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Health promotion and behaviour change models
Health promotion helps people gain more control over their health and improve it – and it is broader than health education: according to the Ottawa Charter it includes healthy public policy, supportive environments, community action, personal skills and reorienting health services.
Why it matters in the exam
Items on this topic ask for the definition of health promotion according to the Ottawa Charter (1986), the difference between it and health education (education is one component within health promotion), and the five action areas and three strategies – advocate, enable and mediate. Other items describe a patient or community and ask which behavioural model fits: the health belief model (perceived susceptibility, severity, benefits and barriers, and cues to action), the transtheoretical model of stages of change (precontemplation, contemplation, preparation, action and maintenance), or social cognitive theory, centred on self-efficacy. Also tested are "health-promoting settings" – healthy cities, health-promoting schools and workplaces – and the Health Impact Assessment, which examines in advance the health effect of a policy or project outside the health field. Health literacy has three levels – functional, interactive and critical. In the exam remember that matching the intervention to the stage of change matters: a smoker who is not considering quitting is not given a detailed cessation plan, but awareness is raised and motivation strengthened, for example by motivational interviewing.
Key points
- Health promotion enables people to increase control over their health.
- The Ottawa Charter defines five action areas.
- The health belief model includes susceptibility, severity, benefits, barriers and cues.
- An intervention is matched to the person's stage of change.
- A Health Impact Assessment examines in advance a policy outside the health field.
Summary table
| Model or concept | Main components | Use |
|---|---|---|
| Ottawa Charter (1986) | Healthy policy, supportive environments, community action, personal skills, reorienting services | A framework for planning health promotion |
| Health belief model | Susceptibility, severity, benefits, barriers, cues, self-efficacy | Explaining uptake of screening and vaccination |
| Stages of change | Precontemplation, contemplation, preparation, action, maintenance | Matching the intervention to the stage |
| Social cognitive theory | Self-efficacy, observational learning, outcome expectations | Building confidence to change |
| Health-promoting settings | Healthy cities, schools and workplaces | Changing the environment, not only the individual |
| Health Impact Assessment | Prospective assessment of a policy's effect on health | Planning a road, an airport or an industrial zone |
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Sources
- WHO, Ottawa Charter for Health Promotion, 1986 — Five action areas and three strategies
- Glanz, Rimer & Viswanath, Health Behavior: Theory, Research, and Practice, 5th ed., 2015 — Health belief model; Transtheoretical model; Social cognitive theory
- Nutbeam, Health literacy as a public health goal, 2000 — Health Promotion International – levels of health literacy
Sources are given for further reading; the text is written afresh and not copied from them.
Reviewed by the Examqo AI Professor · 2026-11-06. The text may contain errors; when in doubt, check the source.