Week 1: Defining Health, Promoting Healthy Behaviour Change, and Evaluating Health
1. What are the key characteristics of the medical model of health?
- health defined as the opposite of illness, absence of disease and/or disability
- when patient returns to “neutral” state, intervention is stopped
- doctor is viewed as all-knowing; patient is dependent on doctor
- focus on retroactive treatment
2. Compare and contrast the wellness model and the risk factor model of health.
- risk factor model: mortality (& morbidity?) rates linked to various risk factors, variables that are
associated with increased risk of developing a disease -> focus on proactive prevention
- wellness (holistic) model: combine both treatment and prevention from medical and risk factor models,
but also considers additional factors that affect health, such as social, mental, occupational, emotional ,
environmental, and spiritual health
3. Name and briefly describe the seven dimensions of health.
- physical health: body functioning, susceptibility to disease or disorders, also ability for daily functioning
(e.g. getting out of bed, off the toilet)
- social health: capacity for satisfying interpersonal relationships, interacting with others and adapting to
various social situations
- mental health: capacity to think clearly, reason objectively, analyze critically and use brain to effectively
meet challenges in life
- occupational health: satisfaction from one’s own career or stage of career development; as well, a
balance between work and leisure
- emotional health: ability to effectively and appropriately express emotions
- environmental health: appreciation of the external environment and one’s own role in preserving,
protecting and improving it
- spiritual health: health of “the deepest or innermost part of you” 4. Many different factors influence health. Brainstorm a list. Now group each of these based on
the seven dimensions of wellness. Identify the ones that are within your control to change in order
to improve your health.
5. Define mortality, morbidity, and preventable years of life lost.
- mortality: death rate stats
- morbidity: illness rates
- life expectancy: number of years an individual is expected to live, calculated from a specific age (e.g.
- preventable years of life lost: life expectancy – age at death = PYLL
6. Explain why cardiovascular disease accounts for a high percentage of premature deaths and a
low percentage of PYLL, while the opposite is true for accidents.
- consider that accidents is more preventable than cardiovascular disease, especially in premature deaths
- the PYLL calculated for those killed by accidents is considerably higher (life expectancy is higher) than
those who were killed by cardiovascular disease
7. What four supports are required for a successful health promotion program? Give practical
and specific examples of each one.
- educational supports: promote learning
- organizational supports: programs and services that encourage participation
- environmental supports: rules governing attitudes and behaviors and which also support decisions to
- financial supports: monetary incentives to motivate healthful decision making
8. Differentiate between primary, secondary, and tertiary prevention. Give a specific example of
- primary prevention: measures made to prevent health problems from occurring (e.g. engaging in
regular physical activity)
- secondary prevention: early recognition of a health problem and intervention to eliminate or reduce it
before more serious illness occurs (e.g. modifying diet and physical activity levels in response to a blood-
cholesterol or blood-glucose test)
- tertiary prevention: treatment made after a person has become sick (misnomer, retroactive response)
9. Outline the health benefits to choosing healthy behaviours as listed by your text.
- reduce risk for cardiovascular disease, cancer, major diseases; increase lifespan; improve quality of life;
greater energy levels; stronger immune system; improved self-confidence, self-concept, self-esteem, self-
efficacy; enhanced relationships due to better communications and “quality time” etc. 10. What health behaviours identified by your text show a significant relationship to increasing
- getting goodnight’s sleep, maintaining healthy eating habits, maintaining weight, participating in regular
physical activities, regular brushing of teeth, avoiding tobacco products
11. Differentiate between the concepts of "years added to life" and "life added to years". What
behaviours are associated with the latter?
12. According to the article "Four Simple Habits add 14 Years to Life", what are the four habits?
Briefly describe the studies that led to these conclusions.
- Not smoking, Drinking moderately (1-14 drinks/week), Keeping physically active, Eating five servings
of fruits and vegetables daily
- longitudinal cohort studies: examine the risk of mortality in individuals with either none or combo of the
13. Explain what predisposing, enabling, and reinforcing factors are. Give an example of each one
and how it influences behaviour.
- predisposing factors: factors that are likely to lead to a particular behavior (e.g. include age, sex,
ethnicity, income, family, education)
-> e.g. if your parents smoked, you’re 90% more likely to start smoking
- enabling factors: skills or abilities, physical, emotional and mental capabilities, and resources and
accessible facilities that make health decisions more convenient or difficult (i.e. positive or negative
enablers either encourage to carry through with your intentions or work against your intentions to change)
-> e.g. membership fee of fitness centre is $1000, can be a negative enabler
- reinforcing factors: refer to support and encouragement or discouragement that come from significant
others or situations in your life that enable a particular behavior you have chosen
-> e.g. you decide to stop smoking but your family and friends smoke in your presence
14. Explain the key principles of the Health Belief Model of behaviour change. What factors must
support a belief in order for change to be likely? What factors are linked to the perceived risk of
health problems? Use an example such as cessation of tobacco use or promotion of condom use to
demonstrate how this model is used. You may find using the figure of the Health Belief Model
provided by your text helpful in answering these questions.
- In order for change to be likely, belief must be supports by the following factors: perceived seriousness
of the health problem, perceived susceptibility to the health problem and cues to action (reminders or
alerts about a potential health problem)
- 3 factors linked to perceived risk for health problems are: demographic variables (e.g. age, sex,
ethnicity), sociopsychological variables (e.g. personality traits, social class and pressure), structural
variables (e.g. knowledge about or prior contact with the health problem)
- Person positively affected by the 3 factors for perceived risk for health problems sees risk of seriousness and susceptibility to lung cancer
- cues from media campaigns also increase his perception that there is threat of lung cancer
- there are few environmental barriers (his family/friends support the change)
15. Discuss the theory of reasoned action and how it relates to behaviour change. Use specific
examples to support your explanation.
- theory of reasoned act