Psychology of prevention and health promotion: Primary prevention & health
promotion (lesson5)
LEVELS OF PREVENTION ! Important to focus more on prevention instead treatment.
Primary prevention: healthy population
- Promote well-being and staying healthy
- Prevent from going to the at-risk group
Secondary prevention: early intervention
- Prevent progression to established disease
- E.g. cancer screening, COVID-test after risk contact, STDtest after
risky sexual contact
Tertiary prevention: disease management
- Established disease, in rehab/recovery, continuing care
- Keeping it under control, prevent complications, prevent worsening of the disease
PREVENTION AS PART OF A CONTINUUM
Different forms of prevention: continuum of health care, incl. health promotion.
PRIMARY PREVENTION1 (2 strategies)
Both: identify risk factors
Risk avoidance strategy Risk reduction strategy
Prevent risk behaviour among low risk persons Reduce (the influence of) risk factors among at risk persons
Cf. prevent obesity, bcs risk factor: cancer, diabetes Cf. older/ vulnerable people wearing a mask in public during Covid
Reduce the transition from low risk to at risk Reinforce protective factors among at risk persons
- Expenses in healthcare: BE is fourth highest in EU.
- Expensive in preventive healthcare: BE is rather lower (7th last)
Life expectancy vs. health life years
Life expectancy is only part of the story, the quality of healthy life, that
number of years is also important (for e.g. health care system).
Increasing mental health issues:
- 90%: think there is a mental health crisis in the US today.
- 1/3: adults, felt anxious always/ often past year.
- 1/3: get not mental health services they needed.
PREVENTION OF MENTAL HEALTH ISSUES: cost-effective:
- Target prevention vs universal prevention
- Screening + CBT (CGT) at school
- Parenting interventions & workplace interventions (health promotion)
TYPES OF INTERVENTION (avoidance/ reduction)
- Universal interventions2
Cf. vaccination, wearing mask during Covid, iodine in salt…
- Selective interventions3
Cf. aids prevention among gay men or sex workers
- Indicated interventions4
1
Primary prevention= Preventive interventions that precede the development of an illness.
2 Universal interventions= Aimed at (sections within) the population when there is a general risk. Risk reduction/
avoidance, where the whole population benefits from it.
3
Selective interventions= Aimed at groups within the population that are considered at risk. There is known that these
particular groups are at risk for a certain problem.
4
Indicated interventions= Aimed at persons in whom risk factors have been observed(but no symptoms yet).
, Cf. cholesterol reducing medication in people where high cholesterol levels have been observed, breast cancer
checks in women with genetic predisposition
ADVANTAGES AND DISADVANTAGES OF THE STRATEGIES
Universal Selective & indicated
Advantage Large scope Selectivity & (cost) effectiveness
Disadvantage High cost Risk of stigmatization (cf. ‘you belong in this group’)
Only For effective, acceptable and Risk factors can be observed & in a valid way;
indicated affordable interventions. Side effects are limited
Benefits must outweigh the costs!
HEALTH PROMOTION
Health promotion comes even before primary prevention, and is about the promotion of a healthy life (even
when people are not sick), and make the people become masters of their own health.
- Launched in 1986 for high-income countries
• Response to: “diseases of civilization” (cf. CV diseases, cancer, accidents, mental health issues)
• Traditional medical prevention was limited
- Aim: Empower individuals and groups to control health determinants
- Strategy: Facilitate healthy choices
Principles:
- Focus on the determinants of health
- Use a combination of complementary methods and approaches (communication, policy, measures)
- Ensure a multidisciplinary and intersectoral approach
- Emphasize participation of the population
- Develop healthy public policies
MULTIDISCIPLINARY AND MULTISECTORAL
Multidisciplinary and intersectoral approach is essential to influence health determinants:
- Health is determined by a multitude of factors: sex, age, lifestyle, contextual factors (cf. SES, living
conditions, education).
- Most health determinants are non-medical & fall outside the healthcare system's direct control.
Effective prevention requires:
- Multidisciplinary cooperation: doctors, nurses, behavioral scientists, sociologists, media experts, etc.
- Intersectoral collaboration: involvement of sectors beyond health (e.g., education, housing, agriculture)
ACTIONS FOR HEALTH PROMOTION:
- Developing personal knowledge and skills
- Creating supportive environments
- Strengthening community action
- Building healthy public policies
- Reorienting health services
promotion (lesson5)
LEVELS OF PREVENTION ! Important to focus more on prevention instead treatment.
Primary prevention: healthy population
- Promote well-being and staying healthy
- Prevent from going to the at-risk group
Secondary prevention: early intervention
- Prevent progression to established disease
- E.g. cancer screening, COVID-test after risk contact, STDtest after
risky sexual contact
Tertiary prevention: disease management
- Established disease, in rehab/recovery, continuing care
- Keeping it under control, prevent complications, prevent worsening of the disease
PREVENTION AS PART OF A CONTINUUM
Different forms of prevention: continuum of health care, incl. health promotion.
PRIMARY PREVENTION1 (2 strategies)
Both: identify risk factors
Risk avoidance strategy Risk reduction strategy
Prevent risk behaviour among low risk persons Reduce (the influence of) risk factors among at risk persons
Cf. prevent obesity, bcs risk factor: cancer, diabetes Cf. older/ vulnerable people wearing a mask in public during Covid
Reduce the transition from low risk to at risk Reinforce protective factors among at risk persons
- Expenses in healthcare: BE is fourth highest in EU.
- Expensive in preventive healthcare: BE is rather lower (7th last)
Life expectancy vs. health life years
Life expectancy is only part of the story, the quality of healthy life, that
number of years is also important (for e.g. health care system).
Increasing mental health issues:
- 90%: think there is a mental health crisis in the US today.
- 1/3: adults, felt anxious always/ often past year.
- 1/3: get not mental health services they needed.
PREVENTION OF MENTAL HEALTH ISSUES: cost-effective:
- Target prevention vs universal prevention
- Screening + CBT (CGT) at school
- Parenting interventions & workplace interventions (health promotion)
TYPES OF INTERVENTION (avoidance/ reduction)
- Universal interventions2
Cf. vaccination, wearing mask during Covid, iodine in salt…
- Selective interventions3
Cf. aids prevention among gay men or sex workers
- Indicated interventions4
1
Primary prevention= Preventive interventions that precede the development of an illness.
2 Universal interventions= Aimed at (sections within) the population when there is a general risk. Risk reduction/
avoidance, where the whole population benefits from it.
3
Selective interventions= Aimed at groups within the population that are considered at risk. There is known that these
particular groups are at risk for a certain problem.
4
Indicated interventions= Aimed at persons in whom risk factors have been observed(but no symptoms yet).
, Cf. cholesterol reducing medication in people where high cholesterol levels have been observed, breast cancer
checks in women with genetic predisposition
ADVANTAGES AND DISADVANTAGES OF THE STRATEGIES
Universal Selective & indicated
Advantage Large scope Selectivity & (cost) effectiveness
Disadvantage High cost Risk of stigmatization (cf. ‘you belong in this group’)
Only For effective, acceptable and Risk factors can be observed & in a valid way;
indicated affordable interventions. Side effects are limited
Benefits must outweigh the costs!
HEALTH PROMOTION
Health promotion comes even before primary prevention, and is about the promotion of a healthy life (even
when people are not sick), and make the people become masters of their own health.
- Launched in 1986 for high-income countries
• Response to: “diseases of civilization” (cf. CV diseases, cancer, accidents, mental health issues)
• Traditional medical prevention was limited
- Aim: Empower individuals and groups to control health determinants
- Strategy: Facilitate healthy choices
Principles:
- Focus on the determinants of health
- Use a combination of complementary methods and approaches (communication, policy, measures)
- Ensure a multidisciplinary and intersectoral approach
- Emphasize participation of the population
- Develop healthy public policies
MULTIDISCIPLINARY AND MULTISECTORAL
Multidisciplinary and intersectoral approach is essential to influence health determinants:
- Health is determined by a multitude of factors: sex, age, lifestyle, contextual factors (cf. SES, living
conditions, education).
- Most health determinants are non-medical & fall outside the healthcare system's direct control.
Effective prevention requires:
- Multidisciplinary cooperation: doctors, nurses, behavioral scientists, sociologists, media experts, etc.
- Intersectoral collaboration: involvement of sectors beyond health (e.g., education, housing, agriculture)
ACTIONS FOR HEALTH PROMOTION:
- Developing personal knowledge and skills
- Creating supportive environments
- Strengthening community action
- Building healthy public policies
- Reorienting health services
