Health promotion theories and models

There are a number of significant theories and models that underpin the practice of health promotion. It would be useful to make a differentiation between theories and models. The following information has been adapted from Theory at a glance. A guide for health promotion practice. (Second edition). (US Department of Health and Human Services. National Institutes of Health. 2005.) For further information go to www.nci.nih.gov/theory Theory An integrated set of propositions that serves as an explanation for a phenomenon Introduced after a phenomenon has already revealed a systematic set of uniformities A systematic arrangement of fundamental principles that provide a basis for explaining certain happenings of life Examples: Social Cognitive Theory, Theory of Planned Behaviour Model A subclass of a theory. It provides a plan for investigating and or addressing a phenomenon Does not attempt to explain the processes underlying learning, but only to represent them Provides the vehicle for applying the theories Examples: Health Belief Model, Transtheoretical Model The main models and theories utilised can be summarised as follows: 1. Those theories that attempt to explain health behaviour and health behaviour change by focusing on the individual. Examples include: Health Belief Model Theory of Reasoned Action Transtheoretical (stages of change ) Model Social Learning Theory 2. Theories that explain change in communities and community action for health. Examples include: Community mobilisation o social planning o social action

community development Diffusion of innovation

3. Models that explain changes in organisations and the creation of health- supportive organisational practices. Examples include: Theories of organisational change Summary of Theories: Focus and Key Concepts Theory Individual Level Stages of Change Model Focus Individual's readiness to change or attempt to change toward healthy behaviours Key concepts Precontemplation Contemplation Decision/determination Action Maintenance Perceived susceptibility Perceived severity Perceived benefits of action Cues to action Self-efficacy Behaviour capability Reciprocal determinism Expectations Self-efficacy Observational learning Reinforcement Empowerment Community competence Participation and relevance Issue selection Critical consciousness Problem definition (awareness stage) Initiation of action (adoption stage) Implementation of change Institutionalisation of change Relative advantage

Health Belief Model

Person's perception of the threat of a health problem and the appraisal of recommended behaviour(s) for preventing or managing the problem Behaviour is explained via a 3way, dynamic reciprocal theory in which personal factors, environmental influences and behaviour continually interact Emphasises active participation and development of communities that can better evaluate and solve health and social problems Concerns processes and strategies for increasing the chances that healthy policies and programmes will be adopted and maintained in formal organisations

Interpersonal Level

Social Learning Theory

Community Level

Community Organisation Theories

Organisational Change Theory

Diffusion of

Addresses how new ideas,

Innovations Theory

products and social practices spread within a society or from one society to another

Compatibility Complexity Trialability Observability

HEALTH AS A MULTIFACTORIAL PHENOMENON

FACTORS AFFECTING HEALTH A. POLITICAL Involves ones leadership how/she rules, manages and other people in decision making. 1. Safety - the condition of being free from harm, injury or loss of authority or power 2. Oppression - unjust or cruel exercise of authority or power 3. Political will - determination to pursue something which is for the interest of the majority. 4. Empowerment - the ability of a person to do something - creating the circumstances where people can use their faculties and abilities at the maximum level in the pursuit of common goals

B. CULTURAL - relating to the representation of non-physical traits, such as values, beliefs, attitudes and customs shared by a group of people and passed from the generation to the next. 1. Practices - a customary action usually done to maintain or promote health like use of anting-anting and lucky charms. 2. Beliefs

- a state or habit of mind wherein a group of people place into something or a person. C. HEREDITY - the genetic transmission of traits from parents to offspring; genetically Determined.

D. ENVIRONMENT - the sum of all the conditions and elements that make up the surroundings and influence the development of the individuals.

E. SOCIO-ECONOMIC - refers to the production activities, distribution of and consumption of goods of an individual. THE NATIONAL HEALTH SITUATION Majority of the 68,616,536 million Filipinos (millions) in the urban and 35 million in the rural areas) cannot avail of adequate health care because of misdistribution of health personnel and facilities, and high cost of medicines and services. There are 1,742 hospitals in the country; most of them are in the urban areas. Of this number, 1103 are privately owned; 639 are government owned. There are 2,385 poorly equipped Health Centers. The Philippines is the leading exporter of nurses abroad. Sixty eight percent (68%) of the Filipino doctors go abroad; 32% of them remain the country, but most stay in the cities For every 10 deaths, 6 were not seen by a doctor. The leading causes of death and illness are predeceases and other socially related problems such as AIDS and drug abuse. Pneumonia and tuberculosis are leading cause of death 16 Filipinos , 11 of whom are children, die everyday from diarrhea 2 babies die every hour from pneumonia, diarrhea, measles and malnutrition.

The Philippines:

- number I in the world for whooping cough, diphtheria and rabies. - number 3 in the world for blindness due to vitamin A. deficiency - number 1 in the Western Pacific region for tuberculosis, schistosomiasis and polio.

As a result of mainly poverty, malnutrition is also a major health problem. 2 million of Filipino pre-school children are malnourished. 1.6 million Filipinos have Vitamin a, iron and iodine deficiencies. more than 50% pregnant or breastfeeding mothers are anemic. in addition to poor nutrition, poor sanitation and lack of a safe water supply make an individual susceptible to disease. - 13 million Filipinos have no access to safe water - 16 million Filipinos have no access to a sanitary toilet. in Manila alone, 5 million tons of garbage is disposed daily.

The National Health Situation is intimately linked to the economic, political and sociocultural system of the society.

A VISION OF HEALTHY TOMORROW: 1. 2. 3. 4. 5. 6. 7. 8. Preventive , promotive health care Community participation Traditional medicine Affordable medicine Adequate food, clothing and shelter Available basic health services Accessible health care facilities Clean environment

Danger Signs: To attain the dream of healthy tomorrow, everyone should take part in working for its fulfillment. Everybody must participate in the planning, implementation, monitoring and evaluation of the communitys program