1, 2 - Defining Health and Health Promotion

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traditional medicine/allopathic medicine/treatment based would define health as the

absence of disease

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What is the traditional/allopathic/treatment-based medicine more specific definition of health?

-        Absence of the 5 D’s

-        Death

-        disease

-        discomfort

-        Disability

-        Dissatisfaction

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Primitive view of health

-        Believed Spirits were responsible for health.

-        Consequence of personal doings

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Change in health with industrial revolution-rural transition to urban

overcrowding, lack of clean water, poor food supply, disease

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18th and 19th century engineering advances

sewage control and food preservation

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1900s advances in health

  • vaccinations and antibiotics

  • prevent morbidity and mortality

  • control over diseases like tuberculosis, diphtheria, pneumonia, syphilis, tetanus

  • simple preventative measures such as washing hands and food preparation

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the late 20th century introduced

chronic diseases because people were living longer

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What is the definition of health and sickness: Defined by extremes?

-        Absence of disease

-        Good hygiene

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What is the 1947 world health organization definition of health?

-        Complete physical, mental, social well being, not just the absence of disease or infirmity

-        First time health meant more than an absence of illness. to more holistic

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How has the “cause of death” changed over the years?

-        shift from infectious to chronic diseases

-        decreased morbidity and mortality rates.

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Based on the average Canadian child born in 2003, who has a longer life expectancy, males or females?

-        Females longer (82.4)

-        Males shorter (77.4)

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Mortality rates indicate people are living ______. Morbidity rates indicate ______ people suffer from infectious disease.

-        longer

-        fewer

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Even though people are living a longer life, are they living a healthy life?

-        Healthy life 66 years

-        Impaired life 11.6

-        Although living longer, not whole life is quality.

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WHO definition of healthy life

-        Healthy life expectancy is based on life expectancy but includes an adjustment for time spent in poor health.

  • Male LE = 77.2, HLE = 70.1

  • Female LE = 82.3, HLE = 74

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What is the most current definition of health?

-        The dynamic, ever-changing process of trying to achieve individual potential in the following 7 dimensions:

1.       Physical

2.      Social

3.      Mental

4.      Emotional

5.      Spiritual

6.      Environmental

7.      Occupational

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The current definition of health also implies what 4 things: health is a _______, people _______ their own health, health is related to? Health is a _____ state.

-        Health is a process.

-        People can influence their own health.

-        Health is related to our environment (social, physical, psychological)

-        Health is a relative state (state of mind is crucial)

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What is the difference between health and wellness?

-        Health: dynamic, multi-dimensional, adaptability to life situations

-        Wellness: achieving a high level in each dimension of health

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holistic health

  • a view of health in terms of its physical, emotional, social, intellectual, and spiritual make up

    • not a fad or quack medicine

    • not incompatible with conventional medicine

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Describe physical health.

-        Susceptibility to disease

-        Body weight/composition

-        Visual

-        Strength, endurance, coordination

-        Functioning and ability to perform activities of daily living.

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Describe social health.

-        Ability to have satisfying interpersonal relationships and adapting to various social situations.

-        Interactions in friendship, work, school, family

-        Communication, listening, conflict management.

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What is mental/intellectual health?

-        Ability to think clearly, act on information, clarify values and beliefs, analyze critically, decision making capacity.

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Occupational health

-        Employment satisfaction

-        Feeling good about their jobs -> themselves -> healthier lifestyle

-        Work and leisure balance

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Emotional health

  • feelings

  • Ability to: cope with stress, remain flexible, compromise, goals.

  • Self efficacy, confidence

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Describe environmental health.

-        The appreciation of external environment

-        Individual role in preserving, protecting, and improving environment.

-        Can include home or study environment (desk, room, lighting, noise level, comfortable atmosphere)

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Describe spiritual health.

-        Guiding sense of meaning in life

-        Can include religion, beliefs.

-        Sense of belonging, community, familiar practices

-        Can enhance by engaging in new experiences with nature, art, music.

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How might one enhance their health in each of the 7 dimensions of health?

To enhance health in each of the 7 dimensions of health, consider the following:

  1. Physical: Engage in regular exercise, maintain a balanced diet, and get enough sleep.

  2. Emotional: Practice stress management techniques, seek support from loved ones, and engage in activities that bring joy.

  3. Mental: Stimulate your mind through reading, learning new skills, and engaging in critical thinking.

  4. Social: Build and maintain healthy relationships, participate in social activities, and communicate effectively.

  5. Occupational: Find satisfaction and fulfillment in your work, set goals, and maintain a work-life balance.

  6. Environmental: Create a safe and clean living environment, connect with nature, and practice sustainable habits.

  7. Spiritual: Engage in activities that align with your values and beliefs, practice mindfulness or meditation, and seek spiritual guidance if desired.

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For health promotion, you need to create optimal conditions for successful behaviour change through:

  • educational supports

  • organizational supports

  • environmental supports

  • financial supports

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Pan-Canadian Healthy Living strategy

  • supports Canadian health-care system

  • uses a population health approach

    • living and working conditions need to be addressed to achieve change by individuals

  • emphasizes physical activity and nutrition and their relationship to healthy weight

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primary prevention

  • actions designed to stop health problems before they start

  • ex. physical activity, participaction

  • prevent

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secondary prevention

  • intervention early in development of health promotion to decrease symptoms or stop progression

  • ex. Physical activity to decrease risk of high blood pressure

  • at risk

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tertiary prevention

  • treatment or rehab to limit the effects of a disease someone already has

  • ex. physical activity to help manage arthritis

  • treatment

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what are the trends in leading causes of death in Canada, 2005

  1. Malignant neoplasms (29.3)

  2. Diseases of the heart (22.4)

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factors reflecting sex biases in medical research

  • androcentricity

  • overgeneralization

  • sex insensitivity

  • double standards

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androcentricity

tendency to look at something from male perspective

  • ex. having male only participants/researchers

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overgeneralization

findings use to treat EVERY group, even though finding were only based on males

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Sex insensitivity

ex. pregnancy guidelines for physical activity (researchers had no experiences with topic and scared to harm women ) → being insensitive to that life stage

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double standards

  • how information is expected and shared

  • creating physical activity guidelines

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2 factors that are targeted in improving your health: key behaviours to

  • help lengthen life

  • quality of life

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key behaviours to help lengthen life

  • good sleep

  • healthy eating habits

  • PA regular

  • oral hygiene

  • safe sex

  • avoid tobacco

  • limit alcohol

  • regular medical exams

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key behaviours to help improve quality of life

  • control stress

  • maintain meaningful relationships

  • time for yourself

  • fun activities

  • value each day

  • learn from mistakes

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factors influencing behaviour change

  • predisposing factors

  • enabling factors

  • reinforcing factors

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predisposing factors to behaviour change

  • sex, race, income, family education, knowledge, beliefs

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enabling factors of behaviour change

skills, abilities, physical/emotional/mental capabilities

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reinforcing factor

support, encouragement from others (ex. workplace has a gym)

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belief

an appraisal of the relationship between some object, action, or idea and some attribute of that object, action, or idea (what you think)

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attitude

a relatively stable set of beliefs, feelings, and behavioural tendencies in relation to something or someone

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health belief model

  • explains how beliefs may or may not influence behaviours

  • factors that support belief that change is needed:

    • perceived seriousness of the health problem

      • how big of a deal you think it is

    • perceived susceptibility to the health problem

      • if you think you are to get it

    • cues to action

      • places to be physically active

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what is theory of resoned action

suggests that behaviours result from intentions, which are influenced by:

  • attitudes towards the behavior

  • subjective norms

  • perceived behavioural control

  • It posits that people are more likely to engage in a behavior if they have a positive attitude towards it and perceive social pressure to perform the behavior.

<p>suggests that behaviours result from intentions, which are influenced by:</p><ul><li><p>attitudes towards the behavior </p></li><li><p>subjective norms</p></li><li><p>perceived behavioural control</p><p></p></li><li><p>It posits that people are more likely to engage in a behavior if they have a positive attitude towards it and perceive social pressure to perform the behavior.</p></li></ul>
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Theory of reasoned action: What is attitude toward the behaviour?

  • how we think about the action will affect if we try it

  • does it sound fun, do we like it, are we good at it?

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Theory of Reasoned Action: subjective norm

  • what you think other people will think of you doing this behaviour

  • pressure of what others want you to do

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theory of reasoned action: perceived behavioural control

  • do you think you have control over this action

  • sometimes perceived different than actual (think we can’t but can)

  • manage it? equipment? time?

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theory of reasoned action: attitude toward the behaviour

  • does it sound fun

  • how we think about the action will affect if we try something

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sources of efficacy

  • mastery experience

  • verbal persuasion

  • vicarious experience

  • physiological/affective states

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mastery experience

actual experience

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verbal persuasion

positive encouragement

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vicarious experience

seeing similar others do well in it

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physiological/affective states

  • positive mood and how you are feeling in the moment

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what source of efficacy is most related to norms

  • vicarious experience most related to norms

  • knowing similar others can do it, so can you

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behaviour change techniques

  • shaping: developing new behaviours in small steps

  • visualizing: the imagined rehearsal

  • modeling

  • controlling the situation

  • reinforcement

  • changing self-talk

  • self-assessment: antecedents and consequences

  • analyzing the behaviours you want to change

  • decision making: choices for change

  • goal setting and behaviour change: Super SMART

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describe Shaping: developing new behaviours in small steps

  • start slowly

  • keep steps small and achievable

  • be flexible

  • refuse to skip steps

  • reward yourself for meeting short and long term goals

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Visualizing: The imagined rehearsal

visualizing the perfect turnm how to stand up from a fall

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modeling

careful observation of other (role model)

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controlling the situation

  • situation inducement

  • pack gym runners in bag before work, avoid going home, signing up for a class at a specific time

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reinforcement

  • types of positive reinforcers to reward behaviour

    • Consumable (treat)

    • Enjoyable activity (show, movie)

    • Manipulative incentives (companies paying for memberships, bonus for being active)

    • Possessional (medal)

    • social

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Pros and Cons of reinforcement

pros:

  • gets people started

Cons:

  • don’t want to get reliant on rewards

  • compare rewards to previous times

  • can become expectation

  • only focuses on external motivation, need internal motivation to continue long term

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changing self talk

  • Rational emotive therapy

    • close connection between what people say to themselces and how they feel

  • meichenbaum’s Self-instructional methods

    • self instructions and positive affirmation

  • blocking or thought stopping

    • purposely stopping negative thoughts

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self talk example

  • negative

    • I hate going to the dentist, it’s scary

  • positive

    • while it might involve temporary pain, I’ll feel much better long term once I have this toothache looked at

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analyzing the behaviours you want to change

  • frequency

  • duration

  • seriousness

  • basis for the problem behaviour

  • antecedents

    • what comes before this event that caused it?

    • skipping a workout because tired of work

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decision making: choices for change (DECIDE)

  • decide in advance what the problem is

  • explore the alternatives

  • consider the consequences

  • identify your values

  • decide and take action

  • evaluate the consequences

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Super smart goals

  • Self-controllable

  • Public

  • Rewards

  • Specific

  • Measurable

  • Adjustable

  • Realistic

  • Time based

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mid-late 20th century implementation of health education

  • only effective for those in upper middle class

  • some people do not have the same lifestyle choices as others

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determinants of health

  • gender

  • race

  • income and income distribution

  • education

  • social exclusion

  • early life

  • indigenous health

  • food security

  • social safety net

  • health services employment and working conditions

  • housing

  • unemployment and job security

  • disability

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income and income distribution

  • strong link between SES and health

  • influences other determinants of health

  • affects overall living conditions, psychological functioning, and influences health related behavior like diet, physical activity, alcohol

  • hollowing out of the middle class

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relationship of life expectancy and income

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