Name: Munsaka Siapwaya

ID#: Phys/16/02/000052

Course: Health promotion

Class:5.1

Lecturer: Mrs. Malambo FB

Due date: 23/11/2020

Question: Disscus the Theories of Underpining Health Promotion and Behavioral Change under the
following.

 Individual Level theories

 Community Level theories
 Organisation and Public Policy levels.

INTRODUCTION

Health promotion is more relevant today than ever in addressing public health problems. Therefore
there is a need to explain what health and health promotion is as well as outline the underpinning
theories of health promotion which will be further discussed in this assignment.

Health , as the World Health Organization (WHO) defines, is the state of complete physical, social and
mental well being and not just the absence of disease or infirmity.
Health promotion is the process of empowering people to increase control over their health and its
determinants through health literacy efforts and multisectoral action to increase healthy
behaviors(WHO,2013).

There are four levels of health promotion which are identified as environmental, social, organisational
and individual. It is argued that health promotion interventions should not be confined to one level but
instead an integrated approach should be adopted, in which the relationships between the four levels
and the outcomes at all levels ought to be considered and analysed. It is suggested that these four levels
are used as a checklist when health promotion interventions are planned

Individual level

The individual level is the most basic one in health promotion practice, so planners must be able to
explain and influence the behavior of individuals. Many health workers do one-on-one activities such as
counseling or patient education, and individuals are often the primary target audience for health
education materials. Because individual behavior is the fundamental unit of group behavior, individual-
level behavior change theories often comprise broader-level models of group, organizational,
community, and national behavior. Individuals participate in groups, manage organizations, elect and
appoint leaders, and legislate policy. Thus, achieving policy and institutional change requires influencing
individuals. In addition to exploring behavior, individual-level theories focus on intrapersonal factors
(those existing or occurring within the individual self or mind). Intrapersonal factors include knowledge,
attitudes, beliefs, motivation, self-concept, developmental history, past experience, and skills.
Individual-level theories include the following .

The Health Belief Model (HBM) : looks at the individual’s perceptions of the threat posed by a health
problem,the benefits of avoiding the threat, and factors influencing the decision to act

Stages of Change (Transtheoretical) Model :describes individuals’ motivation and readiness to change a
behavior.

The Theory of Planned Behavior (TPB:) examines the relations between an individual’s beliefs, attitudes,
intentions, behavior, and perceived control over that behavior.

The Precaution Adoption Process Model (PAPM:) names seven stages in an individual’s journey from
awareness to action. It begins with lack of awareness and advances through subsequent stages of
becoming aware, deciding whether or not to act, acting, and maintaining the behavior.

Individuals can fill various roles and have different levels of responsibility for health promotion. At the
most basic level individuals have the responsibility to promote their own health. This means becoming
educated about health, particularly the risk and protective behaviours. Individuals should then make
choices that promote their own health.Furthermore, an individual is responsible to promote health to
those around them. This includes promoting health at your school, to your peers, and family.

Community level

Community participation means the involvement of people from the earliest stages of the development
process, as opposed to simply asking their opinion of project propos-als that have already been
developed, or for their contribution to the implementationof projects imposed from
outside.Participatory approaches have been widely tested in the fields of water, sanitation and hygiene,
and experience has shown that involvement of the community can producewide-ranging benefits. This
level aim to involve all members of a society in a participatory process.

Communities should also be involved in planning environmental-management pro-grammes that seek to

reduce the risk of disasters,for facilitating recovery after a disaster has struck, and for stimulating
community organization that is the basis for sustainable development.

Community-level models explore how social systems function and change and how to mobilize
community members and organizations. They offer strategies that work in a variety of settings, such as
health care institutions, schools, worksites, community groups, and government agencies. community-
level models address individual, group, institutional, and community issues. When planning community-
level interventions, it is critical to learn about the community’s unique characteristics. This is particularly
true when addressing health issues in ethnically or culturally diverse communities. Theories under
community level;
Community Organization :Community-driven approaches to assessing and solving health and social
problems.

Diffusion of Innovations: How new ideas, products, and practices spread within a society or from one
society to another

Communication Theory:How different types of communication affect health behavior

Organization level and Public policy level

Organization level

The European Network for institution Health Promotion has defined organisation health promotion as
the combined efforts of employers, employees and society to improve the health and well-being of
people at work. This vision of workplace health promotion places particular emphasis on improving the
work organization and working environment, increasing workers' participation in shaping the working
environment, and encouraging personal skills and professional development.

Organisation level health promotion focuses on a number of factors that may not be sufficiently covered
in the legislation and practice of occupational health programmes, such as the organizational
environment, the promotion of healthy lifestyles, and non-occupational factors in the general
environment. Non-occupational factors include family welfare, home and commuting conditions, and
community factors which affect workers' health

.The organizational level has the opportunity to reach more people in different sectors of the
community. Organizations like schools, and workplaces can take it upon themselves to keep employees
and students safe from STDs. Schools can do this by making condoms available at school clinics like Apex
University does. In addition to that, an organization can provide counselling and immunization services,
coupled with effective insurance plans for workers. Making affiliates of organizations aware of these
benefits is also very important.

In this model, a community refers to the culmination of the various organizations in an area. These
organizations can pool resources and ideas together in order to improve community health. For
example, a hospital agrees to have some of its nurses teach sex education in a nearby school.
Organizations in an area could coordinate health events designed to educate and equip affiliates with
knowledge and materials to help prevent the spread of STDs in the community.

Public policy level

Public policy are Local, state, and federal policies and laws that regulate or support healthy actions and
practices for disease prevention, early detection, control, and management. They are policies that have
been considered as ‘an authoritative statement of intent adopted by governments on behalf of the
public with the aim of improving the health of the population’ (Palfrey 2000: 3).

Healthy Public Policy systematically and transparently incorporates concern for population health and
well-being into the planning and implementation of policies, programs, projects and services by
government, non-government and the private sectors by proposing actions to minimise health risk,
promote health and reduce health inequity.Building healthy public policy is the first of the health
promotion action areas listed by the World Health Organisation in the Ottawa Charter. As is central to
the promotion of health because, without the support of healthy public policy, other health promotion
actions are likely to be of limited value. As Milio (1990: 295) has expressed it.Other policies include
those that restrict behavior such as tobacco use in public spaces and alcohol sales and consumption and
those that provide behavioral incentives, both positive and negative, such as increased taxes on
cigarettes and alcohol. Additional policies relate to violence, social injustice, green policies, foreign
affairs, the economy, global warming.

governing bodies are in charge of the prevention effort. They do this by establishing agencies and laws
at every level of government to do research on the spread of STDs and figure out more effective ways of
dealing with the problem. The government should set the laws and enforce those laws. This level of the
Socio-ecological Model is important because it affects a larger portion of the population than the other
levels. For example, a law that ensures that people are immunized before joining an organization or, a
law that provides funding to the availability of condoms.

Behavioral Change Theories

A number of behavioral change theories exist to explain why people do and do not adopt certain health
behaviors. Often, these theories examine the predictors and precursors of health behavior.

The behaviour change approach promotes health through individual changes in lifestyle that are
appropriate to people’s settings [1]. The assumption is that, before people can change their
lifestyle,they must first understand basic facts about a particular health issue, adopt key attitudes, learn
a set of skills and be given access to appropriate services. The simple logic is that some behaviour leads
to ill-health, and so persuading people directly to change their behaviour must be the most efficient and
effective way to reduce illness.

The evidence about the effectiveness of behaviour change approaches is unclear, for example, about
handwashing among children [3] and cooking and food skills among adults [4]. However, this has not
prevented health promoters from continuing to extensively invest in this approach. They use a range of
techniques including interactive communication technologies, motivation, counselling, persuasion,
influencing social norms and coercion.

Fundamentally, people do not resist change, but they do resist being changed. This is a situation made
worse by health promotion programs that have an over-reliance on didactic styles of communication,
inappropriate message content and weak material development .The art of health promotion is knowing
when and how to use the science to produce a desired outcome.

Behaviour change and health promotion can be made more effective and sustainable if the following
elements are included (1) a strong policy framework that creates a supportive environment and (2) an
enablement of people to empower themselves to make healthy lifestyle decisions.

Conclusion

The underpinning theoritical Models of health promotion has proven, in many differing situations, that
in order to get the best results out of people at risk, it is best to approach the situation while addressing
all levels of the framework. Many situations can be complicated on different levels, making a multi-
faceted approach the best way to conquer a problem at all different angles.

Reference

Bernier, N. Health promotion program resilience and policy trajectories: A comparison of three
provinces.

In Health Promotion in Canada: Critical Perspectives; O’Neill, M., Rootman, I., Pederson, A., Dupéré, S.,
Eds.;

Canadian Scholars’ Press Inc.: Toronto, ON, Canada, 2007.

3. Watson, J. Does Targeting Children with Hygiene Promotion Messages Work? The Effect of
Handwashing
Promotion Targeted at Children, on Diarrhoea, Soil-Transmitted Helminth Infections and Behaviour
Change,

in Low- and Middle-Income Countries. Trop. Med. Int. Health 2017, 22, 526–538. [CrossRef] [PubMed]

4. Hollywood, L.; Surgenor, D.; Reicks, M.; McGowan, L.; Lavelle, F.; Spence, M.; Raats, M.; McCloat, A.;

Mooney, E.; Caraher, M.; et al. Identification of behavior change techniques applied in interventions to

improve cooking skills and food skills among adults. Crit. Rev. Food Sci. Nutr. 2017, 1–14. [CrossRef]

[PubMed]

5. Syme, L. Individual vs. Community Interventions in Public Health Practice: Some thoughts about a

New Approach. Vichealth Lett. 1997, 2, 2–9.

6. Corcoran, N. Communicating Health: Strategies for Health Promotion, 2nd ed.; SAGE Publications:
London,

UK, 2013.

Ståhl T, Wismar M, Ollila E, Lahtinen E, Leppo K (Eds.) (2006) Health in All Policies: Prospects and
potentials, Ministry of Social Affairs and Health: Helsinki. Access PDF

Blau J, Ernst K, Wismar M, Baro F, Gabrijelcic Blenkus M, von Bremen K, et al. (2006) The Use of Health
Impact Assessment Across Europe in Health in All Policies: Prospects and potentials (Eds Ståhl T, Wismar
M, et al.), Ministry of Social Affairs and Health: Helsinki, 209-230. Access PDF
Wismar M, Blau J, Ernst K, Elliott E, Golby A, van Herten L, et al. (2006)

Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood

Cliffs, N.J.: Prentice-Hall, 1986.

Glanz K, Rimer BK, Lewis FM. Health Behavior and Health Education: Theory, Research, and

Practice (3rd Edition). San Francisco, Calif.: Jossey-Bass, 2002.

Prochaska JO, DiClemente CC, Norcross JC. In Search of How People Change: Applications to

the Addictive Behaviors. American Psychologist 47:1102–1114, 1992.

Rosenstock IM, Strecher VJ, Becker MH. Social Learning Theory and the Health Belief Model.

Health Education Quarterly 15(2):175–183, 1988.

van Ryn M, Heaney CA. Developing Effective Helping Relationships in Health Education Practice.

Health Education and Behavior 24:683–702, 1997.

Kotler P, Andreasen A. Strategic Marketing for Nonprofit Organizations (5th Edition).

Prentice-Hall, 1996.
Office of Cancer Communications, National Cancer Institute. Making Health Communication

Programs Work: A Planner’s Guide (revised December 2001). NIH Pub. No. 02-5145, 2002.

Glanz, Karen and Rimer, Barbara K. Theory at a Glance: A Guide for Health Promotion Practice.

National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human

Services. NIH Pub. No. 97-3896. Washington, DC: NIH, Revised September 1997.

Hochman, S., Kernan, W. (2011) A social-ecological model for addressing stress on the college campus.
Retrieved May 9, 2012, from
http://health.columbia.edu/files/healthservices/alice_SocEcoStress_ACHA_2010.pdf.

Moses, K., Schoenfield, D., Swinford, P., Grizzell, J. (2011). Healthy campus: reintroducing the ecological
model and collaboration for student learning outcomes(webinar). National Association of Student
Personnel Administrators, Health in Higher Education Knowledge Community.

National Association of Student Personnel Administrators and American College Personnel Association.
(2004). Learning reconsidered: A campus-wide focus on the student experience. Washington, D.C.:
National Association of Student Personnel Administrators and the American College Personnel
Association. Retrieved May 1, 2012, from
http://www.myacpa.org/pub/documents/learningreconsidered.pdf.

Robert Wood Johnson Foundation. (2010). A new way to talk about the determinants of health.
Retrieved May 1, 2012, from http://www.rwjf.org/files/research/vpmessageguide20101029.pdf.

U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion.
(2011, November 15). Determinants of health. Retrieved May 1, 2012, from
http://www.healthypeople.gov/2020/about/DOHAbout.aspx.