LO2: In relation to an identified need, critically analyse and evaluate the impact of contemporary socio-political policy and other influences on public health and health promotion practice
LO3: With reference to theory justify, apply and critically evaluate approaches to health promotion designed to influence behaviour and health improvement related to the identified need.
LO4: Critically justify and discuss appropriate strategies that you would use to evaluate your health promotion activity
Essay Template
This essay will critically analyse and evaluate global, national and local policies relating to … Formulation of a community profile has identified an increased incidence of … within the practice area of a …. Models and approaches to health promotion designed to influence behaviour and improve patient outcomes will be critically evaluated and applied in relation to the identified health challenges for the …. Discussion and justification of the chosen strategy to evaluate … the health promotion activity will be employed through a process of critical analysis. In conclusion implications on practice, reduction of health inequalities and improved quality of care provision within the chosen community will be highlighted.
LEARNING OUTCOME 2
GIVE A BRIEF OVERVIEW ON THE CONEPT OF HEALTH PROMOTION, HISTORY, PRACTICES, DIMENSIONS…. Incorporate a chosen policy herewith for example a policy addressing health inequalities; health promotion etc… highlight the main objective within the policy. Consider some key aspects such as where/whom the responsibility lies with to implement strategies in services.
What are the importance of such policies?… what role do they play in ensuring needs are met lawfully for example? What are the main aims of public health policies? Again an example of a policy relevant to chosen topic (this could be local, national or global policy). Considering these various policy context will demonstrate that you have considered not only the local, but national/global political aspect of the topic and the impact it’s having on population.
What are some national/Global statistics on the severity of your chosen topic(why is it a challenge?) (is it health related, or otherwise?). PS: these are not the average figures you would have populated in your profile report. They are for example – “the World Health Organisation, National Institute for Clinical Care and Excellence, Department of Health etc…. identified that 800,000 people in the e.g. UK/world…. have …… however it is estimated that a further 1 million with the condition are undiagnosed or don’t access health care etc…..” (DO YOUR BACKGROUND READING ON YOUR CHOSEN TOPIC – LOOK UP THE HEALTH ISSUE FROM A LOCAL, NATIONAL AND GLOBAL PERSPECTIVE TO DEVELOP YOUR ESSAY)
Look up the economical aspect of this to the NHS(why is it fundamental for that health issue to be addressed). For example, if the NHS will be in “so many billion pounds” deficit by year ….. What does this call for? Reduction in disease prevalence? How should this be done, national and/or local level? Why is this information of impact for your chosen topic and why is it fundamental for policy development? Also look at the efforts that have gone into addressing the problem and despite this, what is observable/ what remains a challenge/problem? (at every point ending the paragraph and starting the next paragraph with the same thing)
Looking into a more specific policy on your chosen topic….
Highlight a national policy, when the policy was introduced and by whom? (what has been set, national documents)What was introduced in this policy in relation to your chosen area (an effort to reduce/address a particular problem within the UK population for example).(has it addressed a particular problem)What has the policy/regulation/legislation help to achieve (reduction in … increase in …) despite this, HIGHLIGHT what your community profile identified as compared to national average for example (DON’T RESTATE THE FIGURES, JUST STATE WHETHER IT WAS ABOVE, LOWER, THE SAME…) IN RELATION to the chosen topic. Link this back to the policy considered – highlight in your discussion the population which the policy is failing to reach(not addressing target population) for example and THREFORE why a health promotion activity within the identified area is paramount for local NHS Trust to reduce ……
Local policy/legislation/regulation in relation to chosen area….highlight what it currently targets, (does identified area fit within that agenda)where and which population (LOOK WITHIN THE PUBLIC HEALTH AGENDA IN YOUR LOCAL AUTHORITY, IF YOU CAN’T FIND A LOCAL policy/legislation/regulation ON YOUR TOPIC. The local authorities’ agenda on health and social care could cover this)(are there places they can go to for support). What have been established; put in place from local initiative relevant to your chosen topic. DEVELOP SOME CRITIQUE ON THIS – for example is this policy/legislation/regulation contradictory to the aims of the district nursing or health visiting service which aims to ….(look at the people who have been put forward to push the policy)
Thinking of your chosen topic, in relation to this policy, what have been omitted within this policy? For example is there a local health promotion initiative as an outcome of this policy – which population was targeted, was it NOT cascaded to your target population?(highlight that)… CONSIDERING your professional practice (as DNs or HVs or OTHERWISE), as a main healthcare professional working with the group of people you have identified, was there any indication to involve your line of practice in the provision of the initiative (for example – was there opportunities to train staffs, invite to meetings/events related to the local issue?) IF NOT, what GAP has this created in terms of how your professional service is provided/delivered?
Although there are Global, national and local policies which clearly aim to reduce …. State how your chosen topic, through a process of health promotion, will therefore play a key role in addressing the identified inequalities within the local area. (all have intentions-clear hint to achieve health outcomes and how to propose health promotion activities)
LEARNING OUTCOME 3
DEFINITION of health promotion(breakdown exactly what health promotion does)… main/key aspects to health promotion. Why is health promotion a challenge/why is it complex? As a result what does health promotion strategy/ies require? (Health promotion is just a plan. There are things to consider to help people promote health)
What are health promotion theories, what do they provide? What ESSENTIALLY do they provide? Ensuring that all aspects and possible variable have been considered? (DO YOUR BACKGROUND READING ON HOW HEALTH PROMOTION THEORIES/MODELS/IDEAS have been criticised)(overview)
Highlight/discuss various models that have been devised for health promotion
For example – the Health Belief Model. Discuss the focus of the model. Application of this model to the proposed health promotion activity would assume that people would need (for example an incentive to stop; to change, to improve ….) what approach does this model take Is it client-focused, encouraging the individual to explore the benefits of behavioural change in terms of a specific health outcome? ?(what will stop them from taking a different perspective) However, what are the wider determinants/factors in relation to the individual’s ability to change behaviour?…. therefore, a consideration of your named population – in relation to this model alone would be (for example -considered? (DO YOUR BACKGROUND READING ON HOW HEALTH PROMOTION THEORIES/MODELS/IDEAS have been criticised)
Highlight/discuss various models that have been devised for health promotion
For example – the Health Belief Model. Discuss the focus of the model. Application of this model to the proposed health promotion activity would assume that people would need (for example an incentive to stop; to change, to improve ….) what approach does this model take? Is it client-focused, encouraging the individual to explore the benefits of behavioural change in terms of a specific health outcome? However, what are the wider determinants/factors in relation to the individual’s ability to change behaviour?…. therefore, a consideration of your named population – in relation to this model alone would be (for example – questionable in terms of the best likely outcomes)
Tanahill’s model. What does this model of health promotion consider? What are the main intentions of the model? AGAIN how has this model been criticised? In terms of your chosen area, how would this model fit in with the health promotion activity (for your chosen population or a wider population). Highlight the main aspects that need to be covered to make the activity a success. (for example “… encompassing the social and psychological implication …. [for your chosen population] is paramount to making the activity successful0
Consider a theory RELATING to people’s behaviour, attitudes and beliefs(makes people change/what makes people chamge)(How have they been criticised in the pasthow does it apply to population. Then consider a national campaign tactic that have been used via media campaigns (e.g. explicit pictures of smoking or obesity related conditions and organ damage). Consider what motivates people to change behaviour?…. blaming, coercion, empowerment etc…(thinking of the people you are trying to promote the model for)
Ewles and Simnett model. What does this model suggest is required to achieve positive results in health promotion? Could highlight the 5 main domains embedded within a model/plan etc.. (i.e. the behavioural, educational, medical, client centred (empowerment) and social). Exploring the theories and models for health promotion has identified what issues in relation to your chosen population? ….. [e.g. the need for behavioural change, prevention, social circumstances, incentives, patient education, professional education etc…]. Why is ongoing evaluation a key aspect of your health promotion activity? (trying to find ut which model is best for issue and population identified and how to take forward)
LEARNING OUTCOME 4
For example …. Ewles and Simnett’s model therefore encompasses the requirements for the proposed activity. [Include as an Appendix a plan of proposed activity in relation to health promotion activity to be considered for your chosen population]
Appendix 1
Ewles and Simnett Model in relation to proposed activity
Aspect of health promotion Identified
Consideration for Health Promotion Activity
Behaviour What activity is proposed
Evaluate proposed activity and identify barriers
Medical What do you aim to prevent, manage? Evaluation
Education Who are those to be educated?
Professionals, patients and on what?
Evaluation.
Social What are social issues relevant to target population e.g. social isolation, limited mobility, inability to access outside services, lack of incentive. Evaluation
Empowerment How to empower population? What will this include to help them manage their health? Evaluation
Having explored your local community through a profiling exercise you have highlighted several issues – access to health services, social class, health status, ethnicity, and geographical location etc… all of which contributes to the determinants of a health promotion outcomes within a population. THEREFORE, state what is needed in order to achieve your proposed outcome of planning the health promotion activity.
Re-emphasise the main point – of what models for planning health promotion activities provide …? What does it help to ensure? Considers what lays the basic foundations [i.e. the blue print] for planning or the basis upon which a health promotion activity is built (e.g the current need, what is to be achieved, how it is to be achieved). What will this allow room for?….
The Precede-Proceed Framework for health promotion planning [or any other planning framework you come across in your reading] what does this framework provide to a health promotion activity? What do the different phases of the model prompts to be considered? How does it guide you in planning your health promotion activity? [COULD INCLUDE A PICTURE OF THE FRAMEWORK WITHIN YOUR ESSAY].(how are you going to go about setting aims and objectives)
AGAIN HOW HAS THIS model been criticised – considering it has 9 phases what could be some of the potential challenges to using this model to plan your health promotion activity? Highlight this. Based on the issues highlighted, suggest an alternative model (a mode concise one) which will be adopted and which encompasses the needs to be achieved for the planned health promotion activity.
For example – Ewles and Simnett (2003) Planning Health Promotion Model provides a 7 step guide to planning a health promotion activity [IF USING, DEVELOP THESE STEPS WITHIN A TABLE, TO MINIMISE WORD COUNT]. AGAIN consider a critique on this model – for example it is too generalised in context. However what are the benefits of using them to plan your health promotion activity? Highlight what must be considered throughout the planning process and at each step of the 7 steps. Etc…
If adopting this model state:
Where step 1 of the planning model have been addressed in your work. State how you have set step 2 [aim and objs]. Did you adopt a model for example to set this? [INCLUDE THIS MODEL AS AN APPENDIX AND STATE CLEARLY WHAT AIMS AND OBJs YOU PLAN ON ADDRESSING]
Appendix 2
SMART Aims and Objectives
SMART Aims and objectives
Specific aims and objectives To provide, increase etc …
Measurable Monitor numbers of patients/clients/people who…. from local practice figures
Achievable Delivery of …(by whom? E.g. through staff already
visiting patients in their own homes). What other avenues might be utilised? (e.g. something available from the hospital, or via the GP practice etc..)
Realistic What is already available that you could access? (e.g. a tool, mechanism etc…) are there already e.g. specialist teams that could support as and when needed with problematic cases etc
Timely How long will you monitor and support patients for (is this based on a current current policy?)
Where will figures be monitored from, how often and for what length of period? What will this monitoring try to ascertain? (e.g.
an impact of hospital admission etc….)
DESCRIBE your proposed plan for Step 3 to examine the methods that will best deliver, achieve maximum results from the health promotion activity… What is it you want to promote? [E.g. Reduction in a particular behaviour, increasing awareness through education etc…] what methods/intervention will best suit your targeted population. Highlight also what could be the potential challenge of the method/intervention with the population group. What will be paramount for the proposed activity? [DO BACKGROUND READING TO SEE WHAT METHODS OF INTERVENTION ARE USED IN HEALTH PROMOTION ACTIVITIES] FOR example – if it is an interview, what type of interviewing strategy have been used?(you do not have to go through all 7 steps)
Is media campaign part of your proposed plan for the health promotion activity? What formats are used in health promotion activities? How have they been used on your chosen topic and how has it been targeted to your chosen population? What outcomes have these had on the proposed outcome? [Again read up on this] How do you plan to use them for your proposed activity?… what are the challenges that you should consider when using such interventions within your health promotion strategy.
Describe your plan for Step 4 of Ewles and Simnett model in terms of resources required to fulfil the activity.
Step 5 – consider why is evaluation fundamental to a health promotion activity? And why it should be an on-going process in the activity? What are models of evaluation commonly used to determine a health promotion activity? What assurance does evaluation provide for a health promotion activity? What method of evaluation would be appropriate for the proposed activity from the initial planning stages?
Step 6 – consider specific details (action plan) of the proposed activity. Why is it important to set an action plan to be implemented to complete the health promotion tasks…? For example, why is it important to document tasks, resources, timescales etc…? Why must ethical considerations be documented? Why must every individual practitioner
CONCLUSION
In conclusion … highlight what the completion of a community profile within the local practice area has identified (for example as above the national and local averages). Thus highlighting health inequalities within health care provision.
Summarise what the critical analysis of…Global, national and local policies; exploring the theories and models of health promotion have assisted in identifying.
Summarise what your health promotion activity aims to achieve and what it will for example – hopefully reinforce within the community through a process of involvement within the chosen activities. How will implementation of policy impact on professional practice?
Brief summary re-emphasising the complex and intricate process of health promotion, what steps are required? But at the same time stating its use in improving health outcomes. What undertaking this study has helped to achieve? What it will enable specialist health practitioners to do/achieve in working with people in the community. r consider their practice?
10. Indicative Reading:
Essential Reading
Green, J., Tones, K., Cross, R. and Woodall, J. (2015) Health promotion: planning and strategies. London: SAGE Publications
Downie, R. S., Tannahill, A. and Tannahill, C. (1996) Health Promotion: Models and Values. 2nd ed. Oxford: Oxford University Press.
Wilson, F. and Mabhala, A. (2009) Key concepts in public health. London: SAGE Publications
Naidoo, J. and Wills, J. (2010) Developing practice for public health and health promotion. Edinburgh: Bailliere Tindall
Peckham, S. and Hann, A. (2010) Public health ethics and practice. Bristol: Policy Press
Recommended Reading
Alcock, P. (2008) Social Policy in Britain. New York: Palgrave Macmillan.
Barry, A. M. and Yuill, C. (2008) Understand the Sociology of Health. 2nd ed. London: Sage
Beaglehole, R. and Bonita, R. (2009) Global Public Health: A New Era. 2nd ed. Oxford: Oxford University Press.
Beauchamp, T. L. and Childress, J. F. (1995) Principles of Biomedical Ethics. 5th ed. Oxford. Oxford University Press.
Brownson, R. (2011) Evidence-Based Public Health. 2nd ed. Oxford: Oxford University Press.
Cowley, S. (ed.) (2007) Community Public Health in Policy and Practice. 2nd ed. London: Baillière & Tindall.
Crinson, I. (2009) Health Policy: A Critical Perspective. London: Sage. Davey-Smith, G. (ed.) (2003) Health Inequalities: Life Course Approaches. London: The Policy Press.
Davies, M. and MacDowall, W. (2006) Health Promotion Theory. Maidenhead: Open University Press.
Department of Health. (2005) Creating Healthier Communities: A Resource Pack for Local Partnerships. London: Office of the Deputy Prime Minister and Department of Health.
Department of Health. (2009) Tackling Health Inequalities: Ten Years On. London: Department of Health
Department of Health. (2010) Healthy Lives, Healthy People: Impact Assessments [Online]. Available from: https://www.gov.uk/government/publications/healthy-lives-healthy-people-impact-assessments [Accessed 7 August 2015]
Department of Health. (2010a) Healthy Lives, Healthy People: Our Strategy for Public Health in England [Online]. Available from: https://www.gov.uk/government/publications/healthy-lives-healthy-people-our-strategy-for-public-health-in-england [Accessed 7 August 2015]
Douglas, J., Earle, S., Handsley, S., Lloyd, C. E. and Spurr, S. (2007) A Reader in Promoting Public Health: Challenge and Controversy. London: SAGE Publications
Ewles, L. (2005) Key Topics in Public Health: Essential Briefings on Prevention & Health Promotion. London: Churchill Livingstone.
Graham, H. (2009) Understanding Health Inequalities. 2nd ed. Maidenhead: Open University Press.
Hawtin, M. and Percy-Smith, J. (2007) Community Profiling: A Practical Guide: Auditing Social Needs. 2nd ed. Maidenhead: Open University Press.
Improvement and Development Agency. (2010) A Glass half-full: How an Asset Approach can Improve Community Health and Well-being [Online]. Available from: http://www.local.gov.uk/c/document_library/get_file?uuid=bf034d2e-7d61-4fac-b37e-f39dc3e2f1f2 [Accessed 7 August 2015]
Killoran, A., Swann, C. and Kelly, M. P. (2006) Public Health Evidence: Tackling Health Inequalities. Oxford: Oxford University Press.
Lloyd, C. E., Handsley, S., Douglas, J., Earle, S. and Spurr, S. (2007) Policy and Practice in Promoting Public Health. London: Sage.
Naidoo, J. and Wills, J. (2010) Public Health and Health Promotion: Developing practice. 3rd ed. London: Bailliere Tindall.
Tones, K. and Green, J. (2010) Health Promotion Planning and Strategies. 2nd ed. London: Sage.
Wilkinson, R. and Pickett, K. (2010) The Spirit Level. Why is Equality Better for Everyone? London: Penguin.
Journals:
• British Journal of Health Psychology
• Critical Public Health
• Ethnicity & Health
• European Journal of Public health
• Family & Community Health
• Health Education Research
• Health Education Journal
• Health Education and Behaviour
• Health Policy and Planning
• Health Promotion International
• Health Promotion Practice
• International Journal of Epidemiology
• Journal of Community Health
• Journal of Epidemiology and Community Health
• Journal of Public Health
• Journal of the Royal Society for the Promotion of Health
• Public Health Ethics
• Public Mental Health
• Sociology of Health & Illness
Useful Websites:
• Population Health Promotion: An Integrated Model of Population Health and Health Promotion
http://www.phac-aspc.gc.ca/ph-sp/php-psp/index-eng.php
• CAPT – Child Accident Prevention Trust
www.makingthelink.net
• Creating Healthy Communities
http://welluk.org/
• Department of Health
http://www.dh.gov.uk/
• The UK’s Faculty of Public Health
www.fph.org.uk
• Best Practices – Health Promotion. [Readings & Resources]
http://www.bestpractices-healthpromotion.com/coursereadings/index.html
• Health Education/Health Promotion Resource Site
http://www.bettycjung.net/Healthed.htm
• Institute for Innovation and Improvement:
www.nhsinstitute.co.uk
• National Electronic Library for Health:
http://www.nelh.nhs.uk/
• National Institute for Health and Care Excellence
http://www.nice.org.uk/Guidance
• Systematic Reviews in Health Promotion
http://eppi.ioe.ac.uk/cms/Default.aspx?tabid=73
• World Health Organisation Europe:
http://www.euro.who.int/en/home