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PubMed1995

Psychology, health promotion and aesthemiology. Paper one: Social cognition models as a framework for health promotion: necessary, but not sufficient.

Much of health promotion is premised on the notion that health-related behaviours are under individual control, and strongly influenced by intra-psychic factors, including knowledge and attitudes. The emphasis placed on such factors has led to a neglect of the social and material context in which the individual is situated. This paper describes a number of psychological theories which have influenced health promotion, and suggests ways in which a wider set of psychological theories and methods, which take into account social and material factors, may more usefully inform health promotion initiatives.

Cognition↗
PubMed1998

A systematic review of the effectiveness of health promotion aimed at improving oral health.

OBJECTIVE: To examine the quality of oral health promotion research evidence and to assess the effectiveness of health promotion, aimed at improving oral health using a systematic and scientifically defensible methodology. BASIC RESEARCH DESIGN: Systematic review of oral health promotion research evidence using electronic searching, iterative hand-searching, critical appraisal and data synthesis. CLINICAL SETTING: The settings of the primary research reviewed were clinical, community, schools or other institutions. The participants were children, the elderly, adults and people with handicaps and disabilities. INTERVENTIONS: Only studies which reported an evaluative component were included. Theoretical and purely descriptive papers were excluded. MAIN OUTCOME MEASURES: The review examined the evidence of effectiveness of oral health promotion on caries, oral hygiene, oral health related knowledge, attitudes and behaviours. RESULTS: Very few definitive conclusions about the effectiveness of oral health promotion can be drawn from the currently available evidence. Caries and periodontal disease can be controlled by regular toothbrushing with a fluoride toothpaste but a cost-effective method for reliably promoting such behaviour has not yet been established. Knowledge levels can almost always be improved by oral health promotion initiatives but whether these shifts in knowledge and attitudes can be causally related to changes in behaviour or clinical indices of disease has also not been established. CONCLUSIONS: Oral health promotion which brings about the use of fluoride is effective for reducing caries. Chairside oral health promotion has been shown to be effective more consistently than other methods of health promotion. Mass media programmes have not been shown to be effective. The quality of oral health promotion evaluation research needs to be improved.

Adult↗
PubMed2006

[Health promoting interventions for migrants. Analysis of the database "Health Promotion for the Socially Disadvantaged" www.gesundheitliche-chancengleichheit.de].

The nationwide database "Health Promotion for the Socially Disadvantaged" (http:// www.gesundheitliche-chancengleichheit. de), set up by Federal Centre for Health Education (BZgA), includes about 2,700 projects, and amongst other activities also interventions for migrants living under socially disadvantaged circumstances. Based on qualitative interviews with the coordinators of some selected interventions, this contribution presents basic strategies and methods for reaching the target group.

Cultural Characteristics↗
PubMed2000

The 5 A day Virtual Classroom: an on-line strategy to promote healthful eating.

Communications technology can help stimulate youth to become involved in health promotion. This article reports on an innovative, Internet-based nutrition program that encouraged children to be advocates for policies that promote eating more fruits and vegetables, the 5 A Day Virtual Classroom. Through this program, students from across the United States discussed the recommendation of 5 A Day at the same time in a classroom without walls. In September 1997 children were asked, "If you were President Clinton, how would you get kids across the country to eat 5 A Day?" Based on content analysis of responses, this article suggests strategies that policymakers could use to encourage children to consume more fruits and vegetables. Approximately 2,600 students participated; 635 entries and 910 suggestions were received. The suggestion categories cited most often were mass media (19.8%), economic issues (15.4%), and social influence (13.8%). The most frequently mentioned specific ideas were to reward children for eating fruits and vegetables and to use presidential authority. Some regional, age, and gender patterns were found. Findings support the potential impact on health education of the 5 A Day Virtual Classroom and of interventions based on communications technology.

Child↗
PubMed1986

Strategies for health promotion.

A key element in most efforts to prevent disease and promote health is behavioral change to lower risk. One-to-one programs to help people change their behavior are seriously limited because of the difficulty people have in making behavioral changes and because one-to-one programs do little to modify those forces in the community that continually produce new people at risk. In addition to one-to-one programs, therefore, environmental strategies for disease prevention are needed. Several clues regarding environmental interventions can be gleaned from the study of patterns of disease distributions. Not only are environmental approaches to prevention more efficient and practical than one-to-one programs, they also may shed new light on our understanding of disease etiology.

Behavior↗
PubMed1990

Health promotion and self-care in the case of cardiovascular disease.

Since the early 1970s experimental studies on self-care and chronic disease have demonstrated the importance of combining professional knowledge and the experiential insight of patients. As a means of promoting health the Duo Formula Group approach (DFG) method has been developed. Part of a larger DFG study focuses on the application and evaluation of a self-care programme following cardiac surgery. The duo formula method teaches patients how to assume more responsibility for the management of their physical condition. This DFG study used an experimental/control group design whereby 59 patients and 49 partners were assessed pre-intervention (M1), post-intervention (M2) and during a follow-up period of 6 months (M3). The study examined changes in illness behaviour, depression, Type A behaviour and anxiety in both patients and partners. At this intermediate stage of the study, patients show decreased depression (M2-M1: t = 2.79, p less than 0.01); and their partners decreased anxiety (M2-M1: t = 1.97, 0.05 less than p less than 0.10).

Adult↗
PubMed1997

Effectiveness of health education and health promotion: meta-analyses of effect studies and determinants of effectiveness.

Interventions to promote health that have been developed over the last 20 years in the relatively new scientific health education tradition, have often been evaluated for their effectiveness. Meta-analyses of effect studies on various subfields, show that these interventions generally have quite substantial effects (mean effect sizes, ES, of 0.46 for primary prevention and 0.49 for secondary prevention and patient education). A planned and systematic application of social science theory in intervention development is a strong determinant of effectiveness. However, learning principles such as rewards and feedback, that have been shown to increase effectiveness, are often not or not adequately applied. Also, too few interventions focus on possibilities to facilitate the desired behavior (such as reminders, financial stimuli, and skills improvement). The potential effectiveness of interventions in practice may be increased by systematic development of adoption and implementation strategies, including the creation of 'linkage systems' between intervention developers and representatives of the target and user systems.

Health Behavior↗
PubMed1994

Cancer communication: the health promotion challenge.

The way of communicating messages about cancer is the essence of this paper. There is a challenge to promote health, and demystify misconceptions about cancer and its treatment. But how do you reach those who seldom read or who are illiterate? How do you convince people that early presentation of symptoms that may be caused by cancer can positively influence outcome? How can you present a practical and realistic message about life-style factors and cancer? This paper explains initiatives in the UK to address some of these issues. The role of research and evaluation is important, but so are the ethical issues when you may be trying to persuade and convince the public of the benefits of life-style change. Finally, the issue of training of health professionals is addressed.

Communication↗
PubMed1996

Rethinking grief: nursing implications for health promotion.

The healthy process of grieving is explored in relation to the nursing process. Grieving is postulated as facilitating growth and promoting health when viewed as a healing process. How one grieves determines to a large extent one's health and how one lives.

Adult↗
PubMed1986

A public health intervention model for work-site health promotion. Impact on exercise and physical fitness in a health promotion plan after 24 months.

We need effective ways of getting adults to exercise if we are to meet the Surgeon General's 1990 health goals for the nation. This study reports a comprehensive effort to evaluate the sustained effect of a public health intervention model to achieve these health goals. Employees at four companies (N = 2,600) were exposed to a health promotion program, while employees at three comparison companies (N = 1,700) were offered an annual health screen. Daily energy expenditure in vigorous activity increased 104% among employees at companies offering the health promotion program, compared with a 33% increase among employees at comparison companies. Changes in exercise habits were corroborated by estimates of maximal oxygen uptake. Exercise and physical fitness improvements were distributed throughout the work force. Meaningful population changes in exercise and physical fitness can be produced at the work site and are of a magnitude that makes it possible to meet the 1990 goals for exercise and physical fitness.

Adolescent↗
PubMed2000

Health promotion at Swedish Child Health Centres.

Effective health promotion intervention is understood to modify appropriate risk and protective factors. The relevance of such interventions for the Child Health Service (CHS) was examined in three steps. In the first step, the six most important public health problems in the target group that might be affected by CHS interventions were identified. The health problems include sudden infant death syndrome (SIDS), mental health problems, injuries, infections, asthma and allergic and nutritional disorders. In the second step, three groups of modifiable determinants were identified: risk and protective factors for (i) SIDS, asthma and allergic disorders and airway tract infections (determinants: breastfeeding, environmental tobacco smoke, sleeping non-prone and lacking indoor ventilation). (ii) injuries and (iii) mental health problems. In the third step, evidence for the preventive measure's ability to alleviate the effects of these risk factors was scrutinized. Evidence was found for effectiveness of CHS interventions aiming at decrease of environmental tobacco smoke. Evidence was also found for injury prevention provided that the intervention is a part of a wider community effort, and possibly also if it is very focused. Requirements for mental health promotion are also at hand. Thus, effective health promotion via CHS interventions is feasible.

Child↗
PubMed1988

The stress-coping process in school-age children: gaps in the knowledge needed for health promotion.

Most health promotion research on the stress-coping process among children has applied theory developed by adults for adults, with little examination of its applicability. Most instruments used with children have been developed from an adult perspective of what is stressful to children and how children should cope, with little validation of the accuracy of such instruments by the children themselves. Recommendations for further development of theory about and knowledge of the stress-coping process and relevant health promotion interventions from the children's perspective are offered.

Adaptation, Psychological↗
PubMed2005

[Association of Internet addiction with health promotion lifestyle profile and perceived health status in adolescents].

OBJECTIVES: To identify the relationship between the internet addiction of adolescents and their Health Promotion Lifestyle Profile and Perceived Health Status, and thereby to detect the impact of internet addiction on the health of adolescents, produce the basic information necessary to develop a prevention program for internet addiction and to plan for a health promotion program. METHODS: This study was designed as a cross-sectional study, and the subjects were the second-grade students of three junior-high and three high schools located in the city of K in Kyung Gi Province. Out of 769 subjects, 764 completed the questionnaires (99.3%); 369 (48.3%) junior-high school students and 395 (51.7%) high school students. The questionnaires were composed of Young's Internet Addiction, Health Promotion Lifestyle Profile, Perceived Health Status, and general characteristics. We used t-test, ANOVA in means comparison between groups, chi2-test in frequency analysis, and multiple regression analysis in multivariate analysis, using the SAS 8.1 program. RESULTS: There was a statistically significant difference in Health Promotion Lifestyle Profile according to internet addiction status (severe addiction vs. other status, P < 0.0001). The Perceived Health Status scores was lowest in the severe addiction group (P < 0.001). There was also a significant negative correlation between internet addiction and Health Promotion Lifestyle Profile (P < 0.0001). The results of multiple regression showed that Young's Addiction Score was significant for the subjects' Health Promotion Lifestyle Profile after controlling for other variables (P < 0.0001). CONCLUSIONS: This study showed that the severe internet addiction group had the lowest score in Health Promotion Lifestyle Profile and Perceived Health Status, which suggests that the addiction could have a negative effect on the health status of adolescents.

Adolescent↗
PubMedDate not supplied

Project Salsa: development and institutionalization of a nutritional health promotion project in a Latino community.

PURPOSE: Project Salsa was a community-based effort seeking to promote health through nutritional behavior change in a Latino community of San Diego, California. The purpose of this article is to report on program factors related to long-term institutionalization of Project Salsa interventions. DESIGN: Project Salsa was a demonstration rather than an experimental project. To ensure maximum sensitivity to the needs and values of the community, Project Salsa began with an extensive health needs assessment, including development of an advisory council, telephone survey, archival research, and key informant interviews. SETTING: Project Salsa interventions took place in San Ysidro, California, located near the U.S.-Mexico border adjacent to Tijuana from 1987 to 1992. SUBJECTS: The intervention community had 14,500 residents, of which nearly 83% were Latino. INTERVENTIONS: Interventions included coronary heart disease risk factor screenings, meal preparation classes, newspaper columns, point-of-purchase education, school health and cafeteria programs, and breast-feeding promotion. MEASURES: Institutionalization of intervention components. RESULTS: Two of the interventions, the risk factor screenings and school health programs, are still in operation 4 years after the end of project funding. CONCLUSIONS: Four factors common to institutionalized components are presented in the paper.

Adult↗
PubMed2000

Financial incentives, participation in employer-sponsored health promotion, and changes in employee health and productivity: HealthPlus Health Quotient Program.

Employer-sponsored health promotion can improve employee health and morale and reduce medical claims and absenteeism. Effectiveness depends on the participation of those employees who are at increased risk of ill health. HealthPlus Health Quotient is an incentive/disincentive approach to health promotion. The employer's contribution to the employee cafeteria-plan benefit package is adjusted on the basis of an annual health risk appraisal. We evaluated whether this financial incentive/disincentive predicted participation in health promotion activities, and whether participation improved future health risk and productivity. In the first year, participation was proportional to overall health risk (P < 0.01). Participation in targeted programs was proportional to levels of body fat, cholesterol, and blood pressure. Participation in activity-related health promotion was proportional to prior-year activity or fitness scores. Health promotion participants improved their subsequent-year health risk more than did non-participants. Participation was associated with reduced illness-related absenteeism and (although inconsistently) with medical claims paid and short-term disability.

Absenteeism↗
PubMed1998

Assessing public health capacity to support community-based heart health promotion: the Canadian Heart Health Initiative, Ontario Project (CHHIOP).

This paper presents initial findings of the Canadian Heart Health Initiative, Ontario Project (CHHIOP). CHHIOP has two primary objectives. The programmatic objective is to coordinate and refine a system for supporting effective, sustained community-based heart health activities. This paper addresses the scientific objective: to develop knowledge of factors that influence the development of predisposition and capacity to undertake community-based heart health activities in public health departments. A systems theory framework for an ecological approach to health promotion informs the conceptualization of the key constructs, measured using a two-stage longitudinal design which combines quantitative and qualitative methods. This paper reports the results of the first round of quantitative survey data collected from all health departments in Ontario (N = 42) and individuals within each health department involved in heart health promotion (n = 262). Results indicate low levels of implementation of heart health activities, both overall and for particular risk factors and settings. Levels of capacity are also generally low, yet predisposition to undertake heart health promotion activities is reportedly high. Analyses show that implementation is positively related to capacity but not predisposition, while predisposition and capacity are positively related. Overall, results suggest predisposition is a necessary but not sufficient condition for implementation to occur; capacity-related factors appear to be the primary constraint. These findings are used to inform strategies to address CHHIOP's programmatic objective.

Causality↗