Week 6: Health Promotion

Perspectives on Health:

What causes heart disease?

If you ask the same question to three different health professionals, you may get three
different answers.

For example, a cardiologist doctor: and she/he may tell you that:
Ø Hypertension
Ø family history and
Ø build-up of arterial plaque

However, a different health professional e.g. public health worker:

Ø Smoking
Ø Physical inactivity
Ø Excess alcohol consumption
Ø High fat diet

Social worker:
Ø Stress
Ø Poverty
Ø Unemployment

WHO defined health promotion as “enabling people to gain control over their lives”
(empowerment)
Health Promotion can be characterized by four other main developments:
The need for planning
The importance of evaluation
The used of social and behavioural science theories and the systematic
application of empirical data and theory

Health promotion planning frame-work is Green and Kreuter’s PRECEDE/

PROCEED model (Green & Kreuter, 1999; as cited in Michie & Abraham, 2004)

The PRECEDE model starts with analyses of:

•quality of life

•behaviour and environmental factors

• predisposing, reinforcing and enabling determinants (correlates) of behaviour and

environmental factors.

q In PROCEED a health promotion intervention is developed, implemented and

evaluated
Theories comprise a very important tool for professionals in health education
and promotion
A health promotion programme is most likely to benefit participants and communities
when it is guided by:
Ø social and behavioural science theories of health behaviour and health
behaviour change
Ø Theory driven health promotion programmes require an understanding of the
components of theories, operational and practical forms of theories
Finding and applying relevant theories is a professional skill that health educators
have to master (Bartholomew et al., 2001; as cited in Michie & Abraham, 2004).

Health Psychologists seek to describe, explain, predict and change cognition and
emotion and behaviour
Theories are descriptions on how things or people are constructed and how they
behave. Furthermore, theories help us to understand events and predict what is likely
to happen next ;also to articulate casual explanations describing sequences of
interconnected mechanisms underlying psychological responses and behavioural
patterns. In other words, such theories explain why people behave differently and
thereby facilitate prediction of the behaviour and also these models may used as a
means to develop the intervention and evaluate its effectiveness.

Good theory is the key pin of evidence- based practice

Best practice is most likely to emerge from theory-based interventions that in turn
inform and improve theory

Using theories in Psychological Interventions: Importance of theory:

In order to achieve this a number of psychosocial theories (or models––the two terms
may used interchangeably have been developed to predict, explain, and change
health behaviours
Interventions have been developed as a means to change behaviours and promote
healthier lifestyles
Different models in health behaviour are used and these are discuss in turn
HP explores the predictors of a range of behaviours:
Eating, Smoking, Physical activity, Alcohol, Screening, Adherence to medication,
Condom use and contraception use etc.
There are many strong arguments for targeting health related behaviours.
For example:
Alcohol consumption costs the UK economy £7 billion each year
Overweight and Obesity cost approximately the same
²Therefore, Interventions that promote healthy lifestyles; enhances quality of life
among individuals with chronic health conditions; reduces health service demand
We have reviewed different models of Health Behaviour Change.
For example:
Ø Health Belief Model (HBM)
Ø The transtheoretical model (TMC)/ Stages of Change (SOC)
Ø Protection Motivation theory (PMT)
Ø Theory of Reasoned Action (TRA)
Ø Theory of Planned Behaviour (TPB)

Overall, these models and theories overlap to a considerable extent, but each
emphasizes key concepts that significantly influence health behavior change.
References:
Michie, S., & Abraham (2004). Health Psychology in Practice