PPT 2b - Internal Environmental Factors and the effects on human development

1. PPT 2b - Internal Environmental Factors and the effects on human development Lesson objective – to understand how health agencies and voluntary organisations target specific groups with information about health factors.

2. Health campaigns • Starter – can you list as many health campaigns linked to all forms of ‘health’ that you have noticed and understood. • Can you list any people that you know have acted on the advice and help from health campaigns? • Lesson objective – to understand how health agencies and voluntary organisations target specific groups with information about health factors.

3. What is health and well-being? • Several theories say that health can be holistic, this means looking at the ‘whole person’ and their lifestyle, such as: • being free from illness • living in decent accommodation and not a poor neighbourhood • not suffering from stress • not having a chronic illness • spiritual in good health • emotionally in good fitness • personal health and hygiene is good • family health is good all round • social health is good all round • None has addictions in your family • support from family, friends and professional networks is good. • Defining health is a difficult task as it means many different things to people rather like ‘stress’ or ‘happiness’ does. We need however, to understand the meaning of ‘health’ as we use the word in titles such as ‘health visitor’, ‘healthy education’ and ‘health promotion’. • Lesson objective – to understand how health agencies and voluntary organisations target specific groups with information about health factors.

4. Printout WHO defines health and well-being as- • The World Health Organisation (WHO), part of the United Nations Organisation, was set up in 1948 and at the time defined, ‘health’ as being ‘a state of complete physical, mental and social swell-being and not merely the absence of disease or infirmity.’ Later on criticisms about the idealistic nature of ‘complete state of well0-being’ and the unreal, implied view that health is static throughout one’s lifespan, led to an expansion of this definition by several groups and individuals in the mid 1980’s. • Seedhouse (1986) proposed health ‘as a foundation for achieving a person’s realistic potential’, whereas WHO offered a revised concept of health as ‘the extent to which an individual or group is able, on the one hand, to realise aspirations and satisfy needs, and on the other hand, to change or cope with the environment.’ • What do you think this means? • Lesson objective – to understand how health agencies and voluntary organisations target specific groups with information about health factors.

5. More specifically, key factors that have been found to influence whether we are healthy or unhealthy include: • Income and social status • Social support networks • Education and literacy • Employment/working conditions • Social environments • Physical environments • Personal health practices and coping skills • Healthy child development • Biology and genetics • Health care services • Gender • Culture • Lesson objective – to understand how health agencies and voluntary organisations target specific groups with information about health factors.

6. Why do we need health campaigns? • One of the greatest barriers that many face is the attitude of certain groups when monitoring peoples health. When people are unwell, make poor lifestyle choices, the cost to government and the ‘department of health’ is large. Many lifestyle choices result in long-term illness and as a consequence people suffer from prejudice and covert (indirect) discrimination. • There is a great deal of misunderstanding and confusion surrounding disabilities, mental illness, addiction, chronic illness, deprivation and there is often a stigma attached to many of these illnesses, especially in lower social class groups. • Over the next three lessons, we are going to look at health campaigns and who they are targeting. The umbrella term for this is ‘health promotion’. Therefore, this process describes a range of activities to improve the health of individuals. • Lesson objective – to learn how health agencies and voluntary organisations target specific groups with information about health factors.

7. Aims of health promotion campaigns? • What do you think a health promotion campaign is trying to achieve, if delivered in a school? • Lesson objective – to understand how health agencies and voluntary organisations target specific groups with information about health factors.

8. Aims of Health promotions • If you think it is trying to educate you to be more knowledgeable about issues relating to healthy living, this is known as raising health awareness. • If you think it is trying to get people to generally improve their fitness, this is known as ‘education and behavioural’ health promotions. • If the health promotion is trying to improve stop people from becoming ill, this is again known as an educational approach.

9. AfL • They are all interconnected – if you inform a group of school leavers about fitness and leisure time, this means you are raising their awareness about health issues, thereby improving fitness levels and helping to prevent obesity, heart disease and respiratory problems in later life.

10. Different approaches to health promotion • Biomedical approach – looking at the images what do you think is being promoted?

11. Biomedical approach • Focuses on preventing disease or disability through intervention by medical professionals. It is important when using this model to have a group of lcients who act in accordance with medical advice and the use of preventative measures. • Example: at Nafferton Group Practice there are a large number of people over 65+. The senior partner has sent letters to all his clients over the age of 65 inviting them to have an ‘anti flu jab’ in October/Novmeber 2011. • Why is this?

12. Distribution o of leaflets and explaining the dangers of all types of substance abuse, talks on the dangers of smoking, and advice on birth plans

13. Educational/behavioural approach • This model emphasises information giving promotion and better knowledge and understanding of health matters. The relevant, accurate information should be delivered at the right level to an audience capable of making informed decisions. • What does this mean? • Health promoters using this model will also believe in the rights of individuals to choose their own lifestyle.

14. The behavioural approach • The behavioural aspect of this approach puts health firmly in the hands of the individual rather than the expert. • The downside of this approach is that it places the blame for a poor lifestyle choice on the individual, especially if they are not yet ready to make ‘healthy judgments' for other reasons such as peer pressure, life stage, environment and low income. • The educational approach assumes that the more a client knows about the health issue, the more likely that he or she will adopt a different way of thinking and behaving differently. • This may take place with some clients and the resulting change in behaviour may not be the desired one: for example, information on the dangers associated with substance abuse may result not in cessation of the habit but of a different substance being abused. Many smokers are aware of the dangers of smoking but continue to smoke or will change to cigars or a pipe smoking.

15. Societal approach or model • This model concentrates on trying to change society rather than the individual. Therefore, this encompasses either national or local political decisions ro change physical, social or economic environments for the greater health of society.

16. How might this happen?

17. Government white papers – ‘choosing health – making health choices easier’ (2004) • The changes aim to place health promotion at the heart of the NHS. This involves a big change in attitude, among NHS staff and the public, in helping people choose healthier lifestyles and giving them greater control over their health. Some of the new initiatives and services mentioned in the White Paper include:- Introduction of 'health trainers' to help people live a more healthy lifestyle- Expansion of school nursing services- Smoke free workplaces and enclosed public places by 2008- Campaigns targeted at young people about the dangers of unprotected sex

18. One of four sources will usually trigger a campaign • Normative needs -A public health need is established when research repeatedly shows an increase or cluster of certain diseases or health-adverse factors and if corrections are deemed necessary. • Felt need – these are needs which people feel, that is things we want. For example, people might want their food to be free of genetically modified (GM) products. • Expressed need – a felt need which is voiced . For example, the felt need to have GM – free food may become a public debate, with pressure groups focusing on the issue. • Comparative need – this arises from comparisons between similar groups of people, where one group is in receipt of health promotion activity and the other is not . Examples here might be one school having a well-thought-out and planned Personal and Social Health Education (PSHE) curriculum but another does not.

19. Health campaigns for drug misuse • Health care education has a particular role in destigmatising substance misusers. • The costs of substance misuse to the NHS are enormous, so it makes economic as well as clinical sense to invest in greater emphasis on addressing the issue, during both undergraduate and postgraduate training. Until this happens, health services will help to perpetuate stigma rather than take the lead in reducing it. • From analysing over 20 years of work and research in the field of Drug Education, the following principles and components are recommended for effectiveness: • Programmes should: • Enhance protective factors and reverse or reduce risk factors. [Protective factors are those associated with reduced potential for drug use. Risk factors are those that make the potential for drug use more likely.] • Address all forms of drug abuse, alone or in combination, including the underage use of legal drugs (e.g., tobacco or alcohol); the use of illegal drugs; and the inappropriate use of legally obtained substances (e.g., inhalants), prescription medications, or over-the-counter drugs. • Include a strong family-based component (in addition to the school-based component) to enhance family bonding and relationships and include parenting skills; practice in developing, discussing, and enforcing family policies on substance abuse; and training in drug education and information. • Start early in a child’s life (at pre-school) to address health issues and risk factors for drug use and be long-term and ongoing through children’s school years. • Have a targeted programme for key transition times such as transition to secondary school. • Involve schools, having Head Teachers and teachers committed to programmes and providing follow-up work and reinforcement of programme objectives. • Involve the entire community. • Involve press/media to support drug education aims (through campaigns, advertisements, etc). • Use interactive teaching techniques for active involvement in learning, such as discussion, decision making and role play. • Include general life skills training and training in skills to resist drugs when offered, strengthen personal attitudes and commitments against drug use, and increase social competency (e.g., in communications, peer relationships, self-efficacy, and assertiveness). • Be age-specific, developmentally appropriate, and culturally sensitive. Drugs Awareness Campaign http://www.patient.co.uk/showdoc/16#alc http://www.lifeeducation.org.uk/newsletter/newsindex.php?action=publicarticle&id=392 http://www.patient.co.uk/showdoc/16#alc

20. Lesson objective – to understand how health agencies and voluntary organisations target specific groups with information about health factors.

21. Mass Media Campaign • Lesson objective – to understand how health agencies and voluntary organisations target specific groups with information about health factors.

22. Lesson objective – to understand how health agencies and voluntary organisations target specific groups with information about health factors.

23. The national drugs campaign FRANK • (http://www.talktofrank.com/) supports the Drug Strategy's objective of preventing young people from becoming problem drug users, by aiming to provide credible and accurate drugs information to young people, parents and carers through a variety of different media (including by phone, online and by paper materials). • It also aims to support stakeholders across the country by supporting local activities and providing information. It was launched in May 2003 achieving widespread media coverage. • Adverts on the television and radio, posters and other campaign materials were used to raise awareness of the resource and to reach as many people as possible. In its first year, 1.5 million people logged onto FRANK's website, and over 400,000 calls were received to its helpline. Parents and young people are accessing FRANK, and 73% of stakeholders believe that the service does not need improvement.

24. Task – 1 assessment piece Task list – Either research leaflets, Internet or books and magazines. Focus on the target groups Focus on the health care campaign What type of media tactics is the campaign using? What type of imagery? Is there any data to advice weather the campaign is working? Put a display together of your findings And evaluate how effective you think the campaign is. • Working in groups of two - • You are requested to research two campaigns that focus on biomedical, educational, behavioural or societal approaches to health care. • Lesson objective – to understand how health agencies and voluntary organisations target specific groups with information about health factors using BIOMEDICAL. EDUCATIONAL/BEHAVIOURAL AND SOCIETAL APPROACHES

27. Lesson objective - To learn how lifestyle choices can affect our general health and well-being L/O To learn how lifestyle choices can affect our general health and well-being

28. The media campaign advisers Health Communication Strategies • The National Cancer Institute and the Centers for Disease Control and Prevention define Health Communications as: • The study and use of communication strategies to inform and influence individual and community decisions that enhance health. • Research and evaluation of ongoing health communications programs have affirmed the value of using specific communication strategies to promote health and prevent disease. 1 Effective strategies combine theories, frameworks, and approaches from behavioral sciences, communication, social marketing, and health education. 2 • Health communication can take many forms, both written and verbal. Essential to any effective health communication effort is strategic planning. All strategic communication planning involves some variation on these steps: • Identify the health problem and determine whether communication should be part of the intervention • Identify the audience for the communication program and determine the best ways to reach them • Develop and test communication concepts, messages, and materials with representatives of the target audiences • Implement the health communication program based on results of the testing • Assess how effectively the messages reached the target audience and modify the communication program if necessary

29. Effective health communication campaigns • Effective health communication campaigns use various methods to reach intended audiences: • Media Literacy—teaches intended audiences (often youth) to analyze media messages to identify the sponsors motives; also teaches communicators how to create messages geared to the intended audience's point of view • Media Advocacy—through influencing the mass medias selection of topics and shaping the debate on these issues, seeks to change the social and political environment in which decisions on health and health resources are made • Advertising—places paid or public service messages in the media or in public spaces to increase awareness of and support for a product, service, or behavior • Entertainment Education—seeks to include health-promoting messages and storylines into entertainment and news programs or to eliminate messages that counter health messages; can also include seeking entertainment industry support for a health issue

30. L/O To learn how lifestyle choices can affect our general health and well-being

31. How effective are media health campaigns ?

33. Why middle class women are dying for a drink: Alcohol abuse among professional women is causing devastating health problems Middle-class women are increasingly using alcohol to counteract dissatisfaction with their lives Binge? You bet! A new study says loads of middle-class women binge drink. No kidding. Yes, we binge drink. That's because we are so busy juggling everything, and so irritated that we have to do so much more than the men in our lives, that when we do get a night off, we want to make the most of it, and blow the hangover the next morning. In fact, if bingeing means doing something for a short time, in an extreme way, then I binge pretty much everything that is to do with me, rather than my kids and husband. I binge smoke (when binge-drinking with like-minded friends - never in front of the kids, obviously, or anyone who disapproves). Yes, I know it's stupidly bad for me but it's fun and reminds me of what life was like when I was nearly 30, rather than nearly 40. I binge work - sitting down at the computer sometimes at 10pm to start something that won't be finished til 3am because I simply haven't had time to do it during normal working hours. I binge sleep - if my mum and dad take the kids for a weekend, I sleep for 12-hour stretches, presumably making up for the fact that I rarely get more than three or four hours at a time usually, thanks to one of my kids having a bad dream or needing the loo, or some such. And I binge trying to look good - suddenly deciding my daily dog walk should become a run, and then after two weeks deciding I've had enough of that. Likewise, when my roots are really showing and I realise I have neglected my appearance for two months and am on the verge of totally letting it go, I book a whole afternoon at the local salon and get my hair done at the same time as my pedicure and waxing, resolve to come back in four weeks, but never do.

34. L/O To learn how lifestyle choices can affect our general health and well-being Sunbathing choices

35. Simon O ‘Rouke says An "uncompromising" campaign is under way that aims to dampen people's enthusiasm for soaking up the sun. Blame and guilt are key facets of the television and radio messages, with the parents of pre-teen children the target. But the Health Sponsorship Council is making no apologies for the tone of the advertisements, pointing out that skin cancer is the most common form of cancer in New Zealand. Spokesman Wayde Beckman said most parents of today would relate well to the images, which were likely to bring back memories of their own childhood experiences. Leona says of the campaign: ‘I’m proud to be supporting Teenage Cancer Trust’s Shunburn campaign. TCT is a charity that I hold very close to my heart and this campaign is so important because young people really need to know how to stay safe in the sun. I want to encourage teenagers to realise that whether you’re in the UK or abroad, it’s vital to cover up and use a sun cream with an SPF of 30 or above. It’s time to respect your skin!’ Research shows that one of the main reasons young people get burnt is because they simply forget to put on suncream. With the help of free SMS text messages from the TCT, we can stop this happening. Cancer Research UK’s SunSmart campaign is encouraging festival goers to enjoy the sun safely this summer.Protect yourself from sunburn – cover up, relax in the shade and don’t forget to apply at least SPF 15 sunscreen, even in the UK. Outcomes: The campaign achieved high recall. It prompted some parents to improve their children’s sun protection. The others, who felt they were already protecting their children enough, agreed it was a useful reminder. Relevance: This campaign highlights on how to best communicate sun safety messages to parents and caregivers of 8 to 12 year olds.

36. http://www.drdonnica.com/celebrities/index-001.htm

37. The World Health Organisation predicts that by 2020 depression will be the world's most disabling condition, above cancer and AIDS. One in five people will experience depression at some point in their lives, and it underscores most mental illness. Suprisingly, we still do not know what causes the condition and therefore treatments and therapies vary. 2011 marks a significant milestone in SANE's history - our 25th anniversary. Our focus, as ever, remains very firmly dedicated toward helping anyone affected by mental illness. SANE has launched the Black Dog campaign to increase awareness and understanding of depression and other mental illness, to stimulate research, bring about more effective treatments, and encourage people to seek help. Download the campaign brochure.

38. Get on Board – Southern Ireland – Metal Health campaign your young people http://www.youtube.com/watch?v=YZ4_WJwUbFE Man Drinking Fat. NYC Health Anti-Soda Ad. Are You Pouring on the Pounds? http://www.youtube.com/watch?v=-F4t8zL6F0c Time to Change Campaign http://www.youtube.com/watch?v=aIArbJULkPA&NR=1

39. Task – 2 & 3 assessment piece • You are requested to research a campaign that has been targeted in a celebrity/educational approach linked to breast cancer. • You are requested to research passive smoking in public places and why it was necessary to adopt a societal health campaign for this health problem.

40. L/O To learn how lifestyle choices can affect our general health and well-being

41. L/O To learn how lifestyle choices can affect our general health and well-being

42. L/O To learn how lifestyle choices can affect our general health and well-being

43. L/O To learn how lifestyle choices can affect our general health and well-being

44. Summary Health What it means to be healthy for different people • To decide whether a model affects society, individuals or groups revisit your notes. AIMS Raising awareness Improving fitness Preventing ill health APPROACHES Biomedical approach Educational/behavioural Societal approach Health Promotion

45. AfL • When the improved health is likely to arise from medical intervention (using scientific methods) to large numbers of people then the biomedical approach is being used. • If society has been affected by the approach then it is the societal approach. • When information has been dispatched to individuals to persuade the recipients to change to healthier lifestyles, then it is the educational/behavioural approach.