01 Foundations of Lifespan Health Promotion

Foundations of health promotion

Health promotion helps people gain greater control over their health and supports well-being in physical, mental, and social dimensions. It extends beyond advice in a clinic: families, communities, organizations, and public policy can all influence whether healthy choices and services are accessible.

The Ottawa Charter emphasizes five areas for action: building healthy public policy, creating supportive environments, strengthening community action, developing personal skills, and orienting health services toward prevention.

Health is shaped by individual behavior as well as development, family and community support, housing, education, income, safety, access to care, and other social conditions. Effective care identifies a person’s strengths and barriers, sets goals with them, and connects them with practical resources. Health promotion and prevention are related efforts across the lifespan.

Prevention and screening

Prevention has three levels, distinguished by when they act in relation to a condition:

• Primary prevention acts before disease or injury occurs. Examples include vaccination, injury-prevention counseling, and supporting healthy nutrition and activity.

• Secondary prevention detects a condition early, often through screening, so timely evaluation or treatment can reduce harm.

• Tertiary prevention limits complications or disability after a condition is established. Examples include rehabilitation and preventing complications of diabetes.

Screening is not diagnosis. A positive result may need confirmatory testing, and screening can have benefits as well as potential harms. Offer evidence-based screening suited to the person’s age, health history, risk, and current guidance. Explain what a result can and cannot show, possible follow-up, and the person’s options. A screening program is incomplete without a plan to communicate results and arrange follow-up.

Care across life stages

At each encounter, consider the person’s developmental stage and trajectory, not age alone. Compare growth and development with appropriate standards, ask about concerns, and use validated screening tools when indicated. A screening result identifies a need for further assessment; it does not by itself establish a diagnosis. Individualize and update preventive recommendations as needs, risks, and evidence change.

Before and during pregnancy

Preconception counseling can review health conditions, medications and supplements, vaccination history, and steps to support a healthy pregnancy. Prenatal care monitors the health of the pregnant person and fetus, provides counseling and support, and may include laboratory, infection, and fetal screening. Explain that prenatal screening estimates the chance of a condition but does not diagnose it. Discuss available choices and follow-up without pressure.

Infancy and childhood

Support nurturing relationships, nutrition, sleep, oral health, safety, immunization, and developmental progress. Teach caregivers with concrete examples and demonstrations. Regular well-child visits use age-based assessments and screenings; concerns may require additional visits or evaluation.

Adolescence

Offer developmentally appropriate guidance on emotional well-being, healthy relationships, sexual health, substance-use prevention, safety, and preventive care. When appropriate, provide a confidential and respectful opportunity for discussion, explain the limits of confidentiality, and involve caregivers in ways that support the young person’s safety and well-being.

Adulthood

Emphasize prevention suited to personal history and risk. This includes recommended immunizations and screening, reproductive and sexual health, mental well-being, and management of risk factors and chronic conditions. Support realistic goals for nutrition, activity, sleep, and tobacco or substance-use prevention.

Older adulthood

Prioritize function, independence, and the person’s own goals. Review chronic conditions, medications, sensory and cognitive concerns, mood, social connection, immunization and screening needs, and fall risks. Adapt activity and self-management plans to abilities and health conditions; include strength and balance when suitable. Older adults vary widely, so do not assume age alone determines ability or preferences.

Effective health education

Effective health education is relevant, actionable, and collaborative. Begin by asking what the person already knows, what matters to them, and what obstacles they anticipate. Agree on one or more achievable next steps, then use plain language, brief explanations, pictures or demonstrations when helpful, and a written or verbal action plan.

Use teach-back by inviting the person to explain the plan in their own words. This checks how clearly information was communicated; it is not a test of the person. Organizations, as well as individuals, have a role in making health information and services understandable and usable.

Tailor the approach to the learner. Involve caregivers appropriately for children, give adolescents space to ask questions, and accommodate adults’ preferred format, language, sensory needs, and readiness to change. Reinforce key messages over time and connect advice to accessible resources. For example, instead of simply saying “exercise more,” work with the person to choose a feasible activity, place, and schedule.

Culturally responsive care

Treat each person as an individual. Ask about preferred language, beliefs, family or community roles, care practices, and priorities rather than making assumptions based on identity. Respectfully discuss how personal practices fit with recommended care, and make room for informed choice.

When needed, use qualified interpreters and translated materials rather than relying on children or untrained interpreters for sensitive clinical communication. Address practical barriers to access and partner with community resources. The National CLAS Standards describe actions for providing respectful, responsive, culturally and linguistically appropriate services.