Health Promotion

Promo Power - Core & Charter

• Health Promotion (WHO): "Process of enabling people to ↑ control over, & improve, their health."
• Core Principles:
  • Empowerment: People gain control over health.
  • Participation: Involving all in decisions.
  • Equity: Reducing health disparities.
  • Intersectoral Collaboration: Sectors working together.
  • Sustainability: Long-term health benefits.
• Ottawa Charter (1986, Ottawa, Canada): First International Conference on Health Promotion.
  • 📌 Mnemonic (5 Action Areas): Bad Cats Smell Dead Rats
    • Build Healthy Public Policy (e.g., seatbelt laws)
    • Create Supportive Environments (e.g., smoke-free zones)
    • Strengthen Community Action (e.g., self-help groups)
    • Develop Personal Skills (e.g., health education)
    • Reorient Health Services (focus on prevention)

⭐ The Ottawa Charter was adopted at the First International Conference on Health Promotion in Ottawa, Canada, in 1986.

Behavior Change - Mind Matters

• Health Belief Model (HBM): Predicts likelihood of behavior change. Key constructs:

  • Perceived Susceptibility: Personal risk perception.
  • Perceived Severity: Seriousness of condition.
  • Perceived Benefits: Efficacy of action.
  • Perceived Barriers: Obstacles to action.
  • Cues to Action: Triggers for action.
  • Self-Efficacy: Confidence to act.

• Transtheoretical Model (TTM) / Stages of Change: Describes process of intentional behavior change.

  • Stages: Precontemplation (No intent), Contemplation (Intent in 6 months), Preparation (Action in 1 month), Action (Behavior changed <6 months), Maintenance (Behavior changed >6 months), Termination (No relapse).
  • 📌 Mnemonic: People Can't Prepare All Meals Today.

  ⭐ Relapse is common in TTM, often cycling to earlier stages, not necessarily linearly.

• Theory of Planned Behavior (TPB): Links beliefs to behavior via intention. Constructs:

  • Attitude: Towards behavior.
  • Subjective Norms: Social pressure.
  • Perceived Behavioral Control (PBC): Perceived ability.
  • These influence intention, which predicts behavior.

• Model Comparison:

  Feature	HBM	TTM	TPB
  Focus	Threat perception	Stages of change	Intention formation
  Key Driver	Perceived threat, benefits vs barriers	Readiness to change	Attitudes, norms, PBC

Promoting Health - Action Stations

• Approaches:
  • Medical/Preventive: Disease prevention (e.g., immunization).
  • Behavioral Change: Lifestyle modification (e.g., healthy diet).
  • Educational: Knowledge for health choices (e.g., hygiene education).
  • Empowerment: Enabling control over health (e.g., SHGs).
  • Social Change: Modifying societal norms (e.g., gender equality).
• Methods & Examples (India):
  • IEC (BCC): Pulse Polio campaign.
  • Social Marketing: ORS promotion.
  • Advocacy: For pro-health policies (e.g., tobacco tax).
  • Legislation & Policy: COTPA (Tobacco control).
  • Community Mobilization: Swachh Bharat Abhiyan.
  • Intersectoral Coordination: Mid-Day Meal Scheme.

⭐ 'Primordial prevention' is a key strategy in health promotion, aiming to prevent the development of risk factors.

Indian Initiatives - Nation's Pulse

• National Health Mission (NHM) & National Health Policy (2017): Champion health promotion, preventive/promotive care, wellness, intersectoral action for 'Health for All'.
• Ayushman Bharat - Health & Wellness Centres (AB-HWCs): Transform primary care. Deliver CPHC: MCH, NCD screening/management, wellness, health promotion.

  ⭐ AB-HWCs aim to shift focus from curative care to comprehensive primary care including wellness and prevention.

• Key Programs with Strong Health Promotion:
  • Swachh Bharat Abhiyan (SBA): Nationwide cleanliness, hygiene, sanitation (ODF).
  • Anemia Mukt Bharat (AMB): 6x6x6 strategy reducing anemia in vulnerable groups.
  • Eat Right India (ERI): Encourages safe, healthy, sustainable diets.
  • Fit India Movement: Promotes physical activity, sports as a way of life.
  • NPCDCS: NCD prevention, early detection, management strategies.
• Grassroots Cadre (ASHA/AWW/MPW): Frontline for health education, BCC, screening, referral at community level.

High‑Yield Points - ⚡ Biggest Takeaways

• Health Promotion, per Ottawa Charter, enables people to ↑ control over & improve health.
• Ottawa Charter's 5 action areas include Healthy Public Policy & Supportive Environments.
• Approaches: Medical, Behavioural Change, Educational, Empowerment, Social Change.
• Primordial prevention (preventing risk factor emergence) is key.
• IEC & BCC are crucial for effective health promotion strategies.
• Focuses on positive health & well-being, beyond mere disease prevention.
• Models like Health Belief Model guide behaviour change interventions.