HEALTH PROMOTION AND HEALTH MAINTENANCE

Health promotion, as defined by the WHO, is the process of enabling people to increase control over, and to improve, their health. The National programme, HEALTHY PEOPLE 2010, reflects the nations commitment to promote the healthy living of the population by improving the health and health awareness

DEFINITION
Health promotion is defined as behaviour motivated by the desire to increase wellbeing and actualize human health potential. (Pander, Murdaugh and Parsons 2002) Health promotion is the process of enabling people to increase control over and to improve their health. (WHO.)

EVOLUTION OF HEALTH PROMOTION

Commitment of WHO to the goals of Health For All (1977) International Conference on Primary Health Care, Alma-Ata (1978) "Alma-Ata Declaration" Followed by, International Conferences on health promotion in:Ottawa 1986 Adelaide 1988 Jakarta 1997 Sundsvall 1991 Mexico 2000 Bangkok 2005

The First International Conference on Health Promotion in Industrialized Countries (Ottawa 1986).
Five strategic actions set out in Ottawa charter for health promotion. Build healthy public policy Create supportive environment Strengthen community action Develop personal skills Reorient health services

1. 2. 3. 4. 5.

THE BASIC PEINCIPLES OF HEALTH PROMOTION.

According to the Ottawa Chapter for Health Promotion the basic principles of health promotion are:Prerequisites for health Advocate Enable Mediate Create supportive environments Strengthen community action Develop personal skills Reorient health services

WHO key principles:

Involves whole population in context of daily life rather than focusing on people at risk of disease Directed at the determinants of health Combines diverse approaches Aims at effective public participation Health professionals have an important role in enabling health promotion

Why do we need health promotion?

Promotes quality of life Reduces inequalities in health Reduces pressure on services Adds life to years Adds years to life Health Promotion is concerned with making healthier choices easier choices

HEALTH PROMOTION STRATEGY 2004 2007

Vision Statement To improve the health of the population by focusing on healthier lifestyles and to meet the needs of the local community by promoting inclusive and sustainable initiatives, thereby enabling people to increase control over and improve their health and well-being

Key Aims
To meet national and local targets in relation to health promotion and to address recommendations made by the Audit Commission in February 2004 To develop health promotion elements of agreed local health and community strategies To engage and work in partnership with other local agencies and disciplinesworking in a variety of settings

Action Planning: key areas

Healthier Eating Physical Activity Smoking Cessation Tobacco Control

APPROACHES TO HEALTH PROMOTION

1. Medical 2. Behavior change 3. Educational 4. Empowerment 5. Social change

Medical Approach
Aim To reduce morbidity and premature mortality. To ensure freedom from disease and disability. Activity Uses medical intervention to prevent illhealth or premature death. Eg. - Immunization, screening, fluoridation. Based on scientific methods.

Medical Approach
Expert-led, top down. Emphasizes compliance. Does not focus on positive health. Ignores social and environmental dimensions. Evaluation: Reduction in disease rates & associated mortality.

Behaviour Change Approach

Aim To encourage individuals to adopt healthy behaviours. Views health as the responsibility of individuals. Methods: Communication Education Persuasion, motivation Expert-led, top down. Victim-blaming Behaviour is very complex & Multi-factorial.

Behaviour Change Approach Evaluation:Behaviour change after the intervention.

The

behaviour change is only apparent after a long time. Difficult to isolate any behaviour change as attributable to a health promotion intervention.

Educational Approach
Aim To provide knowledge and information. To develop the necessary skills for informed choice. The outcome is clients voluntary choice. Methods Information-giving through interpersonal channels, small groups and mass media, so that the clients can make an informed choice. Group discussion for sharing and exploring health attitudes Role play for decision-making and negotiating skills

Educational Approach
Weakness Assumes that by increasing knowledge, there will be an attitudinal change, which leads to behavioural change. Ignores the constraints that social, economic and environmental factors place on voluntary change. Evaluation Knowledge, attitude and practice.

Empowerment Or Client-centred Approach Aim

Helps

people to identify their own needs and concerns, and gain the necessary skills and confidence to act upon them.

Role of health promoter: facilitator and catalyst.

Empowerment Or Client-centred Approach

Two types of empowerment:
1. Self-empowerment - based on counselling and aimed at increasing peoples control over their own lives. 2. Community empowerment - related to community development to create active, participating communities which are able to change the world about them through a programme of action.

Empowerment Or Client-centred Approach

Methods
Client-centred,

including counselling, community development and advocacy. Health advocacy refers to the action of health professionals to influence and shape the decisions and actions of decision- and policy-makers who have some control over the resources which affect or influence health Promoting public involvement and participation in decision-making on health-related issues.

Evaluation
Difficult

because empowerment is long term. Results are hard to specify and quantify.

Empowerment Or Client-centred Approach

Evaluation

includes:-

Outcome

evaluation - the extent to which specific aims have been met. evaluation - the degree to which the individual and community have been empowered as a result of the intervention.

Process

Societal/Social Change Approach

Aim
To

bring about changes in physical, social, and economic environment which enables people to enjoy better health. Radical health promotion - makes the environment supportive of health. To make the healthy choice the easier choice. The focus is on changing society, not on changing the behaviour of individuals.

Societal/Social Change Approach

Methods
Focus

on shaping the health environment

lobbying/advocacy development

of healthy public policies and legislation fiscal measures creating supportive social and physical environments

Approaches in Health Promotion: the example of healthy eating

Approaches Medical Behaviour change Health education Intervention Diagnosis of need for reduction in Saturated fat, sugar or salt intake e.g. Obesity, hypertension, diabetes BMI Index etc Encouragement of healthier eating Information given regarding healthier Foods via health promotion Arrangements; leaflets, posters, media

Client centred self help weight control groups, food Co-operatives, grow your own (empowerment schemes ) Social change Public health legislation (e.g. Food Labelling); policy development in the Workplace; lobbying for cheaper Foodstuffs e.g. lean meat

THE PROCESS OF HEALTH PROMOTION

FOCUS STRATEGIES IMPACT Behavioural Outcomes Quality of life

Individuals

Education educational couselling change Economic change Legislative change Social,

Groups

Better Health

Population

Policy or economic and organisation environment change change

A FRAMEWORK FOR HEALTH PROMOTION ACTIVITIES

Health education programmes

AREAS OF HEALTH PROMOTION ACTIVITY

NURSING STRATEGIES FOR HEALTH PROMOTION

Role modelling Acting as a change agent Health education Setting priorities Using principles of behaviour modification Promoting holistic health Collaborating with other health care providers

THE NURSES ROLE IN HEALTH PROMOTION

Model healthy lifestyle behaviours and attitudes. Facilitate client involvement in the care. Teach self care strategies Assist individuals, families and communities to increase their levels of health. Educate clients to be effective health care consumers. Help individuals and families to choose activities conducive to health promotion Promote problem solving skills. Advocate in the community for changes those promote a healthy environment.

HEALTH MAINTENANCE
PREVENTION Exercise Smoking cessation Healthy diet Alcohol Multiple vitamins Calcium Eye examination Dental examination

CANCER SCREENING TESTS Breast cancer Cervical cancer Testicular cancer Colon cancer Skin cancer. Prostate cancer

SAFETY Seat belts. Smoke detectors Helmets Guns SELF CARE

FLU DOS AND OTHER HEALTH MAINTENANCE TIPS

1. Get vaccinated as recommended by your physician. There will be at least 2 vaccines for the flu. One for the seasonal and one for H1N1 (Swine flu). Make sure to get both. Also ask your physician about getting the pneumonia vaccine. 2. Wash your hands thoroughly and frequently. Use a hand sanitizer if soap and water are not available. 3. Cover your cough/sneeze with a tissue and discard the tissue immediately. If no tissue is available, use your sleeve or the crook of your elbow. 4. Try to avoid close contact (less than 6 feet) with sick people.

5. Use antiseptic cleaners on surfaces at home and work, cold and flu viruses can live on them for 2 hours or longer. 6. Avoid touching your eyes, nose or mouth with your hands, viruses spread this way. 7. Eat right, get enough sleep, reduce stress, take your medications as ordered and always practice safe sex. Maintaining a healthy lifestyle helps your immune system become stronger. 8. If you think you caught the flu, call your physician immediately. Antivirals need to be started within 24-48 hours.

ELEMENTS FOR EFFECTIVE STRATEGIES FOR STAYING HEALTHY AND IMPROVING ONES HEALTH
1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

PUTTING HEALTH KNOWLEDGE TO PRACTICE ROLE OF SCIENCE IN HEALTH PUBLIC HEALTH WORKPLACE WELLNESS PROGRAMS HEALTH CARE STRESS MANAGEMENT HYGIENE EXERCISE SPORTS NUTRITION NUTRITION:-

Assignment
Health maintenance activities for old age Common health risk behaviours among adolescents and preventive measures

References
Wikipedia. Health promotion. Retrieved November 2, 2009 from http://en.wikipedia.org/wiki/Health_promotion Infoshihat. Approaches to health promotion. Retrieved November 2, 2009 from http//:infosihat.gov.my/.../Approaches%20to%20Health%20Promoti on.ppt Infoshihat. Introduction to health promotion. Retrieved November 2, 2009 from http//:infosihat.gov.my/.../Intro%20to%20Health%20Promotion.ppt Midsussex. Health promotion. Retrieved November 10, 2009 from www.midsussex.gov.uk/Nimoi/sites/.../Health%20promotion1.pdf Wikipedia. Health maintenance. Retrieved November 10, 2009 from http://en.wikipedia.org/wiki/Health_maintenance_organization Clevelandclinic. Health maintenance guidlines. Retrieved November 20, 2009 from my.clevelandclinic.org/...health.../health_maintenance.aspx

Presented by: Mr. Sujith Kuriakose st M.Sc. Nursing 1 NUINS.CON