0
Prof Pekka Puska
Ex Director General
National Institute for Health and Welfare (THL)
Finland
Combining medical and social
...
medical
epidemiological
framework
Social
behavioural
framework
GENERAL GOAL
- Improved Public Health
MAIN OBJECTIVES
- Spe...
“Nothing is so practical
as a good theory”
13/03/2014 Pekka Puska, Ex Director General
Major behavioral and social
theoretical perspectives
(used e.g. in North Karelia Project, Finland)
1. Social marketing Mar...
I. SOCIAL MARKETING
Background: Large experience and practice of
commercial marketing (of various products)
Question: Shou...
II. BEHAVIOUR MODIFICATION
6. COMMUNITY
ORGANIZATION
5. ENVIRONMENTAL
SUPPORT
4. SOCIAL
SUPPORT
3. PRACTICAL
SKILLS
2. PER...
1. Increased health knowledge
• simple message
• practical advise
• check understanding
• several channels
• personal cont...
2. Persuasion
• credible message source
• attention to emotional aspects
• anticipate counter arguments
• achievable goals...
3. Training for practical skills
• demonstration of desired
behaviours
• guided practice
• feed-back
• positive reinforcem...
- family
- work-site groups
- establishment of therapeutic
groups:
weight reduction etc
4. Social support
13/03/2014 Pekka...
5. Environmental modification
• food-industry
• food marketing
• restaurants, canteens etc
13/03/2014 Pekka Puska, Ex Dire...
6. Community organization
- general support in the community
for the desired goals
- formal decision making: political
lea...
III. COMMUNICATION - BEHAVIOUR
CHANGE
• Mass communication can reach large
masses
• Historical development:
- early enthus...
III. COMMUNICATION - BEHAVIOUR
CHANGE
• Well designed mass communication,
combined with relevant field work can have
meani...
IV. INNOVATION - DIFFUSION
• New risk reducing lifestyles are
innovations that diffuse in the
community following certain ...
IV. INNOVATION - DIFFUSION
Two-step flow of innovation:
a) Mass media are effective in
disseminating information
b) Opinio...
VI. COMMUNITY ORGANIZATION
• Every community is a complex network of
organizations
• Every individual in the community is
...
VI. COMMUNITY ORGANIZATION
Critical for Success:
• Collaboration calls for shared interest
• Personal contacts and trust
2...
13/03/2014 Pekka Puska, Director General
COMMENTS
• Many programmes emphasize
dissemination of information and
persuation - while the greatest problems
for change ...
COMMUNITY-BASED
(PILOT/
DEMONSTRATION)
PROGRAMMES
NATIONAL
PROGRAMMES
AND POLICIES
13/03/2014 Pekka Puska, Ex Director Gen...
PUBLIC
POLICY
HEALTH PROGRAMME
POPULATION
PRIVATE
SECTOR
13/03/2014 Pekka Puska, Ex Director General
National policies and...
FOR SUCCESSFUL
PROGRAMME
1)Do the right thing
2)Do enough of it
13/03/2014 Pekka Puska, Ex Director General
FOR SUCCESSFUL
PROGRAMME
Combine 1) leadership
with 2) partnership
13/03/2014 Pekka Puska, Ex Director General
13/03/2014 Pekka Puska, Ex Director General
Thank you
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Pekka puska combining medical and social behavioural theories to devolop strategies for prevention and health promotion ncd helsinki_10032014

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Transcript of "Pekka puska combining medical and social behavioural theories to devolop strategies for prevention and health promotion ncd helsinki_10032014"

  1. 1. Prof Pekka Puska Ex Director General National Institute for Health and Welfare (THL) Finland Combining medical and social behavioural theories to develop strategies for prevention and health promotion
  2. 2. medical epidemiological framework Social behavioural framework GENERAL GOAL - Improved Public Health MAIN OBJECTIVES - Specific NCDs, health outcomes INTERMEDIATE OBJECTIVES - risk factors, behaviours PRACTICAL INTERVENTION PROGRAMME 13/03/2014 Pekka Puska, Ex Director General
  3. 3. “Nothing is so practical as a good theory” 13/03/2014 Pekka Puska, Ex Director General
  4. 4. Major behavioral and social theoretical perspectives (used e.g. in North Karelia Project, Finland) 1. Social marketing Marketing 2. Behavior - modification (Social) Psychology 3. Communication - behavior change Communication 4. Innovation - diffusion Sociology 5. Community organization Social policy Theory Discipline area 13/03/2014 Pekka Puska, Ex Director General
  5. 5. I. SOCIAL MARKETING Background: Large experience and practice of commercial marketing (of various products) Question: Should we not market health in the same way? Yes: We should apply as much as possible the good principles of marketing: • associating the message with emotional issues • sequencing the target audience • pre-testing etc Problem: Marketing health issues is a more profound task than marketing choice of certain products 13/03/2014 Pekka Puska, Ex Director General
  6. 6. II. BEHAVIOUR MODIFICATION 6. COMMUNITY ORGANIZATION 5. ENVIRONMENTAL SUPPORT 4. SOCIAL SUPPORT 3. PRACTICAL SKILLS 2. PERSUASION 1. KNOWLEDGE (Puska and McAlister) 13/03/2014 Pekka Puska, Ex Director General
  7. 7. 1. Increased health knowledge • simple message • practical advise • check understanding • several channels • personal contacts 13/03/2014 Pekka Puska, Ex Director General
  8. 8. 2. Persuasion • credible message source • attention to emotional aspects • anticipate counter arguments • achievable goals • positive goals, minimize fear 13/03/2014 Pekka Puska, Ex Director General
  9. 9. 3. Training for practical skills • demonstration of desired behaviours • guided practice • feed-back • positive reinforcement 13/03/2014 Pekka Puska, Ex Director General
  10. 10. - family - work-site groups - establishment of therapeutic groups: weight reduction etc 4. Social support 13/03/2014 Pekka Puska, Director General
  11. 11. 5. Environmental modification • food-industry • food marketing • restaurants, canteens etc 13/03/2014 Pekka Puska, Ex Director General
  12. 12. 6. Community organization - general support in the community for the desired goals - formal decision making: political leaders, health authorities, school authorities etc - other formal leaders: business, mass media etc - informal opinion leaders 13/03/2014 Pekka Puska, Ex Director General
  13. 13. III. COMMUNICATION - BEHAVIOUR CHANGE • Mass communication can reach large masses • Historical development: - early enthusiasm - empirical nihilism - balanced view • Generally mass communication reinforces existing attitudes and behaviours 1. 13/03/2014 Pekka Puska, Ex Director General
  14. 14. III. COMMUNICATION - BEHAVIOUR CHANGE • Well designed mass communication, combined with relevant field work can have meaningful impact • Mass communication should be combined with practical work in the community, promoting interpersonal interaction • Small relative effects can mean big absolute numbers - and favourable cost effective ratio (e.g. stop smoking TV programmes in Finland) 2. 13/03/2014 Pekka Puska, Ex Director General
  15. 15. IV. INNOVATION - DIFFUSION • New risk reducing lifestyles are innovations that diffuse in the community following certain rules • Project represents change agent - people can be classified as innovators, early adopters, early and late majority and laggards • Critical mass, reaching early majority is crucial 1. 13/03/2014 Pekka Puska, Ex Director General
  16. 16. IV. INNOVATION - DIFFUSION Two-step flow of innovation: a) Mass media are effective in disseminating information b) Opinion leaders and interpersonal contacts influence opinions, attitudes and behaviour • Opinion leaders (“gatekeepers”) can be identified and used in the programme (e.g. lay leader programme in North Karelia) 2. 13/03/2014 Pekka Puska, Ex Director General
  17. 17. VI. COMMUNITY ORGANIZATION • Every community is a complex network of organizations • Every individual in the community is connected with a great number of organizations that influence his/her behaviours • The health project can work with many organizations to promote the desired changes in the community 1. 13/03/2014 Pekka Puska, Ex Director General
  18. 18. VI. COMMUNITY ORGANIZATION Critical for Success: • Collaboration calls for shared interest • Personal contacts and trust 2. 13/03/2014 Pekka Puska, Ex Director General
  19. 19. 13/03/2014 Pekka Puska, Director General
  20. 20. COMMENTS • Many programmes emphasize dissemination of information and persuation - while the greatest problems for change are issues that relate to social and physical environment • The big task and strength of community based programmes is to influence the community as a whole so that the desired behaviours are as easy as possible! 13/03/2014 Pekka Puska, Ex Director General
  21. 21. COMMUNITY-BASED (PILOT/ DEMONSTRATION) PROGRAMMES NATIONAL PROGRAMMES AND POLICIES 13/03/2014 Pekka Puska, Ex Director General
  22. 22. PUBLIC POLICY HEALTH PROGRAMME POPULATION PRIVATE SECTOR 13/03/2014 Pekka Puska, Ex Director General National policies and private sector involvment: Social change process
  23. 23. FOR SUCCESSFUL PROGRAMME 1)Do the right thing 2)Do enough of it 13/03/2014 Pekka Puska, Ex Director General
  24. 24. FOR SUCCESSFUL PROGRAMME Combine 1) leadership with 2) partnership 13/03/2014 Pekka Puska, Ex Director General
  25. 25. 13/03/2014 Pekka Puska, Ex Director General Thank you
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