Health Promotion and Disease Prevention
This domain tests whether you can apply prevention science inside a school: how disease and injury are classified, which behavior-change models explain student choices, and how epidemiologic data drive school policy. Expect scenario items that ask you to name the level of prevention, the stage of change, or the link in the chain of infection.
Levels of prevention
- Primary - stop the problem before it starts: immunization, handwashing instruction, helmet and seat-belt policies, tobacco-refusal curricula.
- Secondary - detect and treat early: vision, hearing, and scoliosis screening; contact tracing; blood-pressure checks; depression screening with referral.
- Tertiary - limit disability once disease exists: asthma action plans, diabetes self-management, cardiac rehabilitation, 504 accommodations. Mnemonic: before, between, after.
Models you must be able to apply
- Health Belief Model - perceived susceptibility, severity, benefits, barriers, cues to action, self-efficacy. Best for explaining one-time uptake (e.g., why a teen refuses a vaccine).
- Transtheoretical model - precontemplation, contemplation, preparation, action, maintenance, with relapse expected. Match the message to the stage: a precontemplator needs awareness, not a detailed action plan.
- Social Cognitive Theory - reciprocal determinism, observational learning, outcome expectations, self-efficacy; peer modeling is powerful.
- Ecological model - intrapersonal, interpersonal, organizational, community, public policy. Single-level programs rarely hold.
Infectious disease essentials
The chain of infection runs pathogen → reservoir → portal of exit → mode of transmission → portal of entry → susceptible host; break any link and transmission stops. Active immunity (illness or vaccination) is slow to develop but durable; passive immunity (maternal antibody, immunoglobulin) is immediate but temporary. Herd immunity shields people who cannot be vaccinated.
Worked example
A middle school reports a cluster of influenza-like absences, and the health teacher is asked for one action at each level.
- Primary: teach hand hygiene and respiratory etiquette in every class and post signage at sinks - prevents new infections.
- Secondary: enforce "stay home while febrile" and monitor daily attendance and nurse logs - finds and separates early cases.
- Tertiary: review asthma action plans with the nurse for affected students - reduces complications. Reasoning: classify by when in the disease process the action occurs, not by who performs it. A nurse teaching handwashing is still primary prevention.
Traps that cost marks
- Calling screenings "primary" - they are secondary.
- Labeling a vaccine dose as passive immunity.
- Treating the stages of change as linear, or assuming a student in precontemplation will accept an action plan.
- Ignoring community and policy levels when the stem mentions vending machines, recess policy, or district rules.