Lecture 3
Health promotion
● Good health or wellness is a personal and collective achievement
● WHO defines health promotion as: “the process of enabling people to increase
control over, and to improve, their health
● Different perspectives:
○ Individual vs.
○ Medical practitioner vs.
○ Psychologist vs.
○ Media
Smart canadians: Lalonde report (1974)
● Proposed the concept of the “health field”
● Identified two main health principles
○ The health care system
○ Prevention of health problems and promotion of good health
● First modern government document in the western world to acknowledge that our
emphasis upon a biomedical health care system is wrong
What are health behaviours?
● Behaviours employed by people to enhance or maintain their health
● Health behaviours (good or bad) become health habits
● A health habit is a health behaviour that is well established and is performed
automatically
● If reinforced early: resistant to change
Role of health behaviours
● Patterns of disease have shifted over 70 years
○ Acute diseases vs. preventable diseases
○ Modifying health behaviours can lead to a 50% reduction in deaths
● Benefits of modifying health behaviours
○ Reduction in deaths due to lifestyle-related diseases
○ Increased longevity (life expectancy)
○ Longer disease-free period (quality of life)
○ Reduced overall health care costs (approx 200 billion)
Influential factors
● Health behaviours are influenced by several factors including: socio economic, age,
gender, values, personal control, social influence, personal goals, perceived
symptoms, access to healthcare, location, cognitive factors
Health habits in children and adolescents
● Health habits are strongly affected by:
○ Socialization (parents as role models)
○ Teachable moment (educational opportunity)
○ Closing the window of vulnerability (adolescence)
, Are you at risk?
● Benefits of identifying at risk people
○ May eliminate or prevent poor health habits
○ Efficient and effective use of health dollars
○ Help identify risk factors in this patient population
● Problems with identifying at risk people
○ Hypervigilance: over sensitive to stressors
○ May become defensive and disregard risk factors
Ethical issues
● Ethical issues must be considered when identifying at risk people
● Identification may initiate symptoms
● There might not be a clear intervention
● Interpersonal issues may arise
Health habits in elderly
● The main goal for elderly is to improve the quality of life
● Factors to consider include: exercise, participation in social activities, monitor alcohol
consumption, controlled diet, vaccinations
Other factors to consider
● Gender and ethnic differences can influence vulnerability to particular health risks
○ Alcohol consumption (men vs women)
○ Smoking (aboriginals)
○ Drug-use
○ Exercise
How can we change health behaviours?
● Our goal is to change views and prevent unhealthy behaviours
● Different approaches include
○ Educational appeals: credible, colourful, concise
○ Fear appeals: use fear to change behaviours, may be counterproductive,
coupled approach
○ Message framing: messages that stress benefits
■ Loss framed works best for high risk behaviour
■ Gain-framed works best for low risk behaviour
Models of health behaviour change
● Changing beliefs instead of attitudes
● Models include:
○ Social cognition model: expectancy-value theory, engage in behaviors that
will be successful and they value
○ Health belief model: perception of threat, berieced threat reduction
○ Planned behaviour model: health behaviours is a result of a behavioural
intention
Theory of planned behaviour
● Direct result of behavioural intention
Health promotion
● Good health or wellness is a personal and collective achievement
● WHO defines health promotion as: “the process of enabling people to increase
control over, and to improve, their health
● Different perspectives:
○ Individual vs.
○ Medical practitioner vs.
○ Psychologist vs.
○ Media
Smart canadians: Lalonde report (1974)
● Proposed the concept of the “health field”
● Identified two main health principles
○ The health care system
○ Prevention of health problems and promotion of good health
● First modern government document in the western world to acknowledge that our
emphasis upon a biomedical health care system is wrong
What are health behaviours?
● Behaviours employed by people to enhance or maintain their health
● Health behaviours (good or bad) become health habits
● A health habit is a health behaviour that is well established and is performed
automatically
● If reinforced early: resistant to change
Role of health behaviours
● Patterns of disease have shifted over 70 years
○ Acute diseases vs. preventable diseases
○ Modifying health behaviours can lead to a 50% reduction in deaths
● Benefits of modifying health behaviours
○ Reduction in deaths due to lifestyle-related diseases
○ Increased longevity (life expectancy)
○ Longer disease-free period (quality of life)
○ Reduced overall health care costs (approx 200 billion)
Influential factors
● Health behaviours are influenced by several factors including: socio economic, age,
gender, values, personal control, social influence, personal goals, perceived
symptoms, access to healthcare, location, cognitive factors
Health habits in children and adolescents
● Health habits are strongly affected by:
○ Socialization (parents as role models)
○ Teachable moment (educational opportunity)
○ Closing the window of vulnerability (adolescence)
, Are you at risk?
● Benefits of identifying at risk people
○ May eliminate or prevent poor health habits
○ Efficient and effective use of health dollars
○ Help identify risk factors in this patient population
● Problems with identifying at risk people
○ Hypervigilance: over sensitive to stressors
○ May become defensive and disregard risk factors
Ethical issues
● Ethical issues must be considered when identifying at risk people
● Identification may initiate symptoms
● There might not be a clear intervention
● Interpersonal issues may arise
Health habits in elderly
● The main goal for elderly is to improve the quality of life
● Factors to consider include: exercise, participation in social activities, monitor alcohol
consumption, controlled diet, vaccinations
Other factors to consider
● Gender and ethnic differences can influence vulnerability to particular health risks
○ Alcohol consumption (men vs women)
○ Smoking (aboriginals)
○ Drug-use
○ Exercise
How can we change health behaviours?
● Our goal is to change views and prevent unhealthy behaviours
● Different approaches include
○ Educational appeals: credible, colourful, concise
○ Fear appeals: use fear to change behaviours, may be counterproductive,
coupled approach
○ Message framing: messages that stress benefits
■ Loss framed works best for high risk behaviour
■ Gain-framed works best for low risk behaviour
Models of health behaviour change
● Changing beliefs instead of attitudes
● Models include:
○ Social cognition model: expectancy-value theory, engage in behaviors that
will be successful and they value
○ Health belief model: perception of threat, berieced threat reduction
○ Planned behaviour model: health behaviours is a result of a behavioural
intention
Theory of planned behaviour
● Direct result of behavioural intention
