Models of Behavioural Change + Health promotion Peer support P and Virginia

Defintion What is health promotion? – Is the process of enabling people to increase control over their health and its determinants and thereby improve the their health

Definition What is disease prevention? – Action aim at eradication, eliminating, or minimising the impact of disease and disability or if none of these is feasible, retarding the progress of disease and disability

What is the difference between health promotion and disease prevention? – Health promotion: Think about the positive definition of health Achievning harmony and equilibrium between physical, emotional and spritiual aspects of health Freedom to live the fulfest – Disease prevention: Think about negative definition of health Absence of disease

What are the models of Health promotion? (2) Ewles and Simnett’s FIVE appraoch Beattie’s Model of health promotion

Ewles & Simnett’s FIVE Approaches in Health Promotion Approach MedicalEarly detection of smoking related disorders e.g. spirometry EducationalGiving information on health effects of smoking in schools Client CenteredClient identifies what they want to know / do about smoking Behaviour changeSmoking cessation support Societal change No smoking policies, taxation No ‘right’ approach, need mix

Beattie’s Model of Health Promotion INDIVIDUALCOLLECTIVE AUTHORITATIVE (Top Down) NEGOTIATED (Bottom Up) HEALTH PERSUASION (Conservative ideology) Behaviour change Education / advice Mass media / social marketing PERSONAL COUNSELLING (Libertarian ideology) Counselling Empowering individuals to make changes LEGISLATIVE ACTION (Reformist ideology) Legislation Policy making / implementation Health surveillance COMMUNITY DEVELOPMENT (Radical pluralist ideology) Lobbying Community development Action research Skills sharing

Disease prevention What are the 3 level of disease prevention? – Primary, secondary and tertiary Defintion? – Primary: prevent disease in the first place – Secondary: find and treat – Tertiary: prevent complication, maintain QoL

What kind of prevention are the following? Immunisation before going to medical school Cervical screening Stroke rehabilitation 5-a-day Regular exercise Faecal specimen to test for occult blood

Health belief model Based on social cognition theory – Transetheoretical model – Theory of planned behaviour – Health belief model

Precontemplation Preparation Contemplation Maintenance Action Relapse

Which stages are they? Paul is a 40 years old, he stops smoking for 3 months and now he has a stressful situation and he started smoking again Steve Way was 16.5 stone, and started exercise, now he is planning to run London Marathon Mary, a 32 years old woman. She was just diagnosed with diabetes and was told to lose weight, she is thinking about it. Sarah, 19 years old student has been saying that she need to quit smoking for 2 months to her family, and this is the one day she hasn’t smoked Harry is a binge drinker, and admitted to hospital because of oesophageal varices, and doctor told him to stop drinking. He said “I don’t give a sXXX of it”

Theory of Planned Behaviour (TPB) Behaviour Behavioural Attitude Subjective Norm Perceived Behavioural Control Behavioural beliefs + Outcome evaluation Normative beliefs + Motivation to comply Control beliefs + Self-efficacy Behavioural Intention (Ajzen, 1988)

Health-Belief Model (HBM) Health Behaviour Perceived Threat Perceived Severity Perceived Efficacy Perceived Susceptibility Perceived Benefits Perceived Barriers (Rosenstock, 1966)