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420 -Wellness & Illness Prevention Concepts & Strategies

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Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director,
Podcast Host: Counselor Toolbox & Case Management Toolbox
– Explain the purpose of wellness and disease prevention
– Identify the benefits of it
– Define the 3 types of prevention and intervention activities
– Describe the steps to initiate a change
– Apply knowledge of the principles of effective programs

Purpose of Prevention and Early Intervention
– Attainment of the highest possible standard of health depends on a comprehensive, holistic approach which goes beyond the traditional curative care, involving communities, health providers and other stakeholders.
– This holistic approach should empower individuals and communities to take actions for their own health, foster leadership for public health, promote intersectoral action to build healthy public policies and create sustainable health systems in the society
– Benefits include:
– Knowledge about risk factors for developing health problems
– Awareness of personal risk factors
– Screening to identify whether health conditions may be present
– Coaching about how to manage newly identified health problems
– Strategies for prevention of future health problems
Dimensions Model of Health
– The Dimensions Model of Health includes 6 dimensions
– Biophysical Dimension
– Psychological and Emotional Dimension
– Behavioral Dimension
– Socio-cultural Dimension
– Environmental Dimension
– Health Systems Dimension
– Reducing Risk Factors
– Individual
– Microsystem (immediate family, peers)
– Exosystem (neighborhood, school, work)
– Macrosystem (culture)
– Enhancing Protective Factors
– Individual
– Microsystem (immediate family, peers)
– Exosystem (neighborhood, school, work)
– Macrosystem (culture)

Types of Prevention
– Primary prevention (Wellness) aims to prevent problems before they ever occur by reducing risk and enhancing protective factors. (Diabetes, TBI, Smoking, Depression)
– Education about healthy and safe habits
– Safe schools and communities through effective enforcement of community laws and norms regarding health and mental health behaviors.
– Annual, universal screenings for health and mental health issues.
– Access to safe housing, nutrition and medical care.
– Opportunities for gainful employment to prevent poverty and increase community connection.
– Access to parenting education.

Types of Prevention
– Secondary prevention reduces the impact of problems that have already begun, with the goal of halting and reversing the progression. (Diabetes, TBI, Smoking, Depression)
– Access to early intervention, self-help groups and counseling
– Access to medication and patient assistance programs
– Access to safe, sober housing

Types of Prevention
– Tertiary prevention prevents additional issues from Diabetes, TBI, Smoking, Depression
– Job coaching and advocacy to ensure employment
– Financial counseling and assistance to prevent poverty and financial stress
– Access to adequate nutrition, medication and healthcare for overall health and wellbeing
– Access to safe, sober housing to prevent homelessness

Types of Interventions
– Universal interventions attempt to reduce specific health problems across all people in a particular population such as children in your county, by reducing risk and promoting protective factors (Prevent TBI)
– Selective interventions are aimed at a subgroup determined to be at high-risk due to their exposure to risk factors (football players)
– Indicated interventions are targeted to individuals who are already experiencing problems or distress. (Football players with TBI)
Steps to Initiate Change
– Complete a community needs assessment
– Priorities
– Resources
– Collect information from those who would benefit and indicate how you will gather information, including:
– Listening sessions and public forums
– Interviews with members of prioritized groups
– Focus groups, interviews, and/or surveys with prioritized groups and their subgroups

– Indicate what you will ask about (listen for), including:
– Knowledge of the issue including how often the problem (or desired) behavior occurs
– Importance of the goal/desired behavior for the audience (e.g., Why is that important-)
– Expected benefits of adopting the changed behavior
– Expected benefits and costs of adopting or continuing the behavior

– State the issue or broad goal the campaign is trying to address
– Outline the basic principles of the social marketing campaign including:
– Product: What are the behaviors/outcomes that you are trying to change and among whom
– Price: How much time, effort, and other consequences (e.g., money, social approval, lost opportunities) will it cost a person to change their behavior/outcome-
– Place: Where should the behaviors occur (not occur)- What are the barriers (opportunities) for the behavior to occur-
– Promotion: What communications will occur, from what sources to whom, and through what channels of influence-
– State the desired attributes and expected benefits of each target behavior.
– Implementation
– Engage partners, stakeholders, and community members
– Assess individual and organizational readiness for change, using the Stages of Change Model.
– Provide education to the individuals (i.e., healthcare providers, administrators, or teachers) and organizations (i.e., healthcare facilities, worksites, or schools) who will be involved in implementing PSE changes.
– Foster partnerships and coalitions to support broader reach and sustainability.
– Ensure implementation of strategies
Principles of Effective Programs
– Include multiple types of activities, affect multiple settings, and go beyond awareness-raising to enhancing protective factors and reverse or reduce risk factors.
– Include written materials, videos and interactive activities to help people learn the material based on their age, abilities and learning style.
– Help participants apply the information and use the tools in session, at home and at work.
– Encourage adult participants to model the behavior so children can learn it.
– Have a special section and programming at the library for parents of young children
– Administer a pre- and post-test to provide feedback to participants about their mastery of the tools.

Principles of Effective Programs
– Address all forms of physical and mental health issues, alone or in combination in the local community by targeting modifiable risk factors and strengthening identified protective factors.
– Prevention programs should be tailored to address risks specific to population or audience characteristics, such as age, gender, and ethnicity, to improve program effectiveness.
– Family-based prevention programs should enhance family bonding and relationships and include parenting skills; effective communication skills and health literacy.
– Prevention programs can be designed to intervene as early as the prenatal period
Principles of Effective Programs
– Prevention programs for elementary school children should target improving academic and social-emotional learning and physical health
– Behavioral self-control
– Emotional awareness
– Communication skills
– Social problem-solving
– Academic support, especially in reading
– Self Esteem
– Positive health behaviors

Principles of Effective Programs
– Prevention programs for middle or junior high and high school students should increase competence with the following skills:
– Study habits and academic support
– Goal setting
– Communication
– Peer relationships
– Coping and problem-solving
– Self-efficacy and assertiveness
– Health literacy
– Strengthening of personal commitments to healthy choices
Principles of Effective Programs
– Universal prevention programs at key transition points, such as the transition to middle school, or high school graduation can produce beneficial effects.
– Community prevention efforts that combine two or more evidence based interventions such as family-based and community-based programs, can be more effective than a single program alone.
– Community prevention programs reaching populations in multiple settings are most effective when they present consistent messages across settings. To accomplish this goal, a community coalition is often helpful.
– Prevention programs should be long-term with repeated interventions (i.e., booster programs) to reinforce the original prevention goals.
Principles of Effective Programs
– School and work based prevention programs should include teacher/supervisor training on management practices and motivational enhancement.
– Prevention programs are most effective when they employ interactive techniques, such as peer discussion groups, role-playing, and gamification
– Programs should be tailored to fit within cultural beliefs and practices of specific groups as well as local community norms.
– A systematic outcome evaluation is necessary to determine whether a program or strategy worked”

Learning Styles for Effective Education
– Method of Reception
– Visual Learners
– Verbal Learners
– Tactile/Manipulative Learners
– Pace of Learning
– Active Learners
– Reflective Learners
– Format of Learning
– Sequential Learners
– Global Learners

Barriers to Learning
– English Language Barriers
– A Low Level of Literacy
– Poor Health Literacy
– The Presence of Stress and Pain
– Health Beliefs Including Spiritual and Cultural Beliefs
– Cognitive, Psychological and Emotional Challenges
– Physical and Functional Limitations

Goals of Communication/Promotion
– Increase risk perception
– Reinforce positive behaviors
– Influence social norms
– Increase availability of support and needed services
– Empower individuals to change or improve their health conditions

– Radio
– Television
– Local magazines
– Flyers
– Brochures
– Internet
– Employer Intranet
– Social media tools (i.e., Twitter, Facebook, and YouTube)
– Digital “billboards”
– Health Fairs
– Art Fairs
– School carnivals
– Cause walks/runs

Effective Communication/Promotion
– Relevant, useful, and interesting
– Features that appear on CDC’s homepage are a great place to find topics and content that can be repurposed for Facebook, Twitter, and text messages
– Review published research reports for social media-worthy content: An interesting “Did you know-” fact.
– Let people know about individual guidelines, such as Physical Activity Guidelines for older adults
– Easy to understand and share
– Put relevant, intriguing information at the beginning as a question
– Use fewer characters than allowed to make sharing easy.
– Keep messages short but relevant.
– Ensure someone can “get it” in less than 2 seconds-
– Provide enough context so your message can stand alone.

Effective Communication/Promotion
– Friendly, conversational, and engaging
– Is culturally responsive
– Action-oriented
– Use a specific call to action with verbs such as “learn,” “watch,” or “join.”
– Include links to Web content that offer more detail or supply a phone number or e-mail address, but not e-mail addresses for individuals.
– Use ALL CAPS sparingly, for emphasis only
– When you’re typing a public health partner’s name in your post, add the @ symbol in front of it. This will trigger the tagging feature in Facebook, automatically creating a link and displaying the post on the partner’s page

– Rural Tobacco Control and Prevention Toolkit
– Rural HIV/AIDS Prevention and Treatment Toolkit
– Northeast Louisiana Regional Pre-Diabetes Prevention Project (RPDP)
– Reducing Obesity and Improving Fitness for People with Serious Mental Illness
– Wellness Worksheets (SAMHSA)
– As we move toward a capitated model of healthcare, prevention will become increasingly important.
– Prevention activities
– Can be started as early as the prenatal period
– Can be integrated into school curricula
– Are more effective if presented in multiple settings and formats
– Need to be tailored to the age, abilities and culture of the recipients