1. บทบาทของคณะแพทยศาสตร์ในการจัดการศึกษาด้าน การสร้างเสริมสุขภาพ
อานุภาพ เลขะกุล
คณะแพทยศาสตร์ มหาวิทยาลัยสงขลานครินทร์

2. Scope of Presentation Concept of health promotion
Medical school and HP
Health Promotion in Medical Curriculum, PSU

3. Medical Education Health Care System Medical Service Medical Education
Health Promotion in Medical Curriculum, PSU

4. Concept of Health Promotion
Health Promotion in Medical Curriculum, PSU

5. นโยบายสร้างเสริมสุขภาพ
สร้างนำซ่อม
ใคร……สร้าง
ใคร……ซ่อม
สร้าง……อย่างไร
Health Promotion in Medical Curriculum, PSU

6. การส่งเสริมสุขภาพ การสร้างเสริมสุขภาพ
นโยบายสร้างเสริมสุขภาพ
การส่งเสริมสุขภาพ vs
การสร้างเสริมสุขภาพ
Health Promotion in Medical Curriculum, PSU

7. Health Health Care Organization Human Biology Lifestyle Environment
Lalonde, 1974
Health Promotion in Medical Curriculum, PSU

8. How Poverty Affects Health
Food poverty, Fuel poverty
Poor housing, Poor transport
Social isolation, Relative powerlessness
Poor access to recreation/social facilities
Psychological
Health Effects
Stress
Anxiety
Depression
Low self-esteem
Behavioral changes
Smoking
Drug abuse
Low exercise levels
Poor diets
Physical Health
Effects
Low birth weights
Infant deaths
Poor growth in children
Respiratory diseases
Heart disease
Accidents
(Blackburn,1992)
Health Promotion in Medical Curriculum, PSU

9. Maslow’s Needs Self Actualization Esteem Needs Needs for Love & Care
Safety Needs
Physiological Needs

10. Health Promotion (WHO)
A process of enabling people to increase
control over and improve their health
To reach a state of complete physical,
mental, social and spiritual well-being,
an individual or group must be able to
identify and to realize aspirations, to
satisfy needs, and to change or cope
with the environment
Health Promotion in Medical Curriculum, PSU

11. From disease prevention to
health promotion
Health Promotion in Medical Curriculum, PSU

12. Levels of Disease Prevention
Behavioral
risk factors
Tobacco
Alcohol
Physical
inactivity
Diet
Physiological
risk factors
BMI (Obesity)
Blood pressure
Blood glucose
Cholesterol
Disease
outcomes
Heart disease
Stroke
Diabetes
Cancer
Accidents
COPD
Chronic diseases
Health Promotion in Medical Curriculum, PSU

13. Health Promotion (WHO)
A comprehensive social and political process
It not only embraces actions directed at
strengthening the skills and capabilities of
individuals, but also action directed towards
changing social, environment and economic
conditions so as to alleviate their impact on
public and individual health
Health Promotion in Medical Curriculum, PSU

14. Health Promotion
Health is, therefore, seen as a resource of everyday life, not objective of living
“…the health of populations will not be
improved without the participation of all groups with an interest in and an influence on health care..”
Health Promotion in Medical Curriculum, PSU

15. Three Basic Strategies for Health Promotion
Advocacy
Political, economic, social, cultural, environment, behavioural and biological factors can all favour health or be harmful to it.
Enabling
To support people in communities to achieve their full health potential and to reduce health inequalities
Mediating
To coordinate and collaborate all groups concerned

16. Five Priority Actions for Health Promotion (The Ottawa Charter, 1986)
Building a healthy public policy
Creating supportive environments
Developing personal skills
Strengthening community action
Reorienting health service
(from tertiary to primary)
Health Promotion in Medical Curriculum, PSU

17. (Jakarta Declaration, 1997)
Five Priority Actions
for 21st Century
Health Promotion
(Jakarta Declaration, 1997)
Promote social responsibility for health
Increase investments for health development
Expand partnerships for health promotion
Increase community capacity and empower
the individual
Secure an infrastructure for health promotion
Health Promotion in Medical Curriculum, PSU

18. Key Issues in Health Promotion Equity
Being fair and just, not equality
Effectiveness and evidence-based practice
Collaborative working
Health Promotion in Medical Curriculum, PSU

19. Evidence-based Practice
Effectiveness and
Evidence-based Practice
Medical model
RCT, challenged extensively in the literature
Educational model
Ensure clients and patients have access to information
Behavioural model
Promote behavioral changes linked to health lifestyles
Social model
Modify people’s environment
Empowerment model
Empowerment of individuals and communities
Health Promotion in Medical Curriculum, PSU

20. Collaborative Working
Identify the need for shared objectives
Innovative work
Commitment of time
Resources and energy
Regular review procedures
Importance of key players
Impact of different professional and
organization culture
Impact of funding issues
Health Promotion in Medical Curriculum, PSU

21. Beattie’s Model of Health Promotion Mode of Intervention
Authoritative
Focus of Intervention
Individual Collective
Negotiated
Health Promotion in Medical Curriculum, PSU

22. Focuses/Levels of Health Promotion
An individual
Organization level
Healthy cities, villages, islands
Healthy promoting schools,
hospitals, market places
Healthy workplaces
Community level

23. Medical School and HP
Health Promotion in Medical Curriculum, PSU

24. Medical Schools and HP Health Promoting Hospital
Health Promotion in Higher Education
Health Promotion in Medical Curriculum
Medical Schools and Communities

25. Medical Schools and HP Health Promoting Hospital
Health Promotion in Higher Education
Health Promotion in Medical Curriculum
Medical Schools and Communities

26. Health Promotion in Hospitals
Management Policy
Patient Assessment
Patient Information and Intervention
Promoting a Healthy Workplace
Continuity and Cooperation

27. Medical Schools and HP Health Promoting Hospital
Health Promotion in Higher Education
Health Promotion in Medical Curriculum
Medical Schools and Communities

28. Health Promotion in Higher Education (ACHA)
Integration with the learning mission of higher education
Collaborative practice
Cultural competence
Theory-based practice
Evidence-based practice
Continuing professional development and service

29. Medical Schools and HP Health Promoting Hospital
Health Promotion in Higher Education
Health Promotion in Medical Curriculum
Medical Schools and Communities

30. Planning a Curriculum Identifying the need
Establishing the learning outcomes
Analysing possible constraints
(SWOT analysis)
Agreeing the content
Organising the content including the
sequence
Deciding the educational strategy
Health Promotion in Medical Curriculum, PSU

31. Planning a Curriculum Deciding the teaching methods
Preparing the assessment
Communication about the curriculum
Promoting an appropriate educational
environment
Managing the curriculum
Health Promotion in Medical Curriculum, PSU

32. What to Teach Cognitive (Knowledge) Skills Affective
Health Promotion in Medical Curriculum, PSU

33. Application of HP Components in Teaching
Building a healthy public policy
Creating supportive environments
Building environment in favor of staff and
patient’s health
Developing personal skills
Learning and skills development in
communicating with patients and relatives
Health Promotion in Medical Curriculum, PSU

34. Application of HP Components in Teaching
Strengthening community action
Empower community of decide, of their
own, the right choices of their health
Reorienting health service
(from tertiary to primary)
Holistic approach for promotive,
preventive and curative
Health Promotion in Medical Curriculum, PSU

35. Examples of Core Content
Health behavior model
Determinants of health
Concept of healthy lifestyle and health
promotion
Social aspect of health and diseases
Health promotion model and level :
Individual, group/organization, community
Self-development and technique
Communication skills : counseling, group
dynamics, social marketing
Health Promotion in Medical Curriculum, PSU

36. Examples of Core Content
Health promotion : Individual level – life
cycle approach
Healthy eating
Oral health
Substance use – drug abuse, alcohol,
tobacco
Physical activity and exercise
Stress reduction
Healthy sex
Healthy elderly
Health Promotion in Medical Curriculum, PSU

37. Examples of Core Content
Health promotion : Organization level
Healthy workplace
Healthy city
Health promoting hospital
Health promotion : Community level
Health reform
People empowerment
Social movement
Civil society
Alternative medicine
Health promotion : Community level
Health reform
People empowerment
Social movement
Civil society
Alternative medicine
Health Promotion in Medical Curriculum, PSU

38. HP in Preclinical teaching
Topics related to health
Anatomy
Musculoskeleton – Working posture
Osteoarthritis
Accidents - fracture
Cardiovascular – Coronary heart disease
Respiratory – Occupation lung disease
Smoking, COPD
Health Promotion in Medical Curriculum, PSU

39. HP in Preclinical teaching
Topics related to health
Physiology
Blood pressure – Hypertension
Exercise
Menopause, Aging process
Biochemistry
Carbohydrate metabolism – DM
Lipid metabolism – Dyslipidemia
Calcium metabolism – Osteoporosis
Nutrition - Obesity
Health Promotion in Medical Curriculum, PSU

40. HP in Preclinical teaching
Topics related to health
Genetics
Prenatal diagnosis
Genetic counseling
GMO
Microbiology
AIDS
Hygienic control
Infection control
Biological terrorism
Parasitic infection
SARS, Avian flu
Health Promotion in Medical Curriculum, PSU

41. HP in Preclinical teaching
Topics related to health
Pharmacology
Rational use of drugs
Herbal medicines
Pathology
Pathogenesis of diseases
Miscellaneous
Hazardous risk management in Lab
Healthy learning
Health Promotion in Medical Curriculum, PSU

42. Skills in Health Promotion
Social skills
Communication skills
Negotiation & empowerment skills
Research skills
Epidemiology skills
Professional (clinical) skills
Counseling skills
Education skills
…………………
Health Promotion in Medical Curriculum, PSU

43. How to Teach Separate or integrated teaching
Issues of number of hour available,
number of subjects taught
Educational strategies
Create learning environment
Extra(supporting)-curricular activities
How to integrate with existing
curricula
Start with students’ own lifestyle
Health Promotion in Medical Curriculum, PSU

44. Content-based Education
Yr 1
Yr 2
Yr 3
Yr 4
Yr 5
Yr 6
Content 1
Content 2
Content 3
Content 4 .
Content n
Health Promotion in Medical Curriculum, PSU

45. Outcome-based Education
Yr 1
Yr 2
Yr 3
Yr 4
Yr 5
Yr 6
Competency 1
Competency 2
Competency 3
Competency 4 .
Competency n
Health Promotion in Medical Curriculum, PSU

46. Putting Health Promotion into
the Curriculum
Unfamiliar to medical students, as well as
teachers
A hybrid/integrated discipline
Social sciences
(Sociology, Social policy, psychology)
Medical sciences
(Including Epidemiology, Biostatistic)
Not only function of Community Medicine
Inadequate body of knowledge/experiences
Health Promotion in Medical Curriculum, PSU

47. Putting Health Promotion into
the Curriculum
Specialist (expert) can teach HP
Incorporate health-promotion principles
in learning approaches
Use practical vignettes enables students
to identify key characteristics of health
promotion
Practical and concrete illustrations of the
potential of health promotion
Health Promotion in Medical Curriculum, PSU

48. Putting Health Promotion into
the Curriculum
Promote students’ health
Starts with their own needs
Encourages collaborative working
Develops their personal skills
Provide safe and secure environment
in which to practise new skills and
approaches
Health Promotion in Medical Curriculum, PSU

49. Improving HP Teaching Role of institution Creating HP environment
Staff development/Role model
Multidisciplinary and multiprofessional
approach
Concrete real-life experiences
Integrating HP into various clinical
specialties
Research for body of knowledge
Health Promotion in Medical Curriculum, PSU

50. Health Promotion in Medical Curriculum, PSU