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PubMed1996

The integrated model: implications for worksite health promotion and occupational health and safety practice.

Within a single firm it is common to find both occupational safety and health and worksite health promotion interventions operating in isolation from one another, with different intervention targets, methods, and personnel. Overcoming the segmentation of the two fields will require, among other things, the promulgation of an overarching model of work and health. The purpose of this article is to describe an integrated model and to show how it can be applied to improve worksite health interventions for both occupational safety and health and worksite health promotion. Practice examples from both fields are used to illustrate interventions that focus on different areas of the model (individual behavior, psychosocial, organization, and contextual factors). It is argued that occupational safety and health and worksite health promotion practitioners need to develop more comprehensive interventions and rigorously evaluate these programs to determine if they are more effective than programs with a more narrow focus.

Accidents, Occupational↗
PubMed2006

Public health, health promotion and the health of people in prison.

Recent policy changes in England and Wales have transferred commissioning and funding of prison healthcare from the prison service to the National Health Service for the first time in its history. Most health services in prisons are now provided by primary care trusts (PCTs), with the consequence that PCTs have a new highly vulnerable population for whom health needs must be assessed and services provided. This article describes what is currently known about the health needs of prisoners and the subsequent implications for public health and health promotion. Following a brief discussion of national and international policy on health promotion in prisons, an overview is given of recent national and local initiatives on public health issues.

England↗
PubMed2004

[The International Union for Health Promotion and Education's Global Programme on Health Promotion Effectiveness].

The Global Programme on Health Promotion Effectiveness (GPHPE) is a multi-partner initiative, coordinated by the International Union for Health Promotion and Education (IUHPE) in collaboration with the World Health Organization, and supported by a number of partners from across the world. The GPHPE aims to raise standards of health promoting policy-making and practice worldwide by: reviewing evidence of effectiveness in terms of health, social, economic and political impact; translating evidence to policy makers, teachers, practitioners, researchers; stimulating debate on the nature of evidence of effectiveness. The principal challenge for the GPHPE is to develop a sustainable approach with adaptations suitable to different regional needs, whilst maintaining the high quality for which the European work that triggered the programme is recognised. Although varied, the regional activities are all clearly designed to contribute to the global body of knowledge that the GPHPE aims to build. The article presents the origins of the GPHPE, its operational structure and zooms in on some of the specific activities of the European Region.

Europe↗
PubMedDate not supplied

Ecological influences on health-promoting and health-compromising behaviors: a socially embedded approach to urban African American girls' health.

An ecological framework provides the underpinnings for the examination of factors associated with the health-promoting and health-compromising behaviors of African American adolescent females (N=137). Findings indicate that more positive family, peer, and neighborhood factors were associated with less engagement in health-compromising behaviors and increased engagement in health-promoting behaviors. Also, more positive family interactions buffered the relationship between neighborhood characteristics and adolescents' engagement in health-compromising behaviors. Overall, the findings suggest that the health-related behaviors of African American adolescent females are best understood in the context of their social relationships and environmental contexts.

Adolescent↗
PubMed1996

Obstacles to community health promotion.

The health transition ushered into the world in this century calls for a reorientation of traditional health services to manage the new causes of morbidity and mortality, renewing interest in disease prevention and health promotion. Community-based health promotion emphasizes prevention and community participation with people's empowerment to overturn current inequities and increase control over their health. Encouraged worldwide by the World Health Organization for the last two decades, some community health promotion programs have been implemented and lessons learned. However, the shift in focus required means nothing less than a paradigm change demanding not only a reorientation of professional training, but also a reorganization of social structures in communities. This article discusses nine of the interrelated obstacles that must be overcome to further develop community health promotion.

Community Health Services↗
PubMed1989

Do general practitioners promote health? A needs assessment.

A random sample of 5% of NSW general practitioners was surveyed in December 1986 regarding their attitudes to health promotion in clinical practice. The results were compared with those of simultaneous surveys of trainee general practitioners and fourth-year medical students. Smoking, alcohol and weight reduction were the health behaviours that were considered by general practitioners to be the most difficult to change. More general practitioners than did students or general-practitioner trainees reported finding less difficulty in changing health behaviours. More than three-quarters of the general practitioners were in favour of promoting health in their practices. A commonly reported barrier was the current Medicare financing arrangements for preventive practice. Other barriers included a lack of time for preventive practice. The complaint of a lack of training was expressed commonly; half the sample was willing to participate in advanced training in health promotion that would be organized by The Royal Australian College of General Practitioners.

Adult↗
PubMed2005

Global priority setting for Cochrane systematic reviews of health promotion and public health research.

BACKGROUND: Systematic reviews of health promotion and public health interventions are increasingly being conducted to assist public policy decision making. Many intra-country initiatives have been established to conduct systematic reviews in their relevant public health areas. The Cochrane Collaboration, an international organisation established to conduct and publish systematic reviews of healthcare interventions, is committed to high quality reviews that are regularly updated, published electronically, and meeting the needs of the consumers. AIMS: To identify global priorities for Cochrane systematic reviews of public health topics. METHODS: Systematic reviews of public health interventions were identified and mapped against global health risks. Global health organisations were engaged and nominated policy-urgent titles, evidence based selection criteria were applied to set priorities. RESULTS: 26 priority systematic review titles were identified, addressing interventions such as community building activities, pre-natal and early infancy psychosocial outcomes, and improving the nutrition status of refugee and displaced populations. DISCUSSION: The 26 priority titles provide an opportunity for potential reviewers and indeed, the Cochrane Collaboration as a whole, to address the previously unmet needs of global health policy and research agencies.

Evidence-Based Medicine↗
PubMed2001

Health promoting hospitals: a typology of different organizational approaches to health promotion.

This paper draws on a review of the literature about the types of health promotion activities conducted by health promoting hospitals and an observation of how some Australian hospitals have structured the organizational arrangements to be more health promoting. This paper also draws on the experiences of one of the authors (A.J.) in managing and evaluating an organizational change process at a major specialist hospital in Adelaide, South Australia, that sought to re-orientate the hospital towards placing more emphasis on health promotion. From these three sources, a typology of four approaches of organizational arrangement to health promotion is presented. These approaches are: 'doing a health promotion project'; 'delegating it to the role of a specific division, department or staff'; 'being a health promotion setting'; and 'being a health promotion setting and improving the health of the community'. For the re-orientation of the specialist hospital to occur and be sustainable, the research indicated that over the case study period of 1994-1998 there had to be strong organizational commitment to change, supported at multiple levels of the organization, and reflected in policy and practice change. The paper concludes that more evaluative research of this type will be important if the rhetoric of healthy settings is to become a reality.

Attitude of Health Personnel↗
PubMed2001

Health promotion programs, modifiable health risks, and employee absenteeism.

This literature review demonstrates that the health risks and failure of employees to participate in fitness and health promotion programs are associated with higher rates of employee absenteeism. When determining how to manage absenteeism, employers should carefully consider the impact that health promotion programs can have on rates of absenteeism and other employee-related expenses.

Absenteeism↗
PubMed2004

How can critical incidents be used to describe health promotion in the Finnish European Network of Health Promoting Schools?

The purpose of this study was to elicit critical incidents that illustrate the reality in which health promotion processes take place in the Finnish European Network of Health Promoting Schools (ENHPS). In this study, critical incidents were used as a data collection method. The data were collected by asking representatives (n = 30) of the schools to describe in writing both positive and negative critical incidents related to health promotion in their school community. Altogether 48 critical incidents were analysed using qualitative content analysis. The results show that collaboration in a network of participants from inside and outside the school community to plan and implement a special school health day was the most commonly described positive critical incident. In addition, the organizational culture of the schools seemed to improve in a positive way. The reorganization of resources for health promotion resulted in positive progress, whereas a lack of resources had a frustrating and negative effect. The most commonly described negative critical incident was a failure to discourage smoking by pupils.

Adolescent↗
PubMed1999

A health promotion programme for oil refinery employees: changes of health promotion needs observed at three years.

The main aim of this three-year follow-up study was to evaluate the long-term effects of a workplace health promotion intervention programme offered by the Neste Oyj corporation's occupational health service. Another aim was to study factors associated with changes in health promotion needs. These were assessed using information obtained by means of questionnaires and laboratory measurements. The target areas assessed were physical activity, musculoskeletal problems, dietary habits, obesity, blood pressure, serum lipids, smoking, quality of sleep and mental well-being. Participants from one oil refinery were offered special health promotion counselling, while those from the other oil refinery studied received only their personal results, written information and instructions. Evaluation of the changes in needs was mainly based on comparison of the results of two examinations performed with an interval of three years. Effects of special health promotion counselling were observed in the target area of physical activity. Elimination of certain health promotion needs was seen in both groups in all of the target areas. The most extensive changes were seen in the target areas of musculoskeletal symptoms, dietary habits, blood pressure and mental well-being. Basic education, occupational status and age-group, as well as the value of tending health were frequent variables explaining the reduction in the need for health promotion activities. Worker participation in health promotion counselling activities provided by occupational health services can be high, as in this study in which the participation rate was 90% and the drop-out rate during the three years only 10%.

Adult↗
PubMed2004

Stage of change for general health promotion action and health-related lifestyle practices in Chinese adults.

BACKGROUND: We propose general health promotion action (GHPA) to represent the general intention and actual practices aimed to promote health. The transtheoretical model (TTM) has not been applied to GHPA. The objectives of this study were to determine whether TTM can be applied to Chinese adults by measuring the subjects' stage of change for GHPA, and to study whether stage for GHPA is associated with health-related lifestyle practices. METHODS: Randomly selected Hong Kong Chinese subjects (3233) aged 18-64 were interviewed in telephone survey. RESULTS: Thirty-nine percent had not taken any health promotion actions and had no intention to do so (precontemplation). Twelve percent had taken action but had no intention to continue (at-risk for relapse). Three percent had not taken any actions and intended to do so in the next 6 months, but not in the next 1 month (contemplation). Eleven percent had not taken any actions but intended to do so in the next 1 month (preparation). Fifteen percent had been taking action for less than 6 months and intended to continue (action). Twenty-one percent had been taking action for at least 6 months and intended to continue (maintenance). Precontemplators were less likely than maintainers to be never smokers (OR = 0.62; 95% CI = 0.49-0.80), exercisers (0.097; 0.077-0.12), to eat fruit twice a day (0.53; 0.41-0.69) and remove fat when eating (0.72; 0.54-0.95), with increasing trends in the odds of reporting these practices from precontemplation to maintenance. CONCLUSIONS: Our findings have provided preliminary findings on the applicability of TTM on GHPA in Chinese adults with evidences of concurrent criterion validity.

Adult↗
PubMed2006

Health promotion in adolescents: a review of Pender's health promotion model.

Adolescents have unique health considerations as they transition from parent-managed healthcare to personal responsibility for health behavior. One question to consider is the goodness-of-fit of available theoretical models for explaining and predicting adolescent health-promoting behavior. This integrative review explored Pender's health promotion model in relation to adolescent health. Specifically, this review summarizes the components of Pender's model and the supporting theoretical underpinnings based in the social cognitive theory. Research literature related to the health promotion model and various aspects of teen health is explored. Recommendations for further research and theory development are discussed.

Adolescent↗
PubMed2004

Health promotion and cardiovascular health in adult monozygotic twins.

PURPOSE: To describe relationships among cardiovascular health indicators and health-promoting behaviors in adult monozygotic (MZ) twins. DESIGN: The descriptive, correlational design with a convenience sample of adult twins (77 twin pairs, or N = 154) obtained during a public conference held in the Midwestern United States. METHODS: Bivariate correlational analyses with twins as their own controls and with each twin pair. This double-entry approach allowed for the creation of a symmetrical scatterplot of twin characteristics and accounted for the genuine effects of outliers. Relationships were examined among cardiovascular health indicators (systolic and diastolic blood pressures, body mass indices, serum lipids) and health-promoting behaviors. FINDINGS: Thirteen intermeasure correlations for cardiovascular indicators were significant, and 74% of the variance in the cardiovascular health indicators was shared within each twin pair, thus indicating evidence of common behavioral and genetic influences. CONCLUSIONS: Both behavioral and genetic factors contributed to cardiovascular health in adult MZ twins who shared close familial and environmental ties. This finding is consistent with previous literature identifying behavioral and genetic effects on the development of cardiovascular disease.

Adult↗
PubMed1991

Addressing the contradictions: health promotion and community health action in the United Kingdom.

Within mainstream health education/promotion in the United Kingdom, the last few years have witnessed an upsurge of interest in community development, sometimes coupled with an undermining of the fundamental principles of this approach. This article addresses some of the contradictions and dilemmas that this development has presented for the community health movement. Current trends in health promotion policy and practice are examined in relation to broader health and welfare policy of the 1980s, the history of community development in health, and the background to the World Health Organization's "Health for All by the Year 2000" and health promotion initiatives. The possibilities and limitations of utilizing the rhetoric, to support community health action, are explored with reference to recent attempts by the community health movement to "reclaim" Health for All.

Community Health Services↗
PubMed2006

[Evidence and evaluation in health promotion and prevention: the example of the health promotion initiative "healthy living in Bavaria"].

BACKGROUND: The use of evidence and evaluation is rapidly gaining importance in the field of health promotion and prevention. The evidence base, evaluation methods as well as the capacity and required competencies among practitioners are still being developed. AIMS: Beyond its specific health-related targets, the health promotion initiative "Healthy Living in Bavaria" aims to integrate the use of evidence and evaluation as key components into project funding as part of a total quality management concept. Another objective is the creation of new evidence for the field of health promotion and prevention. APPROACH: A core element of the quality management concept is the initiative's multistage evidence and evaluation model which embraces the initiative as a whole as well as the individual projects. The model is operationalized through a set of matching instruments for application, reporting, evaluation, and appraisal. CONCLUSION: Nationally as well as internationally, evidence and evaluation stand out as central aspects of quality improvement instruments in health promotion and prevention. Characteristic of Bavaria's quality improvement approach is the seamless process from the application to the evaluation under consideration of scientific as well as pragmatic aspects.

Germany↗
PubMed1997

Multiplying health gains: the critical role of capacity-building within health promotion programs.

Health outcomes in populations are the product of three factors: (1) the size of effect of the intervention; (2) the reach or penetration of an intervention into a population and (3) the sustainability of the effect. The last factor is crucial. In recent years, many health promotion workers have moved the focus of their efforts away from the immediate population group or environment of interest towards making other health workers and other organisations responsible for, and more capable of, conducting health promotion programs, maintaining those programs and initiating others. 'Capacity-building' by health promotion workers to enhance the capacity of the system to prolong and multiply health effects thus represents a 'value added' dimension to the health outcomes offered by any particular health promotion program. The value of this activity will become apparent in the long term, with methods to detect multiple types of health outcomes. But in the short term its value will be difficult to assess unless we devise specific measures to detect it. At present the term 'capacity-building' is conceptualised and assessed in different ways in the health promotion literature. Development of reliable indicators of capacity-building which could be used both in program planning and in program evaluation will need to take this into account. Such work will provide health-decision makers with information about program potential at the conclusion of the funding period, which could be factored into resource allocation decisions, in addition to the usual information about a program's impact on health outcomes. By program potential, we mean ability to reap greater and wider health gains.

Australia↗