TOPIC 6 targets of health promotion in australia

diff health promotion campaigns and reflects ottawa charter, programs to imp abo health, promoting healthy eating in aus, challenges in bringing about nutritional change

whats health promotion

process of enabling people to inc. control over and imp. their health by providing resources, skills and knowledge.

Health promotion is to create conditions that enc. healthier lives to prevent ill health. Preventative measures.

diff initiatives/programs/campaigns to focus and remember:

• quit campaign - focus = smoking and vaping

• good sports program - focus = alcohol misuse

• Victorian road safety strategy 2021-2030 - focus = road safety

• sunsmart - focus = skin cancer

• livelighter - focus = ow&ob

Issues targeted → smoking & vaping, alcohol, road safety, skin cancer, ow&ob, abo health, healthy eating. These are targeted because

• these issues contribute significantly to BOD in aus

• these issues incur substantial economic costs through healthcare, absenteeism, loss of productivity, social security payments

• associated with social impacts such as avoidable deaths and inequalities between population groups

• they all have a modifiable component, if addressed significant improvements can be made

Quit campaign and the ottawa charter

run by cancer council vic, funded by vic gov. & vichealth, aims to dec. use of ciggies by assisting indiv. to quit and prevent uptake of behaviours.

1. build healthy public policy

   • quit does research - gives advice to state gov. → laws to not smoke in public places, ads, ban on disposable vapes, display of ciggies, tobacco taxes

2. create supportive env

   • gives support throughout quitting process from trained staff

3. strengthen community action

   • uses abo quit specialists from abo quitline w additional training to assist ppl w smoking in culturally appropriate way

   • provides specialist training for health prof. to implement brief interventions, work w community and population groups to create public edu materials, health info, treatment pathways,

4. develop personal skills

   • gives info about tobacco smoking/v, benefits of not smoking. Done through public education using mass media ad campaigns, info.

   • gives advice on strats for quitting, easy follow steps to assist smokers for reasons to quit, preparing, managing setbacks, promoting knowledge

5. reorient health services

   • free online training program for health prof. To inform patients benefits of quitting, do cessation interventions, provide info about quit vic support services

quit campaign and impact on health status and h&w

health status

• dec. prev of smoking-related conditions (cancer, CVD, respiratory)

• reduction in premature death from smoking related diseases = inc. LE

• dec. morb rates from back pain

• dec. YLD from asthma

• Dec. inci. of low-bw babies = dec. infant and u5MR

h&w

• dec. smoking rates = higher fitness lvls → physical

• greater immune system function = lower lvl of infectious diseases = work towards purpose in life → spiritual

• lower lvl of diseases = reduce stress & anxiety in community due to fewer ppl develop life-threatening diseases → mental

• lower lvl of disease = inc. capacity of ppl to stay socially connected → social

• ppl dont develop conditions like cancer, CVD = think clearly = accurately recognise and respond to emotions → emotional

good sports program and the ottawa charter

run by alcohol and drug foundation, funded by state and federal gov. Support for reducing alcohol and drug misuse

1. build healthy public policy

   • provides sport clubs w free resources and support to reduce negative impacts of alcohol misuse. Helps club prepare potential drug-related issues by assisting dev. and implementation of illegal drug policies in form of info and expert advice

2. create supportive env

   • moving away from an alcohol-centred culture promotes healthier and safer, family-friendly env for sport clubs.

3. strengthen community action

   • involves parents and clubs o reduce junior players exposure to alcohol, tobacco and illicit drugs, creating positive playing env.

4. develop personal skills

   • promotes positive behaviours around alcohol - giving young club members w lifelong decision-making skills that reduce potential harms from alcohols like road trauma

5. reorient health services

   • good sport program promotes healthy and inclusive convos around mental health = strong support network for members who seek help, inc. access to health professionals

good sport program impact on health status and h&w

health status

• dec. risk of members driving under the influence of alcohol = dec. mortality due to road trauma

• dec. consumption of alcohol = dec. inci. of alcohol-related conditions like cirrhosis of liver

• social connectedness is protective factor for mental health issues, program dec. YLD from depression and anxiety

• dec. alcohol consumption = dec. women drinking while preggo = dec. inci of FASD

• dec. exposure to tobacco smoke = dec. morb due to asthma dec. asthma attacks

h&w

• members and volunteers can participate knowing its a safe env. to socialise, → social

• parents experience better mental h&w bc they know their kids are free to enjoy sport in family-friendly env. assured positive healthy behaviours role modelled = dec. stress → mental

• inc. connections to sporting clubs = provide members sense of connection to their world → spiritual

• inc. participation in regular pa = maintain healthy body weight → physical

• strong support networks created by the program = assist indiv. working through challenges in lives = resilience → emotional

victorian road safety strategy and ottawa charter

a healthy public policy developed by road safety vic in collab with victoria road safety partners - Transport accident commission, vic police, dept justice & community safety, dept. health & human services. Aims to halve road toll, eliminate road accidents deaths through infrastructure, road laws, human behaviour and vehicle safety

1. build healthy public policy

   • developed to remove risk-takers from roads (creates supportive env.)

2. create supportive env

   • installing fleet of AI enabled camera systems, to detect illegal mobile phone use, seatbelt absence and other offences

   • rumble strips, life saving infrastructure

3. strengthen community action

   • acknowledges road safety is complex, takes collective response gov. agencies, industry partners, vic community to deliver safer roads.

4. develop personal skills

   • education initiatives through road to zero, a road safety experience at melb museum to provide education to hs kids

   • support drivers to better understand safest vehicle options

5. reorient health services

vic road safety impact to health status and h&w

health status

• safer roads = less car crashes = dec. incidence of injuries

• dec. road trauma = dec. deaths = higher LE

• dec. no. permanent disabilities caused by road trauma = dec. YLD

h&w

• dec. road trauma = ppl less likely to be injured = body systems to function more effectively → physical

• dec. deaths on road = lower lvls of grief in community, → emotional

• ppl not injured as result of road accidents = spend time with friends → social

• mental

• spiritual

sunsmart and ottawa charter

initiative of cancer council vic and funded by them and vic health to raise awareness of importance of sun protection

1. build healthy public policy

   • policies adapted to schools etc, enc. to implement sunsmart policy into curriculum

2. create supportive env

   • imp. env protection strats like info on options for built and natural shade, promoting sunsmart uv app.

3. strengthen community action

   • assisting orgs. like schools to implement sun safety measures

4. develop personal skills

   • through mass ad campaigns media strats help ppl know when they need sun protection

     • slip, slip, slap, sleek, slide → using combo sun protection measures

     • uv. it all adds up → raised awareness effect of UV exposure overtime

     • how to remove a skin cancer → graphic footage of skin cancer removal

   • sunsmart in school curriculum educating kids

5. reorient health services

   • provides support for health profs. by promoting awareness of UV exposure and early detection of skin cancer and providing edu material for health prof to use on patients

sunsmart impact on health status and h&w

health status

• dec. uv exposure = dec. incidence of skin cancer

• dec. rates melanoma = dec. no. premature deaths = inc. HALE and LE

• dec. skin cancer rates = dec. ppl undergo surgery = dec. YLD

h&w

• lower lvls of uv exposure = dec. ppl develop skin cancer = more ppl living w/o disease → physical

• skin cancer surgery can be disfiguring due to lots of tissue removed. Reducing this = less ppl experience low self-esteem → mental

• dec. rates of skin cancer = less ppl die = dec. grief in community → emotional

• social

• spiritual

livelighter and ottawa charter

is a public health edu campaign to help ppl eat well and be physically active and avoid excess weight gain.

1. build healthy public policy

   • policy templates for free, like traffic light system giving guide to enc. ppl eat food w 2 nutrients in green category.

2. create supportive env

   • healthy options easy option by advocating for less promotion of junk food, better access to healthy food, imp. food labelling and infrastructure and policies to empower ppl to be more active.

3. strengthen community action

   • working with retailers, unis, community org, and all lvl of gov.

4. develop personal skills

   • gives fact sheets and range of healthy recipes for free

5. reorient health services

   • provides professional dev. opportunities for health prof. assist in reducing risk of patients dev. obesity -relating conditions like CVD and type2diabetes

livelighter impact on health status and h&w

health status

• dec. rates of obesity = lower incidence of conditions like arthritis, depression, type2

• dec. obesity lvls = less ppl die prematurely from cvd = dec. mortality

• less deaths = inc. LE

h&w

• dec. rates of obesity = ppl have more energy → physical

• ow&ob cause ppl to feel self conscious = dec. of this = higher self-esteem → mental

• ppl have healthy body weight = more likely to participate in social activities → social

• emotional

• spiritual

whats social justice and its importance in developing programs to promote health outcomes

social justice = relates to fairness within society based on 4 principles.

its important consideration as social justice ensures underlying causes of disadvantage are addressed.

4 principles of social justice - HAPE

Human rights

• the freedom & conditions every person is entitled to regardless of factors such as race, religion, gender identity, sexual orientation, age, sex. Governments. work to ensure all ppl have human rights protected, respected and promoted

Access

• all ppl have adequate access to resources & opportunities to thrive. Food, water, shelter, education, employment, income, healthcare, and participate in decisions that affect their lives

Participation

• everyone in society has opportunity to participate in community and have their voice represented.

Equity

• disadv indiv. & groups have their specific challenges addressed to achieve same level of h&w as others in population. Providing more support for those who need it.

whyre aboriginal target of health promotion activities

They often experience factors that contribute to variations in health outcomes and have potential to experience significant health imp. compared to other population groups. The inequalitities they experience include

• lower LE, higher Mortality, twice rate of low bw babies and infant mortality, less likely to rate health status as excellent or very good, BOD is higher, higher rate of chronic conditions like cancer CVD respiratory,

closing the gap program and ottawa charter & social justice

Its a commitment agreement from the council of australian gov and local that agreed to work together to achieve equality in health status and LE between abo and non-indig aus.

ottawa charter

build health public policy

• is a policy made by governments

strengthen community action

• has multiple stakeholders involved in planning and implementation of the agreement.

social justice

• aims to imp. health outcomes, educational attainment, employment and housing, out of home care, violence and suicide, promote legal rights to land and water → equity as they have their challenges addressed, access by inc. access to healthcare etc, human rights being respected about land and water

deadly choices intitiative and ottawa charter & social justice

deadly = great. This initiative works to enc. & empower abo ppl to make healthy choices for themselves & families - stop smoking, eat good food, exercise daily.

ottawa charter

strengthen community action

• empowers abo communities to provide health services managed by community members. Culturally appropriate healthcare inc. likelihood of accessing this.

develop personal skills

• education programs including tobacco cessation & cooking to develop skills

reorient health services

• encourages ppl to access local community controlled health service and do annual health checks, health workers identify those at risk of health concerns and address them

social justice

• gives access to education and healthcare by empowering abo ppl, promotes equity bc abo ppl experience worser health outcomes than non-indig.

2spirits program and ottawa charter & social justice

program that embraces whole community approach to imp. sexual h&w of abo gay men, sistergirls and brotherboys through education, prevention, health promotion and community development activities. Some services → peer education workshops, PD programs, retreats, social support groups, campaigns

• sistergirl = abo transgender women (male at birth) who have distinct cultural identify and have female roles

• brother boy = abo transgender men (girl at birth) do male roles

ottawa charter

build healthy public policy

• provides consultancy to NGOs and gov. to include cultural identities, gender identities and sexuality of abo sistergirl and brotherboy ppl as core elements of policies and frameworks.

create supportive env

• peer education program provides culturally appropriate and safe network for everyone, promoting access to h&w education, resources, support

strengthen community action

• has community forums across state to develop rapport and partnerships w community stakeholders and services, working collaboratively to promote h&w, sexuality, inclusion etc.

develop personal skills

• condoman and lubelicious are in comic books, videos, online media to provide skills that promote safe sex in culturally appropriate way.

reorient health services

• delivers inclusive services training package for health prof. to imp. ability to appropriately support abo sistergirl and brotherboy ppl

social justice

• human rights ensures all ppl feel accepted and LGBTQI abo are respected, access peer education program enables abo ppl to access education, resources etc, participation has community forums allowing community to have their voice heard, equity focuses on disadv group within abo community

tackling indigenous smoking (TIS) initiative and ottawa charter & social justice

TIS is a fed gov. initiative working to imp. LE among abo by reducing tobacco use.

ottawa charter

build healthy public policy

• advises aus gov. on policies that can assist in closing the gap by reducing smoking among abo. Developing and implementing smoke-free policies for other orgs. as well.

create supportive environment

• has regional tobacco grants for local orgs. to implement tobacco cessation activities, aiming to imp. capacity of quitline services to provide accessible culturally appropriate services = supportive

develop personal skills

• works with victorian aboriginal health service, developing a kids book addressing tobacco use and promote healthy behaviours, deadly dan the smoke free man to educate young abo.

reorient health services

• implements 3day quitskills training program, providing knowledge and skills for health workers to assist them in supporting abo ppl quitting smoking.

social justice

• equity addresses significant issues within abo community which is smoking rates. access empowers ppl giving them access to resources to thrive like education and healthcare.

aboriginal quitline and ottawa charter & social justice

is a telephone counselling service giving confidential support for abo who want to quit.

ottawa charter

create supportive env

• provides confidential support, can provide links to local support groups for more supportive environments.

develop personal skills

• provides callers a plan for quitting thats tailored to their needs and has info on diff quitting methods and products

social justice

• equity addresses smoking issue which significantly contributes to lower health status in abo compared to non-indig. access to resources needed to thrive like culturally appropriate healthcare.

evaluating initiatives in capacity to imp. abo h&w

discuss potential effectiveness of program in promoting health outcomes

• education → retained after program = sustainable improvements → education passed onto other people = health promotion msgs spread

other things that can inc. effectiveness but isnt part of criteria

• free programs → inc. access for lower SES

• tv ads → exposes ppl to the health promotion and raise awareness

8 considerations in evaluating programs for abo

1. actual improvements to h&w

   • research to determine success achieved of health outcome improvements

2. no. of participants taking part in initiative

   • inc. participants overtime = target audience engaged with initiative

3. feedback given by participants

   • indicates level of success

4. ottawa charter action areas evident

   • develop personal skills is a main one. Community action → multiple stakeholders bring strengths

5. whether initiative is culturally appropriate

   • culturally appropriate inc. participation and health outcomes

6. whether program has taken specific needs of target group into account

   • improved health outcomes when specific needs are targeted

7. funding provided to implement initiative

   • helps implement program

8. whether program addresses significant health issue for abo ppl

how to answer diff sac qs

• some qs ask for ottawa charter action areas evident in program

• some ask for how program improves h&w outcomes

• some ask for how program shows social justice principles

• some ask for evaluate effectiveness of program and improvements to health outcomes → need to address the pinwheel considerations, ottawa charter and link it to health outcomes. (maybe add social justice).

booklet qs examples

use the considerations to evaluate following initiatives in relation to their capacity to imp. abo ppl health outcomes 3marks:

1. deadly choices initiative

   • Deadly choices addresses ottawa charter-develop personal skills through education programs like cooking to encourage healthy eating. This knowledge can be passed onto family, promoting physical h&w by maintaining healthy body weight. Deadly choices also is culturally appropriate through health services provided by abo… which is shown to inc. access and participation in healthcare. This can dec. incidence of conditions such as ow&ob, CVD from smoking etc.

2. 2spirits program

   • Targets specific population group needs - the disadv group which is more likely to be gay men, sistergirls and brotherboys from abo ppl.. This can promote mental h&w by dec. stress & anxiety lvls about sexual health by inc. accessibility to this program. Its also culturally appropriate through the peer education program, creating supportive network of abo ppl.. this can dec. incidence of diseases caused by unsafe sex such as STI’s.

3. TIS initiative

   • Addresses ottawa charter-develop personal skills through ‘deadly dan the smoke-free man’ which educates kids on healthy behaviours that reduce tobacco use. This can promote the body and its systems to function efficiently from healthy respiratory lung function, promoting physical h&w. Also addresses significant health issues for abo .. which is usually high smoking rates compared to other population groups. By targeting this, it improves LE from dec. mortality rate caused from tobacco related deaths such as lung cancer in abo ppl. Its also culturally appropriate through grants given to local orgs. to implement abo ppl which acn inc. participation.

6 considerations when evaluating healthy eating initaitives

1. ease of understanding

   • visual guides for ppl with low lvls of health literacy, translations for NESB

2. access

   • free resources for low SES, online

3. inclusiveness

   • relate to all groups in aus can benefit from initiative.

4. relevance

   • significant need of community

5. effectiveness

   • degree to which program achieves its objectives

6. sustainability

   • impact of program being able to continue into future

what is the Australian dietary guidelines

Guidelines by national health and medical research council, thatre designed to address causes of the increase in diet-related conditions.

Guidelines are used by health prof., educators, and others to promote healthy eating. Doesnt target those with seriouds medical conditions like type2diabetes who need specialised dietary advice.

• guidelines in english, low vision format, free on eat for health website

• it provides advice to types & amount of food, food groups and dietary patterns for

  • healthy dietary patterns, reduce risk of diet-related conditions, chronic conditions.

• advice for indiv. differences like

  • diff lifespan stages, pregnant, vegetarians & vegans, asians, abo, remote ppl, low ses, losing weight, maintain weight.

the 5 guidelines in ADG

guideline 1

• achieve & maintain healthy weight, be physically active and choose amounts of nutritious foods to meet energy needs

  • energy for growth and development

  • relates to energy balance (amount of energy consumed is same as amount of energy required, no weightgain/loss)

    • positive energy imbalance = too much → cvd, type 2 diab, cancer

guideline 2

• enjoy wide variety of nutritious foods from 5 food groups everyday and water

  • lower mortality & morb

guideline 3

• limit intake of foods containing saturated fat, added salt, sugars and alcohol → discretionary foods

  • replace food w poly&monounsaturated fats

  • discretionary foods → doesnt provide required nutrients but adds variety. its energy dense.

guideline 4

• encourage, support and promote breastfeeding

  • breastfeeding for healthy growth and dev of infants, dec. risk of infection, asthma, sids, obesity, hypertension, chronic diseases later in life

guideline 5

• care for food → prepare & store safely

  • reduce risk of food-borne diseases.

the 5 food groups

fruit

• low in fat, provides carb for energy, high in fibre & antioxidants, imp. immune system function,

grain → pasta, bread

• high fibre, dec. risk of obesity, colorectal cancer, cvd

lean meats & alternatives → fish, poultry, egg

• high in protein, helps immune and cv function, dec. risk of cvd from having mono&polyunsaturated fat in fish

dairy products & alternatives

• high in calcium for bone health and dec. risk of osteoporosis

water

• for digestion, waste removal, chemical reactions. Reduces risk of weight gain, dec. dental caries bc no sugar.

strengths & limitations of ADG

strengths

• free

• advice for indiv with diff needs eg, diff lifespan, cultural backgrounds

• accessible formats for low vision ppl

• shows no. serves and what represents a serve, assist male and female of diff ages to consume recommended amounts of each food group

• if ppl enjoy wide variety of nutritious foods from 5 food groups everyday & water → energy dense food intake dec., assist in addressing obesity

limitations

• hard to understand guidelines for ppl with low health literacy levels

• only in english

• is based on average person, thus serving sizes not appropriate for all

what is the australian guide to healthy eating & abo one

AGHE → a visual guide food selection tool incorporated into ADG that reflects guidelines 2 and 3. Used by consumers to help plan, select and consume adequate proportions of food from 5 food groups.

• 5foodgroups divided into wedges reflecting proportion to be consumed on daily basis.

• provides basic nutrition advice but no serving sizes and composite foods hard to follow

features

• grain & veggie is biggest sections, then meat, then fruit and milk.

• bottom left corner shows healthy fats use in small amounts

• bottom right corner → discretionary food that should be limited

• water intake in top right

aboriginal AGHE → has reference to traditional foods like kangaroo, crab, bush fruit, damper, lizard.

strengths & limitations of AGHE

strengths

• 10+ translations to inc ability of linguistic diverse people to use

• guides apply to all ages

• visual representation for guideline 2&3, easy to understand

• based on latest research inc. effectiveness to address health outcomes (based on g2&3)

• range of food included from diff culture

limitations

• proportion of 5fg but no serving sizes, ppl can overconsume or not eat enough and have misunderstanding that they should eat whole wedge of 5g

• hard to separate composite food like pizza

• no specific advice for ppl with dietary conditions, dec. amount of ppl who use it

personal factors that affect nutritional change

relate to characteristics of indiv. that influence food intake.

• willpower and taste preference

  • ppl prefer certain foods, establishing taste preferences over long periods.

  • foods high in fat/salt/sugar have flavour enhances stimulating taste buds → craving & dopamine = hard for nutritional change

• attitudes and beliefs

  • perception that healthy food is bland, ignoring negative effect of unhealthy food, vegan, organic ppl, restrict certain food = underconsumption

• h&w factors

  • food allergies, intolerance to cow milk and gluten, stress eating

sociocultural factors that affect nutritional change

relate to aspect of persons society and culture that influence food intake

• SES

  • lack of nutritional knowledge and cooking skill = eat unhealthy

  • lack of edu = no skills to assess current food intake, know benefits, how to read food labels

  • low income = lack resources to prepare healthy food, eat cheap unhealthy fast food

  • occupation like truck driver rely on food near employment as theyre not at home, eg. fast food.

• EMPLOYMENT STATUS

  • if working, less time spent preparing food, thus rely on pre-prepared meals which is unhealthy

• FAMILY & PEER

  • may eat traditional foods.

  • food is eaten in social setting with others, whats eaten there influence food consumption

• COMMERCIAL FACTORS - next flashcard

commercial factors that affect nutritional change

Relate to impact private sector has on h&w. conditions, actions and policies of corporate org. that impact h&w. Private sector → part of economy not run by gov.

• supply chains

  • relate to process food undergo when produced and consumed. Influences distribution, pricing of food, processing, additives, packaging, labelling

• distribution and affordability

  • some food expensive some not due to transport and retailers

• processing

  • manufacturers can add additives, shelf life stuff, consumers might not know about it

• packaging and labelling

  • marketing tool by food manufacturers, eg. cartoon characters marketing to kids, hard for nutritional change. Might say fat free but lots of sugar

• lobbying

  • food company lobby govs about trade agreements, marketing fast food, intro to health promotion interventions like sugar tax. Influences food available and how marketing is carried out.

• marketing strats and use of media

  • ads, tv, internet, promotions, sponsorships, celebs, product placement. Create conflicting messages for indiv. affecting ability to choose healthy food

children most susceptible to marketing of unhealthy foods → affect nutrition knowledge, food pref, product requests, consumption patterns.

kids can differentiate ads vs factual info. Kids influence items bought while shopping

environmental factors that affect nutritional change

relate to elements of physical env. that influence food intake.

• geographic location

  • live remote = limited, rely on non-perishable food = not healthy and also expensive due to transportation

  • socioeconomic disadvantage areas have more fast food outlets = high in fat/salt/sugar harder to make change if living nearby.

• workplaces

  • some workplaces allow ppl to access food during breaks like canteen, some provided meals. Influencing what they eat

• housing env

  • facilities available in house like appliances. Lack of this impact how ppl store, prepare their food and limit options

• transport

  • need road or PT. Lack of access to transport = rely on food close to home or need to be delivered.