2
Focus of this health
Improving the health of improvement effort has shifted
individuals, communities from environments, systems
and populations is a long
standing societal issue.
and populations to individual
based approaches and back
First legislative action re again.
health improvement went
beyond the individual and
sought to address the
socio-economic conditions
that people found
themselves in. (1796)
However evidence indicated that health-
related behaviour and individuals are not
just isolated acts, always under the
autonomous control of the individual, but
are socially conditioned, culturally
embedded and economically determined.
Strengthening
community
action
Developing Reorientating
personal skills health services
7
Health promotion is the process of enabling
people to increase control over and to improve
their health. . Health is a positive concept
emphasising social and personal resources, as well as
physical capacities. Therefore, health promotion is not
just the responsibility of the health sector, but goes
beyond healthy lifestyles to well-being. Ottawa Charter for
Health Promotion (1986)
Ottawa Charter health promotion = radical
social change.
Enabling individuals to increase control over the
determinants of their health (or disease) means
challenging the status quo (accepted ways of
doing things existing vested interests) at an
individual and collective level
(community/society).
Health promotion happens within & out with the
health sector.
Developing public
policy. Creating supportive
environments.
Strengthening
community action.
1. Medical or preventive
2. Behaviour change
3. Educational
4. Empowerment
5. Social change
Education
Authoritarian Policy making and
implementation
Behaviour change
Health surveillance
Mass media campaign
Individual Collective
Focus of
intervention
Counselling
Lobbying
Education
Action research
Group work
Skills sharing and training
Group work
Community development
Negotiated
5 6. Positive health
1. Preventive services, Health education
e.g. immunization, protection, e.g.
cervical screening, workplace
2 7
hypertension case smoking policy.
4 6
finding, 1 Health
developmental Prevention 3 protection 7. Health education
surveillance, use of aimed at positive
nicotine chewing gum health protection,
to aid smoking
3. Preventive health protection, e.g. e.g. lobbying for
cessation. a ban on tobacco
fluoridation of water.
advertising.
2. Preventive health 4. Health education for preventive
education, e.g. health protection, e.g. lobbying
smoking cessation for seat belt legislation.
advice and 5. Positive health education, e.g
information. life skills with young people.
Interventions are activities used by
programme planners to bring about
outcomes identified in the programme
objectives
These activities are sometimes referred to
as treatments
An intervention may be made up of a
single activity but it is more common for
planners to use a variety of activities to
make up an intervention for a
programme
Selection should be based on a sound
rationale as opposed to chance and the
intervention should be both effective
and efficient. The following questions will
serve as a guide:
1. Do the intervention activities fit the goals
and objectives of the programme?
2. At what level(s) of influence will the
intervention be focused?
3. Are the activities based on an
appropriate theory?
4. Is the intervention an appropriate fit for
the target population?
5. Are the necessary resources available
to implement the intervention
selected?
6. What types of intervention
activities are known to be
effective in dealing with the
programme focus?
PEER GROUP Useful where shared experiences, support, awareness are important.
DISCUSSION Participants homogeneous in at least one factor, e.g. old people,
prisoners, teenagers.
SIMULATION Useful for influencing attitudes in individuals with varying abilities.
Generally in school setting, but of relevance to other groups.
ADVERTISING
One component of marketing mix
AUDIENCE SEGMENTATION:
The division of a mixed population
into more homogenous groups or
market segments. Market segments
are defined by certain shared
characteristics which affect
attitudes, beliefs and knowledge.
Targeting specific market segments
allows for more specific messages
which will have a greater effect.
Unrealistic expectations of media
effectiveness due in part to a basic
misunderstanding
COLLABORATION: Media
professionals should be involved to
determine how best to use the
media
when a wide exposure is desired
when public discussion is likely to
facilitate the educational process
when awareness is the main goal
when media is on-side
when accompanying on the
ground back-up can be provided
when long-term follow-up is
possible
when a generous budget exists
when counter-argument is likely to
be productive
when the behaviour goal is simple
when a hidden agenda is public
relations
TYPE CHARACTERISTICS
Limited reach media
PAMPHLETS Information transmission. Best where cognition rather than
emotion is desired outcome.
INFORMATION Quick convenient information. Use as series with storage folder.
SHEET Not for complex behaviour change.
The process includes acquiring skills which The health promoter may find his or her role
are transferable, for example, communication contradictory. O whom are they ultimately
skills, lobbying skills. accountable employer or community?
If health promoter and people meet as equal, Work is usually with small groups of people.
it extends principle of democratic
accountability.
NO The community is told nothing, and is not involved in
PARTICIPATION any way.
VERY LOW The community is informed. The legacy makes a plan
PARTICIPATION and announces it. The community is convened or
notified in other ways in order to be informed;
compliance is expected.
LOW The community is offered token consultation. The
PARTICIPATION agency tries to promote a plan and seeks support or at
least sufficient sanction so that the plan can go ahead.
It is unwilling to modify the plan unless absolutely
necessary.
MODERATE The community advises through a consultation process.
PARTICIPATION The agency presents a plan and invites questions,
comments and recommendations. It is prepared to
modify the plan.
Cont