Health Promotion and Health Education

Health promotion and health education can be regarded as a system for helping people to lead a healthier life and develop attitudes and engage in behaviours that will result in good health. 

1. Individual factors: including habits, behaviours attitudes and beliefs held by the individual. Habitual and addictive behaviours are resistant to change and people must have incentives to change. One possible incentive may be knowledge of the benefits of a healthy lifestyle from health educationalists. 

2. Interpersonal factors: family and friends act as models for behaviour. It may be that for a person to change their behaviour they will need to change their friends.

3. Community factors: health promotion and education which takes place within a person's own community are likely to be more effective than national health campaigns. Communities may have specific values and established patterns of behaviour on which the campaign should focus. 

1. Information giving- about healthy diet, exercise and medical conditions associated with specific substance abuse. The information may come from the media, the internet and the medical profession. 

2. Information to motivate- certain types of information motivate the person to want to be healthy. This may be how the message is framed (fear appeals) and personalised advice. 

3. Motivational interviewing- usually on a one-to-one basis, where the resistances and motives of the individual are explored to identify what needs to change for the person to lead a healthier life.

4. Behavioural techniques- aimed at changing unhealthy behaviours and replacing them with healthy behaviours. These techniques usually involve the use of rewards, especially ones that are important for the individual. 

Aim: To review the effectiveness of work-based attempts to help employees stop smoking.

Method: Outcomes of different types of programmes were reviewed. Some programmes focused on individuals (group therapy, counselling etc.) and others were aimed at the workforce as a whole (competition, incentive schemes, bans etc). 

Results: Self-help materials had little effect. Whole workforce programmes didn't reduce smoking, although competition and incentive-based schemes did increase attempts to stop. Bans decreased consumption during the working day but had little effect on total consumption. 

Conclusion: The most effective workplace programmes to help employees stop smoking are those which focus on individuals. 

A model of behaviour change related specifically to substance abuse. Developed by Prochaska et al in 1992. This model proposes that behaviour change takes place through a six stage process. 

Stage 1: Pre-contemplation

Stage 2: Contemplation

Stage 3: Preparation

Stage 4: Action

Stage 5: Maintenance 

Stage 6: Termination 

The person is not aware that they have a substance abuse problem and have no intention of changing their behaviour. 

The person has become aware that they have a problem and starts to think about changing their behaviour. As yet no commitment has been made to change; people may stay in this stage for a long time, perhaps years. 

The person has made a decision to change their behaviour in the near future. Substance abuse level may have been reduced in preparation for ceasing to take the substance. 

Here behaviour actually changes. Once behaviour has changed for at least one day the person is in the action stage. 

The behaviour change, either reduction or cessation of substance abuse, is maintained. If a person has not abused the substance for at least 6 months then they are in the maintenance stage. The main danger in this stage is relapse. 

The new behaviour has become established and is now 'normal' for the person. Danger of relapse has passed. 

• Participants in programmes that use the Prochaska model of behaviour change report high completion rates with high success- for example people stopping smoking. 
• Smokers who try to stop smoking when in the early stages of the model are less successful than if they try to stop smoking when prepared (preparation stage) and go into the action stage. The period of abstinence from smoking is also longer. 
• Use of a stage model for health promotion and cessation of substance abuse presents the person with a structured programme that they can manage and  they can plan how to tackle each stage. When the task of stopping substance abuse is not broken down into stages, it can appear overwhelming and impossible to achieve.