Naidoo and Willis (2009) argue that “Each approach has different objectives like to prevent disease, to ensure that people are well informed and able to make health choices. To enable people the skills and confidence to take control of their health and to change policies and environment in order to facilitate healthy choices”
My models for my artefact are based on Tannahill and Ewles and Simnett models. Tannahill model consists of three overlapping spheres (see appendix 3) and seven sub domains. My artifact will focus on positive health education. This consists of health education aiming at changing the behaviour of the individual and to help individuals to develop a positive health attribute. For example teaching an individual health related life skills. The artifact is also based on the prevention side; it aims to teach preventative measures to an individual. However this is a secondary prevention approach, because testicular cancer can not be prevented by being detected in its early stages (Ewles and Simnett 2000 b). Secondary prevention is used to reduce the risk of disease and increase the success rates through early detection. As mentioned earlier the Ewles and Simnett approach consists of five approaches, I have chosen the educational approach for my artefact. The purpose of the educational approach is to provide information and the skills to help people make an informed choice about their health. As nurses we are in the position of providing health education to patients. They aim to educate patients the importance of prevention techniques such as healthy eating, affects of smoking, the importance of self examination, so they can detect any abnormalities and get treatment quicker. The educational approach is based on the relationship between knowledge and behaviour in that by increasing knowledge there will be a change in attitude which can lead to a change in behaviour. This is so the individual can make an “informed choice on their health” (Ewles and Simnett 2000c p.44). My clothes tag booklet will be based on this approach to empower my target group to change their attitude about testicular self examination (TSE) and to examine themselves regularly, appropriately and react if any changes are found.
The artefact is based on men aged 15-35 years of age. Cancer Research UK (2003) states that incidence rates are increasing. In 1997 the department of health and social services started too focus on reducing these rates by early diagnosis screening and to increase the community awareness of the disease. A report by Baker (2002) explains that men are reluctant users of primary care services, making little use of preventative services and often presenting late in the course of an illness. This is why male’s success rates of cancer are lower than females. Therefore it is important to empower the target population about testicular cancer and self examination. It is important for men of all ages to regularly check themselves for testicular changes, however only a small percentage of men regularly check themselves. This is either because they do not know how to correctly examine themselves, or they are too embarrassed to do so. There is also the possibility that they do not have the physical ability to examine themselves.
TSE is a good approach to prevention; the information is straight forward and put into practice with the right approach. This essay shows an alternative way to empower men to perform TSE based on this evidence. Males tend to get embarrassed around this subject, which makes health promotion a lot harder. Butler (1999) has found that building a good rapport with the patient can help men feel less embarrassed. For my clothes tag booklet to be effective to my target population access to this information needs to be discreet and easily readable, this is why my idea is to hand the boxer shorts out for free in fresher week. Men are more likely to look at the guide in the privacy of their bedrooms or share it with their partners. It would also be available for nurses to hand out to patients of any ages. The booklet will contain basic information about testicular cancer and how to perform TSE.
The design of my artefact is to keep it simple to promote TSE in a simplistic way. Plain language has been used to make it easy to read. I have decided to use the slogan “look after your testes” with a picture of golden balls. The reason I have chosen golden balls is because it is eye catching and bright. The term itself is borrowed from mass media and a game show known as “Golden Balls”. Due to this diagram being in the media it could draw people’s attention, then the slogan is used to promote testicular awareness and tell people what the topic is about.
A diagram of the TSE procedure has been added to help the individual to visually see how to perform the procedure correctly and also written text has been added with step by step information. Hubley and Copeman (2008 p.167) explains that the use “of diagrams can be misunderstood, this can happen when people from one culture see printed material that is intended for those from another culture”. Following the National Health Services (NHS) toolkit guidelines I have used the font size of 12 due to it being easy to read, key words are in blue bold text to provide empathise. Blue is commonly used in the NHS guidelines and doesn’t fade quickly. Men tend to prefer this colour and blue can be described as a calming colour (www.precisionintermedia.com 2008). Dyslexic people find it hard to read writing against a pure white background, I have accommodated this by producing my leaflet on cream card, and this is aimed to enable people of all disabilities to easily read the leaflet (Hubley and Copeman 2008b). The leaflet has given direction to people on how to obtain further information in the hope that this will allow the reader to take action on what they have read.
The Department of Health (2003) stated that leaflets should be short, to the point and that colour should be kept simple, because people could lose interest quickly. Using a basic style of font, such as Arial, is recommended in the NHS toolkit guidelines. To address any discrimination for people with learning disability this clearly gives accessible information for this group of people. The booklet is attached to a pair of boxer shorts that is available in any size and can be found in shops or from the nurse after the promotional week. “Research has shown that the use of clothing items can be personal and be used to cement attitudes and commitment to ideas” (Egger Et al 2005 p. 114). I decided to use the idea as it is discreet as well as a fun way to promoted TSE, and hopefully men will take more notice of it. The use of boxer shorts could make a difference in promoting awareness. The use of leaflets in health promotion is a useful way of providing information; however it has limits of not being able to provide a lot of information and they are easily lost and not very durable (Ewles and Simnett 2003d p.206).
My artefact could be improved by making a design in Braille for people who have visually impairment. As ethnic minorities now make up 9% of the UK population (Census, 2001), the booklet would also be made available in different languages and the use of different culture diagrams would need to be used to avoid bias. It could also be made into a female friendly copy as a male’s partner is vital in assisting in detecting this disease. This booklet could be produced in a larger form and found in doctor’s surgeries or leaflet stands or in men magazines. The more places available the more likely it would be taken notice of. Leaflets are not the best form of promotion health; however a study carried out by the British Medical Journal (1997) stated that people found leaflets that were provided by post useful, and this will help males overcome any issues they may have with embarrassment.
In summary the use of the two health promotion models have worked well to help produce a self awareness leaflet to promoted testicular cancer. The artefact was aimed to be a fun way of promoting a serious disease, to enable men to discreetly access relevant information. It would, however, be hard to measure the effectiveness of this leaflet. The only way it could be measured is by monitoring the volume of males contacting their local doctor or NHS service seeking more advice on this subject and presenting the early stages instead of later ones. My goal of changing the target populations behaviour and educate them about the importance of TSE was hopefully achieved. I have learned the importance of empowerment and health promotion, and how a nurse uses these health aspects to improve an individual’s health.
Appendix 2
Five approaches to health promotion
(Ewles & Simnet, 1995) [25]
Appendix 3
Tannahill model
“Health Education: communication activity aimed at enhancing well-being and preventing ill-health through favourably influencing the knowledge, beliefs, attitudes and behaviour of the community.
Health Protection: refers to the policies and codes of practice aimed at preventing ill-health or positively enhancing well-being, for example, no smoking in public places.
Prevention: refers to both the initial occurrence of disease and also to the progress and subsequently the final outcome”, ()
Appendix 1
Ottawa charter (2009)
- The Ottawa charter identifies the prerequisites for health which are
- peace,
- shelter,
- education,
- food,
- income,
- a stable eco-system,
- sustainable resources,
- social justice, and equity
The methods to achieve health promotion through, advocacy, enabling, mediation
And the five main action areas
These action areas are:
-
Build healthy public policy
is about putting health on the agenda of policy makers at all levels and includes legislation, economic measures, taxation and organisational change.
-
Create supportive environments
refers to living and working conditions that are safe, stimulating, satisfying, enjoyable and provide a positive benefit to health.
-
Strengthen community action
deals with empowering communities to exert ownership, control and action over their own endeavours and destinies.
-
Develop personal skills
covers providing information, education for health and enhancing life skills.
-
Reorientate health services
acknowledges that health services need to focus more on prevention than simply treatment and cure. The responsibility for health is shared amongst individuals, the community, government, institutions and other organisations
Appendix 2
Five approaches to health promotion
(Ewles & Simnet, 1995) [25]
Appendix 3
Tannahill model
()
“Health Education: communication activity aimed at enhancing well-being and preventing ill-health through favourably influencing the knowledge, beliefs, attitudes and behaviour of the community.
Health Protection: refers to the policies and codes of practice aimed at preventing ill-health or positively enhancing well-being, for example, no smoking in public places.
Prevention: refers to both the initial occurrence of disease and also to the progress and subsequently the final outcomes
References
Baker, P (2002) Getting it sorted: A New Policy for Men health. A consultative document. London. The men’s health forum
British Medical Journal (1997)
Wardle, J, Steptoe A, Burckhardt R, Vogele C, Vila J,
Zarczynski Z (1994) Testicular self-examination:
Attitudes and practices among young men in
Europe. Preventive Med 23: 206–10, 1994
Cited from Cook, N (2000) Testicular cancer: Testicular self-examination and screening. Journal off Nursing (Online). Vol 9:6 pg 338, Avaliable athttps://www.internurse.com/cgi-bin/go.pl/library/article.cgi?uid=6337;article=BJN_9_6_338_343 [Accessed 12.12.09]
Butler, C. Mason, P & Rollnick, S (1999) Health behavioural change. London. Churchill Livingstone
Cancer Research UK (2003) Testicular Cancer. London CRUK
Cancer Research UK (2003) b. Testicular cancer London. CRUK
Cook, R (2000). Teaching and promoting testicular self examination. Nursing Standard, 14.24.48-5
Department of Health (2003) Toolkit for producing Patient information. (Online) Available at: [Accessed 12.12.09]
Downie, R. S, Tannahill, C, Tannahill, A (197) Health promotion- Models and Values, 2nd Ed. Great Britain. Oxford University press.
Egger, G, Spark, R & Donovan (2005) Health Promotion Strategies and Methods. 2nd ed. Australia. McGraw-Hill.
Ewles and Simnett (2000) Promoting health- a practical guide. Page 45. London. Biallere Tindal
Ewles and Simnett (2000b) Promoting health- a practical guide. London. Biallere Tindal
Ewles and Simnett (2000c) Promoting health- a practical guide. Page 44. London. Biallere Tindal
Ewles and Simnett (2000d) Promoting health- a practical guide. Page 206. London. Biallere Tindal
.
Hubley and Copeman (2008) Practical Health Promotion pg167, Cambridge. Polity Press
Hubley, J and Copeman J. (2008b) Practical Health Promotion pg173 Cambridge. Polity Press
Naidoo, J and Willis, J (2003) Health Promotion – Foundations for practice. London Biallere Tindal
National health services (2008) Written information: general guidance. (Online) Available at: [Accessed 12.12.09]
Nutbeam, D. (1998) Health Promotion Glossary. Health promotion international 13 (4), 349-364
Office for National Statistics (2001) Census. (Online) Available at [Accessed 19/12/09]
Orchid Cancer Appeal 2005 testicular cancer: the problem. (Online) Available at [Accessed 12.12.09]
Precision Intermedia (2008) Colour psychology and marketing. (Online) Available at: [Accessed 12.12.09]
Royal collage of nursing (2003) Elements of nursing care.
The World Health Organisation (1986) Health promotion. (Online) Available at: [Accessed.12.12.09]
