Health Promotion: Scrutiny and Practical Implementation


There exist a number of definitions of health promotion (HP); one provided by the World Health Organization states that HP is “the process of enabling individuals and communities to increase control over the determinants of health and thereby improve their health” (as cited in Dawson & Grill, 2012, p. 101). HP includes three levels which address disease at different stages. HP is crucial for increasing the overall health levels of the population, and for helping to improve patient outcomes and decrease health insurance costs (Potter, Perry, Stockert, & Hall, 2016).

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Health Promotion Levels

There exist three levels of HP: primary, secondary, and tertiary. The primary level is comprised of health promotion (which includes, for example, health education, sex education, adequate housing and diet, safe working conditions, and medical screening) and specific protection (e.g., immunization, utilization of proper nutrients for a specific condition, personal hygiene, healthy environment), and is aimed at people who have not yet developed a (serious) medical condition. The secondary prevention consists of early diagnosing and providing fast treatment (such as mass examinations, selective screening to detect illnesses), and preventing impairment (high-quality treatment to prevent disease complications which may cause disability or death); the target population is individuals suffering from a health problem. The tertiary prevention comprises rehabilitation and restoration (e.g., work therapy in healthcare institutions, supplying facilities for retraining and learning), and is aimed at people who have undergone treatment, but have not yet recuperated from the disease (Potter et al., 2016, p. 71).

Health Promotion into the Practice

Obesity has numerous adverse effects on people’s health; for instance, it increases the risk of cancer, stroke, asthma, type 2 diabetes, etc.; it also leads to other complications such as low self-esteem, eating problems, social prejudice, and many other issues (Djalalinia, Qorbani, Peykari, & Kelishadi, 2015, p. 240). Therefore, it is important to address the risk of obesity development in population, which can be done by implementing HP. At the primary level, education regarding the risks of obesity and measures to prevent it, as well as promoting adequate diet and healthy environment, may be employed. At the secondary level, people who have started becoming overweight should be assisted by consulting them about the measures to prevent further weight gain, and helping them to implement these measures. At the tertiary level, obese people should be supplied with facilities that could help them to lose weight, e.g., with special physical training programs, etc.

Evidence-Based Practice

It is stated that in the last years obesity has become a widespread condition, and that the military servicepersons also suffer from this problem (Sammito, 2013, p. 728). To address this issue in the German military forces, an Obesity Intervention Programme (OIP) was carried out. Although the report about the intervention is not tied to the concept of HP, soldiers with different degrees of being overweight were involved, and all the three levels of HP were implemented. The measures corresponding to the primary level includes educational activities and dietary recommendations for soldiers; among the measures corresponding to the secondary level, the physical exercise for soldiers who were inclined towards obesity, and dietary adjustments, can be named; at the tertiary level, obese soldiers were provided with the opportunity to participate in additional physical exercise and to change their food intake. OIP is reported to have helped decrease obesity levels (Sammito, 2013, pp. 728-729).


To sum up, it should be pointed out that the levels of HP (primary, secondary, and tertiary), in fact, correspond to different levels of development of a health problem; the primary level promotes awareness and is aimed at disease prevention; the secondary level addresses people who are already suffering from the disease; the tertiary level deals with people who have undergone treatment, but have not recuperated from the negative effects of an adverse health condition. It is crucial to follow the guidelines of HP in the nursing practice in order to provide adequate assistance for patients with different levels of health problem progression, and minimize the risks posed by disease.


Dawson, A., & Grill, K. (2012). Health promotion: Conceptual and ethical issues. Public Health Ethics, 5(2), 101-103. doi:10.1093/phe/phs024

Djalalinia, S., Qorbani, M., Peykari, N., & Kelishadi, R. (2015). Health impacts of obesity. Pakistan Journal of Medical Sciences, 31(1), 239-242. doi:10.12669/pjms.311.7033

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Potter, P. A., Perry, A. G., Stockert, P., & Hall, A. (2016). Fundamentals of nursing (9th ed.) [Google Books version]. Web.

Sammito, S. (2013). Obesity intervention during a work health promotion: The obesity intervention program of the German military forces. Journal of Occupational and Environmental Medicine, 55(7), 728-731. doi:10.1097/JOM.0b013e318297337b

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