15.5: Chapter Summary
Health promotion and disease prevention are overlapping yet distinct processes that guide the Healthy People 2030 initiative. Best defined by the Ottawa Charter, health promotion is the process of enabling people to increase control over, and to improve, their health. The six dimensions of health promotion behaviors include responsibility, physical activity, nutrition, interpersonal relations, spiritual growth, and stress management. Disease prevention involves undertaking specific interventions geared toward decreasing the burden of disease and its associated risk factors. Preventive care, including screenings, immunizations, check-ups, and counseling, are a large portion of prevention. Nurses play an important role in both health promotion and disease prevention.
Nurses select and perform health promotion and disease prevention interventions at the individual and community levels. The nurse can use the five key action areas of the Ottawa Charter for Health Promotion to guide interventions. To appropriately apply interventions, nurses must understand the stages of disease and their corresponding levels of prevention, which can lead to disease risk reduction and prevention of complications of a current disease.
Nurses and other health care professionals use theoretical models and frameworks to provide appropriate support for health promotion and disease prevention practices at different levels. A variety of theories and models exist at the individual (intrapersonal), interpersonal, and community levels. Prominent models include the socio-ecological perspective, the health belief model (HBM), the stages of change (transtheoretical) model, social cognitive theory (SCT), and diffusion of innovations theory.
Individual- and system-level barriers, described as the social determinants of health (SDOH), influence the health of individuals and communities. The health care delivery system itself poses barriers to health promotion and disease prevention. Predisposing, enabling, and reinforcing factors can be supportive or produce obstacles, and the health care professional must consider these in their efforts to promote health and prevent disease. Health promotion settings include cities, hospitals, schools, universities and colleges, workplaces, and others. Many successful health promotion and disease prevention programs encourage collaboration and coordination across multiple settings.