Health Promotion and Disease Prevention
What you must know
This domain emphasizes prevention, screening, and holistic care. Know primary, secondary, and tertiary prevention and apply them: immunizations, substance-use screening (SBIRT), suicide and depression screening, intimate partner violence screening, and metabolic/cardiovascular monitoring in patients on psychotropics. Understand health disparities, social determinants, trauma-informed and culturally congruent care, and patient education/self-management. Know lifespan prevention: prenatal and postpartum screening, adolescent risk behavior, and geriatric fall, cognition, and polypharmacy screening. Recognize the bidirectional relationship between physical and mental health-obesity, diabetes, smoking, and cardiovascular risk are elevated in serious mental illness.
Traps
Stems may ask you to identify the level of prevention-vaccination is primary, screening is secondary, rehabilitation is tertiary-and distractors blur these. Another trap is neglecting physical health monitoring because the visit is "psychiatric," or ignoring cultural and language factors that affect adherence. Watch for failure to screen for substance use or IPV when red flags appear.
Rule of thumb
Every psychiatric visit is a prevention opportunity: screen (depression, suicide, substance use, IPV), monitor (weight, BP, glucose/lipids on antipsychotics), and educate. Ask "what level of prevention is this?" to sort answer choices.
Worked example: A patient on olanzapine gains weight and has rising glucose. The PMHNP orders metabolic monitoring and provides diet/activity education-this is secondary/tertiary prevention addressing a treatment complication, not a reason to ignore the finding.