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Healthpromotion Models 170917140729

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27 views41 pages

Healthpromotion Models 170917140729

Uploaded by

Maheboob Sutar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Models of Health Promotion

Col Zulfiquer Ahmed Amin


M Phil, MPH, PGD (Health Economics), MBBS
Armed Forces Medical Institute (AFMI)
‘Health promotion is the process of enabling people to increase control over,
and to improve, their health’.
Model:
In science, a model is a representation of an idea, an object or
even a process or a system that is used to describe and explain
phenomena that cannot be experienced directly.

A. Explain
observations
B. Predict future
observations

C. Be realistic
Why we do something, and don’t do the other?
Beliefs
Direct Belief about an
Observation object or person Personal
Attitude
Behavior Action
Behavior
Information from Intention
various sources. Belief about Subjective
eg TV some performing Norms

infer basing on Belief about some


information performing with
knowledge of
‘approval’/
‘disapproval’ of
people, ‘who are
important to us’
Some Psychological
Terms:
Affect: Affect is the experience and outward expression of feelings and
emotion. Affect can be a tone of voice, a smile, a frown, a laugh, a smirk, a
tear, pressed lips, a crinkled forehead, a scrunched nose, furrowed
eyebrows, or an eye gaze.

We experience affect in the form of mood and emotions. Mood refers to the
positive or negative feelings that are in the background of our everyday
experiences. Emotions are brief, but often intense, mental and physiological
feeling states. In comparison with moods, emotions are shorter lived,
stronger, and more specific forms of affect. Emotions are caused by specific
events (things that make us, for instance, jealous or angry), and they are
accompanied by high levels of arousal. Whereas we experience moods in
normal, everyday situations, we experience emotions only when things are
out of the ordinary or unusual.
Cognition (Thought): Refers to the mental processes involved in
gaining knowledge and comprehension. These processes include
thinking, knowing, remembering, judging and problem-solving.
These are higher-level functions of the brain and encompass
language, imagination, perception, planning, and interpretations
of ourselves and other people.
Behavioral intention (BI): Refers to a person's perceived
likelihood or "subjective probability that he or she will engage in a
given behavior“.

Behavior: Refers to observable activity of an organism; anything


an organism does that involves action and/or response to
stimulation. Human behavior is the term used to describe a
person's actions and conduct.

Imagine a wrapped present. You can't see what's inside, but there
are clues available to you: the size and shape of the package, the
sound it makes when you shake it, how heavy it is, even whether
it feels solid or soft. You can make an educated guess about what
the present is if you observe all of these things.
Human behavior is like that. Everything we do and say tells the
world about what's going on inside us.
Attitude is a settled way of thinking or feeling about someone or
something, typically one that is reflected in a person's behavior.
In psychology, an attitude refers to a set of emotions, beliefs,
and behaviors toward a particular object, person, thing, or event.
Attitudes are often the result of experience or upbringing, and
they can have a powerful influence over behavior.

Subjective Norm: Perceived or subjective norm is "the perceived


social pressure to perform or not to perform the behavior" in
question. The perceived expectations from others that influence
a user to perform a particular behavior
Health Promotion Model:
Concepts of Health Promotion Model
Models of Health Promotion

Tannahill (1985) Model of health Promotion


Beattie’s (1991) Model of health Promotion
Tones and Tilford’s (1994) Model of health
Promotion
Caplan and Holland (1990) Model of health
Promotion
Caplan & Holland’s Model
Key features:
• More complex & theoretically driven.
• Attempts to unpick what determines health and ill-
health and therefore what activities can be used to
address health issues.
• One axis refers to a theory of knowledge and how
knowledge is generated in relation to health.
• The other axis refers to how society is constructed
and how this impacts on health.
MODEL OF HEALTH PROMOTION: FOUR PARADIGMS OF
HEALTH PROMOTION (CAPLAN AND HOLLAND - 1990)

Radical

Nature of society
RADICAL HUMANIST RADICAL STRUCTURLIST
change
• Holistic view of health • Health reflects structural
inequalities
• De-professionalization
• Need to challenge inequity
• Self-help networks
and radically transform society.

Subjective Objective

Nature of knowledge
HUMANIST
TRADITIONAL
• Holistic view of health
• Health = absence of
• Aims to improve understanding disease
and development of self
• Aim is to change behaviour
• Client-led
Social • Expert-led
regulation
An objective perspective is one that is not influenced by
emotions, opinions, or personal feelings - it is a perspective
based in fact, in things quantifiable and measurable.

A subjective perspective is one open to greater interpretation


based on personal feeling, emotion, aesthetics, etc.
Radical Humanist Paradigm (subjective-radical change) Theorists
in this paradigm are mainly concerned with releasing social
constraints that limit human potential. They see the current
dominant ideologies as separating people from their "true selves".
They use this paradigm to justify desire for revolutionary change,
through process of education.

Humanism is an approach in study, philosophy, or practice that


focuses on human values and concerns.

Radical Structurlist: Contemporary society is characterized by


fundamental conflicts which generate radical change through
political and economic crises.
Beattie’s Model
Key Features:
Examines 2 axis
1. Type of approach used top-down (Authoritarian) or bottom
up (Negotiated or owned by the clients)
2. Size of approach
Categories 4 types of activities
A. Personal counseling: Working with dietician on food and
physical individual personal plans and goals.
B. Health persuasion: Campaign for eating 5 fruits and
vegetables a day on TV.
C. Legislative action: Laws that subsidize the price of healthy
food stuff
D. Community development: Communities producing and
distributing food themselves.
MODEL OF HEALTH PROMOTION: HEALTH PROMOTION
METHODS USING BEATTIE’S TYPOLOGY (BEATTIE – 1991)

MODE OF INTERVENTION
Advice
Authoritarian Legislation
Education
Policy making and
Behaviour change implementation
Mass media campaign Health surveillance

Individual Collective

Focus of intervention

Counseling Lobbying
Education Action research
Group work Skills sharing and training
Group work
Community development
Negotiated
MODEL OF HEALTH PROMOTION: THE CONTRIBUTION OF
EDUCATION TO HEALTH PROMOTION (TONES et al – 1990)

Public pressure Healthy public Lobbying


policy
Advocacy
Mediation
Healthy social
and physical
Empowered Healthy promoting
environment
participating organization
community
HEALTH Healthy
services
Critical
Agenda Healthy Professional
consciousness
setting choices education
raising
Education for health
The Health Action Model (HAM), developed by Tones, has two
main parts:
1. ‘Behavioral Intention’ which is composed of three dimensions
(belief, motivation, and normative) and
2. Factors that determine whether an individual's intention leads
to action.

HAM identifies key psychological, social, and environmental


factors which influence an individual adopting and sustaining
safe or unsafe related behavior.
Health Action Model (HAM),

Normative System - A system based on what is established as


the norm.
Tannahil’s Model

Spheres:
• Health-education: Communication to enhance well
being and prevent ill health through influencing
knowledge and attitude.
• Prevention: Reducing or avoiding the risk of diseases
and ill health primary through medical interventions.
• Health protection: Safeguarding population health
legislative, fiscal or social measures.
Dimensions:
Example of various dimensions in Tannahill Model
MODEL OF HEALTH PROMOTION: A TYPOLOGY OF HEALTH
PROMOTION (FRENCH – 1990)

DISEASE
MANAGEMENT
• Curative services
• Management services HEALTH EDUCATION
DISEASE PREVENTION • Agenda setting
• Caring services
• Preventive services • Empowerment and
• Medical services support
• Behaviour change • Information
POLITICS OF HEALTH
• Social action
•Policy development
• Economic and fiscal
policy
Social action means taking steps to change the things that are
wrong in our society and introducing new ideas and processes
for doing things better in the future.
Empowerment: The term empowerment refers to measures
designed to increase the degree of autonomy and self-
determination in people and in communities in order to enable
them to represent their interests in a responsible and self-
determined way, acting on their own authority
Participation and Empowerment

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