The Royal Society for Public Health Level 2 Award in Understanding Health Improvement Outcome 2 Heal

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The Royal Society for Public HealthLevel 2
Award in Understanding Health ImprovementOutcom
e 2Health Improvement Factors
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• Factors influencing health improvement
• Interventions that support health improvement
• Tackling inequalities in health
• Layers of influence on an individual
• The four basic communication skills
• Barriers to effective communication
• Ways to overcome communication barriers

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Interventions that support health improvement

• Behavioural Change
• Educational Approach
• Social Change

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Behavioural change approach

• Aims to help individuals adopt healthy
  behaviours
• Methods used in this approach are targeted at the
  individual
• One-to-One or group counselling
• e.g. goal setting/action plans
• Supportive counselling
• Education

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Social Change approach

• This is aimed at groups and populations and is a
  top down method
• Methods used need to affect policy and are
• Lobbying
• Policy planning
• Negotiating

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The Educational Approach

• Aim is to allow people to make informed choices
• It is based on the premise that if you increase
  knowledge, attitudes will change which will
  affect behaviour
• Methods used
• leaflets, booklets, videos etc
• Teaching sessions
• One-to-One or group discussions

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Tackling inequalities in health

• Strengthening individualsEnsure people are well
  informed and able to make healthier choices
• Strengthening communitiesHelp people in their
  communities to acquire the skills and confidence
  to take greater control over their health with
  training and education

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Tackling inequalities (continued)

• Improve access to facilities and servicesMay
  involve mediating between agencies to ensure that
  needs are met
• e.g provide outreach services and link workers
• Encourage a healthy public policyChange policies
  and environments in order to facilitate healthy
  choices

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Layers of influence on health Dalgren
Whitehead (1991)

• Personal behaviours and lifestyles
• Support and influence within communities which
  can sustain or damage health
• Living and working conditions and access to
  facilities and services
• Economic, cultural and environmental conditions
  such as standards of living and the labour market

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References

• Naidoo, J., Wills, J. (2000) Health Promotion
  Foundations for Practice
• London Bailliere Tindall
• Ewles, L., Simnett, I. (2003) Promoting Health
  A Practical Guide, 5th Edition
• London Bailliere Tindall.
• Sidell, M. (1997) Debates Dilemmas in
  Promoting Health A Reader
• Basingstoke Macmillan for Open University Press.
  
• Bernard, M. (2000) Promoting Health in Old Age
  Critical Issues in Self Health Care
• Buckingham Open University Press.
• DoH papers and publications
• Promoting Optimal self care
  S. Tomkins A Collins DoH 2005
• The White paper, Saving lives our Healthier
  Nation
  DoH July 1999
• Improving Health Changing BehaviourNHS Health
  trainer Handbook. Michie S
  et al DoH 2007

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Communication
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Definition of Communication

• The transmission of information so that the
  recipient understands what the sender intends
  Clarke (2004)

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Purpose

• To provide a safe environment for the client to
  explore issues they may have
• To provide the information and emotional support
  for each client
• To achieve maximum health and wellbeing

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Four components

• Non-verbal (body language)
• Para-verbal (accompaniments to speech)
• Verbal (speech)
• Active listening

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• Non-Verbal Communication is
• Reinforcing the spoken word
• Replacing the spoken word using
• the body to make visual signals or
• the voice to make oral but non-verbal signals
• An area of study in its own right
• you can make your own observations in all sorts
  of situations
• Easy to take for granted
• we are often not aware of our own Non-verbal
  Communication but
• we are aware of that of other people

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Non-verbal Communication

• Appearance
• Facial Expression
• Eye contact
• Posture
• Proximity
• Personal Space
• Bodily Contact

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Para-verbal Communication

• Aspects of how we speak, including
• Tone of voice
• Speed of speech
• Volume of speech
• Clarity of speech
• Accent

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• Non-verbal accompaniments to listening Eg
• Smiles and frowns
• Head nods
• Gestures
• YesNo etc

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Verbal Communication

• Language is concerned with communicating
  Meanings
• Non-verbal and para-verbal communication is more
  concerned with communicating Attitudes and
  Feelings

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• Information Gathering
• Information Transmitting
• Assertiveness
• Listening and Helping

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Asking open questions

• Open questions are questions that dont lead the
  person towards an answer
• Ask questions that encourage the person to give
  you more information
• questions that cant be answered with one word or
  yes/no
• Asking closed questions may suggest that you
  already know what the client is going to say

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• Closed questions
• Did that make you feel bad?
• Do you want to change your eating habits?
• Do you think smoking is good for you?
• Is your diet unhealthy?

• Open questions
• How do you feel about that?
• What would be the benefits of changing your
  eating habits?
• How does smoking affect your life at the moment?
• What do you think about your diet?

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Active listening

• Giving Attention
• Encouraging
• Paraphrasing
• Reflecting Feelings
• Reflecting meanings
• Summing up

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Barriers to effective communication

• When there is a mismatch between a verbal and
  non-verbal message, the non-verbal message is
  more likely to be believed
• When two people misinterpret the meaning of a
  verbal utterance, miscommunication occurs
• Miscommunication can be more damaging than a lack
  of communication

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Overcoming language barriers

• Language can be problematic between people of
  different ethnic backgrounds
• The use of a translator could be beneficial
• Speak clearly and slowly and dont raise your
  voice to get the message across
• Repeat what you think may not have been understood

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Overcoming language barriers (continued)

• Use simple terms and words
• Say things in a logical sequence
• Use pictures ,mime and simple written
  instructions
• Always check that you have been understood
• Avoid asking closed questions

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References

• Michie S et al 2007 Health Trainer Handbook.
  Written by the Health Psychology team DoH
• Ewles L Simnett I 2005 Promoting health a
  practical Guide Bailliere Tindall
• Sussex S Scourfield P Social Care Level 4 2004
• Burnard P 1997 Effective Communication skills
  for health professionals London Nelson Thornes