Documentos de Académico
Documentos de Profesional
Documentos de Cultura
Health Promotion
HH2602
Lecture 1
February 2014
Jennifer Ryan
@jennifer_m_ryan
Learning Outcomes
• Define health promotion and differentiate between primary
and secondary prevention
• List and describe methods of recognising people at increased
risk of cardiovascular disease
• List modifiable risk factors for noncommunicable diseases
• Describe consequences of physical inactivity, poor diet,
tobacco use and excess alcohol consumption
• Describe current recommendations for physical activity, diet,
smoking and alcohol
• Discuss methods for modifying unhealthy behaviours
Health Promotion
• The process of enabling people to exert control over the
determinants of health and thereby to improve their health.
1
19/02/2015
CVD
Cancer
2
19/02/2015
Cardiovascular Disease
Smoking
Poor diet
Physical
Cancer inactivity
Overweight
/obesity
Excess alcohol
Chronic Lung Disease consumption
5 min
3
19/02/2015
Prevention of NCDs
• Primary prevention: aims to prevent new onset NCDs by
reducing risk factors
- most effective way of fighting NCDs
- avoids death or disability resulting from first events (e.g.
stroke, cancer, heart attack)
- primary prevention that targets modifiable risk factors
has the benefit of preventing all NCDs
4
19/02/2015
5
19/02/2015
6
19/02/2015
Risk scores
• Metabolic syndrome
• Heartscore
• Framingham Risk Score
• Framingham Stroke Profile
Reduced HDL-C (drug treatment for reduced HDL-C is an alternate <40mg/dL (1.0 mmol/L) in males; <50mg/dL (1.3
indicator) mmol/L) in females
Elevated blood pressure (antihypertensive drug treatment in a Systolic ≥130 mmHg and/or diastolic ≥85 mmHg
patient with a history of hypertension is an alternate indicator†)
7
19/02/2015
Physical Activity
Physical activity is….
8
19/02/2015
10. This is the least active state in America. Which state is it?
Tie breaker: What percentage of GPs know the physical activity guidelines?
28.0%
9
19/02/2015
16 Men W omen
14
Fractions (%)
12
10
8
Attributable
0
Low CRF Obesit y Smoker Hyper tens ion High Cho les ter ol Diabet es
Attributable fractions (%) for all cause deaths in 40 842 (3333 deaths) men and 12 943
(491 deaths) women in the Aerobics Center Longitudinal Study. The attributable fractions
are adjusted for ages and each other item in the figure. (Taken from Blair, 2009)
10
19/02/2015
Smoking Recommendations
• Smoking cessation support should be offered to all smokers
with the aim of encouraging all people who smoke to quit
11
19/02/2015
Consequences of Smoking
- Chronic Lung Disease
- Cancer
- Cardiovascular disease
Approximately 2.5 million deaths per year worldwide (4% of all deaths)
12
19/02/2015
Light to
moderate Abstainers Heavy drinkers
drinkers
13
19/02/2015
14
19/02/2015
Individual Approach
• Brief advice
• Referral
15
19/02/2015
Activity
https://www.youtube.com/watch?v=vBnv1cCWBCg
10 min
16
19/02/2015
(NICE, 2006)
(NICE, 2006)
17
19/02/2015
Brief Advice
Includes:
• Verbal advice
• Discussion
• Negotiation or encouragement
• May include written support
• Follow-up
• Can be opportunistic
• Varies from basic advice to a more extended, individually focused
discussion
• Can typically take from <1 minute to 20 minutes
(Nice, 2013)
18
19/02/2015
Smoking cessation
• Opportunistic, brief advice to encourage all smokers to quit
and to point them to effective treatments that can help
• Referral to an intensive support service (e.g. NHS Stop
Smoking Services)
- Prescription of pharmacotherapy
- Behavioural counselling
- Group Therapy
• Record and review smoking status once a year
(NICE, 2006)
19
19/02/2015
Influences on Behaviour
Interpersonal
• Friends, family, employer, physiotherapist, sports coach
Organisational/environmental
• Work hours, initiatives, layout, accessibility
Community
• Establishing networks, involving all members of the
community
Policy
• Guidelines, inclusion (e.g. considerations for different
ethnicities, people with disabilities)
Activity
https://www.youtube.com/watch?v=apLQqKN-Lx8
10 min
20
19/02/2015
Recommended Reading
• Heyward, V.H. and Gibson, A.L. (2014) “Physical activity,
health, and disease: an overview,” in Heyward, V.H. and
Gibson, A.L. (eds.) Advanced Fitness Assessment and Exercise
Prescription. 7th edition. USA: Human Kinetics, pp. 1-20.
• Reference list on BBL
21