HEALTH PROMOTION

Health promotion is a process of enabling

people to increase control over the
determinants of health and thereby
improve their health. WHO (1986) Ottawa
Charter
Participation is essential to sustain health
promotion action

STRATEGIES FOR HEALTH
PROMOTION
Advocacy for health to create the
essential conditions for health,
Enabling all people to achieve their full
health potentials, and
Mediating between the different interests
in society in the pursuit of health

Health Promotion Model
(Nola Pender,1996)
Individual characteristics and experiences
can be useful in predicting if an individual
will incorporate and use health related
behaviors.
If a behavior has been used before and
becomes a habit, it is more likely to used
again.
Behavior- specific knowledge, beliefs and
relationships major motivators for
engaging in health behaviors.

A health related behavior is initiated by
committing to a plan of action,
accompanied by developing associated
strategies to perform the value behavior.

HEALTH PROMOTION MODEL (HPM)
NOLA PENDER
Conceptualized that motivation to
participate in health promoting behavior is
influenced by cognitive-perceptual factors
and modifying factors
COGNITIVE-PERCEPTUAL
FACTORS INCLUDES:
Importance of health
Perceived control of health
Self efficacy
Definition of health
Perceived health status
Perceived benefits of health promoting
behaviors
Perceived barriers to health promoting behaviors
HEALTH PROMOTION
THEORY
Self-efficacy
It is a belief that one has the capabilities to
execute the courses of actions required to
manage prospective situations.
Example:
A person with high self-efficacy may engage
in a more health related activity when an
illness occurs, whereas a person with low
self-efficacy would harbor feelings of
hopelessness.
Therefore:
Self efficacy is
the ability or the
power to
produce an
effect/ change.

Psychologist Albert Bandura has defined
self-efficacy as one's belief in one's ability
to succeed in specific situations.
One's sense of self-efficacy can play a
major role in how one approaches goals,
tasks, and challenges.
According to Bandura's theory, people with
high self-efficacy:
are those who believe they can perform well
are more likely to view difficult tasks as
something to be mastered rather than
something to be avoided.

How self-efficacy affects human
function
Choices regarding behavior
People will be more inclined to take on a task
if they believe they can succeed. People
generally avoid tasks where their self-efficacy
is low, but will engage in tasks where their
self-efficacy is high.
Motivation
People with high self-efficacy in a task are
more likely to make more of an effort, and
persist longer, than those with low efficacy.
Thought patterns & responses
Low self-efficacy can lead people to believe
tasks are harder than they actually are.
People with high self-efficacy often take a
wider overview of a task in order to take the
best route of action.
People with high self-efficacy are shown to be
encouraged by obstacles to make a greater
effort.
Self-efficacy also affects how people respond
to failure.
A person with a high self-efficacy will attribute
the failure to external factors, where a person
with low self-efficacy will attribute failure to
low ability.

Health Behaviors
Health behaviors such as non-smoking,
physical exercise, dieting, condom use, dental
hygiene, seat belt use, or breast self-
examination are, among others, dependent on
ones level of perceived self-efficacy (Conner
& Norman, 2005).
Self-efficacy beliefs are cognitions that
determine whether health behavior change
will be initiated, how much effort will be
expended, and how long it will be sustained in
the face of obstacles and failures.
Self-efficacy influences the effort one puts
forth to change risk behavior and the
persistence to continue striving despite
barriers and setbacks that may undermine
motivation.

Self-efficacy is directly related to health behavior, but
it also affects health behaviors indirectly through its
impact on goals.
Self-efficacy influences the challenges that people
take on as well as how high they set their goals (e.g.,
"I intend to reduce my smoking," or "I intend to quit
smoking altogether"). A number of studies on the
adoption of health practices have measured self-
efficacy to assess its potential influences in initiating
behavior change (Luszczynska, & Schwarzer, 2005).


TYPES OF HEALTH
PROMOTIONAL ACTIVITIES
HEALTH EDUCATION (information
dissemination)
Use of variety of media to offer information to
the public about the particular lifestyle choices
and personal behavior, the benefits of
changing that behavior and the improvement
of quality of life
FIVE PRIORITY ACTIONS AREA
Build healthy public policy;
Create supportive environments for health;
Strengthen community action for health;
Developed personal skills;
Re-orient health services
Jakarta Declaration on Leading
Health Promotion into the 21
st

Century (1997)
Strategies and action areas are
relevant for all countries
Comprehensive approaches to health
development are most effective.
Setting for health offer practical
opportunities for the implementation of
comprehensive strategies.
Participation is essential to sustain efforts.
Health literacy fosters participations.
Five Priorities
Promote social responsibility for health;
Increase investments for health
development;
Expand partnerships for health
promotion;
Increase community capacity and
empower the individuals;
Secure an infrastructures for health
promotion
ACTIVITIES FOR HEALTH
PROMOTION
HEALTH APPRAISAL WELLNESS
ASSESSMENT PROGRAM
Appraise individuals of their risk factors that
are inherited in their lives/family in order to
motivate them to reduce specific risk and
develop positive health habits
Wellness assessment programs are focused
on more positive methods of enhancement
LIFE-STYLE AND BEHAVIOR CHANGE
PROGRAM
Basis for changing behavior
Geared towards enhancing the quality of life
and extending the life span
WORKSITE
WELLNESS
PROGRAM
Includes programs that
serve the needs of the
persons in their work
places
ENVIRONMENTAL
CONTROL
PROGRAM
Developed to address
the growing problem of
environment pollution
such as air, land,
water etc.
DISEASE PREVENTION
Disease prevention covers measures not
only to prevent the occurrence of
diseases, such as risk factor reduction, but
also to arrest it progress and reduce its
consequences once established. WHO
(1984)

Disease prevention is sometimes used as
a complementary term alongside health
promotion.
Although there is frequent overlap
between the content and strategies,
disease prevention is defined saparetly.
Disease prevention is considered to be
actions which usually emanates from
health sector, dealing with individuals and
populations identified as exhibiting
identifiable risk factors, often associated
with different risk behaviors.
LEVELS OF DISEASE
PREVENTION
PRIMARY LEVEL
Directed towards preventing the initial
occurrence of disease.
Decreases the risk or exposure of
individual and community to disease.
Example:
Health education about accident and poisoning
Health education about standards of nutrition and
growth and development, exercise requirements,
stress management, protection against
occupational hazard.
Immunization
Risk assessments for specific disease
Family planning services and family counseling
Environmental sanitation and provision of
adequate housing, recreation and work conditions
SECONDARY LEVEL
Focus on early identification of health
problem and prompt intervention to
alleviate health problems.
Includes prevention of complications and
disabilities.
Example
Screening surveys
Encouraging regular medical and dental
examination
Teaching self-examination for breast and testicular
cancer
Assessing growth and development of children
Maintaining skin integrity, turning, positioning,
exercising client, ensuring adequate rest and
sleep, food and fluid intake, elimination,
administering medical therapies such as
medications
TERTIARY LEVEL
Begins after illness, when defect or
disability is fixed or determined to be
irreversible
Focus to help rehabilitate individuals and
restore hem to an optimal level of
functioning within the constraints of the
disability
Example:
Referring client to a support group
Teaching diabetic client to prevent complications
Referring client to rehabilitation center
BAHAVIOR ASSOCIATED WITH
LEVELS OF PREVENTION
PRIMARY
Quit smoking and avoid alcohol intake
Regular exercise and eat well balance diet
Reduce fat and increase fiber intake
Take adequate fluid intake
Maintain ideal body weight
Complete immunization program
Avoid over exposure to sunlight and wear
protective gear at work place

SECONDARY
Have annual health examination
Regular paps test for women
Monthly BSE for women (20 and up)
Sputum examination for tuberculosis
Anal stool guaiac test and rectal examination
for client 50 y.o. and above
TERTIARY
Self monitoring of blood glucose among
diabetic client
Physical therapy after CVA
Participate in cardiac rehabilitation after MI