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Never believe what a patient tells you his doctor said.
SIR WILLIAM JENNER (1815–98)
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Health promotion is the motivation and encouragement of individuals and the community to see good health as a desirable state that should be maintained by the adoption of healthy practices. It is also the process of helping people to increase control over and improve their health (WHO definition 2009).
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For those who feel healthy, the message may have little meaning, but it is reinforced by contact with others who become ill, particularly within the family.
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The Lalonde report1 highlighted the notion that all causes of death and disease had four contributing elements:
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Health education is the provision of information about how to maintain or attain good health.
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There are many methods, including the advertising of health practices, the provision of written information (e.g. about diet and exercise, immunisation, accident prevention and the symptoms of disease), and information about methods to avoid disease (e.g. sexually transmitted infection).
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A lot of so-called ‘health’ education is, in reality, information about the cause of particular illnesses. Clearly, the medical practitioner is in a pre-eminent position to provide his or her patients with specific information about the cause of an illness at the time, either individually or to the family. This educative strategy has a preventive objective that is often the modification of help-seeking behaviour.
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Every consultation is an opportunity to provide information about the condition under care and this can be reinforced in written, diagrammatic or printed form. Patients’ own X-rays can be similarly used to illustrate the nature of the problem.
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HEALTH PROMOTION IN GENERAL PRACTICE
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GPs are ideally placed to undertake health promotion and prevention, mainly due to opportunity.
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There are several reasons for this health promotion role:
Population access: over 80% of the population visits a GP at least once a year.2
On average, people visit a GP about five times each year.
GPs have a knowledge of the patient’s personal and family health history.
The GP can act as leader or coordinator of preventive health services in his or her local area.
The GP can participate in community education programs.
GPs should undertake opportunistic health promotion—the ordinary consultation can be used not just to treat the presenting problem, but also to manage ongoing problems, coordinate care with other health professionals, check whether health services are being used appropriately and undertake preventive health activities.2
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OPPORTUNISTIC HEALTH PROMOTION
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The classic model by Stott and Davis (see TABLE 3.1 in CHAPTER ...