An Overview of the Impact of Health Promotion on Changing Individuals and Community Behavior
- 1. Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, UAE
Human behavior plays a key role in the maintenance of human health, and wellbeing. This review highlighted the influences of health promotion on changing individuals and community behaviors. Furthermore, it explored the importance of tackling both individuals and community behaviors in health promotion interventions, especially in emergencies such as coronavirus disease-19 (COVID-19) pandemic.
Health promotion, Individuals, Community, Behaviour
CURRENT OPINION OF HEALTH PROMOTION
Health promotion is defined by the World Health Organization (WHO) as “the process of enabling people to increase control over, and to improve their health” . Health promotion moves beyond a focus on individual behavior towards a wide range of social and environmental interventions . Researchers reported two main effects of interventions, first one, through a direct effect on people initially targeted by the intervention (individuals), and second one, an indirect effect mediated by social influence and by the observation of other people’s behavior (the community) . As unhealthy behavior is responsible for poor human health, therefore, the common goal of public health is to encourage behavior change, through proposing suitable health promotions programs to promote healthy behaviors . Health promotion enhance people to increase control over their diseases, be productive, and safe their resources [4-6]. A plethora of studies documented the strong relationship between health promotion and positive health outcomes [4-9]. Human behavior plays a key role in the maintenance of human health, and wellbeing . To have a positive health outcomes, health promotion interventions such as healthy lifestyles, physical activity and nutrition should take into account both individuals and community behaviors as both of them are closely interrelated. This interrelation was documented by many researchers [10,11]. Therefore, logic follows that, studying both of them together and not merely separately could propose interventions aiming to have effective health promotion interventions.
To enhance the efficacy of health promotion interventions aiming to have better health outcomes at both individuals and the community levels, many actions are needed such as redesigning the role of professionals and people . In order to adopt a healthy behavior, three phases of changes are needed awareness, motivation, and action; this was explained well by Cheung, et al, by taking nonsmoking via smoking cessation as an example .
Although health promotional interventions are cost effective in improving health and wellbeing of nations [4-9], they are not without challenges [14,15]. Thus, researchers proposed many suggestions to overcome such challenges including:
- Application of a comprehensive strategy targeting behavior change and health promotion that can play a role in overcoming through well planning, coordination, and community involvement 
- Working together (community and individual) to enable behavior change towards a common shared goal such as climate changes 
- Building capacity of health promotion to focus on vulnerable and marginal members of the community .
- Maintaining the sustainability of health promotion interventions by involving of multi-stakeholder such as agencies, organizations, and employees . Despite of relative success in achieving behavior change in the short term, it can be difficult to sustain such success in long term . Therefore, to ensure sustainability of health promotion programs at early stages of planning, developing and implementing certain factors need to be considered including organizational capacity, partnerships, strategic planning, funding, program evaluation and capacity building .
Behavioral changes were more prominent during infectious diseases, especially in emergencies such as coronavirus disease-19 (COVID-19) [19-21]. For example, in Singapore, Long and Liu reported 97% of the participants suffered at least one behavioral change on account of the pandemic .
It is worth mentioning that, such integration between individuals and community health promotion was so fruitful in promoting mental health during COVID-19 pandemic [19,20,22].
In the past and present, it is clear health promotion has been contributing to maintain health and wellbeing of nations. To have positive health outcomes and with low cost, health promotion needs to be included in future policies. Researchers predicted health promotion to play a key role in helping people achieve the highest levels of wellness . In future, maximizing usefulness of digital health promotion and prevention such as mobile appbased health promotion programs for the general population including schools, sport clubs, and healthcare facilities is recommended, especially in developing [24,25].
In conclusion, health promotion plays a positive role (the maintenance of human health, and wellbeing) in changing individuals and community behaviors in the past, present and future.
1. World Health Organization. Health Promotion.
2. Robin Schimmelpfennig, Sonja Vogt, Sönke Ehret, Charles Efferson. Promotion of behavioural change for health in a heterogeneous population. Bull World Health Organ. 2021; 99: 819–27.
3. Bouton ME. Why behavior change is difficult to sustain. Prev Med. 2014; 68: 29–36.
4. Sanjiv Kumar, Gs Preetha. Health Promotion: An Effective Tool for Global Health. Indian J Community Med. 2012; 37: 5–12.
5. Smith HJ, Portela AG, Marston C. Improving implementation of health promotion interventions for maternal and newborn health. BMC Pregnancy Childbirth. 2017; 17: 280.
6. Salman A, Tolma E, Chun S, Sigodo KO, Al-hunayan A. Health Promotion Programs to Reduce Noncommunicable Diseases: A Call for Action in Kuwait. Healthcare (Basel). 2020; 8: 251
7. Aung MN, Yuasa M, Koyanagi Y, Nyein T, Aung N, Moolphate S, et al. Sustainable health promotion for the seniors during COVID-19 outbreak: a lesson from Tokyo. J Infect Dev Coutries. 2020; 14: 328–31.
8. Salama B. The importance of health promotion in the prevention of COVID-19. Ann Clin Anal Med. 2020; 11: S309-314.
9. Simkhada P, Mahato P, Tamang P, Teijlingen E, Shahi P. The Role of Health Promotion during the COVID-19 Pandemic. J Heal Promot. 2020; 8: 1–4.
10. Institute of Medicine (US) Committee on Health and Behavior: Research, Practice, and Policy. Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences. Washington (DC): National Academies Press (US); 2001.
11. Morrison D, Lawrence C, Oehmen R. Community level influence on individual behaviours. 2014.
12. FRANCESCA PENNUCCI , SABINA DE ROSIS , ANNA MARIA MURANTE and SABINA NUTI. Behavioural and social sciences to enhance the efficacy of health promotion interventions: redesigning the role of professionals and people. Behav. Public Policy. 2022; 6:13–33.
13. Cheung K, Hors-Fraile S, Vries H. How to use the integrated-change model to design digital health programs. Mobile and Wearable Devices for Participatory Health Applications. Elsevier; 2021. 143–57.
14. Laverack G. The challenge of behaviour change and health promotion. Challenges. 2017; 8: 10–3.
15. Fogg Rogers L. Society vs the individual: How can we work together to enable behaviour change?. Presented at Community Psychology Festival. Bristol, UK. 2017.
16. Anugwom EE . Health Promotion and Its Challenges to Public Health Delivery System in Africa. In: Anugwom E E, Awofeso N, editors. Public Health in Developing Countries - Challenges and Opportunities. London: IntechOpen; 2020.
17. Raphael D. The social determinants of health: what are the three key roles for health promotion? Heal Promot J Aust. 2006; 17: 167–70.
18. Bodkin A, Hakimi S. Sustainable by design: a systematic review of factors for health promotion program sustainability. BMC Public Health. 2020; 20: 964.
19. Long VJE, Liu JCJ. Behavioural changes during the COVID-19 pandemic: Results of a nationwide survey in Singapore. Ann Acad Med Singap. 2021; 50: 222–31.
20. Nadira A, Ruzlin M, Chen XW, Yunus RM, Samsudin EZ, Zaliha Ismail. Promoting mental health during the COVID-19 Pandemic: a hybrid, innovative approach in Malaysia. Front Public Heal. 2021; 9: 747953.
21. Bharti N. Linking human behaviors and infectious diseases. Proc Natl Acad Sci U S A. 2021; 118: e2101345118.
22. Gilmore B, Ndejjo R, Tchetchia A, Claro V De, Mago E, Diallo AA, et al. Community engagement for COVID-19 prevention and control: a rapid evidence synthesis. BMJ Glob Heal. 2020; 5: e003188.
23. Dee W Edington, Alyssa B Schultz, Jennifer S Pitts, Angela Camilleri. The Future of Health Promotion in the 21st Century: A Focus on the Working Population. Am J Lifestyle Med. 2015; 10: 242–52.
24. Lee M, Lee H, Kim Y, Kim J, Cho M, Jang J, et al. Mobile App-Based Health Promotion Programs : A Systematic Review of the Literature. Int J Environ Res Public Health. 2018; 15: 2838.
25. Stark AL, Geukes C, Dockweiler C. Digital Health Promotion and Prevention in Settings: Scoping Review. J Med Internet Res. 2022; 24: e21063.