Rationale

Many interventions at the individual level must be supported by actions at the community level. Physicians will be expected to advocate for community-wide interventions and address issues that occur to many patients across their practice.

Key Objectives

1. Understand the three levels of prevention: primary, secondary, and tertiary

2. Describe strategies for community needs assessments, health education, community engagement, and health promotion

3. Appreciate the role that physicians can play in promoting health, managing risk factors, and preventing diseases at the individual and community level (e.g., reducing injury, immunization, obesity prevention, smoking cessation, cancer prevention)

4. Understand how public policy can influence population-wide patterns of behaviour and affect the health of a population

Enabling Objectives

1. Define the levels of prevention in an individual (clinical) and in a population as well as formulate preventive measures to include in clinical management strategies

2. Name and describe the common methods of health protection (e.g., agent–host–environment approach for communicable diseases, source–path–receiver approach for occupational and environmental health)

3. Describe the importance and impact of effective, culturally appropriate communication with the patient, the patient’s family and, if necessary, the community as a whole regarding risk factors and their modification

4. Apply the principles of screening, evaluate the utility of a proposed screening intervention, and be able to discuss the potential for lead-time bias and length-prevalence bias

5. Understand the importance of disease surveillance in maintaining population health and be aware of approaches to surveillance

6. Identify ethical issues in restricting individual freedoms and rights for the benefit of the population (e.g., restricting movements of a person with active tuberculosis)

7. Describe the advantages and disadvantages of identifying and treating individuals versus implementing population-level approaches to prevention

8. Describe the application of health promotion in a particular situation to help people increase control of their health and improve it

9. Describe one or more models of behaviour change, including predisposing, enabling, and reinforcing factors

10. Identify the potential community, social, physical, and environmental factors and work practices that might promote healthy behaviours, as well as identify ways to assist communities and others to support these factors and practices

11. Be aware of the role of community and social service agencies (e.g., schools, governments, municipalities, nongovernmental organizations) and work collaboratively with them

12. Demonstrate awareness of the importance and contribution of other allied health professionals (both regulated and unregulated) in addressing population health issues

13. Be able to describe the health impact of community-level interventions to promote health and prevent disease

14. Describe examples of public policies that have had a positive effect on population health