The role of prevention in cancer control is not solely economic, but also humanitarian and ethical, in recognition of current estimates that one-third of cancer is preventable.13
The Ottawa Charter was a landmark document created by the World Health Organisation (WHO) which reoriented health care systems towards primary health care and health promotion. The charter advocates that health promotion action must occur on five fronts including:18
- building healthy public policy.
- creating supportive environments.
- strengthening community action.
- developing personal skills.
- reorienting health services.
Consistent with the principles of the Ottawa Charter for health promotion18, successful approaches to cancer prevention require a multi-focal approach that addresses broader issues of public policy, the environment, community action and health services as well as micro-level issues such as the development of personal skills. The charter emphasises the interrelationship of all of these aspects of health promotion.
There are many factors that influence whether a person will participate in prevention activities. A number of models and theories have been developed to explain health behaviour including Social Learning Theory, Health Belief Model, Theory of Reasoned Action and the PRECEDE model of health education.19 A key publication by Cummings et al (1980) identified six categories of variables influencing health behaviour:20
- Attitudes toward heath care benefits and health care quality
- Perceptions of symptoms and beliefs about susceptibility to illness
- Accessibility of health services
- Knowledge of health services
- Social support characteristics
- Demographic variables (particularly social status, income and education).
It has been identified that behavioural change efforts need to focus on common models that emphasise the skills needed for behavioural change, diverse and sustained interventions, and social and other forms of support for the maintenance of behavioural changes. An approach involving well defined interventions delivered to individuals, such as counselling and prescription drugs for smoking cessation and comprehensive, multi-component programs directed to large groups such as state-wide tobacco control programs has been advocated. 19
Cancer Forum, March 2012, Vol 36 Issue 1, Cancer Prevention
Access the webpage The Ottawa Charter for Health Promotion and:
- Outline three examples of how the Ottawa Charter for Health Promotion can be applied in the area of cancer control?
- Identify potential benefits of taking a primary health care approach to cancer control. In your response, provide examples from your understanding of existing efforts in cancer control.
Reflect on your own lifestyle and identify areas where you consider you have adopted health–promoting behaviours and areas where you consider you have not. Identify the factors which influence whether or not you adopt health promoting behaviours?
Access The conceptual framework of the International Tobacco Control (ITC) Policy Evaluation Project(PDF, 220KB)21 and discuss how the international approach to a public health issue has had positive influence on health behaviours.
Access the AIHW's Chronic Disease and Risk Factors page and consider the behaviour change education you could provide to patients at risk of any of the conditions listed.