Implementing Health
Promotion
Course: HSC 1202
Prepared by: Dr James and Mrs Marshall
Week #4
Objectives
By the end of this session students should be able to:
 Identify common strategies used to implement health
promotion
 Discuss the roles required in facilitating health
promotion interventions.
What is the Health Promotion Strategic
Framework?
 The Health Promotion Strategic Framework is strategic framework use for health
promotion in the HSE. It has been developed to support the HSE’s strategic
objectives of promoting and improving the health of the population.
 The framework sets out clear, consistent, national objectives for the HSE in
relation to its health promotion priorities.
 The framework does not only guide the activity of the Health Promotion workforce,
but sets out a model for developing a health service that integrates health
promotion into all aspects of HSE services in line with international best practice.
(HSE National Health Promotion Office, 2011).
Strategic Framework
 The framework outlines a model of health promotion that addresses the broad
determinants of health and health inequalities, through health services,
community and education settings.
 It describes the approaches that are to be applied in each setting and sets out
priority objectives and actions for national processes to support the implementation
of the framework and for each of the three priority settings identified (HSE National
Health Promotion Office, 2011).
Health promotion priorities in the health
service setting
 In the health service setting, the framework outlines an approach that focuses on
creating an appropriate balance between the promotion of health and the
prevention and treatment of disease.
 The main objective for the health setting is the development of a Health Promoting
Health Service (HPHS). Through implementation of this objective, the health
service itself becomes health promoting, and not just a place in which health
promotion activity takes place. This means that the environment, the staff-patient
relationship, and the services, are designed to improve and sustain health and
wellbeing (HSE National Health Promotion Office, 2011).
Health promotion priorities in health
services settings
 Health promotion priorities in the community setting Within the community
setting, the priority objective is to develop and implement a model for health
promoting communities that will enable and empower communities and individuals
to have greater influence over factors that affect their health. A strong focus on
inter-sectorial collaboration is essential to achieve this objective.
 Health promotion priorities in the education setting Within the education
setting, the priority objective is to implement a nationally agreed model for
promoting health in preschool, primary, post-primary, third level and out-of-school
settings based on existing Health Promoting School (HPS) approaches. (HSE
National Health Promotion Office, 2011).
The purpose of the HPSF
 The Purpose of HPSF is to set out the means by which
the HSE will:
 1. Achieve its strategic objectives of protecting, promoting and
improving the health of the population
 2. Ensure health promotion practice throughout the health
service is in line with international evidence
 3. Build the capacity of the organization to improve health and
wellbeing within the population and across the social gradient
The purpose of the HPSF
 4. Integrate health promotion into all aspects of its service (i. e.
progress the development of the HSE as a health promoting health
service based on international best practice) (HSE National Health
Promotion Office, 2011).
 5. Develop a robust multi-sectorial approach in all settings to
addressing the social determinants of health and health inequalities
 6. Increase the effective and efficient use of resources to promote
the health of the population thus reducing the cost burden of
chronic disease
 7. Ensure value for money (VFM),particularly in the context of a
reducing workforce (HSE National Health Promotion Office, 2011).
Interventions for Health Promotion
There are a number of health promotion interventions
used to maintain the health of populations. These
interventions include (but are not limited to) the
following:
 Screening
 Health Education
 Nutrition counselling
 Exercise
 Stress management
 Holistic health strategies (Edelman & Mandle, 2006)
Interventions for health promotion
 Screening
• Screening is a valuable tool for health care professionals,
particularly as the paradigm shifts from a medical to a prevention
context (Edelman, 2006)
• Though education about screening falls under the umbrella of
primary prevention, the actual process of screening is a form of
secondary prevention.
• The primary objective of screening is to detect a disease in its
early stages, to treat it & deter its progression.
• The basic assumption behind screening is that detection during
the early asymptomatic period allows for treatment at a time
when the course of the disease can be altered significantly
(Edelman, 2006)
Interventions for health promotion
 Screening cont’d
• The concept of screening is based on the principle that diseases
frequently are preceded by a period of asymptomatic
pathogenesis(disease development) when the risk factors that
predispose an individual to that condition are building momentum
towards manifestation of the disease (Edelman, 2006).
• Screening takes advantage of the pre-pathogenic state & the
early pathogenic state identifying risks in the earliest & most
treatable stages.
• The tests conducted during the asymptomatic stages identify
specific variables that distinguish individuals who most likely
have, or have an increased risk for, the condition from those who
do not (Edelman, 2006)
Interventions for health promotion
 Screening cont’d
• The ultimate goal of screening is to prevent further development of the condition &
to ameliorate the possible outcomes.
• Secondly, it aims at reducing the costs of managing the disease by avoiding the
more vigorous interventions required during its later stages (Edelman, 2006)
Advantages of Screening
Screening tests offer several advantages:
• They are often simple & inexpensive.
• It can be applied to both individuals & large groups.
• Can provide one-test disease-specific screening or multiple test screening
• It creates an opportunity for providing health education to a group of individuals
who may not otherwise receive it (Edelman, 2006).
Interventions for health promotion
 Disadvantages of Screening
• The disadvantages of screening stem largely from the imperfection
of modern science which results in a margin of error for most
instruments & tests (Edelman, 2006)
Interventions for health promotion
Selection of a screenable disease
• The selection of a screenable disease goes beyond examination of the disease
alone. The selection process must also encompass less-tangible factors, such
as the emotional & financial impact of the disease’s detection on the screened
population (Edelman, 2006)
• The answers to the following three questions provide a basis for
designating a disease as screenable or not screenable:
1. Does the significance of the disorder warrants its consideration as a
community problem?
2. Can the disease be detected by screening?
3. Should screening for the disease be done?
A. What are the health benefits?
B. What are the tangible & intangible costs?
(Edelman, 2006)
Interventions for health promotion
 Exercise
Regular physical activity & exercise enhance both physical &
psychological health (Edelman, 2006)
• Physical activity is referred to as “bodily movement that is
produced by the contraction of skeletal muscles & that substantially
increases energy expenditure” (Edelman, 2006).
• Exercise is defined as “planned, structured & repetitive bodily
movement performed to improve or maintain one or more
components of physical fitness (Edelman, 2006).
Areas of focus should include:
• Effects of exercise on the aging process, cardiac risk factors and
other diseases associated with old age (Edelman, 2006)
Interventions for health promotion
 Nutrition counselling
Focus areas should include:
• Awareness of what the recommended dietary allowance for each
nutrient is.
• Identification of foods rich in the essential nutrients.
• Effects of dietary excess and imbalances(health problems caused
or exacerbated by poor nutrition).
• Consumption of fortified foods(many manufacturers add
additional nutrients to their food products).
• Indications for nutrient supplementation & vitamin toxicity.
• Food safety; food borne illnesses, methods of preparation.
(Edelman, 2006)
Stress Management
Before discussing the management of stress, it is important to be
knowledgeable about the sources of stress, the effects of stress & the
health benefits of managing stress (Edelman, 2006).
 Stress Management Interventions
• Developing self-awareness-this is one of the most effective stress
management tools. Self-awareness helps people learn about
interactions among mind, body & spirit; increases a sense of control
& counters self-defeating perceptions. Self awareness helps
individuals recognize stress that they create through negative,
exaggerated, unrealistic thinking.
• Healthy diet-The body requires rest, a healthy diet of balanced food
choices & exercise if it is to overcome stressors.
• Sleep hygiene-Good health & the ability to meet life’s many
demands & manage stress effectively require proper rest.
Reference
Edelman, C & Mandle, C(2010) Health Promotion
throughout the Lifespan(7th Ed.). St. Louis, Mosby Inc.
HSE (2011). Health Promotion Strategic Framework:
Main report. Retrieved from
http://www.healthpromotion.ie/hpfiles/docs/HPSF_HSE.pdf