To be successful in achieving an impact in public health you need to start with a basic understanding of what it is. The Faculty of Public Health defines public health as: 

“…promoting and protecting health and wellbeing, preventing ill-health and prolonging life through the organised efforts of society”. 

Health promotion and health education form part of this, but there are a range of other interventions which community pharmacies may be involved with which count too. A number of approaches can be adopted when helping your customers to make changes.

• The medical approach involves medical interventions to prevent or ameliorate ill health. These include immunisation or screening
• The behavioural approach involves encouraging individuals to adopt healthier behaviours, such as giving up smoking
• The educational approach involves developing knowledge and skills to help people make an informed, and hopefully healthy, choice
• The empowerment approach involves helping people gain the skills and confidence to identify their own concerns and act upon them
• The social change approach involves influencing policy or the environment to make the healthy choice the easy choice.

Not everyone will respond to the same approach, and a successful public health campaign will use a range of approaches. For example, a heart health campaign run in a pharmacy could include blood pressure and atrial fibrillation screening (medical), smoking cessation posters and leaflets (behavioural change), leaflets and a video explaining the salt content of foods and the impact of salt on cardiovascular health (education), action planning for lifestyle change included in MUR interventions (empowerment), and organising a weekly local community walk at lunchtime (social change).

We can also think of interventions in terms of the target of the prevention activity.

• Primary prevention focuses on the avoidance of ill health, helping your customers reduce their risk by choosing healthier behaviours
• Secondary prevention focuses on early identification of health issues to allow early treatment, and includes screening as well as education to help people recognise early symptoms or introduce regular self-checking behaviours
• Tertiary prevention focuses on avoiding deterioration in patients with diagnosed disease, and might include lifestyle change regimes, support for carers and taking measures to avoid relapse by means of providing anticipatory guidance.

Pharmacies already provide interventions based on these three types of prevention activity. Recognising these approaches will help to deliver impact through a coordinated plan.