Strategies for Health Improvement
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Name 2 types of strategies for health improvement
• High risk approach 2. Whole population approach
Describe a high risk approach as a strategy for health improvement
• Identified individuals who have characteristics putting them at high risk • Manage risk by individual patient care to achieve risk reduction
Describe a whole population approach as a strategy for health improvement
• Recognises majority, though having lower risk, will account for many new disease incidence • Better to reduce risk in everyone by small amount
What are 2 advantages of strategy targeting high risk individuals for prevention?
• Explanation of risk to patient 2. Tailor individual care to manage risk
What are 2 disadvantages of strategy targeting high risk individuals for prevention?
• Costly • Specialist care is needed • Continuous • Cannot address underlying causes of risk
Name 3 advantages of strategy targeting whole population for prevention
• Whole population shift in risk • Lower cost • Addresses determinants of disease at population level
Name a disadvantage of strategy targeting whole population for prevention
Widen health inequalities
Describe the advantage of whole population strategies over high risk approaches with regards to a Bell curve
• Bell curve will shift down with whole population approach • Change in entire distribution not just top group • Shifting whole population benefits more individuals than shifting top group into lower category
How can high risk approaches and whole population strategies be used together?
Hybrid approach of high risk and whole population strategies by targeting communities at highest risk
What are 2 advantages of using a hybrid approach to prevention?
• More effective use of resources 2. Easier to measure effectiveness at community level
What are 2 disadvantages of using a hybrid approach to prevention?
• Can only apply if you can identify communities at risk 2. Nature of communities change over time with migration and new build
What is proportionate universalism?
Intervention targeted in proportion to disease risk and need
Name 4 examples of application of different strategies for prevention
• Change for Life (England) • Childsmile Scotland • Designed to Smile (Wales) • Clinical care
Describe Change for Life (England) in terms of its strategy for prevention
Whole child population strategy to reduce obesity
Describe Childsmile Scotland in terms of its strategy for prevention
Multi-level whole population programme to prevent childhood dental caries using a proportionate universalism approach
Describe Designed to Smile: Wales in terms of its strategy for prevention
Oral health improvement programme using a high-risk population strategy
Describe clinical care in terms of its strategy for prevention
High-risk individual approach
What is the focus of Change for Life (England)?
• Diet and exercise - “Fun ideas to keep children healthy)
Name 3 examples of sugar swaps from sugary cereals
• Wheat biscuits • Porridge • No added sugar muesli
Name 3 examples of sugar swaps from sugary drinks
• Water • Lower-fat milks • No added sugar drinks
Describe the need for Childsmile Scotland
• Persistently high levels of dental caries in children - Water fluoridation not a practical option
Name 3 components of Childsmile Scotland
• Childsmile Core (Universal) • Nursery and School / Core + (Areas of high deprivation) • Childsmile Practice
Describe Childsmile Core
• All children given free toothbrushes and toothpaste • 6 occasions in 5 years • Feeding cups • 3 and 4 year olds in nursery schools get free daily supervised toothbrushing
Describe Childsmile Practice
• Support workers link children in first year of dental life to dental practices • Dentists receive fees to fissure seal first permanent molars