Ozren Polašek

Interventions in social medicine

Biologic – vaccines Behavioral – individual, community Political – lobbying and advocating Structural – laws and regulations, norms

Biological strategies Immunizations Prophylaxis Improved nutrition Mother and child health programs Microbicides Improved sanitation Improved water quality

Behavioural strategies Promote lifestyle change Focus people where they are available –

schools and workplaces Promote immunization programs and other

interventions TV, radio and media public health messages Promote safe sexual behavior

Political strategies Promote healthy, safe communities Promote and enforce appropriate health

laws and regulations Promote universal access to health care,

especially preventive care Improve standard of living (e.g., housing)

and reduce poverty

Basic intervention tools - Glossary

Needs assessment Prevention Harm reduction Immunization and vaccination Social anxiety

Needs assessment

Where we are and where do we want to be

Prevention

What if you hated the rain?

Needle exchange

Immunization. Vaccination Immunization – a process of improving an

individual’s immune system Can be passive or active (vaccination) Passive immunization – introduction of

ready antibodies Vaccination - admistration of antigenic

material to stimulate an individual's immune system to develop adaptive immunity to a pathogen

Vaccination Prevent infection (HPV) Prevent disease (Influenza) Prevent transmission and protect

community

Technical requirements Must be safe* Should be easy to administer (e.g., nasal

spray, oral) Must elicit a protective immune response Must stimulate both humoral and cellular

immunity Must protect against all variants of the agent Must provide long-lasting immunity Must be practical to produce, transport and

administer

Social anxiety as a tool Useful, but…

Too little No actionJust as much ActionToo many Panic and no action

Community intervention Getting the community to recognize the

problem Getting the community to accept

responsibility and implement change Changing community norms (e.g., smoking,

condoms)

10,001 Dalmatians The Croatian Biobank Research resource, but also a health

intervention People are invited and are free to accept

the invite or reject it Those who approach the site are offered a

number of examinations (blood, urine, ECG, DEXA, spirometry, …)

Increasing participation Postal invites Radio appearance Phone calls Local newspapers Direct contact - it’s free, oh great :-/ Offered additional specialist exams

(surgeon, ophtalmologist)

First fiasco

Sending out the laboratory results

… more ideas … Retired people home Invited NGOs Approached informal groups Leaflets, flyers Asked friends and relatives for support

Response

Go out there and intervene…