HEALTH

PROMOTION,
RISK
REDUCTION
AND CAPACITY-
BUILDING
STRATEGIES
Chapter 5
OBJECTIVES:
Demonstrate an understanding of the difference between health promotion and
health protection.
Define risk.
Discuss the relationship of risk to health and health promotion activities.
List health behaviors for health promotion and disease prevention.
Relate the clinical implication of health promotion and risk reduction activities.
Analyze a health promotion program using the Ottawa Charter for Health
Promotion
Differentiate health education from patient education.
Describe effective health education.
 HEALTH PROMOTION
“Any combination of health education and related organizational,
economic, and environmental supports for behavior of individuals,
groups, or communities conducive to health”
- Green and Kreuter (1991)

A behavior that is motivated by the desire to increase well-being and to

reach the possible health potential.
- Parse (1990)
 HEALTH PROTECTION
Refers to the behaviors in which one engages with
the specific intent to prevent disease, or to
maximize health within the constraints of disease.
- Parse (1990)
RISK – the probability that a specific event will
occur in a given time frame. (Oleckno, 2002)

RISK ASSESSMENT – is an exposure that is

associated with a disease. (Friis, 2004)
THREE CRITERIA FOR ESTABLISHING A
RISK FACTOR:
The frequency of the disease varies by category, or
amount of the factor.
The risk must precede the onset of the disease.
The association of concern must not be due to any
source of error.
 RISK ASSESSMENT
Is a systematic way of distinguishing the risks posed by
potentially harmful exposure.
Hazard Identification
Risk Description
Exposure Assessment
Risk Estimation
 TWO TYPES OF RISKS
Modifiable Risks – are those aspects of health risk over
which an individual has some control.

Non-modifiable Risks – are those aspects of risk over

which one has little or no control.
RISK REDUCTION – a proactive process in
which individuals participate in behaviors that
enable them to react to actual or potential
threats to their health. (Pender, 1996)

RISK COMMUNICATION – is the process

through which the public receives information
regarding possible or actual threats to health.
DIET– one of the most modifiable of risk factors.

Over weight and Obesity - defined as abnormal or excessive fat

accumulation that may impair health.

Malnutrition- lack of proper nutrition, caused by not having

enough to eat, not eating enough of the right things, or being
unable to use the food that one does eat.
PHYSICAL ACTIVITY

WEIGHT BETTER FIT INTO FAVORITE

INCREASE ENERGY
MANAGEMENT APPEARANCE CLOTHES

PREVENT DEVELOPMENT STRESS IMPROVING INCREASE

OF CHRONIC ILLNESS MANAGEMENT MOOD SELF-ESTEEM
WALKABILITY SURVEY
Walking path modal conflict
Availability of walking paths
Availability of crossings
Grade crossing safety
Motorist behavior
Amenities
Disability infrastructure
Obstructions
Security from crime
 SLEEP
AN ESSENTIAL COMPONENT OF CHRONIC DISEASE PREVENTION
AND HEALTH PROMOTION

THE SLEEP IS REGULATED BY TWO PROCESS:

THE LONGER WE ARE AWAKE, THE STRONGER THE DESIRE TO SLEEP.
2. CIRCADIAN BIOLOGICAL CLOCK
IN THE BRAIN, SUPRACHIASMATIC
NUCLEUS, WHICH RESPONDS TO
LIGHT.
SLEEP HYGIENE
Avoid caffeine and nicotine close to bedtime.
Avoid alcohol as it can case sleep disruption.
Retire and get-up at the same time everyday.
Exercise regularly, but finish all exercise and vigorous activity at least 3 hours
before bedtime.
Establish a regular, relaxing bedtime routine (a warm bath, reading a book)
Create a dark, quiet, cool sleep environment.
As much as circumstances allow, have
c comfortable beddings.
Use the bed for sleep only; do not read, listen to
music, or watch TV in bed.
Avoid large meals before bedtime.
HOW MUCH SLEEP DO YOU REALLY NEED?
AGE SLEEP NEEDS
NEWBORN (1-2 MONTHS) 10.5 – 18 HOURS

9-12 HOURS DURING NIGHT AND 30 MINS

INFANTS (3-11 MONTHS) TO TWO HOUR NAPS, ONE TO FOUR
TIMES A DAY

TODDLERS (1-3 YEARS) 12 – 14 HOURS

PRESCHOOLERS (3-5 YEARS) 11 – 13 HOURS
SCHOOL-AGED CHILDREN (5-12 YEARS) 10 – 11 HOURS
TEENS (11-17 YEARS) 8.5 – 9.25 HOURS
ADULTS 7-9 HOURS
OLDER ADULT 7 9 HOURS
TOBACCO AND HEALTH
RISK
Smoking causes cancer, heart disease,
stroke, lung diseases, diabetes, and chronic
obstructive pulmonary disease (COPD),
which includes emphysema and chronic
bronchitis. Smoking also increases risk for
tuberculosis, certain eye diseases, and
problems of the immune system, including
rheumatoid arthritis.
STEPS TO QUIT SMOKING
1.Make a decision to quit.
2.Set a date to quit and choose plan.
3.Deal with withdrawal.
4.Staying off of tobacco is a lifelong
process.
ALCOHOL CONSUMPTION
Alcohol consumption is a causal factor in more than
200 diseases, injuries and other health conditions.
Drinking alcohol is associated with a risk of developing
health problems such as mental and behavioural
disorders, including alcohol dependence, and major
noncommunicable diseases such as liver cirrhosis, some
cancers and cardiovascular diseases.
HEAVY DRINKER– Is defined as consuming
more than two drinks per day on average for
men, or more than one drink per day for
women.

BINGE DRINKER– Is drinking five or more

drinks on a single occasion for men, or four or
more drinks on a single occasion for women.
SHOULD NOT DRINK ALCOHOL AT ALL
 OTTAWA CHARTER FOR HEALTH
PROMOTION
Organized by the WHO, the first International Conference on Health
Promotion was held at Ottawa, Canada on November 17-21, 1986.
The Charter, signed during this conference, calls for a commitment to
health promotion to achieve the goal of Health for All by the year 2000 and
beyond.
The Charter defines health promotion as the process of enabling people to
increase control over, and to improve, their health, which requires that an
individual or group must be able to identify and realize aspirations, to
satisfy needs, and to change or cope with the environment.
THREE BASIC PRINCIPLE OF
HEALTH PROMOTION
ADVOCACY for health to provide for the conditions
and resources essential for health.
ENABLING all people to attain their full health
potential.
MEDIATING among the different sectors of society
in efforts to achieve health.
PREREQUISITES FOR HEALTH
PEACE
SHELTER
EDUCATION
FOOD
INCOME
A STABLE ECOSYSTEM
SUSTAINABLE RESOURCES
SOCIAL JUSTICE AND EQUITY
FIVE PRIORITY ACTION AREAS
1 Build Healthy Public Policy

2 Create Supportive Environment

3 Strengthen Community Action

4 Develop Personal Skills

5 Reorient Health Services

Build Healthy Public Policy
Health promotion puts health on the agenda of
policy makers in all sectors and at all levels,
directing them to be aware of the health
consequences of their decisions and to accept
their responsibilities for health.
Create Supportive Environment
Promotes health and assists people in making healthy
lifestyle choices. This priority recognizes the impact
that broader determinants have on health and aim to
promote a healthy physical and social environment for
the community to allow people to live healthy lives.
Strengthen Community Action
Focuses on building link between individuals and
the community and the centers around the
community working together to achieve a
common goal. Skills need to be developed in the
community in order for action to be taken to
improve healthy.
Develop Personal Skills
Education is the key aspect of this
priority. It refers to gaining knowledge
and life skills to make informed decisions
that may indirectly effect their health.
 Reorient Health Services
Refers to reorienting the health system so that
it promotes health as opposed to only
focusing on diagnosis and treating illness, as
is it the case with the biomedical model.
 SAMPLE CASE
Element of Building Create Strengthen Reorient
Develop
Charter Healthy Supportive Community Health
Personal Skills
(Issues) Public Policy Environment Actions Services
Childhood Develop a Run a Develop a Teach student Invite a local
Obesity in healthy lunch breakfast school about healthy Doctor or
primary policy. Tax on program and approach to eating so they Dietician to
schools junk food make a healthy eating can make talk about the
canteen a and include healthy dangers of
healthy food healthy recipes choices in unhealthy
zone. in the school food eating.
newsletter. technology
and health
classes.
HEALTH EDUCATION– is a process of
changing people’s knowledge, skills, and
attitudes for health promotion and risk
reduction.

PATIENT EDUCATION– refers to a series of

planned teaching-learning activities designed for
individuals, families, or groups with an identified
alteration in health.
THE EFFECTIVE NURSE EDUCATOR
Message Format Environment

Experience Participation Evaluation

Community Health Worker
or Barangay Health Worker
The goal it to volunteers’
development of competencies that
will enable them to provide
primary services to their own
community or neighborhood.
BHW functions; communication,
interpersonal, teaching,
organizational, and advocacy
skills.
OBJECTIVES:
√ Demonstrate an understanding of the difference between health promotion and
health protection.
√ Define risk.
√ Discuss the relationship of risk to health and health promotion activities.
√ List health behaviors for health promotion and disease prevention.
√ Relate the clinical implication of health promotion and risk reduction activities.
√ Analyze a health promotion program using the Ottawa Charter for Health
Promotion

√ Differentiate health education from patient education.

√ Describe effective health education.