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Foundations of Health Promotion, Social Construction of Health (Disease vs…
Foundations of Health Promotion
Social Construction of Health
Prevention
Primary
: before health event occurs
Secondary
: identify cases early (before onset of symptoms / signs)
Tertiary
: prevent further deterioriation post diagnosis
Disease vs Illness
Prevention of disease, risk factors, behavior
Promotion of resilience, health engaging behavior, positive personal and social outcomes
disease
: objective presence of physiological dysfunction that results in signs & symptoms
illness
: social category; subjective experience of disease
Health Definition
Various health interpretations, dependent on
age
ethnic group
socioeconomic status
WHO definitions
health achievable, but not as an outcome; it is a mean to an unspecified end
Academic definitions
Coherence
(Antonovsky): predictability over inteernal & external environment
Self-actualization
(Maslow): achieve what you are capable of
Functional
(Parson): fulfill social role
Empowerment
(Tones & Green): empowered to achieve own sense of health
Social health
(Tones & Green): ability to be independent, to form relationships and to accept responsibility
Advantages & Disadvantages of promoting positive health
Health promotion
social / behavioral / environmental interventions (no medicine)
primary intention: health effect
addressing health using the health definition of the target group
possible: negative consequences
Individual behavior change models
Health Belief Model
self efficacy
perceived threat
outcome expectations
Transtheoretical Model
precontemplation
contemplation
determination
action
maintenance
relapse
Social cognitive theory
cognitive learning
knowledge, attitude, expectations
environmental factors
social norms, access in community, influence on others
behavioral factors
skills, practise, self-efficacy
Theory of planned behavior (=theory of reasoned action)
behavioral intention
perception / attitude towards behavior
subjective norms
perceived behavior control
Community Level Behavior Change models
Eco-social framework
individual
: behavior, skills, beliefs, knowledge
community
: social networks, peer norms, available services, local environment
society
: laws, gender relations, policies, political economy, cultural attitudes & expectations
Social cohesion
Social Capital
bonding
bridging
linking
Critical Consciousness
Collective Action
#
Participation
Asset Model
salutogenesis
Social Determinants of Health
Health Field Concept
Health care organization
Lifestyle
Human biology
Environment
Policy rainbow (Dahlgren and Whitehead)
Individual (age, sex, heredetiary factors)
individual lifestyle factors
social & community networks
Living and Working conditions
General cultural and environmental conditions
Health inequality
Material explanation
lack of resources
Neo-materialist explanation
uneven provision of services & welfare
Psycho-social concept
stress due to perceived social status, social comparision and social support
Cultural and behavioral explanations
norms strengthening certain behavior
Selection
Health causes direct/indirect descent in social class
Radical theories of state
capitalism: people's health is exchanged for economic growth
Evaluation of Health Interventions
(M)ASTOR
Aim
Settings
Target Group
Objectives (SMART)
Resourses
Mission
Political and ethical considerations
The four prinicple approach
Respect for autonomy
Non-maleficience
Beneficience
Justice