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Summary Health Promotion and Disease Prevention

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Summary of all the lectures of the course Health Promotion and Disease Prevention

Voorbeeld 4 van de 59  pagina's

  • 13 december 2022
  • 59
  • 2022/2023
  • Samenvatting
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Health Promotion and Disease Prevention (HPDP)

Lecture 1: Introduction

Elementary HPDP aspects:
 Able to distinguish lifestyle and risk factors, and HPDP terminology
 Able to name and apply different types of prevention and intervention levels
 Able to name and determine different tools and instruments for HPDP intervention

Many chronic diseases are influenced by lifestyle factors:
 Lifestyle factors: BRAVVO-acronyme
 Bewegen, Roken, Alcohol, Voeding, Veilige seks, Ontspannen/stress, or;
 PA, Smoking, Alcohol, Nutrition, Safe sex, Stress
 Risk factor: when unhealthy behavioural choices are made
 PA → low levels of PA
 Smoking → >10 cigarettes a day
 Alcohol → > 7 units a day

Socio-ecological model: levels of influence over human behaviour:




Health promotion
= maintaining peoples’ current health status...and ideally shifting towards better health
 E.g. smoking reduction with the aim of maintaining an optimal respiratory and CV-
system

Disease Prevention
= preventing people getting a disease... and prevent a shift towards the seriousness of a
disease
 E.g. smoking reduction with the aim to reduce the chance of getting lung cancer

, Many lifestyle factors focus initially on Health Promotion (increase PA, reduce
smoking) → and then have an effect on Disease Prevention (preventing obesity,
preventing cancer)

Types of prevention:
1) Primary prevention
To prevent (development) of disease
2) Secondary prevention
Screening of disease/early detection
3) Tertiary prevention
Prevent/reduce the seriousness or complications of disease




Prevention targets different population levels:
 Universal
Designed to reach entire population, without regard to individual risk factors and
intends to reach a very large audience
 Selective
Targets subgroups of general population that are determined to be at risk. Subgroups
may be distinguished by traits such as age, gender, family history, economic status
etc.
 Indicated
Involves a screening process and aims to identify individuals who exhibit early signs
of a disease and other problem behaviours

,Intervention levels, and tools or
instruments
 Eliminate, restrict,
disincentive e.g.,
legislature/law, sanctions
 Incentive, shift, enable e.g.,
pricing, nudging, facilities
 Enable, educate e.g.,
education, training




HPDP in real-life setting:
 HPDP requires multi factorial interventions in the complexity of real-life settings
 Individuals more from setting to setting, and constantly making lifestyle choices,
influences on different levels (intra and interpersonal, institutional, community, policy).
Consequently, interventions are often aimed at a specific setting
 Definition of a setting: physical and recognizable structure with predefined
geographical boundaries


Lecture 2: Upstream determinants of lifestyle behaviours and chronic disease
risk

Upstream determinants
= upstream determinants of public health are one of the most useful determinants, because
they try to resolve problems by setting interventions/searching for the cause of the health
problem. These factors lie outside of the control of the individual.
Upstream determinants involve:
 Adjust pricing
 Adjust environment
 Adjustments in law: e.g. fat- and sugar tax

Exposure
= can be defined as environmental and lifestyle behaviours and how these exposures relate
to health, all non-hereditary influences → so everything that is not related to your genome
Genome and exposome upstream determinants interact

, Cortisol (stress hormone) makes you want to flight or fight and for that you need fast energy
> so triggered by all the fast food places

Structering environmental determinants: ANGELO
Micro: individual level
Meso: group level
Macro: community/governmental level
Micro Meso Macro
Socio-cultural
Physical
Economic
Political



The evidence in a nutshell:
Socio-cultural
 SEP: huge determinant in lifestyle related chronic diseases/obesity
 Social capital
 Social network
Economic environment
 Evidence mostly from economic field
 Healthier diets are more costly
 Pricing strategies are effective: taxing/discounts; especially if they are salient (you
also put a sign about the price change; higher or lower)
 Effects on NCDs yet to be determined
Political environment
 Taxation of SSB
 Mandatory food labelling
 Car-free streets/Sundays
 Advertisement ban
 Schools: healthier canteens
 Physical education policy
Physical environments
 The risk of obesity is higher in urban areas
 More green space contributes to less risk of diabetes
 Walk ability the higher the better cause less diabetes




Evidence base is relatively thin:

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