Health Promotion I

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HEALTH PROMOTION METHOD & APPROACHES:

HEALTH PROMOTION METHOD & APPROACHES Kurt K. Hubbard, PhD(c), OTD, OTR/L

APPROACHES TO HEALTHY PROMOTION (THE EXAMPLE OF HEALTHY EATING):

APPROACHES TO HEALTHY PROMOTION (THE EXAMPLE OF HEALTHY EATING) APPROACH AIMS METHODS WORKER/CLIENT RELATIONSHIP Medical To identify those at risk from disease. Primary health care consultation, e.g. measurement of body mass index. Expert led. Passive, conforming client. Behavior change To encourage individuals to take responsibility for their own health and choose healthier lifestyles. Persuasion through one-to-one advice, information, mass campaigns, e.g. “Look After Your Heart” dietary messages. Expert led. Dependent client. Victim blaming ideology.

PowerPoint Presentation:

APPROACH AIMS METHODS WORKER/CLIENT RELATIONSHIP Educational To increase knowledge and skills about healthy lifestyles. Information. Exploration of attitudes through small group work. Development of skills, e.g. women’s health group. May be expert led May also involve client in negotiation of issues for discussion. Empowerment To work with clients or communities to meet their perceived needs. Advocacy Negotiation Networking Facilitation e.g. self image group. Health promoter is facilitator. Client becomes empowered. Social change To address inequities in health based on class, race, gender, geography. Development of organizational policy, e.g. hospital catering policy. Public health legislation, e.g. food labeling. Entails social regulation and is top-down.

PowerPoint Presentation:

AIM APPROPRIATE METHOD Health awareness goal Raising awareness, or consciousness, of health issues. Talks, group work, mass media, displays and exhibitions, campaign. Improving knowledge Providing information. One-to-one teaching, displays and exhibitions, written materials, mass media, campaigns, group teaching. Self-empowering Improving self-awareness, self-esteem, decision making. Group work, practicing decision-making, values clarification, social skills training, simulation, gaming and role play, assertiveness training, counseling. OT/PT? Changing attitudes and behavior Changing the lifestyles of individuals. Group work, skills training, self-help groups, one-to-one instruction, group or individual therapy, written material, advice. Societal/environmental change Changing the physical or social environment. Positive action for under-served groups, lobbying, pressure groups, community-based work, advocacy schemes, environmental measures, planning and policy making, organizational change, enforcement of laws and regulations.

SUMMARY OF INTERVENTION STRATEGIES:

SUMMARY OF INTERVENTION STRATEGIES TYPE DESIGN EMPHASIS Cognitive interventions Design to use both information and emotions to change perceptions Structural interventions Designed to use changes in the behavioral environment/ context to influence behavior Behavioral interventions Designed to provide incentives (natural or external) to reward desired behavior Policy interventions Designed to use social force or approval to influence behaviors and related determinants Marketing interventions Designed to create exchange relationships with specific target population to provide benefits with lower obstacles/cost Participatory interventions Designed to maximize in the most feasible manner the active involvement of the target population in every program stage on the premise that people ultimately know what is best for themselves and will sustain self-designed interventions longer than those externally imposed.

SUMMARY OF MEDIA METHODS:

SUMMARY OF MEDIA METHODS TYPE CHARACTERISTICS Limited reach media PHAMPLETS Information transmission. Best where cognition rather than emotion is desired outcome. INFORMATION SHEET Quick convenient information. Not for complex behavior change. NEWSLETTERS Continuity. Personalized. Labor intensive and requires detailed commitment and needs assessment before commencing. POSTERS Agenda setting function. Visual message. Creative input required. T-SHIRTS Emotive. Personal. Useful for cementing attitudes and commitment to program/idea. STICKERS Short messages to identify/motivate the user and cement commitment. Cheap, persuasive. VIDEOS Instructional. Motivational. Useful for personal viewing with adults as back-up to other programs.

SUMMARY OF MEDIA METHODS:

TYPE CHARACTERISTICS Mass media reach TELEVISION Awareness, arousal, modeling and image creation role. May be increasingly useful in information and skills training as awareness and interest in health services. RADIO Informative, interactive (talkback). Cost effective and useful in creating awareness, providing information. NEWSPAPERS Long and short copy information. Material dependent on type of paper and day of week. MAGAZINES Wide readership and influence. Useful as in supportive role and to inform and provide social proof. SUMMARY OF MEDIA METHODS

SUMMARY OF GROUP METHODS IN HEALTH PROMOTION:

SUMMARY OF GROUP METHODS IN HEALTH PROMOTION DIDACTIC GROUP METHODS LECTURE-DISCUSSION Best for knowledge transmission, motivation in large groups. Requires dynamic, effective speaker with more knowledge than the audience. SEMINAR Smaller numbers (2-20). Leader-group feedback. Leader most knowledgeable in the group. Best for trainer learning. CONFERENCE Can combine lecture/seminar techniques. Best for professional development. Several authorities needed.

SUMMARY OF GROUP METHODS IN HEALTH PROMOTION:

EXPERIENTIAL GROUP METHODS SKILLS TRAINING Requires motivated individuals. Includes explanation, demonstration and practice (e.g. relaxation, exercise). BEHAVIOUR MODIFICATION Learning and unlearning of specific habits. Stimulus-response learning. Generally behavior specific (e.g. quit smoking, pain management). SENSITIVITIY/ ENCOUNTER Consciousness raising. Suitable for professional training and some health goals. INQUIRY LEARNING Used mainly in school settings. Requires formulating and problem solving through group co-operation. PEER GROUP DISCUSSION Useful where shared experiences, support, awareness are important. Participants homogeneous in at least one factor (e.g. age prisoners). SUMMARY OF GROUP METHODS IN HEALTH PROMOTION

SUMMARY OF GROUP METHODS IN HEALTH PROMOTION:

SIMULATION Useful for influencing attitudes in individuals with varying abilities. Generally in school setting, but of relevance to other groups. ROLEPLAY Acting of roles by group participants. Can be useful where communication difficulties exist between individuals in a setting (e.g. families, professional practice, etc.). SELF-HELP Requires motivation and independent attitude. Valuable for ongoing peer support, values clarification, etc. Can be therapy or a forum for social action. SUMMARY OF GROUP METHODS IN HEALTH PROMOTION

COMMUNITY PARTICIPATION IN PLANNING HEALTH WORK:

COMMUNITY PARTICIPATION IN PLANNING HEALTH WORK NO PARTICIPATION The community is told nothing, and is not involved in any way. VERY LOW PARTICIPATION The community is informed. Compliance is expected. LOW PARTICIPATION The community is offered ‘token’ consultation. The 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 PARTICIPATION The community advises through a consultation process. The agency presents a plan and invites questions, comments and recommendations. It is prepared to modify the plan.

COMMUNITY PARTICIPATION IN PLANNING HEALTH WORK:

HIGH PARTICIPATION The community plan jointly. Representatives of the agency and the community sit down together from the beginning to devise a plan. VERY HIGH PARTICIPATION The community has delegated authority. The agency identifies and presents an issue to the community, defines the limits and asks the community to make a series of decisions which can be embodied in a plan which it will accept. HIGHEST PARTICIPATION The community has control. The agency asks the community to identify the issue and make all the key decisions about goals and plans. It is willing to help the community at each step to accomplish its goals even to the extent of delegating administrative control of the work. COMMUNITY PARTICIPATION IN PLANNING HEALTH WORK

ADVANTAGES AND DISADVANTAGES OF THE COMMUNITY DEVELOPMENT APPROACH:

ADVANTAGES AND DISADVANTAGES OF THE COMMUNITY DEVELOPMENT APPROACH ADVANTAGES DISADVANTAGES Starts with people’s concerns, so it is more likely to gain support. Time consuming. Focuses on root causes of ill health, not symptoms. Results are often not tangible or quantifiable. Creates awareness of the social causes of ill health. Evaluation is difficult. The process of involvement is enabling and leads to greater confidence. Without evaluation, gaining funding is difficult. The process includes acquiring skills which are transferable, for example, communication skills, lobbying skills. The health promoter may find his or her role contradictory. To whom are they ultimately accountable – employer or community? If health promoter and people meet as equal, it extends principle of democratic accountability. Work is usually with small groups of people.

Change Any Way You Can:

Change Any Way You Can Informal meetings

Examples:

Examples http://www.youtube.com/watch?v=JGnkDk0Xb_U PT/OT flyer

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