The biomedical model of disease, in which health is viewed as the absence of disease, is becoming obsolete. Burgeoning health care costs coupled with an increased focus on health promotion and illness prevention have created new demands on the health care delivery system. A biopsychosocial model of health care — in which disease is seen as an interplay between environmental, physical, behavioral, psychological, and social factors — can integrate mental health services into the primary care sector. Social workers, as primary providers of psychosocial care, can close the gap between physical health and mental health services. Strategies for implementing the biopsychosocial model, methods to evaluate its effectiveness, potential problems, and recommendations for future research are discussed. Show
This content is only available as a PDF. Copyright © 1989 by the National Association of Social Workers, Inc. You do not currently have access to this article. An interdisciplinary team of specialists at the Department of Health Professions at the Bern University of Applied Sciences, Switzerland, focused on the connection between health promotion, prevention, and psychosocial health. This team newly defined these topics in relation to how they could be synergistically combined to promote psychosocial health. A practical E-learning program was developed to promote their integration at this university. In this article, these newly established definitions, as well as an action model, will be introduced.
The proposed definitions (Table ) delineate that health promotion and prevention can be distinguished conceptually, as their approaches to health and illness differ from one another. While health promotion aims at improving/promoting health and resources (salutogenesis), prevention focuses on avoiding disease and its associated risk factors. In practice, however, health promotion and prevention often have the same goal, which is to improve or maintain the health and health competencies of the population. Consequently, they have been combined in the targeting of psychosocial health. Health promotion focuses on strengthening the personal resources of individuals and groups as well as improving the resources present in the social environment. Primary prevention targets detecting and reducing the risk of an illness from occurring (e.g. from unhealthy behavior or detrimental environments). Secondary and tertiary prevention focus their interventions on reducing the negative consequences of symptoms or diseases. The aim of quaternary prevention is the identification of patients’ risk for over-medicalization. Primordial prevention focuses on the avoidance of the development of risk factors, which have not yet occurred (e.g. early childhood health programs to avoid disease later in life). The combined support of health promotion and prevention positively impacts the psychosocial health of individuals, groups, and societies. Table 1. Defining psychosocial health, health promotion and prevention for health professions (including the relationship between them).
In order to depict how health promotion and prevention could be systematically utilized to promote the psychosocial health of individuals, groups, and society, a novel action model was developed (Fig. ). This action model is designed to guide health professionals and authorities in promoting psychosocial health amongst their target groups. In this graphic, health promotion and prevention are encircled together with a dotted line, which depicts that they are meant to be utilized jointly. Situated between health promotion and prevention are two grey triangles. They represent the interdependence that salutogenesis has with health promotion and prevention. The triangle connected to health promotion illustrates that it focuses on what makes people healthy; whereas, the triangle connected to prevention symbolizes that it focuses on avoiding what makes them ill. The sun-like symbol in the middle of the graphic depicts the significance and interconnectedness that the Determinants of Health have in relation to health promotion, prevention, and psychosocial health. The Determinants of Health are often social in nature, and therefore, impact the health of all individuals living in the surrounding environment []. Examples of the social Determinants of Health include the physical environment, social network, education and health literacy, employment opportunities, and the healthcare system []. Thus, improvement in these social determinants of health are a key focus of health promotion and prevention strategies. The circles surrounding the graphic portray how this action model can be utilized at all population health levels (individual, group, community, global). The arrow with “outcome” written inside is the “action” part of the model. It depicts how health promotion and prevention actions, strategies, models, etc., can be used to promote psychosocial health. Thus, the improved psychosocial health of individuals, groups, etc., is seen as an outcome. The arrow with “resource” written inside represents that if an individual has adequate resources (through her/himself and her/his environment) and sufficient psychosocial health, it is likely that she/he will be more motivated and able to maintain health and to avoid illness. Importantly, a lack of resources may make it more difficult to undertake health-promoting or preventive measures. The proposed action model is based upon already well-established concepts, models and frameworks in health promotion and prevention practice. In a further step, we have depicted them in a way that clearly integrates and combines their core concepts for their practical application in promoting psychosocial health. As there is a lot of overlap present among these topics, this clear illustration is important to promote their systematic and planned usage. It will now be highlighted in more detail how this action model is intended to be applied (Fig. ).
Ottawa Charter: A key component in health promotion practice is the advocating, enabling, and mediating action strategies delineated in the Ottawa Charter: developing personal skills, strengthening community action, creating supportive environments, reorienting health services, and building healthy public policy []. Additionally, there are specific principles that guide health promotion practice. The principles of participation, empowerment, and a holistic and positive conceptualization of health, are the basis for the relationship which will be formed between the health professional and the individual/group [,]. Other health promotion principles, such as advocacy and social justice and equity in health [], reflect that the health professional is focused upon reducing inequities in health. The remaining principles, such as intersectoral collaboration, building upon existing strategies, and usage of multiple strategies, guide health professionals in the broadening and systematic usage of their targeted interventions/projects []. The use of a settings approach, which denotes taking action in the settings in which everyday life takes place (e.g. workplace, schools, hospitals, cities, etc.), is also core to health promotion strategies []. There is a specific focus on the organizational structures and systems within the settings approach, as these affect the health of all involved individuals. The settings approach is also connected with an ecological model of health promotion, as it acknowledges that health is “determined by a complex interplay of environmental, organizational and personal factors” (Dooris, 2006, p. 55).
Differentiated usage of the five main types of prevention (primordial, primary, secondary, tertiary, quaternary (see previous description) are important in the development of strategies/interventions /projects, as they target different persons/groups at varying stages of health/disease []. Prevention strategies can either focus directly on the behavior of individuals/groups/society (e.g., with information & education), or they can target the structure which indirectly affects behavior. Structural (environmental) prevention measures enable health-promoting behaviors and deter potentially hazardous behaviors, by making them more difficult to engage in. Examples of such structures are the built environment (sidewalks, green space, bike paths) or legislation /policies (food composition and labeling, advertisement, seatbelt legislation) [, ].
There are numerous, more specific models and frameworks which guide health professionals in planning and implementing interventions/projects/ programs. Family-centered Care [], Theory of Planned Behavior [, ], Transtheoretical Model of Behavioral Change [, ] and Self-efficacy [-], are examples of more focused models, which, in addition to the broader, core concepts of health promotion and prevention, offer more specific guidance to health professionals. Models, such as the Integrated Model of Population Health Promotion Model [], the Public Health Action Cycle [], and the Precede-Proceed Model [, ], are tools that can be utilized during project/program planning to ensure more systematic usage of health promotion and prevention. Fig. (2). Health promotion, prevention, and psychosocial health: An innovative action model (with pop-ups, based on contents in the E-learning program from the SALUTE Project), Bern University of Applied Sciences, Switzerland, 2020.It is also important to integrate more general, public health-related concepts when introducing change among various population health levels. Integration of constructs, such as epidemiology, ethics in public health, healthcare systems, and policies, along with study design (quantitative, qualitative or mixed methods), is also important when planning interventions/projects/programs in health promotion and prevention.
The definitions and action model are based upon core aspects from health promotion and prevention practice, along with expert knowledge from an interdisciplinary team of specialists. To the authors’ knowledge, such an action model does not exist in the international literature. This new and innovative approach encourages the systematic usage of health promotion and prevention in the promotion of psychosocial health. The next step would be the implementation and evaluation of this action model, especially the measurement of the outcome (psychosocial health).
The integrative and intentional use of health promotion and prevention is an innovative approach for the promotion of psychosocial health in public health practice. The proposed action model guides health professionals in utilizing health promotion and prevention to promote psychosocial health among their target groups. Internationally, such a model does not exist. Therefore, it offers a new and systematic approach to promote psychosocial health among various population health levels. What have the models of health promotion and illness prevention been used for quizlet?Explanation: Several models of health promotion and illness prevention have been used to help healthcare providers understand health-related behaviors and adapt care to people from diverse economic and cultural backgrounds.
What are the 3 models of health promotion?Individual models of health behavior -Health belief model, Transtheoretical Model (Stages of Change), theory of Reasoned Action and theory of Planned Behavior.
What is the purpose of health promotion models?The Health Promotion Model aims to explain the factors underlying motivation to engage in health-promoting behaviors and it focuses on people's interactions with their physical and interpersonal environments during attempts to improve health [14].
What have the models of health promotion and illness prevention been used for?There are several theories and models that support the practice of health promotion and disease prevention. Theories and models are used in program planning to understand and explain health behavior and to guide the identification, development, and implementation of interventions.
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