Karen Matthews Royal Infirmary of Edinburgh
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1 National HIV Nurses Association (NHIVNA) Study Day Health Promotion Karen Matthews Royal Infirmary of Edinburgh 18 November 2009, Surgeons Hall, Edinburgh Health promotion and Motivational Interviewing The Theory Dr Audrey Matthews Claire Glen Karen Matthews 1
2 Learning Outcomes Understand the key principles of health promotion which relate to motivational interviewing theory Evaluate how HP and MI theories can be utilised through discussion of case scenarios Determinants of Health (Dahlgren & Whitehead 1991) 2
3 What is Health Promotion? Health Promotion is the process of enabling people to increase control over, and to improve their health (Ottawa Charter, 1986) Main objectives of Health Promotion To prevent disease (Medical or Preventive) To ensure people are well informed and able to make healthy choices (Behaviour Change and Educational) To help people to acquire the skills and confidence to take greater control over their health (Education and Empowerment) To change policies and environments in order to facilitate healthy choices (Empowerment and Social Change). 3
4 Health Promotion Actions Building a healthy public policy Creating supportive environments Strengthening community action Developing personal skills Re-orientating health services Comeback Tour 4
5 1. Heart Disease 2. Oral Health 3. Child Healthy Weight 4. Alcohol 5. Suicide Prevention 6. Smoking Cessation 7. Breastfeeding Heat Targets Health Promotion Theories Concerned With the Individual Health Belief Model Theory of Reasoned Action Stages of Change Model Social Cognitive Theory 5
6 Health Belief Model Theory of Reasoned Action 6
7 Stages of change model Prochaska & DiClemente (1977) Social Cognitive Theory 7
8 Common elements of Individual Change Theories a strong, positive intention to perform the behaviour an absence of environmental barriers preventing the behaviour skills to perform the behaviour advantages of performing the behaviour outweigh the disadvantages social pressure to perform the behaviour consistency between the behaviour and a person s self image a more positive than negative emotional reaction to performing the behaviour perceived self-efficacy (or confidence) to perform the behaviour (Fishbein et al., 1991) Pre-requisites for change (RUHBC, 1989) The change must be self-initiated The behaviour must become salient The salience of the behaviour must appear over a period of time The behaviour is not part of the individuals coping strategies. The individual s life should not be problematic or uncertain. Social support is available. 8
9 Health Promotion Strategies One to one counselling sessions with health professionals Brief advice delivered by a health professional, tailored to take account of the individual s readiness to change Smoking cessation work has pointed to the effectiveness of the intervention of health professionals in increasing a person s chances of quitting smoking. Summary (Nutbeam & Harris, 1999) The importance of knowledge & beliefs about health The importance of self efficacy: the belief in ones competency to take action The importance of perceived social norms & social influences The recognition of the stage of change that an individual is at The importance of shaping or changing the perception of the environment 9
10 References Barnes, J Health promotion in sexual health1: different theories and models of health promotion. Nursing Times, 105 (18) Barnes, J Health promotion in sexual health 2: how to put theory into practice and empower clients. Nursing Times, 105 (19), pp Glanz, K., Rimer, B.K., & Lewis, F.M. (eds.). (2002). Health behavior and health education: Theory, research, and practice (3rd edition) Naidoo and Wills Health Promotion Foundations for Practice. Balliere Tindall. Nutbeam, D and Harris, E Theory in a Nutshell. A Guide to Health Promotion Theory. McGraw Hill Australia Ogden, J Health Psychology. 3 rd ed. Berkshire: Open University Press Research Unit in Health and Behaviour Change (RUHBC) (1989) Changing the Public Health. John Wiley & Sons, Chichester. 10
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