Coming into MHST 631, I had no idea what to expect as I have never worked in health promotion, nor is it a topic that was given much focus during my Physiotherapy Masters degree. Now approaching the course’s completion, I am evaluating my previous teachings and understandings of public health and health promotion through a different lens. Prior to this course, the majority of what I was familiar with related to this is topic focused on the issue of health promotion through a very individual or intrapersonal perspective. For instance, during physiotherapy school I learned about the transtheoretical model of change and the health belief models and how to use such models to coach patients to adopt more healthy behaviours. In fact, we spent a great deal of time learning about how to use techniques such as motivational interviewing to empower patients to consider their capacity to change—a technique that is used frequently by many of my co-workers at my current workplace.
Reflecting on this now, I think that a lot of what I learned previously failed to take into account the larger forces at play (such as inter-personal factors, societal factors, public policy factors, etc.) that influence individual health behaviour and subsequent health outcomes. Even more importantly, an individual-behaviour-focused approach often fails to consider the perspectives, values and lived experiences of those whom public health initiatives are attempting to be helping. I think that that was the biggest “aha moment” for me this semester: my realization of the tendency for well-meaning health policy and health promotion programs to be born of the paternalistic instincts of those with privilege to try and “help” those lacking these same privileges. What I have learned this semester is the importance of tempering our impulses as healthcare workers to be “experts” in a particular area that we are trying to impact, and to instead seek out those with lived experiences to be experts and partners in health promotion endeavors.
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