Health Promotion and Public Health Campaigns

What is health?

• A state of complete physical, mental & social well-being and not merely the absence of disease or infirmity (WHO 1947)

• A state of optimum capacity for effective performance of valued tasks

• The expression of the extent to which the individual and the social body maintain in readiness the resources to meet the exigencies of the future

• A basic human right and essential for social and economic development

What is public health?

• The science and art of preventing disease, prolonging life and promoting health through the organised efforts and informed choices of society, organisations, public and private, communities and individuals

• The term “public” refers to individual members of the community, social groups in which individual play a part and organisations both local and national, including government

• The organised efforts of these groups thus include a wide spectrum of activities that influence global and national policies such as reducing carbon emissions, creating fairer societies and include legislative measures (eg. banning smoking in public places and providing social services

What is health promotion?

• the process of enabling people to increase control over and to improve their health

• The 5 Ottawa strategies for success are:

  • Build healthy public policy

  • Create supportive environments

  • Strengthen community action

  • Develop personal skills

  • Re-orient health services

• According to WHO, health promotion represents a mediating strategy between people and their environments, synthesizing personal choice and social responsibility in health care to create a healthier future

Health promotion = Health education x Healthy Public Policy

Health Education

Three aspects to Health Promotion suggested by Tannahill:

1. Prevention → reducing or avoiding the risk of diseases and ill health

2. Positive health education → communication to enhance well-being and prevent ill-health through improving knowledge and attitudes

3. Health protection → safeguarding population health through legislative, financial or social measures

What is health advocacy?

• Influencing policy makers, leaders and media to raise profile of health programmes

• Addressing legal, financial and service obstacles to health action

• Tackling discrimination and inequalities

What are the goals of public health campaigns and health promotion?

• Want to improve health

• Want to reduce health inequality

• To reach and educate on community population level

• Create roadmap to quitting smoking services

What makes a good public health campaign?

• Motivates behavioral changes

• Demonstrates consequences

• Want them catchy and stand out since they compete with the audience’s attention to different ads, campaigns, phones, etc…

• Campaign will have partial service - Full service can be accessed after viewer accesses source later

An effective response should…

1. Provide the information and power for the community to make decisions

2. Make the healthy choice the easiest option

3. Remove barriers to action

4. Reach across socio-economic strata

What are the major challenges facing health promotion?

• Spread of misinformation

• Cultural stigma

• Under-representation of minority groups

• Lack of funding for national-level health campaigns

• Language barriers

• Mistrust in government leads to resistance

• Glamorisation of harmful products

• Harder for information to reach people with disabilities

Effective Implementation of Media Campaigns

• Anti-smoking advertising has to compete in a crowded media marketplace — a hook is needed to engage the emotions of the target audience

• Most successful campaigns contain a variety of messages — “threatening” and “supportive” styles of delivery can complement each other

• While promoting benefits of not smoking, advertising should not tell people what they should do

• Smokers are motivated by knowing that they are not alone, and that support and help are available

• Content and style of delivery are of equal importance — smokers can accept unpalatable messages if the context is encouraging and supportive

The role of media in health promotion

• Having a clear media message from science is important

• Mass media provides an important link between the rural residents and vital health information

• The distribution of pamphlets created by specialized health bodies can disseminate vital health info reliably (eg. Aids campaign under Thatcher)

• Internet-misinformation — either due to inaccurate information, misleading information or misinterpretation of health information, can have potentially dire consequences, triggering mass panics, misleading uninformed policy-makers, etc..

Mass media campaigns reinforce public health messages by…

1. Mobilising and supporting local agencies/professionals who have direct access to individuals within the target population

2. Bring together partnerships of public, voluntary, professional and private sector bodies

3. Inform and educating the public

4. Influence public opinion

5. Encourage local and national policy changes to create supportive environments

What interventions are used to change health behaviours?

• Increasing knowledge and awareness of risks

• Increasing physical or interpersonal skills (eg. using condoms, or deploying assertiveness skills to suggest that condoms be used)

• Changing beliefs and perceptions

• Influencing social norms

• Changing structural factors and influencing the wider determinants of health

• Influencing the availability and accessibility of health services

Evidence-based strategies to support change

Key elements for success in changing health behaviors:

• Using theoretical models in developing interventions

• Targeted and tailored

• Providing basic, accurate information through clear, unambiguous messages

• Using behavioral skills training, including self-efficacy, MI

• Joining up services with other community provisions

• Working with community members as advocates of appropriate services (local action)

Public health campaign strategies

• Past campaigns show the importance of policy impact as well as of cultural change

• Convey clear scientific messages through the media and creating networks of key organisations in strategic alliances have been effective strategies

• Attention must also be paid to the political dimension of a concern such as alcohol and possible alliances with industry

The role of fear in health promotion

• Fear arousing imagery can be good at attracting attention and is often memorable

• Fear-based campaigns are more persuasive for individuals who are already engaging in the desired, health-protective behaviour (justifies their hard work)

• Arousing fear in individuals can have many unintended consequences, such as denial or othering

• Arousing fear is not an effective means of facilitating sexual behavior change

Depiction of disease may lead to stigmatisation

• Campaigns that focus solely on the neg. consequences of HIV infection may serve to disempower men with HIV by making them appear weak, helpless or diseased

• Depictions of visible symptoms may reinforce commonly held perceptions that they can tell who has HIV by looking at them, and may also discourage newly diagnosed men from taking anti-HIV therapies for fear of potential side effects

Role of pharmacies in public health campaigns

• Each year pharmacies are required to participate in up to 6 campaigns at the request of NHS England

• This involves the display and distribution of leaflets provided by NHS England

• Most popular pharmacy campaigns:

  • Quit Kits

  • Stoptober

  • Act F.A.S.T.

  • Be Clear on Cancer

  • FRANK

  • Smokefree

  • Change4Life

  • Dementia

When to use the media in health promotion?

Media can be effective tool in health promotion given the appropriate circumstances and conditions such as:

• when awareness is the main goal for wide populations

• facilitate health education

• urgent timeframe

• simple behavioral goals

• generous budget available