Health Promotion Cycle: Plan-Implementation

Now what I’m wanting to talk about is the next stage in the health promotion cycle. We’ve talked briefly about the planning and I’ve emphasized how important it is. Now we get to the bit that we all like, the doing. The strategies that we’re going to choose. The things that are going to make a difference if they’re implemented well. In the model that I presented you around PABCAR, these were identified as potential strategies. Things like education and behavior change, the use of technology, regulatory or policy changes, environmental changes, or organizational changes. These are just some of the ways in which we can create a health enhancing environment. But how do we make that decision? How do we choose?

Sometimes it’s about pragmatics Sometimes it’s about the fact that we only have the capacity to do an educational intervention. But I need you to think about when you’re doing something that is significant in health promotion, what is the outcome we’re trying to achieve? What is the legacy I want to leave? Because policy, regulation, and environmental adaptations leave a legacy; they alter the environment. Education can lead to behavior change,

but just remember: it needs to be repeated, it needs to be reinforced, it needs to be supported. And each generation that comes through needs to go through that education again. So we can’t assume that health literacy in all its facets is going to be automatically assimilated. It needs direct action. Whereas changes to policy, regulation, and environmental adaptation are there, they’re always there. So have a really good could think about the capacity to be able to use those things which actually create a health enhancing environment.

Now for those of you who are thinking deeply at this point, you might start to see some tension emerging between the very first lecture that I gave, where I was talking about the role of Health Promotion to advocate, to mediate, and to enable and then some of these strategies that I’m suggesting here. Some of you may feel that they impinge upon human rights, they impinge upon the rights of people because we’re restricting their behaviors. For example, not allowing smokers to smoke in public venues. But it’s worth coming back to some of those elements around health promotion. That process where we talk about partnership and participation, the process of co-design, of co-implementation, of co-evaluation, they need to be considered here.

If you’re worried about doing victim-blaming or dictating, think also about the fact that you actually have a mandate to mediate, and that when we’re doing things such as changing an environmental condition. It may be that we’re making a roadway safer, they were putting up safety barriers. It may be that we’re stopping others from being recruited into smoking. So that the mediation process is not about a disempowering, it’s about ensuring that we’re enabling people to make healthy choices. In an environment, which is often loaded towards those unhealthy choices.

The industries that sell and promote unhealthy behavior whether it be smoking, the use of e-cigarettes, or excessive alcohol consumption, are not concerned about ensuring that people are able to have all the information when they’re doing those behaviors. So it’s important for us to be able to mediate on their behalf to ensure that to the highest degree possible, the environment is health enhancing.