Chapter 5 Models and approaches to health promotion
The medical approach
Aims
The medical approach to health promotion is popular because:
Public health medicine is the branch of medicine which specializes in prevention, and most day-to-day preventive work is carried out by the community health services which include specialist community public health nurses and district nurses.
Methods
For screening to be effective for the condition or disease:
What methods can you think of that are used to increase the uptake of preventive screening services?
Evaluation
The medical approach is not always successful. Recently, whooping cough has re-emerged in countries with high vaccination coverage and low mortality rates (British Medical Journal 2002). What could account for this?
You probably included some of the following:
Behaviour change
Aims
This approach aims to encourage individuals to adopt healthy behaviours, which are seen as the key to improved health. Chapter 9 shows how making health-related decisions is a complex process and, unless a person is ready to take action, it is unlikely to be effective. As we saw in Chapter 4, seeking to influence or change health behaviour has long been part of health education.
Evidence supports some factors, e.g. lack of money (Morris et al 2000). Other factors, e.g. ‘food deserts’, are more speculative (Cummins & Macintyre 2002).
It is clear that there is a complex relationship between individual behaviour and social and environmental factors. Behaviour may be a response to the conditions in which people live and the causes of these conditions (e.g. unemployment, poverty) are outside individual control.
The educational approach
Aims
The educational approach is based on a set of assumptions about the relationship between knowledge and behaviour: that by increasing knowledge, there will be a change in attitudes which may lead to changed behaviour. The goal of a client being able to make an informed choice may seem unambiguous and agreed upon. However this ignores not only the very real constraints that social and economic factors place on voluntary behaviour change, but also the complexities of health-related decision-making (see Chapter 9).