303/13_3_2007_719_726.pdf Ottawa Charter and Health Promotion https://www.youtube.com/watch?v=G2quVLcJVBk Social Determinants of Health https://www.youtube.com/watch?v=ES1IX3Mam20 https://www.youtube.com/watch?v=qykD-2AXKIU WHO sites: http://www.who.int/topics/health_promotion/en/ http://www.who.int/healthpromotion/conferences/previous/ottawa/en/ Geoffrey Rose – Sick individuals and sick populations http://apps.who.int/iris/bitstream/10665/70950/1/bu1409.pdf Acknowledgement: Some of the lecture material is produced by Prof. Emer Shelley  Questions? Discussion Forum on VLE E-mail: [email protected] THANK YOU 27