Health promotion and health education theory, models and principles
What is examined
This domain tests the difference between health education (planned learning to improve health literacy) and health promotion (the wider process of enabling people to increase control over, and improve, their health). Expect scenarios asking you to select the model, level of intervention or evaluation design that fits.
Core rules and concepts
- The Ottawa Charter (WHO, 1986) sets five action areas: healthy public policy, supportive environments, community action, personal skills, and reorientation of health services. Its three basic strategies are enable, mediate and advocate.
- The socio-ecological model organises determinants at individual, interpersonal, community, organisational and policy levels; effective programmes act on several levels at once.
- The Health Belief Model predicts behaviour from perceived susceptibility, severity, benefits and barriers, plus cues to action and self-efficacy. It explains one-off decisions better than maintenance.
- The Transtheoretical Model describes precontemplation, contemplation, preparation, action and maintenance; interventions are matched to stage, and recycling is normal.
- Social Cognitive Theory adds reciprocal determinism, observational learning and self-efficacy; it underpins skills-based and peer-led programmes.
- PRECEDE-PROCEED is a planning and evaluation framework in which social, epidemiological, behavioural and environmental diagnosis precede implementation.
- Settings approaches such as health-promoting schools and healthy cities change environments rather than only individuals and are preferred where the question asks for sustainability.
Worked example
A school asks you to reduce smoking uptake. A single information assembly targets personal skills only. A stronger answer maps the socio-ecological model: individual (refusal skills, normative education), interpersonal (peer leaders, parent messaging), organisational (smoke-free campus, staff training), community (youth clubs, enforcement of sales law) and policy (tobacco taxation, display bans). Evaluation is planned at baseline and 12 months using self-reported uptake validated by cotinine in a subsample, with a comparison school where feasible. The reasoning is that the outcome is behavioural, the determinants are multi-level, and the design must match both.
Traps
Do not call a leaflet campaign health promotion without environmental or policy components; do not describe the Health Belief Model as a stage model; do not evaluate a community programme using only individual knowledge change; do not treat empowerment as a slogan without naming participation and control.