Running head: DISCUSS HOW HEALTH PROMOTION PROGRAMMES CAN EMPOWER INDIVIDUALS TO CHANGE Discuss how health promotion programmes can empower individuals to change July 27, 2009 Discuss How Health Promotion Programmes Can Empower Individuals to Change Introduction With a consistently growing emphasis, supported by relevant policies and literature, on promoting health by focusing on persons capacities, strengths, and resiliency capabilities, health promotion is becoming an increasingly important concept. The word health originates from the Latin word hael (heal) that means whole. Therefore, when considering health it is important to consider the whole individual. Health has many definitions, however, the most important one is, arguably, the definition provided by the World Health Organization (WHO):…a state of complete physical, mental and social well-being, not merely the absence of disease or infirmity. As health has a number of dimensions, including physical, mental, emotional, social, spiritual and societal health, health promotion is very important and is often considered the issue of primary importance in health care. Health promotion is the process that enables individuals to enhance and maintain control over their health.
In order to achieve a state of complete social, mental, and physical well-being, a person should be able to understand, identify and to realize aspirations to satisfy basic needs and to change the environment, respectively. Therefore, heath can be considered not an objective of living but rather a resource for everyday life, becoming a positive concept that places emphasis on personal and social resources along with physical capacities. Therefore, although health promotion is merely a responsibility of health care sector, it goes far beyond lifestyle to individuals well-being. The research paper elaborates on health promotion and discusses how health promotion programmes (namely, obesity prevention programmes) can empower individuals to change. The research paper presents a conceptual framework for understanding health promotion for those with obesity as well as the importance of obesity prevention health promotion programmes for adults in the workplace. The paper considers the needs assessments, discusses its importance, provides a set of recommendations concerning models of health promotion that might be useful for this specific programme, provides explanations of the relevant models as well as its application to the target group, discusses activities that could be used to meet the obesity prevention programmes aims and objective, elaborates on ethical issues that would need to be considered so that individuals are empowered, and, finally, discusses strategies and tools that could be used to evaluate health promotion programme focusing on obesity prevention, illustrating effective and strong strategies that enhance health of the target group and, underscores the potential and power of obesity prevention approaches for restoring and protecting the health of those with obesity. Health Promotion Programmes: Obesity Prevention in the Workplace Target Group The paper focuses on health promotion programmes in the workplace, as this type of programmes positively influences the employees and employers.
The vast majority of medical authorities consider obesity the most important world health problem. Over the last few decades obesity has reached epidemic proportions in the world, and is associated with a number of serious health consequences and medical risk factors (Baldwin & Kulbok, 1992).
Obesity results in both an economic burden to health care system and personal costs, in terms of length and quality of life for the individuals. In most world countries a large proportion of these costs are borne by the private sector; therefore, no wonder that obesity prevention programmes rank high in health promotion programmes in the workplace. The obesity prevention programme will target employees (both healthy individuals and those suffering from obesity) within the different age range. The programme will focus on obesity prevention through healthy eating and obesity education.
Levels of Health Promotion: Primary, Secondary, Tertiary The programme is relatively complex one, as it will embrace three levels of health promotion, namely, primary, secondary and tertiary. Primary prevention (the prevention of the onset of obesity) will target healthy employees and will be aimed to encourage the prevention of obesity and the maintenance of healthy weight in individuals, assessment of body composition for individuals, BMI calculations, skinfold measurements, etc.. Secondary prevention (the prevention of the progression of obesity by early detection) will target employees who are suffering from obesity at an early stage. Finally, tertiary health promotion (the prevention of avoidable complications of obesity) will target employees suffering from obesity and will aim to minimize negative consequences of obesity and to encourage healthy lifestyle. In such a way, the primary health promotion will include but will not be limited to increased awareness of factors contributing to obesity, weight reduction and obesity related information, etc. The secondary health promotion will include cholesterol testing, blood pressure monitoring, etc., while the tertiary health promotion will includes but will not be limited to aids for employees suffering from obesity, adherence to medication or intervention strategies, if necessary, adoption and maintenance of healthy lifestyle, various support groups, to mention a few. All health promotion strategies, if implemented correctly, will enhance their awareness concerning obesity and associated health risks and empower individuals to change their attitude to health lifestyle (Damrosch, 1991).
Needs Assessment Planning an effective obesity prevention programme will require a comprehensive analysis of the problem to be addressed.
This analysis will play crucial role to effective development of goal and objectives for the health promotion programme that is achievable and realistic. In its turn, assessing needs is an important part of deciding what problem health promotion programme will address (Green & Kreuter, 1991).
Needs assessment is, therefore, used to identify the process that will provide an effective indication of the priority needs and address what individuals will need to improve their health. Assessing needs is important due to the following reasons. According to Naidoo and Wills (2000, p.335), there are four major reasons, namely: To improve the health of the population To maximise health potential To reduce inequalities in health To establish equity in the use of resources. In addition to these reasons, the needs assessment is required to provide a starting point for obesity prevention programme planning, to determine the employees health behaviour patterns, to respond to specific needs of the groups of employees whose health needs have not been fully met, to identify the extent and kinds of health priorities and needs in the workplace, to identify risk factors, to prioritise which improvements in employees health should be targeted, to mention a few (Flynn, 1996).
Therefore, in terms of obesity prevention programme health needs assessment should be treated as a tool utilized to adopt a needs-led approach to effective planning and providing relevant health care needs to the employees in the workplace. The obesity prevention programme will be based on normative and felt needs. Normative needs are the needs that are based on experience and opinion of the experts in compliance with the current research and findings. Health experts consider that a reduced physical activity and inappropriate nutritional intake (high fat, high calorie foods low in vitamins and minerals) are risk factors for obesity; therefore, the employees suffering from obesity might be strongly advised to maintain healthy lifestyle. Secondly, felt needs are the problems that the individuals think need addressing. Aims and Objectives With regards to obesity prevention programme, the following aims should be pursued: health awareness (raising the level of awareness concerning obesity), self-empowering (improving decision making and self-esteem levels in employees), and changing attitudes and behaviours (changing lifestyles; adopting and maintaining healthier lifestyles).
It should be also mentioned that effective health promotion programme can enhance the companys image, reduce medical care costs, and enhance productivity level within the organization. Therefore, obesity prevention programme should be developed to achieve these goals.
Basically, the goals can be divided into two categories: health goals and management goals (O’Donnell, 2001).
Management goals will imply enhanced image of the organization, reduction in medical care costs, enhances productivity level, etc. At the same time, health goals will mostly address the level of desired health change in employees suffering from obesity as well as the specific area of change (for example, fitness, nutrition, etc.).
It should be also mentioned that health and management goals will not always achieved by means of the same health promotion programme design, and the relative proprieties of these categories of goals will influence the focus of obesity prevention programme in the workplace. Recommended Model of Health Promotion In order to define what model of health promotion might be useful for obesity prevention programme, it is necessary to understand how these models can be used to help individuals to change their behaviour so they can improve their health. There are six major factors that should be taken into account before the individuals can change: The change must be self-initiated; The behaviour must be salient; The behaviour must be important over a period of time; The behaviour must not be part of an individuals coping strategies; The individuals life must not be problematic when they attempt to change; The individual must have a range of social support in place. Taking into consideration all the information above it appears that Health Promotion Change Model (Prochaska and DiClemente, 1982) is the most appropriate for obesity prevention programme in the workplace.
This model is very helpful to identify and gain in-depth understanding of the stages that employees go through when they are trying to change their behaviours (Nyamwaya, 1997).
Therefore, this model will be very helpful as it can be used in fostering positive changes and health promotion. The Change Model assumes that change is a complex process. The Change Model comprises of the six stages: Pre-contemplation stage (when the person has no motivation or desire to introduce positive changes in his/her life); Contemplation stage (the person enters this stage when he/she has enough motivation to contemplate changing his/her behaviour); Commitment stage (the person enters this stage when he/she has made decision to make necessary behavioural changes); Action stage (the person enters this stage when he/she actively changes behaviour) Maintenance stage (the person maintains changed behaviour and develops coping strategy); Relapse stage (the person enters this stage when he/she lapses into previous negative behaviour and fails to maintain changed behaviour) Ethical Issues to Be Considered so That the Individuals Are Empowered There are few ethical issues to be considered during the implementation of obesity prevention programme so that the individuals are empowered (Robertson & Minkler, 1994).
As far as ethics studies the basis of moral judgements, values and principles, it is important to consider own morals based on universal and widely accepted beliefs and values to assure that all decisions are made in ethically acceptable manner (Gillon, 1990).
Also, there are four ethical principles to be considered, as they can help to clarify decisions that should be made in relation to health promotion, namely, autonomy (the rights of individuals and the right of people to make decisions concerning their own lives); non-maleficence (doing no harm); beneficence (doing good), and justice (being fair and equitable).
With regards to autonomy principle, the health care practitioner should identify whether he has the right to intervene, as this involves making an ethical decision.
The practitioner should avoid simply accepting the individuals right to autonomy when the individual is engaged in harmful or detrimental behaviour. The health care practitioner can intervene the individuals right to autonomy to ensure that he or she is aware of the right to make own choices concerning behaviour. In this case this can be considered ethical (also called empowerment).
Non-maleficence and beneficence are less complex but still may lead to ethical dilemmas in health promotion relating to putting the common good before the individual good. It is very important to carefully consider whether the benefits to community outweigh the harm to few individuals. Finally, justice relates to being equitable and fair. In relation to health promotion programme, justice principle involves making decisions concerning treating individuals equally and is interrelated with beneficence and non0maleficence principles. Justice involves respect for group and individual rights, fair distribution of resources, and following morally acceptable laws. Compliance with these ethical principles will help to make more effective and ethical decisions during implementation of health promotion programme. While considering autonomy regarding obesity prevention programme the following ethical issues can occur.
For example, the employee may choose to behave in a way that can be considered to be detrimental to health. In this case the health care practitioner should respect the right of the employee to be autonomous but should undertake all efforts to convince the employee about positive changes in behaviour and to educate him/her concerning detrimental impact so that the employee changes decision and behaviour accordingly. Health Promotion Programme Evaluation The evaluation is very important because it relates to looking critically at what happened during the implementation of health promotion programme and making judgements concerning the programmes value, benefit, or worth. Health promotion program evaluation is importance because it provides with the information about how the programme was going, what effect it has, and what changes may be necessary to improve the program. Evaluation allows to see whether the programme is working, whether the health promotion programme achieved what was planned, to justify implementing the programme, to share experiences and to see whether the efforts were worth it (Hawe, Degeling, & Hall, 1990).
In addition to evaluating the effect of obesity prevention programme on health outcomes, the evaluation should also measure the extent to which the programme succeeded to address the long-term goals and current priorities (Owen, 1993).
The evaluation plan should include what should be evaluated, when, how, by whom and for what specific purpose and should be prepared as the obesity prevention programmes plan is developed. In addition, some baseline measures should be recorded before each set of activity is launched so that the progress of each activity against these values can be assessed. Conclusion In conclusion it should be said that health promotion programmes are very important as, if implemented appropriately, they equip individuals with knowledge and skills enabling them to maintain control over their health. Health promotion programmes can empower individuals to change, to eliminate detrimental behaviours and to foster positive changes in their lifestyle. The increase in obesity, which is interrelate with a large number of medical risk factors and serious health consequences became the issue of primary importance, as obesity has reached epidemic proportions. As obesity becomes an economic burden for employees and employers, the development of obesity prevention programme is very important. The programme will target employees in the workplace and will focus on obesity prevention.
It will embrace three levels of health promotion: primary prevention targeting healthy employees and aiming to encourage obesity prevention and maintaining healthy weight; secondary prevention targeting employees suffering from obesity at an early stage, and tertiary prevention targeting employees suffering from obesity and aiming to minimize negative consequences of obesity and to motivate employees to adopt and maintain healthy lifestyle. The programme will be based on normative and felt needs and will pursue the following objectives: health awareness, self-empowering and changing attitudes and behaviours. Health Promotion Change Model will be used in fostering positive changes and health promotion. Ethical issues will be considered so that the individuals are empowered to assure that all decisions are made in ethically acceptable manner. Finally, the programme will be evaluated to assess the effect of obesity prevention programme on health outcomes and to evaluate whether the programme was effective enough to empower individuals to change. Bibliography Baldwin, J., & Kulbok, P.
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