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  • Indian J Community Med
  • v.37(1); Jan-Mar 2012

Health Promotion: An Effective Tool for Global Health

Sanjiv kumar.

International Institute of Health Management Research, New Delhi, India

Health promotion is very relevant today. There is a global acceptance that health and social wellbeing are determined by many factors outside the health system which include socioeconomic conditions, patterns of consumption associated with food and communication, demographic patterns, learning environments, family patterns, the cultural and social fabric of societies; sociopolitical and economic changes, including commercialization and trade and global environmental change. In such a situation, health issues can be effectively addressed by adopting a holistic approach by empowering individuals and communities to take action for their health, fostering leadership for public health, promoting intersectoral action to build healthy public policies in all sectors and creating sustainable health systems. Although, not a new concept, health promotion received an impetus following Alma Ata declaration. Recently it has evolved through a series of international conferences, with the first conference in Canada producing the famous Ottawa charter. Efforts at promoting health encompassing actions at individual and community levels, health system strengthening and multi sectoral partnership can be directed at specific health conditions. It should also include settings-based approach to promote health in specific settings such as schools, hospitals, workplaces, residential areas etc. Health promotion needs to be built into all the policies and if utilized efficiently will lead to positive health outcomes.

Introduction

Health promotion is more relevant today than ever in addressing public health problems. The health scenario is positioned at unique crossroads as the world is facing a ‘triple burden of diseases’ constituted by the unfinished agenda of communicable diseases, newly emerging and re-emerging diseases as well as the unprecedented rise of noncommunicable chronic diseases. The factors which aid progress and development in today's world such as globalization of trade, urbanization, ease of global travel, advanced technologies, etc., act as a double-edged sword as they lead to positive health outcomes on one hand and increase the vulnerability to poor health on the other hand as these contribute to sedentary lifestyles and unhealthy dietary patterns. There is a high prevalence of tobacco use along with increase in unhealthy dietary practices and decrease in physical activity contributing to increase in biological risk factors which in turn leads to increase in noncommunicable diseases (NCD).( 1 – 3 ) Figure 1 below illustrates how lifestyle-related issues are contributing to increase in NCDs.( 4 ) The adverse effects of global climate change, sedentary lifestyle, increasing frequency of occurrence of natural disasters, financial crisis, security threats, etc., add to the challenges that public health faces today.

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Illustration of how lifestyle-related issues contribute to increase in noncommunicable diseases( 4 )

Health, as the World Health Organization (WHO) defines, is the state of complete physical, social and mental well being and not just the absence of disease or infirmity. The enjoyment of highest attainable standard of health is considered as one of the fundamental rights of every human being.( 5 ) Over the past few decades, there is an increasing recognition that biomedical interventions alone cannot guarantee better health. Health is heavily influenced by factors outside the domain of the health sector, especially social, economic and political forces. These forces largely shape the circumstances in which people grow, live, work and age as well as the systems put in place to deal with health needs ultimately leading to inequities in health between and within countries.( 6 ) Thus, the attainment of the highest possible standard of health depends on a comprehensive, holistic approach which goes beyond the traditional curative care, involving communities, health providers and other stakeholders. This holistic approach should empower individuals and communities to take actions for their own health, foster leadership for public health, promote intersectoral action to build healthy public policies and create sustainable health systems in the society. These elements capture the essence of “health promotion”, which is about enabling people to take control over their health and its determinants, and thereby improve their health. It includes interventions at the personal, organizational, social and political levels to facilitate adaptations (lifestyle, environmental, etc.) conducive to improving or protecting health.( 1 , 2 )

Health Promotion: Historical Evolution

Health promotion is not a new concept. The fact that health is determined by factors not only within the health sector but also by factors outside was recognized long back. During the 19 th century, when the germ theory of disease had not yet been established, the specific cause of most diseases was considered to be ‘miasma’ but there was an acceptance that as poverty, destitution, poor living conditions, lack of education, etc., contributed to disease and death. William Alison's reports (1827-28) on epidemic typhus and relapsing fever, Louis Rene Villerme's report (1840) on Survey of the physical and moral conditions of the workers employed in the cotton, wool and silk factories John Snow's classic studies of cholera (1854), etc., stand testimony to this increasing realization on the web of disease causation.

The term ‘Health Promotion’ was coined in 1945 by Henry E. Sigerist, the great medical historian, who defined the four major tasks of medicine as promotion of health, prevention of illness, restoration of the sick and rehabilitation. His statement that health was promoted by providing a decent standard of living, good labor conditions, education, physical culture, means of rest and recreation and required the co-ordinated efforts of statesmen, labor, industry, educators and physicians. It found reflections 40 years later in the Ottawa Charter for health promotion. Sigerist's observation that “the promotion of health obviously tends to prevent illness, yet effective prevention calls for special protective measures” highlighted the consideration given to the general causes in disease causation along with specific causes as also the role of health promotion in addressing these general causes. Around the same time, the twin causality of diseases was also acknowledged by J.A.Ryle, the first Professor of Social Medicine in Great Britain, who also drew attention to its applicability to non communicable diseases.( 7 )

Health education and health promotion are two terms which are sometimes used interchangeably. Health education is about providing health information and knowledge to individuals and communities and providing skills to enable individuals to adopt healthy behaviors voluntarily. It is a combination of learning experiences designed to help individuals and communities improve their health, by increasing their knowledge or influencing their attitudes, whereas health promotion takes a more comprehensive approach to promoting health by involving various players and focusing on multisectoral approaches. Health promotion has a much broader perspective and it is tuned to respond to developments which have a direct or indirect bearing on health such as inequities, changes in the patterns of consumption, environments, cultural beliefs, etc.( 3 )

The ‘New Perspective on the Health of Canadians’ Report known as the Lalonde report, published by the Government of Canada in 1974, challenged the conventional ‘biomedical concept’ of health, paving way for an international debate on the role of nonmedical determinants of health, including individual risk behavior. The report argued that cancers, cardiovascular diseases, respiratory illnesses and road traffic accidents were not preventable by the medical model and sought to replace the biomedical concept with ‘Health Field concept’ which consisted of four “health fields”-lifestyle, environment, health care organization, human biology as the determinants of health and disease. The Health Field concept spelt out five strategies for health promotion, regulatory mechanisms, research, efficient health care and goal setting and 23 possible courses of action. Lalonde report was criticized by skeptics as a ploy to stem in the governments rising health care costs by adopting health promotion policies and shifting responsibility of health to local governments and individuals. However, the report was lapped up internationally by countries such as USA, UK, Sweden, etc., who published similar reports. The landmark concept also set the tone for public health discourse and practice in the decades to come.( 7 – 10 ) Health promotion received a major impetus in 1978, when the Alma Ata declaration acknowledged that the promotion and protection of the health of the people was essential to sustained economic and social development and contributed to a better quality of life and to world peace.( 5 )

Conferences on Health Promotion

Growing expectations in public health around the world prompted WHO to partner with Canada to host an international conference on Health Promotion in 1986. It was held in Ottawa, and produced not only the “Ottawa Charter for Health Promotion” but also served as a prelude to subsequent international conferences on health promotion. The Ottawa Charter defined Health Promotion as the process of enabling people to increase control over and to improve their health. To reach a state of complete physical, mental and social well being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. The fundamental conditions and resources for health are: peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice and equity. Health promotion thus is not just the responsibility of the health sector, but goes beyond healthy lifestyles to well being. The Charter called for advocacy for health actions for bringing about favorable political, economic, social, cultural, environmental, behavioral and biological factors for health, enabling people to take control of the factors influencing their health and mediation for multi sectoral action. The Charter defined Health Promotion action as one a) which builds up healthy public policy that combines diverse but complementary approaches including legislation, fiscal measures, taxation and organizational change to build policies which foster equity, b) create supportive environments, c) support community action through empowerment of communities - their ownership and control of their own endeavors and destinies, d) develop personal skills by providing information, education for health, and enhancing life skills and e) reorienting health services towards health promotion from just providing clinical and curative services.( 11 )

This benchmark conference led to a series of conferences on health promotion - Adelaide (1988), Sundsvall (1991), Jakarta (1997), Mexico-City (2000), Bangkok (2005) and Nairobi (2009). In Adelaide, the member states acknowledged that government sectors such as agriculture, trade, education, industry and communication had to consider health as an essential factor when formulating healthy public policy. The Sundsvall statement highlighted that poverty and deprivation affecting millions of people who were living in extremely degraded environment affected health. In Jakarta too poverty, low status of women, civil and domestic violence were listed as the major threats to health. The Mexico statement called upon the international community to address the social determinants of health to facilitate achievement of health-related millennium development goals. The Bangkok charter identified four commitments to make health promotion (a) central to the global development agenda; (b) a core responsibility for all governments (c) a key focus of communities and civil society; and (d) a requirement for good corporate practice.( 12 , 13 ) The last conference in October 2009 in Nairobi called for urgent need to strengthen leadership and workforce, mainstream health promotion, empower communities and individuals, enhance participatory processes and build and apply knowledge for health promotion.

The health promotion emblem [ Figure 2 ] adopted at the first international conference on health promotion in Ottawa and evolved at subsequent conferences symbolizes the approach to health promotion. The logo has a circle with three wings. It incorporates five key action areas in health promotion (build healthy public policy, create supportive environments for health, strengthen community action for health, develop personal skills and reorient health services) and three basic HP strategies (to enable, mediate and advocate).

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Health promotion emblem

  • The outer circle represents the goal of “Building Healthy Public Policies” and the need for policies to “hold things together”. This circle has three wings inside it which symbolise the need to address all five key action areas of health promotion identified in the Ottawa Charter in an integrated and complementary manner.
  • The small circle stands for the three basic strategies for health promotion, “enabling, mediating, and advocacy”.
  • The three wings represent and contain the words of the five key action areas for health promotion – reorient health services, create supportive environment, develop personal skills and strengthen community action.( 14 )

True to its recognition of health being more influenced by factors outside the health sector, health promotion calls for concerted action by multiple sectors in advocacy, financial investment, capacity building, legislations, research and building partnerships. The multisectoral stakeholder approach includes participation from different ministries, public and private sector institutions, civil society, and communities all under the aegis of the Ministry of Health.( 3 )

Approaches to Health Promotion

Health promotion efforts can be directed toward priority health conditions involving a large population and promoting multiple interventions. This issue-based approach will work best if complemented by settings-based designs. The settings-based designs can be implemented in schools, workplaces, markets, residential areas, etc to address priority health problems by taking into account the complex health determinants such as behaviors, cultural beliefs, practices, etc that operate in the places people live and work. Settings-based design also facilitates integration of health promotion actions into the social activities with consideration for existing local situations.( 3 )

The conceptual framework in Figure 3 below summarizes the approaches to health promotion. It looks at the need of the whole population. The population for any disease can be divided into four groups a) healthy population, b) population with risk factors, c) population with symptoms and d) population with disease or disorder. Each of these four population groups needs to be targeted with specific interventions to comprehensively address the need of the whole population. In brief, it encompassed primordial prevention for healthy population to curative and rehabilitative care of the population with disease. Primordial prevention aspires to establish and maintain conditions to minimize hazards to health. It consists of actions and measures that inhibit the emergence and establishment of environmental, economic, social and behavioral conditions, cultural patterns of living known to increase the risk of disease.( 15 )

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Conceptual framework for health promotion

Examples of Health Promotion in Communicable and Non-communicable Diseases

Health promotion measures are often targeted at a number of priority disease – both communicable and noncommunicable. The Millennium Development Goals (MDGs) had identified certain key health issues, the improvement of which was recognized as critical to development. These issues include maternal and child health, malaria, tuberculosis and HIV and other determinants of health. Although not acknowledged at the Millennium summit and not reflected in the MDGs, the last two decades saw the emergence of NCD as the major contributor to global disease burden and mortality. NCDs are largely preventable by effective and feasible public health interventions that tackle major modifiable risk factors - tobacco use, improper diet, physical inactivity, and harmful use of alcohol. Eighty percent of heart diseases and stroke, 80% of diabetes and 40% of cancers can be prevented by eliminating common risk factors, namely poor diet, physical inactivity and smoking.( 16 ) Against this background health promotion as the “the science and art of helping people change their lifestyle to move toward a state of optimal health” is a key intervention in the control of NCDs. The following paragraphs showcase the application of an issue based approach of health promotion, using communicable and NCDs as examples capturing the components of individual and community empowerment, health system strengthening and partnership development.

Communicable Diseases

These diseases can be adequately addressed through health promotion approach. Here is one example:

Improving use of ITNs to prevent malaria: Insecticide-treated bed-nets (ITNs) are recommended in malaria endemic areas as a key intervention at the individual level in preventing malaria by preventing contact between mosquitoes and humans. (a) The individual level health promotion action would include providing access to ITNs and encouraging their regular and proper use every night from dusk to dawn. Available evidence points to the fact that this can be best achieved by social marketing campaigns to promote demand of ITNs. The messages should be tailored to cultural beliefs, for example the belief in some communities that mosquitoes have no role in the etiology of malaria. Distribution of ITNs to the community should ideally be followed by ‘hang up’ campaigns by trained health care workers educating the community on how to use the nets and helping them hang the nets, especially for the most vulnerable groups. (b) The community empowerment efforts, a collaborative initiative with the community to understand the cultural beliefs and behaviours and educating them about the disease would produce desirable results. There are documented examples of how women in a community empowerment program in Thailand developed family malaria protection plans, provided malaria education to community members, mosquito-control measures in a campaign, scaled-up use of insecticide-impregnated bed nets, instituted malaria control among migrant labourers, as well as activities to raise income for their families. Another program in Papua New Guinea empowered community members to take responsibility for the procurement, distribution and effective use of bed nets in the village, which led to a significant decrease in the incidence of malaria-related mortality and morbidity. (c) Strengthen health systems, integration of malaria vector control and personal protection into the health system through innovative linkages to ongoing health programs and campaigns is likely to lead to strong synergies, economies, and more rapid health system strengthening compared to new vertical programmes.. Successful examples of this include piggybacking the distribution of ITNs through antenatal care or immunization campaigns for measles and polio. (d) Partnerships are key in malaria control because of the involvement of multiple sectors. Action outside the health sector to remove barriers to the uptake of malaria prevention strategies has included lobbying for reduction or waiver of taxes and tariffs on mosquito nets, netting materials and insecticides and stimulating local ITN industries. Intersectoral collaboration has played an integral role in vector control measures for malaria prevention, including environmental modification, larval control, etc.( 17 )

Noncommunicable Diseases

In NCDs, two path-breaking studies need special mention. These studies are the Framingham Heart Study (started in 1951) and study on smoking among British doctor (started in 1948) have helped us in understanding how lifestyle affects various NCDs. The study in British doctors showed that prolonged cigarette smoking from early adult life tripled age-specific mortality. The excess mortality associated with smoking mainly involved vascular, neoplastic and respiratory diseases caused by smoking. The Framingham Heart Study has led to the identification of major CVD risk factors such and blood pressure, blood triglycerides and cholesterol level, age, gender and psychosocial issues (Framingham Heart Study).( 18 )

Cardiovascular Diseases

In the early 1970s the mortality rate from coronary heart disease was the highest in the world among men of Finland. The dietary practices of the Finnish population centered around dairy products and their food was rich in saturated fats, salt and low in unsaturated fats, fruits and vegetables. The North Karelia project, a major community-based intervention was launched in North Karelia, a fairly rural and economically poor province. This project developed comprehensive community based strategies to change the dietary habits of the population, with the main goal to reduce the high cholesterol levels in the population. The strategy focused on reduction intake of high saturated fat as well as the salt intake and to increase the consumption of fruits and vegetables. At the individual and community level, health information and nutritional counseling were made available, skills were developed, social and environmental support was provided all the while ensuring community participation. The health system was closely involved with the project. The project also developed strong partnerships with schools, health related and other nongovernmental organizations, supermarkets and food industry, community-based organizations and media. Collaborations were done with the food industry to reduce the fat and salt content of common food items such as dairy food, processed meat and bakery items. Dairy farmers were encouraged to switch to berry farming through the launching of a Berry project. The North Karelia project was extended to the entire country with the health care services also responsible along with schools and nongovernmental agencies in implementing nutrition and health education. Nation-wide nutrition education and collaboration with food industry were backed by legislative actions and were rewarded with remarkable results. Surveys showed a transformation in dietary habits with a marked reduction intake in saturated fats and salt and declared ischemic heart disease mortality declining by 73% in North Karelia and by 65% in Finland from 1971 to 1995.( 19 )

Diabetes Mellitus

Diabetes mellitus is one of the NCDs which has led to high rates of morbidity and mortality worldwide. Health promotion is being increasingly recognized as a viable, cost-effective strategy to prevent diabetes. The interventions at the individual and community level includes lifestyle modification programs for weight control and increasing physical activity with community participation using culturally appropriate strategies. The Kahnawake School's Diabetes Prevention Project (KSDPP) in Canada provides an example of a project that involved the local Mohawk community, researchers and local health service providers, in response to requests from the community to develop a diabetes prevention program for young children. The long-term goal of KSDPP was to decrease the incidence of type 2 diabetes, through the short-term objectives of increasing physical activity and healthy eating. Such preventive interventions have to be backed by strengthening of the health system which combines identification of high risk groups with risk factor surveillance and availability of trained primary health care providers for risk assessment and diabetes management. Online training courses offer an innovative approach to enhance health system capacity for diabetes health promotion, such as a course targeted at workers in remote indigenous communities in the Arctic to foster learning related to the Nunavut Food Guide, traditional food and nutrition, and diabetes prevention. Partnership and network development is key to the achievement of these measures. As part of the city-wide ‘Let's Beat Diabetes initiative’ in South Auckland, New Zealand the district health board with support from local government provided safe environments for physical activity by upgrading parks and worked with the food industry to provide healthier food options at retail outlets in order to reduce consumption of sweetened soft drinks and energy dense foods. Sugar-free soft drinks were made available as default options to customers, unless specifically requested otherwise. Intersectoral action on risk factors for diabetes also acts on the determinants of the other major risk factors for the NCD burden, such as heart disease, cancer and respiratory disease, hence health promotion activities aimed at reducing risk of diabetes mellitus have added advantages.( 17 )

Settings Based Approach to Health Promotion

The concept of ‘healthy settings’ which maximizes disease prevention through a whole system approach had emerged from WHO's Health for All strategy and Ottawa Charter. The call for supportive environments was followed up by the Sundwal statement of 1992 and the Jakarta declaration of 1997. The settings approach builds on the principles of community participation, partnership, empowerment and equity and replaces an over reliance on individualistic methods with a more holistic and multidisciplinary approach to integrate action across risk factors. The ‘Healthy Cities’ programme launched by WHO in 1986 was soon followed up by similar initiatives in smaller settings such as schools, villages, hospitals, etc.( 20 )

Health Promoting Schools

Health promoting schools build health into all aspects of life in school and community based on the consideration that health is essential for learning and development. To further this concept, WHO and other UN agencies developed an initiative, ‘Focusing Resources on Effective School Health (FRESH), emphasizing on the benefit to both health and education if all schools were to implement school health policies, a healthy school environment, with the provision of safe water and sanitation an essential first step, skills-based health education and school-based health and nutrition services.( 21 )

Healthy Work Places

Currently, globally an estimated two million people die each year as a result of occupational accidents and work-related illnesses or injuries and 268 million nonfatal workplace accidents result in an average of three lost workdays per casualty, as well as 160 million new cases of work-related illness each year.( 22 ) Healthy work places envision building a healthy workforce as well as providing them with healthy working conditions. Healthy working environments translate to better health outcomes for the employees and better business outcomes for the organizations.( 23 )

Health Promotion in India

Health promotion is strongly built into the concept of all the national health programs with implementation envisaged through the primary health care system based on the principles on equitable distribution, community participation, intersectoral coordination and appropriate technology. Nevertheless, it has received lower priority compared to clinical care. The government, through the component of IEC has always strived to address the issue of lack of information, which is a major barrier to increasing accessibility of health care services.( 24 ) The National Rural Health Mission (NRHM) called for a synergistic approach by relating health to determinants of good health such as segments of nutrition, sanitation, hygiene and safe drinking water and by revitalizing local traditions and mainstreaming the Ayurvedic, Unani, Siddha and Homeopathic systems of medicine to facilitate health care.( 25 ) NRHM offers an excellent opportunity to target and reach every beneficiary with appropriate interventions through microplanning into district planning process.( 26 )

Health promotion component needs to be strengthened with simple, cost-effective, innovative, culturally and geographically appropriate models, combining the issue-based and settings-based designs and ensuring community participation. Replicability of successful health promotion initiatives and best practices from across the world and within the country needs to be assessed. Efforts have already been initiated to build up healthy settings such as schools, hospitals, work places, etc.( 20 , 22 , 27 ) For effective implementation of health promotion we need to engage sectors beyond health and adopt an approach of health in all policies rather than just the health policy.

Conclusions

Today, there is a global acceptance that health and social well being are determined by a lot of factors which are outside the health system which include inequities due to socioeconomic political factors, new patterns of consumption associated with food and communication, demographic changes that affect working conditions, learning environments, family patterns, the culture and social fabric of societies; sociopolitical and economic changes, including commercialization and trade and global environmental change. To counter the challenges due to the changing scenarios such as demographic and epidemiological transition, urbanization, climate change, food insecurity, financial crisis, etc. health promotion has emerged as an important tool; nevertheless the need for newer, innovative approaches cannot be understated. A multisectoral, adequately funded, evidence-based health promotion program with community participation, targeting the complex socioeconomic and cultural changes at family and community levels is the need of the hour to positively modify the complex socioeconomic determinants of health.

Source of Support: Nil

Conflict of Interest: None declared.

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  • Section 12. Documenting Health Promotion Initiatives Using the PAHO Guide

Chapter 2 Sections

  • Section 1. Developing a Logic Model or Theory of Change
  • Section 2. PRECEDE/PROCEED
  • Section 3. Healthy Cities/Healthy Communities
  • Section 4. Asset Development
  • Section 5. Collective Impact
  • Section 6. The Institute of Medicine's Community Health Improvement Process (CHIP)
  • Section 7. Ten Essential Public Health Services
  • Section 8. Communities That Care
  • Section 9. Community Readiness
  • Section 10. The Strategic Prevention Framework
  • Section 11. Health Impact Assessment
  • Section 13. MAPP: Mobilizing for Action through Planning and Partnerships
  • Section 14. MAP-IT: A Model for Implementing Healthy People 2020
  • Section 15. The County Health Rankings & Roadmaps Take Action Cycle
  • Section 16. Building Compassionate Communities
  • Section 17. Addressing Social Determinants of Health in Your Community
  • Section 18. PACE EH: Protocol for Assessing Community Excellence in Environmental Health
  • Main Section

Introduction: What is Health Promotion?

Health promotion is defined by the World Health Organization (WHO) as “a process of enabling people to increase control over their health.”  This idea is put into practice using participatory approaches; individuals, organizations, communities, and institutions working together to create conditions that assure health and well-being for all.

In its simplest terms, health promotion fosters changes in the environment that help promote and protect health. These include changes in communities and systems—for instance, programs that assure access to health services or policies that arrange for public parks for physical activity and spending time with others.

Health promotion involves a particular way of working together. It is:

  • Population-based :  Health promotion considers health in terms of the whole population ; that is, all the people who share the place, such as a municipality or region, or experience such as being young or poor or at risk for a particular outcome.
  • Participatory : Health promotion involves the collaboration of all community stakeholders in the selection, planning , implementation, evaluation, and maintenance of health-promoting interventions, policies, and conditions.
  • Intersectoral : Health promotion engages all sectors or parts of the community – individual citizens, business, governmental institutions, faith communities, and non-governmental organizations such as health and human service organizations, social and cultural organizations, etc. – in making health-promoting changes in their programs, policies, and practices .
  • Sensitive to Context : Health promotion takes into account all relevant aspects of the place and time; including the history , demographics, past experience, geography , culture , politics, economics, social structure, and other important factors.
  • Multi-level :  Health promotion operates at many different levels – individual and relationship, organizational, community, and broader system – to achieve population-health goals.

The ultimate goal of health promotion is the continued improvement of health-related conditions and status in the entire population, with a particular emphasis on the needs of the most marginalized or excluded members of the community.

Social Determinants of Health—Ottawa Charter and the WHO Commission on Social Determinants of Health A WHO conference in Ottawa, Canada in 1986 adopted the Ottawa Charter, a document that recognizes that health is not the product simply of medical or other conditions directly related to health, but that it is a comprehensive issue, determined by a complex of social and environmental factors. The Ottawa Charter spelled out these social determinants of health: Peace Shelter  Education  Food  Income  A stable ecosystem  Sustainable resources  Social justice  Equity In its final report in 2008, the WHO Commission on Social Determinants of Health focused attention on several key social determinants that lead to inequities or unfair and avoidable differences in health outcomes: Unequal distribution of power, income, goods and services : Some groups of people—for instance, the poor, women, and others of lower social status—have unequal exposures to stressors and health-damaging experiences. Social exclusion or marginalization : Some groups of people—for example, indigenous peoples or those experiencing discrimination—have unequal access to social and material support to buffer the effects of stressful conditions. To promote health equity, the WHO Commission recommends: Improving daily living conditions: This involves assuring early childhood education and schooling, including for girls and others denied access. It also involves reducing exposures to harsh conditions, such as environmental toxins and the daily stressors of poor housing, violence, and other living conditions. Assuring mechanisms of social protection: This requires that governments adopt policies and build systems that allow a healthy standard of living for everyone. Health promotion works on the principle that population health is a product not only of addressing specific health needs, such as assuring primary health care, but also of addressing these broader social determinants . This principle underlies the concept of health promotion, the Guide, and the work of PAHO and other regional offices of the World Health Organization.

What is evidence of health promotion's effectiveness?

In this context, “evidence” refers to an indication that efforts to promote health are working. establishing an evidence base for health promotion can be a particular challenge:.

  • Health promotion initiatives are difficult to document : Health promotion engages multiple partners at multiple levels in changing the programs, policies and practices that affect health. It can be challenging to document what is being done to improve health.
  • Their complexity makes it hard to see causes and effects : Since multiple factors affect multiple and interrelated outcomes, it is challenging to establish what aspects of a particular initiative resulted in particular outcomes. In this context, evidence may take the form of showing the contribution of multiple environmental changes—such as new programs policies, and practices—on related population-health outcomes.
  • Much promising work in developing countries/communities is never documented : The research literature consists largely of reports of work in more affluent countries by researchers who have greater access to resources for research.Thus, many promising health promotion efforts in lower-income communities/ countries are not publicly available.
Global Programme on Health Promotion Effectiveness (GPHPE) With support from the World Health Organization, the International Union for Health Promotion and Education (IUHPE) launched the GPHPE in 2001. This project has engaged teams throughout the world—including the Working Group of the PAHO Regional Initiative to Evaluate the Effectiveness of Health Promotion—in developing and implementing methods to extend the evidence base. This PAHO Guide for documenting health promotion initiatives is one of the tools resulting from that effort.

What is the PAHO Guide for Documenting Health Promotion Initiatives?

The PAHO Documentation Guide's primary purpose is to create a simple, standard format to help support documentation of health promotion initiatives . Use of the PAHO Guide will expand available indications about whether and how efforts are working to create conditions that promote health and health equity.

The PAHO Documentation Guide is in the form of a seven-part questionnaire, asking for information about the health promotion effort.  (For a copy of the PAHO Documentation Guide, please see Tool #1.)

Much promising health promotion work in the Americas is not documented and the effects of such efforts are not analyzed. The aim of the PAHO Guide is to expand available information on how they are working, including in parts of the world with limited resources for research. Use of the Guide will assist in: (a) describing the health promotion efforts taking place in the Americas and other WHO regions; and (b) analyzing the processes used to promote health that can then be shared with others around the world.

The Guide should also be of benefit to those using it. Systematic reflection on practice can lead to the refinement of methods and new ideas for improving the initiative . Engaging community partners as participants in the documentation can contribute to better understanding of what happened, as well as enhanced efficacy or influence among those giving meaning to the effort. Establishing a clear record of what happened , and with what results, can make it more likely that others will help sustain valuable efforts.

Answering the questions posed in the Guide might take some time and thought, but it will be time and thought well spent.  Ultimately, the widespread documentation should contribute to understanding of health promotion initiatives among funders and policy makers, the experience using the Guide should help organizations improve their efforts as well as gain recognition and funding, and documented examples will serve as practical examples which can inform similar initiatives in other countries.

Why should you use the Guide?

Answering the questions in the PAHO Documentation Guide will take time for those involved in the initiative, including interviews with stakeholders who have a perspective on the effort. You are busy enough already trying to support this and other activities, so why take the time to create this record of your health promotion initiative?

There are, in fact, a number of good reasons to use the Guide, including:

  • Using the Guide will contribute to an evidence base that will help advance the field of health promotion . Improved policies and practice based on this knowledge could help make life better for millions of people throughout the world.
  • Using the Guide will contribute to better understanding about what is successful in Latin America and expose the rest of the world to significant health promotion practices in Latin America.
  • Contributing information through use of the guide will allow you to connect with others in the field , both in your own and other countries.
  • By involving community partners through participatory action research , you can empower participants in your initiative , and engage them in learning new skills.
  • Use of the Guide will result in a careful analysis of your effort , help you to better understand your strengths and pinpoint areas to improve , and thereby make your work more effective.
  • Documentation will make it possible to communicate what you have accomplished to others, perhaps through websites or journal reports.  As a result, you have a chance to gain international recognition and credibility.
  • Describing the accomplishments of your effort can raise your group’s profile.That, in turn, could increase your possibilities for funding and other support.

Who should use the Guide?

The PAHO Health Promotion Documentation Guide is intended for use by any group conducting an initiative aimed at assuring conditions that promote health and health equity . Some documented efforts may be relatively small programs involving a few organizations in local municipalities, while others might cover whole states or provinces, or even whole nations.  Some efforts might target very specific cultural, racial, or ethnic groups, or groups at risk for particular health conditions, such as childhood immunization programs or efforts to promote physical activity or healthy nutrition to reduce risk for diabetes or cardiovascular diseases.

Some of the individuals, organizations, or institutions that might be conducting health promotion initiatives that would be appropriate for inclusion in the Guide include:

  • NGOs (non-governmental organizations) or CBOs (community-based organizations) engaged in health and/or human service work.
  • Local, state or provincial, or national health or human service agencies.
  • Ministers or Secretaries and ministries or departments of health at all levels.
  • Community health activists.
  • Healthy community, healthy school, and healthy workplace initiatives.
  • Faith based communities and or organizations.
  • Health Impact Assessment teams.
  • Environmental groups.
  • Individuals or organizations concerned with providing affordable housing for marginalized individuals and families, including those who are homeless or living in informal settlements.
  • Individuals or organizations working to improve health equity and to improve health and quality of life for marginalized individuals or families.
  • Those working to change living conditions; for instance, by assuring access to clean drinking water, decent housing, or sanitation

Who in the initiative organization should actually participate in the documentation ? It depends. If the work of health promotion initiatives was distributed among many different people – doing different tasks in different sectors of the community – then these key leaders should be involved in documenting and giving meaning to the effort . The dialogue may be facilitated by one or two people close to the effort. The reporter who completes the Guide may simply be an administrator or a good writer who gathers all the documentation from others and puts it in the appropriate form.  In a smaller organization or in a program or effort where one person has her finger on the pulse of the work, it may make the most sense for that person to complete the documentation.  In many cases, a combination of these methods might be used, with different people completing the parts of the documentation with which they are most familiar.

How do you use the Guide?

As explained earlier, the PAHO Documentation Guide takes the form of a questionnaire, rather than a manual. By answering the questions, and adding whatever material is necessary to fully describe and analyze your effort, you’ll create the documentation that will make it possible to demonstrate the effectiveness of your work. This will also allow others to reproduce what you did in their situation. In addition, it will help you to understand what you are doing well, and what you need to change to improve community health.

In this section, we’ll look at the questions the Guide asks to help you describe and document your work. The focus is on how to best answer the questions to pass on the information others might need to replicate (reproduce) it, and to get the most out of the process for your organization.

The Guide is divided into seven parts to obtain information on various aspects of the Health Promotion initiative. We’ll look at each of these parts separately.

CONTACT INFORMATION

This section focuses on documenting the sources of information.

  • Submission date : Date on which the questionnaire is being completed/submitted
  • Your contact information : Contact information of the person completing the questionnaire
  • Lead organization : Contact information for the organization that has primary responsibility for the initiative
  • Other partners : Contact information for other organizations, institutions, businesses, etc., involved in or supporting the initiative. The form facilitates five (5) responses. For additional information attach a separate sheet.

PROGRAMME/PROJECT/INITIATIVE SUMMARY

This section gathers basic information on the project and provides an overview of the initiative.

  • Title/Name of Initiative : By what name is the initiative known?
  • Purpose(s) or objective(s): What the initiative sets out to do, its main focus . For instance, this might be to increase access to physical activity opportunities, improve access to clean drinking water, reduce exposure to environmental toxins, to reduce highway injuries, increase participation in primary education, etc.
  •   Expected outcomes/results : What are the expected outcomes/results of the initiative (both the process and the product of the effort) as appropriate to the initiative .
  • Time frame for the initiative : Start date and end date are inserted using the calendar menu which comes up when each field is selected. If the initiative is ongoing and continuous enter the start date and check the ongoing/continuous box. There is a comment box for you to provide an explanation for the responses checked if necessary. This is optional.
  • Stage of implementation : Indicate what stage/phase of the initiative is being documented - start up, in progress, or completed.
  • Geographic coverage : Select the country in which the initiative is/has been implemented from the drop down field. Check each appropriate geographic division – province/state/region, etc. in which the programme is being implemented and insert in the text field the name(s) of the geographic division.
  • Setting:  This might include school, community, workplace, etc. where the initiative is being/was conducted. Using the check boxes, check the appropriate setting, check more than one if applicable and state additional setting(s) if appropriate option is not available.
  • Brief description: In narrative form, describe the initiative in not more than 300 words (space limited to one page). This is meant to be a summary of the initiative.

GENERAL CONTEXT

Characteristics of the setting :

  • This question is divided into section A which aims to capture information on the characteristics of the setting before the implementation of the initiative/programme ; and section B which aims to capture information about the setting at this current moment which can be during implementation, or after implementation if completed.

Specific information requested includes:

  •   Demography – population characteristics. Here, the demographics of the general population – gender, age, marital status, urban/rural, income level, race/ethnicity, etc. – are called for.  Who are the people you’re working or have worked with?  How do their demographic characteristics (e.g., age, gender, education, income, social status) compare to those of the general population of the community?  How are those characteristics related to the reason you’ve chosen to work with this group?
  • Population health profile - life expectancy, infant mortality, diseases or health conditions especially common in the community or society, the threat of epidemics, sanitation, nutrition, unusual positive aspects of population health (exceptional longevity, lack of common medical conditions – hypertension or cardiovascular disease, for example – remarkable lung capacity, etc.), exposure to both human-caused and natural environmental health risks (pollution, parasites). What are the positive and negative aspects of the health of the population you’re concerned with ? Are there particular threats to community health or the health of the specific population (e.g., infants and children from disadvantaged communities)? Is the incidence of one or more diseases or conditions particularly high or particularly low? Are there local conditions that present barriers to health promotion (e.g., lack of sanitation, extreme poverty, local customs that support unhealthy practices)? Are there conditions that work in favor of health promotion (e.g., clean environment, sustainable farming practices, good universal health care, and healthy diet)?
  • Political context – The nature of the national government, government support for health promotion, political factions in the community or society , or political priorities may all be important to the success of your effort.  What is the character of the local government?  Is health a political priority? Do elected officials ask of a policy option: Is it good for the people’s health? What are the relationships among your population and various others in the community?  What is the history of those relationships? Do they affect the delivery of health services or the possibility of health-promoting conditions for particular groups? Will (does) the political environment affect your effort or decisions about how to conduct it?  If so, how? These and other similar broad political factors might be discussed here.
  • Socio economic conditions - The state of the economy, employment and the labor market, economic divisions in the society, economic migration (people moving from rural areas to cities in search of jobs and income, for example, or large numbers of migrants or displaced persons), government support for the poor (food subsidies, housing, income subsidies, etc.), and government involvement in the economy in general.
  • Sociocultural – What is the education level, cultural and religious background, norms, and values of the population you’re working with? How do they compare with the community as a whole?  Are there sociocultural factors that make reaching this population difficult?  Are there sociocultural factors that socially exclude or isolate this population, or specifically affect their health and well-being?  Will you (did you) have to change attitudes or social norms in order to make health promotion a priority for this group?
  • Citizenship - level of participation – overview of level of participation in community initiatives of the average citizen in the specific area. In the larger context, this might refer to the willingness of stakeholders (those who care about the initiative) to be involved in anything that might draw attention to them. For instance, is the government repressive or likely to be threatened by what it sees as the mobilization of independent groups? It might also refer to stakeholders’ familiarity with the issues and their willingness or their perception of their ability to participate fully. Were all stakeholders involved in the various phases of your effort (or the phase you’re documenting)? If not all, were any stakeholders involved?  Which groups?  What was the mechanism by which stakeholders were involved? Were there barriers to stakeholder involvement, and how were they (or were they not) overcome?

These factors may have a profound effect on how you conduct your effort and how it is received by the population. Because the context can have so much influence on any health promotion initiative, it’s important to describe it carefully, so that others can determine whether a similar initiative might (or might not) work in their situations.

  • In response to an unmet need . There might, for instance, have been little or no health information available to a particular population or that population may not have access to clean drinking water or healthy food.
  •   In response to a crisis . An accident such as the 1986 meltdown of the nuclear reactor at Chernobyl in Ukraine might demand an effort to address possible health consequences.  The same might be true for a natural disaster, such as the virtual destruction of New Orleans by Hurricane Katrina in 2005, where several feet of polluted water raised enormous health concerns for those (many low-income African Americans) still in the city.
  • In response to an opportunity . A grant became available to address a health issue of importance to the community; for example, a community group might mobilize to address the issue of violence.
  • In response to a political request . A public official, responding to demands of constituents, might obtain political support for a health promotion effort in a particular neighborhood or city. An effort to address community safety, for instance, might be started as an attempt to gain votes just before an election. A particular issue might be raised by publication of an influential report, media coverage of the issue, or public pressure brought to address it.
  • In response to citizen/community action . An individual or group of persons who organized themselves to address a public health issue - e.g., a group of parents who organize a school traffic safety patrol, a community concerned about crime in the neighborhood who organize a community policing group, etc.
  • In response to a funding opportunity . Funds were made available to or through a group to address a health or community issue.
  • Initiated by an individual on behalf of an organization . An individual mobilized a community to pursue an initiative being promoted by a particular organization.
  •   Strategies/models or frameworks used in the design of this initiative : Check yes or no if the initiative was guided by any strategies, models or frameworks e.g., Healthy Communities and Municipalities (HMC), Healthy Markets (HM), Health Promoting Schools (HPS). If yes is checked, identify which strategies, models or frameworks and describe briefly, stating which aspects and how the concepts and principles of health promotion informed the initiative.

These questions attempt to determine the investment, source of funds and other resources necessary for the implementation of the initiative . For information on financial resources, please see: Generating, Managing, and Sustaining Financial Resources.

  • Budget – Some initiatives will have had a specific budget, others will not. However, try to put a value of what has been invested/spent on the initiative to start it, on an annual basis to maintain its activities, and total amount spent if the initiative is completed.
  • Source of funds – Select source(s) of funding and state “other” if option is not available. If received from a donor through project funding, grant or other, please state source and amount received.
  • Non financial resources – Resources necessary for the successful implementation of HP initiatives go beyond financial and include non financial resources such as human resources with technical/ training skills etc., and community assets - material, infrastructure, transportation volunteers, in-kind contributions, space, media coverage, etc. Please list what was made available to support the implementation of the selected initiative.
  • Adequacy of financial resources – Is (was) your budget adequate to accomplish your goals? If no, please explain the challenges and shortcomings.
  • Adequacy of non financial resources – Were the resources that were made available, including community assets, adequate to accomplish the goals of the initiative? If no, please explain the challenges and shortcomings.

PROCESS/ PARTNERSHIPS

The next three questions focus on partnerships

  • Key partners and their roles and responsibilities : List the names of all partners that have been/are involved in the initiative, and for each one state the main roles and responsibilities.
  • Evolution of partnerships and roles and responsibilities : Indicate whether the partnerships changed over time and if they did describe how they changed over time.
  • New partnerships : Indicate whether new partnerships were developed during the implementation of the initiative, and indicate who the new partners were (not the ones involved initially, those that were incorporated for one reason or another during the intervention).

These questions aim to capture the strategies used to facilitate the implementation of the initiative . The strategies are primarily the key health promotion strategies outlined in the Ottawa, Caribbean, and Bangkok charters for health promotion:

  • Participation – Focuses on involving stakeholders/target audience and other partners in decision making, to support implementation, possibly mobilize resources, etc. This is about establishing ‘ownership’ of the initiative by the people in the respective setting .  What did you do to enable people to participate in your project/intervention?
  • Partnerships/collaboration/intersectoral action – How working relationships were forged among various community sectors – government, businesses, organizations, institutions, NGOs, key individuals, faith communities, etc. in order to implement the specific initiative .  What did you do to encourage collaboration?
  • Empowerment/Capacity Building - How did the initiative help people gain more control over the forces that have an impact on their lives? How were people trained or skills built (e.g., cancer detection through self examination, budgeting or life skills shared and knowledge transferred to the persons)?  How were those involved able to get things done and follow through implementing the initiative to bring about the desired outcomes?
  • Public policy – Changing formal policies (laws, regulations, stated policies and procedures) and informal policies (decrees, etc.) that affect the way things are done and thus the development of the people in respect to specific issue being addressed by the initiative. What did you do to change policies or advocate for policy and legislative change?
  • Communications and public relations   – Providing information, increasing awareness, obtaining information from target populations and keeping them informed. Also speaks to communication among stakeholders and implementing partners .
  • Advocacy – Refers to ways used to ‘sell’ the ideas of the initiative , convince people to support and provide resources, present information/evidence to inform policy changes, bring about other changes e.g., the way services are provided, physical changes to a structure or physical environment, etc.
  • Building leadership – How were the people who were responsible for implementing the initiative organized?  What formal/informal structures for decision making did you set up? What was your leadership strategy and who was involved in it?  How did you train and bring in new leaders?
  • Creating supportive environments   – What did you do to support the community change you wanted to see? What cultural norms did you try to influence and how did you do that? How did you change access to goods and services in order to support individual behaviour changes?
  • Improved access to resources/services -- What policies did you change to enable community members to have greater access to resources and services ? What did you do to make community programs easier for people to get to? What did you do to make services more affordable?
  • Challenges that the initiative faced – Describe any challenges that the initiative encountered that were not covered under Question 24. Please also include a discussion about what was done to overcome them.
  • Actions/strategies that the initiative used – Describe any strategies or actions the initiative used that were not covered under Question 24. Please also include a discussion about how these actions/strategies contributed to the initiative (negatively or positively).
  • Notable achievements/results/outcomes : List and or describe the main achievements/results and outcomes of the initiative.
  • Millennium Development Goals plus : How did (or will) the effort help to achieve the Millennium Development Goals (MDGs)?  Which goal(s) does it address? Select all relevant goals and explain briefly how this was done. The MDG Plus is included and you are asked to select this one if applicable. Since it covers a number of diseases and more importantly risk factors, these are listed and you are requested to check as many as relevant to the initiative.
The Millennium Development Goals .  In 2000, the United Nations Development Programme set out to achieve the eight Millennium Development Goals (MDGs) adopted at the U.N. Millennium Summit in September of that year. These goals, targeted to be achieved by 2015, were agreed on by 189 countries and officially adopted by 147. They are meant to stimulate and coordinate efforts to improve outcomes for the world’s poorest people, those trying to live in conditions of extreme poverty. Although some countries/communities have made great strides toward meeting them, there are few well documented efforts to achieve the MDGs. The eight Millennium Development Goals (MDGs) are (by 2015) to: Eradicate extreme poverty and hunger.  Cut in half the number of people living on less than $1 a day. Achieve universal primary education. Promote gender equality and empower women. Reduce child mortality.  Cut by two-thirds the mortality rate for children under five. Improve maternal health.  Reduce the death rate of women in childbirth by three-quarters, and achieve universal access to reproductive health. Combat HIV/AIDS, malaria, and other diseases.  Halt and begin to reverse the spread of HIV/AIDS, provide universal access to HIV treatment by 2010. Ensure environmental sustainability.  Spread principles of environmental sustainability, foster biodiversity, reduce by half the percentage of people without safe drinking water. Develop a global partnership for development.  Establish systems and partnerships that recognize and attend to the needs of developing countries – particularly the poorest – increase development assistance, manage debt, encourage trade, provide access to affordable essential drugs in developing countries, make technology – phones, cell phones, Internet – available.  MDGs Plus . In recognition of related challenges, many of those working on the MDGs are inclined to add some other important health-related MDGs. The “Plus”was added in recognition of the fact that some countries may have particular needs or problems (violence, chronic diseases, environmental issues) that must be addressed in order to achieve the MDGs, or because of their particular importance to communities. PAHO’s Efforts to Address the MDGs : The Faces, Voices, and Places initiative. The Pan American Health Organization (WHO/PAHO) has implemented a regional effort to address the health-related MDGs. Known as the Faces, Voices and Places initiative, this was adopted by PAHO in 2006.  As noted in the PAHO Documentation Guide: “This is an effort to build political will at the highest level while at the same time providing technical assistance to address the social and economic determinants of health at the local level. It advocates for the most vulnerable and helps build citizenship with a focus on shared rights and responsibilities. This is achieved through intersectoral and interagency collaboration that unites efforts and commitment toward the achievement of the Millennium Development Goals.” According to PAHO, the purpose of Faces, Voices and Places is to: Respond to the needs of the poorest and most vulnerable communities from the perspective of the social determinants of health. Elevate the values of equality and Pan Americanism. Synchronize efforts and unify actions and the will to achieve the MDGs. Promote the objectives of public health among people and territories. Emphasize rights and responsibilities, to ensure sustainable development. Consolidate the power of advocacy for the most vulnerable. Transition from a focus on poor countries to a focus on people living in poverty. With its Faces initiative, PAHO aims to encourage “a model of sustainable development that calls for a multiplicity of factors and players at different levels to successfully address the social determinants of health” and the many causes of poverty.
  • Changes at individual level . Increases in the ability of individuals to solve their own problems and meet their own needs. These might include the development of a skilled workforce, the emergence of leadership from within the community, a gain in organizational skills, or individual attitude or behavioural change.
  • Changes in communities . These may include a shift in community attitudes (about alcohol abuse or domestic violence, for instance) or increases in community awareness (about the need for particular services, or the frequency of particular behaviors or events). It may also involve enhanced capacity for community advocacy or mobilization (coalitions, communication networks, community organizing) or democratization (more people involved directly in decision-making, greater participation, emergence of leaders from the community). It may also take the form of new community resources or assets created (health clinics, schools, organizations, clean-water wells, etc.) or community commitment to improvement in the quality of life for everyone.
  • Changes in policy at local, regional, state/province, and national levels .This might include improvement in the infrastructure (roads, utilities, and communication), and changes in organizational policies.
  • Changes at organizational or institutional level .This might include improvements and changes in organizations and institutions (public and private) working at the community level or that are part of the initiative. Examples of such changes could be an increased allocation of resources to issues related to the initiative, the establishment of a new unit responsible for health promotion, assignment of personnel to work on the initiative, institutionalization of participatory methods into work plans, etc.
  • Which change was most important and why : Indicate which of the changes made and identified in Question 29 were most important and indicate why .
  • Sustainability :   Is the initiative one that requires sustainability (not a project intervention that is specifically time bound)? If it is an initiative to be sustained , indicate whether it has been or not. If not, explain why not; if yes, explain what was done to enable the initiative to be sustained/integrated/ mainstreamed into other activities/processes.
  • Evaluation process : Describe how the initiative was evaluated.  How did you gain an understanding of what worked?  How did you find out what needed to be changed?   What information helped you better organize the process, set the timeline, and manage the logistics?  How did you measure your success?  (What outcome measures were used?)  How did you use the evaluation to adjust and improve the effort?
  • Main lessons learned : What have you learned , both for the effort as a whole and for each phase (planning, implementation, evaluation, sustainability) – about the efficiency and effectiveness of the processes, methods, and systems you used? What have you learned about the accuracy of your expectations? About the effectiveness of your work in obtaining the desired outcomes? About whether the desired outcomes had the desired results (i.e., were you on the right track?). What have you learned about how you might have conducted the effort better?  Is this effort applicable to other circumstances, or would it only work in your community or one very similar to it, and why?
  • Revising the intervention . How would you change the intervention to make it more effective and efficient?  What would you do differently next time?
  • Implications for participatory research .  How would you draw more stakeholders and participants into all phases of the process ?  Would that be feasible in all phases, given the nature of the effort? Would any of them need training or mentoring, and how would you provide it?
  • Implications for practice . What have you found that would seem to be a best practice, or would help others in trying to achieve outcomes similar to yours?  It is as important to describe here what didn’t work as what did, since eliminating particular methods or approaches can be as helpful as suggesting ones to be used.
  • Communication materials, tools, manuals, protocols, etc .: Since one purpose of this exercise is to share experiences and so facilitate the advancement of health promotion initiatives, you are requested to share the material, tools, documents, etc. developed to support this initiative. This will particularly be useful to practitioners as they attempt similar initiatives in their respective countries.
  • Photographs: List and attach in a separate file any photographs that tell the story of the initiative implemented.

The PAHO Documentation Guide is meant to help you create a record of the whole of your health promotion effort – the process of planning, designing, implementing, evaluating, and sustaining it. It focuses on the context, as well as your methods, results, and the lessons learned.  If you answer the questions in the Guide, you will have a complete picture of what you’ve done, how you’ve done it, and what’s important about it. That documentation will make it possible to pass on what you’ve learned, and to help others create healthy communities.

Contributor

Contributed by the Working Group of the PAHO (Pan American Health Organization) Regional Initiative to Evaluate the Effectiveness of Health Promotion. The Working Group includes World Health Organization (WHO)/PAHO Collaborating Centers: Center for Chronic Non-Communicable Disease Policy (Public Health Agency of Canada); Work Group for Community Health and Development (University of Kansas, USA); Center for Evaluation, Training, and Advocacy in Health Promotion (CEDETES, Center for Development and Evaluation of Public Health Policies and Technologies, University of Valle, Cali, Colombia); Center for Health Promotion Research (Center for Community Health Promotion Research, University of Victoria, Canada); Center for Health Promotion (University of Toronto, Canada); Center for Healthy Cities (Indiana University, USA); Center for Healthy Cities and Health Promotion (CEPEDOC – Center for Study, Research, and Documentation in Healthy Cities, University of Sao Paulo, Brazil); the United States Centers for Disease Control (National Center for Chronic Disease Prevention and Health Promotion); and representatives from the Areas of Sustainable Development and Environmental Health and Health Surveillance, Disease Prevention and Control of PAHO.

Online Resources

Guidelines for Using PAHO Guide to Document Health Promotion Initiatives.

Faces, Voices, and Places .  The PAHO web page for Faces, Voices and Places.

PAHO .  The Pan American Health Organization (PAHO), the arm of the World Health Organization in the Americas.

United Nations Development Programme. The United Nations Development Programme web page on the Millennium Development Goals.

Social Determinants of Health .  The WHO Commission on the Social Determinants of Health.

Work Group for Community Health and Development .  The Work Group for Community Health and Development at the University of Kansas, the developer of the Community Tool Box and a collaborator on the PAHO Guide. The Work Group is a World Health Organization Collaborating Center.

World Health Organization .  The World Health Organization (WHO), the health promotion agency of the United Nations.

Print Resource

Health Promotion Effectiveness Working Group. (2008).  Guide for Documenting Health Promotion Initiatives . Pan American Health Organization.

Poland, Blake, Krupa, Gene, McCall, Douglas. (2009).  Settings for Health Promotion: An Analytic Framework to Guide Intervention Design and Implemenation .  Health Promotion Practice.

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Health Promotion International

Article Contents

Health promotion is a pro-active discipline.

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Gabriel Gulis, Health promotion is a pro-active discipline, Health Promotion International , Volume 35, Issue 6, December 2020, Pages 1253–1255, https://doi.org/10.1093/heapro/daaa127

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Health promotion by definition enables people to take control over their health; governmental actions in most of countries of the world in 2020 did exactly the opposite! Most of the foundational values of health promotion such as democracy, evidence-based decision-making, accountability, transparency, equity and ethical conduct went through serious challenges this year. The coronavirus disease 2019 (COVID-19) situation stretched health systems, and within them public health—including health promotion.

The health promotion community responded to the COVID-19 pandemic through a common statement (later ‘the Statement’) issued in collaboration between IUHPE, the health promotion section of European Public Health Association (EUPHA), and the United Nations Educational, Scientific and Cultural Organization (UNESCO) chair for global health and education ( IUHPE, 2020 ). Its authors replaced the five key strategies in the logo of the Ottawa Charter on health promotion by the terms intersectorality, sustainability, empowerment and public health engagement, equity and a life course perspective. This approach seems to supersede the Ottawa Charter (and its elaborations through more recent World Health Organization (WHO) Global Health Conference pronouncements) with rather more regressive perspectives.

The sustainability argument of the Statement is discussing resilience of public health, disease care and social services; this is nothing new and can be aligned with the call to re-orient health services from the original Charter. The COVID-19 crisis taught us that health systems still lack resilience in many countries, coordination within the public health-primary care-hospital care-social care system is rather poor, and balance among the four corners of this square is missing ( Figure 1 ). Health promotion is known to be at the innovation edge of actions for better health (equity) and this is an opportunity to extend our call to action. I believe we must advocate for more support to disease prevention-oriented work and strengthening of public health systems within healthcare delivery systems as described by Saracci ( Saracci, 2020 ) and Gavande ( Gavande, 2020 ).

Four corners of the square.

Four corners of the square.

The identification of intersectorality in the Statement as such an important tenet in COVID-19 times can be well-aligned with strengthening community action for health as per the Ottawa Charter. In our not-too-novel perspective, community action by its very nature is inter- or rather cross-sectoral. In addition to ‘traditional’ areas of concern at the community level (like care for vulnerable populations, health literacy, harmonized collaboration of elements of a community) COVID-19 has made us more acutely aware of the need for local information systems to provide valid, transparent, timely and accessible data. This is the very least we should accomplish if the community is to be supported in making important life choices during the pandemic. The ‘big data industry’ proved to be a new ‘sector’ to be included in future especially into community driven surveillance work ( Chan and Brownstein, 2020 ).

Empowerment and public health engagement in the Statement is largely discussing health communication issues. As important as these are, true empowerment and engagement for better health (and better health policies and systems) also requires an examination of existing power differentials and structures. Within the communication parameters the health promotion field should be deeply cognizant of the reflex/trend toward the elicitation of fear in (COVID-19) messaging. Looking back to health communication messages to the public in 2020 one can see fear creation as the driving force of communication. This is strictly against the core principles of the Ottawa Charter and of considerable risk to the population ( Stolow, 2020 )! Appeals to fear and anxiety can never create supportive environments for health and lead to develop health positive personal skills ( Ruiter, 2014 ). To use the word ‘empowerment’ at a time when people are by force confined to their apartments, restricted of movement in open space and nature is indeed ironic. If anything, the pandemic has taught us to explore new forms of empowerment and support, online, from balconies, or reviving new-ish traditions ( Gauthier and Rainville, 2020 , describe the ‘tintamarre’ to support Quebecois hospital staff).

Life course perspectives and the pursuit of equity should be an integral and organic part of any healthy public policy. The late Sir Richard Doll at the International Epidemiology Association conference in Florence, Italy in August 1999 said ‘public health contributed to expand life expectancy substantially during last century. In many countries, we are approaching the biological limit a human organism can reach. It is time to focus on improving quality of life and to decrease suffering and disabilities…’ (free quote based on the author’s memories). This quote reminds us that the life course has two natural bookends; we are born, and we die. Zero mortality does not exist and so, zero risk does not exist. Soon, this sentence became a slogan used by WHO and many health policy experts ‘Don’t’ just add years to life, also add life to years’. Healthy public policies should be driven by evidence and not by un-realistic expectations. To me, both the statement of Sir Richard Doll and the WHO slogan means among others that we need a balanced approach to responses to health threats; we need to preserve years and consider whether we add life to them. Naturally, the aim of health promotion (and public health) is to minimize the risks and maximize health benefits. This needs to be done respecting knowledge, democracy and dignity. Evans et al. ( Evans et al. , 1994 ) in their seminal work ‘Why are some people healthy and others not’ describe the determinants of health of populations and the evolution from disease-care model to health as prerequisite of well-being. Healthy public policy should allow people to live in optimum well-being, good health with minimum ill health and disabilities. In addition to societal and human costs of achieving well-being, health economist set monetary values to a quality-adjusted life year (QALY) ( McCabe, 2008 ), though values differ by countries ( Nilsson, 2014 ). In Denmark, according a think tank Cepos, this cost accepted by society is DKK (Danish krone) 500 000 (about USD 80 000) per 1 QALY ( CEPOS, 2020 ); according an analysis of the same think tank the actions of Danish government on COVID-19 increased this cost 5-times. It is obvious that such over-use of resources will lead to large inequities among different causes of ill health and human suffering. Shall health promotion within its ethical foundations and the focus on life course and equity but also on all other strategies described in this editorial lead an open discussion on such cost estimates? Shall risk perception and acceptance be part of a renewed agenda of health promotion and its health literacy dimension, in an ‘post Covid-19’ era?

‘Medicine is a social science, and politics nothing but medicine at larger scale’; this famous statement of Rudolf Virchow has probably never been so true as in spring of 2020. At a time, when countries are categorized by colors of semaphores from safe to hazardous and those colors can change unexpectedly due to gentle but clear political pressure of one country on other (for instance, as a result of subtle threats to economic parameters related to travel restrictions), one must ask whether the relation described in Virchow’s belief is one- or bi-directional? The answer is simple, of course it is reciprocal. Medicine this year changed not only the health of populations, but also politics has changed medicine and public health all around the world. The need, and aspirations for global collaboration was quickly supplanted by traditionalist nation-state thinking, in which firm borders were re-established in a manner not seen for many decades, if ever. A declared support for collaborative global development was replaced by concrete barriers, police and army forces on nation state borders, especially in Europe even within the Schengen Treaty area not respecting its own laws in a claimed allegiance to public health rules. Democracy and international conventions were quickly abandoned ( Thomson and Ip, 2020 ). Emotions, driven by avalanches of catastrophic absolute numbers reported virtually every newscast quickly overtook the common wish for calm, evidence-based decision-making. In many cases—as described by Pearce et al. (Pearce et al. , 2020 ) even the most basic principles of epidemiological reasoning have been flaunted.

In light of all these issues, we call on the health promotion community to stick to principles of the original Ottawa Charter, to principles of public health science and to keep applying them in everyday practice. The perceived urgency to produce new Statements can be appreciated, but as outlined above, is largely a vain pursuit and possibly even regression. What we need is calm under pressure, a grounding in commonly validated principles and fact, and advocacy for better responses and innovations, rather than a departure from our core beliefs. This Journal is proud to remain a platform for such views.

CEPOS. https://cepos.dk/publications/we-pay-minimum-five-times-as-much-for-a-life-year-with-the-corona-measures-than-we-normally-do/ (last accessed 18 August 2020 ).

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Gauthier M. , Rainville P. ( 2020 ) Un émouvant tintamarre pour le personnel de l’hôpital de La Baie. Le Quotidien , 1 April 2020. https://www.lequotidien.com/actualites/covid-19/un-emouvant-tintamarre-pour-le-personnel-de-lhopital-de-la-baie-e128467beb32abf9c2314fe96f0b05d8 (last accessed on 15 October 2020).

IUHPE ( 2020 ) A Health Promotion Focus on COVID-19. Keep the Trojan horse out of our health systems: Promote health for ALL in times of crisis and beyond! EUPHA-HEALTH PROMOTION, IUHPE and UNESCO Chair Global Health & Education. https://www.iuhpe.org/index.php/en/iuhpenews/1366-covid19-health-promo (last accessed 08 October 2020).

McCabe C. , Claxton K. , Culyer A. J. ( 2008 ) The NICE cost-effectiveness threshold . Pharmacoeconomics , 26 , 733 – 744 .

Nilsson A. ( 2014 ) The Monetary Value of Human Life -Examining the differences between sectors, Master thesis, Lund University, Sweden. https://lup.lub.lu.se/luur/download? func=downloadFile&recordOId=4460825&fileOId=4460826 (last accessed 08 October 2020).

Pearce N. , Vandenbroucke J. P. , VanderWeele T. J. , Greenland S. ( 2020 ) Accurate statistics on COVID-19 are essential for policy guidance and decisions . American Journal of Public Health , 110 , 949 – 951 .

Ruiter R. A. , Kessels L. T. , Peters G. J. Y. , Kok G. ( 2014 ) Sixty years of fear appeal research: current state of the evidence . International Journal of Psychology , 49 , 63 – 70 .

Saracci R. ( 2020 ) Prevention in COVID-19 time: from failure to future . Journal of Epidemiology and Community Health , 74 , 689 – 691 .

Stolow J. A. , Moses L. M. , Lederer A. M. , Carter R. ( 2020 ) How fear appeal approaches in COVID-19 health communication may be harming the global community . Health Education & Behavior , 47 , 531 – 535 .

Thomson S. , Ip E. C. ( 2020 ) Covid-19 emergency measures are hurting democracy globally . American Journal of Public Health , 110 , 1356 – 1357 .

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177 Health Promotion Topics

This compilation of health promotion topics explores the multifaceted world of promoting health and well-being. Health promotion encompasses a wide range of strategies, interventions, and policies aimed at empowering individuals and communities to take control of their health and make positive lifestyle choices. Let’s examine the significance of health promotion in preventing diseases, improving quality of life, and fostering a more equitable and healthy society together! Have a look at innovative health promotion approaches in nursing and discover the global health challenges. This will help highlight healthcare professionals’ role in shaping healthier futures for all of us.

🧑‍⚕️ 10 Health Promotion Topics

🏆 best health promotion research topics, 💉 health promotion topics nursing, 👍 examples of health promotion topics, 🌶️ health promotion project ideas, 🎓 interesting health promotion topics.

  • The Role of Health Education for Healthy Behaviors.
  • Health Promotion in Schools.
  • Global Health Promotion Initiatives.
  • Health Disparities in Underserved Communities.
  • Promoting Physical Activity and Exercise.
  • The Intersection of Policy and Health Promotion.
  • Health Promotion Strategies for Emotional Well-Being.
  • The Impact of Nutrition Education on Healthy Eating Habits.
  • The Role of Technology in Enhancing Health Promotion.
  • Tackling Non-Communicable Diseases through Community-Based Programs.
  • Health Promotion Proposal Obesity Prevention The purpose of this proposal is to inform and educate parents, children and adolescents of the importance of having a well balance diet and exercise in their daily lives to avoid obesity.
  • Health Promotion Strategies for Obesity The paper outlines and critically analyses the population based strategy as a method of managing and preventing obesity used in United Kingdom.
  • Health Promotion and Disease Prevention The research of the work is focused on finding the roots of the development of common adult diseases and addressing these roots at the early stages.
  • Nutrition and Weight Status: Health Promotion Plan This health promotion plan addresses the issue of nutrition and weight status and increases the public understanding of the problem and possible consequences for the life.
  • The MEDRAD Healthcare Facility Quality Promotion As the case study set in the MEDRAD healthcare facility shows, there is a significant gap between different quality provision tools.
  • Health Promotion: Scrutiny and Practical Implementation Health Promotion is crucial for increasing the overall health levels of the population, and for helping to improve patient outcomes and decrease health insurance costs.
  • Health Promotion Role in Public Health The three levels of health promotion are sufficient in curbing and treating such severe conditions as, for instance, diabetes mellitus due to their preventive nature.
  • Health Promotion Role and Practice Health promotion is able to enhance the health status of the nation, improve the quality of life and reduce the costs needed for medical treatment.
  • Health Promotion: Health Insurance Costs Reducing Health promotion is targeted towards increasing the control over the health of the target audiences as well as the improvement of their health.
  • Nursing and Health Promotion in Family Pediatrics The modern approach to the delivery of nursing care is focused on the significant improvement of people`s quality of life and the environment in which they live
  • Health Promotion Among Hispanic Minority Group The following paper addresses the issue of health disparities of the Hispanic minority group through health promotion.
  • Nursing Health Promotion and Its Importance Health promotion is one of the concepts that must be more explicitly defined for nursing due to its frequent use and the development of different health care trends.
  • Nola J. Pender’s Health Promotion Model in Nursing To understand how the Health Promotion Model has influenced the practice of the advanced practice nurse, firstly, it is important to describe the essence of this model.
  • Childhood Obesity and Health Promotion Today, childhood obesity is one of the critical health concerns. Being an important factor impacting the future of the nation, children`s health should be cultivated.
  • Healthy Lifestyle Promotion and Its Evaluation The main purpose of this project is to assess the importance of the promotion of healthy lifestyles by nursing professionals via educational programs for patients.
  • Pender’s Health Promotion Model and Parse’s Theory The purpose of this paper is to investigate Nola J. Pender’s Health Promotion Model and Rosemarie Rizzo Parse’s Human Becoming Theory.
  • Health Promotion and Autonomy-Based Ethical Concerns Health promotion initiatives are associated with ethical concerns that affect their implementation and effectiveness.
  • Environmental Health Promotion in Nursing In the 21st century, the issues of environmental health and the health effects of environmental climate change became a pressing matter for the international health community.
  • Health Promotion Model and Human Becoming Theory The health promotion model (HPM) developed by Pender in 1990. The theory of human becoming was developed by Parse in 1981.
  • Nursing Theory’s Role in Health Promotion A nursing theory acquires the top priority as one of the ways to improve the comprehension of current processes in the healthcare sphere
  • Motivational Axiom, Health Behavior and Promotion The purpose of this paper is to discuss motivational axioms and health behavior theories that apply to the health promotion project.
  • “Let’s Move” Program for Healthy Lifestyle Promotion The introduction of a nationally coordinated program “Let’s Move” was a significant step forward in the government’s attempts to fight obesity and cardiovascular problems.
  • Health Promotion and Ethical Considerations Sometimes a nurse might wish to manipulate a patient’s fears to achieve the goal. However, it is not appropriate to use manipulation, even for the benefit of a patient.
  • Health Promotion Among Hispanic Population Hispanic Americans are still an underprivileged group that has limited access to healthcare services. The major health issues are related to healthy lifestyle.
  • Health Promotion: Benign Prostate Hypertrophy Benign Prostate Hypertrophy (BPH), a condition that causes the prostate gland to enlarge inducing urethral obstruction, urinary flow restrictions, and urinary retention.
  • Health Promotion Among Diverse Populations Statistical data on the health level of different social and ethical groups shows certain harmful tendencies and inequality.
  • Aging and Health Promotion Biological theories explain aging either by a programmed switching of different phases in the development of the body or by the damage inflicted by the environments.
  • Health Promotion and Diverse Populations Health status of the population belongs to the number of the most important factors defining the quality of life of the humanity.
  • Self-Care Health Promotion This paper will discuss the importance of self-care within the medical profession as well as introduces a personal health plan on the basis of behavior and habit assessment.
  • Popular Health Concerns, Awareness, and Promotion Nurses can engage in health promotion practices, giving and organizing free lectures for the target audiences, creating brochures with beneficial notes, and so on.
  • Health Promotion and Three Levels of Prevention Health promotion is a basic refrain for nursing practice. It has been a major focus in the nursing practice in the recent decades due to its contribution to the nursing philosophy.
  • Health Services Access and Health Promotion The nature of the health promotion problem revolves around the inability of many citizens in the United States to receive quality medical care.
  • Asthma Patients’ Health Education and Promotion The purpose of this paper is to discuss the health education, health promotion information, and strategies that should be used when working with asthma patients.
  • Effective Health Promotion Plan Importance Medical professionals should use their competencies to empower people to control health outcomes. They can achieve the objective by implementing powerful environmental, health.
  • The Role of Nurses in Health Promotion and Disease Prevention.
  • Promoting Healthy Lifestyles: Strategies for Encouraging Physical Activity.
  • Nutrition Education for Patients: Improving Dietary Choices.
  • Smoking Cessation Programs: Supporting Patients to Quit Smoking.
  • Mental Health Promotion in Primary Care Settings.
  • Implementing Immunization Campaigns for Disease Prevention.
  • Promoting Sexual Health: Education and Safe Practices.
  • Managing Chronic Conditions: Empowering Patients for Self-Care.
  • Health Literacy: Enhancing Understanding for Better Health Outcomes.
  • The Importance of Sleep in Health Promotion.
  • Promoting Hand Hygiene to Reduce Infections in Healthcare Settings.
  • Empowering Patients with Chronic Pain: Non-Pharmacological Approaches.
  • Preventing Falls in the Elderly: Assessment and Interventions.
  • Creating Healthy Work Environments for Nurses and Healthcare Professionals.
  • Health Promotion for Pregnant Women: Prenatal Care and Education.
  • Addressing Substance Abuse and Addiction: Support and Treatment.
  • Promoting Cardiovascular Health: Managing Hypertension and Cholesterol.
  • The Role of Nurses in Promoting Vaccination Awareness.
  • Stress Management Techniques for Patients and Healthcare Workers.
  • Health Promotion in Schools: Addressing Childhood Obesity.
  • Promoting Infection Control Practices in Community Settings.
  • Supporting Breastfeeding: Education and Encouragement.
  • Integrating Mental Health Services in Primary Care for Better Access.
  • Preventive Screenings and Early Detection: Empowering Patients to Act.
  • Health Promotion for Aging Populations: Enhancing Quality of Life.
  • Promoting Awareness of Sexually Transmitted Infections (STIs).
  • Promoting Cultural Competence in Healthcare: Addressing Diverse Needs.
  • Using Technology for Patient Engagement in Health Promotion.
  • Promoting Safety in Home Care Settings: Fall Prevention and Home Assessments.
  • Community Health Promotion: Collaborating with Local Organizations.
  • Diseases and Health Promotion in African Americans African Americans tend to be faced with certain adverse health conditions, such as diabetes, hypertension, HIV, and stroke, more often than White individuals.
  • Diabetes Type 2 Treatment and Health Promotion The purpose of this paper is to develop evidence-based management and a plan for a patient with diabetes type 2 and describe health promotion and possible follow-up.
  • Self-Care Health Promotion Plan Health promotion is one of the key elements of nursing care that necessitates the identification of illness prevention opportunities during the course of care provision.
  • Social Media Categories for Public Health Promotion This paper discusses social media categories, singles out popular and cutting-edge tools, and outlines how these tools might be used for the issue of community health.
  • Health Promotion by Nursing Professionals Health promotion has been a major priority for healthcare providers for several decades, but many nursing professionals still fail to understand their role in this process.
  • Health Disparity and Promotion in Afro-Americans The purpose of this paper is to identify the current health status of African-Americans as a minority group, identify factors that improve or mitigate the promotion of healthcare.
  • Health Status and Promotion Among African Americans This paper not only looks into the current health status of African Americans, but also assesses issues of health promotion and health disparities as they relate to this group.
  • Pender’s Health Promotion Model and Social Behavior The paper reviews “The effect of a multi-strategy program on developing social behaviors based on Pender’s health promotion model to prevent loneliness.”
  • Health Promotion Among Latino Population in the US The health status of different population groups largely depends on their cultural and socio-economic factors, including values, beliefs, and attitudes to health care practices.
  • Nursing Guides Theories: Nola J. Pender’s Health Promotion Model and Parse’s Theoretical Perspective The development of Rosemarie Rizzo Parse’s theoretical perspective has helped to frame nursing knowledge. Nursing is human art and science that uses evidence-based knowledge.
  • Community Health Promotion as a Nurse’s Role It is necessary to protect the safety of populations within communities through disease protection and health interventions.
  • Health Promotion Among African Americans The present paper offers the analysis of health problems faced by African Americans and suggests health promotion approaches to reduce the risks.
  • Health Promotion Among Diverse Populations: Downtown Miami Downtown Miami is positioned around the Central Business District (CBD) of Miami. The history of Downtown Miami is not very long, but it is rather interesting.
  • Pender’s Health Promotion Models This essay will compare Pender’s health promotion model and the transtheoretical approach, then use the former in a theoretical scenario.
  • Health Promotion in Native Hawaiian Population Health promotion is an approach that aims to enable people to control their health and its social determinants.
  • Health Promotion in Latin American Immigrants To help Latin American immigrants improve their health situation, it is essential to select an intervention plan for a reduction in the number of strokes and other issues.
  • Tobacco Free Florida and Health Promotion An anti-tobacco organization, Tobacco Free Florida launches health education programs and helps citizens quit smoking.
  • Health Promotion in Minority Populations The paper discusses the major health concerns African Americans face and the most appropriate care plan that can address their needs.
  • Family-Centered Health Assessment and Promotion Family-centered care is a medical practice aimed at helping all the members of the same family, which is often the case when several problems manifest themselves.
  • Secondhand Smoking: Environmental Health Promotion Smoking remains a significant environmental problem that affects many people. Secondhand smoking can also be a dangerous issue because of the pernicious impact of tobacco.
  • Ethnic Minorities’ Health Disparities and Promotion Ethnicity is a complex and sensitive subject that requires greater attention in the sphere of healthcare when trying to achieve health equality for the entire population.
  • Health Promotion in Asian Americans and Pacific Islanders The health status of Asian Americans and Pacific Islanders may be closer to the nation’s average than that of some other minority groups.
  • Informatics in Health Promotion Programs The issue of childhood obesity is particularly relevant since the emergence of excess weight at an early age is fraught with serious diseases in the future.
  • Technology Creates Health Promotion Opportunities The major purpose of this brief is to inform my colleagues about the potential of technology to create health promotion opportunities.
  • Health Promotion for Indians and Alaskan Natives American Indians and Alaskan Natives had to withstand the immense pressure from the majority populations that have compromised their culture, lifeways, health and wellness.
  • Older Adult Population: Community Health Promotion The paper analyzes the older adult population, their main demographic characteristics, mortality and morbidity risk factors, and effective plans for promoting health.
  • Overview of Health Promotion This paper describes different types of models that represent health issues and its distribution and contains evaluation of health promotion.
  • Intervention and Health Promotion Plan for Hispanic and Latino Community Such primary health problems of young Hispanics as STDs, HIV, heart diseases, and cancer are imposed by excessive alcohol consumption as a moderator of acculturative stress.
  • Interprofessional Health Promotion Resources: Substance Abuse in Adults Available interventions, risks, and factors contributing to substance abuse in adults will be discussed in the present paper.
  • Health Promotion Role in Reducing Health Insurance Costs Health promotion is crucial as it ensures that people understand the risks of their lifestyle and the know-how to avoid them.
  • Health Promotion Program in South Carolina In South Carolina, the top five leading causes of death are heart disease, malignant neoplasms, cerebrovascular issues, unintentional injury, and chronic lower respiratory disease.
  • Health Promotion Among Hispanic-Latino Population This paper aims to review the health status of the Hispanic/Latino population and discuss the best health promotion methods for this segment.
  • Health Promotion in School Health Center The purpose of education activities is to inform the audience about healthy lifestyles and address the social issues affecting their well-being and health.
  • Health Promotion Using Healthcare Informatics Social media platforms could be used efficiently by care providers to design and implement projects that elevate the level of health literacy among older adults.
  • Health Promotion: Coronary Heart Disease Prevention Assessment of the clinical history of the patient shows that the patient had demonstrated an elevated blood pressure level five years back, which is under control with medication.
  • The Importance of Value-Based Care in Health Promotion The foundational principle of the value-based care approach is the focus on the quality of medical care provided in healthcare organizations rather than its volume.
  • Health Literacy and the Role of Healthcare Providers in Its Promotion Health literacy is a well-recognized asset across the globe as an effective evidence-based strategy for improving health outcomes and reducing healthcare costs.
  • A Preliminary Randomized Controlled Evaluation of a Universal Healthy Relationships Promotion Program for Youth This essay will discuss and analyze a research article describing a small group program focused on preventing bullying and decreasing substance abuse among adolescents.
  • Health Promotion in American Indians and Alaska Natives Minority This paper will study a minority of Native Americans and Alaska Natives to identify major health problems and barriers and find ways of health prevention.
  • Health Promotion: Disease Control and Prevention Much attention from healthcare providers and healthcare agencies is dedicated to the problems of obesity. Still, not many professionals discuss the risk of being overweight.
  • Health Promotion Plan: Infant and Older Adults The health of the patients is of first and foremost importance to any health promotion campaign, and the campaigners do not forget that for a single moment.
  • Nutrition Education and Public Health Promotion To improve people’s health, governments may embark on a powerful leadership position aimed at developing literacy promotion strategies and ensuring sustained financing.
  • Health Promotion Concepts and Factors This paper discusses a range of health promotion theories and concepts, and discusses the most beneficial aspects and factors that influence health outcomes.
  • Chronic Disease: Occupational Health Promotion Interventions for Individuals at Risk Coal mining workers are exposed to numerous health threats due to their exposure to adverse substances at work and the lifestyle they lead associated with their occupation.
  • Health Promotion: What Are Energy Therapies? The purpose of this article is to review several energy therapy methods used in surgery and other health care areas.
  • Fall Prevention and Health Promotion Plan This paper discusses fall prevention and practices for health improvement and individuals/groups that might benefit from the education session.
  • Application of Pender’s Health Promotion Model Pender’s model can influence the physiological condition of the aging population due to the implementation of new behavioral patterns.
  • Health Promotion Model: The Lifestyle Change Project This paper will present the assessment of one family (a 44-year-old male, divorced but living with his six-year-old son) relative to the Health Promotion Model.
  • Health Promotion: Community, Nation, and the World The purpose of this paper is to describe the health promotion that is studied at the community, national, and global levels.
  • Analysis of Current MRSA Health Promotion Pamphlet Methicilin Resistant Staphylococcus aureus (MRSA) is a bacterial strain that is resistant to beta-lactam antibiotic penicillin.
  • Empowerment Measures in Health Promotion Personal orientation of health promotion aims to reach every single person with information on how to monitor and improve his or her health conditions.
  • Health Promotion and Community Resource Teaching Many resources can be used for educational activities for the population. They are provided by organizations that want to help prevent cardiovascular disease.
  • Typhoid Fever: Health Promotion Pamphlet Parents /guardian should pay close attention on their children especially in monitoring the kind of food and water that they take.
  • Promotion of Quality Healthcare Services Through Public Laws The analysis will focus on the healthcare laws that exist and how they contribute towards the realization and promotion of quality healthcare services in the country.
  • HIV in Adolescent Population: Healthy Promotion Intervention Plan The intervention program is about the distribution of leaflets for adolescents with HIV as well as other representatives of society.
  • Health Promotion Among HIV, AIDS Patients The paper Healthy People 2020 points out the intervention measures against HIV/AIDS among young people in the United States.
  • Evaluating the Importance of Community-Based Participatory Research in Health Promotion Processes The promotion of a healthy community is an ongoing concern that has assumed an international imperative for governments, policymakers, and practitioners.
  • Health Promotion Theory for Chronic Kidney Disease Effective prevention of chronic kidney disease (CKD), clearly, requires different approaches to lessen the number of deaths in the world.
  • Importance of Theory in Health Promotion Effectual health promotion initiatives assist persons to uphold and advancing health, lessening disease risks, and controlling persistent illness.
  • Health Promotion Project for Chronic Diabetic Kidney Disease The health promotion model designed and proposed by Nola Pender is one of the most effective nursing approaches in promoting health among communities.
  • Nola Pender’s Health Promotion Model Nola Pender is one of the greatest nursing theorists of the 20th century. Pender’s Health Promotion Model (HPM) theory supports the best health practices towards a quality life.
  • Adult Nursing Theories, Practice and Health Promotion This paper describes some of the tools that promote good healthcare in the UK: fitness, healthy eating, lifestyle checks, and sexual health tools among others.
  • Community-Based Health Promotion: Anytown Community There is the paramount need to promote healthy eating habits and physical activity among residents of the Anytown community as described in the preceding discussions.
  • The Health Promotion Model by Nola Pender This essay examines the health promotion model by Nola Pender with a view of providing the guiding propositions and their application in modern care institutions.
  • Parish Nursing: Health Promotion Parish nursing in faith-based communities is a relatively new practice that has gained popularity rapidly. It is a powerful tool with the purpose of health promotion.
  • The Project of Health Promotion Health Promotion Game aims to increase the awareness of adolescents and young adults on depression as a mental illness and encourage early diagnosis.
  • Health Promotion to Meet the Identified Health Need Hughes (1999) has offered ten strong reasons why social workers should be included in the behavioral health plan for community support.
  • Analysis of Health Promotion Theories A model of health promotion is a framework that helps healthcare practitioners to explain, plan and evaluate health enhancing activities.
  • Health Promotion to Reduce Lung Cancer: Grant Proposal Template The project aims to reduce the rate of lung cancer infection and deaths among Aboriginal and Torres Strait Islander people in South Australia.
  • Urban-Rural Differences in Medicare Health Promotion The purpose of the study was to assess the impact of a multi-component health promotion and disease self-management intervention on physical function, etc.
  • Health Promotion for Obesity in Adults This is a health promotion proposal for preventing obesity among adults in the US. People get obesity when they acquire a given body mass index.
  • Ethical Health Promotion-Related Issue Most new HIV-positive patients prefer to maintain their status confidential, which raises an ethical concern regarding the protection of the well-being of the people at risk.
  • Promotion of Public Health: Improvement Strategies In health promotion, it is necessary to be able to amalgamate education both on health maintenance and preventative techniques.
  • The Purpose of Health Promotion This paper discusses the purpose of health promotion and how the nursing role and responsibilities are evolving health promotion.
  • Health Promotion and Disease Prevention Strategies for Access to Care A strategy to increase access to health care is to create more free community centers with programs focused on education and healthy lifestyles.
  • Cardiovascular Health Promotion in the United States Statistics show that the awareness of central causes of CV problems remains low, and broad populations, especially aged people, possess a poor understanding of the disease.
  • Design and Health Promotion Program for Someone to Quit Smoking The paper will present a smoking intervention program that combines medical and psychological solutions that address all the aspects of smoking addiction.
  • Health Promotion: Reducing Tobacco Use by Adults The purpose of the project is to discuss various strategies for implementing health promotion programs such as the ‘You Can Quit Tobacco Use Program’.
  • Sudden Infant Death Syndrome: Health Promotion Plan This paper aims at developing a health promotion plan that investigates SIDS and related best health improvement practices.
  • Hispanic or Latino Populations of the USA: Health Status and Promotion and Disease Prevention The socioeconomic factors play a particularly important role as a barrier to the health promotion of the group.
  • Health Promotion and Students’ Well-Being Critique Soler-Masó et al.’s article “Health promotion and students’ well-being in secondary schools in Catalonia” centers on the mental health of adolescents in schools.
  • Smoking and Health Promotion in the UK In the following paper, issues of health promotion and smoking, in particular, will be evaluated and analysed on the basis of facts from the United Kingdom.
  • High Risk Family Assessment and Health Promotion Family violence has continuously been a health issue in the United States for a long time. According to Whyte, in every family, there is always the center of power.
  • Health Disparities and Health Promotion in Vulnerable Populations Health disparities among the different populations pose great threat to the progress of all countries in spite of their constant effort to minimize them.
  • Health Promotion in the Preschoolers The study targets, eating and activity habits that are linked to inappropriate weight gain, formed in early childhood.
  • Health Promotion Program Based on the Healthy People 2020 Target Objectives The vision of the Healthy People 2020 program is to develop “societies whereby all people live long, healthy lives”.
  • Health Promotion Among Australian Aborigines with Respiratory Diseases The high prevalence rate of respiratory diseases among the Aborigines in Australia has prompted an urgency to carry out a need analysis for its causal factors.
  • Nurses’ Role in Health Promotion: Systematic Review The role of nurses in health promotion has been increasing over the years, and some of the interventions are viewed as incredibly efficient.
  • Aesthetic Approach to Health Promotion Intervention This paper aims to discuss the impact of cancer on psychology, identify the primary stressors of the condition, and propose an aesthetic intervention framework.
  • Statistic for Public Health Promotion Interventions Statistics are relevant to the planning of health promotion interventions because they are paramount for identifying the groups that need such interventions in the first place.
  • Healthcare Promotion and Ethical Considerations This paper will discuss some of the ways in which healthcare professionals are able to address the problems introduced by the popularization of healthy living in society.
  • Community and Public Health Nurses Responsibilities in Health Promotion Public and community health nurses can significantly improve the well-being of society by assessing the situation, educating people, and providing them with tools for health care.
  • Nurse’s Role in Health Promotion The paper describes that nurses should give the necessary recommendations considering age, physical development, and belonging to a particular culture.
  • Good Health and Well-Being Promotion Initiatives The author is studying good health and well-being promotion initiatives because he wants to understand the scope of existing health issues and the existence of potential solutions.
  • Health Education and Health Promotion Health education and promotion are highly crucial. They can connect the audience and sustain the link between professionals and the public.
  • Health Education and Promotion Implementing efforts to make healthier lifestyle choices can help populations significantly reduce the risks of poor health.
  • Health Promotion Plan: How to Protect Babies? Sudden Infant Death Syndrome is a dangerous and undiagnosed phenomenon characterized by sudden death from respiratory arrest at less than one year of age.
  • Public Health Promotion: World Health Organization The paper discusses the role of the World Health Organization’s mission and vision in promoting health, and factors that assist and hinder the organization’s progress.
  • A Personal Health Promotion Plan As part of personal health promotional plan, the author aims to devote a minimum of 210 minutes to physical activities per week.
  • Personal Health Promotion Plan: Better Eating Habits While there are various options for health promotion, the author has set himself a goal to improve nutrition and develop better eating habits.
  • The Pender Health Promotion Model for Behavioral Change The central feature of this prevention model is that it emphasizes the proactive interventions people should adopt to avoid illness in general.
  • Health and Health Promotion Creating premises for improving public health and preventing health issues in community members are some of the core goals that a health expert must pursue.
  • Public Health Promotion in Everyday Life One of the most common examples of public health promotion in daily life is the use of various types of educational signage, such as posters and labels.
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Health Promotion - Assignment Example

Health Promotion

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  • Important Initiatives in the Promotion of Public Health In addition, the task force recognised the importance of enhancing access to healthy foods in the country. Today, the initiative is one of the most comprehensive and well-funded programs that are effectively addressing the age […]
  • Pricing and Promotional Strategies in Health Facilities Penetration Pricing The model advocates for a pricing method where an organisation sets its prices at a low rate than that offered by the competitor; the aim of the approach is attack a large mass […]
  • STD/HIV Health Promotion Evaluation Plan Process evaluation will emphasize on quality and suitability of the interventions and approaches of the program. A critical aspect of process evaluation will be to determine and track the areach’ of the program.
  • The Role of Te Tiriti o Waitangi and the Equity Principle in Relation to the Health Promotion Practice in New Zealand The Aspects and Importance of Te Tiriti o Waitangi The aspect of protection which is discussed in relation to different interpretations of Te Tiriti o Waitangi is important to be analysed as the key concept […]
  • Health Evaluation Plan for the ARTreach Health Promotion Program Evaluation Goals and Objectives The major objective of evaluating the project is to establish the effectiveness of ARTReach project in empowering women, who are the marginalised in the community.
  • Public Health Promotion Program Evaluation This category of questions helps to understand how the process may influence the outcomes of the program and define who or what undergo the most considerable changes during the process under consideration.
  • Health Promotion Program in Kenya The spread of the disease was noted by Wachira, Naanyu, Genberg, Koech, Akinyi, Kamene, and Braitstein as being the direct result of a lack of sufficient education regarding the spread of HIV and other STDs […]
  • Health Promotion Program HIV/AIDS in Kenya Studies have established that married couples and other people in more stable relationships have contributed to the highest number of new HIV/AIDS infection in Kenya.
  • Health Promotion Initiative for Young Families The main objective of this health promotion initiative is to promote healthy lifestyle with the aim of reducing high cases obesity, overweight and other chronic diseases among children and young adults through healthy diets and […]
  • The Relationships Between Public Health and Health Promotion The primary objective of this paper is to evaluate how the society has responded to the issue of mental disorders and mental health.
  • Health Promotion Model by Nola Pender The environment as the second concept of the Health Promotion Model refers to the physical, cultural, and social background in which an individual grows.
  • Pender’s Health Promotion Model Application The model will be of great significance to nursing practice and the public at large. Consequently, one can conclude that a patient can be influenced to help in the prevention of diseases.
  • Australian Health Promotion Program’ Evaluation The sustainability of the programs designed to promote health in society depends on the feasibility of the holistic approaches used by the government and the private institutions.
  • Social Marketing in Public Health Promotion The article will use numerous examples to counter the argument that social marketing is a waste of time and money. The use of social marketing may help a health organization to reach many people.
  • Population Health Promotion in Spartanburg The status of the public health of Spartanburg County is determined by a range of factors. In particular, the Road to Better Health coalition is one of the most prominent of them.
  • Health Promotion: Depression Awareness in Teenagers In addition to community sensitization and promoting the expression of melancholic emotions by adolescents, the DAP program will include depression screening days in schools.
  • Youth Suicide Prevention: Health Promotion Plan In this paper, a proposed mental health initiative to meet the challenges of at-risk youth is discussed using the PDSA model and related evidence-based strategies based on IHI indicators included. Access to the program will […]
  • Health Promotion: Motivation and Skills for Changes For provider interventions, the key goals are to enhance screening levels and improve their knowledge of strategies to motivate and educate patients to enhance their lifestyle.
  • Sex Workers’ Health Promotion Program The fact that the nature of issues associated with sexual health is very sensitive also prevents the broad discussion of the issue and the identification of viable solutions.
  • Health Promotion and Sustainable Development The concept of sustainable development emerged as a guiding principle in the formulation of policies to address health and development issues around the world.
  • Public Health Promotion: Female Genital Mutilation Socialisation of sexuality is manifested in the assimilation of sexual and social norms, a culture conditioned by sexual education and, the development of attitudes, the kinetics and postures of sexual intercourse and the development of […]
  • Personal Career in Health Promotion She is a professional in the field of health promotion. In addition to community health, the organization is engaged in policy and research.
  • Mental Health Promotion and Effective Interventions In their article “The Evidence of Effective Interventions for Mental Health Promotion,” Clemens Hosman and Eva Jane-Llopis state that to prove the effectiveness of the programs contributing to mental health, it is necessary to refer […]
  • Doctors Education: Health Promotion and Preventive Care The fourth role that can minimize health risks and improve the quality of care is continued evaluation of patients’ needs. Physicians should therefore use their competencies and resources to support the wellness of their colleagues.
  • Medications and Physical Health Promotion in Psychiatric Nursing However, she continues to engage with treatment and is seen to be more active in her communication with friends and family. In this case, it is expected to help YW with nightmares.
  • RN’s Role in Health Promotion and Patient Outcomes Once the needs are identified, the nurse’s role shifts to monitoring the state of the patient and adjusting the amount of dependent-care or self-care agency.
  • Importance of Mental Health Promotion in Society Mental health is an integral part of health which serves as the foundation for the well-being and effective functioning for a person and society.
  • Mobile Health Promotion Unit “Hearty Bus” The proposed name of the MHPU is “Hearty Bus” due to the central features of the vehicle. In short, CPI is expected to become valuable metrics for controlling the performance of “Hearty Bus”.
  • Role of Theory in Health Promotion In order to support the health goals of the targeted people, practitioners, social workers, and clinicians can embrace the use of an effective theory.
  • Health Promotion and Nutrition During Pregnancy The leaflet also states that fat is a crucial part of the diet for pregnant women and that its increase is not a negative sign.
  • The Necessity of Health Promotion During Pregnancy It is vital to provide examples of adverse outcomes related to drinking to help patients understand the threat that alcohol may pose.
  • Health Promotion Among Aboriginal Australians Based on the causes of illicit substance usage among Aboriginal Australians, the social norms theory is the best-suited behaviour change theory to be used in the intervention protocol.
  • Developing Leadership for Health Promotion The main goal of public health practitioners is to promote the health and wellbeing of individuals and communities. As for Leadership in public health, Moodie defines it as maximizing personal potential, as well as the […]
  • Mobile Health Promotion Unit Project Goals and objectives for the present project are closely connected to the distinctive characteristics of the MHPU.”Hearty Bus” is a non-profit endeavor that needs significant initial investments to buy the vehicle, furnish it with necessary […]
  • Diabetes and Health Promotion Concepts The list of determinants and their relation to the disease is as follows: Income and social status: Treatment of diabetes requires time and money to treat properly.
  • National Health Promotion Program Analysis The development and implementation of national health promotion programs can be seen as one of the ways to achieve these goals.
  • Partnering with Communities in Health Promotion The project launched under the title of “A Place to Call Home” revolved around the issues of homelessness and housing insecurity.
  • Healthy People 2020: Health Promotion Strategies The evidence-Based Resources database available on the Healthy People official site provides a wide range of materials derived from surveys and researches conducted in the sphere of health care since 2000.
  • Health Promotion in American and Alaskan Natives Due to some disparities linked to populations’ economic status, access to resources, and other factors, specific approaches to health promotion are needed to encourage the well-being of minorities.
  • Disease Prevention and Health Promotion Laws The Jakarta Declaration was the document that influenced the reorganization of activities based on the transition from health prevention to promotion.
  • Disease Prevention and Health Promotion Initiatives Healthy People initiative sets 10-year country-wide objectives for enhancing the health of all Americans and to address the current challenges in public health and provide support on various matters in the context of health issues.
  • Lack of Health Promotion Issue Analysis Social ecology includes the hub of the suppositions of human health and the progression of useful strategies to enhance personal and combined welfare.
  • A Study of the Health Promotion Needs in Organisation or Community Community-based Intervention in the context of health is a vital concern often ignored in most organizations and even hospitals, which hold the notion of health promotion.
  • Concepts of Health Promotion in Australia This should lead to changes in attitude and also organisation in health services, which make a new focus on the whole requirements of an individual as a complete person.
  • “Review: “”Leadership in Workplace Health Promotion Projects”” by Delve and Colleagues” The research involved a comprehensive analysis of the attendance of employees in correlation to the leadership characteristics of their leader at the workplace.
  • Improving Health. Strategies for Effective Health Promotion. Health promotion is defined as “the art of science of motivating people to enhance their lifestyle to achieve complete health, not just the absence of disease” through a combination of strategies to increase awareness, facilitate […]
  • Theories of Aging and Health Promotion With the reduced rate of fertility, and the survival of a higher fraction of individuals up to older ages, the average figure of the individuals of or above the age of sixty-five years, “has been […]
  • Health Promotion Program Tactics Policy, regulatory and environmental actions will help the implementation of the health promotion program more effectively. It will help in creating a good surrounding for health promotion programs thereby promote the effectiveness of their implementation.
  • Health Promotion Program Design The group selected for the health promotion program is the high school teenage group, ranging from fifteen to nineteen years of age.
  • Community Health Promotion for Aged People in Warren The major purpose of the community health promotion is to make identification of the constructs of the planned behavior theory, which has the inclusion of behavioral beliefs, control beliefs based on an individual’s perception, and […]
  • School-Based Nutrition Health Promotion Program This was based on the fact that, healthy eating habits in both children and adolescents had increasingly been noted to have deteriorated over the years hence the need to promote the health, growth and intellectual […]
  • Health Promotion and Obesity Prevention The study conducted by Lovasi, Neckerman, Quinn, Weiss, and Rundle focuses on the effects of the walkability of the neighborhood and its influence on the condition of the population.
  • Health Promotion Theories: An Ecological Approach Low access to healthcare, on the other hand, is a social environmental factor that can also affect the health of the population.
  • The Happy Older Latinos Are Active: Health Promotion Program HOLA is the health promotion program which was developed for old Latinos with the purpose of prevention their mental disorders, including anxiety and depression.
  • Involving the Community in Health Promotion Program To implement the program, it will be necessary to investigate the current condition of the community to be able to understand the lifestyles of the population.
  • Health Education and Health Promotion The website that belongs to the Centers for Disease Control and Prevention provides a lot of relevant information that can be used by healthcare professionals, researchers, educators, and students. The CDC website provides health educators […]
  • Health Promotion Program Evaluation In this paper, the evaluation of a health education program for high-risk groups will be described and explained to identify the main benefits of the idea, to choose appropriate methods of evaluation, and to clarify […]
  • Utilizing Pender’s Health Promotion Model: Patient Education P, the necessity to manage the patient’s sugar blood levels is currently the main priority and the essential goal of the treatment process.
  • Implementing and Evaluating Prevention and Health Promotion Activities That is why it is necessary to develop suitable health promotion activities that will improve public health and limit the spread of the condition under analysis. In addition to that, the given framework is suitable […]
  • Personal Health Promotion Plan It is important for people to embrace good eating habits and exercise to reduce the chances of developing chronic health complications.
  • Promotion of Cardiovascular Health and Cancer Prevention The purpose of this presentation is to review recommendations of the NAS Global Report 2017 for cancer and cardiovascular diseases prevention, analyze the current international healthcare policies, and define the reasons for their implementation.
  • Health Promotion Program: Cardiovascular Disease Mortality Decrease Around the world cardiovascular disease happens to be the leading cause of death, and among the major causes of disability and diminished productivity in adults.
  • Health Promotion Pamphlet Analysis The pamphlet is laid out in such a way that it is appealing in that it is systematically subdivided into subheadings starting with a definition of high blood pressure, what high blood pressure does to […]
  • Health Promotion Program by the World Health Organization The name of the program is Bangkok program for Health Promotion in a Globalized World, in accordance with the Bangkok treaty, on the basis of which the program was initiated.
  • Use of Precede Model for Reviewing a Global Health Promotion Program The program under review will enter the PRECEDE model at phase one as it involves determination of the social problems, the needs, and thus the quality of life of the individuals in need of developing […]
  • Health Promotion: Diabetes Mellitus and Comorbidities This offers a unique challenge in the management of diabetes and other chronic diseases; the fragmented healthcare system that is geared towards management of short-term medical emergencies often is not well prepared for the patient […]
  • Settings for Oral Health Promotion Action in Nursing Homes in Sydling Health promotion offers the potential to tackle the underlining determinants of oral health thereby improve the oral health of this section in society. Assessing the oral health needs is an essential step in developing effective […]
  • The Holistic Health Promotion Model Overview This paper will therefore address the concerns in a holistic approach that will include spiritual support and beliefs, physical concerns, and the possible distress in the context of a family; the significance of a holistic […]
  • Cultural Factors in Health Promotion Strategies Health promotion is aimed at bettering the individual social, economic and environmental conditions in a bid to minimize the effects on the overall health of the individual and the society.
  • A Needs Assessment in Health Promotion The VMOSA model will be chosen as the framework for strategic planning, in which the objects are community-oriented, with the mission and the vision being identified through the course of the assessment.
  • Exploration of a Health Promotion Priority To enhance the understanding of the process and theoretical frameworks, the promotion of physical activity and active communities in Victoria will be discussed.
  • School Campus Service: Wellness and Health Promotion Majority of the campuses in the United States try to offer the best services to their workers and students. The funds are always enough for the performance of the agency to provide the best health […]
  • Health Promotion in Nursing Analysis In this essay, a review of the literature of three journals will be put in perspective with a view of knowing the definition of health promotion, and the roles of the nurses in the overall […]
  • Family Health Assessment: Health Promotion Strategy This system is referred to as the Gordon’s Functional Health Patterns and it’s a very comprehensive approach of collecting information from a patient so that nurses and doctors can use the information for diagnosis of […]
  • Community-Based Health Promotion Project The main goal of this paper is therefore to propose the implementation of a health promotion program for the adolescents in New Jersey as part of the community-based project. The health promotion program to be […]
  • Community Health Promotion: The Fight Against Diabetes in a Community Setting Applying principles of community-based health promotion it is important to focus on Type 2 diabetes and the people that are prone to acquiring this medical condition.
  • Water for Environmental Health and Promotion The recognition of the effect of the epidemiological triangle is quite crucial, as people ought to realize the interrelationship of the host, environment and agent in the process of spreading diseases and the effect that […]
  • Health Promotion: Empowerment Strategies Community empowerment develops from individual to group, and embodies the objective to trigger social and political transformation in support of the community that embarks on the course.
  • Scientific Writing: Effectiveness of Health Promotion Programs Under the “Healthy People 2010” In this case, the purpose of the study was to determine the effectiveness of the programs under the “Healthy People 2010” initiative.
  • Health Promotion Activity to Prevent Obesity The data collected in the triage units at the hospital indicate a persistent increase in the average weight of patients who come to the hospital.
  • Analysis of the Current Health Promotion Pamphlet According to the SMOG tool, the discussed pamphlet is of the average readability level, and the required reading levels are correlated with the 7th and 8th grades.
  • A Model for Implementing Health Promotion Programs in Communities The Community Health Improvement Plan proposed in the community as the program to address the issue of obesity should be discussed in the context of the MAP-IT framework and with references to the planning and […]
  • Health Promotion on Hypertension Amongst African Americans For instance, in this case where health promotion is aimed to inform people on the importance of managing their blood pressure, the messages that support these people may encourage the African Americans to seek medical […]
  • Health Promotion and Challenges Faced by Women Type 2 Diabetes Mellitus affects the health outcomes of many women in the world. I have also identified several practices that can improve the health outcomes of many women with T2DM.
  • Cholesterol Screening Program and Health Promotion The role of the health sector in the cholesterol-screening program is to conduct extensive research on the prevalence of the condition in addition to educating on its effects and ways of alleviation.
  • Health Promotion: Competency Framework A competency framework that is deployed in the health care sector incorporates nine competencies that are important in guiding the provision of health care and the healthcare promotion practice.
  • Nursing Health Interventions for Health Promotion The custom may bear a witness to the high cultural and spiritual development of the related members. The practical implementation characteristics of family traditions and routines are the tools of health promotion.
  • Nursing: Health Promotion Overview The following actions of a nurse can promote the state of a patient with diabetes. Finally, the nurse should include and involve the patient’s family into the process: it is obvious, that the closest people […]
  • Reflection Journal. Health Promotions Health Fair It was my privilege to realize that most parents knew the benefits of good nutrition and exercise to their kids between the age of three and six years.
  • Health Promotion and Smoking Cessation I will also complete a wide range of activities in an attempt to support the agency’s goals. As well, new studies will be conducted in order to support the proposed programs.
  • Health Promotion: Life Course Theory Life Course Theory implements to the concept of health promotion for the aging population and the population with reduced physical activity in multiple terrains.
  • Health Promotion in the Adults Aged 65 and Older The social determinants of health and a sustained healthy lifestyle can have long-term effects, and the cost of care for that impact in the older population should not be a burden to the society as […]
  • Elderly Health Promotion Intervention Plan Extensive research conducted over four decades haS underlined the role of regular physical activity in the elderly as the most important aspect that contributes to the well-being of the population that ages.
  • Health Promotion for Older Adults in America To learn and adopt different forms of physical activity appropriate for older adults To motivate older adults to create small teams in their neighborhoods to participate in different forms of physical activity within the community […]
  • Identification of a Goal for Health Promotion The main goal of this health promotion project is to identify the problems that may bother people nowadays and to clarify the ways of how medical workers and nurses can participate in the solution of […]
  • Health Promotion Weight Loss: How to Change People Behaviors and How to Keep Them Motivated to Lose Weight For example, when advising people on losing weight one should try to talk to them to get to details about their eating habits and whether they know how risky those are habits to their lives.
  • Exercise and Health Promotion: Chandler Fitness Center I came to recognize that the objectives and the philosophy of the facility were to change people’s lives through fitness enhancement.
  • Continuous Quality Improvement and Risk Management in Health Promotion S history as an example, CQI according to American Medical Association study in 1910, found the need to improve hospital conditions and follow up on patients to assess service delivery. By 1966, the focus had […]
  • Health Promotion: “Jeans for Genes” The principle of the CMRI is that medical research is central in prevention of future congenital disorders and treatment of current conditions in order to improve the lives of children and future generations.
  • Sonagachi Project: The Health Promotion Program The union fights for the sex workers to hold the leadership of their projects for the benefit of the locals. Additionally, the sex workers are the occupants of administrative and decision making roles in the […]
  • Research Methods in Health Promotion Therefore, it is vital that the data collection instruments are valid and relevant so as to ensure validity in the health promotion research study.
  • Cardiovascular Diseases and Health Promotion in Women The article notes that women are at higher risks of developing this condition due to misdiagnosis and lack of specialized care and treatment procedure and very few manage to get guideline-based preventive and treatment services.
  • Health and Wellness Promotion in Queens Village: Community Educational Program This presentation will describe the Queens Village community, its health needs, and design the educational proposal.
  • Evidence-Based Health Promotion Program: Immunization The purpose of this presentation is to inform about the question of immunization in detail while accentuating evidence-based effects of vaccination on children and adolescents.
  • Approaches to Health Promotion and Disease Prevention In this case, disregard for the principles of individual responsibility and freedom of choice is the lesser evil that was adopted to achieve positive public health outcomes.
  • LGBTQ: Personal Characteristics in Health Promotion According to GLMA, since the patient’s cultural relevance is vital to improve their health in this healthcare facility, in addition to biophysical information, the questionnaire should contain cultural questions.
  • On the Strategies for Healthy Eating Promotion Today, I will discuss three strategies for healthy eating: I will first talk about the importance of making a food journal and planning meals and snacks for each week based on the available budget.
  • Health Promotion Levels Overview Hence, the process of health promotion and disease prevention should also include different perspectives and channels to secure positive health care tendencies.
  • Self-Empowerment Health Promotion Model In terms of the self-empowerment model, the patient is taught to enhance the sense of personal identity and responsibility by being encouraged to pay attention to the decision-making process.
  • Family Health Promotion Strategies Collective health begins at home, and a nurse can become a medium between the family and the society, explaining the importance of different health strategies to the family members.
  • Environmental Factors and Health Promotion: Indoor and Outdoor Air Pollution This presentation offers some information about the damage of air pollution and presents a health promotion plan with helpful resources and evidence from research.
  • Health Promotion Theories and How They Can Help Patients The introduction of interventions to correctly calculate calories, change daily activity, and take specific medications can help in the treatment of the patient.
  • Public Health, Health Promotion, and Health Education The relationship between public health, health promotion and health education is an interesting one yet has humble origins that begin within with your average school.
  • Osteoporosis: Pathophysiology, Health Promotion, and Disease Prevention Idiopathic; affects adults aged 50 and above or results from the effect of any other disorder. Sex women are at a higher risk.
  • Health Promotion Model for Teaching Patient The purpose of this essay is to describe the model of health promotion and the barriers that affect the ability of patients to learn.
  • Why Partnership Is Important for Public Health Promotion? In addition to treatment, they work with the prevention of illness, establish coordination between patients and the health system, and take part in improving public health. Additionally, it is important to recognize the role of […]
  • Role of the Pediatric Nurse in the Promotion of Health in School The role of a pediatric nurse is to promote physical and emotional health in schoolchildren and adolescents. The role of the pediatric nurse is to ensure that the child grows into a healthy and responsible […]
  • The Importance of Ethical Health Promotion Most of the privacy and state-of-the-art strategies put in place are still inadequate and incapable of meeting the demands of more patients.
  • Health Promotion Plan: Smokers in Mississippi The main strategies of the training session are to reduce the number of smokers in Mississippi, conduct a training program on the dangers of smoking and work with tobacco producers.
  • Values of a Nurse’s Health Promotion and a Client The most proper way to tackle it is to accept it and follow the will of a patient. It is obligatory to respect the worldview and opinion of a patient.
  • Sexual Health and Diversity, Health Promotion Thus, there are obstacles to promoting sexual and reproductive health among LGBTI people, and they must be overcome to improve the nation’s health.
  • Family Nursing Care Plan – Health Promotion and Disease Prevention Therefore, it is critical to consider a holistic approach to take care of the family and improve the quality of their lifestyle.
  • Health Promotion: The Role of Nurses The Health Belief Model is a theoretical concept that allows nurses to predict the behaviors and beliefs of the people in a community towards medical health.
  • Health Promotion and Role of Nutrition One of the major aspects of health promotion concerns the patterns of nutrition, as there is a tendency of miscomprehending their impact on health.
  • Smoking Cessation and Health Promotion Plan Patients addicted to tobacco are one of the major concerns of up-to-date medicine as constant nicotine intake leads to various disorders and worsens the health state and life quality of the users.
  • Health Promotion and Disease Prevention and Management Strategies Since its founding in 1884, Montefiore Medical Center has worked tirelessly to improve the health and well-being of the people of New York City.
  • Teen Pregnancy: A Health Promotion and Sexual Education Plan For example, condoms may be used to prevent STDs, and oral contraceptives may be taken in order to ensure birth control. Pregnancy is related to a significant number of procedures and complicated care.
  • Health Promotion and Interdisciplinary Approach In the realm of health promotion, experts from various multidisciplinary health workers have agreed on the characteristics of effective collaboration and an interdisciplinary approach. Thus, their skills and approach will be essential in the success […]
  • Nora Pender’s Health Promotion Model The use of the Health Promotion Model for the EB is validated by the compatibility between the theory’s central idea and the EB’s goal of improving the quality of nurses’ work with patients for improving […]
  • Pender’s Health Promotion Model HPM clearly states that the idea of health promotion is multidimensional, and all the levels that impact one adherence to a health plan are interconnected based on their relationship and the overall outcome.
  • The Health Promotion Model Analysis As a result, the distinction is reflected in how diverse health models depict a person and the methods used to persuade them of the same notion of health and how to attain it.
  • Human Immunodeficiency Virus and Health Promotion For instance, it highlights the role of parents in the care process of minors, the right to access healthcare information for minors, the role of patients in self-care and the role of nurses in communicating […]
  • Nudging as an Ethical Health Promotion-Related Issue Non-educative nudging goes against patient rights of autonomy and informed consent, and healthcare professionals should abstain from them to not lose the patient’s trust.
  • Nutrition and Health Promotion This shows that nutritional balance is essential in the development of a body, and thus excess or deficient intake can lead to health complications.
  • Health Promotion and Educational Needs of Patients To compare the effectiveness of the preventive measures, it is necessary to explain the role of healthcare providers in stopping the spread of disease.
  • Nursing Theory and Health Promotion Model To use theory effectively in all realms of practice, training, and investigation, it is necessary to understand how to explain, analyze, and assess the concept.
  • Health Promotion Strategies and Barriers Health promotion is one of the critical activities of the modern healthcare sector. The term implies the process of enabling people to improve their health and increase control of their well-being.
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Promoting health and preventing ill health Essay Sample

Promoting health: schizophrenia.

This essay is based on the prevention and promotion of schizophrenia. The paper will begin by describing the background of schizophrenia. It will also explain the rationale for selecting schizophrenia as a health condition for this essay. Next, the paper will provide a critical discussion on the epidemiology of schizophrenia, including the risk factors, vulnerable population, its presentation, and prevalence in the UK. Additionally, the essay will explain the assessment of schizophrenia and the applicable assessment tool. The next section of the paper will describe three health promotion goals that the paper intends to realise by completing this work. Furthermore, it will provide a critical discussion on the interventions for health promotion goals, including roles of individual and his/her social network, multi and interdisciplinary teams, organisations, and departments, among others. Lastly, the essay will provide a critical discussion on evaluating health promotion care planning, including its effectiveness, alternatives, justification, and recommendations. The conclusion will contain a summary of key elements discussed throughout the essay.

Background of Schizophrenia

Swiss Psychiatrist Paul Eugen Blueuler first coined the term schizophrenia in 1910. In Greek, the words schizo mean 'spilt' and phren means 'mind.' schizophrenia was initially intended to mean 'loosing of mind and feelings' since it was characterised by fragmented thinking and mental confusion. It was also referred to as 'split personality (Perkovic et al., 2017). However, National Collaborating Centre for Mental Health (Great Britain) (2013) indicates that schizophrenia is not a split or multiple personality but involves psychosis where one cannot differentiate what is imagined and what is real. The world may appear to them as a jumble of confusing sounds, thoughts, and images. The individual with schizophrenia struggle in the society and hardly do well in school at work, and in relationships. Often, they feel withdrawn and frightened.

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Emil Kraepelin first defined schizophrenia as dementia praecox, a progressive mental health disorder of unknown aetiology. He observed the early onset of the condition to begin in adolescence, leading to a less or more irreversible deterioration in cognitive and functional capacity (Kendler 2020). According to National Collaborating Centre for Mental Health (Great Britain) (2013), schizophrenia is a chronic, severe mental disorder characterised by distorted thinking, emotions, perceptions, language, behaviour, and sense of self. According to Perkovic et al. (2017), the symptoms of schizophrenia include hallucination, delusion, lack of motivation, disorganised speech, and trouble with thinking. Early interventions diminished reoccurrences and contribute to improved quality of life. However, Perkovic et al. (2017) assert that schizophrenia does not any known cure, but there are antipsychotic medications that help elevate the symptoms and improve long-term outcomes.

Knowledge and early intervention of schizophrenia are crucial to individual quality of life, health, and wellbeing. Catalano et al. (2021) noted that schizophrenia could be disabling and change the course of one's life. The early onset-of schizophrenia begins in young adults and threatens an individual's independence and quality of life at a crucial time (Kimotho 2018).  Timely access to necessary support and treatment enabled people with schizophrenia to lead a healthy life, work, have families, and pursue their life goals, thus, positively contributing to society. Moreover, for decades, societies have stigmatised and stereotyped people with mental health conditions such as schizophrenia as violent and split or multiple personalities. Moreover, there are also myths that individuals with schizophrenia belong to the mental hospital and cannot recover.  Katschnig (2018) also argued that society treats individuals with schizophrenia as lesser humans, making them feel isolated and deprived of social life. According to Kimotho (2018), this contributes to further stress and depression, which affect even those who are already on medication. Therefore, it is essential to promote health to enhance early interventions and adherence to treatment and change the societal perspective regarding schizophrenia.

Epidemiology of Schizophrenia

Schizophrenia is a major psychiatric disorder that changes one's perception, thoughts, and behaviour. The positive symptoms include delusion, hallucination, and negative thoughts comprise emotional apathy, poverty of speech, social withdrawal, self-neglect, and lack of drive (Halvorsrud et al., 2019). Schizophrenia is unequally distributed in society. According to Cadge, Connor, and Greenfield (2019), schizophrenia tends to more prevalent in lower- socio-economic groups. Halvorsrud et al. (2019) also state that men are 1.4 times likely to develop schizophrenia compared to women. Wang et al. (2020) indicated that the incidence of schizophrenia is about 16 per 1000 people. The condition affects 0.7% of the UK population (Cadge, Connor, and Greenfield 2019).  According to the Office for Statistics, Schizophrenia affects about 9.65 of children between 5 and 16 years and accounts for about 25% of the mental health disorders among adolescents between ages 10 to 18 years (Halvorsrud et al., 2019).

Janoutová et al. (2016) indicated that one quarter has wholly recovered in long-term follow-up on people who have schizophrenia. Most conditions have improved while deteriorations are only 10% throughout their lifetime. Halvorsrud et al. (2019) argued that schizophrenia has a worse prognosis with early onset in childhood or adolescence than onset in adult life. Wang et al. (2020) also indicate that about one-fifth of individuals with schizophrenia experienced positive outcomes with only mild impairment. Halvorsrud et al. (2019) indicate that one-third of individuals with Schizophrenia present severe impairment that requires psychiatric and intensive social support. According to Cadge, Connor, and Greenfield (2019), individuals with schizophrenia have a 5 to 10% chance of dying by their own hands within 10 years after being diagnosed with schizophrenia which is around 3times higher compared to the general population.

The risk factors for schizophrenia include genetics; there is a greater likelihood of schizophrenia being passed to children from parents. Secondly, environmental factors such as exposure to toxins like marijuana, viral infections, or highly stressful situation can trigger Schizophrenia (Wang et al. 2020). Schizophrenia can also result from brain abnormality and changes in brain chemistry and circuits.

Early diagnosis of schizophrenia is essential in reducing the challenges such as social, physical, and economic impacts and its debilitating effects. Holistic and systematic assessment is crucial to both the service user and physician (Macfadden et al., 2011). The presence and severity of schizophrenia can be screened using Clinical Global Impression-Severity (CGI-SCH) scale. CGI-SCH is effective in assessing positive, negative, depressive, and cognitive symptoms of schizophrenia. Grover et al. (2017) also indicates that CGI-SCH is a reliable and valid questionnaire used to evaluate the severity and treatment response in schizophrenia. Additionally, the service user's functionality can be assessed using the Personal and Social Performance (PSP) scale, Strauss-Carpenter Levels of Functioning (LOF), and Global Assessment of Functioning (GAF) (Psychosis, NICE 2014). These assessment tools are used to rate the service users functioning over the past months in four areas, including personal and social relationships, aggressive and disturbing behaviour, self-care, and engagement in socially useful activities.

The physicians assign scores from 1 (lack of autonomy in basic functioning) to 7 (excellent functioning) in all four areas. The service user's health status is also assessed using Medical Outcomes Survey Short Form -36 (SF-36). The survey has 36 items and screens the service user's health status over the past four weeks in eight different areas, including physical health. The survey evaluates body pain, general health, physical functioning, and role-physical (Grover et al., 2017). The mental health assessment comprises role emotional, mental health, social functioning, and vitality. The assessment evaluates for adverse events and serious adverse events associated with schizophrenia. According to Psychosis, NICE (2014), the Diagnostic and Statistical Manual (DSMIV-TR) is used to evaluate the presence of schizophrenia based on the symptoms presented and to rule out the presence of schizoaffective and mood disorder.

Health Promotion Goal

The increased medical morbidity and mortality are associated with schizophrenia and related mental health disorders. The additional deaths are historically attributed to suicide and accidents (Stilo and Murray 2019). However, these only accounts for a small fraction of deaths as most deaths related to schizophrenia emerge from physical illness. The World Health Organisation definition of healthy life comprises mental, physical, and emotional health. The goals of health promotion for schizophrenia will thus reflect the physical, social, and emotional health of service users.

Goal 1: To create public awareness on factors influencing an individual's wellbeing to minimise mental health by 30% by 1 st December 2022. While there are many misconceptions about mental health, specifically schizophrenia, society has no adequate information regarding factors, such as environmental factors, such as drug and substance abuse and depression, contributing to Schizophrenia (Stilo and Murray 2019). Moreover, the goal aims to create a supportive society that tolerates, accommodates, and supports individuals with mental health issues to support their recovery.

Goal 2: To conduct education and training programs to educate people with schizophrenia about their conditions to stimulate self-acceptance and positive coping mechanisms to promote medication adherence and minimise relapse by 40% by 1 st December 2022.  Leonhardt, Hamm, and Lysaker (2020) indicate that most people with schizophrenia hardly accept their condition and are forced to take their medication under supervision. Lack of self-acceptance and limited information regarding one's mental health status reduces their compliance to medication and commitment to the recovery process leading to relapse and further deterioration.  

Goal 3: To train people with psychosis on nutrition, physical activity, and healthy living style to reduce obesity-associated antipsychotic medications by 60% by 1 st December 2022. Antipsychotic drugs are known to have a side-effect on weight gain (Townsend 2018). Weight gain can contribute to depression, lack of self-esteem, and social withdrawal, thereby contributing to further deterioration. Thus, the goal is to ensure that people diagnosed with schizophrenia and are under antipsychotic medications adopt healthy living habits.

Interventions

The physical and social health disparity of individuals with schizophrenia and severe mental illness is increasingly concerning. Besides the unwanted side-effects of antipsychotic medications, the increased morbidity is attributed to adverse lifestyle factors such as physical inactivity, poor diet, and drug and substance abuse (Tranter and Robertson 2021). Additionally, the social determinates of mental health, such as families, individuals, community, and the entire population, also increase the risk of mental health condition and substance user disorder, thereby worsening the existing mental illness or substance abuse (Compton and Shim 2020). Therefore, the multidisciplinary approach can be adopted to implement evidence-based interventions that aim to minimise mental health conditions, promote recovery, and improve quality of life and health outcomes.

The community mental health nurses, social workers, and psychologists will work alongside public health organisations to employ a universal approach in educating the community members about schizophrenia. The initiative will promote healthy lifestyles, clarify misconceptions and myths about schizophrenia, prevent the onset, and eliminate or reduce causal risk factors such as substance abuse (Compton and Shim 2020). The intervention will also aim to provide society with adequate information regarding the need for early screening and check-ups to identify the early onset of schizophrenia and make a timely intervention. However, Tanaka et al. (2018) noted that mental health's societal attitudes and stereotypes prevent people from accepting their mental health conditions and challenging them not to seek mental health screening.  Catalano et al. (2021) also reiterate that societal beliefs and attitudes toward mental illness impede the recovery process of individuals with schizophrenia due to social isolation, discrimination, and prejudice. Thus, the educational and information campaign will ensure that community members understand accurate and precise information about mental health conditions and change their attitudes and behaviour towards people with mental health conditions.  

Additionally, the psychologist, mental health nurses, psychiatrist, GP, and the government will selectively work with individuals diagnosed with schizophrenia to promote their adherence to medication and self-acceptance (Compton and Shim 2020). The team will employ diverse strategies, including restrictions, enablement, environmental restructuring, persuasion, and education, to promote the behaviour change. Education will increase the service users' knowledge and understanding of their condition and encourage self-care.  The government will equally play a role in passing rules, legislations, policies, and guidelines to reduce opportunities for people with schizophrenia to access drugs and substances and promote inclusion. The government can also encourage people with schizophrenia by passing regulations and legislation that eliminate the criminal justice system, employment, educational, and financial inequalities (Carney, Bradshaw, and Yung 2016). Moreover, environmental restructuring will be employed to change people's social and physical context with schizophrenia. These will include providing diet, private gym, and behavioural support classes to help service users participate in interventions together with the trainer. According to Valiente et al. (2021), lack of self-acceptance limits medication adherence and management. These interventions will eliminate barriers to early screening and early interventions to prevent the prevalence of schizophrenia.

Furthermore, obesity, as a side effect of antipsychotic drugs in people with schizophrenia, increases physical disability, mortality, and morbidity. For instance, the health effects of obesity include high blood pressure, diabetes, heart disease and stroke, breathing difficulties, and cancer. Moreover, the individual with increased body weight due to antipsychotic medication is likely to get depressed due to their new appearance (Luo et al. 2020). This can further contribute to depression, stress, and suicidal behaviour. The intervention will thus focus on ways to prevent relapse and adopt healthy lifestyles that prevent obesity. This intervention will require a nutritionist to personalise a healthy diet to service users. The physician will also actively work with the service user to engage in physical activities. Other multidisciplinary teams in this intervention will include service user's family members and carers to provide them with social support. The community mental health nurse also assesses medication adherence, and the social workers will assess service users' living conditions, self-care, and living activities.

Evaluation of health promotion care planning

Mental health influenced an individual's quality of life and can be maintained by finding a community for social support. Shereda et al. (2019) asserted that community is about feeling connected to and accepted by others. Cochrane, Moran, and Newton (2021) argue that loneliness and isolation deteriorate people with mental health conditions. As such, an inclusive, accommodating, and supportive community is critical for people with schizophrenia to thrive. Also, Shereda et al. (2019) stipulated the importance of early screening to improve mental health conditions and recovery management. However, the traditional beliefs and misconceptions about mental illness have persistently hindered people from undertaking early mental health screening to escalate recovery-focused interventions. Elraz (2018) further suggested that mental illness misconceptions have promoted isolation and discrimination against people with mental health conditions. El-Nady et al. (2018) also indicated that community-level initiatives effectively reduce discrimination and stigma, promote mental health awareness, prevent mental disorders, and support social inclusion and recovery. Thus, public education is a critical strategy intervention that helps change society's mind towards mental illness and develop a more inclusive and supportive culture towards people with schizophrenia.

Additionally, the interventions geared towards people with schizophrenia are critical in improving their understanding of their mental condition, accept-self, and adhere to medications (Nguyen et al. 2020). In addition, government interventions through legislative and policy initiatives will improve individual's access to employment and educational opportunities, thus reducing the concern that if one is screened and found to have a mental health condition (Gray, Davies, and Snowden 2020), they are still confident of completing their education, securing jobs, and being accommodated in the society. Cochrane, Moran, and Newton (2021) confirmed that psycho-education and training effectively help the service user deal with the social stigma associated with schizophrenia and cope with emotional distress. Gurusamy et al. (2018) also reiterated that psycho-education coupled with family interventions improves mental health outcomes and reduces relapse rates. Elraz (2018) also noted that antipsychotic drugs are associated with weight gain, leading to serious psychological and physical health effects. Consequently, the Nursing and Midwifery Council (2018) contend that service users with schizophrenia must be informed of the negative and positive outcomes of these medications and other available evidence-based alternative options so that they can make informed treatment options. Shereda et al. (2019) also argued that individuals with schizophrenia under antipsychotic medications must be trained to engage in healthy eating habits, physical activity and adopt healthy lifestyles.

Alternative Health Promotion Initiatives for Schizophrenia: The alternative options in promoting health for schizophrenia include coercion and modelling. The coercion could be used to ensure that people with schizophrenia are prohibited from undertaking unhealthy habits such as substance abuse, physical inactivity, unhealthy eating and are forced to take their prescriptions to prevent relapse. Secondly, modelling can inspire and motivate people with schizophrenia to imitate healthy lifestyles and adhere to their drugs.

Justification: Some people with schizophrenia hardly accept their mental health conditions, hence reluctant to take their prescriptions without supervision. Moreover, Baldacchino and Sharma (2021) noted that people with schizophrenia are more likely to involve in drug and substance abuse which exacerbates their conditions. Besides, Zhou and Li (2020) indicated that collaborative modelling effectively helps individuals with schizophrenia to shift their negative energy and attitude to productive lifestyles and adhere to their care plan. Collaborative modelling fosters self-management (Mezey et al., 2021). Therefore, coercion and modelling are equally effective approaches in helping persons with schizophrenia to adhere to their medications and adopt necessary lifestyles to prevent adverse effects of antipsychotic drugs.

Recommendation : Brown et al. (2019) indicated that while mental health conditions affect the community regardless of class, people in low-income communities face serious mental health inequities. Hence, the mental health promotional programs and government interventions should focus on low-income communities to increase the community knowledge of mental health conditions and stimulate healthy mental health practices.

Health promotion is critical in empowering individuals to control their health and recovery process and health outcomes. The traditional beliefs, myths, stigma, and stereotypes of psychosis continue to lower the confidence and self-esteem of people diagnosed with mental health conditions. Consequently, people are reluctant to screen for their mental health and access early interventions to fear being stigmatised and discriminated against. The health promotion program for schizophrenia thus targets the community, families, and individuals and encompasses multidisciplinary teams' efforts to change society's attitude and behaviour toward mental health conditions. The initiatives, including public education and campaigns, psycho-education and training, persuasion, and restriction of service users, were adopted to enhance community and individual response to schizophrenia. These programs, alongside government intervention, are critical in helping individuals accept their mental health conditions, adhere to their medications, and adopt healthy eating and healthy lifestyles. 

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Tranter, S. and Robertson, M., 2021. Improving the physical health of people with a mental illness: holistic nursing assessments.  Mental Health Practice ,  24 (2).

Valiente, C., Espinosa, R., Contreras, A., Trucharte, A., Caballero, R. and Peinado, V., 2021. The feasibility and acceptability study of a positive psychology group intervention for people with severe psychiatric conditions.  The Journal of Positive Psychology , pp.1-14.

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In NURS 434 assignment 1 Community Health Promotion...Given...

In NURS 434 assignment 1 Community Health Promotion...Given community of pregnant women who use cannabis in the Calgary NW, Alberta. Write scholarly paper in detail, focus on the following sectors. Please provide references as well.

1.  Setting and chosen community are clearly articulated.

2.  A minimum of 4 community health concepts/nodes are selected for in depth discussion (examples concepts could include            but are not limited to: harm reductions, health promotion, community resilience, health literacy or primary health care). This            discussion should include, but is not limited to answering the question of how is each concept                  demonstrated/applied/analyzed        in relation to the issue or trend that you have chosen in your community?

3. Role of the nurse and evidenced based nursing practice are clearly articulated in relation to each of the 4 community health concepts.

4. Ability to analyze, evaluate, create, and engage in critical inquiry is evident throughout.

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Health Promotion: Giving up Smoking in Pregnancy Introduction The object of this assignment is to critically appraise a health promotion initiative related to midwifery practice. The initiative chosen is a NHS Health Scotland leaflet entitled ‘Smoking: giving up during pregnancy: a guide for pregnant women who want to stop smoking’ (NHS Health Scotland 2003). It will be referred to as the ‘initiative’ or the ‘leaflet’ throughout this assignment. The World Health Organisation (WHO) identified that health promotion was a way of equipping people to have more power enabling them to make choices in regard to improving their well-being (WHO 1986).

Ewles and Simnett (2003) determine from this, that the fundamental elements of health promotion are improving health and empowerment. The Scottish Office paper ‘Towards a Healthier Scotland’ (1999) recommended making more health promotion available for pregnant smokers. This appraisal will systematically review the literature relating it to the health promotion initiative chosen using Ewles and Simnett (2003) Five Approaches to Health Promotion model. It will furthermore evaluate the midwife’s role in promoting the issue highlighted and conclude with a summary and any proposals to improve future practice.

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Critical Appraisal The Scottish Office paper ‘Towards a Healthier Scotland’ (Scottish Office 1999) recommends reducing the numbers of women smoking during pregnancy from 29% to 20% in the next 5 years. According to the Health Education Authority (1999) the rate for smoking in pregnancy in the UK was 30% however nearly 90% classified smoking as dangerous to their unborn child. Johnston et al (2003) point out that smoking is the main preventable cause of disease and disability in the fetus and newborn.

Around 13 000 individuals die from smoking in Scotland each year (NHS Health Scotland and ASH Scotland 2004a). This initiative is based on the normative needs concept as it is influenced by expert opinion and government policies (Ewles and Simnett 2003). Epidemiological evidence in its favour allows the initiative to be evaluated by reduction in the mortality and morbidity (Naidoo and Wills 2000). This is cost effective because the initial resources for implementing the smoking cessation will be significantly less than the cost of hospitalisation later in life (NHS Health Scotland and ASH Scotland 2003).

The leaflet that will be critiqued (appendix 1) is aimed at pregnant women who currently smoke but who want to give up. It is split into five sections titled: pregnancy and smoking; stopping smoking; tips for stopping; stopping smoking is worth it and thinking about your smoking. The Ewles and Simnett (2003) model comprises of five approaches to health promotion; medical approach; behaviour change approach; educational approach; client-centred approach and societal change approach.

The behaviour change approach is the main focus for this initiative, although it does utilise aspects of all approaches. The behaviour change approach as described by Ewles and Simnett (2003) is a way of encouraging changes in an individual’s attitudes and beliefs to take up a healthier lifestyle. It is, however considered by some, to be more forceful depending on the degree of encouragement and persuasion utilised (Crafter 1997, Norton 1998). The behaviour change approach uses a number of models to guide health promoters to facilitate clients to achieve a positive outcome.

The Stages of Change Model (Prochaska and DiClemente 1984 as cited by Ewles and Simnett 2003) is a five stage cyclical model that has been found to be particularly useful in work with addictive behaviours (Naidoo and Wills 2000). This cycle incorporates a pre-contemplation stage where the individual is unaware of any need for change or has no interest in changing (Ewles and Simnett 2003). At this stage the midwife would assess whether the woman is genuinely not interested in stopping smoking at present and respect this decision but inform her she will be asked throughout her pregnancy about her smoking status (Crafter 1997, Dunkley 2000).

The leaflet may still be issued as having the information readily at hand may prompt the individual to think about stopping smoking. The advantages of leaflets mean they allow individuals to read through them at their own pace (Ewles and Simnett 2003). The second stage is the contemplation stage where the individual is motivated to consider changing their behaviour, maybe she reads the leaflet and attempts to seek information (Naidoo and Wills 2000). The role of the midwife at this stage would be to determine why the woman smokes and what barriers she may face in stopping smoking (Dunkley 2000).

The leaflet facilitates this by allowing the woman to question why she smokes and how she feels about it. It also seeks to establish what the woman feels is good and bad about smoking and how she anticipates changing her behaviour towards smoking. It has been suggested (McLeod et al 2003) that some midwives find it difficult to broach the subject of smoking particularly with women who have no desire to stop and those who are still considering stopping.

However McLeod et al (2003) found from their qualitative study that women expected to be asked about smoking during routine antenatal care and indeed they felt it was part of the midwives role to ask. The preparation stage is where the woman is committed to giving up smoking. She may seek extra help and is likely to attempt change soon (Dunkley 2000). If the woman is in this planning stage she may benefit from smoking cessation services, which the midwife can offer such as Smokeline, or other local services.

Within the leaflet is a free phone number for Smokeline (HEBS 2003) who offer advice and issue the booklet ‘Aspire to Stop Smoking’ (HEBS and Action on Smoking and Health Scotland 2001). This supporting information helps the woman to discover what she can do to help herself to stop smoking. NHS Health Scotland and ASH Scotland (2004b) challenge the reliability of answers to questions Midwives and other health promoters may be asking individual’s with regard to their interest in stopping smoking as that individual may feel that agreeing is what is expected.

Hesitancy in answering may be indicative of reluctance to commit to stopping at present, so ensuring they understand that there are many options available in the future can enhance the chance of them stopping (NHS Health Scotland and ASH Scotland 2004b). The midwife would continue to support the individual during this time offering advice and encouragement (Crafter 1997) and also would remind the patient of the importance of social support from partners and friends (NHS Health Scotland and ASH Scotland 2004b).

The findings from a study by McLeod et al (2003) concur with the need to have partner involvement. They found that although the women were supported by the midwives there was a failing in educating the partners to the women’s needs while trying to stop smoking (McLeod et al 2003). Moreover Thompson et al (2004) would like to see this expanded out with the antenatal setting. This issue has been addressed in part by the initiative, which encourages the woman to seek partner involvement to support her at this time (HEBS 2003).

The penultimate stage is the making the change stage this is when the woman is taking action (Naidoo and Wills 2000). NHS Lothian (2002) supports making a date to stop and sticking to it. One of the options is nicotine replacement therapy (NRT), which has caused debates over its place in smoking cessation during pregnancy (Dunkley 2000, McNeill et al 2001). McNeill et al (2001) found that using NRT, although not recommended in pregnancy, could be beneficial, as all the pollutants from actual cigarettes would not be delivered to the mother or the fetus. The final stage is the maintenance stage.

It is vital that the midwife maintains good support through the postnatal period as Pollock (2003) found that 60% of women who give up during pregnancy restart smoking within 1 month of birth. Encouragement from the midwife to eat a sensible a diet (Crafter 1997) and use diversionary tactics like regular brushing of teeth and saving cigarette money up for treats (NHS Lothian) helps the woman to stay stopped. The leaflet in its favour mentions how other smokers managed to stop and what they have done to help themselves. In this final stage there is room for relapse or slipping.

The leaflet lets individuals know it is ok to relapse but encourages them to learn from this. It also mentions some of the side effects that women may experience from nicotine withdrawal. The medical approach to health promotion aims to ensure individuals are disease and disability free (Ewles and Simnett 2003). This approach could be viewed as paternalistic, where professionals decide what is best for an individual (Crafter 1997) and as pregnancy is not a state of ill health (Dunkley 2000) it brings into question its validity in midwifery care.

However women could jeopardise the health of themselves and their unborn child if they are involved in risk taking behaviour such as smoking during pregnancy. The initiative mentions some of the health risks involved such as miscarriage and low birth weight babies (HEBS 2003) but favourably does not go into detail to avoid victim-blaming. Within the medical approach such initiatives as General Practitioner’s or other health professionals advocating smoking cessation during consultations is found to be more useful than no mention at all (HEBS 1998) resulting in approximately 2% of smokers stopping long term.

Recommendation 1. 2 of the Smoking Cessation Guidelines for Scotland (NHS Health Scotland and ASH Scotland 2004a) states that a midwife should ascertain a patient’s smoking status and discourage them from smoking at the earliest opportunity. The midwife should also offer support and treatment to aid cessation (NHS Health Scotland and ASH Scotland 2004a). Crafter (1997) identifies the need for midwives to give unbiased information, however justifies the obligation to educate women about damaging behaviour such as smoking during pregnancy.

Facts specific to smoking in pregnancy are not included in the leaflet such as smoking in the first 3 months of pregnancy accounts for a quarter of low birth weight babies (Scottish Executive 2001). An educational approach to health promotion is giving individuals information to discover the health benefits or detriments for themselves (Ewles and Simnett 2003). Crafter (1997) argues that there can be no true educational approach when it comes to smoking in pregnancy because midwives would be unable to remain neutral due to the fact that evidence is available that clearly shows smoking is detrimental.

Naidoo and Wills (2000) explain that the educational approach differs from the behaviour change model, as the educational model does not use encouragement to achieve its aims. NHS Health Scotland and ASH Scotland (2004b) concur with this view advocating that it is not the role of the midwife to persuade but to inform. They go on to defend the use of facts in conjunction with the leaflet. The National Institute for Clinical Excellence (2003) also emphasise the need for women to be informed of the risks, which can make a purely educational approach unattainable in relation to smoking cessation.

The information could be available to patient who enquire about if for them to discover the advantages and disadvantages for themselves with the midwife advising them of where to find resources. In a study by Pullon et al (2003) it showed how suitable resources helped educate women to stop smoking. Critically however it appeared that the midwives concerned were involved in a more behavioural change role as then conclusion commented on the midwives powerful influence (Pullon et al 2003).

The client-centred approach facilitates health promotion of things that the client feels will be of benefit (Ewles and Simnett 2003), this could mean that an individual may not consider that smoking cessation is an issue they want to address and as such the topic may never be discussed. This model is said to facilitate autonomy (Dunkley 2000) but as such the leaflet may never be looked. If however the client felt that smoking cessation was something she was interested in, the midwife would be able to offer any help that was available to her to empower the woman to achieve her objective (Crafter 1997).

The societal change approach focuses on changing the whole society not just individuals within it (Ewles and Simnett 2003). Implementation of changes at community level or above looks to bring about changes to the attitudes and beliefs about smoking during pregnancy to the population. This would include laws such as that to be introduced in spring 2006 banning anybody smoking in enclosed public spaces in Scotland (Scottish Executive 2004).

The majority of pregnant smoker’s are age 16-24 and low socio-economic groups highlighting the important fact that deprivation and inequality increase the incidences of smoking and of teen pregnancy (Lazenbatt et al 2000, NHS Health Scotland and ASH Scotland 2003). Conclusion Midwives play an important role in promoting the health and wellbeing of individuals and their families and delivery of health education (Scottish Executive 2001). The initiative appeared to have some weaknesses as a stand-alone leaflet, however as part of a multi-dimensional approach it emerged favourably.

The midwife must endeavour to gain trust and support to deliver the required service and promote empowerment (Dunkley 2000). She must take care not to alienate the women that require her help. There must be a trusting relationship built up between the midwife and the woman to achieve a positive outcome. Approximately 20% of smoking mums give up during pregnancy and of them over 50% who gave up attributed it to being pregnant (HEA 1999) this indicates further that women want to stop and indeed manage successfully to stop smoking.

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Effective Approaches to Health Promotion Assignment Sample

  • Subject Name : Nursing

Principles of Primary Health Care

Introduction to effective approaches to health promotion.

Primary health care refers to the initial level care for persons, families and society with proper healthcare system. Primary health care involves the whole society and approach towards total health promotion (World Health Organization,2020). Health promotion practices enables individual to improve their health and control over health problems. Health promotion increases the quality life of all human beings and improves global health status (Hubley &, Copeman 2018). Primary health care and health promotion activities go parallel to each other as illness prevention programs are equally important with focus on patient care. Medical treatment of critical diseases through trained nursing facility is important to prevent further damage to health. Rheumatic heart disease considered as a major threat to community health in both developed and under developed countries. The role of nurses in critical health care is well discussed in this essay topic and the importance of proper nursing management in rheumatic heart disease. This essay will demonstrate that nurses of Ottawa accept the core challenge to prevent and control the global threat of rheumatic heart disease.

Role of Nurses in Health Promotion

In common practice, the role of nurses involve treatment of sick people, care of family health, child health nursing, encourage healthy ageing, illness prevention, rehabilitation and community development, problem solving for patients and advocacy of research and education for primary health care. The relevance of these nursing roles will depend upon the nature of illness, nursing context and position responsibility. In general nursing practices health care promotion played an important role in promoting healthy behavior and providing accurate information to the people about adopting healthy lifestyle. Health promotion activities engage nurses to manage and improve person’s health and equip patients with correct guidance to gain ultimate control on health. The critical role of nurses regarding health promotion involves disease prevention and act as an educator with the patients about medications and immunization. Beside this, it helps to decrease premature deaths among young adults due to several life threatening conditions.

Rheumatic heart disease is a serious health condition caused due to rheumatic fever. The rheumatic fever occurs when scarlet fever or strep throat is inadequately treated. Also, rheumatic fever is known as an inflammatory disease that cause permanent heart damage, affect brain, joints and skin of patients. Early diagnosis of throat infection and timely treatment with prescribed antibiotics may prevent serious effects of rheumatic fever. The health condition of rheumatic heart disease involves inflamed heart valves that forcing harder the heart to pump the blood resulted to scarred heart valves. The health complication related to rheumatic heart disease (RHD) includes heart failure, ruptured valves of heart, bacterial endocarditis and complications in pregnancy due to serious heart ailments. Moreover, RHD can be prevented with proper health care promotion activities in the community and provide non-medical precautions for control of rheumatic heart disease among peoples from poor socio-economic background. RHD identified as a significant threat for person living in poverty conditions including young children and adults. Equally, this chronic condition accesses the health of poor people background and increases the chances of premature deaths due to poor health situation of underdeveloped countries. Health promotion practice carried out by trained and professional nurses spreads awareness in health education of rheumatic fever and reduces the burden of RHD. Research shows that knowledge about rheumatic heart disease increases understanding about the serious consequences of rheumatic heart disease in the young population and establishment of Ottawa Charter for Health Promotion advocates health educators and nurses to promote awareness for RHD. WHO conducts health and welfare promotion activities in under privilege countries and support the primary health care facilities to offer additional community health care nurses to educate about rheumatic heart disease.

The role of nurses in managing and controlling RHD is important to assess the signs and early symptoms of rheumatic heart disease (Phillips, 2019). The nurse should be alert at all time and check for sudden complaints of chest pain, palpitations and pericardial tightness. The role of nurses in RHD care is to notice about any chances of second degree cardiac attack due to rheumatic heart disease. Furthermore, the nurses must keep close watch on irregular breathing pattern, unconsciousness level and use of masculine activities. The important subjective data that nurses must collect from rheumatic heart disease patients are past medical history, family history of any rheumatic fever, recent strep throat infection, active physical activities of patient and any nutritional metabolic disorder of patient (Golinowska et al., 2016). The nursing intervention is important in taking care of RHD patients with proper administration of penicillin therapy to minimize the chances of further heart damage. Give prescribed NSAIDS by medical practitioner to suppress any rheumatic activities. The main responsibility of nurses is to notice the effectiveness of antibiotic therapy on patients and take necessary records of improvements. Besides that, nurses can provide assistance in health survey in schools to detect early causes of rheumatic fever. For treatment of carditis it may continued for more than 10 years and severe heart disease patients need lifelong medication treatment and nursing support (Mitchell et al., 2019).

The primary responsibility of health care nurses is to proper treatment to give proper treatment to sick patients (Stigler et al., 2016). In the same way,, primary health care nurses may asses nursing requirements for ill patients, timely medication, taking correct samples, writing records, organising workloads and monitoring critical patient’s pulses, blood pressure and temperature. One of the important roles of nurses in promoting health and prevention of critical disease is to act as an educator (Lopez‐Dicastillo et al., 2020). Incidentally, nurses can also use their professional settings and Ottawa charter structure to inform and guide young people about healthy community policy to improve health of common people.

A global milestone in health promotion segment established with the Ottawa charter for health promotion. In order to reach the complete state of physical, psychological and social well being, a person or community must identify the benefits of health and aspire to change unhealthy behaviour to cope with the surroundings (Mitchell et al., 2019). The Ottawa charter recognizes basic features of health promotion activities including food, shelter, education, peace, and income, stability in resources, social equality and justice. The first international conference on promoting health organized by WHO in Ottawa,(Canada) 1986, The Ottawa charter for health promotion international agreement is signed in that international conference. After that series of health practices launched in international health platform and many national and international governments come forward to achieve the public health objective of “Health For All” by year 2000 and also beyond that year for good health promotion (Hubley &, Copeman 2018). The basic strategies of Ottawa charter for health promotion are advocate, enable and mediate.

Five important health action strategies of Ottawa charter are-

  • Building better healthy policy for public
  • Establishing supportive environment
  • Strengthening healthy action for community
  • Developing skills and knowledge in field of health
  • Re-directing primary health care services to promote health and prevent critical illness

The role of nurses in promoting above strategies of Ottawa charter for health promotion is very important to discuss because through these strategies nurses helps to build supportive environment for public health9 (Hubley &, Copeman 2018). The participant nurses advocate the current public health policy and give commitment towards equality in health sector (Lopez‐Dicastillo et al., 2020). The community nursing provides prompt response to the health and knowledge gap within community people and tackles all in-equalities developed by political practices. The nurses acknowledge the people as a main source of health and provide adequate support to enable themselves and their families about self well-being and healthy living conditions. Lastly, recognizing the health maintenance challenges involved in health promotion is vital to address each ecological and health related issues.

Conclusion on Effective Approaches to Health Promotion

The discussion presented in this essay paper concludes that the primary health care providers are needs of everyday life. Whether it is general nursing or critical nursing practices the role of nurses is very important to determine the health prospective of the community people. To empower and enable the individual, their families and society about multispectral policies of health promotion, proper health care approach is needed. It is concluded that Health promotion practices requires proper guidelines to follow by primary health acre providers to deliver better education on health promotion (World Health Organization,2020). The Ottawa charter for health promotion established by WHO in first international conference, states that community health givers, nurses, doctors are always available to provide critical health services. The five action strategies of Ottawa charter incorporate several perspectives of health promotion. All in all, it is truly said that if all perspectives of Ottawa charter will be directed towards health promotion then many complex issues may get solved. Finally, role of nursing practices will be correctly implemented so that critical ill patients may get ultimate and rewarding medical treatment ( Stigler et al., 2016). 

References for Effective Approaches to Health Promotion

World Health Organization. (2020). Hearts: technical package for cardiovascular disease management in primary health care.

Stigler, F. L., Macinko, J., Pettigrew, L. M., Kumar, R., & Van Weel, C. (2016). No universal health coverage without primary health care.  The Lancet ,  387 (10030), 1811.

Phillips, A. (2019). Effective approaches to health promotion in nursing practice.  Nursing Standard .

Lopez‐Dicastillo, O., Zabaleta‐del‐Olmo, E., Mujika, A., Antoñanzas‐Baztán, E., Hernantes, N., & Pumar‐Méndez, M. J. (2020). “Missed nursing care” in health promotion: Raising awareness.  Journal of Nursing Management .

Hubley, J., & Copeman, J. (2018).  Practical health promotion . John Wiley & Sons.

Golinowska, S., Groot, W., Baji, P., & Pavlova, M. (2016). Health promotion targeting older people.

Yu, E., Malik, V. S., & Hu, F. B. (2018). Cardiovascular disease prevention by diet modification: JACC health promotion series.  Journal of the American College of Cardiology ,  72 (8), 914-926.

Saggi, M., & Kalia, R. (2020). Rheumatic Fever and Rheumatic Heart Disease.  Asian Journal of Nursing Education and Research ,  10 (3), 360-364.

Mitchell, A. G., Belton, S., Johnston, V., Gondarra, W., & Ralph, A. P. (2019). “That Heart Sickness”: Young Aboriginal People’s Understanding of Rheumatic Fever.  Medical anthropology ,  38 (1), 1-14.

Watkins, D. A., Johnson, C. O., Colquhoun, S. M., Karthikeyan, G., Beaton, A., Bukhman, G., ... & Nascimento, B. R. (2017). Global, regional, and national burden of rheumatic heart disease, 1990–2015.  New England Journal of Medicine ,  377 (8), 713-722.

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Health Promotion Models Example

Write a one page paper about something you have learned in this class and how you plan to use it in the future personally and professionally! Remember, you  should have a thesis statement, conclusion and correct grammar.   APA Health Promotion Models Example

This can be on making stress my friend.TED TALK or about health promotion health models etc Health Promotion Models Example

You  must  proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.Health Promotion Models Example

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Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

Models of health promotion

The kinds of health promotion programmers that students and schools implement reflect the health education models on which they are based. There are three main categories in which health education models can be broadly placed:Health Promotion Models Example

  • behavioral change model
  • self-empowerment model
  • collective action model.

(For more information about these models, see ‘Characteristics of the health promotion and health education models’. Refer also to Nutbeam, 2000; Colquhoun, Goltz, and Sheehan, 1997; and French and Adams, 1986.)

While the three models are not mutually exclusive (many teachers and health professionals use all of them to some extent),  Health and Physical Education in the New Zealand Curriculum (1999) (PDF, 688 KB) focuses on the self-empowerment and collective action models.Health Promotion Models Example

Teachers’ notes

Knowledge and understanding of health promotion is essential content for students studying health education at level 8 of the curriculum, and is required for students preparing for assessment against NCEA level 3 achievement standards and the Scholarship standard.

Physical education and home economics teachers need to understand the processes and the theoretical origins of health promotion so that they can apply these processes in their teaching and learning program mes without making health promotion a specific content focus for their students.

Behavioral change model

The behavioral change model came into use before the other two approaches. Many early New Zealand health campaigns were based on this model, and it is still widely used, in conjunction with other models, as part of comprehensive health campaigns.

The behavioral change model is a preventive approach and focuses on lifestyle behaviors that impact on health. It seeks to persuade individuals to adopt healthy lifestyle behaviors, to use preventive health services, and to take responsibility for their own health. It promotes a ‘medicated’ view of health that may be characterized by a tendency to ‘blame the victim’. The behavioral change model is based on the belief that providing people with information will change their beliefs, attitudes, and behaviors. This model has been shown to be ineffective in many cases because it ignores the factors in the social environment that affect health, including social, economic, cultural, and political factors.Health Promotion Models Example

Self-empowerment model

This approach (also known as the self-actualization model) seeks to develop the individual’s ability to control their own health status as far as possible within their environment. The model focuses on enhancing an individual’s sense of personal identity and self-worth and on the development of ‘life skills’, including decision-making and problem-solving skills, so that the individual will be willing and able to take control of their own life. People are encouraged to engage in critical thinking and critical action at an individual level. This model, while often successful for individuals, is not targeted at population groups and is unlikely to affect social norms.

Collective action model

This is a sociology-ecological approach that takes account of the interrelationship between the individual and the environment. It is based on the view that health is determined largely by factors that operate outside the control of individuals. (See the information about determinants of health in the Appendix.)Health Promotion Models Example

This model encompasses ideas of community empowerment, which requires people individually and collectively to acquire the knowledge, understanding, skills, and commitment to improve the societal structures that have such a powerful influence on people’s health status. It engages people in critical thinking in order to improve their understanding of the factors affecting individual and community well-being. It also engages them in critical action that can contribute to positive change at a collective level.

Given the importance of determinants of health, the use of a collective action model is more likely to achieve healthy outcomes, both for individuals and for groups within society.

Health promotion and the Ottawa Charter

The Ottawa Charter for Health Promotion (WHO, 1986) provided much of the impetus for the change to using a sociology-ecological approach for health education and health promotion. This charter recognized that major health gains were linked not so much to advances in medical knowledge as to increases in wages and living standards and to public health initiatives accompanied by policy changes at government and community levels.

When we simply offer health advice to people (‘You should stop smoking if you want to get rid of that cough and improve your general health’, or ‘No wonder you’re putting on weight – you should get out and do a bit more exercise!’), we approach it from our perspective. We think the person should do ‘this’ (stop smoking or take more exercise) to improve ‘that’ (their cough or weight).Health Promotion Models Example

But when we come at it from a health promotion point of view, we look at it from the person’s perspective. It’s no longer what we think the person should do – it’s about what he or she wants and, probably more importantly, what he or she is prepared to change to get what they want.

So instead of advising or telling the person what they have to do to improve their health, we begin by finding out what the person would like to see improved, how he or she thinks it could be improved, and how ready he or she is to make the change – even just a small change to get things started.

That’s not to say there isn’t a place for giving people advice to improve their health. People will see you as someone they can turn to for advice and they will actively seek it – when they’re ready. You’ll then be able to use your knowledge to suggest appropriate changes, or help the person access expert advice or information. But that’s a bit different from taking one look at a person who is clearly overweight and saying to him or her: ‘You need to lose weight’. It might seem like good sense from a health point of view, but the approach you’ve taken may have the opposite effect from the one you seek by making the person feel he or she is losing control of their own body and stubbornly refuse to play ball.

You may come across some people who are signed up to a formal health promotion ‘course’ – they may have joined a smoking cessation group run by a practice nurse, for instance, or are attending specialist counseling sessions to help them overcome anxieties or worries that are stopping them from getting on with their lives and affecting their health as a result. But more often than not, positive health promotion messages emerge during normal everyday conversations you’ll have with your patients/clients, when a problem or issue they raise offers the chance to speak about lifestyle changes that might not only solve their identified problem, but also improve their general health. Patients/clients might well speak casually about their weight, or lack of physical activity, or any part of their life that presents an opportunity to talk about lifestyle change.Health Promotion Models Example

This idea of making every contact with a patient/client a chance to speak about improving their health is now seen as being very important. Health Education England’s Making Every Contact Count website provides resources and information on the effects it can have. While it has been developed for England only, the lessons it teaches have far wider relevance.

In the meantime, we’re going to look at another idea that is very important in terms of supporting people to live healthier lifestyles – the Stages of Change Model.Health Promotion Models Example

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    Assessment 1. Select an existing health promotion intervention of your choice and, with reference to relevant behavioral theory and evidence, critically report on its effectiveness in driving positive changes in health behaviors.

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    There are three main categories in which health education models can be broadly placed:Health Promotion Models Example. behavioral change model. self-empowerment model. collective action model. (For more information about these models, see 'Characteristics of the health promotion and health education models'.

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