Primary Prevention

primary prevention

alter risk factors prior to the onset of disease to prevent onset or reduce severity of the disease

• through Health Promotion

health promotion

helping people change their lifestyle to move toward a state of optimal health

ideology of health promotion

effective ways to help people maximize their health

• good health is a universally shared objective

• agreement on what being healthy means

• scientific consensus on which behaviors facilitate good health

health promotion through

• goals

• means to achieve

• criteria for evaluation

behavior change approach

bring about changes in behavior by changing cognition

• provide info on risks and hazards

• create awareness

• assumes humans are rational decision-makers based on knowledge

behavior

tangible actionable item

mechanism for behavior change

intervention impact → changes risk factor + new behavior = healthy outcome

examples of behavior change models

• health belief model

• theory of planned behavior

criticisms of behavior change

• can’t target major socio-economic causes of ill health

• operates top-down

• assumes population is same and direct link between education and behavior

• doesn’t account for impulse and emotion

• narrow definition of behavior isolated from context

self-empowerment approach

empowers individuals to make healthy choices “therapy model”

• creates participatory techniques

• to increase control over the environment

objective: power is a universal resource that can be mobilized by every individual

relies upon individual’s capacity to act rationally

empowerment

enhances possibilities for people to control their own lives

• many skills are already present or possible

• poor functioning is a result of social structure and lack of resources

collective-action approach

improve health by addressing socio-economic and environmental causes of ill health

• individuals organize collectively to change physical/social environment

• modify structures that generate ill health

how is collective action different from self-empowerment

community is the health promotion resource as an opportunity for growth

whereas self-empowerment is limited to the individual

collaboration

research partnership among equals with complementary knowledge/expertise

partnership

establishing and sustaining a mutually respectful relationship based on sharing responsibilities, costs and benefits, and outcomes

empowerment

process of enabling groups and individuals to gain understanding and control over circumstances to improve life situations

process of collective action

assessment of problem → mobilization → develop a coalition (group) → take action (collective action)

assessment

approach to identifying health needs and problems in the community

• essential for community engagement and participation

community health assessment

identifying, collecting, analyzing, and disseminating info on assets, strengths, resources, and needs

i.e. who is the population? what are their needs?

ethical considerations of community

how is the community selected?

do you have clear understanding of the community?

community mobilization

1. define community

2. assess capacity for mobilization

3. understand community agenda

7 steps to community mobilization

1. recruit stakeholders

2. assessment

3. develop prevention plan

4. develop evaluation plan

5. implement

6. evaluate

7. sustain

coalitions

help to mobilize and influence, an avenue for recruitment, exploits resources

• involved in new issues without sole responsibility

• develop widespread public support

• maximize power

• minimize duplication of services

development stages of coalitions

initial mobilization & organization → capacity and planning for action → implementation , refining, and institutionalizing membership process

collective action

critical consciousness + social capital

critical consciousness

community recognizes social and economic limits, and health influences

social capital

supportive community with networks and organizations

social capital bonding

within networks

social capital bridging

linking across networks

Prince Georges Coalitions

created 5 new practices to serve 10,000 residents with limited access

Impact DMV

establish a culturally sensitive community-collaboration to reduce HIV & STD rates