Health Promotion

and Emergency Care

Main part

By: Dr Ali Davod Parsa (MD, PG Dip, PhD)

Senior Lecturer- Allied Health& Medicine

Updated: Oct 2012

Learning outcomes:
1. Recall Definition: Public Health, health promotion & Education & Main Concept Describe the Selected Methods of health promotion Student will be able to identify the different areas of health that can be promoted within the A&E departments 4. Student will be able to identify health promotion ideas that can prevent health emergencies 2. 3.

Outline:
1. Review of Basic Background in Health Promotion 2. Different Practical Ways are Used for Health Promotion 3. Defining the Different Approach to Health Promotion in the Context of the Emergency Care 4. Practice on Different Scenarios in Promoting Health within an A&E setting

Health:
Health is defined in the WHO(1948) as: A state of complete physical, social and mental well-being, and not merely the absence of disease or infirmity.

Health Includes:
Physical Health Mental Health Emotional Health Social Health Spiritual Health Societal Health (Ewles & Simnett, 2003, p. 6)
Adopted from: (KP 2010)

What Does Public Health include?

1. 2. 3. 4. 5. Health Education

Health Promotion
Health Development Health Improvement Disease control (CDSC)

(Piper 2009 Ch.1, p18-28)

Public Health Is:

Promoting Health

Preventing Disease

Prolonging Life

Acheson (1998), (Department of Health, 1998)

Disease Prevention:
Protecting as many people as possible from

the harmful consequences of a threat to

health.

What is health promotion?

Health promotion is the process of enabling

people to increase control over their health

and improve it. (WHO 1986)

Ways of Promoting Health

Developing healthy lifestyles Encouraging Access to Services Health Decisions Involvement Making Healthy Choice, the Easier choice Educating about the Body and Keeping it Healthy
Naidoo and Wills (2009)

SENDER

RECEIVER

Reach Senses

Gain Attention

Message Understood

Message Accepted

Behaviour Change

Improvement in Health

Health Promotion(2);

Choice of Methods

Choice of Methods
Face-to-face methods in various settings
one-to-one, group, large group, meetings, patient education, schools

Any one or a combination of these methods

Mass media
radio, TV, newspapers, billboards, posters, magazines

Support activities
development of educational materials, leaflets, wall charts, videos, training of field staff

Role of the family health promotion

-An Important Role -The Capacity of Families

Level of operation

Mechanism of operation
Commercial influences News/documentary coverage
of issues

Effect

Individuals direct effects Social network discussions within family, friends and communities Public agenda discussion, debate and concerns in communities Policy agenda concerns of policy makers

Media coverage of role models

Media: National Local Community

Health promotion advertising

campaigns sponsorship

Social marketing

Health Promotion Campaign

A short intensive programme of mass media often supported by other activities such as public events and endorsements by celebrities

Print Media
Leaflets Wall charts Teaching packs

John Hubley & June Copeman 2008

Other potential uses

Social Networks influence health Electronic Media and the Internet Mobile phones text messages
(e.g.remind patients, inform young people on sexual health topics).

Automated dialling

1st Session Break

A&E- Health Promotion

How an A&E Department can promote Health? How Does Health Promotion Support A&E Department Services?

Out line
What is an Emergency? Different Areas of Medical Emergencies Management of Emergencies Approach to the Emergencies How health promotion can contribute to the management of an Emergency? A Case study

A&E- Health Promotion

How an A&E Department can

Promote Health?

Health Promoting Emergency Department Programme (HPEDP)

How an A&E department can promote health? Accident and Emergency units are often regarded as the 'shop window' of a health service. There are opportunities for health education amongst a 'captive audience
Accid Emerg Nurs. 1999 Jul;7(3):164-7.

Framework for A&E Department Health Promotion

Integration of health promotion strategies into the

Management of Disease is Recommended

Bensberg and Kennedy

How an A&E Department can promote health? The lengthy A&E wait times is as an opportunity to assess the health status of the population are served.

Health promotion and disease prevention in the ED-Can J Emerg Med 2006;8(2):100-5

An A&E Department can promote health by: 1-Identification of Health Issues 2- Interventions offer and 3. Changing The Staff Attitude

A&E Departments and Health Promotion

Are A&E Departments are a suitable setting for Health Promotion? Yes, But!!!

A&E Depts. and Health Promotion

Needs Changing the Staff Attitude Because: Staff are Educated to think exclusively of

Own Medical Care

Changing the Staff Attitude

Need organisational shift, Required to make them more inclusive of health promotion WHY ?

A&E Departments and Health Promotion

A Point of Entry to Health System A Reliable Source of Health Information Can Deal with Health Inequality Share Similar Goal Infrastructure Already Existed

A&E Departments and Health Promotion

share similar goal:

Individual& Community Health Improvement

A&E Departments and Health Promotion

Existing Infrastructure:
Planning Processes, Professional Alliances and Community Network

The Scope of Emergency Medicine

Health Promotion and

Disease Prevention

The Scope of Emergency Medicine

to identify health risks and To offer immediate interventions to the patients Who?

How an A&E Can Promote Health? 1-identification: Adult A&E patients who are:
smokers, problem drinkers and/or substance abusers, and need for immunization and Pap smears

Are provided with appropriate counseling

How an

A&E can promote health?

1. Eligible for immunization-receives immunization on the same A&E visit 2. Overdue for a pap smear -offered a pap smear in the A&E or referred to an appropriate outpatient clinic 3. Reported substance abuse( alcohol, street drugs and both)-referral for counselling 4. Smoking, referral to a smoking cessation program 5. Injury prevention counselling

How an emergency care department can promote health? The A&E Department could screen for additional health risks including hypertension, geriatric falls, smoke detector counselling and domestic violence.
Health promotion and disease prevention in the ED-Can J Emerg Med 2006;8(2):100-5

A&E Departments and Health Promotion

willingness of A&E patients to participate in Health Promotion and Disease Prevention

Health promotion and disease prevention in the ED-Can J Emerg Med 2006;8(2):100-5

A&E Departments and Health Promotion

1-Patient health information
Written, audio visual materials, Discharge planning, Telephone advice

2-Screening& Early intervention programme -Alcohol abuse -Domestic violence - women Cancer 3-Injury prevention

How an A&E department can promote health?

Accident and Emergency units are often regarded as the 'shop window' of a health service. opportunities for health education particularly in relation to Accident Prevention.
Accid Emerg Nurs. 1999 Jul;7(3):164-7.

A&E Departments; Injury prevention: -The influence of one A&E department amongst primary school children to increase their awareness of cycle safety Developing Educational materials &, a series of visits to schools and organising a competition positive responses from the children
Accid Emerg Nurs. 1999 Jul;7(3):164-7.

How an emergency care department can promote health? A&E Clinical Staff Local Head Teachers Urged to Encourage STUDENTS

Helmet Use
Injury Prevention 2006;12:271272

2nd Session Break

A&E- Health Promotion

How an A&E Department can promote Health? How Does Health Promotion Support A&E Department Services?

How Promoting Health Can Help an A&E ?

Key Aim is to: Reduce the number of people seeking unscheduled care with an emphasis on prevention and health promotion
Accid Emerg Nurs. 1999 Jul;7(3):164-7.

Important Areas of Health Promotion: Mental Health Tobacco use Alcohol/ drug use Sexual Health Obesity Physical Activity Any other condition as an emergency??

How promoting health can help an A&E ? Please make a list of possible urgent visits to the A&E department: 1, 2 3, ,

How Promoting Health Can Help an A&E What about Minor Burns? When you think of health promotion in MI what do you think of?

 Primary prevention in MI (which model of

Health Promotion?)

Primary health promotion intervention for FALLS PREVENTION

Examples of manage medicines e.g. Anti-hypertensives, diuretics etc. Nutrition Good feet good shoes Home safety
- Lounge, kitchen, bedroom, bathroom - Telephone - Lighting and wiring - Outside

Exercise

Childhood Accidents: How Health Promotion May Help

The accident prevention strategies for school children For an effective accident prevention, hazards and/or risk taking behaviour should be reduced.
J Child Health Care. 1998 Autumn;2(3):128-31

Childhood Accidents: How Health Promotion May Help

HP in schools reaches a large audience and is an important means of reaching this age group

J Child Health Care. 1998 Autumn;2(3):128-31

Childhood Accidents: How Health Promotion May Help

Why It is Important?

Mortality Morbidity

Promotion of bicycle helmet

Many children suffer from injuries caused by bicycles, scooters, skateboards, and roller skates accidents Head injury is the most common cause of death and serious disability in bicyclerelated crashes.
http://www.ncbi.nlm.nih.gov/pubmed/17969306

Cycle Related Head Injuries in primary school children

Almost 300 primary school aged cyclists are killed or seriously injured in the UK each year, the majority from severe head injury. This figure could be substantially reduced if more children wore cycle helmets.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2586770/

Bicycle-related Head Injuries

Each year in the US, bicycling accidents cause approximately 1,300 deaths and 60,000 injuries. Head trauma is the most frequent cause of death and serious injury among bicyclists.
Prevention of bicycle-related head injuries. Weiss BD

Bicycle-related Head Injuries

Bicycling accidents cause many serious injuries

Riders with helmets had an 85% reduction in their risk of head injury/ 88% reduction in their risk of brain injury
N Engl J Med. 1989 May 25;320(21):1361-7

promotion of bicycle helmet for children up to 18 yrs

The use of bicycle helmets = the Most

Effective Measure in preventing head

injury
http://www.ncbi.nlm.nih.gov/pubmed/17969306

Childhood Accidents : Health Promotion

- Health Problem: Childhood Accidents - Solution: health promotion model - Target: Reduced hazards and/or risk taking behaviour
J Child Health Care. 1998 Autumn;2(3):128-31

Childhood accidents: a health promotion model

-Need for accident prevention national strategies for school children - To develop effective health promotion and accident prevention nurses need to work in cooperation with other agencies

J Child Health Care. 1998 Autumn;2(3):128-31

Primary school Aged Cyclists

Head Injury
(death and serious injury )

More Children Wore Cycle Helmets

Substantially Reduced
Injury Prevention 2006;12:271272

Health promotion & Pandemics Emergencies

Health promotion & Pandemics Emergencies

Training on Health Promotion and
Human Influenza SARSA

Preparedness for Civil Society H1N1 influenza virus

Health promotion & Pandemics Emergencies

Training on Health Promotion
-Training community leaders and local NGO members how to prepare individuals against the threat of pandemic and Disseminate information, Education, and Communication material

Health promotion & Pandemics Emergencies

Training on Health Promotion Epidemiology, prevention and control of pandemic Simulation Exercises Strengthening Community response in
Schools, workplaces

Any Questions

Thank you Any Question ?

For further guidance contact: Dr Ali Parsa Senior Lecturer (Allied Health& Medicine) Fulbourn: Ext. 5332
ali.parsa@anglia.ac.uk

References:
Practical Health Promotion by Hubley, J. & Copeman, J. Polity Press Evaluation in health promotion Principles and perspectives- WHO Regional Publications, European Series, No. 92 Framework for Health promoting Emergency Department A Case-Control Study of the Effectiveness of Bicycle Safety Helmets http://www.nejm.org/doi/full/10.1056/NEJM198905253202101 The rationale for promotion of bicycle helmet legislation for children up to 18 years , http://www.ncbi.nlm.nih.gov/pubmed/17969306 Prevention of bicycle-related head injuries. http://www.ncbi.nlm.nih.gov/pubmed/3453198 Effectiveness of bicycle safety helmets in preventing head injuries. A casecontrol study. Thompson DC, Rivara FP, Thompson RS,

http://www.ncbi.nlm.nih.gov/pubmed/8971066