Health Promotion Strategies_study notes.docx

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Health Promotion
HPRO 3397
Jacqueline Gahagan

Health Promotion Strategies and methods Definitions: Qualitative data: Use of words instead of numbers to represent their data. Descriving observations, interactions, and insights. Quantitative data: identify variables that can be observed and measured. These variables are recorded as numbers, and statistics can be used to determine relationships between and among the variables. Health promotion program vs. Strategies: Program: A planned event that helps an organization by funding, or helping a community for instance. Strategy: Identified gaps within a program and implementing a strategy to reduce or eliminate the gap. Community: LGBT community, religious community, etc. Medical or Disease model of addiction: describes an addiction as a lifelong disease involving biologic and environmental sources of origin. Determinants of Health 1. Income and Social Status 2. Social Support Networks 3. Education and Literacy 4. Employment/Working Conditions 5. Social Environments 6. Physical Environments 7. Personal Health Practices and Coping Skills 8. Healthy Child Development 9. Biology and Genetic Endowment 10. Health Services 11. Gender 12. Culture What is theory? A set of interrelated concepts, definitions, and propositions that presents a systematic view of events or situations by specifying relations among variables in order to explain and predict events of the situations Why use theory in CHPS? A theory based approach provides direction and justification for program activities and serves as a basis for processes that are to be incorporated into the health promotion program Over the centuries humankind has relied on 5 sources of evidence: 1. Custom & tradition 2. Authority 3. Personal experience 4. Deductive reasoning 5. Scientific inquiry CAEDS Evidence-based practice – assessing the needs, assessing the causes from previous research, assessing the evidence for effective strategies, assessing through evaluation (Green & Kreuter, p. 224) Microlevel behavior change theories  Focuses largely on individual behaviour & how to change/ motivate behaviour change  Social learning theory – stresses interrelationships between people, their behaviour, their environment through “reciprocal determinism”  Theory of reasoned action – focus on the role of personal volition in determining if a behaviour will occur or not  Diffusion of Innovations Theory – must be related to a behaviour already doing, simple, low risk, better, flexible  Exchange Theory – foundation for social marketing, “exchange” of time, money, or effort for a good idea or service if they believe in the benefits Macro-level theory  Focuses on the individual within the larger social context  Does not simply look at the individual cognitive processes in behaviours or behaviour change  Often connected to structural issues  Can help drive health policy outcomes  Social determinants of health  EXAMPLES?  Social Marketing Theory  Behavioural Community Psychology Theory  Community Development Theory Models:  Can serve as the conceptual framework for our CHPS  Usually have a theoretical component to them  Community organization model – works with the community to effect healthy changes  Model of Disease Self-management – looks at what the patient wants to get from (outcomes) their treatment  Stages of Change Model (“Transtheoretical model”) – people move through distinct stages in adopting new healthy behaviours or quitting unhealthy one  Health Belief Model – health behaviour is a function of both knowledge & motivation (perceptions of vulnerability)  What are the 4 key factors associated with self-efficacy? 1.personal experience, 2. observational experience, 3. verbal persuasion, 4. physiological state POPP Diffusion of Innovations Theory  What is the significance of “early adopters” for this theory?  They can influence others to adopt the new idea  Works best when: simple to understand, low risk, low cost (time & money), better than other ways, easy to try, similar to what they are already doing  Community leaders or early adopters were seen as role models & were encouraged to set a good example for other  Used this leverage with store owners to remove tobacco advertisements from their stores Public Policy:  The main aim of healthy public policy is to create a supportive environment to enable people to lead healthy lives.  Such a policy makes healthier choices possible or easier for citizens.  It makes social and physical environments health-enhancing. Goodson Levels of theory: 1. Intrapersonal level 2. Interpersonal level 3. Institutional/organizational level 4. Community level 5. Public policy level 3IsCP  Four key steps involved in policy development: 1. Analyzing the problem 2. Identifying stakeholders 3. Describing effective policies 4. Evaluating policy (impacts/outcomes) AIDE Social Psych & Policy: 3 Key elements  Policy making not always rational – it is value driven, influence driven, use of persuasion;  Wide-ranging health policy topics provides proof of the utility of the social psych approach; and  Interdisciplinary approaches allows for augmented influence from a variety of perspectives. Housing affects health in 3 ways; Proximate Environment Socioeconomic Status Spatial Aspect Children and Housing  Spatial requirements Inadequate space for urban families Immigrant and aboriginal families  Neighborhood safety Limited outdoor activity Quality of structure Access to utilities Protection from the elements Exposure to mold and toxins (lead) Necessary elements for social change include: 1. An acknowledged crisis 2. A critical mass of evidence 3. The obvious presence of „victims‟ 4. A tug at the heart strings 5. Strong political leadership 6. A balanced perspective Explain the “spillover” effect: A secondary effect that follows from a primary effect, and may be far removed in time or place from the event that caused the primary effect. Paralysis analysis: over-analyzing (or over-thinking) a situation, or citing sources, so that a decision or action is never taken, in effect paralyzing the outcome. Valued prevention: what the community wants, or what they identified is something they want. Characteristics of harm reduction: 1.Pragmatism 2. Humanistic Values 3. Focus on Harms 4. Balancing Costs & Benefits PH FB Gains to society:  1) decreased health costs for IDUs  2) decreased mortality rates for IDUs  3) increases in productivity of IDUs  4) decreased criminal activity  Does the medical model provide a ‘moral disapproval’ of the addict? Some key issues in measuring success of drug use initiatives 1. What are health promotion programs? In Health Promotion Programs 2. Retention in treatment (measurable?) 3. Reduction in drug related crime 4. Reduction in drug related deaths &/or spread of HIV & Hep C infections 5. Increase in ‘pro-social’ activity (measurable?) 6. Reduction in drug use Social Marketing is based on: • Exchange Theory – people exchange time, money, effort for a good service or idea with benefits • Consumer Orientation – focuses on the consumer or the target audience • Audience or Market Analysis- the needs of the community members are identified, also costs & benefits • Audience or Market Segmentation – community members are grouped by their similarities in order to design messages & programs to meet their needs. • Marketing Integration & Evaluation – product, price, promotion, place (also participation and politics) & evaluation techniques to determine effects • Social Marketing cannot fix all public health issues in isolation from other techniques or strategies • Some health issues do not fit well into the Social Marketing framework • Media Advocacy looks not only at the health issue but also the conditions which can contribute to ill health (social & political environment) • Media campaigns can be costly, scope-limited, time-limited, resource intensive & challenging to evaluate • Web-based social marketing strategies can help overcome some of these issues but concerns about computer literacy, lack of contact with health personnel, privacy, etc. require consideration • How would you develop a social marketing strategy with your community? What are the key considerations in your case? 1. (Egger, Spark, Lawson & Donovan) Health Promotion Strategies and methods:  Changing health patterns  Global strategy on diet, physical activity and health  Rise of obesity and the risk factors (stroke, heart disease, cancer, asthma, diabetes,…etc.  Mass media, together with community organization and capacity building processes, might be necessary to encourage change in the early and late majority.  Combining strategies according to: o The characteristics of the target group and their needs o The type of intervention required o The timeframe of the project o The goals of the organization sponsoring the project, and resources available, both financial and human  Danger of overzealousness in the health field is the creation of increased anxiety and decreased pleasure of life. For example, increased interest in health in some pa
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