Category: Health Promotion

BIOLOGICAL AND PHYSIOLOGICAL INTERVENTIONS

These involves the use anti depressants medications and the use of light therapy, electro convulsive therapy, diet and also exercise in promoting positive health promotion.

In relation to the depression interventions explained above I related all my interventions which are the social interventions, psychological interventions, biological and physiological inteventions to the TANNAHILL MODEL OF HEALTH PROMOTION which is classified into health education, health Prevention and health protection,

In health education communication is carried out to enhance the lives of well being and to prevent ill health through the influence of knowledge and practice, while health Prevention involves reducing or avoiding the risk of diseases and ill health primarily through medical interventions and health protection focuses on safeguarding polpulation health through legislative fiscal or through social measures. All these approaches are interrelated and reflect distinctive ways of looking at health issues.

Also I am discussing the social rank theory of depression which I underlie to the social intervention /approach and One area, in particular, that is pervasively linked to depression is socio-economic status .The social rank theory (SRT), originally the social competition hypothesis, of depression is an evolutionary theory that endeavours to account for the social rank–mental health relationship; which, unlike other evolutionary theories, accounts for the inferiority and submissiveness that is typical of depression .Social Rank Theory proposes that low mood and submissive behaviour are involuntary yielding responses to defeating competitive situations ( in the competition for resources, such as for food or mates, with dominant others), and these responses are as a means of inhibiting an aggressive ‘comeback’, communicating a ‘no threat’ status and facilitating acceptance of the situation . This is reflected in the submissiveness, withdrawal and self-criticism that are indicative of depression state. Importantly, these symptoms occur when the subordination is involuntary, as there will be situations were subordination is voluntary or desired ( with parents or watching sports). When an individual lacks social power, they may want to challenge or change their situation, but are inhibited to do so by automatic physiological shut-down responses .

This adaptive reaction leads to a stress response in the subordinate individual, with elevations in the stress hormone cortisol as the hypothalamic–pituitary–adrenal axis (HPA) is activated (Abbott et al., 2003). This stress response may be modulated by the social environment, in particular exacerbated with isolation from others, or lessened with increased social support (Abbott et al., 2003). Evidence suggests subordinate male baboons have a hyper-cortisol response, activated by the aggressive behaviour and personalities of so-called dominants, leading to a loss of control for the subordinate, and perpetuated through a feedback resistance in the brain caused by higher stress. Social defeat effects may also impact additional physiological processes, such as reduction in the neurotransmitter dopamine’s transporter (DAT) binding (Isovich et al., 2001) and the dysregulation of innate immune responses (Ambrée et al., 2018). . Additionally, mood variation in patients with bipolar has been closely linked to social rank evaluations, and this may be evidence of a maladaptive instability in social rank .These adaptive mechanisms evolved outwith the modern world, and they may underpin depression, but with the human context having changed significantly there are more triggers for a maladaptive depressive response (e.g., abusive relationships). Indeed, unlike any other animal, humans can self-subordinate by engaging in self-critical thinking . For humans the need to succeed in social arenas may be particularly pertinent, as perceptions of lower rank may impact upon finding a partner, having a successful career and forming friendships, and therefore the need to be accepted, feel attractive and be valued by others are the modern day ‘competition for resources’. Psychological factors such as external shame (perception of feeling inferior in the minds of others), self-criticism, striving to avoid inferiority and rumination about feeling inferior are associated with perception of lower social rank ,this implies that internal thinking may be a crucial factor in the activation and maintenance of the dysregulation of these defensive strategies . Indeed, entrapment can manifest itself in the desire to escape from our internal thoughts, memories, or worries; and therefore we can stimulate the physiological flight mode within the internal world.

Yes the type of interventions/approaches to depression fits in perfectly well, with the main causes of depression mentioned in my background.

ETHICS

• Protection of safety, taking into account risks alongside expected benefits.
• Promotion of autonomy (both in the sense of supporting people’s capacity to make their own decisions and in the sense of protecting their sense of who they are).
• Protection of people’s privacy, bearing in mind that some devices may collect sensitive personal data.
• Promotion of equity both in terms of access to innovative products, and in addressing social stigma and discrimination.
• Promoting public understanding and trust

Virtues

In describing the kinds of behaviours and approaches that are needed to protect and promote these interests, the following are therefore expected- Inventiveness ,Humility and Responsibility .

POLICIES ON DEPRESSION

While 23% of the total burden of disease is attributable to mental health problems, only 13% of NHS health expenditure is spent on mental health . Health economic analyses of the cost of depression in the UK suggest a cost of £17 billion or 1.5% of the UK gross domestic product. Without effective treatment, people suffering recurrent depression have a high risk of repeated lifetime depressive episodes. The substantial health burden attributable to depression could be offset through making accessible evidence-based interventions that prevent depressive relapse among people at high risk of recurrent episodes . To stay well, the recently re-named National Institute for Health and Care Excellence (NICE) recommends that people with a history of recurrent depression continue antidepressants for at least two years . However, there are many drivers for the use of psychosocial interventions that provide long-term protection against relapse .The majority of patients express a preference for psychosocial approaches that can help them and to address this need, mindfulness-based cognitive therapy was developed as a psychosocial intervention intended to teach people with a history of depression the skills to stay well in the long term]

. Mindfulness-based cognitive therapy is a manualized psychosocial, group-based relapse prevention programme for people with a history of depression who wish to learn long-term skills for staying well . It combines systematic mindfulness training with elements from cognitive-behavioural therapy. It is taught in classes of 8 to 15 people over eight weeks. Through the mindfulness course, people learn new ways of responding that are more self-compassionate, nourishing and constructive. This is especially helpful at times of potential depressive relapse, when patients learn to recognise habitual ways of thinking and behaving that tend to increase the likelihood of relapse and can choose instead to respond adaptively.

The NHS England has made ‘improving access to psychological therapies’ a priority in order to focus effort and resources on improving clinical services and health outcomes . The recently launched Parity of Esteem programme has ‘a national ambition to increase access so that at least 15% of those with anxiety or depression have access to a clinically proven talking therapy services, and that those services will achieve 50% recovery rates’. Similar policy pledges in other UK countries aim at improving access to psychological therapies with a specific focus on prevention, like amongst the six high level outcomes in the Welsh Strategy ‘Together for Mental Health’, one is: ‘Access to, and the quality of preventative measures, early intervention and treatment services are improved and more people recover as a result. There is a growing commitment amongst policy makers, commissioners, and those delivering services to ensuring that people with mental health problems receive the evidence-based treatments they need, this is mirrored in patient advocacy groups calling for greater access to and choice in psychosocial treatments.

CONCLUSION

Globally, more than 300 million people suffer from depression (WHO, 2017). It is the most prevalent mental health problem worldwide (GBD, 2015), with the incidence of depressive disorders notably higher in women than in men . Depression is often described as an overwhelming sadness, despair and hopelessness that can last for months or years. Examples of symptoms include, a loss of energy, appetite and self-confidence (Mental Health Foundation, 2018). It can be debilitating, with findings from the Global Burden of Disease Study indicating that depression is the second leading cause of years lived with a disability (Ferrari et al., 2013). Depressed individuals are at an elevated risk of suicide, with more than 90% of those who die by suicide estimated to have a diagnosable psychiatric disorder, and a history of self-harm (defined as non-fatal self-injury) being a strong predictor of dying by suicide. Due to the debilitating nature of depression, much research has been employed to identify factors contributing to its aetiology; these include biological, environmental, social and psychological variables , which has been explained in my background of depression.

REFERENCES

1. Bembnowska .M, Jodwiga J.O (2015), What Causes Depression In Adults, vol.125, pp 116-120.
2. Irene L.G, Hervas .G, Vazquez .C, (2019) The Integrative Positive Psychological Intervention For Depression, pp 1-9.
3. Nagy .E, Moore .S, (2017) Social Interventions: An Effective Approach To Reduce Adult Depression, vol.218, pp 131-152.
4. Wetherall .K, Rory C.O, (2019), Social Rank Theory Of Depression, vol. 246, pp 300-319.
5. Willis .N. Foundations For Health Promotions, (3) pp 79-80.

Health promotion is a way in which information can be wider spread to individuals for them to make informed choices about choosing a healthier lifestyle. to consider taking actions to irradiate or prevent commonly known illnesses. Some of the models that have been constructed to help health care workers aid individuals in a way that is person centered these are the stages of change model, the health belief model, biopsychosocial.

The Biopsychosocial model of health was first derived in 1977 by George.L.Engel for physician to use this new model as an holistic approach to health, looking at an individual’s biology as well as social factors and also psychological factors to determine their route of illness. Firstly, looking at the ’bio’ biological part of this model, to look at the patient’s genetic makeup such as physical health, gender, genetic vulnerability and low immunity. (Varnekar, 2019).

Secondly, to look at the psychological aspect of the model and persons health, using emotions and behaviors the could potentially manifest an illness (Physiopedia, 2019) such as depression, if it’s been suppressed. Finally, the third component is to look at the social concept of the model as the individual engages with relationships, a working environment, social environment and peer group, all of these could have impact on the individual’s health (wiseGEEK, 2019).

Other models used is the stages of change model also known as the transtheoretical model. The Transtheoretical Model (Prochaska & DiClemente, 1983; Prochaska, DiClemente, & Norcross, 1992) is an integrative, biopsychosocial model to conceptualize the process of intentional behavior change. The breakdown of this model includes.

• Pre-contemplation – this is the stage where the individual Is unaware of any illness or lacks knowledge surrounding the illness.
• Contemplation – individual’s aware of a problem being present and wanting to take action in regards to resolving the illness.
• Preparation – Individual’s plan on taking action for this in a near future but have been unsuccessful in previously trying.
• Action – individuals make significant lifestyle changes to their behavior, environment and experience, this stage requires severe commitment, time and energy. (Sussex, Herne and Scourfield, 2008)

Maintenance – this is now there process that the individual with have see change and now has to maintain this goal and also consider all things gained over this period.

Although in diagrams this model is often represented as a circle, however many individuals may have to repeat this process to achieve thr end goal, so could be looked at as spiral rather than the circle. (Allen,2019)

Health beliefe model summersie and write here 6 diff factors

When comparing two of these models the stages of change mode and the biopsychosocial model, they both share same values but bot models have different opinions on health. Whereas The stages of changes model focuses on the prediction of behaviours around the health choices of individuals, whereas the bio model of health has a more of holistic approach. Looks at multiple aspects of the individual and looking at other factor that contribute to poor health management.

The similarities of the models are that they are both used by healthcare professionals in health promotion to target health conditions and disease management. Both models look widely at promoting health, educating, empowering, providing specific medical information, social and behavioral influences.

Evaluation

In a recent set task for promoting a health need for awareness of Prader-willi syndrome, a campaigned aimed at educating people on this syndrome so less stigma involved.

Campaign objectives were to widely spread the knowledge of this syndrome throughout health care and society, so it becomes a more commonly known health problem and also for people living with the syndrome to be more easily integrated into society with few limitations and assumptions from people that aren’t educated enough on the matter.

Prader- willi syndrome is easily connected to both models mainly looking behaviors and management of the syndrome.

Stages of change offers a behavioral technique for individuals to self-efficiency, their own condition. This was first proposed to the parents of the newly diagnosed as a way to manage the aspect of the disease such as feeding and behavioral issues associated with the syndrome. Firstly, coming to terms with the syndrome itself and understanding its long-term effects, as at present there is no cure this links to the per-contemplation and contemplation stage of the stages of change model.

The preparation part of the model is to assist parents of the newly diagnosed, offering support via a wide community of support groups, online forums and specialist care centers.

Actioning things learnt via the support given can aid the person living with Prader-willi syndrome a more meaningful life things to consider when enforcing actions is nutritional value and the motivation to move more, the individual will have a sluggish metabolism a factor associated with the syndrome. Parents to also educate the individual on the syndrome so they can learn to self help and be assisted to make informed decisions on their own health

Keeping this a consistent routine through life progress this then teaches the individual living with Prader- willi syndrome the value of their own life and what to do to maintain it. All of this also relates the biopsychosocial model especially in the biological aspect as this syndrome is heavily weighed on genetics and the vulnerabilities around this.

The promotion In hand supported both models and the education around the syndrome, providing education of the biological effect, enabling empowerment for the individuals living with the syndrome and families supporting them, also as a social aspect to raise awareness as is a 1 in 25,000 births are effected.

The sources that was a used for the health promotion of Prader – willi syndrome was pwsauk website the information provided was very extensive thought out the life of a individual living with the syndrome, with a breakdown of care for all parents, Gps , and healthcare workers, after liaison with a fundraising administrator this lead to signposting back to the original website, little support was there.

Information was provided in the form of bulk text, not in a desired format for easy readability. However self-publications were made to summaries information of the syndrome and the interactive promotion allowing information to be taken away in the format provided on these proved better readability, bright colours to engage audience along with pictures and diagrams to help in relation the health campaign.

Had leaflets been provided by the leading organization used to support the syndrome to attending individuals the information could have been carried over thus wide spreading the objectives of this campaign.

Having the aims to wide spread the knowledge of this syndrome the pitched audience could have been more of a mixed demographic, however was pitched to a younger adolescent audience, this then making this promotion unsuccessful in management due to the audience.

In conclusion, the health promotion delivered key specific medical information. Feedback was gathered and attendees felt they retained the information delivered, this enabling education and awareness. However, the attending audience as previously spoken about, made this promotion unsuccessful. The aims of the campaign were met through the information delivered but was not successful in meeting the intended objectives and requires much bigger audience those including parents, healthcare professional and care givers. To summaries overall the health promotion was to raise awareness and educate of the rare genetic syndrome to a wider spread audience and reduce stigma involved around this.

According to the body mass index (BMI) calculator, a normal weight range for my height would be in between 107 to 140 lbs. and my BMI should be 18.5-24.9. However, I am classed as overweight based on BMI of 29, and I have a strong family history of cardiovascular diseases, diabetes, high cholesterol and sleep apnea. All this condition can be exacerbated by overweight. So, I am intending to target on weight reduction as an aspect of my health promotion project.

Theoretical Frame Work (Health Belief Model)

The theoretical framework I chose to guide my health promotion project is Health Belief Model (HBM). The Health Belief Model (HBM) is one of the first theories of health behavior developed in 1950s by a group of U.S. Public Health social scientists to explain why people were not participating in disease prevention. HBM is an intrapersonal behavioral model which address the relationship between a person’s beliefs and behaviors (McEwen & Willis, 2014, p.322). HBM postulates that health-seeking behavior is influenced by a person’s perception of a threat posed by a health problem. The major six concepts of health belief model are perceived susceptibility, perceived severity, perceived benefits, perceived barriers to action, cues to action, and self-efficacy (McEwen & Willis, 2014, p.322). An individual’s perceived threat to sickness or disease by not undertaking certain health actions is known as perceived susceptibility. The belief of consequence is called Perceived severity. Perceived benefits are the potential positive benefits of action. If a person believes that an action will decrease the susceptibility to a health problem, then that person is most likely to involve in that action. Even if a person sees a health condition as threatening, perceived barriers may prevent the person to engage in the health-promoting behavior. The health belief model also posits the necessary of a cue to prompt people into health-promoting behaviors. The stimulus that prompt to action are called Cues to action. With more powerful cues, the person is more stimulated to act. Self-efficacy refers to a person’s confidence and competence to successfully perform a behavior. According to health belief model the person with a greater level of self-efficacy will more likely engage in a specific behavior to improve health.

I chose this theory because I believe that individuals hardly implement healthy behavior unless they perceive the severity of the problem and is ready to adopt positive changes. Currently I am overweight and I am at high risk for becoming obese and developing obesity associated co morbidities (perceived susceptibility). In my case, my family history of stroke, diabetes, cardiovascular diseases and cancer are my perceived threats. I am clear that obesity associated medical complications such as risk for chronic illnesses and social consequences such as family life, social relationships can be fatal and may change the quality of life (perceived severity). Inconvenience in scheduling daily workout due to full time job, school, responsibilities of my family and kids and lack of motivation are preventing me from losing weight and being unhealthy (perceived barriers). As a health care professional, I have seen a lot of patients suffering from complications of obesity and I know that it is crucial to start eating healthier and engage in physical activity (cues to action). Now, I am dedicated and motivated to reduce my weight through adopting a life style with healthy eating and routine exercise because I believe that controlling my weigh will reduce my risk of having health problems and will improve my physical appearance and self-confidence to live my life to the fullest (perceived benefit).

Article Summaries

In a study by Mcarthur, Riggs, Uribe, and Spaulding (2017), College students weight-related beliefs were measured using 6 scales focused on perceived severity of the consequences of overweight, susceptibility to becoming overweight, barriers to adopting healthy eating and physical activity habits to achieve a healthy weight, benefits to adopting such habits, and internal and external cues to action to adopt these habits. Preceding these scales, students were instructed to consider definitions for the terms healthy eating habits and healthy physical activity habits when completing the scales. Findings suggested that the anticipated favorable outcomes of making healthy food choices and engaging in regular physical activity outweighed potential obstacles such as food preferences, time availability, and expenses. Beliefs from the internal cues to action scale focusing on issues such as body image dissatisfaction and perceived unfair judgments by others based on weight were rated higher than were those from the external cues scale focusing on advice from diverse sources about achieving and maintaining a healthy weight, which indicated that internal cues were regarded as stronger motivators for behavior change. However, the inverse association between perceived severity and BMI suggested that students who regarded the potential consequence of becoming overweight as less personally threatening had higher BMIs.

Summary

I recognized the dangers of obesity and the need to change my unhealthy behaviors to correct my overweight for improving my quality of life. As a first step, I joined in a 6-week series of wellness classes focusing on nutrition and weight management at my Work. I started eating healthier meals and snacks by incorporating fresh fruits and vegetables in each meal and started walking 1 miles a day and started exercising on treadmill and exercise bike. Even though sometimes I get exhausted and frustrated with my new life style modification believing in the advantages of my new behavior is helping me to bypass the difficulty of changing my habits and sticking to my weight loss plan. Now I am becoming more accustomed to the new changes and I feels more confident that I will be able to maintain my new exercising routine and eating habits. I am finding that my assumption regarding immediate health beliefs regarding healthy eating and work out were accurate as my days are infused with greater energy.

References

1. McArthur, L. H., Riggs, A., Uribe, F., & Spaulding, T. J. (2017). Health Belief Model Offers Opportunities for Designing Weight Management Interventions for College Students. Journal of nutrition education and behavior, 50(5), 485-493. DOI: 10.1016/j.jneb.2017.09.010
2. McEwen, M. & Wills, E.M. (2014). Theoretical Basis for Nursing (4th Edition). Philadelphia: Wolters Kluwer Health/ Lippincott Williams & Wilkins. ISBN 978-1-4511-9031-1.

Promotion is a health strategy of the 21st century, which based on the new health perspective that WHO (World Health Organization 1986) proposed in the 1986 Ottawa Charter and re-proposed in the Bangkok Charter of 2005. It is defined as “the process of enabling people to increase control over, and to improve, their health”. In recent years, growth of the Internet has contributed access easy to get lots of information, currently Internet user in the UK shows 90% of people (Office for National Statistics [ONS] 2018). Additionally it has brought people to know the effect and harm of smoking for health. In the UK, smoking continues to be an essential issue for wellbeing.

Puclic Health England(PHE 2015) demonstrates that the smoking populace was 19% in 2014. Being contrast with 1980, it demonstrates the smoking populace that was 39% (GLS 2008). It appears the number of inhabitants in smoking has been dropped than the past, and still, at the end of the day it there are still a few issues in regards to medical issues. From the view purpose of the medicine viewpoints, clearly the smoking cause a few assortments of infection, for example, malignant growth, respiratory ailment, cardiovascular ailment. Moreover, it was accounted for that one of three smokers were murdered by smoking (Jha et al. 2006: Frieden and Bloomberg 2007). As unending obstructive aspirator malady (COPD), which is foreseen that the death rate will be expanded later on (WHO 2012). In like manner, the danger of smoking was called attention to that there are probably being to become depleted with cardiovascular illness (Rabe 2007).

To keep away from such wellbeing danger, intrigue has been coordinated to smoke and, yet a few things that are obstructions to smoke suspension are considered. It is realised that nicotine which is the substance of tobacco contains subordinate substances, which make it troublesome for nonsmokers to act (Health Line 2018). This can be the most obstruction when endeavouring to stop smoking. Be that as it may, there are extra conceivable causes. For instance, it is the earth encompassing them. This is basic in poor territories. Yet on the off chance that the encompassing smoking rate is high, it will be hard to turn awareness toward the smoking suspension. Moreover, the home condition can likewise be a factor affecting. On the off chance that guardians or guardians are smokers and they don’t go to class and don’t get sufficient wellbeing instruction. It is recommended that the effect on kids (Bell et al. 2010). This is called wellbeing imbalance (Bartley 2017), however, a significant number of them incorporate social factors, for example, poor families, poor regions and low instructive foundation (Bell et al. 2010).

Furthermore, one of the principal reasons why you can’t quit smoking is focused. Numerous causes, for example, working environment, work, human connection, tension about the future can be considered, however a few smokers use tobacco as stress adapting (Hajek et al. 2010). In this way, smoking end might be troublesome for the individuals who discover the impact of smoking. There may likewise be bodies of evidence in which social developments against smoking are additionally focusing on smokers. It might be that such social weight should make smokers feel disgrace (Bell et al. 2010) and might be pessimistic about smoking suspension. In any case, a great deal of mischief to smoking has been accounted for, and smoking and ought to be elevated to advance individuals’ wellbeing.

The social movement is to advance smoking and is likewise done in the UK, and lately endeavors to seek after more accommodation has been made as per the spread of the Internet. That is Soptober (PHE 2018) ‘Stoptober’ was established in 2012, which is the 28-day stop smoking challenge organised by Public Health England. There are over one and a half million people attempt to quit, additionally, it shows it more is likely to people are 5 times success (Brown and West, 2017). In this paper, among the Stoptober, we will look at the smoking and program everywhere throughout the nation to be held in October consistently. It is a relatively new approach, however, it should be examined adaptation and consideration about future prospects to be more widespread acceptance. The Stoptober was established by PHE in 2012, which have been carried out on every 1st of October. Participants use the Stoptober app, Facebook, twitter to remind every day and motivate them through the message, additionally people can have a face-to-face advice from experts (PHE).

As quitting options, Public Health England recommends e-cigarettes and nicotine gum as complementary products. Brown and West (2017) stated that quitting success rate over 19.8% for the first six months in 2017, enormously higher than the standard (15.7%) for the last ten years. As campaign background, the media budget is considered as the issue to solve. The 2017 Stoptober was calculated £2.1million, which increased from £390.000 in 2016. As a reason for this, PHE successfully used digital media last year only to reduce expenses, however the campaign occured population biased. Because of that, in 2017, they posted advertisements on media such as television and radio, so it took a lot of expenses. The advantage of the campaign is set beforehand for 28 days, and yet it is a place where unity can be obtained because it is done all over the country. Although it is said that those with empowerment from someone are more likely to succeed in behavior change (Lacina and Griffith 2017), Stoptober gets a sense of security that it is not challenging to smoke alone by a message from someone It may be done. This campaign also focuses on the psychological aspects of smokers. In particular, it is possible to evaluate the psychological change of participants using the stages of changes model (Prochaska and DiClemente 1983) It focus on contemplation stage which is one of the stages in the stages of change model and stimulating smokers’ awareness of smoking cessation by calling for a cessation of smoking through the media.

The limited quit-smoking campaign for 28 days has a clear time scheduling and it addresses all over the UK, so current smokers may feel a sense of unity. Health effect and economic effects are introduced as a merit of smoking cessation in PHE’s web page, and it is placed at shift to the next stage at the time of determination. Smoking cessation using the Internet is easy to feel convenience for those who are intending to quit smoking. At the time of Contemplation, when you care about the health and search the internet about smoking cessation, you can know the existence of this campaign by Stoptober’s posting. At the same time, this web page explains the disadvantage of smoking and the merits of smoking cessation, so it is possible that you might be working on the health conscious dominance. Regarding the health damage of smoking, there are many things you might be familiar with on television, the Internet, or school education, but by understanding it again, you may be able to face your own health. Also, as a merit of smoking cessation via the Internet, convenience such as using social media such as Facebook and participating in smoking cessation by downloading the smart phone application may be leading the participants to quit smoking.

Currently, in the UK, spread of the Internet makes it easier to find information on smoking cessation, but smoking cessation, which is done focusing on this convenience, can be integrated into everyday life. With the conventional smoking program, you have to go to the regional health center or GP, and if you have to work, parenting or school, it will be hard to adjust the schedule. Difficult participation or continuation of Smoking cessation may have formed part of the obstruction of non-smoking behavior. However, as long as you are a web based, you can participate anywhere, so even those who have been hesitant to join can have interest. In addition, telephone consultation by experts is possible, and support is in place, which contributes to the maintenance and improvement of participant’s anxiety disorder and self-efficacy (Bandura 1977). Some smokers may have failed trying to quit smoking in the past. We can not ignore the problem of self stigma (Link 1987) which can recognize himself as a person with low social value by being given stigma, which leads to deterioration of self-esteem, escape from community, decrease in treatment behavior (Corrigan et al. 2006)

That is, stigma is required to deal with both public stigma and self stigma derived from it. For such people, advice from experts will have a dominant advantage. Moreover, there is a possibility that not only their own health hazard but also the harm of the surrounding passive smoking (WHO 2018) is concerned, and by the recommendation of the family and friends, it decides to quit smoking In such a case, we will go to Determination and prepare for challenging smoking cessation. At the time of Determination, although determination of behavior change is generally seen, what is important during this period will be the improvement of self-efficacy. However, Stoptober’s campaign is a massive one all over the country, and it is difficult to adapt it to individuals. In this regard, it will be considered as one of the problems of smoking cessation done on the Internet. Therefore, on the Stoptober’s Web page, there is a goal to shift to the next step from determination by suggesting the benefits of smoking cessation and health damage caused by smoking.

And the most important support is Active’s time which is challenging to quit smoking. Smoking cessation begins in October, but there is addiction in nicotine (Li 2018), and since withdrawal symptoms of nicotine are seen several days after starting smoking cessation (Johnson et al. 2012) It may be the major barrier to annoy us. According to Johnson et al (2012), psychological symptoms such as anxiety and irritation appear as withdrawal symptoms, but in order to alleviate such anxiety, as a reminder, from the organizer side every day as a reminder message notification is sent. Such encouragement will lead to motivation of participants to keep smoking cessation. Behaviour changes in behavior, encouragement and support from other companies has been shown to lead to behavioral preservation (Lacina and Griffith 2017), and this reminder is also expected to expect this effect. However, for this encouragement, clear evidence has not been verified as to whether encouraging e-mails contributed to the success of smoking cessation or smoking reduction in other Internet-based smoking cessation, but research by Munoz et al. (2006), It is known that artificial intelligence created messages tailored to individuality, thereby raising participants’ motivation.

Since Stoptober transmits simultaneous mail, it is difficult to create individual mail, but in order to obtain self-efficacy by adopting the system of artificial intelligence and acquiring the self-efficacy of the intervention method that captured the character and character of participants It may become. However, if there is something that hates a message everyday, that effect cannot expect. If it feels troublesome for messages periodically received, this Internet-based intervention is considered ineffective, but since clear and qualitative data of the participants are insufficient. We cannot make a study. Nicotine replacement therapy is recommended as a countermeasure against nicotine withdrawal symptoms other than encouragement by messages Electronic cigarettes are useful in terms of providing safe choices for smokers and providing permanent alternatives because harmful substances are about one-tenth that of cigarettes compared to cigarettes (Laugesen, 2010: Brown-Johnson et al. 2016). In addition, electronic cigarettes containing nicotine are useful as a substitute for cigarettes, because the nicotine concentration in the body is maintained even when replaced by cigarettes (Yan and D’Ruiz 2015).

However, even if it shifts from cigarette to electronic cigarette, harmful substances, are contained in mainstream smoke, nicotine dependence or nicotine withdrawal symptoms appears, and the possibility that the number used can be increased has been shown (Kawamura et al. 2018). Although PHE positively recommends substitute use of electronic cigarettes, there are few studies of the long-term harm of electronic cigarettes, and its usefulness is also questioned. In this Internet-based smoking cessation, treatment with individuality is difficult, there is a possibility that substitution therapy of e-cigarett may be dependent on nicotine, and it is necessary to set up an opportunity to educate on use and duration of use there will be. However, there are several limitations to this web-based smoking cessation method. One of them is the case that the effect is low for Pre-contemplation. Originally, for people who are not interested in smoking cessation, it is hard to think of searching for words such as ‘smoke-free’ on the Internet, and even if you advertise Stoptobber on television and radio, it is questionable whether it will affect them is there. However, as mentioned earlier, as a result of reducing advertising expenditure in 2016, participation in relatively poor people declined.

It is unknown which stage the people of this social poor belonged, but the publicity of television and radio will be known for some people. What is considered as a problem of smoking cessation is generally health damage, but at the same time health disparities (Bartley 2017) are also considered as a social problem. Furthermore, regarding social status and smoking rate (ONS 2012) is known to have high rates of quitting (about 33% for males and about 25% for females) when social status is low (Q 1). As a background for these, it is thought that wanting to receive adequate health education is a cause, and it may be considered that it is influenced by the surrounding smoking environment and the interest in smoking cessation is thin. The background of such health inequalities is that their social determinants of health are involved (GOV. UK 2017), but ignoring them as they are at the stage of pre-contemplation as it is. The health disparity has expanded. The relationship between smoking and income is also suggested (Press et al. 2018), and smoking issues need to be reviewed throughout the society from the perspective of widening economic disparity. This web-based Stoptober is regarded as important by ‘individuality’ that the smoker himself pushes the participation button, and in that respect it can be regarded as an individual’s health behavior, which is the philosophy of health promotion You will also need a nudge for smokers who are not interested in quitting at all. It is clear that they need to be interested in smoking cessation as Self stigma is known to have a negative impact on disease treatment, recovery and interpersonal relationship (Corrigan et al. 2006) As an alternative method, it may be necessary to intervene with health belief model (Becker 1974) to effectively consciousness them about their health.

However, for pre-contemplation people, the act of ‘encouraging smoking cessation’ itself may have a stigma embraced. In this case, public stigma for society (Bell et al. 2010) is considered rather than a self stigma for self. Even if you understand social health activities, deviation from pre-contemplation may be hard if you feel that you are aversion to yourself. However, it is possible that participants will be biased as well as the results of Stoptober in 2016, considering that they stop smoking campaigns, so also for intervention methods using the health belief model I will have to scrutinize it. Also, people who do not frequently use the Internet cannot do this quit smoking method. The penetration rate of the Internet is increasing year by year, and in the UK, about 90% or more people use the Internet. However, Internet usage rate over 75 years old is 44%, which are shorter than half of that of young people 90% (ONS 2018). Web-based non-smoking support can be easily participated by participants, but people who do not use the Internet, people who cannot use smart phones well, learning disabilities, people with mental illness may be unable to participate easily. Likewise, the action could not be continued during the period of smoking cessation: self stigma cannot be ignored even for those who failed smoking cessation (relapse), and efforts to affect their self-efficacy are clarified Not.

Overall, web based Sotoptobber may be very effective for contemplation. It is easy to participate using apps and SNS, and since it starts all over the country. There is sense of unity with other participants and may avoid loneliness during quitting. It is possible to create a poster to raise consciously health by raising individual’s health awareness as the object of health promotion consciously. However, some problems still remain. There are also concerns about advertising expenses problems and the campaigns themselves are not effective for some people who do not use the Internet, questions about the usefulness of the reminder effect during smoking cessation challenge, and health damage of alternative use. In order to develop health promotion through promotion of smoking cessation in the future, we need to think about reminders that can participate offline. But in doing so, obstacles will become problematic in securing the financial resources and the number of staff members. From the viewpoint of public health, it is indispensable to raise awareness of individual health, but it is also necessary to reconsider the laws for improving health and environmental service creation at the same time. Health benefits, social benefits, and economic benefits obtained by smoking can be planned in the future, so it is possible to reduce smoking rates by considering how to quit the web based on the future. In conclusion, this Stopober ‘s attempt is suitable for the modern Internet society, it also follows the idea of health promotion, such as the participants are willing to participate actively, and also the reputation is seen about the effect of the success rate of smoking cessation . However, in terms of using the Internet, there are aspects that are not suitable for elderly people or some people with low social status. In order to aim for future health promotion, it is necessary to construct an environment where many people can participate.

Hundreds of thousands of babies are brought into this world daily. With our population growing more rapidly than ever, there is an apparent demand for pediatric nurses to provide care to these children. Pediatric nurses have the ability to promote a healthy lifestyle to children through many stages of their lives with the use of ample resources to maintain well-being and to allow patients to retain the healthy habits they have been taught in order to thrive from birth into adulthood. This paper will explore how pediatric nursing is closely intertwined with health promotion, as nurses play an essential role in educating their patients on how to live an active lifestyle, and preventative actions against unhealthy behaviours.

Pediatric nurses work with children alongside their parents to deliver expert health care from birth to late adolescence. Pediatric nurses provide a variety of services with specialized skills in many work settings in order to effectively care for children at every stage of development. Some well-known fields of pediatric nursing include neonatal pediatric nursing, neonatal intensive care unit nursing, and labor and delivery nursing. Pediatric nurses work in settings such as children’s hospitals, community hospitals and major medical centers. Examples of tasks which pediatric nurses are widely responsible for include: identifying changes in a child’s signs and symptoms, advocating for children, differentiating between normal and abnormal findings, analyzing situations to detect changes in status, determining a child’s needs in relation to pain management and administering medication (Graduate Nursing EDU, n.d.). The Canadian Association of Paediatric Nurses (2017) identifies five national standards of pediatric nursing which serve as a framework for pediatric nursing to ensure consistency and high-quality nursing care is met with the delivery of services to all children. These standards include: supporting and partnering with the child and their family, advocating for equitable access and the rights of children and their family, delivering appropriate care, creating a child and family friendly environment and enabling successful transitions within the plan of care and between health care professionals and institutions (Canadian Association of Paediatric Nurses [CAPN], 2017). Pediatric nursing is recognized by the Canadian Nursing Association (CNA), but the specialty only emerged in the mid 1800s when the first children’s hospital opened, making it a fairly new medical specialty. According to Broadribbs Introductory Pediatric Nursing (Hatfield, 2006), children were cared for by their relatives and often died due to sickness or fatal diseases in the 1800s. In the 1980s, physicians Marshall Klaus and John Kennell conducted studies that revealed separation of babies from their mothers at birth had negative effects on family relationships (Hatfield, 2006 p.4). Hospitals then began modifying regulations and slowly implemented more policies which reflected the needs of children and families (Hatfield, 2006 p.4). There are challenges in pediatric nursing as nurses must be able to cope with the sorrow associated with children who are ill. Pediatric nurses also deal with stressed parents whose children are in a vulnerable state, and they must be capable of reducing the parents’ anxieties. Although there are challenges pediatric nurses face, there are also rewards associated with pediatric nursing. In particular, neonatal nurses’ job satisfaction is correlated with compensation such as improved patient health status and advocacy such as assisting a new nurse with a task they have not done independently (Archibald, 2006). A critical aspect of job satisfaction in pediatric nursing is positive patient outcomes, which is strongly influenced by health promotion.

Health promotion is a means of achieving positive health outcomes in nursing as it has the ability to increase quality of life, increase understanding of the patient’s illness, and it allows patients to self-manage their illness (Kemppainen, Tossavainen, & Turunen, 2012). Health promotion aims to eliminate factors that could cause disease or illness with the use of programs and education to raise public awareness. According to the World Health Organization (WHO), health promotion is defined as the process of enabling people to increase control over, and to improve their health (The WHO Health Promotion Glossary, 1998). Preventative care, which focuses on maintaining health and not only the treatment of disease, can be categorized into three levels of prevention; primary, secondary and tertiary. Primary prevention aims to reduce risk factors of poor health and promote protective health by intervening before the consequences occur. Secondary prevention strives to prevent the advancement of a disease by intervening when diseases are detected in the early stages. Tertiary prevention targets the management of chronic diseases to increase one’s quality of life and improve their ability to function (Tasmanian Government, n.d.). Nursing creates an opportunity for nurses to educate their patients with appropriate information to manage and improve their health status. In nursing, health promotion can be implemented at the level of public health and population health. Public health involves a concern for people around the globe and it works to prevent health problems prior to occurrence. Examples of public health include immunizations, promoting healthy eating and active living, and protection against environmental health hazards. Public health maintains the well-being of our community and keeps it free from illnesses which could have been prevented through the implementation of health policies and programs (Falk, 2014). In contrast, population health focuses on the health of specific groups of individuals and aims to reduce health inequities (Falk, 2014). Using the results of the health of specific populations, policies can be implemented to improve the health of those which are at risk for ill health. Through the promotion of healthy lifestyles and reinforcement of methods that reduce and prevent illness, nurses have the capability to significantly improve the overall health and well-being of the population.

Pediatric nurses are actively involved in health promotion on a daily basis when interacting with their patients. Firstly, pediatric nurses practice primary prevention by educating children and their parents on healthy diet habits to prevent obesity. “Treatment of Child and Adolescent Obesity: Reports from Pediatricians, Pediatric Nurse Practitioners, and Registered Dietitians” states: Like adult obesity, childhood obesity prevalence is rising. As these children age, the obesity epidemic will lead to epidemics of diabetes, hypertension and cardiovascular disease… studies in obese children suggest that interventions focused on improved eating and activity behaviour may lead to marked, sustained weight loss, with long-term outcomes superior to adult studies. (Barlow, Trowbridge, Klish, & Dietz, 2002, para. 5)

Pediatric nurses are responsible for ensuring their patients’ diets are well balanced and their food intake is appropriate for factors such as the child’s age, height and weight. Through the prevention of childhood obesity, there are many risk factors that are eliminated which could have resulted in negative health outcomes that are extremely difficult to eradicate as an adult. Parents should also be involved in the child’s education on nutrition as they play an important role in implementing good dietary habits and making lifestyle changes for their child. Pediatric nurses may also give instructions for weight loss through diet and physical activity changes to patients who are already overweight which is secondary prevention. Furthermore, the collection of family health history is a useful tool for health promotion in pediatric nursing. Family health history is a risk factor for chronic disease, as one’s risk of developing a disease increases drastically when a relative has previously had it (Kanetzke, Lynch, Prows, Siegel, & Myers, 2011). Collecting family health history is a particularly important part of health care visits during childhood as it allows pediatric nurses to address the condition at an early stage before it progresses if children show risk factors to a disease (Kanetzke et al., 2011). Catching a disease or illness at an early stage and preventing its progression is an example of secondary prevention. Compiling family health history also benefits the parents as they can apply directives given by the nurse to themselves, which can raise awareness to healthy habits they should participate in. Lastly, pediatric nurses incorporate health promotion into their profession through aiding children with type 1 diabetes mellitus with the development of independent behaviours to effectively care for themselves and manage their glycemic control. Type 1 diabetes mellitus is one of the most common chronic diseases in children and it requires treatment that encompasses many specialized skills such as insulin injections, nutrition management and physical activity (Pelicand, Fournier, Le Rhun, & Aujoulat, 2013). Self-management support is a crucial component of managing the chronic illness as it is imperative for children to learn to autonomously control their glycemic levels without the need to rely on their parents. The education and support from pediatric nurses helps to avoid the very serious consequences which could arise from insufficient management of the disease and treatment (Pelicand et al., 2013). The management of a disease such as diabetes mellitus is an example of tertiary level prevention which indicates the promotion of health through the management of a chronic disease to increase quality of life.

Pediatric nurses work closely with their patients and their patients’ families to provide adept health care in a variety of different environments. Not only do pediatric nurses engage in direct illness treatment but as well as health promotion at primary, secondary and tertiary levels to improve the health of their patients and the public. Through emphasis on health promotion in pediatric nursing, the prevention of disease and management of disease progression in children is improving each generation to create a healthier population. Children are the future of creating abundant wellness in our society and this all begins with the health of our youths.

Introduction

In 1941, the far-famed medical scholar Henry Sigerist wrote that the most things that has got to be enclosed in a very national health program square measure free education, as well as health education for all, the simplest doable operating and living conditions, the simplest doable suggests that of rest and recreation, and therefore the very best treatment.

For Sigerist, treatment was ‘a system of health establishments and medical personnel, out there to any or all, chargeable for the people’s health, prepared and ready to advise and facilitate them within the maintenance of health and in its restoration once hindrance has de-escalated.” the present attention system is split between 2 elementary branches: drugs, that thinks about with the treatment of malady, and public health, that thinks about with the promotion of health and therefore the hindrance of malady. whereas the previous contains a way bigger quantity of resources, public health is believed to directly have an effect on a lot of peoples’ lives. The promotion of health and therefore the hindrance of malady involve 3 distinct strategic levels of implementation:

Societal measures to generally improve the customary of living of the population, as well as efforts to cut back state and to extend academic opportunities. associate degree example of this level may be seen within the initial success of the hindrance of T.B. once mortality rates were dropping in England, Wales, and Scandinavia, even before the reason for T.B. was understood, most likely because of improved nutrition that allowed folks, particularly youngsters, to resist infection.

Public health interventions to foster health promotion and malady hindrance within the society as a full. associate degree example of a sure-fire public health strategy may be seen with the widespread utilization of acute anterior poliomyelitis vaccination, that had a serious result in reducing morbidity and mortality.

Healthcare suppliers activity preventive interventions for individual patients, either to stop malady (primary prevention) or to observe malady at associate degree early stage (secondary prevention). associate degree example of such intervention is within the declining morbidity of lymphoma within the late twentieth century because of earlier designation and treatment of that condition.

Disease Management and malady Prevention: Finding a wise Balance

In reality, however, a mere fraction of the whole attention budget has been allotted to hindrance. In 1991, for instance, the us spent $750 billion on attention of that solely 3 % was dedicated to government public health activities designed to stop unwellness. Officially, preventive attention has been a serious goal of us policy since publication of ‘Healthy People: The Surgeons General’s Report on Health Promotion and malady Prevention’ in 1979. In 1990, ‘Healthy folks 2000: National Health Promotion and malady hindrance Objectives’ (United States Department of Health and Human Services) listed 3 broad goals to be reached by the year 2000.

1. Increase the span of healthy life for Americans.
2. cut back health disparities among Americans.
3. attain access to preventive services for all Americans.

Such goals need a shift of resources from a attention system accentuation malady management to true malady hindrance and health. With bigger balance between malady management and preventive attention, it may be expected that the standard of the attention system will improve to handle the requirements of our society, whether or not to people through attention suppliers or through public health strategies to larger segments of the population.

Of course we have a tendency to all understand that preventing malady is way higher than treating it, particularly if we have a tendency to square measure considering chronic diseases like cardiovascular disease and cancer, that cures square measure terribly tough. Among the baby-boom generation generation, a lot of and a lot of income goes toward upbeat services and preventive attention, serving to to shift the paradigm from malady management to health promotion.

One of the first options of complementary/alternative drugs is that the stress placed on the reason for malady as compared to the stress in standard drugs on the designation of the clinical entity. Understanding the reason for malady provides U.S.A. an amazing advantage in advocating an efficient attention strategy to stop it.

Five Principles of Healthy fashion

To begin, it’s necessary to acknowledge that there square measure sure elementary principles of health that there square measure extremely no alternatives. These may be thought of as spokes on a wheel. If even one spoke is weak, the wheel won’t flip swimmingly and therefore the entire vehicle are going to be noncontinuous. to keep up associate degree optimum level of health and well being, we’ve got to relate to 5 elementary, non-alternative principles:

• Good nutrition, as well as clean air and pure water
• Adequate exercise
• Proper posture
• Sufficient rest
• A positive, peaceful state of mind

Whatever else we have a tendency to might need within the manner of knowledge and resources to optimize our health or treat a lot of chronic diseases, we have a tendency to cannot avoid listening to those 5 elementary areas of fashion. they’re basic and essential to maintaining and promoting our health.

We should perceive that true health will solely be earned if we have a tendency to sleep in harmony with concept as a matter of our every day fashion. By incorporating the principles of a health-building fashion program into our daily routine, we are able to maximize the potential for a extended and happier life. no matter else we have a tendency to do to extend our level of health and vitality, such a way of life program are going to be the solid foundation upon that everything else are going to be based mostly.

When We Fail to measure by the Principles of Health

When we fail to measure in accordance with the principles underlying the health building fashion, we have a tendency to lose the inner balance that characterizes the healthy state. it’s conjointly doable that, considering the degree of environmental toxicity to that we have a tendency to square measure exposed, and therefore the level of stress beneath that most folks live, even those folks living a comparatively healthy fashion may be thrown out of balance, setting the stage for the onset of chronic malady.

Once we’ve got begun to lose our health, it’s unlikely that the health-building fashion alone are going to be decent to reverse the matter. we start to expertise minor chronic symptoms, that square measure nature’s early warning signals that corrective action has to be taken. As powerful as our innate capability for self-healing is, at an exact purpose the buildup of environmental/metabolic toxicity and emotional/mental stress merely becomes over the system will handle.

It would be wise at now to talk to associate degree integrative health care provider (one World Health Organization has data of each standard and different medicine) to form positive that there’s no unknown malady. even though you are feeling you’re in wonderful health and have fully no symptoms in any respect, it’s wise have a periodic standard diagnostic analysis to rule out any malady conditions before continuing with a help program on one’s own.

Using Natural Health Promotion, Before malady Develops

Once applicable examinations have excluded the presence of malady, our next step is that the use of natural health promotional programs, which might facilitate correct the issues before serious conditions develop. Even those following a health building fashion would be wise utilize these same programs as a preventive strategy to keep up and more promote their level of health.

The place to start is in our response to minor acute unwellness. usually the onset of the uncomfortable symptoms of colds, minor skin eruptions, epithelial duct issues, and different common complaints square measure nature’s manner of attempting to handle inferior infection or inflammation. By learning a way to use nontoxic natural medicines like homeopathics, we are able to join forces with nature instead of foolishly suppressing the symptoms.

Detoxification

In addition, the mixture of toxicity and mental-emotional stress puts a vast burden on the self-regulatory systems of the body. By addressing this issue as early as doable, we are able to considerably cut back the danger of a lot of serious malady developing down the road. the difficulty of toxicity involves those strategies which will effectively promote healthy epithelial duct operate and rid of the alimentary canal of parasites and different contaminants that we’ve introduced through the food or water. Food additives, flavorings, colorings, pesticides, preservatives, antibiotics, and hormones, among others, set out reactions within the body that may cause a range of health issues. Used on a periodic basis, ideally each season or a minimum of twelve times every year, associate degree enteric detoxification program combined with liver and blood cleansing will facilitate defend the body against ‘inner pollution’ by flushing out environmental toxins also because the noxious by-products of metabolic processes.

Positive state of mind

The importance of a positive, peaceful state of mind has already been mentioned in concert of the key factors in a very health-building fashion program. it’s believed by many who negative mental-emotional patterns like rancor, envy, fear, and guilt will greatly disrupt and disorder the balance of our mind. trendy science is collateral that each emotion contains a corresponding organic chemistry supported the discharge of powerful neurotransmitters, that square measure naturally-produced chemicals that may exert either a useful or damaging influence on our body’s physiology or operate.

Stress management

Because this mind-body affiliation mediate by with chemicals active neurotransmitters is such a vital consider malady feat and malady hindrance, it’s changing into progressively clear that we want to manage stress on an everyday basis so as to optimize the capability of our inherent self-healing and self-regulatory mechanisms.

Conclusion

We have chosen to stress a health promotional approach exploitation medical care medicines, detoxification, and stress management as a result of they’re typically safe, simple to implement, and will, in most cases, effectively improve your level of health. Of course, as was emphasised earlier, it’s continuously suggested to debate these approaches together with your doc or authorised health care provider, and to talk to your doctor if any ill health fails to resolve promptly or if there’s any question concerning the existence of a a lot of serious condition.

As we have a tendency to get in the primary years of this new century, we have a tendency to square measure poised for nice strides within the promotion of health, extension of life, and therefore the hindrance of malady. By taking a lot of personal responsibility for our health and changing into a lot of autonomous in accessing those tools that may effectively serve U.S.A., can|we’ll|we are going to} be within the best position to require advantage of the breakthrough advances in biotechnology and drugs that science will beyond question give U.S.A..

Abstract

Mental health is one of the most misunderstood fields of nursing. Physicians frequently misconstrue the complexities of individual’s symptoms. This misunderstanding results in several unsuccessful trials of medication therapy while avoiding the root cause of the illness. Health promotion in the field of mental health is a slow timely process that requires a broad approach to treatment. Nola Pender’s Health Promotion Theory speaks to altering unhealthy behaviors to endorse health. Theoretical concepts on person, environment, nursing, health, illness, and reflects social cognitive philosophy. Personal traits and environment are connected and can shape one’s behavior. Pender believes the environment encompasses a social, cultural, and physical context in which life unfolds and individuals can be both sources of and adapt to healthy behavioral changes (Petiprin 2016). The real question is how effective behavioral therapy in mental health is? This paper will expound on the purpose of the Health Promotion Model, demonstrate influences for selecting the noted theory to narrate mental health needs, exemplify plans to implement the theoretical model into current mental health practice, and barriers that may interfere with implementation. The purpose of this paper is to reveal the contribution Nola Pender Health Promotion Model can bring to the advancement of mental health and patient/s welfare within mental health treatment.

Introduction

Nola Pender’s Health Promotion Model defines health as a positive dynamic state being without illness and focuses on improving an individual’s state of well-being (Petiprin 2016). This model serves as a reflection of the social cognitive theory, in which cognition affects action and environmental events are indirectly projected as functioning control over behaviors (Misener, Phillips, McGraw 2000). Pender purposes that conduct can change via one’s perception and the benefits of that change can improve the quality of life by pursuing self-enrichment goals. The Health Promotion Model has three structural components: personal traits and experiences, (including environmental factors) specific congenital behavioral effects, and the outcome of behaviors (Petiprin 2016). Pender’s theory focuses on promoting health mentally, physically, emotionally, socially, and spiritually.

The Motivation for Theoretical Philosophy

Mental Health is composed of a variety of symptoms, predisposing factors, and is individually specific. Behaviors are actions learned through cultural methods, reactions to things experienced, and means to maintain self-control within self and the environment. Pender’s Health Promotion Model relates to mental health in a way that some other theories may not. Operating in crisis stabilization is another motivating factor. Crisis stabilization involves constantly seeing the same patients with the same problems based mainly on non-compliance as a result of environmental, financial, and emotional stressors. Stays range from 3-10 days when the patients come to detox off substances and/or receive medication adjust based on mental status. Through this process it is difficult to focus on the overall needs of the patient, yet it could be the ultimate cause of frequent re-admission. Promoting healthy behaviors along individual therapy and medication management could be the key to improving patient’s overall well-being. There is a need for the promotion of health by altering behaviors or ways of responding, within mental health care. This theory will allow people suffering from mental illness to retain some self-control, aid in their control of negative health diminishing behaviors, and encourage health-promoting behaviors that may enhance their quality of life.

Health-Promoting Behaviors

Pender model includes thirteen theoretical statements (Petiprin 2016 p.1):

• “Prior behavior and inherited and acquired characteristics influence beliefs, effect, and enactment of health-promoting behaviors.”
• “Persons commit to engaging in behaviors from which they anticipate deriving personally valued benefits.”
• “Perceived barriers can constrain a commitment to action, a mediator of behavior as well as actual behaviors.”
• “Perceived competence or self-efficacy to execute a given behavior increases the likelihood of commitment to action and actual performance of the behavior.”
• “Greater perceived self-efficacy results in fewer perceived barriers to specific health behavior.”
• “Positive affect toward a behavior results in greater perceived self-efficacy, which can, in turn, result in increased positive affect.”
• “When positive emotions or affect are associated with a behavior, the probability of commitment and action is increased.”
• “Persons are more likely to commit to and engage in health-promoting behaviors when significant others model the behavior, expect the behavior to occur, and aid and support to enable the behavior.”
• “Families, peers, and health care providers are important sources of the interpersonal influence that can increase or decrease commitment to and engagement in health-promoting behavior.”
• “Situational influences in the external environment can increase or decrease commitment to or participation in health-promoting behavior.”
• “The greater the commitments to a specific plan of action, the more likely health-promoting behaviors are to be maintained over time.”
• “Commitment to a plan of action is less likely to result in the desired behavior when competing demands over which persons have little control requires immediate attention.”
• “Persons can modify cognitions, affect, and the interpersonal and physical environment to create incentives for health actions” (Petiprin 2016 p.1).

Implementation of Healthy Behaviors

Implementing healthy behaviors in mental health can be a challenging task. To promote healthy inpatient behaviors, healthcare workers must also be seeking to improved personal well-being. Healthcare workers must seek to promote healthy behaviors by example. Nurses displaying healthy behaviors allows them to be more relatable to the challenges of continuing healthy habits and enhances the relationship between the nurse and patient. The patient is not only encouraged via speech but by illustration. Although goals may not be the same for the nurse and patient, knowing that caretakers are striving to improve well-being adds merit. Implementation would include collective and individual behavioral modification therapy, endorsing and assessing patients self- reflecting goals. Educating patients regarding the benefits of improving behaviors, encouraging patients to seek assistance when needed, and improve patient-staff relationships would also be a necessity. Every visit, an individual should feel more equipped to control behaviors and positively respond to triggers and/or stressors. Also, implantation of therapy should be peer-peer therapy because peers have a greater understanding of each other struggles. More empowered individuals should be asked to lead groups to encourage healthy behaviors of peers. The more involved patients are in their care the greater the outcome of them achieving stability and well-being will be.

Patient Barriers That Affecting Implementation.

Patients constantly express a need for self-worth and feel belong in the community. Patients’ perceptions of self are distorted due to frequent negative experiences, current economic status, unemployment, financial instability, and developments of mental trauma impacting their thoughts. The term social functioning was interpreted in a peer group study, stating social functioning includes having a support system, feeling safe and accomplished within their community, feeling less judgment, and more access to jobs (Hannigan B; Bartlett H; Clilverd A (2007). Their depression and behaviors were a result of limitation of healthcare, limited jobs, and not feeling safe. These barriers to patient stability affect their willingness to apply healthy behaviors. The stresses of their current status block their positivity and willingness to thrive. Positive health-promoting behaviors would have a greater effect at younger ages permitting manifestation of those behaviors with age. Group therapy is also important so that professionals will gain understanding of their healthcare situation and perceptions. There can also be barriers related to age, culture, gender, and stage of illness.

Healthcare Barriers that Affect Implementations

Healthcare professionals along with their practices can also be a barrier to implementing healthy-behavior (Barnes, Almasy 2005). Barriers consist of limited study of health promotion in mental health, limited advancement of healthy behaviors, and ineffective coping techniques to advanced mental health. The cost of treatment, and limited time spent with healthcare professionals to gain knowledge of patient conditions is also a barrier. Pender’s model can be used in the development and treatment to enhance compliance with medication and therapy (Lannon SL1997). Healthcare professionals view medication refusal or non-compliance as the patient being difficult while failing to assess the truth behind the refusal. Patients should have the right to refuse treatment unless they are a threat to themselves or others then crisis interventions are necessary. To control or decrease the behaviors medical profession initially or only seeking medication therapy. Although medication therapy is very useful and effective, it may not always be the immediate answer. Fears of aggressive actions, fearing the unknown, patients’ non-compliance, decreased relationship, and array individual therapies needed for patient care sometimes hinder the implementation of social modification therapy. Interventions are needed to promote medication, therapy, behavioral control, and compliance while assessing the reasoning behind the patient’s hesitance to comply.

Methods to Overcome Barriers

Restricting barriers, in a mental health setting, can be a bet taxing. Maslow’s hierocracy of needs is a great tool to use in treatment of mental illness. Physiological needs must be met first. Health-promoting behaviors can be achieved by providing resources and assisting patients to meet their needs McLeod (2018). Assistance with safety, love and belonging, self-esteem and finally self-actualization then follows. Building trusting therapeutic relationships is most effective in limiting barriers. The Health Promotion Model empowers nurses to inspire first self-care and then build patients’ capacity to perform via education and person development (McEwen, M. & Wills, E. 2019). Implementing health-promoting behaviors may allow more understanding of the patient’s mental state through behavioral modification techniques. Encouraging patients to obtain more self-control over conditions, teaching positive methods to cope throughout the disease’s process, and education on when to seek assistance are key factors to assist in the decreased psychiatric hospital stays more patient compliance, and increased patient- staff trusting relationships.

Conclusion

Mental health can truly be impacted by the benefits of promoting healthy behaviors of a patient as well as healthcare providers. Pender’s theory speaks to many healthcare fields. Though mental health can greatly benefit from this model by exhibiting the holistic care values. Guided care within the mental health framework requires the support of first the patient, then the staff, families and overall the community. We all suffer or have suffered from mental instability whether it be situational or genetically acquired. The advancement of mental health could help us all in some way. A daily goal should be striving to improve self: mind, body, soul and even the environment we live in.

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This assignment consists of defining the knowledge, skills, and attitudes that healthcare professionals use to apply to advance wellbeing. This will emphasis on quitting smoking in the adolescent (16-25 years old) population in the community environment, with particular reference to national NHS health guidelines. This assignment is aimed at this population because if adolescent individuals carry on smoking it would lead to a wide scope of health problems and the development of a serious disease in adulthood; for example, hearing loss (Dawes Piers, 2014). Smoking is a process where burning tobacco in cigarettes, pipes, and cigars is inhaled by an individual. Tobacco smoke contains over 5,000 chemicals including tar and nicotine (Saleem et al 2018).

The definition of health promotion is for individuals to have control over their health and make sufficient improvement (Ottawa Charter,1986). WHO (1946) states that ‘’ health promotions defined as the health state of complete, physical, mental and social well-being, and not simply the absence of disease or infirmity; this, therefore, means that physical, mental and social prosperity is part of health promotion as well as the nonattendance of illness or sickness’’. Health promotion helps individuals resolve their health issues via a holistic approach, allowing individuals to get involved in situations that they are comfortable with and therefore helps healthcare professionals to use health promotion to ensure that individuals have a positive outcome with their health (Kumar and Preetha, 2012). According to The Royal College of Nursing, health promotion has a relationship with nursing as it understands that nurses can reduce the impact of illnesses, promote health and help individuals to the best of their ability, regardless of whether it is in a community or hospital setting (RCN, 2019).

Adult Nurses are required for health promotion as they get in contact with the public all the time, accordingly their insight and abilities can lessen sicknesses of patients and advance a more advantageous way of life for the patients as it would lead to a reduction of demands for healthcare professionals and financial pressure on NHS and private healthcare institutions (Kumar and Preetha, 2012), in spite of the fact that wellbeing nurses focus around health, infection, changing the conduct of the people education (Dombrowski et al, 2014). Subsequently, it has enhanced the accessibility of wellbeing administrations, decreased manifestations of perpetual ailment, expanded cost adequacy, upgraded personal satisfaction and encouraged self-administration (Stromberg et al, 2003). Health promotion has the thought of upstream and downstream aspects which underlines how social, cultural, cash related and characteristic components impact prosperity and wellbeing (Smith, 2015). The downstream idea tends to be why an individual turns out to be sick in any case, though the upstream idea centers around starting consideration for the anticipation of sickness, which is basically what health promotion means (Wills, 2014).

Knowledge

Health is most important as it is a source of everyday life. Therefore, health promotion is not just the responsibility of the health sector but it is for healthy lifestyles and wellbeing (Ottawa Charter, 1986). Health promotion is defined as having the understanding to be able to educate individuals, to make the individual mindful and enabling individuals to accomplish their well-being and lifestyle (Veras et al, 2015). This supports people in identifying their physical, mental and social well-being, and helps individuals realize their ambitions and satisfy needs which will help the individual to change or cope with the environment. On the other hand, this could also potentially be a disadvantage due to a minimal amount of understanding and time which is needed to continue health promotion (Veras et al, 2015).

Nurses need the experience to promote smoking in adolescent individuals (16-25 years old) because smoking can cause a wide range of illnesses which can decrease life expectancy (Dawes P, 2014).

Reducing health inequalities in the key to Public Health priority as a way of promoting health (Marmot, 2010). On the other hand, it may also be difficult for subcategories of the population to be in contact with health promotions as it may be ‘’hard-to-reach’’ for Public Health programs due to physical/geographical location or their social/economic situation (Flint, 2008). According to Professor Mike Kelly, director of the NICE Public Health Centre, states: ‘’over 79,000 deaths in England each year are due to smoking tobacco’’. Several health promotion techniques are being utilized for counteractive action and suspension. Evaluation of some of the health promotion intervention studies has appeared to have a positive effect on the decline in smoking. For instance, ‘’the ‘STOPTOBER’ 28-day campaign has helped over 1 million people quit smoking’’ (Stoptober, 2012). Another health promotion that was put in place for adolescent individuals was not being able to buy cigarettes as the minimum age for the legal purchase of tobacco increased from 16yrs to 18yrs in England, Scotland and Wales on 01/10/2007 (BMJ, 2018).

Smoking is a risk factor of chronic diseases such as lung cancer, ‘’with 90% of these cases being the result of smoking’’ (Cancer Research UK 2019). It is the biggest issue increasing particularly with people who live in a poorer society.

‘’Responsible for 80,000 lives for each year, the immense budgetary burden on the NHS to treat sicknesses related to smoking is evaluated at £2.7 billion every year’’ (DH 2010). Research shows that mediations are progressively viable when joined with approaches, for example, campaigns and legislation (Edwards 2010). Having attention to campaigns and legislation is significant for the best practice and guaranteeing that the learning and abilities are cutting-edge, and medical caretakers know about the update arrangements and legislation so they are not giving mistaken data out to the people, a standard set by the Nursing and Midwifery Council (NMC 2008). The standard stated by the NMC Code (2008) was ‘’the standard of education, training, and conduct that nurses and midwives need to deliver high-quality healthcare consistently throughout their careers is done by ensuring that nurses and midwives keep their skills and knowledge up to date and uphold the standards of their professional code” (NMC Code, 2008). Up-to-date data shows that ‘’in 2009, 6% of youngsters matured 11-15 years were consistent smokers’’ (Robinson 2007). However, even when individuals understand the health risk that tobacco smoking can cause, unfortunately, 1 in 5 people continue smoking (DH 2010). Nurses have the responsibility knowing all the information about smoking, the health promotion strategies in place for smoking, what kind of help the individual is getting and where changes could be made if the patient feels like the help they are currently receiving is not helping him or her. Nurses must process enough learning while at the same time utilizing evidence-based techniques as it enables them to support, encourage and share data with individuals to quit smoking. However, diminished learning, expanded feelings of anxiety, constrained data and absence of time are obstructions that prompt the weaknesses of promoting health (Chen et al, 2014).

Health promotion policies are important as they aim to support the country’s priorities with the real health needs of the population so that all people in all places have access to quality health care and live longer, healthier lives (WHO, 2016). There is a wide range of models of health promotions that develop from behavioral and social sciences and borrow from psychology, sociology, marketing, and consumer behavior; it also reflects not just the behavior of the individuals but influences of wider society. The reason why models are put in place is that it helps practitioners and nurses to understand health behaviors and guides the identification of health promotion strategies. The models which are used specifically for smoking in health promotions are:

Tannahill’s model (1990) of health promotion consists of three overlapping circles. An example of this model would be when a nurse contributes to handing leaflets out which educates individuals or the wider community regarding the health risks of smoking and prevention. An example of the element of the model is that ‘’ in 2007 the legal age for selling tobacco increased from age 16 to 18 years to reduce the availability to young people and prevent them from starting to smoke’’ (DH 2008). Another model that can be used for behavior and promoting health would be Prochaska and DiClemente Stages of transformation model (1984). This works as individuals go through stages for them to improve behavior, which leads to maintaining a healthier lifestyle. The stage will depend on how much the patient is smoking and therefore this is when an effective assessment will take place. This model motivates patients to change and get involved in the changing process (Hove et al, 2002). Marmot (2010) stated that the lower social classes had the poorest health and identified social factors such as low income and deprivation as the root causes which affect health and wellbeing. Bilton, T (2002) suggests the environment an individual is at can harm health which can influence patterns of behavior. An example of this would be families who have deprived housing conditions, living in poverty or in an environment where no one socializes, this, therefore, can lead to psychological stress, which encourages people to enforce behaviors such as smoking (Blackburn et al 1991, Earle et al 2005).

Skills

Nurses are required to use various verbal and non-verbal communication methods considering sensitivities to appropriately respond to patients’ personal and health needs (NMC Code, 2015). Verbal communication is used by nurses for the nurse to choose their words carefully so the patients can understand what the nurse is trying to say (Lloyd and Craig 2007). Nonverbal communication is a message which is expressed without using any words. For example, this can be done via gesture, facial expression or touch (Renata et al, 2005). For successful communication between a nurse and the individual, the necessary skills are effective and respectful assertiveness and listening (Boynton, 2017). Overall, good communication skills are necessary for a therapeutic relationship between the nurse and individual, this can be verbal or non-verbal, however, would be seen by having the appropriate body language, posture, respecting the patients’ values and beliefs and allowing time to communicate with the patient (Tanz et al, 2018). Nurses would be active listeners and encourage the patient to talk, using open and closed questions which shows the individual that the nurse is listening and showing concerns for the person’s conditions which therefore demonstrates respect and shows the individual that the nurse is willing to put the effort in and help them out (Peate 2006).

Another skill that is used is motivational interviewing. Motivational interviewing is a counseling method that helps people with their insecurities to find a motivation that they need to change their behavior. Motivational interviewing evolved from Carl Roger’s person-centered, or client-centered, approach to counseling and therapy to allow to help people who find it difficult to change a bad habit e.g. smoking (Rogers 1957). ‘’Smoking cessation is the most effective intervention to prevent deterioration’’ (Aggarwal and Agarwal 2007). Motivational interviewing is often applied in smoking cessation, together with self-efficacy (Bandura 2001) and the trans-theoretical model of change (TTM) (Prochaska and Dicemente 1984).

Motivational interviewing is portrayed as joined, suggestive and humane about the people’s self-governance to support ‘change talk’, where the patients talk about how they will acknowledge change (Miller and Rose, 2009). Now the patients ought to be sure to express their very own inspiration and indecision for conduct changes (Rollnick et al, 2008). Motivational Interviewing has four rules:

• To oppose the correcting reflex,
• To comprehend and investigate the patients’ very own inspiration,
• To tune in with sympathy
• To engage the patients and empower expectation and idealism (Rollnick et al. 2008).

Results appeared ”that experts’ self-detailed aptitudes in the inspirational meeting were inconsequential to capability levels in watched practice” (Miller et al, 2004). According to Lundahl and burke (2009), motivational interviewing showed better results compared to non-intervention.

Another skill for promoting health is Health Education. Health Education promotes an understanding of how to maintain personal health. This skill is necessary for this assignment because, at the moment, there is a lot of health education in place to help people quit smoking. The National Institute for Health and Care Excellent (NICE) guidelines shows that nurses should help individual stop smoking as soon as possible by maybe determining the level of interest in smoking cessation and discuss quitting options. The National Association of School Nurses Standards for Professional School Nursing Practice (NASN, 1998) includes a standard related to health education. Health education aims to change behavior by providing the person with the knowledge they require which allows them to make healthier decisions and ables them to fulfill their potential. Healthy Lives Healthy People (2010) ensure that nurses play an important role when delivering health promotion with attention to the prevention of primary and secondary levels. Nurses have a wide range of skills and knowledge which is used to empower people to make lifestyle changes and choices. This, therefore, underpins people to make changes in their wellbeing and increment sentiments of individual self-sufficiency (Christensen 2006).

Nonetheless, one national strategy which was viable of this intervention was the ‘’ Smoke-Free England’’ campaign which was presented in 2007 ‘’controlling smoking in work environments and encompassed open spots’’. At the point when this arrangement came into spot, ‘’the law smoking discontinuance administrations saw an expansion request by 20%, as smokers felt the environment was conducive to them having the option to stop” (DH, 2008). This policy is also set up on emergency clinic ground, and medical attendants need to guarantee. Health education is important in nursing as there are nursing education programs in place which are given in the classroom and in the clinical practice setting about the importance of patients or individuals understanding their health care conditions to restore, maintain and promote health. The final skill which could be used by nurses to promote health is clinical skills. Clinical skills are needed as part of promoting health, this can be taken up when promoting health by doing a full psychological observation of the individuals which could include HR, RR, BP, Saturations and Temperature, once this procedure is done nurses must always ensure that the observations are recorded and monitored (NICE, 2008).

Attitudes

Nurses have an important role in nursing to show non-smoking behaviors for the individual. there needs to be a consistency between personal and professional beliefs for nurses to engage in smoking health promotion. evidence show in Sue Halls (2005) short report for the survey of practice nurses’ attitudes towards giving smoking cessation advice results showed that nurses had positive attitudes towards this short report for individuals to reduce smoking. For instance, ‘’36% wanted to go for smokers as they felt that the people would react to their recommendation, 28% did not trust that talking about smoking with all smokers was a reasonable and felt like this was tedious, 23% felt that examining smoking with all smokers were probably going to accomplish more mischief than anything lastly 23% did not trust that their recommendation was compelling” (Hall, 2005).

This report was carried out in January 2003 via a cross-sectional survey, it consists of a population of 200 registered nurses. It was a random determination from the Medical Research Council General Practice Research Framework. Practical preparing in smoking suspension for enlisted medical professionals is relied upon to have an expansion rate, therefore along these lines implies that people will tune in to the smoking end encouragement given.

Conclusion

To conclude, wellbeing advancement concerning counteractive action of ailment and sickness, the job of the medical professional is significant as they should bring issues to light and give instruction and counsel to people who need to change their conduct. The difficulties of health promotions specify the extensive competences a nurse must have to empower and encourage individuals. On the other hand, governments have the responsibility to promote and protect health and are essential in presenting the national policy to build ‘’healthy publics” an atmosphere beneficial to health.

Health promotion encourages people to take control over their health. It protects many people with social and environmental interventions that are made to benefit and covers people’s health, and quality of life, by discovering and preventing the root of illnesses, not just based on treatment and cure. Individuals and communities needs to take more control over their health and lives as well. Individuals have the power to provide advice, information, support or they can organise activities themselves about community participation for empowerment of the health, promoting health and wellbeing in communities. I, personally, try to promote healthy habits to myself and my family. I do so by reducing our calories intake, and junk food. I also promote activities such and regular walks or cycles.

The health promotion model focuses on helping individuals accomplish more elevated levels of prosperity. It assists individuals with pursuing better wellbeing or perfect wellbeing through their conduct. As indicated by discovering insights and information identified with Rural Health, the Health Promotion and Disease Prevention Theories and Models support the act of wellbeing advancement and sickness prevention. Speculations and models are utilized in program wanting to comprehend and clarify healthy practices, and it prompts distinguishing proof improvement, and usage of interventions. In any case, when you think of a hypothesis or model to direct health promotion or even disease anticipation programs, it is essential to think about a scope of elements, for example, explicit medical issue to be routed to the population, and the settings inside which the program is being actualized.

Health promotion exercises give people and networks capacity to settle on solid practices and roll out certain improvements to lessen the danger of creating chronic diseases. As indicated by the WORLD HEALTH ORGANIZATION, the meaning of wellbeing advancement is to help individuals improving individuals’ quality of life. Improvement is encouraged by an incredible range of the social and natural intervention and projects. This sort of projects centre around keeping individuals healthy, and encourage individuals to settle on more astute decisions with regards to their wellbeing lessening the danger of creating interminable illness and different morbidities.

The procedure for health promotion and sickness avoidance start with communication, education, policy systems and environment. Consequently without communication it wouldn’t have been conceivable to declare to the public strategies advancing wellbeing and the avoidance of sickness as fairs as mass media campaigns and pamphlets, just to bring issues to light of wellbeing practices to the overall population.

Public service announcements, health fairs and mass media campaigns and newsletters are some examples of communication used for health promotion. These techniques for correspondence are utilized to bring issues to light about healthy practices to the overall population. Wellbeing correspondence incorporates verbal and written techniques to impact and engage people, and communities to settle on more beneficial decisions. Health communication frequently incorporates parts of different hypotheses and models to advance positive changes in frames of mind and practices. Wellbeing correspondence is identified with social promoting which includes the advancement of exercises and interventions intended to decidedly change practices.

Powerful health communication and social showcasing procedures include: utilization of research based systems to shape materials and items and to choose the channels that convey them to the target audience. Improvement of materials, for example, leaflets, transmissions, pamphlets, radio ads, public service, bulletins, billboard, announcements, video recordings, digital equipment, contextual studies, group discussions, wellbeing fairs, field excursions, and exercise manual among others media sources. The assortment of communication channels empowers wellbeing messages to shape broad communications or relational, little gathering, or community level campaigns. Health communication methodologies plan to change individuals’ information, demeanours and practices. They, increment risk perception, fortify positive practices, impact social standards, increment the accessibility of help and required administrations, enable individual to change or improve their wellbeing conditions. An example of wellbeing correspondence battle and intervention is the one aiming to spread tobacco avoidance and discontinuance messages to communities in various manners. Channels can incorporate; broadcast media radio, newspapers and magazines.

As previously stated education is fundamental to health promotion. Regarding education, activities include lectures, courses, seminars, webinars, workshops; class’s health education is one strategy for implementing health promotion and disease prevention programs. Health education provides learning experiences on health topics. Health education strategies are most likely tailored to a specific demographic based on the issue decided to cover. Health education presents information to target populations on particular health topics, including the health benefits/threats they face and provides tools to build capacity and support behavioural change in an appropriate setting. When mentioning health education strategies, it is important to include the characteristics that make these strategies such as, the participation of the target population, completion of a community needs assessment to identify community capacity, resources, priorities, and needs. Planned learning activities increase participants’ knowledge and skills. The proficiency of the programs is ensured by staff through training to maintain fidelity to the program model, as well as, Implementation of programs with integrated well-planned curricula and materials that take place in a location convenient for participants, and presentation of information with audiovisual and computer based supports such as slides and projectors, videos, books, CDs, posters websites, and more. Examples of health education interventions is the oral health outreach program. The oral health outreach program was developed to provide dental education and outreach to children. Health education activities are meant to enhance the overall goal of the health promotion and disease prevention program. Material developed for health education programs must be culturally appropriate and tailored to the target populations to ensure cultural competence. In communities this means addressing cultural and linguistic differences and addressing potential barriers to health promotion and prevention in rural areas. Policy systems and environmental change; However for health promotion and disease prevention strategies to be successful, policies, systems and environments (PSE) must be supportive of health. Therefore policy systems and environment change of strategies are designed to promote healthy behaviour by making healthy choices readily available and easily accessible in the community. Policy systems strategies change are designed with sustainability in mind. A policy is a tool for achieving health promotion goals. Organization decisions policies are made by them, agencies, and stakeholders. Policy approaches include legislative advocacy, fiscal measures, taxation and regulatory oversight. Example of health promotion and disease prevention policy approaches include; establishing policies for smoke free zones and public events, establishing healthy food options in vending machines in public places, adding a tax to unhealthy food options, requiring the use of safety equipment in a work setting to avoid injury. State and local governments often implement policy intervention for rural tobacco prevention and control.

Models for state and local governments are accessible in the provincial tobacco control and anticipation toolbox. Extra contemplations for actualizing provincial wellbeing approach are accessible in the country wellbeing arrangement guide. Frameworks change alludes to a central move in the way issues are understood. Inside an association frameworks, change influences their motivation capacity and associations by their way of life, connections, arrangements and objectives. Case of frameworks change in wellbeing advancement and sickness avoidance incorporate, creating plans implementing new mediation and forms, adjusting or replicating a demonstrated wellbeing advancement model, executing new advances, making preparing or accreditation frameworks that line up with strategies. Natural change methodologies include changing the monetary, social or physical surrounding, or settings that influence wellbeing results. Environmental procedures wellbeing results in benefiting the populace, and the best utilized in blend with different techniques. Instances of condition methodologies for wellbeing advancement and infection counteractive action incorporate, expanding the quantity of parks, scenic routes, and trails in the network, introducing signs that advance utilization of strolling and biking ways, expanding the accessibility of new, solid nourishments in school, cafés and cafeterias.

The adequacy of affirmed wellbeing advancement exercises is broad, yet at the same time not as large as it could be. I decide to say something regarding smoking hits in England. As per new authority insights updated on 2 July, 2019 the positive news is that smoking predominance in England is proceeding to fall.14.4% of grown-ups in England smoke, down from 14.9% the earlier year a drop of very nearly 175,000. There are just about 2,000,000 less smokers now then in 2011. Meanwhile smoking is in terminal decrease, it remains the country’s greatest executioner and today numerous individuals are one bit nearer to a smoke free age despite the fact that there is still a lot of work to do. Grown-up smoking habits in the UK; 2018 distributed by PHE and ONS shows that smoking prevalence in England has gone down to 14.4%. This implies rates are somewhere around just about a quarter from 19.3% five years back getting the assessed number of smokers England to around 6 million

Anyway in spite of the endeavours to lessen imbalances, there are still gatherings where smoking rates remain determinedly high. Smoking among 18 to 24 years of age has fallen quickest however of specific concern is the 1.4 million 25 year old who smoke that is comparable to one out of five individuals. We are likewise observing a consistently enlarging hole between individuals in standard and manual occupations and those in administrative and managerial position.

Despite the fact that there are presently the smokers was about 2,000,000 less than in 2011. There stay around 6 million grown-ups that are as yet dependent upon the overwhelming damage tobacco causes. Decreasing smoking is one of PHE’s key needs and it keeps on working all day every day to help both government and nearby general wellbeing groups with a wide scope of proof date and instruments. However the administration’s tobacco control plan spreads out the desire and steps we are taking to accomplish a smoke free country. Meanwhile the government’s arrangements require a coordinated exertion to arrive at a portion of society’s most powerless individuals. We can possibly accomplish our desire in the event that we gain more ground in helping individuals experiencing poor psychological wellness for which smoking rates stay high. We should take the help to where these individuals are coming through emergency clinic entryways on regular basis. We ought to likewise recall that when smokers see that individuals around them are stopping, it urges them to stop as well.

References

1. www.changeincorported.com/
2. https//doi.org/10.2015/AJPH.93.2.266
3. www.nationalarchives.gov.uk
4. https://www.ncbi.nlm.nih.gov,pmc
5. www.publichealthmatters.blo.gov.uk
6. www.ruralhealththinfo.org

This essay will discuss the opportunities for health promotion at different stages of a person’s lifespan. Such approaches include: medical, such as immunisation from virus-es, behaviour change, for example, take up exercise and a balanced diet, educational (leaflets and adverts to highlight problems with smoking), empowerment (group cir-cles) and social change, such as smoking bans in public places, from lobbying groups. This essay will seek to explain the different health impacts of smoking on the adoles-cence stage, 10-19 years old, and the health promotion interventions on this group.

Furthermore, the importance of ethical principles in the health promotion and public health will be analysed. Health promotion is a program that empower, engage and en-ables peoples to improve their health and make them in the state of complete mentally, physical and social wellbeing (Hubley and Copeman 2013). Background. One of the main interventions for helping adolescents quit smoking is called ‘Smoking Cessation’. The objectives of smoking cessation are well established and includes enhanced treatment efficacy and improved quality of life (Graham, 2016). At present, the average smoking prevalence globally is estimated to be 31.1% for men and 6.2% for women. Smoking is the most important preventable cause of fatality as nearly 6 million deaths every year are caused by this habit, and smoking leads to many adverse health consequences as well (Sun and Mendez, 2019).

It has one of the biggest impacts on the health of males and females at the adolescence stage. This is sufficient proof that health intervention methods are needed. Smoking cessation intervention The objective of this essay is to develop a stop-smoking program to reduce the num-ber of adolescents becoming addicted to it. The planned activities used to achieve these goals could include having a ‘Raise awareness’ programme for 6 weeks in schools, which would include people coming in to give talks on the effects of smoking in gen-eral, information sessions on tobacco consumption being delivered to all adolescents – both smokers and non-smokers. This would be a good idea as it may prevent them from even starting the habit in the first place, if they see how it can affect them.

The classes will even include free advice on how to quit smoking, if the adolescents have already begun. Workshops can be implemented that include seeing in person, all the chemicals that are contained in cigarettes, and the mental, physical and social effects it has. Volunteers could be used to hand out free ‘quit-smoking’ kits. The behaviour change approach will be offered with a motivational interview and advice on strategies for resisting the desire to smoke. The kits could include smoking patches or e-cigarettes designed to wean individuals off the tobacco addiction. This may be expen-sive as these items are not cheap, but it could give people the incentive to try them if they are getting them for free. A cheaper solution might be to have people giving out advice as opposed to handing out free kits. They can then refer the public to the NHS for advice on quitting and the steps needed to do this. In terms of theory, Naidoo and Wills (2016) argue that there have been many health promotion methods in the past and in the present. However, they claim that for health promotion to develop and work, a strong theoretical framework is vital. They state that one prominent theory to tackle smoking habits is Beattie’s four-way paradigm towards tacking social and health problems.

The four parts includes, Health persuasion, Legisla-tive action, Personal counselling and Community development. In terms of quitting smoking, health persuasion, specialist social workers in this field, can be sent to educa-tional institutions, to persuade adolescents to quit smoking or at the very least, give advice as to why smoking is detrimental to their bodies. Legislative actions would in-clude lobbying for tighter controls on selling cigarettes to older adolescents and maybe raise the legal age if needed. Personal counselling could include motivational interview-ing by youth workers sent to schools and colleges to persuade youngsters to give up and refrain from smoking. Finally, community development could be schools working with each other to empower them and give them staff-training to increase skills and methods of tackling smoking. Naidoo and Wills (2016) argue that Beattie’s model is great in terms of deciding a strategy for progress on health, whilst simultaneously, leaving scope for political and social intervention.

Evaluation the success of the Intervention

The best way to evaluate successful intervention is to do testing on the number of ado-lescents smoking before the 6-week program, and then carrying out similar tests on whether the numbers have increased, stayed the same or decreased, due to the pro-posed intervention. However, it is important to note that it may be difficult to reduce number of smokers within six weeks. Hence, a lengthier time may be needed, based on results. Furthermore, testing accurately may be difficult because students may not be honest as to whether they have given up after the intervention has finished. Hence, re-liability of results may be skewed. Finally, the costs of such interventions need to be weighed against the benefits, which again, may be inaccurate.

Ethical issues of intervention in Adolescence

In terms of ethical issues with the intervention, individuals may feel they are being judged and therefore, may become resistant to being tested or even going ahead with the planned intervention (Naidoo and Wills, 2009). Naidoo and Wills (2009), argue that there are four ethical principles that are widely accepted: respect for autonomy, which in this case, giving adolescents their right to do what they want with their lives. Beneficence – the commitment to do beneficial actions, mostly from the practitioner side in this case, as they would want to benefit the adoles-cents. Non-maleficence, which is the obligation not to harm individuals in the interven-tion process, and finally, justice, the obligation to act fairly when dealing with adoles-cents’ rights. These actions must be considered when undertaking the intervention strategy with all adolescents.

Conclusion

To conclude, smoking cessation initiatives on adolescents is an important public health intervention because it prevents nicotine dependence and severe health consequences in the future and increases the life expectancy of the general population. Furthermore, the need for protected and steady families, sheltered and strong schools, together with constructive and strong companions are critical to helping adolescents reach their maximum potential, and achieve the best wellbeing in the change to adulthood.