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INTERVENTION STRATEGIES AND
APPROACH IN HEALTH
PROMOTION
Dr Mabasa RA
1
HEALTH PROMOTION
the process of enabling people to increase control
over, and to improve, their health.
• It moves beyond a focus on individual behaviour towards
a wide range of social and environmental interventions.
• Health promotion and disease prevention programs can
improve health at every stage of life
• There are several strategies for integrating health
promotion and disease prevention perspectives into
everyday practice
THREE TYPES OF INTERVENTION STRATEGIES
• Health Communication
• Health Education
• Policy, Systems, and Environmental Change
HEALTH COMMUNICATION
includes verbal and written strategies to influence and
empower individuals, populations, and communities to
make healthier choices
• integrates components of multiple theories and models
to promote positive changes in attitudes and behaviors
• Effective health communication and social marketing
strategies include the following components:
 Use of research-based strategies to-
shape materials and products and to select the channels
that deliver them to the intended audience.
 Understanding of conventional wisdom, concepts,
language, and priorities for different cultures and
settings.
 Consideration of health literacy, internet access, media
exposure, and cultural competency of target
populations.
 Development of materials such as
• brochures,
• billboards,.
 newspaper articles,
 television broadcasts,
 radio commercials,
 public service announcements,
 newsletters, pamphlets,
 videos, digital tools,
 case studies,
 group discussions, health fairs, field trips, and
workbooks among others media outlets
• Using communication channels can allow health
messages to shape mass media or interpersonal, small
group, or community level campaigns.
• Aims of Health communication strategies
• to change people's knowledge, attitudes, and/or
behaviors; for example:
1. Increase risk perception
2. Reinforce positive behaviors
3. Influence social norms
4. Increase availability of support and needed services
5. Empower individuals to change or improve their
Examples of Health Communication
• Messages on tobacco packets
• HIV talks on Radio
• Newspaper adverts
HEALTH EDUCATION
It is one of the strategies for implementing health promotion
and disease prevention programs
• It presents information to target populations on particular
health topics.
• health education activities include:
 Lectures
 Courses
 Seminars
 Webinars
 Workshops
 Classes
• Characteristics of health education strategies include:
 Participation of the target population.
 Completion of a community needs assessment
 Planned learning activities
 Implementation of programs with integrated, well-
planned curricula and materials.
 Presentation of information with audio-visual and
computer based supports such as slides and projectors,
videos, books, CDs, posters, pictures, websites, or
software programs.
 Ensuring proficiency of program staff, through training,
to maintain fidelity to the program model.
EXAMPLES
• Oral health outreach program
• Health talks in radio and TV stations
POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGE
(PSE)
• For health promotion and disease prevention strategies
to be successful, policies, systems, and environments
(PSE) must be supportive of health.
• Policy, systems, and environmental change strategies
are designed to promote healthy behaviours by making
healthy choices readily available and easily accessible in
the community.
POLICY CHANGE
• Policy is a tool for achieving health promotion and
disease prevention program goals.
• Policy decisions are made by organizations, agencies,
and stakeholders.
• Policy approaches include legislative advocacy, fiscal
measures, taxation, and regulatory oversight
• Examples of health promotion and disease prevention
policy approaches include:
 Establishing policies for smoke-free zones and public
events
 Establishing healthy food options in vending
machines in public places
 Adding a tax to unhealthy food options
 Requiring the use of safety equipment in a work
setting to avoid injury
SYSTEMS CHANGE
• Systems change refers to a fundamental shift in the way
problems are solved.
• Within an organization, systems change affects
organizational purpose, function, and connections by
addressing organizational culture, beliefs, relationships,
policies, and goals.
• Examples of systems change in health promotion and
disease prevention include:
 Developing plans for implementing new interventions
and processes
 Adapting or replicating a proven health promotion
model
 Implementing new technologies
 Creating training or certification systems that align
with policies
ENVIRONMENTAL CHANGE
• Environmental change strategies involve changing the
economic, social, or physical surroundings or contexts
that affect health outcomes.
• Environmental strategies address population health
outcomes and are best used in combination with other
strategies.
• Examples of environmental strategies for health
promotion and disease prevention include:
 Increasing the number of parks, and trails in the
community
 Installing signs that promote use of walking and
biking paths
 Increasing the availability of fresh, healthy foods in
schools, restaurants, and cafeterias
Examples of Health Promotion Projects in SA
• NHI
• Nursing Midwife National Strategic Direction 2020-2021
to 2025-2026 Com DOWNLOAD
• National Health Research Strategy - 2021-2024
compressed
• Management of type 2 Diabetes- Electronic copy
2014_compresseda
• National Health Research Summit Report
• Cervical Cancer Prevention and Control Policy
• Breast Cancer Control Policy
• Policy Framework on Ward Based Primary Healthcare
Outreach Teams(WBPHCOT) -2018/19 - 2023/24
• National Digital Health Strategy for South Africa 2019-
2024
HEALTH PROMOTION THEORIES
• several theories and models that support the practice of
health promotion and disease prevention.
• They are used in program planning –
i. to understand and explain health behaviour
ii. to guide the identification, development, and
implementation of interventions.
• When identifying a theory or model to guide health
promotion or disease prevention programs there are
factors to consider
• ,.
 the specific health problem being addressed,
 the population(s) being served, and
 the contexts within which the program is being
implemented
Health promotion theories and models
 Ecological Models
 The Health Belief Model
 Stages of Change Model (Transtheoretical Model)
 Social Cognitive Theory
 Theory of Reasoned Action/Planned Behavior
ECOLOGICAL MODELS
It highlights peoples interaction with their physical and
sociocultural environment`
Recognizes the multiple levels of influence on health
behaviour:
• Intrapersonal/individual factors, which influence
behaviour such as knowledge, attitudes, beliefs, and
personality.
• Interpersonal factors, such as interactions with other
people, which can provide social support or create
barriers to interpersonal growth that promotes healthy
behavior.
•
• Community factors, such as formal or informal social
norms that exist among individuals, groups, or
organizations, can limit or enhance healthy behaviors.
• Public policy factors, including local, state, and federal
policies and laws that regulate or support health actions
and practices for disease prevention including early
detection, control, and management.
THE HEALTH BELIEF MODEL
• It is used to explain and predict individual changes in
health behaviours
• key factors that influence health behaviours as an
individual's perceived threat to sickness or disease:
 (perceived susceptibility), belief of consequence
 (perceived severity), potential positive benefits of action
 (perceived benefits), perceived barriers to action,
 exposure to factors that prompt action (cues to action),
 and confidence in ability to succeed (self-efficacy).
STAGES OF CHANGE MODEL (TRANSTHEORETICAL
MODEL)
It describes the process of behaviour change as occurring
in stages or the process a person goes through in
behaviour change
These stages include:
 Pre-contemplation: There is no intention of taking
action.
 Contemplation: There are intentions to take action
and a plan to do so in the near future.
 Preparation: There is intention to take action and
some steps have been taken.
 Action: Behaviour has been changed for a short period
of time.
 Maintenance: Behaviour has been changed and
continues to be maintained for the long-term.
 Termination: There is no desire to return to prior
negative behaviours
SOCIAL COGNITIVE THEORY
• Social Cognitive Theory (SCT) describes the influence of
individual experiences, the actions of others, and
environmental factors on individual health behaviours
 Self-efficacy: The belief that an individual has control
over and is able to execute a behaviour.
 Behavioural capability: Understanding and having the
skill to perform a behaviour.
 Expectations: Determining the outcomes of behavior
change.

 Expectancies: Assigning a value to the outcomes of
behavior change.
 Self-control: Regulating and monitoring individual
behavior.
 Observational learning: Watching and observing
outcomes of others performing or modeling the desired
behavior.
 Reinforcements: Promoting incentives and rewards that
encourage behavior change.
THEORY OF REASONED ACTION/PLANNED
BEHAVIOUR
• The Theory of Reasoned Action and the Theory of
Planned Behaviour – suggest that a person's health
behaviour is determined by their intention to perform a
behaviour.
• A person's intention to perform a behaviour (behavioural
intention) is predicted by
• 1) a person's attitude toward the behaviour, and
• 2) subjective norms regarding the behaviour.
• .
• Subjective norms are the result of social and
environmental surroundings and a person's perceived
control over the behavior
• Generally, positive attitude and positive subjective norms
result in greater perceived control and increase the
likelihood of intentions governing changes in behaviour.
THANK
YOU

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PSE strategies for health promotion

  • 1. INTERVENTION STRATEGIES AND APPROACH IN HEALTH PROMOTION Dr Mabasa RA 1
  • 2. HEALTH PROMOTION the process of enabling people to increase control over, and to improve, their health. • It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions. • Health promotion and disease prevention programs can improve health at every stage of life • There are several strategies for integrating health promotion and disease prevention perspectives into everyday practice
  • 3. THREE TYPES OF INTERVENTION STRATEGIES • Health Communication • Health Education • Policy, Systems, and Environmental Change
  • 4. HEALTH COMMUNICATION includes verbal and written strategies to influence and empower individuals, populations, and communities to make healthier choices • integrates components of multiple theories and models to promote positive changes in attitudes and behaviors • Effective health communication and social marketing strategies include the following components:  Use of research-based strategies to- shape materials and products and to select the channels that deliver them to the intended audience.
  • 5.  Understanding of conventional wisdom, concepts, language, and priorities for different cultures and settings.  Consideration of health literacy, internet access, media exposure, and cultural competency of target populations.  Development of materials such as • brochures, • billboards,.
  • 6.  newspaper articles,  television broadcasts,  radio commercials,  public service announcements,  newsletters, pamphlets,  videos, digital tools,  case studies,  group discussions, health fairs, field trips, and workbooks among others media outlets
  • 7. • Using communication channels can allow health messages to shape mass media or interpersonal, small group, or community level campaigns. • Aims of Health communication strategies • to change people's knowledge, attitudes, and/or behaviors; for example: 1. Increase risk perception 2. Reinforce positive behaviors 3. Influence social norms 4. Increase availability of support and needed services 5. Empower individuals to change or improve their
  • 8. Examples of Health Communication • Messages on tobacco packets • HIV talks on Radio • Newspaper adverts
  • 9. HEALTH EDUCATION It is one of the strategies for implementing health promotion and disease prevention programs • It presents information to target populations on particular health topics.
  • 10. • health education activities include:  Lectures  Courses  Seminars  Webinars  Workshops  Classes
  • 11. • Characteristics of health education strategies include:  Participation of the target population.  Completion of a community needs assessment  Planned learning activities  Implementation of programs with integrated, well- planned curricula and materials.
  • 12.  Presentation of information with audio-visual and computer based supports such as slides and projectors, videos, books, CDs, posters, pictures, websites, or software programs.  Ensuring proficiency of program staff, through training, to maintain fidelity to the program model.
  • 13. EXAMPLES • Oral health outreach program • Health talks in radio and TV stations
  • 14. POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGE (PSE) • For health promotion and disease prevention strategies to be successful, policies, systems, and environments (PSE) must be supportive of health. • Policy, systems, and environmental change strategies are designed to promote healthy behaviours by making healthy choices readily available and easily accessible in the community.
  • 15. POLICY CHANGE • Policy is a tool for achieving health promotion and disease prevention program goals. • Policy decisions are made by organizations, agencies, and stakeholders. • Policy approaches include legislative advocacy, fiscal measures, taxation, and regulatory oversight
  • 16. • Examples of health promotion and disease prevention policy approaches include:  Establishing policies for smoke-free zones and public events  Establishing healthy food options in vending machines in public places  Adding a tax to unhealthy food options  Requiring the use of safety equipment in a work setting to avoid injury
  • 17. SYSTEMS CHANGE • Systems change refers to a fundamental shift in the way problems are solved. • Within an organization, systems change affects organizational purpose, function, and connections by addressing organizational culture, beliefs, relationships, policies, and goals.
  • 18. • Examples of systems change in health promotion and disease prevention include:  Developing plans for implementing new interventions and processes  Adapting or replicating a proven health promotion model  Implementing new technologies  Creating training or certification systems that align with policies
  • 19. ENVIRONMENTAL CHANGE • Environmental change strategies involve changing the economic, social, or physical surroundings or contexts that affect health outcomes. • Environmental strategies address population health outcomes and are best used in combination with other strategies.
  • 20. • Examples of environmental strategies for health promotion and disease prevention include:  Increasing the number of parks, and trails in the community  Installing signs that promote use of walking and biking paths  Increasing the availability of fresh, healthy foods in schools, restaurants, and cafeterias
  • 21. Examples of Health Promotion Projects in SA • NHI • Nursing Midwife National Strategic Direction 2020-2021 to 2025-2026 Com DOWNLOAD • National Health Research Strategy - 2021-2024 compressed • Management of type 2 Diabetes- Electronic copy 2014_compresseda • National Health Research Summit Report • Cervical Cancer Prevention and Control Policy
  • 22. • Breast Cancer Control Policy • Policy Framework on Ward Based Primary Healthcare Outreach Teams(WBPHCOT) -2018/19 - 2023/24 • National Digital Health Strategy for South Africa 2019- 2024
  • 23. HEALTH PROMOTION THEORIES • several theories and models that support the practice of health promotion and disease prevention. • They are used in program planning – i. to understand and explain health behaviour ii. to guide the identification, development, and implementation of interventions. • When identifying a theory or model to guide health promotion or disease prevention programs there are factors to consider • ,.
  • 24.  the specific health problem being addressed,  the population(s) being served, and  the contexts within which the program is being implemented
  • 25. Health promotion theories and models  Ecological Models  The Health Belief Model  Stages of Change Model (Transtheoretical Model)  Social Cognitive Theory  Theory of Reasoned Action/Planned Behavior
  • 26. ECOLOGICAL MODELS It highlights peoples interaction with their physical and sociocultural environment` Recognizes the multiple levels of influence on health behaviour: • Intrapersonal/individual factors, which influence behaviour such as knowledge, attitudes, beliefs, and personality. • Interpersonal factors, such as interactions with other people, which can provide social support or create barriers to interpersonal growth that promotes healthy behavior. •
  • 27. • Community factors, such as formal or informal social norms that exist among individuals, groups, or organizations, can limit or enhance healthy behaviors. • Public policy factors, including local, state, and federal policies and laws that regulate or support health actions and practices for disease prevention including early detection, control, and management.
  • 28. THE HEALTH BELIEF MODEL • It is used to explain and predict individual changes in health behaviours • key factors that influence health behaviours as an individual's perceived threat to sickness or disease:  (perceived susceptibility), belief of consequence  (perceived severity), potential positive benefits of action  (perceived benefits), perceived barriers to action,  exposure to factors that prompt action (cues to action),  and confidence in ability to succeed (self-efficacy).
  • 29. STAGES OF CHANGE MODEL (TRANSTHEORETICAL MODEL) It describes the process of behaviour change as occurring in stages or the process a person goes through in behaviour change These stages include:  Pre-contemplation: There is no intention of taking action.  Contemplation: There are intentions to take action and a plan to do so in the near future.  Preparation: There is intention to take action and some steps have been taken.
  • 30.  Action: Behaviour has been changed for a short period of time.  Maintenance: Behaviour has been changed and continues to be maintained for the long-term.  Termination: There is no desire to return to prior negative behaviours
  • 31. SOCIAL COGNITIVE THEORY • Social Cognitive Theory (SCT) describes the influence of individual experiences, the actions of others, and environmental factors on individual health behaviours  Self-efficacy: The belief that an individual has control over and is able to execute a behaviour.  Behavioural capability: Understanding and having the skill to perform a behaviour.  Expectations: Determining the outcomes of behavior change. 
  • 32.  Expectancies: Assigning a value to the outcomes of behavior change.  Self-control: Regulating and monitoring individual behavior.  Observational learning: Watching and observing outcomes of others performing or modeling the desired behavior.  Reinforcements: Promoting incentives and rewards that encourage behavior change.
  • 33. THEORY OF REASONED ACTION/PLANNED BEHAVIOUR • The Theory of Reasoned Action and the Theory of Planned Behaviour – suggest that a person's health behaviour is determined by their intention to perform a behaviour. • A person's intention to perform a behaviour (behavioural intention) is predicted by • 1) a person's attitude toward the behaviour, and • 2) subjective norms regarding the behaviour. • .
  • 34. • Subjective norms are the result of social and environmental surroundings and a person's perceived control over the behavior • Generally, positive attitude and positive subjective norms result in greater perceived control and increase the likelihood of intentions governing changes in behaviour.