What is health promotion?

Health promotion enables people to increase control over their own health. It covers a wide
range of social and environmental interventions that are designed to benefit and protect
individual people’s health and quality of life by addressing and preventing the root causes of ill
health, not just focusing on treatment and cure.

Disease prevention
Are activities that protect people from disease and the effects of disease.

Leavell and Clark (1958) identified 3 levels of prevention commonly described in nursing
practice.
1. primary prevention
2. secondary prevention
3. tertiary prevention

LEVELS OF PREVENTION
PRIMARY SECONDARY TERTIARY
Prevention Prevention Prevention

DEFINITION An intervention An intervention implemented An

implemented before there after a disease has begun, but intervention
is evidence of a disease or before it is symptomatic implemented
injury. after a disease
or injury is
established
INTENT Reduce or eliminate Early identification Prevents
causative risk factors (through screening) and sequelae
(risk reduction) treatment (Stops bad
things from
getting worse)
EXAMPLE Prevent addiction from Screen pregnant women for Teaching
occurring substance use during prenatal insulin
Prevent pregnancy visit and refer for treatment administration
Immunization Screening for STDs in the home

Primary prevention

Relates to activities directed at preventing a problem before it occurs by altering susceptibility

or reducing exposure for susceptible individuals
Health promotion efforts enhance resiliency ad protective factors and target essentially well
populations.

Primary prevention consists of two elements:

A. general health promotion
B. specific protection

Examples of primary prevention

 Promotion of good nutrition

 Provision of adequate shelter
 Encouraging exercise
 Specific protection efforts reduce or eliminate risk factors and includes measures such
as immunization and water purification

Secondary prevention

Refers to early detection and prompt intervention during the period of early disease
pathogenesis.

It is implemented after a problem has begun but before signs and symptoms appear and target
those populations who have risk factors
Directed toward prompt intervention to prevent worsening conditions of affected population

Examples of secondary prevention

 Mammography
 Blood pressure screening
 Newborn screening
 Mass sputum examination for pulmonary tuberculosis
 Teaching mother how to give ORESOL (salt and sugar solution) to her child suffering
from diarrhea to prevent dehydration

Tertiary prevention

Targets population that have experienced disease or injury and focuses on limitation and
disability and rehabilitation.

Aims of tertiary prevention are to reduce the effects of disease and injury and to restore
individuals to their optimal level of functioning

Examples of tertiary prevention

  Teaching how to perform insulin injection techniques and disease management to a
patient with diabetes
 Referring a patient with spinal cord injury for occupational and physical therapy
 Leading a support group for cancer patients who have undergone cancer treatment such
as surgery, chemotherapy and radiation therapy

LEVELS OF PREVENTION
Definition of client PRIMARY SECONDARY TERTIARY
served PREVENTION PREVENTION PREVENTION
INDIVIDUALS Dietary teaching HIV testing Teaching new clients
during pregnancy Screening for cervical with diabetes how to
Immunization cancer administer insulin
Exercise therapy
after stroke
FAMILY Education or Dental examination Skin care for
counseling regarding Diabetes screening incontinent patients
smoking, dental care for family at risk Mental health
or nutrition counseling or referral
Adequate housing for family in crisis
GROUP OR Mother’s class on Vision screening of Dietary instructions
AGGREGATE breastfeeding first grade class and monitoring for
Education for drug Sputum exam family with
abuse prevention for Hearing test for overweight members
high school students elderly Group counseling for
grade school with
asthma
Exercise for diabetics
COMMUNITY AND Fluoride water Health fairs Alcoholic Anonymous
POPULATION supplementation VDRL screening for and other self-help
Environmental marriage license group
sanitation applicants in the city Mental Health
Removal of services for military
environmental veterans
hazards Shelter and
relocation centers for
fire, typhoon victims