PSYCHOLOGY OF PREVENTION AND HEALTH
PROMOTION
THEME 1: INTRODUCTION
WHAT IS PREVENTION SCIENCE?
= tries to prevent psychological and physical ills and promote overall health and well-being
through evidence-based practice at individual and systemic levels
Aims
1. Advancing health and the individual and societal levels by informing policymakers – general
2. Reduce preventable deaths
3. Reduce the number of lost years
4. Increase the healthy life years
5. Increase quality of life
6. Reduce the economical impact of diseases
CAUSES OF DEATH
Know your background
DEFINITIONS
Preventable deaths = number of deaths that could be potentially prevented by prevention / medical intervention
Premature deaths = deaths occurring before the age of 75 (% of the total deaths)
Years of life lost = number of years that people loose due to death / illness
Years lost to disability (YLD) = number of years that a person lives with a limitation
Health life expectancy = life expectancy in good health
Disability-adjusted life years (DALY) = years lost by being sick or premature death
Quality-adjusted life years (QALY) = improvement in quality of living after an intervention
1
,Disability
o Impairment: a problem in body function or structure
o Activity limitation: a difficulty encountered by an individual in executing a task or action
o Participation restriction: a problem experienced by an individual in involvement in life situations
Not just a health problem
Complex phenomenon, reflecting the interaction between features of a person’s body and features of the
society in which he or she lives
Quality of life = the individual’s perception of their position in life in the context of the culture and value
systems in which they live and in relation to their goals
DEATH & DISABILITY
Prevention campaigns changes these across years ; some have good results, others not
What can we prevent (medically)?
o Illnesses related to risk behavior
o Cancer
o Infectious diseases
How do you implement more prevention strategies?
o Countries with higher life expectancy spend more money on health care
o Countries with higher health care spending growth have higher life expectancy gains
2
,HOW TO CHANGE?
TYPES OF PREVENTION
1. Primary prevention
Prevent the problem from ever occurring across the population or within a subgroup
Vb. vaccinations
2. Secondary prevention
Targets groups that are at risk for developing a problem
Vb. early mammograms for woman with a family history of cancer
3. Tertiary prevention
Limiting the impact on a problem that has occurred
Vb. alcoholics anonymous programs
TARGET GROUPS
1. Universal prevention
Interventions that offer value to an entire group or population
Vb. use of seat belts
2. Selective prevention
Interventions targeted to individuals or subgroups above average risk
Vb. head start program
3. Indicated prevention
Interventions targeted to individuals or subgroups at high risk or showing some symptoms
Vb. support groups for widowers experiencing depression and anxiety
PSYCHOLOGICAL THEORIES
/
3
, ARTICLE: STRATEGY OF PREVENTION: LESSONS FROM CARDIOVASCULAR DISEASE
In medicine there is a continuing and regrettable separation of the therapeutic and preventive roles
Doctors see the care of the sick as their whole responsibility
BUT we have a professional responsibility for prevention, both in research and in medical practice
HIGH-RISK STRATEGY
= identify those at the top end of the distribution and give them some preventive care
Cannot influence a large proportion of deaths occurring among the population
We need to measure risks and benefits in absolute rather than relative terms
o Describes the situation for individuals
o Tells us nothing about the effects on the whole community
For the community ; benefit depends on
o The benefit that each individual receives
o The prevalence of the risk factor
If a large benefit is conferred on only a few people, the community is not much better of
Population attributable risk
= the excess risk associated with a factor in the population as a whole
The individual attributable risk the prevalence of the factor in the population
! Many people exposed to a low risk is likely to produce more cases than a few people exposed to a high risk
MASS STRATEGY
= lower the whole distribution of the risk variable by some measure in which all participate
The only ultimate answer to the problem of a mass disease
Not completely effective ; all cases are not detected + detected people will often not take the treatment
Prevention paradox
= a measure that brings large benefits to the community, offers little to each participating individual
o We should not expect too much from individual health education
o People will not be motivated to any great extent to take our advice ; there is little in it for them
Major determinants of behavior
o Social pressure
Brings immediate rewards for those who conform
Health education: create social pressure that makes “healthy behavior” easier and acceptable
o Economics and convenience
! If a preventive measure exposes many people to a small risk, the harm it does may outweigh the benefits
4
PROMOTION
THEME 1: INTRODUCTION
WHAT IS PREVENTION SCIENCE?
= tries to prevent psychological and physical ills and promote overall health and well-being
through evidence-based practice at individual and systemic levels
Aims
1. Advancing health and the individual and societal levels by informing policymakers – general
2. Reduce preventable deaths
3. Reduce the number of lost years
4. Increase the healthy life years
5. Increase quality of life
6. Reduce the economical impact of diseases
CAUSES OF DEATH
Know your background
DEFINITIONS
Preventable deaths = number of deaths that could be potentially prevented by prevention / medical intervention
Premature deaths = deaths occurring before the age of 75 (% of the total deaths)
Years of life lost = number of years that people loose due to death / illness
Years lost to disability (YLD) = number of years that a person lives with a limitation
Health life expectancy = life expectancy in good health
Disability-adjusted life years (DALY) = years lost by being sick or premature death
Quality-adjusted life years (QALY) = improvement in quality of living after an intervention
1
,Disability
o Impairment: a problem in body function or structure
o Activity limitation: a difficulty encountered by an individual in executing a task or action
o Participation restriction: a problem experienced by an individual in involvement in life situations
Not just a health problem
Complex phenomenon, reflecting the interaction between features of a person’s body and features of the
society in which he or she lives
Quality of life = the individual’s perception of their position in life in the context of the culture and value
systems in which they live and in relation to their goals
DEATH & DISABILITY
Prevention campaigns changes these across years ; some have good results, others not
What can we prevent (medically)?
o Illnesses related to risk behavior
o Cancer
o Infectious diseases
How do you implement more prevention strategies?
o Countries with higher life expectancy spend more money on health care
o Countries with higher health care spending growth have higher life expectancy gains
2
,HOW TO CHANGE?
TYPES OF PREVENTION
1. Primary prevention
Prevent the problem from ever occurring across the population or within a subgroup
Vb. vaccinations
2. Secondary prevention
Targets groups that are at risk for developing a problem
Vb. early mammograms for woman with a family history of cancer
3. Tertiary prevention
Limiting the impact on a problem that has occurred
Vb. alcoholics anonymous programs
TARGET GROUPS
1. Universal prevention
Interventions that offer value to an entire group or population
Vb. use of seat belts
2. Selective prevention
Interventions targeted to individuals or subgroups above average risk
Vb. head start program
3. Indicated prevention
Interventions targeted to individuals or subgroups at high risk or showing some symptoms
Vb. support groups for widowers experiencing depression and anxiety
PSYCHOLOGICAL THEORIES
/
3
, ARTICLE: STRATEGY OF PREVENTION: LESSONS FROM CARDIOVASCULAR DISEASE
In medicine there is a continuing and regrettable separation of the therapeutic and preventive roles
Doctors see the care of the sick as their whole responsibility
BUT we have a professional responsibility for prevention, both in research and in medical practice
HIGH-RISK STRATEGY
= identify those at the top end of the distribution and give them some preventive care
Cannot influence a large proportion of deaths occurring among the population
We need to measure risks and benefits in absolute rather than relative terms
o Describes the situation for individuals
o Tells us nothing about the effects on the whole community
For the community ; benefit depends on
o The benefit that each individual receives
o The prevalence of the risk factor
If a large benefit is conferred on only a few people, the community is not much better of
Population attributable risk
= the excess risk associated with a factor in the population as a whole
The individual attributable risk the prevalence of the factor in the population
! Many people exposed to a low risk is likely to produce more cases than a few people exposed to a high risk
MASS STRATEGY
= lower the whole distribution of the risk variable by some measure in which all participate
The only ultimate answer to the problem of a mass disease
Not completely effective ; all cases are not detected + detected people will often not take the treatment
Prevention paradox
= a measure that brings large benefits to the community, offers little to each participating individual
o We should not expect too much from individual health education
o People will not be motivated to any great extent to take our advice ; there is little in it for them
Major determinants of behavior
o Social pressure
Brings immediate rewards for those who conform
Health education: create social pressure that makes “healthy behavior” easier and acceptable
o Economics and convenience
! If a preventive measure exposes many people to a small risk, the harm it does may outweigh the benefits
4
