Discuss the effectiveness of health promotion strategies

who 1986 – HEALTH PROMOTION: ”The process of enabling people to increase control over, and to improve their health”

So: The idea is that you can persuade people to act in certain ways – not an easy task though. What motivates people? Well it differes according to age, sex, socio- economic class, life goals etc. One to one contact is an effective way – but what about changing whole populations?

Modern health-promotion Health education programmes – raise awareness. Public health campaigns to change beliefs, attitudes, and motivation. Changing the wider determinants of health (e.g. changing the physical environment) Public or private health services (e.g. family doctors, pharmacies, smoking cessation clinics). Polical activities (e.g. legislation, setting standards for food available, taxes)

And this is how the US (20 states) did it (implemented evidence-based health-promotion strategies to change or influence behaviours related to obesity, nutrition and physical activity (Yee, 2006) Physical activity (83%) Increasing fruit and veg. Consumption (55%) Calories vs exercise (55%) Decreasing television viewing time (38%) Oh, and this supports that health promotion is now often based on research findings.

Links to articles about health campaigns: Alcohol problems in Scotland: http://news.bbc.co.uk/2/hi/uk_news/scotland/61 07844.stm Celebrities get payed to carry health promotion messages: http://www.dailymail.co.uk/news/article- 1111670/Anger-NHS-pays-90-000-celebrities- public-health-ad-campaigns.html Or a youtube clip- http://www.youtube.com/watch?v=IqJr0WWDzwo

The effectiveness of health campaigns Health campaigns are often criticised for not working. Holm (2002 – Danish survey on food habits) replies: they are, but they cannot stand alone – they must be an integral part of the entire health promotion project.

Denmark and Sweden Holm claims that it needs to be based on people’s daily life in order to be effective – and refers to the Danish rye bread sandwich – vs. Butter (7-40% from 1985 to 2001). Shows that behaviour CAN be changed. A Swedish equivalent – ”6-8 skivor om dagen” (this was a commercial though – not commonly known…) Holm also claims that there is a long-term effect of all the campaigns in Denmark – like ”30 minutes of fitness every day”

Worth knowing Persuasive communication includes: The source must be credible (trustworthy or an expert) The audience should determine how the message is framed The message should be short, direct and explicit (Sepstrup, 1999) Attitude change is more likely to last if the target group has participated in it actively (and not passively).

An example: ”TRUTH, A GENERATION UNITED AGAINST TOBACCO” anti tobacco campaign in florida (1998-99) Aims: prevent teen smoking by changing attitudes (1) and encouraging them to form groups to spread the message forwards themselves (2). MASSIVE ADVERTISING DRIVE WITH COMMERCIALS AND POSTERS SPONSORSHIPS ENCOURAGEMENT TO WORK PROACTIVE VS THE INDUSTRY

RESULT OF ”Truth” Means of survey: telephone surveys on target audience measuring effect, awareness and attitudes. Middle- and high-school teenagers defined as ”current smokers” went down from 19.4 % to 8% And the non-smoking kids said that they had been influenced by the campaign (Evaluation please?) Sly – 2002 carried out a survey 22 months later to investigate if the ads had had an effect on attitude change and found that the exposure to ads with the key message theme predicted that they had remained a non-smoker. Implications: campaigns CAN be effective.