Health Promotion and Health Education
Core concepts
Health promotion enables people to increase control over and improve their health; health education is one strategy within it. The Ottawa Charter's five action areas are healthy public policy, supportive environments, community action, personal skills, and reorientation of health services. Know the health belief model, transtheoretical stages of change, theory of planned behaviour, social cognitive theory, and diffusion of innovations. Understand settings-based approaches, community participation, empowerment, health literacy, social marketing, message segmentation, and formative research. Evaluation should distinguish process, impact, and outcome measures.
Traps
The commonest error is equating health promotion with health education or with mass media alone. Knowledge alone rarely changes behaviour. The stages-of-change model is not a linear guarantee; relapse is normal. The health belief model includes perceived susceptibility, severity, benefits, barriers, and cues to action, but not intention as a core construct. Do not label an activity as community participation when the community merely attends a meeting.
Worked example
A clinic wants to improve diabetes self-management. Process evaluation counts sessions delivered and attendance; impact evaluation measures knowledge, self-efficacy, and foot-care behaviour; outcome evaluation measures HbA1c and complications. A patient in contemplation needs awareness and motivational support, not a rigid action plan designed for someone already in preparation.
Rule of thumb
Assess needs and readiness, involve the community, use more than one strategy, and evaluate at process, impact, and outcome levels.