1. HEALTH PROMOTION Iluminada M. Lerma, M.D.

2. A planned combination of educational, political, regulatory, and organizational supports for actions and conditions of living conducive to the health of individuals, groups, or communities. A planned combination of educational, political, regulatory, and organizational supports for actions and conditions of living conducive to the health of individuals, groups, or communities. DEFINITIONS OF HEALTH PROMOTION Green & Kreuter, 1999

3. The process of enabling people to increase control over and improve their health… The process of enabling people to increase control over and improve their health… a commitment to dealing with challenges of reducing inequities, extending the scope of prevention, and helping people to cope with their circumstances… a commitment to dealing with challenges of reducing inequities, extending the scope of prevention, and helping people to cope with their circumstances… creating environments conducive to health, in which people are better able to take care of themselves creating environments conducive to health, in which people are better able to take care of themselves DEFINITIONS OF HEALTH PROMOTION WHO, 1986

4. BASIC CHARACTERISTICS OF HEALTH PROMOTION 1.Enabling people to take control over, and responsibility for, their health as an important component of everyday life. 2.Requiring the close cooperation of sectors beyond the health services. 3.Combining diverse, but complimentary, methods or approaches. 4.Encouraging effective and concrete public participation. The Working Group on Concepts and Principles in Health Promotion, 1987

5. THE TRIAD OF HEALTH PROMOTION HEALTH EDUCATION HEALTH PROTECTION DISEASE PREVENTION

6. The Health Promotion Triad Health Education Health Protection Prevention

7. DISEASE PREVENTION THREE LEVELS Primary Secondary Tertiary

8. Primary Prevention Secondary Prevention Healthy individual Biological onset of disease Risk Factors Immunization Health Education Prophylaxis Screening Surveillance Rehabilitation Support Asymptomatic signs Functional Status Symptoms and signs Diagnosis Treatment Compliance Adherence The Phases of Prevention in relation to natural history of disease Clinical Course of disease Chronic disease Cure Disability Death Tertiary Prevention

9. PRIMARY PREVENTION -Action taken to avert the occurrence of disease J. Thomas Butler, 2001 -Interventions: o Medical o Legislative o Societal o Educational o Individual efforts

10. PRIMARY PREVENTION -The more directly a behavior is linked to a health problem as a risk factor, the better candidate it is for primary prevention efforts Simons-Morton, Greene, & Gottlieb, 1995

11. SECONDARY PREVENTION -Action taken to identify diseases at their earliest stages and to apply appropriate treatments to limit their consequences and severity. J. Thomas Butler, 2001

12. TERTIARY PREVENTION -Specific interventions to assist diseased or disabled persons in limiting the effects of their diseases or disabilities; also may include activities to prevent recurrences of a disease. J. Thomas Butler, 2001

13. Prevention Prevention MedicalLegislativeSocietalEducational Individual Efforts

14. HEALTH EDUCATION -Planned process, -Combines a variety of educational experiences, and -Facilitates voluntary adaptations or establishment of behaviour conducive to health J. Thomas Butler, 2001

15. HEALTH EDUCATION -Aims primarily at the voluntary actions people can take on their own part, individually or collectively, for their own health or the health of others and the common good of the community Greene & Kreuter, 1999

16. Learning Domains

17. Cognitive Domain Aspect of health education that comprises information and knowledge Aspect of health education that comprises information and knowledge Information gained from health education can be Information gained from health education can be  A new information  A reinforcement

18. Psychomotor Domain Aspect of health education that deals with skill acquisition and reinforcement Aspect of health education that deals with skill acquisition and reinforcement

19. Affective Domain Aspect of health education that is mainly concerned in Aspect of health education that is mainly concerned in  Habit formation  Behavior change  New practice

20. THREE MAIN PURPOSES OF HEALTH PROMOTION/EDUCATION IN TERMS APPLICABLE TO THE THREE LEVELS OF PREVENTION -Promotion of health and illness prevention -Restoration of health when one becomes ill -Maintenance of health while coping with chronic, long-term conditions Potter & Perry, 1993

21. THREE SPHERES Health Education Prevention Health Protection SEVEN DOMAINS 1.Prevention 2.Lifestyle 3.Preventive Policies 4.Policy Maker Education 5. Health Education 6. Health Protection 7. Policy Support HEALTH PROMOTION MODELS

22. 1.Prevention (Preventive Services): This domain includes primary preventive measures, such as immunization and exercise programs, and secondary preventive measures, such as pap smears, hypertension case-finding, and smoking cessation programs. This domain includes primary preventive measures, such as immunization and exercise programs, and secondary preventive measures, such as pap smears, hypertension case-finding, and smoking cessation programs.

23. 2.Lifestyle (Preventive Health Education) This includes education efforts to influence lifestyle to prevent health- related problems and to encourage the uptake of preventive services. This includes education efforts to influence lifestyle to prevent health- related problems and to encourage the uptake of preventive services.

24. THREE SPHERES Health Education Prevention Health Protection SEVEN DOMAINS 1.Prevention 2.Lifestyle 3.Preventive Policies 4.Policy Maker Education 5. Health Education 6. Health Protection 7. Policy Support HEALTH PROMOTION MODELS

25. 3.Preventive policies (Preventive Health Protection) This sphere represents health protection, including fluoridation of public water supplies and inspections of restaurants. This sphere represents health protection, including fluoridation of public water supplies and inspections of restaurants. It can be viewed as a policy commitment to the provision of preventive services such as those described under domain 1. It can be viewed as a policy commitment to the provision of preventive services such as those described under domain 1.

26. THREE SPHERES Health Education Prevention Health Protection SEVEN DOMAINS 1.Prevention 2.Lifestyle 3.Preventive Policies 4.Policy Maker Education 5. Health Education 6. Health Protection 7. Policy Support HEALTH PROMOTION MODELS

27. 4.Policy maker education (Health Education for Preventive Health Protection) Given that health protection measures do not emerge spontaneously, education of policy makers is important. Given that health protection measures do not emerge spontaneously, education of policy makers is important. Example of this is the lobbying by safety- conscious groups to encourage mandated use of automobile seat belts in the face of much public apathy. Example of this is the lobbying by safety- conscious groups to encourage mandated use of automobile seat belts in the face of much public apathy.

28. Efforts to stimulate a social environment that demands or accepts preventive health protection measures are also part of this domain (Downie, Tannahill, & Tannahill, 1996), Efforts to stimulate a social environment that demands or accepts preventive health protection measures are also part of this domain (Downie, Tannahill, & Tannahill, 1996), As is a policy commitment to preventive health education. As is a policy commitment to preventive health education.

29. THREE SPHERES Health Education Prevention Health Protection SEVEN DOMAINS 1.Prevention 2.Lifestyle 3.Preventive Policies 4.Policy Maker Education 5. Health Education 6. Health Protection 7. Policy Support HEALTH PROMOTION MODELS

30. 5.Health education (Positive Health Education) This domain comprises all aspects of positive health education, including influencing behavior by helping individuals, groups, or whole communities develop positive health attributes, such as life skills and self- esteem. This domain comprises all aspects of positive health education, including influencing behavior by helping individuals, groups, or whole communities develop positive health attributes, such as life skills and self- esteem.

31. -Health promotion encompasses health education...and is aimed at the complementary social and political actions that will facilitate the necessary organizational, economic, and other environmental supports for the conversion of individual actions into health enhancements and quality of life-gains. Greene & Kreuter, 1999

32. 6.Health protection (Positive Health Protection) This domain includes implementation of a workplace policy forbidding smoking, graduated drivers’ licenses, and commitment of public funds to provide safe-walking areas and bicycles paths. This domain includes implementation of a workplace policy forbidding smoking, graduated drivers’ licenses, and commitment of public funds to provide safe-walking areas and bicycles paths.

33. 7.Policy support (Health Education Aimed At Positive Health Protection) This domain embraces raising awareness of, and securing support for, positive health protection measures among the public and policy makers. This domain embraces raising awareness of, and securing support for, positive health protection measures among the public and policy makers. It includes a policy commitment to positive health. It includes a policy commitment to positive health.

34. THREE SPHERES Health Education Prevention Health Protection SEVEN DOMAINS 1.Prevention 2.Lifestyle 3.Preventive Policies 4.Policy Maker Education 5. Health Education 6. Health Protection 7. Policy Support HEALTH PROMOTION MODELS

35. HEALTH PROTECTION -Comprises legal or fiscal controls, other regulation policies, and voluntary codes of practice, aimed at the enhancement of positive health and the prevention of ill- health J. Thomas Butler, 2001

36. HEALTH PROTECTION MISSION – reduce the likelihood that people will encounter environmental hazards or behave in unsafe or unhealthy ways. Downie, Tannahill, & Tannahill, 1996

37. Health Protection Philippine Medical Act of 1959 Philippine Medical Act of 1959 PHILHEALTH PHILHEALTH Generics Law; National Drug Policy and Formulary Generics Law; National Drug Policy and Formulary Dangerous Drugs Act Dangerous Drugs Act Cheaper Medicine Bill Cheaper Medicine Bill Code of Sanitation of the Philippines Code of Sanitation of the Philippines

38. Health Protection Disability Act Disability Act Senior Citizens Law Senior Citizens Law Child Protection Laws and Policies Child Protection Laws and Policies Clean Air Act Clean Air Act MMDA Waste Management Policies MMDA Waste Management Policies

39. Strategies HEALTH PROMOTION

40. Strategies Educational Interventions Educational Interventions Organizational Interventions Organizational Interventions Political/ Legislative Interventions Political/ Legislative Interventions Community and Social Interventions Community and Social Interventions Economic Interventions Economic Interventions

41. Educational Interventions Stress management classes for middle- management employees in the workplace Stress management classes for middle- management employees in the workplace Mail-outs to the public describing positive steps a person can take to reduce exposure to HIV Mail-outs to the public describing positive steps a person can take to reduce exposure to HIV Educational programs designed to reduce personal vulnerability to crime Educational programs designed to reduce personal vulnerability to crime Primary school programs to develop the skills to cope with peer pressure Primary school programs to develop the skills to cope with peer pressure

42. Organizational Interventions Annual hearing and vision screening in schools Annual hearing and vision screening in schools Automobile, bicycle, and firearm safety programs conducted by law enforcement agencies Automobile, bicycle, and firearm safety programs conducted by law enforcement agencies Identification of designated smoking areas and development of a smoking policy in a worksite Identification of designated smoking areas and development of a smoking policy in a worksite Official recognition by business management of alcoholism as a disease and not a weakness in character Official recognition by business management of alcoholism as a disease and not a weakness in character Development of support groups by nonprofit organizations and facilities that provide services to people with special needs Development of support groups by nonprofit organizations and facilities that provide services to people with special needs

43. Political/ Legislative Interventions Passage of laws requiring use of helmets while riding motorcycles and bicycles Passage of laws requiring use of helmets while riding motorcycles and bicycles Legislation requiring environmental polluters to measure their pollution and implement effective plans to reduce the pollution Legislation requiring environmental polluters to measure their pollution and implement effective plans to reduce the pollution Fluoridation of the water supply Fluoridation of the water supply Regulations requiring agencies and companies to monitor air pollution and governmental actions to reduce it Regulations requiring agencies and companies to monitor air pollution and governmental actions to reduce it Regulations aimed at reducing youth access to tobacco products and alcohol Regulations aimed at reducing youth access to tobacco products and alcohol

44. Community and Social Interventions Organization and training of out of school youth to reduce vulnerability to sex or drug crimes Organization and training of out of school youth to reduce vulnerability to sex or drug crimes Formation of neighborhood walking clubs Formation of neighborhood walking clubs Health fairs at shopping malls Health fairs at shopping malls

45. Economic Interventions Tax incentives to landlords of low-income housing to encourage maintenance of property and reduction of pest infestation Tax incentives to landlords of low-income housing to encourage maintenance of property and reduction of pest infestation Incentives from insurance companies to those who practice healthy lifestyles Incentives from insurance companies to those who practice healthy lifestyles Incentives from employers to employees who stay healthy and do not miss work Incentives from employers to employees who stay healthy and do not miss work

46. THANK YOU VERY MUCH THANK YOU VERY MUCH& GOOD DAY!