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307CPD Health Promotion Question: Choose and critique a pharmacy-related health promotion activity (HPA) For this assignment you are expected to look out for a health promotion activity and critique it in relation to the information contained within and the way in which it is presented. This is most likely to be a leaflet or poster found in a pharmacy but could be any form of health promotion material such as a website. The important thing is that it must have some relevance to pharmacy practice. Answer: Analysis Of Health Promotion Leaflet On Hepatitis C Health promotion activities are normally geared towards the promotion of good health and prevention of ill health. It sometimes aims to focus on certain group of people for the risk of diseases 1. The main aim of the health promotion activities is to inform the people about the initiatives that can make them healthy or protect them from diseases. Health promotion can be done by a number of means depending upon the clinical condition and the target group .   This essay will aim to critically analyses or appraise the health promotion leaflet related to hepatitis C. The paper will throw light upon the factors that makes it suitable for the health promotion campaign, the sources, the relevancy of the contents and the optimum readability status of the content. The paper will also critically appraise and criticize the leaflet designs and the layout. A small overview of the target audiences have also been taken into consideration. Hepatitis C is caused by a virus that actually infects a liver that may cause liver cirrhosis, liver, failure or liver cancer . The leaflet contained information regarding the portals of entry of the disease, the pathogenesis of the disease, the risk factors and the probable diagnosis of the disease. The leaflet also contained information about the tests that can confirm the occurrence of the disease. The 2004, UK white paper “better information, better choices, better health’ proposed some strategies for improving the dissemination of the health information to the customers or the clients. Each and everybody should have access to high quality of information, health professionals should be able to communicate with the general public and spread awareness. In spite of the extensive advertisements using telephone, digital and social media, and many consumers still do not have the access to the necessary information or information in a way that they can understand. Hence the increasing prevalence of the hepatitis C in UK and the urge of the health professionals to connect with the common people, a very normal form of communication were chosen to spread awareness among the people who find it difficult top access digital or social media . The leaflet has been chosen as a health promotion tool in order to raise awareness regarding he risk factors associated with the contraction of Hepatitis C. An average pharmacy is encountered with a large number of populations and this provides the opportunities for health education and health promotion. The health care professionals can assist the pharmacies about spreading the education for the safety protocols regarding the transmission of the STDs. The pharmacists can help to prevent hepatitis C by providing the leaflets but it can also increase the risk of the over reliance on the factors and hence there should be opportunities for discussing the concerns. The leaflet is an effective medium of the health promotion campaign. The leaflet contained several information regarding the websites where all the fact sheets about the current prevalence of the hepatitis C, the current health promotion activities going on and more is provided. The principle benefit of an information leaflet is that it provides a concise guidance towards any forms of research12. It summarizes the key information of any health promotion activity at a glance. The potential of the leaflet is that the person receiving this can preserve this or can show it to the other people as well after there is no contact with the researcher . Since the purpose of the research is health promotion, hence the language of the leaflet is kept simple for the common people to comprehend. Leaflet is an effective way to communicate with the common public or to spread health awareness among the public. Although leaflet advertising promotion is quite old fashioned in this digital age, yet the effective promotion should be the promotion of both modern and traditional techniques. One of the advantages of using leaflets in promoting health promotion is that it is cost effective. In general the health promotion activities involves a huge amount of cost, hence it can be convenient for the health care practitioners or the stakeholders of the campaign to save the cost of advertising. The beauty of using leaflets in the health promotion activity regarding the contraction of hepatitis C is that one can deliver the message right in the hand of the public2. Health promotion is possible also by using the   social networking site. But using leaflets, one can ensure that the communication is actually occurring one to one. Every section of the population might not find it convenient to use online sources. Hence leaflets are suitable for reaching every section of people . Good medical leaflets should have some checklists, while starting with a health promotion activity. First is the target group, the cover design should clearly indicate about who is the leaflet aimed at. The websites and the contact details should remain up to date, otherwise it will not be of any use to the vulnerable group. Secondly it is necessary to have a look at the tone of the voice12. Is it scaremongering or patronizing? Unsuitable tone can put the reader off and will prevent the actual message to get across the public. It has to be clear that the messages are not influenced by any commercial interests. One has to be sure about the headings, as general public first scan the headings before moving to the actual content. The readability score should be appropriate and finally the leaflet should have a succinct summary with a proper take home message12. The aim of the leaflets is to target the high risk group of contracting hepatitis C. Chronic Hepatitis is the major cause of liver cirrhosis with a prevalence of 3 % worldwide2. It has been found that the prevalence of hepatitis C in UK is mainly centered on those areas having a large number of immigrant populations. The chronic liver diseases have been found to be an added burden to the health care cost of the NHS. The hepatitis C action plan targets the group of the ethnic minorities where the HCV is endemic. Globally about 71 million people have been suffering from hepatitis C and approximately 39000 people die each year due to hepatitis C . It is a blood borne infection and can transmit through the exposure to small quantities of blood. One of the factors of concern is that currently there are no vaccines for hepatitis. The monitoring and the diagnoses of HCV provided in the leaflet are quite simple. More detailed information could have been given such as the patient will be asked to have a blood test and if the GP suggests something wrong then the patient might need a liver biopsy2. Different imaging tests such as MRI, CT scan, and ultrasound can be made to detect the condition of the liver.    While referring to the control measures, the paper had advised to drink within the safe limits like two units and three units in men. It should be kept in mind that hepatitis and alcohol is a dangerous cocktail and Alcohol intake of more than 50 grams in a day may lead to increased risk of liver cirrhosis and fibrosis.  The leaflet has been stating the fact that although there are no vaccinations for hepatitis C, but vaccinations for A & B is necessary . Persons, already affected by hepatitis A and B, have a higher risk of being infected with the hepatitis C virus.  The leaflet did not even provide a short description of the individuals who are vulnerable to this disease. People who are not vaccinated for A and B, anybody having a sex partner with hepatitis C, people sharing needles to inject drugs, persons with end stage renal disease, people living in facilities for people who are developmentally disabled, travelling to region with high rates of hepatitis C, people suffering from chronic liver diseases, individuals with HIV infection2. The leaflet also stated about the risk of taking paracetamol as the pain killer. It should be noted that the combination of paracetamol and hepatitis C can be life threatening. Overdose of acetaminophen can be detrimental for a liver as if taken in excess, the drugs starts accumulating I the liver which causes damage to the liver cells. The highest suggested dose for acetaminophen can be about 3250 mg per day, which is about 5-6 tablets of 500 mg each day. It is necessary to be sure about alcohol intake while taking acetaminophen, as both are processed in the liver and even a healthy person might contract with problem taking them together11.   The information present in the leaflet is quite comprehensible as the language was simple and can be understandable to an age of 10. Literary sources like leaflets, flyers or brochures should have an optimum readability of aged 10. The readability of the packaged leaflets regarding the medical products is generally measured by SMOG grade, Szigriszt’s perspicuity index or Kincaid grade level . The leaflet displayed the readability grade to be a school reading level. Using of simple words for the description of the pathopysiology has been commendable. One of the criticisms regarding the leaflet is that it could have provided the symptoms and the ways of contracting the illness in a detailed form and in bullet points to make it easily detectable .  Short collages of figures could have made the pamphlet more attractive to the readers. Another disadvantage of this leaflet is that the leaflet could have provided more information regarding the organizations to be approached if contracted with Hepatitis C. One link had been provided but that does not suffice the requirements. Links of suitable websites containing authentic information regarding hepatitis C could have been provided. Sometimes the leaflets cane torn or tossed and overlooked but even a small glance at the material is worth compared to the message that is not seen at all. The background of the leaflet should be bright and should be attracting the audience before throwing it12. The writing should be in contrast to the background, such that it is easily readable, which is quite appreciable in this case; blue background with dark colored headings and white contents. The font size of the leaflet is also appropriate such that they can be read quite comfortably with naked eyes. The fourfold pattern of the leaflet makes it compact and handy. While discussing about the relevancy of the content, the content of a leaflet should be short, simple and easily understood. While further assessing the leaflet, the layout should be focused on. The leaflet has used chunks of paragraphs with appropriate headings 12. The concerned leaflet is soothing blue in color, but does not contain any images. Images can be helpful for the people with lower literary skills and the bright colors also aids to draw the attention of persons.  It should be kept in mind that it is the images that actually makes a leaflet catchy to the audiences. The colorful effect can be given by using the photographic collages related to high risk behavior or disease prevention such as needles, condoms and more. The digital image of the virus responsible for the disease can also be given. The main thing that can be kept in mind is that a health promotion leaflet should be patient centered, such as a small epidemiology of the disease, the signs and the symptoms, the probable strategies for contracting the disease12. The diagnoses should be mentioned in detail in the leaflet as detecting is the first stage. A person might tally his symptoms with the symptoms mentioned in the leaflets. The leaflet may contain few pharmacological interventions regarding the disease. Leaflets contains information in precise form hence any contraindications regarding the medications cannot be provided. It can be said that the information provided in the leaflet is quite relevant with appropriate information, except few elaborations were required in some of the areas.  The layout of the leaflet is attractive, although few images could have made it even better. The reading level of the leaflet is also suitable to address general public. The knowledge of the readability tests, simple use of pictorial representations can make the health care professionals to choose the appropriate method of health promotion. References Abel, T., Hofmann, K., Ackermann, S., Bucher, S. and Sakarya, S., 2014. Health literacy among young adults: a short survey tool for public health and health promotion research. Health promotion international, 30(3), pp.725-735. Adepu, R. and Swamy, M.K., 2012. Development and evaluation of patient information leaflets (PIL) usefulness. Indian journal of pharmaceutical sciences, 74(2), p.174. Carter, G.T., Duong, V., Ho, S., Ngo, K.C., Greer, C.L. and Weeks, D.L., 2014. Side effects of commonly prescribed analgesic medications. Physical Medicine and Rehabilitation Clinics, 25(2), pp.457-470. Colledge, A., Car, J., Donnelly, A., and Majeed, A. ,2008. Health information for patients: time to look beyond patient information leaflets. Journal of the Royal Society of Medicine, 101(9), 447–453. Corcoran, N. ed., 2013. Communicating health: strategies for health promotion. Sage. Garner, M., Ning, Z. and Francis, J., 2012. A framework for the evaluation of patient information leaflets. Health Expectations, 15(3), pp.283-294. Gower, E., Estes, C., Blach, S., Razavi-Shearer, K. and Razavi, H., 2014. Global epidemiology and genotype distribution of the hepatitis C virus infection. Journal of hepatology, 61(1), pp.S45-S57. Johnson, N.B., Hayes, L.D., Brown, K., Hoo, E.C. and Ethier, K.A., 2014. CDC National Health Report: leading causes of morbidity and mortality and associated behavioral risk and protective factors—United States, 2005–2013. Kemppainen, V., Tossavainen, K. and Turunen, H., 2013. Nurses’ roles in health promotion practice: an integrative review. Health Promotion International, 28(4), pp.490-501. Krenkel, O., Mossanen, J.C. and Tacke, F., 2014. Immune mechanisms in acetaminophen-induced acute liver failure. Hepatobiliary surgery and nutrition, 3(6), p.331. Martin, T.C., Martin, N.K., Hickman, M., Vickerman, P., Page, E.E., Everett, R., Gazzard, B.G. and Nelson, M., 2013. Hepatitis C virus reinfection incidence and treatment outcome among HIV-positive MSM. Aids, 27(16), pp.2551-2557. McGowan, C.E. and Fried, M.W., 2012. Barriers to hepatitis C treatment. Liver International, 32(s1), pp.151-156. Protheroe, J., Estacio, E.V. and Saidy-Khan, S., 2015. Patient information materials in general practices and promotion of health literacy: an observational study of their effectiveness. Br J Gen Pract, 65(632), pp.e192-e197. Štajner, S., Evans, R., Orasan, C. and Mitkov, R., 2012. What can readability measures really tell us about text complexity. In Proceedings of workshop on natural language processing for improving textual accessibility (pp. 14-22).

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