1. Lecture 6: Models of Health Promotion Dr J. Sitali
MPH 541
Lecture 6:
Models of Health Promotion
Dr J. Sitali

2. Lecture Outline Introduction The Models: Conclusion
Caplan and Holland (1990)
Beatie (1991)
Tannahill (Downie et al, 1996)
Tones (Tones and Tilford, 1994)
Conclusion

3. Introduction Approaches to HP are descriptive.
Can move between approaches.
Models are analytic.
They signify how HP is practiced.
They highlight the framework of HP

4. Introduction Models help to:
Conceptualize or map the field of HP
Interrogate and analyze existing practice.
Plan and chart the possibilities for interventions.
Models help build a theoretical framework.
No consensus on terminology.

5. Introduction No agreement on criteria. Lots of debate on models.
HP still developing a sound theoretical basis for action.
Remember the role social determinants play in health and that of politics, power and responsibility.

6. 1. Caplan & Holland (1990) There are 4 paradigms of looking at HP.
Generated from 2 dimensions:
Nature of knowledge.
Nature of society.
Each represents a way of looking at health.
Each signals a way of practicing HP.

7. 1. Caplan & Holland (1990) Traditional perspective:
Health is absence of disease
Medical & Behavior change approach.
Top – down method.
Emphasizes the use of information to change behavior

8. 1. Caplan & Holland (1990) Humanist perspective.
Holistic view of health
Educational approach.
Individuals are enabled to develop a healthy lifestyle by using their personal resources and skills.

9. 1. Caplan & Holland (1990) Radical humanist perspective.
Empowerment approach.
HP raises consciousness.
Emphasizes personal response to health.
Encourages individuals to form social, organizational & economic networks.

10. 1. Caplan & Holland (1990) Radical structural perspective.
Structural inequalities are the cause of many health problems.
The role of HP is to address the relationship between health and social inequalities.
Need to challenge inequality and radically transform society.

11. 2. Beatie (1991) Structural analysis of HP approaches.
4 paradigms for HP:
Authoritative (top – down)
Negotiated (bottom – up)
Individual
Collective.
Giving 4 strategies for HP

12. 2. Beatie (1991) Health persuasion. Legislative action.
interventions directed at individuals.
Expert led.
Legislative action.
Aim to protect communities.

13. 2. Beatie (1991) Personal counseling. Community.
Focused on personal development.
Client led.
The health promoter is a facilitator.
Community.
Seek to empower a group or local community

14. 3. Tannahill (Downie et al 1996)
Widely accepted by health care workers.
Talks of 3 overlapping spheres of activity:
Health education.
Health protection.
Prevention.

15. 3. Tannahill (Downie et al 1996)
Descriptive model.
It shows the potential and scope in other areas of HP.
Does not give insight on which approach to choose.
Suggests that all approaches are interrelated.
Reflect distinctive ways of looking at health.

16. 4. Tones ( Tones & Tilford 1994)
Empowerment model.
Goal of enabling people gain control of their health.
Prioritizes empowerment in pursuit of HP.
HP = healthy public policy X health education
Education is key to empowerment.
Empowerment is the aim of HP.
Enhances individual autonomy.

17. 4. Tones ( Tones & Tilford 1994)
Change in social environment will lead to self empowered individuals.
Skill to participate effectively in decision making is required to access resources and shape policy.
Support of individuals is necessary for implementing change.

18. Conclusion HP has a lot of different activities.
Organization of these activities into categories gives the various models.
Either descriptive or analytical.
HP needs a theoretical framework.
Models help understand what is possible and what is preferable.

19. The end!