health promotion

[John]

Health Promotion

Health promotion is part of Public Health/Primary Health Care.

How is it different from Health Education?

References

 

•       Wass,A. (2000) Ch. 1 Health Promotion in Context: Primary Health care and the new public health..In: Promoting Health. The Primary health Care Approach.  (Book Readings Pgs.61-67. MUST KNOW.

•       Jakarta Declaration on Health Promotion into the 21st Century (In Wass Chapter above), ) MUST KNOW

•       Ottawa Charter For Health Promotion (In Wass Chapter above)) MUST KNOW

•       Naidoo, J & Wills, J (2000) Health Promotion Foundations for Practice, Bailliere Tindall: London

•       McMurray, A. (2003). Ch 4. The Evolution of Community Health Promotion. In: Community Health and Wellness. A sociological approach. Sydney . Mosby. Pgs.76-77 and 78-81 MUST KNOW

•       See Book of Readings pg.128-141 for examples of health promotion topics.

•       Green Prescription pg. 142-143)

•       Best Practice Smoking Cessation. 144-149)

•           The Other Glass Ceiling (women and alcohol in NZ (Listener 2002)

•       Obesity  fuels Tragedy  (diabetes) NZ Kids

•       Cervical  Cancer Audit.

Definition

Health promotion is the process of enabling people to increase control over, and to improve , their health.

 

Empowerment cardinal (main) principle of health promotion.

5 Key Principles for Health Promotion (WHO)

•              Population as a whole in the context of their everyday life, rather than focus on people at risk for specific diseases

•              Directed towards actions on the determinants of health to ensure total environment is conducive to health

•              Combines diverse complimentary approaches

•              Aims at effective public participation supporting the principle of self-help movements

•              Health professionals have an important role nurturing and enabling health promotion

Settings for Health Promotion

•      Communities

•      Homes and families

•      Schools (see Health Promoting Schools in Bk Readings).

•      Workplaces

•      Hospitals

•      Clinics

Principles of Health Promotion as developed in Ottawa Charter (1986)

•     Build healthy public policy

•     Create supportive environments

•     Strengthen community action

•     Develop personal skills

•      Reorient health services

(see pg. 62 Bk Readings).

Build Healthy Public Policy

•      Characterised by an explicit concern for health and equity in all areas of policy and by accountability for health impacts

•      Example:Read pg. 139 Bk Readings. Case Study Fairburn School, Otahahu

Create Supportive Environments

•      Socio-ecological approach health

•      Reciprocal maintenance- to take care of our communities and natural environment (a focus of your clinical project)

•      living and working conditions that are safe, stimulating, satisfying and enjoyable

•      Example: Read Pg. 138. Case Study: Clendon Park School, Manurewa.

 

Strengthen Community Action

•      Empowerment of communities through concrete and effective community action in setting priorities, making decisions, planning strategies and implementing them to achieve better health (see Waitakere Well-being Project)

•      Community action principles - self determination, capacity building, developing social cohesion, building social support, positive health and wellbeing outcomes

•      Example: Read Pg. 141, Case Study. Bk Readings: Safe Waitakere, West Auckland….and Waitakere Wellness Project for local examples).

Develop Personal Skills

•      Personal and social development through providing information, education for health and enhancing life skills

•      Facilitated in school, home, work and community settings

•      Example: pg. Russell Primary School, Northland. They instituted an anti bullying programme. Began with local Public Health Nurse. Did course in anti bullying. Got ‘buy in’ from the school. Now teachers have done cse and is school policy.

•      Each person (staff and students)is taught peaceful conflict resolution.

Reorient Health Services

•     Away from treatment and care and improving access to health services

•     health promotion direction

•     retrain health professionals in health promotion approach

•     Example: Read pg. 140 Bk Readings: Wesley Primary School, Auckland Central

 

Health Promotion Aims

Health promotion aims to improve the health of communities through an organised effort, based on:

•      Advocacy for public health policies and supportive environments

•      Enabling communities and individuals to achieve their full health potential

•      Mediating between different interests in society for the pursuit of health

Health  promotion makes a difference

•      Comprehensive approaches to health are most effective. Combination of 5 strategies most effective

•      Settings ( cities, local communities, schools, workplace and health care facilities ) offer practical opportunities for the implementation of comprehensive strategies

 

Continued

•      Participation is essential to sustain efforts. People have to be at the centre of health promotion action and decision making processes for ti to be effective

•      Health learning fosters participation. Access to education and information is essential to achieving effective participation and the empowerment of people and communities.

•      But is some criticism. (Take own notes)

What is Health Education?
Is it the same as Health Promotion?

•       “Health Education is any planned educational intervention that is aimed at the voluntary actions people can take to look after their own health or the health of others”(Green and Kreuter 1991, cited McMurray, 2002, p24).

•       It is a part of Health Promotion, but the focus is more on the individual or group rather than populations.

•       Can be Individual, group or community focus.

•       In your clinical experience, you will research and present an educational session to your peers.

•       Read pg. 25-26. McMurray (2003). Health Education (Homework).

Elements Crucial to Good Health Education

Careful planning with respect to:

n           audience,

n           timing,

n           setting,

n           credibility of educator and

n           method of eval‎uation.

Must be educational:

Focus on voluntary change, no coercion, client must

able to make informed choice.

(Use this guide your Group Health Education Session…part of your Clinical Project, and the handout I will give you).

 

 

Empowerment the most important Value and Principle of Health Promotion

Has Two elements. (Know this very well-is important)

n          Social:

•             Gained through participation and working together

•             Influencing policy and decisions

•             Getting a collective sense of control

n          Psychological

•             A felt sense of power and control

•             Developing peoples capacities

•             Feeling and being well through own efforts.

 

 

Linking Health Education, Health Promotion, Population Health and the Ottawa Charter

•      See OHT Table 1: Some Activities used to improve individual and population health.

•      You can download your own copy. Go to MOH Website (see Green Card) Search.

•      Type in Public Health in a Primary Health Care Setting.

•      View pg 8 for this diagram.

What is the NZ MOH position of HP in 2003? What infrastructures has it put in place? (Example)

•      Dec 2002 Public Health Directorate released: A Guide to Developing Health Promotion Programmes in Primary Health Care Settings.(a working document)

•      States: Health promotion is a fundamental aspect on PHC Strategy and will contribute to a population health focus in primary care (pg. 4)

 

 

 

Health Promoting Schools: An excellent example of Health Promotion

•      See Readings in Book Of Readings.

Lec 7. Ethical Issues in Health Promotion

•      Beneficence ( doing good)

•      Non- maleficence ( doing no harm)

•      Autonomy

•      Justice and equity

•      Telling the truth

•      You will examine these more in the next session. Read pgs.160-178)

(Good preparation for Exam).

Tutorial.

•             Listen to Scenario re Media Violence and its effects on children and youth.

•             3 Key negative consequences of children’s viewing of media violence empirically identified:

n          Increase in violent behaviour

n          Distorted perceptions of reality

n          A toleration of ‘real-life aggressive behaviours.

(supported by the American Academy of Pediatrics, the American medical Association, and the American Psychological Association).

Group Work. Using the 5 strategies of the Ottawa Charter, examples from Bk Readings and McMurray to inform you, complete the following:

•              Each Group is to consider the central value of empowerment, and brain storm strategies to address this significant child/health problem.

n           Public policy

n           Create supportive environments

n           Strengthen community action

n           Develop personal skills

n           Reorientate the Health Services.

n           You have 25 mins to brainstorm, and 5 minutes for feedback (each group 25+25 =50 mins)

 

Study Guide

•       Complete the Readings for this lecture.

•       Do a mind map of the 5 strands of the Ottawa Charter

•       For each strand, tabulate at least 3 examples from your own group study and those of your classmates, the examples presented in this lecture, the Health Promoting Schools Workshop and from Ch.6 Healthy Adolescents pg 157-163 McMurray (2002).

•       Define in your own words, health promotion, health education and empowerment.

•       Using Seedhouse’s ethical grid, work through two of the scenarios in Ch 6 Ethical issues in health promotion,pgs. 200-216