Critical Analysis Assignment: Health Promotion Intervention Analysis

This report presents a critical analysis of a health promotion intervention designed to increase physical activity among university students in South Africa, focusing on reducing non-communicable diseases (NCDs). The intervention, based on social cognitive theory, targeted various health behaviors including physical activity, diet, and risk reduction. The analysis evaluates the intervention's effectiveness in relation to the Ottawa Charter principles: developing personal skills, creating supportive environments, strengthening community actions, reorienting health services, and building healthy public policy. The report also assesses the intervention's alignment with equity principles, highlighting both its strengths and weaknesses in addressing health disparities. Recommendations are provided for improving future health promotion initiatives, emphasizing the importance of comprehensive strategies that consider social determinants of health, community engagement, and policy development to effectively reduce NCD incidence and promote health equity among the target population. The report concludes by emphasizing the need for collaboration with government organizations and a focus on patient education to enhance the prevention of NCDs.

Running head: CRITICAL APPRAISAL
Critical Analysis Assignment
Name of the Student
Name of the University
Author Note

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Student Name: Student Number:400867 Critical Analysis Assignment
Executive summary
The primary aim of health promotion is to attain equity in health and wellbeing of all people,
and it also aims at eliminating existing disparities in prevailing health status of the target
population, while ensuring equal resources and opportunities for all. The report contains an
analysis of an article that elaborates on the impacts of health promotion intervention, in
reducing the prevalence of non-communicable diseases among university students of South
Africa. Although the intervention was effective in enhancing their health, several aspects of
health inequities, community participation, and health policies were inadequately addressed.

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Student Name: Student Number:400867 Critical Analysis Assignment
Table of Contents
Introduction................................................................................................................................3
Intervention................................................................................................................................3
Analysis of the intervention in relation to Ottawa Principles....................................................3
Develop personal skills..........................................................................................................3
Create Supportive Environments...........................................................................................4
Strengthen Community Actions.............................................................................................4
Reorient Health Services........................................................................................................5
Build Healthy Public Policy...................................................................................................5
Analysis of the intervention in relation to equity principles......................................................6
Recommendations......................................................................................................................6
References..................................................................................................................................8

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Student Name: Student Number:400867 Critical Analysis Assignment
Introduction
Non-communicable disease (NCD) refers to illnesses that have a prolonged duration
and typically manifest a slow progression (Kontis et al., 2014). NCDs are responsible for
death of 41 million individuals each year (WHO, 2018). The intervention is focused on
health-promotion that generally encompasses the procedure of assisting people to gain a
control over their health, and consequently enhance their wellbeing. The purpose of the
article is to explore the efficacy of a particular health-promotion intervention, with the aim of
enhancing self-reported physical exercise amid university pupils in Sub-Saharan Africa. The
report will critically appraise the article, based on the principles of Ottawa Charter.
Intervention
The intervention that focuses on health promotion was conducted by the researchers
upon 176 second year, university students who had been randomly selected from a university
located in South Africa. The researchers randomised the students to intervention that was
typically based on social cognitive theory and encompassed several aspects namely, targeting
physical activity, health-promotion, vegetable and fruit intake, fat consumption. Reducing
risk of HIV, and addressing sexual-risk behaviours (Heeren et al., 2018). Inclusion criteria for
the participants comprised of those who were aged from 18-24 years and did not have any
plans of leaving their university, within the following 12 months. Participants in intervention
group were able to better meet the guidelines for physical activity, and they reported more
number of days of vigorous intensity exercise. The intervention was also able to lower fried
food servings.

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Student Name: Student Number:400867 Critical Analysis Assignment
Analysis of the intervention in relation to Ottawa Principles
Develop personal skills
It is imperative for health promotion activities to support social and personal
development of people by providing them necessary information (Thompson, Watson &
Tilford, 2018). The health-promotion intervention implemented on the university students
was designed specifically with the aim of increasing attitudes, knowledge, skills, and self-
efficacy, in order to prevent the prevalence and progress of NCDs. In addition, it was also
successful in development of personal skills of the target population owing to the fact that it
helped them in increasing adherence to their physical activities, and also encouraged them to
select healthy diet patterns, and limit their use of alcohol (Heeren et al., 2018). There is
mounting evidence for the fact that enabling individuals to acquire information, throughout
their life, helps them to remain prepared for different stages and also increases their coping
skills, in relation to injuries and chronic illnesses (Hou, 2014).
Create Supportive Environments
It has often been established that bringing about lifestyle modifications creates a
significant positive impact on the health of individuals (Thompson, Watson & Tilford, 2018).
In addition, presence of a supportive environment also increases the access of individuals to
necessary supports, resources and services that are imperative for fostering resilience and
enhancing the overall health and wellbeing (Lee et al., 2016). The intervention that was based
on health promotion was able to provide a supportive environment to the participants, which
in turn allowed them to change their health-related behaviours and gain a sound
understanding of the domains the required necessary modifications for lowering their
likelihood of suffering from NCDs (Heeren et al., 2018).
Strengthen Community Actions

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Student Name: Student Number:400867 Critical Analysis Assignment
Health promotion strategies have been found to work best through the implementation
of effective and concrete community action (Eldredge et al., 2016). The intervention that had
been implemented upon the university students was accurate in setting its priorities, which
was typically focused on lowering the risks of the students from suffering from NCDs,
thereby reducing the incidence of NCDs in the region. The intervention was also able to
enhance self-help activities by helping them adapt to lifestyle modifications that were based
on physical exercise, dietary changes, and HIV risk-reduction (Heeren et al., 2018).
Community action for health places people at centre of health promotion, thus ensuring
fulfilment of the rights and health needs of the people (Thompson, Watson & Tilford, 2018).
However, there was lack of information on utilising community resources for addressing the
health problems.
Reorient Health Services
Recent evidences elaborate on the fact it is mandatory for all health services to adopt
an extended directive that is sensitive towards the cultural preferences and demands of the
patients (Betancourt et al., 2016). In addition, it has also been found that the accountability
for health promotion is shared amid community groups, individuals, health service
institutions, the government and professionals (Thompson, Watson & Tilford, 2018).
Although the university students were subjected to a health promotion intervention that
addressed several lifestyle changes such as, dietary modifications and compliance to physical
exercise, there was a lack of information regarding the involvement of any government
officials or health services for facilitating adaptation to the intervention plans (Heeren et al.,
2018).
Build Healthy Public Policy

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Student Name: Student Number:400867 Critical Analysis Assignment
It is imperative for health promotion policy to identify the major obstacles that act as
an impediment to adoption of healthy policies, and the strategies to eliminate them
(Thompson, Watson & Tilford, 2018). Research evidences elaborate on the fact that higher
poverty rates, social and cultural norms related to health, educational and linguistic
disparities, low access to resources, and reduced access to physical activity and healthy food
options are some common barriers for remote communities (Oliver et al., 2014). Although the
intervention had a major advantage of focusing on behaviour-change theories by using
qualitative research, no information had been provided on the potential barriers that might be
faced, during formulation and enforcement of policies that encompass the health promotion
approach (Heeren et al., 2018).
Analysis of the intervention in relation to equity principles
The intervention was in accordance to the equity principle of prioritising groups that
have been identified to be at high-risk, owing to the fact that several students in South Africa
encounter challenges while moving to university (Heeren et al., 2018). In addition, South
Africa has also been found to experience a surge in the prevalence of NCDs like diabetes,
stroke, heart disease, and lung disease (Pillay-van Wyk et al., 2016). Furthermore, an
equitable approach must always focus on community development and adopt community
structure initiatives for strengthening the health of the community. Thus, it can be suggested
that the intervention was framed in a way that accurately addressed the need for reducing
NCD incidence among the students. However, there was failure in the part of the researchers
to focus their intervention on social determinants, diminish social inequities, and/or foster
partnership with other organisations.

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Student Name: Student Number:400867 Critical Analysis Assignment
Recommendations
 Building a health promotion policy that focuses on mandatory dietary modifications
and adherence to physical exercise would prove beneficial (Horodyska et al., 2015).
 Social determinants of health must also be eliminated by adopting enhanced
governance, promoting policy making participation and strengthening collaboration.
 Health inequity must also be reduced by increasing access of the target population to
high quality food products and creating provisions in community for physical activity
(Chen et al., 2016).
 Efforts must be taken to collaborate with government organisations that will increase
patient education on prevention of NCDs (Yagub, 2014).

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Student Name: Student Number:400867 Critical Analysis Assignment
References
Betancourt, J. R., Green, A. R., Carrillo, J. E., & Owusu Ananeh-Firempong, I. I. (2016).
Defining cultural competence: a practical framework for addressing racial/ethnic
disparities in health and health care. Public health reports.
Chen, J., Vargas-Bustamante, A., Mortensen, K., & Ortega, A. N. (2016). Racial and ethnic
disparities in health care access and utilization under the Affordable Care
Act. Medical care, 54(2), 140.
Eldredge, L. K. B., Markham, C. M., Ruiter, R. A., Kok, G., Fernandez, M. E., & Parcel, G.
S. (2016). Planning health promotion programs: an intervention mapping approach.
John Wiley & Sons.
Heeren, G. A., Jemmott III, J. B., Marange, C. S., Rumosa Gwaze, A., Batidzirai, J. M.,
Ngwane, Z., ... & Tyler, J. C. (2018). Health-Promotion Intervention Increases Self-
Reported Physical Activity in Sub-Saharan African University Students: A
Randomized Controlled Pilot Study. Behavioral Medicine, 44(4), 297-305.
Horodyska, K., Luszczynska, A., van den Berg, M., Hendriksen, M., Roos, G., De
Bourdeaudhuij, I., & Brug, J. (2015). Good practice characteristics of diet and
physical activity interventions and policies: an umbrella review. BMC Public
Health, 15(1), 19.
Hou, S. I. (2014). Health education: theoretical concepts, effective strategies and core
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Kontis, V., Mathers, C. D., Rehm, J., Stevens, G. A., Shield, K. D., Bonita, R., ... & Ezzati,
M. (2014). Contribution of six risk factors to achieving the 25× 25 non-communicable

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Student Name: Student Number:400867 Critical Analysis Assignment
disease mortality reduction target: a modelling study. The Lancet, 384(9941), 427-
437.
Lee, W. W., Choi, K. C., Yum, R. W., Doris, S. F., & Chair, S. Y. (2016). Effectiveness of
motivational interviewing on lifestyle modification and health outcomes of clients at
risk or diagnosed with cardiovascular diseases: a systematic review. International
journal of nursing studies, 53, 331-341.
Oliver, K., Innvar, S., Lorenc, T., Woodman, J., & Thomas, J. (2014). A systematic review of
barriers to and facilitators of the use of evidence by policymakers. BMC health
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Pillay-van Wyk, V., Msemburi, W., Laubscher, R., Dorrington, R. E., Groenewald, P., Glass,
T., ... & Nannan, N. (2016). Mortality trends and differentials in South Africa from
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Health, 4(9), e642-e653.
Thompson, S. R., Watson, M. C., & Tilford, S. (2018). The Ottawa Charter 30 years on: still
an important standard for health promotion. International Journal of Health
Promotion and Education, 56(2), 73-84.
World Health Organization. (2018). Noncommunicable diseases- Key facts. Retrieved from
https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
Yagub, A. I. (2014). Collaboration between government and non-governmental organizations
(NGOs) in delivering curative health services in north darfur state, Sudan-a national
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