The document discusses several models of health promotion: 1. Caplan and Holland's model examines how knowledge is generated about health and how society impacts health. It identifies four paradigms: radical humanist, humanist, radical structuralist, and traditional. 2. Beattie's model examines the type (authoritarian vs negotiated) and size (individual to community) of health promotion approaches. It categorizes four types of activities. 3. Tones et al's model identifies key psychological, social, and environmental factors influencing health behaviors. It shows education's role in setting agendas, raising critical consciousness, and empowering communities. 4. Tannahill's model focuses on health education,

1. Models of Health Promotion
Col Zulfiquer Ahmed Amin
M Phil, MPH, PGD (Health Economics), MBBS
Armed Forces Medical Institute (AFMI)

2. ‘Health promotion is the process of enabling people to increase control over,
and to improve, their health’.

3. A. Explain
observations
B. Predict future
observations
C. Be realistic
Model:
In science, a model is a representation of an idea, an object or
even a process or a system that is used to describe and explain
phenomena that cannot be experienced directly.

4. Why we do something, and don’t do the other?
ActionBehavior
Behavior
Intention
Personal
Attitude
Subjective
Norms
Beliefs
Direct
Observation
Information from
various sources.
eg TV
infer basing on
information
Belief about an
object or person
Belief about
some performing
Belief about some
performing with
knowledge of
‘approval’/
‘disapproval’ of
people, ‘who are
important to us’

5. Some Psychological
Terms:

6. Affect: Affect is the experience and outward expression of feelings and
emotion. Affect can be a tone of voice, a smile, a frown, a laugh, a smirk, a
tear, pressed lips, a crinkled forehead, a scrunched nose, furrowed
eyebrows, or an eye gaze.
We experience affect in the form of mood and emotions. Mood refers to the
positive or negative feelings that are in the background of our everyday
experiences. Emotions are brief, but often intense, mental and physiological
feeling states. In comparison with moods, emotions are shorter lived,
stronger, and more specific forms of affect. Emotions are caused by specific
events (things that make us, for instance, jealous or angry), and they are
accompanied by high levels of arousal. Whereas we experience moods in
normal, everyday situations, we experience emotions only when things are
out of the ordinary or unusual.

7. Cognition (Thought): Refers to the mental processes involved in
gaining knowledge and comprehension. These processes include
thinking, knowing, remembering, judging and problem-solving.
These are higher-level functions of the brain and encompass
language, imagination, perception, planning, and interpretations
of ourselves and other people.

8. Behavioral intention (BI): Refers to a person's perceived
likelihood or "subjective probability that he or she will engage in a
given behavior“.
Behavior: Refers to observable activity of an organism; anything
an organism does that involves action and/or response to
stimulation. Human behavior is the term used to describe a
person's actions and conduct.
Imagine a wrapped present. You can't see what's inside, but there
are clues available to you: the size and shape of the package, the
sound it makes when you shake it, how heavy it is, even whether
it feels solid or soft. You can make an educated guess about what
the present is if you observe all of these things.
Human behavior is like that. Everything we do and say tells the
world about what's going on inside us.

9. Attitude is a settled way of thinking or feeling about someone or
something, typically one that is reflected in a person's behavior.
In psychology, an attitude refers to a set of emotions, beliefs,
and behaviors toward a particular object, person, thing, or event.
Attitudes are often the result of experience or upbringing, and
they can have a powerful influence over behavior.
Subjective Norm: Perceived or subjective norm is "the perceived
social pressure to perform or not to perform the behavior" in
question. The perceived expectations from others that influence
a user to perform a particular behavior

10. Health Promotion Model:

11. Concepts of Health Promotion Model

19. Models of Health Promotion
Tannahill (1985) Model of health Promotion
Beattie’s (1991) Model of health Promotion
Tones and Tilford’s (1994) Model of health
Promotion
Caplan and Holland (1990) Model of health
Promotion

20. Caplan & Holland’s Model
Key features:
• More complex & theoretically driven.
• Attempts to unpick what determines health and ill-
health and therefore what activities can be used to
address health issues.
• One axis refers to a theory of knowledge and how
knowledge is generated in relation to health.
• The other axis refers to how society is constructed
and how this impacts on health.

21. MODEL OF HEALTH PROMOTION: FOUR PARADIGMS OF
HEALTH PROMOTION (CAPLAN AND HOLLAND - 1990)
RADICAL HUMANIST
• Holistic view of health
• De-professionalization
• Self-help networks
HUMANIST
• Holistic view of health
• Aims to improve understanding
and development of self
• Client-led
RADICAL STRUCTURLIST
• Health reflects structural
inequalities
• Need to challenge inequity
and radically transform society.
TRADITIONAL
• Health = absence of
disease
• Aim is to change behaviour
• Expert-led
Radical
change
Subjective
Social
regulation
Objective
Nature of knowledge
Natureofsociety

22. An objective perspective is one that is not influenced by
emotions, opinions, or personal feelings - it is a perspective
based in fact, in things quantifiable and measurable.
A subjective perspective is one open to greater interpretation
based on personal feeling, emotion, aesthetics, etc.

23. Radical Humanist Paradigm (subjective-radical change) Theorists
in this paradigm are mainly concerned with releasing social
constraints that limit human potential. They see the current
dominant ideologies as separating people from their "true selves".
They use this paradigm to justify desire for revolutionary change,
through process of education.
Humanism is an approach in study, philosophy, or practice that
focuses on human values and concerns.
Radical Structurlist: Contemporary society is characterized by
fundamental conflicts which generate radical change through
political and economic crises.

25. Beattie’s Model
Key Features:
Examines 2 axis
1. Type of approach used top-down (Authoritarian) or bottom
up (Negotiated or owned by the clients)
2. Size of approach
Categories 4 types of activities
A. Personal counseling: Working with dietician on food and
physical individual personal plans and goals.
B. Health persuasion: Campaign for eating 5 fruits and
vegetables a day on TV.
C. Legislative action: Laws that subsidize the price of healthy
food stuff
D. Community development: Communities producing and
distributing food themselves.

26. MODEL OF HEALTH PROMOTION: HEALTH PROMOTION
METHODS USING BEATTIE’S TYPOLOGY (BEATTIE – 1991)
Advice
Education
Behaviour change
Mass media campaign
Counseling
Education
Group work
Legislation
Policy making and
implementation
Health surveillance
Lobbying
Action research
Skills sharing and training
Group work
Community development
MODE OF INTERVENTION
Individual
Negotiated
Collective
Focus of intervention
Authoritarian

29. MODEL OF HEALTH PROMOTION: THE CONTRIBUTION OF
EDUCATION TO HEALTH PROMOTION (TONES et al – 1990)
Healthy public
policy
Lobbying
Advocacy
Mediation
Public pressure
Healthy social
and physical
environment
Healthy promoting
organization
Professional
education
Healthy
services
HEALTH
Healthy
choices
Agenda
setting
Education for health
Critical
consciousness
raising
Empowered
participating
community

30. The Health Action Model (HAM), developed by Tones, has two
main parts:
1. ‘Behavioral Intention’ which is composed of three dimensions
(belief, motivation, and normative) and
2. Factors that determine whether an individual's intention leads
to action.
HAM identifies key psychological, social, and environmental
factors which influence an individual adopting and sustaining
safe or unsafe related behavior.

31. Normative System - A system based on what is established as
the norm.
Health Action Model (HAM),

34. Tannahil’s Model
Spheres:
• Health-education: Communication to enhance well
being and prevent ill health through influencing
knowledge and attitude.
• Prevention: Reducing or avoiding the risk of diseases
and ill health primary through medical interventions.
• Health protection: Safeguarding population health
legislative, fiscal or social measures.

35. Dimensions:

36. Example of various dimensions in Tannahill Model

37. MODEL OF HEALTH PROMOTION: A TYPOLOGY OF HEALTH
PROMOTION (FRENCH – 1990)
DISEASE
MANAGEMENT
• Curative services
• Management services
• Caring services
DISEASE PREVENTION
• Preventive services
• Medical services
• Behaviour change
HEALTH EDUCATION
• Agenda setting
• Empowerment and
support
• Information
POLITICS OF HEALTH
• Social action
•Policy development
• Economic and fiscal
policy

38. Social action means taking steps to change the things that are
wrong in our society and introducing new ideas and processes
for doing things better in the future.
Empowerment: The term empowerment refers to measures
designed to increase the degree of autonomy and self-
determination in people and in communities in order to enable
them to represent their interests in a responsible and self-
determined way, acting on their own authority

39. Participation and Empowerment