Our reasons for selecting specific definitions from a range of choices are based on the following: compatibility with the overall direction; ethos and content of the resource; clarity of expression; appropriateness of meaning; credibility and 'status' of the source, and the extent of its current use in the field and the views of staff.
All references have been quoted directly from the original source without adaptation.
Alma Ata Declaration
Brief interventions
Capacity building
Community
Community capacity
Community control
Community development
Community participation
Contributing factor
Determinants of health
Disease
Disease prevention
Early intervention
Environmental Health
Epidemiology
Evaluation
Health
Health behaviour
Health education
Health hardware
Health indicator
Health outcomes
Health promotion
Health sector
Health services
Health status
Incidence
Intersectoral collaboration
Intervention Program
Jakarta Declaration
Lifestyle
Living conditions
Medical model
Morbidity
Mortality
Motivational interviewing
Network
'New' Public Health
Ottawa charter
Policy
Population
Prevalence
Prevention
Primary Health Care
Program
Project
Public health
Qualitative data
Quantitative data
Reliability
Risk factor
Standards
Strategy
Target group
Validity
See Primary Health Care.
These interventions are of low intensity and short duration; typically consisting of 5 to 60 minutes of counselling and education, with usually no more than three to five sessions. They are intended to provide an early intervention… (Higgens-Biddle & Babor 1996:4).
Note: although first used in the Alcohol and Other Drugs field the term has much wider application. The term brief intervention is often used interchangeably with minimal intervention; the preferred term is brief intervention.
See Motivational Interviewing, Disease Prevention and Intervention Program.
… Capacity building … involves developing skills and systems within health services in order to enable them, in turn, to increase communities’ ability to foster good health (King & Ritchie 1999:4).
The concept of capacity building for health promotion, then, embraces:
A specific group of people, often living in a defined geographical area, who share a common culture, values and norms, are arranged in a social structure according to relationships which the community has developed over a period of time. Members of a community gain their personal and social identity by sharing common beliefs, values and norms which have been developed by the community in the past and may be modified in the future. They exhibit some awareness of their identity as a group, and share common needs and a commitment to meeting them.
In many societies, particularly those in developed countries, individuals do not belong to a single, distinct community, but rather maintain membership of a range of communities based on variables such as geography, occupation, social and leisure interests (WHO 1998:5).
In the case of Aboriginal communities:
Aboriginal communities are rarely communal, having been thrown together, at least in remote Australia, as a result of historical and administrative expediency. Even in groups of people who share the same language and social organisation, and who have lived together for 50 years or more, cohesive "communalism" is non-existent… While the uncritical and bland use of the term "community" continues, with its concomitant allusions to homogeneity, communalism and collective decision-making, policy decisions and intervention programs…can go badly askew (Maggie Brady cited by Kunitz 1994:113).
Community control is the local community having control of issues that directly affect their community.
Implicit in this definition is the clear statement that Aboriginal people must determine and control the pace, shape and manner of change and decision-making at local, regional, state and national levels (National Aboriginal Health Strategy Working Party 1989:xiv).
Community development refers to the process of facilitating the community’s awareness of the factors and forces which affect their health and quality of life, and ultimately helping to empower them with the skills needed for taking control over and improving those conditions in their community which affect their health and way of life. It often involves helping them to identify issues of concern and facilitating their efforts to bring about change in these areas (Hawe et al 1990:203).
Processes that enable individuals and groups in the community to contribute to debate and decision-making about a particular activity. In relation to community health, this means opportunities for community members to participate in:
… Community participation … enables services and programs to be tailored to meet the needs of the community being served, and the content of the services to be relevant to local conditions (Baum et al [eds] 1992:299-300).
Any aspect of behaviour, society, or the environment, or anything else which contributes to a risk factor for a health problem, eg. not having easy access to purchase condoms is a contributing factor for having sex without a condom, which is in turn a risk factor for contracting HIV…
…we prefer to maintain a distinction on the basis that a risk factor is directly linked with the health problem and a contributing factor is linked to the health problem via the risk factor - that is, it is a factor which contributes to or helps to explain the risk factor (Hawe et al 1990:204).
See Risk factor.
The range of personal, social, economic and environmental factors which determine the health status of individuals or populations (WHO 1998:6).
Literally, dis-ease, the opposite of ease, when something is wrong with a bodily function. The words disease, illness and sickness are loosely interchangeable, but are better regarded as not wholly synonymous. Susser has suggested that they be used as follows:
Disease is a physiological/psychological dysfunction.
Illness is a subjective state of the person who feels aware of not being well;
Sickness is a state of social dysfunction, ie., a role that the individual assumes when ill (ed Last 1995:48).
Disease prevention covers measures not only to prevent the occurrence of disease, such as risk factor reduction, but also to arrest its progress and reduce its consequences once established (WHO 1998:4).
An early intervention consists of the identification of persons or groups whose drinking behaviour places them at risk and of persons in the early stages of destructive drinking practices (Cohen 1982, in Institute of Medicine 1990:45).
An early intervention is recognising a problem as soon as possible and doing something to stop the harm that the problem will cause (Territory Health Services 1998:45).
Note: although first used in the Alcohol and Other Drugs field the term ‘early intervention’ has much wider application.
See Disease prevention and Intervention program.
Environmental Health comprises those aspects of human health, including quality of life, that are determined wholly or partially by factors in the social and physical environment. It also refers to the theory and practice of assessing, correcting, controlling or preventing those factors in the environment that can potentially affect adversely the health and quality of life of present and future generations (UK Commission on Environment and Health 18 March 1996 in Environmental Health News, Volume 11 No 12, 22 March 1996).
The study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems. "Study" includes surveillance, observation, hypothesis testing, analytical research, and experiments. "Distribution" refers to analysis by time, place and classes of persons affected. "Determinants" are all the physical, biological, social, cultural, and behavioural factors that influence health. "Health-related states and events" include diseases, causes of death, behaviour such as use of tobacco, reactions to preventive regimens, and provision and use of health services. "Specified populations" are those with identifiable characteristics such as precisely defined numbers. "Application to control..." makes explicit the aim of epidemiology - to promote, protect, and restore health (ed Last 1995:55-56).
Evaluation is the process by which we judge the worth or value of something. (Suchman in Hawe et al 1990:6).
See Qualitative Data and Quantitative Data.
The combination of knowledge, practices and attitudes that together contribute to motivate the actions we take regarding health. Health behaviour may promote and preserve good health, or if the behaviour is harmful, eg., tobacco smoking, may be a determinant of disease. (ed Last 1995:74).
See also Lifestyle.
Health education is any combination of learning experiences designed to facilitate voluntary actions conducive to health (Green & Kreuter 1991:17).
Note: Freudenberg broadens the concept of health education:
…those efforts that educate and mobilise people to create more healthful environments, institutions and policies (as well as lifestyles) (Freudenberg 1984:40).
The physical equipment necessary for healthy, hygienic living in [a] remote area. The equipment must have design and installation characteristics which allow it to function and to maintain or improve health status. In a water supply system this will include both the bore and the basin plug (Pholeras et al 1993:v).
Note: the term was first popularised by Professor Fred Hollows (eds Reid & Trompf 1991:343).
A health indicator is a characteristic of an individual, population, or environment which is subject to measurement (directly or indirectly) and can be used to describe one or more aspects of the health of an individual or population (quality, quantity and time) (WHO 1998:9).
A change in the health status of an individual, group or population which is attributable to a planned intervention or series of interventions, regardless of whether such an intervention was intended to change health status (WHO 1998:10).
Health promotion is the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realise aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasising social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy life-styles to well-being (WHO 1986).
The health sector consists of organized public and private health services (including health promotion, disease prevention, diagnostic, treatment and care services), the policies and activities of health departments and ministries, health related non-government organizations and community groups, and professional associations (WHO 1998:12).
Services that are performed by health care professionals, or by others under their direction, for the purpose of promoting, maintaining, or restoring health. In addition to personal health care, health services include measures for health protection, health promotion and disease prevention (ed Last 1995:74-75).
A description and/or measurement of the health of an individual or population at a particular point in time against identifiable standards, usually by reference to health indicators (WHO 1998:12).
The number of instances of illness commencing, or persons falling ill, during a given period in a specified population. More generally, the number of new events, eg., new cases of a disease in a defined population, within a specified period of time. The term incidence is sometimes used to denote INCIDENCE RATE (ed Last 1995:82).
A recognised relationship between part or parts of different sectors of society which has been formed to take action on an issue to achieve health outcomes or intermediate health outcomes in a way which is more effective, efficient or sustainable than might be achieved by the health sector acting alone (WHO 1998:14).
In disease prevention a planned course of action usually targeted on a specific group or discrete population at risk of some identifiable disease or disorder, in order to reduce the risk of this disease or disorder.
Note: Intervention programmes are usually concerned with changing risk factors or risk behaviours in the target group or population, often using health education (Nutbeam 1986:120).
See also Health Promotion
The Jakarta Declaration on Leading Health Promotion into the 21st Century from July 1997 confirmed that [the Ottawa Charter] strategies and action areas are relevant for all countries…The Jakarta Declaration identifies five priorities:
(WHO 1998:2)
Lifestyle is a way of living based on identifiable patterns of behaviour which are determined by the interplay between an individual’s personal characteristics, social interactions, and socioeconomic and environmental living conditions (WHO 1998:16).
See also Health Behaviour
Living conditions are the everyday environment of people, where they live, play and work. These living conditions are a product of social and economic circumstances and the physical environment - all of which can impact upon health - and are largely outside of the immediate control of the individual (WHO 1998:16).
The traditional approach to the diagnosis and treatment of illness as practiced by physicians in the Western World since the time of Koch and Pasteur. The physician focuses on the defect, or dysfunction, within the patient using a problem-solving approach. The medical history, physical examination, and diagnostic tests provide the basis for the identification and treatment of a specific illness. The medical model is thus focused on the physical and biologic aspects of specific diseases and conditions (Anderson et al 1994:968).
Any departure, subjective or objective, from a state of physiological or psychological well-being. In this sense, sickness, illness and morbid condition are similarly defined and synonymous (but see Disease)
(ed Last 1995:108).
Relative frequency of death, or death rate, as in district or community. (Macquarie Dictionary 1987:1116).
Motivational interviewing is a particular way to help people recognize and do something about their present or potential problems. It is particularly useful with people who are reluctant to change and ambivalent about changing … In motivational interviewing, the counselor does not assume an authoritarian role … The strategies of motivational interviewing are more persuasive than coercive, more supportive than argumentative … When this approach is done properly, it is the client who presents the arguments for change, rather than the therapist (Miller & Rollnick 1991:52).
A grouping of individuals, organizations and agencies organized on a non hierarchical basis around common issues or concerns, which are pursued proactively and systematically, based on commitment and trust (WHO 1998:16).
See Public Health
See Health Promotion
The term ‘policy’ is used in a variety of ways to cover many, quite different types of statement, intention and action. ‘Policy’ may refer to the following:
(Palmer & Short 1994:23).
All the inhabitants of a given country or area considered together; the number of inhabitants of a given country or area (ed Last 1995:126).
The number of events, eg., instances of a given disease or other condition, in a given population at a designated time; sometimes used to mean prevalence rate . When used without qualification, the term usually refers to the situation at a specified point in time (point prevalence). Note that this is a number, not a rate (Last [ed] 1995:129).
Primary health care is essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination. It forms an integral part both of the country’s health system, of which it is the central function and main focus, and of the overall social and economic development of the community. It is the first level of contact of individuals, the family and community with the national health system bringing health care as close as possible to where people live and work, and constitutes the first element of a continuing health care process (WHO 1978:2-3).
In health services generally, ‘program’ is increasingly being used to describe a number of related services. The process of turning a group of services into a ‘program’ usually involves either an organisational grouping or the development of specified goals.
A further and increasing use is to group services or activities together on the basis of particular funding categories defined by Commonwealth and/or state governments as in the Home and Community Care Program (HACC), or in program budgeting. This use tends to reflect a bureaucratic perspective on funding categories, rather than how health services are actually delivered at the local level (ed Baum et al 1992:307).
A coherent series of activities, which together make up one strategy or more than one strategy, carried out with a group of participants for the purpose of improving the health status of the target group. This can be individual behaviour change, or environmental, legislative or other change. A [project]* is usually planned in response to an established health need (Hawe et al 1990:211)
Note: Hawe uses the term ‘programme’ instead of ‘project’.
Definition taken from A Memorandum Of Understanding: to establish the National Public Health Partnership for Australia, 1997, and a modification of that proposed in Last, JM. Public Health and Ecology, Connecticut, Appleton and Lange, 1987.
The scope of Public Health activities and processes can be grouped into three key areas:
Public health intelligence is involved with gathering and analysing information about the determinants of health, the causes of ill health and the patterns and trends of health and ill health in the populations.
Public health intervention refers to developing policy, setting priorities for action, developing plans, coordinating services, strategies and interventions aimed at prevention, protection and promotion of the health of the community, where promotion is the action taken to solve public health problems.
Public health infrastructure refers to the administrative, legislative and informational systems developed for making priorities, for developing policy, for funding, for monitoring and surveillance, for research and evaluation, for program delivery, and includes the workforce required to accomplish these tasks (National Public Health Partnership 1997:2).
Data which describe the range of response and variation between responses but do not record frequency of response. Cannot be used with tests of statistical significance (Hawe et al 1990:212).
Data which are recorded as frequency of response; response options may be categorical (eg male/female); ordinal eg (never/often/sometimes) or numerical (number of cigarettes smoked per day). Hypotheses may be supported or rejected by applying tests of statistical significance to quantitative data (Hawe et al 1990:212 ).
A property of questionnaires, surveys or any other measurement tool. Expresses the degree to which the same score is produced on repeated measures with a given instrument, in the absence of any real change. Repeated measures refer to measurements taken with the same instrument either by the same person at different times (test-retest reliability) or by different people (inter-observer reliability) (Hawe et al 1990:213).
Any aspect of behaviour, society or the environment which is directly linked to a health problem in an established or proposed causal pathway. A health problem may have one or more than one risk factor, eg. smoking and elevated levels of serum cholesterol are both risk factors for heart disease (Hawe et al 1990:213).
See also Contributing factor.
Standards explicitly define and describe the characteristics of quality and effectiveness in relation to a particular activity. The Community Health Accreditation and Standards Program (CHASP) standards for community health have been written to reflect core community health concepts and principles (ed Baum et al 1992:309).
The method or range of methods you are going to use in the program to achieve the objectives; that is, how you will do it (Abbott 1990:9)
Those members of a community for whose benefit a health goal is constructed and a health intervention carried out. These people are usually programme participants or intervention group although in some cases the participants might be another group of people who will pass on the benefit to the target group. For example, a parent drug education program may be aimed at reducing drug abuse in children, in which case the children are the target group and the parents are the intervention group (Hawe et al 1990:215).
A property of questionnaires, surveys, or any other research measurement tool. Expresses the degree to which the tool measures what it purports to measure; for example, to what extent a questionnaire can be a valid measure of smoking status (Hawe et al 1990:215).