Practical Health Promotion

This introductory textbook focuses on the range of skills needed to become an effective health promotion practitioner. This textbook is filled with definitions, how-to tips, and practical activities that link to everyday life to encourage reflective practice and facilitate applying skills learned. This textbook is organized around the iterative health promotion planning cycle from needs assessment through evaluation. Part I of the book covers the use of epidemiology in analyzing health impact and behavioral factors. It encourages understanding the lifespan processes for developing tailored intervention for people at different stage of the life course. Part II introduces core health promotion strategies, and Part III discusses settings in health promotion. Part IV ends with managing and implementing health promotion programs and evaluation. This textbook provides a helpful guide and practical tips for students at all levels, and serves as a valuable resource for those who seek to incorporate health promotion practice in serving their clients.

The authors are principal and senior lecturers at Leeds Metropolitan University, located in Leeds city, the biggest business district outside of London in the United Kingdom. Leeds Metropolitan University has a strong tradition in health promotion and public health. Drs. Hubley and Woodall’s specialty are in health promotion. Dr. Copeman is an expert on nutrition and dietetics and her specialty area is nutrition in the elderly.

Part I consists of four chapters. Chapter 1 covers the foundation of health promotion and public health. The authors highlight health promotion as a key area of public health practice, and regroup the five core components of the Ottawa Charter into three categories: health education (develop personal skills and strengthen community action), service improvement (reorient health services to broaden to other sectors), and advocacy (build healthy public policy and create supportive environment). The areas in health promotion often debated are discussed, including the relevance of medical versus social model, individual versus structural approaches, levels of health promotion practice, core values, coercion/persuasion/empowerment approaches, and ethics and principles, in addition to a brief overview on the iterative cycle of health promotion planning processes.

Chapter 2 introduces epidemiological tools for health promotion, in terms of assessing needs and priorities, analyzing data, and determining causes and risk factors for prevention. Chapter 3 seeks to understand the various types of behaviors, behavioral influence on health and illness, how behaviors operate at the individual, family, community, and society levels, and how various behavioral models can be used to help plan tailored health promotion interventions. The role of culture on health and integrative models such as ecological model and health action model are highlighted. Chapter 4 discusses critical issues related to the life span approach, including developmental milestones, cohort effects, life events, the role of family, and ceremonies in marking life transitions, and so on. Culture, ethnicity, class, and the age cohort, all important influencers on significant events in life course, are discussed.

Part II consists of six chapters defining six major health promotion strategies. Chapter 5 focuses on one-to-one communication, which can take place in health facilities, workplace, home, community, and so on. Principles on how to listen actively and common barriers in interpersonal communication are provided. In addition, how to assess provider–patient interaction, work with interpreters, break bad news, and assess the quality of one-to-one communication are highlighted. Chapter 6 discusses the contribution of groups in health promotion programs, factors affecting the success or failure of groups, as well as small-group teaching techniques including participatory learning and assertiveness training. Assertiveness training helps members put forward their idea in a positive, nonaggressive way, and is an important skill in group settings. Chapter 7 discusses the role of mass media, which has the capacity to reach large numbers of people quickly. The authors also illustrate how to use the six-stage model of communication theory for planning mass media—reach the intended audience, attract attention, understand the message, promote message acceptance, produce behavior change, and improve health.

Chapter 8 illustrates the role of print media in health promotion. The authors highlight the importance of matching the levels of readability and literacy for the intended audience to make the the most effective use of print media. Issues such as word choice, length of sentences, and complexity of ideas, layout, as well as visual communication are discussed. The authors also provide a step-by-step framework for producing a leaflet from needs assessment, concept design, graphic design and pretesting, production, distribution, and evaluation. The specific “how-to tips” on doing readability tests, designing the text, and pretest printed materials are also provided. The Internet and stand-alone computer-based technologies such as touch screen, CD-ROMs/DVDs/multimedia are described in Chapter 9. The interactive nature and potential for tailored health information make the Internet and computer-based media a valuable source of information. Special issues of web-based support groups and web access for disabled groups are also highlighted to encourage critical thinking of addressing inequalities. Chapter 10 focuses on advocacy for health. An important role of advocacy activities is to get health issues on the agenda for policy makers, the media, and public. The authors describe various health movements as an important new force in modern society, and illustrate the planning process for advocacy programs. In addition, practical how-to tips on forming partnerships, working with the press, using local media, planning media events, speaking in public, and using the Internet for advocacy are provided.

Part III consists of five chapters defining health promotion strategies in community, health-facility, worksite, and institutional settings. Chapter 11 starts with defining the community as an important setting for health promotion, and moves to the various theoretical bases for community health promotion, such as community development, empowerment, social capital, coalitions, and so on. The authors draw together a number of community level elements and introduce the “building blocks” for developing healthier communities (Henderson, Summer, You, & Raj, 2004) to illustrate the complexity and intersectoral nature of community-level health promotion. Furthermore, a checklist to assess the level of community participation, which is adapted from a measure of participation in primary health care (Rifkin, Muller, & Bichmann, 1988), is suggested. Working with communities involves a cycle of entry, initial actions, further actions, evaluation, reflection and further actions. The authors also introduce the World Health Organization’s healthy city program in this chapter (World Health Organization, 2009).

Chapter 12 aims to improve the reader’s ability to plan patient education programs in health facility setting. The authors introduced the concept of a health promoting waiting area in the primary care settings and a structured patient education approach. The health promotion debates regarding patient-compliance versus health empowerment approach are highlighted to encourage readers consider shifting from information transfer to information exchange (Lee & Garvin, 2003). Finally, the role of health promotion in key health settings such as pharmacies and hospitals are discussed. Chapter 13 moves to health promotion in one of the most important, yet underutilized, settings—the workplace. This chapter highlights the positive and negative influences workplaces have on health, and encourages readers to consider the potential of workplaces for both occupational and general health promoting topics. Issues such as workplace health policies, the types of workplace programs, teamwork, and challenges in workplace health promotion are discussed.

Chapter 14 focuses on settings used by children and young people, including nurseries, schools, out-of-school clubs, colleges, and higher education. The authors encourage readers to critically think how the 10 areas of the National Curriculum could contribute to the health of preschool children (National Curriculum Authority, 2000). School environment, school health services, and health education are three broad ways schools could promote school children’s health. The advantages and challenges of health education as part of other subjects versus a subject area in the National Curriculum for school children are highlighted. Concrete learning methods for school health education, components of World Health Organization’s health promoting schools, and strategies to reach children and young people in out-of-school settings are also discussed. Chapter 15 focuses on health promotion for institutional settings. Although residents at institutional settings can be permanent or transitional, the common feature of many institutions where residents often experience loss of control and freedom and are not there by choice pose unique opportunities, and require special considerations including making the transition as smooth and easy as possible, and preparing for the next stage in their life course. For institutions for older people, the authors illustrate ways of refocusing active health promotion through potential life journey transitions from own home, own home with support, sheltered accommodation, to care home, and so forth. The authors advocate consideration of special needs of persons in prison settings, the role of health promotion in such settings, and the neglected needs of prisoners’ spouses and children who share in the punishment through the disruption of family life (Dixey & Woodall, 2012).

Part IV consists of two chapters and focuses on management and implementation, evaluation and reflection of health promotion practice. Chapter 16 reviews key issues of planning and management of health promotion programs. A range of useful management skills and tools are introduced for practitioners to consider when in a management role with responsibilities for supporting and supervising a team. Practical tips provided include how to write measurable objectives, prepare a work plan for strategic decision-making, delegation and supervision, create a motivating environment, manage meetings and group functioning, plan training programs, manage time and resources, and facilitate change. Chapter 17 ends with evaluation and reflection. The authors provide some basic tools and encourage readers to be reflective practitioners and apply evaluation to critically assess health promotion activities, and be familiar with resources available for professional development.

In summary, Practical Health Promotion is a valuable and much needed practical textbook in health promotion for students and practitioners at all levels. The straightforward write-up and color-coded components and layouts facilitate not only organization but also comprehension. This new edition of Practical Health Promotion also incorporates current trends and standards, both nationally and internationally, in the field. It would have been nice if the text could provide more information on the authors and their institution to provide background information and contacts for further communication in case of interest.

This text is an important contribution to advancing the practice of health promotion that challenges anyone in health profession to find practical ways of promoting health for clients they serve. The authors encourage readers to critically reflect on their own practice and apply concepts learned. Public health professionals, practitioners, students, and anyone interested in making positive changes in their community, facility, workplace, school, or institution are provided practical tips to promote healthy environment and health of the clients they serve.