Evolution of Health Promotion PDF

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Evolution of Health Promotion Canada Health Act 1968 the government became responsible for financing a universal health-care system with service that are accessible to all Canadians Lalonde Report 1974 is a new perspective on the health of Canadians called the Lalonde report. This conceptualized the health field concept including biology, lifestyle, environment and health care organizations as the four elements that determine health  Shift from medical to behavioral approach to health  Emphasizes the individuals responsibility to their own health  Heavily criticized from blaming the victim for poor health Alma-Ata Declaration 1978 was the international health conference on primary health care, health for all in Russia by 2000 (WHO) Ottawa Charter 1986 has identified health as a resource for everyday living and the fundamental conditions and prerequisites in order to obtain health. The charter stressed that the individuals, governments and non-government sectors must work in a partnership in order to obtain health  Canada hosted the first international health promotion conference in Ottawa Five Health Promotion Strategies 1. Build a healthy public policy 2. Create supportive environments 3. Strengthen community action 4. Develop personal skills 5. Reorient health services Epp Report 1986 identified three health promotion challenges of reducing inequalities, increasing prevention and enhancing coping.

Three health promotion mechanism that were identified were self care in the interest of ones own health, mutual aid and healthy environments Three Suggested Strategies I. Fostering public participation II. Strengthening community health services III. Coordinating healthy public policy Strategies for Population Health the influence of environment of personal behaviors and that are “health inhibiting” behaviors could be a way of coping with stress created by living and working Jakarta Declaration – health promotion into the 21st century and was the first conference to be held in a developing country. The Jakarta declaration reaffirmed the Ottawa Charter and declared poverty to be the greatest threat to health Priorities for Action Identified in Jakarta I. Promoting social responsibility for health in public and private sectors II. Increasing investments for all health sectors III. Consolidating and expanding partnerships for health and community capacity and empowering individuals Models of Health Promotion Health promotion is the process of enabling people to increase control over their health and its determinants and thereby improving their health Injury prevention: use strategies to help population and individuals prevent and reduce risk of injury Disease Prevention: activities taken by the health sector to prevent the occurrence of disease, to detect and stop disease development and to reduce the negative effects once a disease is established

Harm Reduction: strategies to decrease the adverse health consequences of substance abuse with the eventual goal of abstinence, instead of abstinence being a prerequisite to the program Risk Avoidance: disease prevention that is use to avoid health problems and to remain at a low risk level Risk Reduction: a disease prevention that is use to reduce or alter health concerns so that the disease is detected and treated early to prevent moving to high risk Health Enhancement: health promotion that is used to increase health and resiliency to promote optimal health Risk factors: variable that create stress and challenges for clients health status Protective factors: variables such as an individuals characteristics, family support systems and environmental support that helps clients manage the stressors associated with being at risk Nursing has moved from doing things for your clients  doing things with your client: working with them, helping take care of themselves and involving them and care and letting them make decisions The Health Belief Model that healthy behavior can best be explained by understanding a individuals belief about health Four components: 1. Individual perceptions – susceptible to threat 2. Modifying factors 3. Cues to action 4. Likelihood of action Nursing interventions consistent with the Health Belief Model include:

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Nursing intervention is to make the threat clear Nurse is the expert Nurse action = health education Provides risks and benefits of treatment

Result of Research  Inconsistent, variable success in changing behavior  Did encourage change in health belief, which can lead to beneficial behavior health changes  Mass media can increase knowledge and belief about health Social Cognitive Theory behavior change is a result of the interplay of individuals and their environment Key elements:  Reciprocal determinism  Observational learning  Expectations  Self-efficacy Self Efficacy Theory self-efficacy is a persons belief about their capabilities of preforming a certain action. Behavior is contingent on efficacy expectations and outcome expectations. Self efficacy is the stronger predictor  Is based on the social learning theory  Perceptions of ability affect our behavior, level of motivation and emotional responses Sources of Efficacy 1. Performance 2. Vicarious experience 3. Verbal persuasion 4. Physiological state Efficacy characteristics include: magnitude, strength and generality but are different for each behavior and may change over time

The self efficacy theory was used to predict behavior, but was use was limited because the life style change was made but wasn’t maintained over time Self-efficacy influences the choices we make, the effort we put forth and how we persist when we confront obstacles Health Promotion Model: extends the health belief model to include the determinant of health-promoting behavior and includes the self-efficacy theory  Health promoting behavior is directed towards improving health and well being and away from reaction to a health threat  Is used to explain patterns of health promoting lifestyle  Limitations to this model include that it is difficult to test because of the large number of variables so it is limited as a guide for practice

Stages of Change Model (1995) Transtheoretical Model: people move through a series of five stages in their effort to change behavior 1) Precontemplation: not considering change 2) Contemplation: think about change 3) Preparation: identifies start date within the next month 4) Action: implementing change builds self-efficacy 5) Maintenance: continues new behavior Health Promotion Strategies Strengthen Community Action Through community development: a process where community members identify health problems or issues impacting their community that require the development of capacity building skills to bring about change

Pender’s Health Promotion Model: recognizes the uniqueness of the individuals past experience. Unique characteristics and experiences contribute to individual health promotion behavior especially when changes in cognitive factors occur  An individuals characteristics and experiences plus the behavior specific cognition and affect lead to the individuals commitment to a plan of action  Competing demands and preferences can support or hinder the adoption of health-promoting behavior

Through capacity building: this is done by recognizing and utilizing strengths rather than weaknesses such as available services, resources and programs that can help individuals, communities or organizations to resolve their health issues

Pender’s Cognitive and Affective Factors:  Perceived benefits of action  Perceived barriers of action  Perceived self efficacy  Activity related affect  Interpersonal influences  Situational influences

Healthy Public Policy: is a policy that has a positive effect on or promotes health. Building a healthy public policy creates environments that support health and reduce inequities in health and social policies

Through empowerment: this is an active process where individuals, groups or communities are able to state their health requirements and be involved in and take charge of the strategies required to achieve improved health

Creating Supportive Environments requires the attention to the determinants of health. These determinants of health:  Have a direct impact on the health of individuals and population health  They are the best predictors of health

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Structure of lifestyle choices Interact with each other to produce health

Health Communication and Social Marketing are strategies used to deliver health promotion messages to various targeted population The 4 P’s of Social Marketing: product, price, place and promotion...