IntroductiontoHEALTH-OERtextbook.pdf

Introduction to

HEALTH

This is an Open Educational Resource Health textbook. This book is FREE to use and adapt.
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Attribution:
This compilation has been developed by Kelly Falcone, Professor of Kinesiology and Health at Palomar College and adapted from SUNY OER book
Disease Prevention and Healthy Lifestyle by Trina DiGregorio, M.S., Adjunct Professor at Monroe Community College. Professor DiGregorio created
the framework for this online textbook by adapting Contemporary Health Issues by Judy Baker, Ph.D., Dean of Foothill Global Access at Foothill
College.
Licenses and Attributions
CC Licensed, Original

● Introduction to Health, Authored by: Kelly Falcone, EdD, Provided by: Palomar College. Located at:
https://docs.google.com/document/d/1g4OYMjgg7ISQeITbqjoWIAd_f5PoXZB_JAIsoQxKfyg/edit?usp=sharing License: CC BY-SA: Attribution-ShareAlike

CC licensed content, Shared Previously
● Disease Prevention and Healthy Lifestyles. Authored by: Trina DiGregorio, M.S.. Provided by: Monroe Community College. Located at:

https://courses.lumenlearning.com/suny-monroecc-hed110/. License: CC BY: Attribution
CC licensed content, Shared previously

● Contemporary Health Issues. Authored by: Judy Baker, Ph.D., Dean of Foothill Global Access at Foothill College. Provided by: [email protected].
Located at: http://hlth21fall2012.wikispaces.com/. License: CC BY-SA: Attribution-ShareAlike

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Table of Contents

Chapter 1: Introduction to Health and Wellness 12
Dimensions of Wellness 12

What is Wellness? 12
What are the Nine Dimensions of Wellness? 12
Your Own Views on Health and Wellness 14

Healthy People 2020 14
Major Health Concerns 15

Leading Causes of Death in the United States 15
Risk Factors and Levels of Disease Prevention 16

What is a Risk Factor? 16
Levels of Disease Prevention 17

Behavior Change and Goal Setting 18
Transtheoretical Model (Stages of Change) 18
SMART Goal Setting 19

Chapter 2: Exercise and Physical Activity 21
Health Benefits of Physical Activity 21

Begin Taking Steps to be More Physically Active Everyday 21
Control Your Weight 22
Reduce Your Risk of Cardiovascular Disease 22
Reduce Your Risk of Type 2 Diabetes and Metabolic Syndrome 22
Reduce Your Risk of Some Cancers 22
Strengthen Your Bones and Muscles 23
Improve Your Mental Health and Mood 23
Improve Your Ability to do Daily Activities and Prevent Falls 23
Increase Your Chances of Living Longer 23

Physical Activity Guidelines for Adults 24
Overall Components of Physical Fitness: 24
Avoid Inactivity 24
Do Aerobic Activity 24

Aerobic Intensity: Target Heart Rate Zone 25
Taking Your Heart Rate 26
Find your Target Heart Rate Zone 27

Strengthen Muscles 27
Muscle-Strengthening Activity 27
Bone-Strengthening Activity 28

Developing a Personal Exercise Program 29
Make Physical Activity a Regular Part of the Day 30
Gradually Increase Your Level of Physical Activity 31

Warm-up and Cool-down 31
Ways to Get Moving 31
Achieving Target Levels of Physical Activity 32

Chapter 3: Nutrition 33

1

Nutrition Basics 33
What is your food made of? 33

Energy of Food 33
Protein 33
Carbohydrates 33
Fats 34
Vitamins 35
Minerals 35
Water 35
What are Antioxidants? 36

Dietary Guidelines for Americans 36
Key Recommendations: Components of Healthy Eating Patterns 37
Implementation of the Dietary Guidelines Through Using MyPlate 38

Click here to compare MyPlate to the Harvard Healthy Eating Plate. 38
Choose Nutrient Dense Foods! 39

Disease Risk and Nutrition 39
Nutrition and Health Are Closely Related 39
Type 2 Diabetes 39
What is prediabetes? 40
What are the signs and symptoms of diabetes? 40

Nutrition Facts Label 41
Changes to the Nutrition Facts Label 41
Highlights of the Final Nutrition Facts Label 42
Compliance Date 44

Organic Foods 44
Organic 101: What the USDA Organic Label Means 44

Chapter 4: Weight Management 46
Prevalence of Overweight and Obesity 46

Overweight and Obesity in the United States 46
Worldwide Obesity Statistics from the World Health Organization 46
Causes and Health Consequences of Overweight and Obesity 47

Balancing Calories 47
The Caloric Balance Equation 47
Am I in Caloric Balance? 48

Measuring Obesity 50
Body Mass Index (BMI) 50

What is BMI? 50
How is BMI used? 51
What are the BMI trends for adults in the United States? 51
Why is BMI used to measure overweight and obesity? 51
How is BMI interpreted for adults? 52
How good is BMI as an indicator of body fatness? 52
If an athlete or other person with a lot of muscle has a BMI over 25, is that person still considered to
be overweight? 53

Health Effects of Overweight and Obesity 53

2

Chapter 5: Stress Management 55
Stress Overview 55

What is stress? 55
How does stress affect the body? 55
How does stress affect your overall health? 56
How can I cope with stress? 56
Key Takeaway 57

Yerkes-Dodson Law 57
Optimal Levels of Arousal (i.e. Stress) 57

The Stress Response 58
General Adaptation Syndrome 59

Health Effects of Stress 60
What are the most common causes of stress? 60
What are some common signs of stress? 61
Can stress affect my health? 61

Managing Stress 62
How can I help handle my stress? 62
What Are Relaxation Techniques? 63

What Is Meditation? 63
What the Science Says About the Effectiveness of Meditation 63

Chapter 6: Emotional & Mental Health 64
Mental Health Overview 64

What Is Mental Health? 64
Early Warning Signs 64
Mental Health and Wellness 65

Psychological Constructs 66
Maslow’s Hierarchy of Needs 66

Physiological Needs 66
Safety Needs 66
Love/belonging Needs 67
Esteem 67
Self-actualization 67

Freud’s Defense Mechanisms 67
Anxiety Dis s 68

Signs and Symptoms 69
Generalized Anxiety Dis 69
Panic Dis 69
Social Anxiety Dis 69

Risk Factors 70
Treatments and Therapies 70

Psychotherapy 70
Cognitive Behavioral Therapy (CBT) 70
Stress-Management Techniques 71
Medication 71

3

Depression 71
Signs and Symptoms 72
Risk Factors 73
Treatment and Therapies 73
Beyond Treatment: Things You Can Do 73

Suicide Prevention 74
If You Know Someone in Crisis 74
Introduction 74
Signs and Symptoms 74
Risk Factors 75
Do gender and age affect suicide risk? 75
What about different racial/ethnic groups? 75
Treatments and Therapies 76
Psychotherapies 76

Eating Dis s 76
What are eating dis s? 76
What are the different types of eating dis s? 77

Anorexia nervosa 77
Bulimia nervosa 78
Binge-eating dis 78

How are eating dis s treated? 78

Chapter 7: Alcohol & Tobacco 80
Alcohol Facts 80

What is a “drink”? 80
What is excessive drinking? 80
Blood Alcohol Concentration (BAC) – Differences Between Women and Men 80
What is moderate drinking? 81
Short-Term Health Risks 81
Long-Term Health Risks 81

Health Effects of Alcohol Abuse 82
Rethinking Drinking 83

Why is being able to “hold your liquor” a concern? 83
Why are women’s low-risk limits different from men’s? 83
Isn’t drinking good for the heart? 83
Is “low-risk” drinking just another term for “moderate” drinking? 83
Can I do anything to protect my liver from the effects of too much alcohol? 84
I am considering cutting down or quitting drinking. How do I begin? 84
What treatments are available for someone with an alcohol problem? 84

Tobacco Use 85
How Does Tobacco Affect the Brain? 85
Electronic Cigarettes 86

What are they? 86
Are they safe? 86
Can they help people quit smoking traditional cigarettes? 86

4

What Other Adverse Effects Does Tobacco Have on Health? 86
Quitting Smoking 87

What are the immediate benefits of quitting smoking? 87
What are the long-term benefits of quitting smoking? 88
Does quitting smoking lower the risk of cancer? 88
Should someone already diagnosed with cancer bother to quit smoking? 88
Are There Effective Treatments for Tobacco Addiction? 88
Behavioral Treatments 89
Nicotine Replacement Treatments 89
Other Medications 89
Current Treatment Research 89

Chapter 8: Drugs and Addiction 90
Understanding Drug Use and Addiction 90

What Is drug addiction? 90
What happens to the brain when a person takes drugs? 90
Why do some people become addicted to drugs while others don’t? 91
Can drug addiction be cured or prevented? 92
Points to Remember 92

Health Effects of Drug Abuse 93
Marijuana 93
Cocaine 94
Methamphetamine 95
CNS Depressants 95
Prescription Opioids 95
Heroin 96

Consequences of Drug Abuse 97
How it affects the family 97

Treatment Approaches for Drug Addiction 98
Can drug addiction be treated? 98
Principles of Effective Treatment 98
How is drug addiction treated? 99
How are medications used in drug addiction treatment? 99
How are behavioral therapies used to treat drug addiction? 100
Points to Remember 101

Synthetic Drugs 102
Overview and History 102
A Rapidly Emerging Threat 102
Risk to the Public Health 102
Sources and Continuing Availability 103
Government Efforts to Ban Synthetic Drug Products 103

Chapter 9: Unintentional Injuries and Violence 104
Unintentional Injuries 104

Motor Vehicle Safety: Distracted Driving 104
What are the types of distraction? 104

5

Distracted driving activities 104
Young adult and teen drivers 105
What is being done? 105

Home and Recreational Safety 105
Falls 105
Water-Related Injuries 105
Poisoning 106
Fires 109

Intentional Injuries: Violence 110
The Social-Ecological Model: A Framework for Prevention 110

Individual 110
Relationship 110
Community 110
Societal 111

What are Social Norms? 111
Social Norms and Violence 111
Misperceptions 112

Intimate Partner Violence 112
The Four Main Types of Intimate Partner Violence 112
Risk Factors for Intimate Partner Violence 113

Individual Risk Factors 113
Relationship Factors 114
Community Factors 114
Societal Factors 114

Protecting Yourself from Relationship Violence 114
What is relationship violence? 115
How do I know if my relationship might become violent? 115
What if I’m not sure if my relationship is violent? 115
Take Action! 116

Chapter 10: Relationships, Sexuality, & Contraception 117
Healthy Relationships 117

Healthy vs. Unhealthy Relationships 117
Love and Attraction Theory 118

Sternberg’s Triangular Theory of Love 118
Effective Communication 119

Developing Effective Communication Skills 119
Three skills to Effective Communication 119

Assertiveness 119
Learning to Be More Assertive 119
Aggressive, Assertive, and Non-Assertive Behavior 120

“I” Statements vs. “You” Statements 120
Sex, Gender, and Sexuality 121

Sex 121
Male, female, and the spectrum of sex 122

6

Gender 122
The continuum of sex and gender 123
Cultural Variations of Gender 123

Sexuality 123
LGBT Health 123

Lesbian, Gay, Bisexual, and Transgender Health 124
The Effects of Negative Attitudes and Discrimination 124
Increasing Positive Perceptions and Acceptance 125

Contraception 125
Purpose and Effectiveness of Contraceptives 125

Reversible Methods for Birth Control 126
Hormonal Methods 126
Barrier Methods 126

Permanent Methods of Birth Control 126
Highly Effective Reversible Birth Control Methods 127

Abstinence 127
IntraUterine Device (IUD), Copper IUD (ParaGard), Levonorgestrel-Releasing IUD (Mirena) 127
The Implant, Implanon 128

Moderately Effective Reversible Birth Control Methods 128
The Pill, combination pill, mini-pill 128
The Shot, Injectable contraceptives, Depo-Provera 128
The Patch, dermal (placed on the skin for absorption), Ortho Evra 128
The Ring, Hormonal Vaginal Contraceptive Ring, NuvaRing 128
Diaphragm or cervical cap 129

Least Effective Reversible Birth Control Methods 129
Male Condom 129
Female Condom 129
Fertility Awareness Method (FAM) 131
Emergency Birth Control 132

Chapter 11: Immune System, Infectious Diseases, and STD’s/STI’s 134
The Immune System 134

Common Pathogen: Influenza 136
STD’s/STI’s 137

The Relationship of STD’s and HIV 138
STD Data 138
Types of STDs/STIs 139

Chlamydia 139
Chlamydia Treatment 139

Gonorrhea 139
Gonorrhea Treatment 140

Genital Herpes 140
Genital Herpes Treatment 140

HIV/AIDS 140
HIV/AIDS Treatment 141

7

Human Papillomavirus (HPV) 141
Human Papillomavirus Treatment 141

Syphilis 141
Syphilis Treatment 142

Bacterial Vaginosis 142
Bacterial vaginosis Treatment 142

Trichomoniasis 142
Trichomoniasis Treatment 143

Viral Hepatitis 143
Viral Hepatitis Treatment 143

STD/STI Prevention 143
Practice Abstinence 144
Use Condoms 144
Have Fewer Partners 144
Talk With Your Partner 144
Get Tested 144
Get Vaccinated 145

Chapter 12: Cardiovascular Disease 146
The Cardiovascular System 146

Heart Disease and Stroke Facts 147
Heart Disease Facts 147

Risk Factors 147
Stroke Facts 148

Common Stroke Warning Signs and Symptoms 149
Cardiovascular Diseases 150

Coronary artery disease (CAD) 150
Causes of CAD 150

Other Conditions Related to Heart Disease 151
Types of Strokes 152

Ischemic Stroke 153
Hemorrhagic Stroke 153
Transient Ischemic Attack (TIA) 153

Risk Factors for Cardiovascular Disease 154
Metabolic Risk Factors 154

#1 A Large Waistline 154
#2 A High Triglyceride Level 154
#3 High Blood Pressure 155
#4 High Fasting Blood Sugar 155
#5 A Low HDL Cholesterol Level 155

Cholesterol Management 155
What Is Cholesterol? 155
What Is High Blood Cholesterol? 156
What Causes High Blood Cholesterol? 156
Factors You Can Control 156

8

Diet 156
Physical Activity and Weight 156

Factors You Can’t Control 156
Heredity 156
Age and Sex 156

How Is High Blood Cholesterol Diagnosed? 157
How Is High Blood Cholesterol Treated? 158
Lowering Cholesterol Using Therapeutic Lifestyle Changes 158

The TLC Diet 158
Weight Management 159
Physical Activity 159

Cholesterol-Lowering Medicines 159

Chapter 13: Cancer 160
Cancer Overview 161

What Is Cancer? 161
How Cancer Arises 161
When Cancer Spreads 162
Tissue Changes That Are Not Cancer 162

Types of Cancer 163
Common Cancer Types 163

Risk Factors for Cancer 164
Alcohol 165
Tobacco 166

Cancer Prevention 166
How Can Cancer Be Prevented? 166

Avoiding Tobacco 166
Protecting Your Skin 167
Limiting Alcohol Intake 167
Keeping a Healthy Weight 168

Chapter 14: Environmental Wellness- A Healthy Planet 169
The Importance of a Healthy Planet 169

What is Climate Change? 169
Global Warming 170
Evidence of Rapid Climate Change: 171

The Impact of the Environment on Public Health 171
Climate Change and Health 172

Creating a Healthier Planet 173
CDC’s Building Resilience Against Climate Effects (BRACE) Framework 173
Living a Sustainable Lifestyle 174

Reduce, Reuse, Recycle 174
Reduce Water 174
Reduce Energy 175
Reduce Waste: Reuse and Recycle 175

Chapter 15: Consumer Health & Aging 178

9

Finding Reliable Health Information 178
Consider the source–Use recognized authorities 178
Focus on quality–All Web sites are not created equal 178
Be a cyberskeptic–Quackery abounds on the Web 179
Look for the evidence–Rely on medical research, not opinion 179
Check for currency–Look for the latest information 179
Beware of bias–What is the purpose? Who is providing the funding? 180
Protect your privacy–Health information should be confidential 180

Health Fraud 180
6 Tip-offs to Rip-offs: Don’t Fall for Health Fraud Scams 180

Not Worth the Risk 181
A Pervasive Problem 181
Health Fraud Tip-Offs 182

Quick Tips for Evaluating Health Websites 183
Criteria for evaluating information from the web: 183

Accuracy 183
Authority 183
Bias/Objectivity 183
Currency/Timeliness 183
Coverage 184

Complementary and Integrative Health 184
Complementary, Alternative, or Integrative Health: What’s In a Name? 184
Complementary Versus Alternative 184
Integrative Medicine 185

Types of Complementary Health Approaches 185
Natural Products 185
Mind and Body Practices 185
Other Complementary Health Approaches 186

Dietary Supplements 187
Federal Regulation of Dietary Supplements 187
Sources of Science-Based Information 188
Safety Considerations 188
Key Points about Supplements 189

Aging 189
Aging Data 190
Guiding Model for Healthy Aging 190
Challenges of Aging 190

10

11

Chapter 1: Introduction
to Health and Wellness

Dimensions of Wellness
What is Wellness?

Wellness is being in good physical and mental health. Because mental health and physical health are linked,
problems in one area can impact the other. At the same time, improving your physical health can also benefit
your mental health, and vice versa. It is important to make healthy choices for both your physical and mental
well-being.

Remember that wellness is not just the absence of illness or stress. You can still strive for wellness even if you
are experiencing these challenges in your life.

What are the Nine Dimensions of Wellness?

12

Learning about the Nine Dimensions of Wellness can help you choose how to make wellness a part of your
everyday life. Wellness strategies are practical ways to start developing healthy habits that can have a positive
impact on your physical and mental health.

The Nine Dimensions of Wellness are:

1. Emotional: Coping effectively with life and expressing emotions in an appropriate manner.
2. Environmental: Occupying pleasant, healthy, and safe environments that support well-being; positively

impacting the quality of our surroundings (including protecting and preserving nature).
3. Financial: Achieving satisfaction with current and future financial situations; handling finances wisely.
4. Intellectual: Recognizing creative abilities and finding ways to expand knowledge and skills; being

open-minded.
5. Occupational: Personal fulfillment and enrichment from one’s work and/or responsibilities.
6. Physical: Recognizing the need for physical activity, healthy foods, and adequate sleep; avoiding

unhealthy habits.
7. Social: Developing a sense of connection, belonging, and sustained support system; having positive

relationships.
8. Spiritual: Having a sense of purpose and meaning in life; establishing peace, harmony, and balance in

our lives.
9. *Cultural: The way you interact with others who are different than you; understanding and celebrating

our differences. (*recently added).

Learn more about the Eight Dimensions of Wellness (does not include Cultural wellness) by watching the video
below:

13

Your Own Views on Health and Wellness

Reflect on the following questions:

● What does health mean to you?
● How important is health to you?
● What are some of your healthy habits?
● Which dimensions of wellness do you need to work on the most?

Licenses and Attributions

Public domain content
● Eight Dimensions of Wellness. Authored by: Substance Abuse and Mental Health Services Administration . Provided by: U.S. Department

of Health and Human Services. Located at: http://www.samhsa.gov/wellness-initiative/eight-dimensions-wellness. License: Public Domain:
No Known Copyright

● Video – The Eight Dimensions of Wellness. Authored by: SAMHSA. Provided by: U.S. Department of Health and Human Services.
Located at: https://www.youtube.com/watch?v=tDzQdRvLAfM&feature=youtu.be. License: Public Domain: No Known Copyright

Healthy People 2020
In December 2010, the Department of Health and Human Services launched Healthy People 2020, which has
four overarching goals:

● Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death;
● Achieve health equity, eliminate disparities, and improve the health of all groups;
● Create social and physical environments that promote good health for all; and
● Promote quality of life, healthy development, and healthy behaviors across all life stages.

Healthy People 2020 tracks approximately 1,200 objectives organized into 42 topic areas, each of which
represents an important public health area. At the time of the December 2010 launch 911 objectives were
measurable with baseline data and established targets. A few objectives that have achieved high levels of
success are being tracked without a target for informational purposes. Targets will be set during the decade for
these objectives if warranted. The rest of the objectives did not have baseline data and were considered
developmental. Targets for the developmental objectives will be set when baseline data become available.
Healthy People 2020 also includes a new Foundation section which addresses several important health topics:
General Health Status, Health-Related Quality of Life and Well-Being, Determinants of Health, and Disparities.

Licenses and Attributions

Public domain content
● Healthy People 2020. Authored by: CDC/National Center for Health Statistics. Provided by: U.S. Department of Health and Human

Services. Located at: http://www.cdc.gov/nchs/healthy_people/hp2020.htm. License: Public Domain: No Known Copyright

14

Major Health Concerns
Leading Causes of Death in the United States
Do you know what the top two leading causes of death are for Americans? Heart disease takes the number
one spot, followed by cancer. As you can see by the graph below, cancer death rates have been steadily
increasing throughout the years. What does this potentially mean for the future? Is cancer going to take over
as the number one leading cause of death? It certainly appears to be headed in that direction.

The 10 Leading Causes of Death in the United States:
1. Heart disease: 614,348
2. Cancer: 591,699
3. Chronic lower respiratory diseases: 147,101
4. Accidents (unintentional injuries): 136,053
5. Stroke (cerebrovascular diseases): 133,103
6. Alzheimer’s disease: 93,541
7. Diabetes: 76,488
8. Influenza and Pneumonia: 55,227
9. Nephritis, nephrotic syndrome and nephrosis: 48,146

15

10. Intentional self-harm (suicide): 42,773

CDC Winnable Battles

To keep pace with emerging public health challenges and to address the leading causes of death and disability,
CDC initiated an effort called Winnable Battles to achieve measurable impact quickly. Winnable Battles are
public health priorities with large-scale impact on health and known effective strategies to address them. By
identifying priority strategies, defining clear targets and working closely with our public health partners, we are
making significant progress in reducing health disparities and the overall health burden from these diseases
and conditions.

Licenses and Attributions

Public domain content
● Leading Causes of Death. Authored by: Centers for Disease Control and Prevention. Located at:

http://www.cdc.gov/nchs/fastats/deaths.htm. License: Public Domain: No Known Copyright
● Winnable Battles. Authored by: Centers for Disease Control and Prevention. Located at: http://www.cdc.gov/winnablebattles/. License:

Public Domain: No Known Copyright

Risk Factors and Levels of Disease
Prevention

What is a Risk Factor?
Part of learning how to take charge of your health requires understanding your risk factors for different
diseases. Risk fac tors are things in your life that increase your chances of getting a certain disease. Some risk
factors are beyond your control. You may be born with them or exposed to them through no fault of your own.

Some risk factors that you have little or no control over include your:
● Family history of a disease
● Sex/gender — male or female
● Ancestry

Some risk factors you can control include:
● What you eat
● How much physical activity you get
● Whether you use tobacco
● How much alcohol you drink
● Whether you misuse drugs

In fact, it has been estimated that almost 35 percent of all U.S. early deaths in 2000 could have been avoided
by changing just three behaviors:

● Stopping smoking
● Eating a healthy diet (for example, eating more fruits and vegetables and less red meat)
● Getting more physical activity

16

You can have one risk factor for a disease or you can have many. The more risk factors you have, the more
likely you are to get the disease. For example, if you eat healthy, exercise on a regular basis, and control your
blood pressure, your chances of getting heart disease are less than if you are diabetic, a smoker, and inactive.
To lower your risks, take small steps toward engaging in a healthy lifestyle, and you’ll see big rewards.

People with a family health history of chronic disease may have the most to gain from making lifestyle
changes. You can’t change your genes, but you can change behaviors that affect your health, such as
smoking, inactivity, and poor eating habits. In many cases, making these changes can reduce your risk of
disease even if the disease runs in your family. Another change you can make is to have screening tests, such
as mammograms and colorectal cancer screening. These screening tests help detect disease early. People
who have a family health history of a chronic disease may benefit the most from screening tests that look for
risk factors or early signs of disease. Finding disease early, before symptoms appear, can mean better health
in the long run.

Levels of Disease Prevention

Prevention includes a wide range of activities — known as “interventions” — aimed at reducing risks or threats
to health. You may have heard researchers and health experts talk about three categories of prevention:
primary, secondary and tertiary. What do they mean by these terms?

Primary prevention aims to prevent disease or injury before it ever occurs. This is done by preventing
exposures to hazards that cause disease or injury, altering unhealthy or unsafe behaviours that can lead to
disease or injury, and increasing resistance to disease or injury should exposure occur. Examples include:

● legislation and enforcement to ban or control the use of hazardous products (e.g. asbestos) or to
mandate safe and healthy practices (e.g. use of seatbelts and bike helmets)

● education about healthy and safe habits (e.g. eating well, exercising regularly, not smoking)
● immunization against infectious diseases.

Secondary prevention aims to reduce the impact of a disease or injury that has already occurred. This is
done by detecting and treating disease or injury as soon as possible to halt or slow its progress, encouraging
personal strategies to prevent reinjury or recurrence, and implementing programs to return people to their
original health and function to prevent long-term problems. Examples include:

● regular exams and screening tests to detect disease in its earliest stages (e.g. mammograms to detect
breast cancer)

● daily, low-dose aspirins and/or diet and exercise programs to prevent further heart attacks or strokes
● suitably modified work so injured or ill workers can return safely to their jobs.

Tertiary prevention aims to soften the impact of an ongoing illness or injury that has lasting effects. This is
done by helping people manage long-term, often-complex health problems and injuries (e.g. chronic diseases,
permanent impairments) in to improve as much as possible their ability to function, their quality of life and
their life expectancy. Examples include:

● cardiac or stroke rehabilitation programs, chronic disease management programs (e.g. for diabetes,
arthritis, depression, etc.)

● support groups that allow members to share strategies for living well
● vocational rehabilitation programs to retrain workers for new jobs when they have recovered as much

as possible.

17

Licenses and Attributions

CC licensed content, Shared previously
● Disease Prevention. Authored by: Institute for Work & Health. Located at:

https://www.iwh.on.ca/wrmb/primary-secondary-and-tertiary-prevention. License: CC BY-NC-ND:
Attribution-NonCommercial-NoDerivatives

Public domain content
● Risk Factors. Authored by: womenshealth.gov. Provided by: U.S. Department of Health and Human Services, Office on Women’s Health.

Located at: https://www.womenshealth.gov/files/assets/docs/lifetime-good-health/lifetimegoodhealth-english.pdf. License: Public Domain:
No Known Copyright

Behavior Change and Goal Setting
Transtheoretical Model (Stages of Change)
The transtheoretical model of behavior change, developed by Prochaska and DiClemente, assesses an
individual’s readiness to implement a healthier behavior, and provides insight into the decision making process
that leads to action. For many people, changing or modifying a behavior that is unhealthy or potentially
harmful can be quite challenging. Here are the stages that lead to behavior change:

● Precontemplation (Not Ready) – You are not intending to take action in the foreseeable future, and
can be unaware that your behavior is problematic

● Contemplation (Getting Ready) – You are beginning to recognize that your behavior is problematic,
and start to look at the pros and cons of your continued actions

● Preparation (Ready) – You are intending to take action in the immediate future, and may begin taking
small steps toward behavior change

● Action – You are making actual changes to your problem behavior by incorporating healthy
choices/behaviors into your life

● Maintenance – You have been able to sustain action for at least six months and are working to prevent
relapse into previous unhealthy behaviors

Check out this supplemental video to review the main concepts of …