Table 1: Defining psychosocial health, health promotion and prevention for health professions (including the relationship between them).

Definition of Psychosocial Health for Health Professions (Condensed Version)
The psychosocial health of an individual varies over time. It can be thought of as being on a continuum between psychosocially healthy and ill. It encompasses an individual’s experience, perception, psychological/mental processes, behaviour, as well as lifestyle.

It has a reciprocally associated relationship to one’s social context and relationships (family, friends, co-workers, etc). Additionally, it is influenced by social structures (society, etc.). The body along with consciousness, are regarded as prerequisites for being able to interact with the social environment. They are necessary to exist in a social context and to express oneself through behaviour.

Psychosocial health varies over time (e.g. different phases of life / life events) and can be strengthened through resources and support (emotional support, own relational abilities). It can also be weakened by risks and stressors (e.g. work-related stress). The locus of psychosocial health is clearly placed upon the individual.
*This definition of psychosocial health is based upon a concept analysis, which is being submitted to a scientific, peer-reviewed journal in 2021. Also, see video based upon this concept analysis: Definition of psychosocial health (in the Supportive/Supplementary Material section of this article).
Definition of Health Promotion for Health Professions
Health promotion supports the process that enables and increases peoples’ self-determination and control over their health. Health promotion improves the personal and social conditions necessary for health.

Based upon the Salutogenic Model from Antonovsky (1979), health and illness move along a continuum. They are also influenced by one’s social, personal and physical resources. This is a paradigm shift in contrast to the biomedical model (pathogenesis), which instead focuses on disease. Salutogenesis thus investigates what keeps people healthy, rather than what makes them ill.

Cooperation between various political policies and healthcare sectors is a prerequisite for the promotion of the health throughout society (WHO, 1998). These sectors are required to advocate for health and equal opportunities, and to enable and support the various health interests of society through mediation and advocacy (WHO, 1986).
Definition of Prevention for Health Professions
The goals of disease prevention are to avoid of the development of risk factors, which have not yet occurred (primordial prevention), and to reduce the risk factors, occurrence and spread of disease (primary prevention). Additionally, early detection is intended to reduce the incidence of diseases (secondary prevention). Chronic diseases should be targeted as early as possible, to prevent subsequent damage or relapses (tertiary prevention).

Identification of patients’ risk for over-medicalization (quaternary prevention) is important for both the patient and the healthcare system.

Preventive interventions can focus on individuals, groups, as well as the societal level (Green & Tones, 2010). Along with the focus of prevention at the societal level, a person-centered approach is also of importance. An essential component is this approach is patient education. It is vital that preventive interventions be planned and implemented with patients, along with their families.
The relationship between Health Promotion and Prevention
Health promotion and prevention can be distinguished conceptually, as their approaches to health and illness differ from one another.

Health promotion emphasizes a positive and holistic view of health (Tengland, 2009). In addition to focusing on a generally healthy population, its strategies also target vulnerable or at-risk groups. This denotes planning and implementing interventions that focus on the social and economic determinants of health (Tengland, 2009). In contrast, preventative measures focus mainly on specific diseases. They aim to either prevent them from occurring, to reduce their risk, to detect them at an early stage, or to reduce their consequences (Tengland, 2009).

Health promotion strategies generally have a broader scope and target group. They tend to have a bottom-up or participatory approach, while prevention strategies often have a top-down approach (Tengland, 2009). In practice, however, Health promotion and prevention often have the same goal, which is to improve or maintain the health and health competencies of the population. Therefore, both measures are necessary to achieve this goal.
The relationship between Psychosocial Health, Health Promotion and Prevention
Health promotion aims to strengthen the personal resources of individuals and to support them. It also aims to reinforce the resources and opportunities present in the social environment. Health promotion can reinforce the relationship between individuals and their social environment (social formations and structures). This is crucial for psychosocial health.

Health promotion focuses its interventions at the group, organizational, community and societal levels. It mainly aims to improve the social determinants of health. This indirectly positively impacts the psychosocial health of individuals. The social environment (work environment) can also be targeted, thus supporting psychosocial health.

Primary prevention activities support the psychosocial health of individuals, by focusing on reducing the risk of illness associated with unhealthy behavior/lifestyles and health hazards. Secondary and tertiary prevention measures support the psychosocial health of individuals via treating/improving the disease/symptoms, or through supporting individuals with chronic diseases. Quaternary prevention supports the psychosocial health of individuals by identifying their risk for over-medicalization.
© Bern University of Applied Sciences, Switzerland, 2020