Health Promotion and Health Education

Things Affecting Ability to learn

• Emotional, Intellectual and physical capability, developmental stage, SDOH

4 Key Motivators of Learning

• Severity of the threat to health

• Vulnerability to the threat

• Effectiveness of the response in reducing the threat

• Ability of the individual to execute the change in behaviour.

Social Motives

•  A need for connection, approval or self-esteem. Ex: exercise makes you look good

Task Mastery Motives

•  Driven by the desire for achievement

Physical Motives

• Desire to maintain and improve health

Self Efficacy

A person’s PERCEIVED ability to successfully complete a task.

4 Factors Affecting Self Efficacy

• Verbal persuasion

• Vicarious experiences

• Enactive mastery experiences

• Physiological and affective states.

• Ex: A child is learning to use an insulin pump. The nurse tells them how to use it (verbal persuasion), shows them how to use it (vicarious experience), the child does it successfully (enactive mastery). When the child is getting their insulin under control, the nurse praises their health (physiological and affective states). 

Transtheoretical Model of Change

• Precontemplation, contemplation, preparation, action, maintenance. 

L.E.A.R.N.S Model

• Listen to patient needs

• Establish therapeutic partner relationships

• Adopt an intentional approach to every learning encounter

• Reinforce health literacy

• Name new knowledge via teach back

• Strengthen self management via links to community resources

Domains of Learning

Cognitive (understanding), Affective (attitudes), psychomotor (motor skills)

Teaching Approaches (5)

• Telling: Useful for limited quick info

• Selling: The nurse paces instruction according to the pt response. 

• Participating: The pt decides on the content and the nurse provides info and counselling. Opportunities are provided for discussion, feedback, goal setting and evaluation. 

• Entrusting: The nurse lets the pt manage self care. They observe progress and remain available to assist without introducing new info. 

• Reinforcing: Positive and negative reinforcements

Social Reinforcers

• Words

Material Reinforces

• Objects like toys and food

Activity Reinforces

• A desired activity

Andragogy

Teaching adult learners in education

Health Promotion

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

Biomedical Approach

•  Health is defined by the absence of symptoms of disease and illness is defined by the presence. 

Behavioral Approach

• People’s ability to adapt and adjust positively to social, mental and physiological change. Health is defined as the absence of disease as well as functioning, role performance and healthy lifestyles. 

What is the ecological model to health promotion?

Focuses on the social determinants of health, and the interplay and interdependence of individuals within subsystems of the ecosystem, such as their community, physical, and social environments (Community perspective)

What is the socioenvironmental approach to health promotion?

Expands upon ecological model of health promotion to incorporate social and environmental factors that can enhance or limit health or healthy behaviors

Ex: people more likely to walk and therefore improve health in areas with safe parks and walking paths

(Public perspective)

Three Challenges to Achieving Health for All in the Framework for Health Promotion Canada

• Reducing inequities, increasing prevention, enhancing coping

Three Health Promotion Mechanisms to Address these Challenges

• Self care, mutual aid, healthy environments. 

Three Implementation Strategies

•  Fostering public participation, strengthening community health services, coordinating healthy public policy. 

Ottawa Charter for Health Promotion Five Action Areas to Improve Health of Populations

•  Build healthy public policy, develop personal skills, strengthen community action, create supportive environments, reorient health services

Three Basic Health Promotion Strategies in Ottawa Charter for Health Promotion

• Enable, mediate, advocate

Population Health Promotion Model

• A 3D cube that reflects populations, the Ottawa charter areas for action, and SDOH. 

Primary, Secondary and Tertiary Prevention

• Primary: Health promotion and specific protection (protecting people from injury or disease). 

• Secondary: Early diagnosis, prompt treatment, disability limitation.

• Tertiary Prevention: When a defect or disability is irreversible and permanent. Tertiary focuses on rehab and restoration.

Active and Passive Strategies of Health Promotion

• Passive: Individual is an inactive participant or recipient of care. Ex: clean sewer systems

• Active: Individual is an active participant in their care. Ex: Exercise. 

What are the 3 goals of patient education and what level of illness prevention does it relate to?

1. Maintaining and promoting health and preventing illness (Primary Prevention)

-Information and skills that pt needs to prevent disease and maintain, manage, and improve their health

-Ex: First aid, health resources, risk factors, stress management

2. Restoring health (Secondary Prevention)

-Information and skills that will help pt manage, regain, or maintain health

-Ex: Patient disease or condition, cause + symptoms of disease, prognosis, limitations on function

3. Coping with Impaired Functioning (Tertiary Prevention)

-Learning to cope with permanent health alterations and assisting the pt with health care management according to pt's needs

-Ex: Home care, medications, self-help devices, prevention of complications