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PubMed1988

Effective and ineffective use of fear in health promotion campaigns.

Health promotion campaigns are typically designed to elicit fear, yet the use of fear is often ineffective in achieving the desired behavior change. Campaigns which attempt to use fear as part of a punishment procedure are unlikely to succeed. Consistent with established principles of learning, fear is most likely to be effective if the campaign allows for the desired behavior to be reinforced by a reduction in the level of fear. This entails five requirements: 1) fear onset should occur before the desired behavior is offered; 2) the event upon which the fear is based should appear to be likely; 3) a specific desired behavior should be offered as part of the campaign; 4) the level of fear elicited should only be such that the desired behavior offered is sufficient to substantially reduce the fear; 5) fear offset should occur as a reinforcer for the desired behavior, confirming its effectiveness. Under some circumstances it may be difficult to ensure that these requirements are met. In general, a positive reinforcement approach may prove to be more effective than the use of fear.

Fear↗
PubMedDate not supplied

Controlled trial of a time-efficient method of health promotion.

Integrating health promotion into daily clinical practice is a challenging undertaking. This project was a prospective trial of a brief physician intervention program, performed as part of routine patient care, that addressed six areas of patients' lifestyle risks (nutrition, exercise, alcohol use, smoking, stress, and seat belt use). The components of the program were lifestyle assessment, physician prescription of lifestyle change, and educational materials. Patients visiting a family practice residency model office for any reason were selected to receive all program components, parts of the program, or no program components. Lifestyle behavior changes over the ensuing four-week period were measured for all groups by a structured phone interview. Patients who received one or more components of the program reported significantly more change at follow-up than those who received no program components (P = .001); the greatest change was seen in the group that received all of the program components. Demographic variables that were significantly related to a higher degree of change were female sex, previous contact with the physician, and being married. In this sample age, income, and education were not related to behavior change. Motivation to change--an expressed desire to work on a given lifestyle area--was a stronger predictor of change than any demographic variable.

Adult↗
PubMed1994

Availability and utilization of health promotion programs and satisfaction with health plan.

There has been increasing interest in using patient satisfaction as an indicator of quality of care by the purchasers of health plans, as well as the basis for marketing by competing plans. Few studies have examined if availability and utilization of health promotion programs are associated with patient satisfaction with the health plan. Data from the Bay Area Business Group on Health 1992 Employee Medical Plan Satisfaction Survey were used to examine these relationships. The findings indicate that persons enrolled in staff-model health maintenance organizations are much more likely to be offered health promotion programs by their plan or physician compared with persons enrolled in independent practice association-model health maintenance organizations and indemnity plans. However, regardless of plan type, employees who have been offered stop-smoking programs, stress management programs, weight-control programs, cholesterol screening and blood pressure screening, or any health promotion program by their plan or physician are more satisfied with their health plan than whose who have not. In addition, employees who have participated in a health promotion program also are more satisfied than employees who have not participated in such a program. The findings have important implications for designing and restructuring health plans to better meet consumer preferences.

California↗
PubMed2006

Experiences of Swedish community health nurses working with health promotion and a patient-held health record.

Community health nurses have a tradition of preventive care, and might therefore be a key group in the introduction of new health-promotion methods. The aim of this study was to describe Swedish community health nurses' experiences in working with health promotion and a patient-held record as an integrated tool in their health-promotion work. Interviews were performed with 12 nurses at primary healthcare centres in the county of Dalarna, Sweden. A qualitative content analysis applying aspects of the grounded theory approach was performed. Central to the analysis was the nurses' struggle for balance, in being both a doer of practical disease-oriented tasks and a health-promotion communicator. Descriptions of the nurses' struggles to balance their work were grouped into three themes: (i) working alone and as a part of a team; (ii) nurse-related and patient-related interests; and (iii) patient's responsibility and shared responsibility between patient and nurse. The findings indicated that the structural organization in the primary healthcare centres was important for the community health nurses' means to work with health promotion and the patient-held record. In addition, the community health nurses' cognitive and emotional needs also affected this balance. In conclusion, the struggle of community health nurses to find a balance between being doers and health-promotion communicators is valuable in understanding health promotion in primary health care. The study indicates that it is not enough to develop health-promotion methods acceptable to community health nurses. A comprehensive examination of working conditions and the content of daily work is needed to ensure an emphasis on health promotion, including long-term usage of patient-held records.

Adult↗
PubMed2005

Health promotion by means of health sport--a framework and a controlled intervention study with sedentary adults.

Only 10-20% of adults in industrialized countries reach the health-related minimum level of a consumption of energy of more than 800 kcal week(-1), additional to activities of daily living. The objective of this longitudinal study was to evaluate the impact of a health-promoting exercise program for sedentary adults on medical and subjective health status and on behavioral changes. The first 12 months of the study (t1-t2) consisted of a structured intervention exercise program. After this period, participants had the opportunity to stay in a follow-up-program or to change to other programs of the same club for further 12 months (t2-t3). Within these 2 years data have been collected from the intervention group (117 subjects) and control group (40 subjects). It can be shown that on the basis of a structured intervention (one session per week, 90 min, for 1 year), a stable behavioral change is reached with positive effects on fitness status, risk factors and mental health. Contrary to findings in other studies, the average health effects are at least stable in the second year in this study.

Energy Intake↗
PubMed2003

Dissemination of heart health promotion in the Ontario Public Health System: 1989-1999.

This paper reports the results of an analysis of the dissemination of community-based heart health promotion strategies. The research draws on diffusion and socio-ecological theories to study the first 10 years of heart health promotion in the public health system in Ontario, Canada. Using case description and interpretive analysis, the study describes developments in five stages of dissemination, and examines the interplay of factors operating in the internal organizational setting and the external environment in order to explain these developments. Findings demonstrate that dissemination of health promotion is a long-term, iterative process involving multiple stages. Dissemination is influenced by a complex interplay of factors operating within the public health system (especially traditional public health practice and champions) and factors in the environment in which the public health system operates (especially research, practice information and health policies). Implications are that policy makers should take a long-term view of dissemination, identify intermediate and long-term goals consistent with dissemination stages, and capitalize on internal and external forces supporting dissemination goals. Similar case-study research in other public health systems and time periods, and in more advanced stages of dissemination, will add further insight into the dissemination process.

Health Promotion↗
PubMed1991

[Priorities in prevention and health promotion in primary health care: views of the professionals].

The aim of the study was to define the health problems, preventive and promotional activities, and self care measures which have a high priority for the primary care professionals in our area. A Delphi study with two rounds of questionnaires. A 69.6% of a panel of professionals selected because of their remarkable degree of participation in clinical, educational, organizational or managerial activities in PHC participated in the study. Chronic diseases and the mental health disorders of the anxiety/depression type were considered the most important health problems. The detection and control of hypertension, medical counseling against smoking, and the compliance with the vaccination schedules were the most supported preventive interventions. Finally, the consulted professionals felt that it is necessary to promote self care in chronic diseases and in some acute conditions such as upper respiratory infections. The primary health care professionals considered as interventions with a high priority for health promotion the counseling of life style and the traditional interventions such as the compliance with the vaccination schedules of the hypertension programs. It is necessary to adapt the training of professionals to the priorities in PHC problems and activities.

Attitude of Health Personnel↗
PubMed2005

Strategies and approaches in oral disease prevention and health promotion.

Oral health is an important element of general health and well-being. Although largely preventable, many people across the world still suffer unnecessarily from the pain and discomfort associated with oral diseases. In addition, the costs of dental treatment are high, both to the individual and to society. Effective evidence-based preventive approaches are needed to address this major public health problem. The aim of this paper is to outline public health strategies to promote oral health and reduce inequalities. An extensive collection of public health policy documents produced by WHO are reviewed to guide the development of oral health strategies. In addition a range of Cochrane and other systematic reviews assessing the evidence base for oral health interventions are summarized. Public health strategies should tackle the underlying social determinants of oral health through the adoption of a common risk approach. Isolated interventions which merely focus on changing oral health behaviours will not achieve sustainable improvements in oral health. Radical public health action on the conditions which determine unhealthy behaviours across the population is needed rather than relying solely on the high-risk approach. Based upon the Ottawa Charter, a range of complementary strategies can be implemented in partnership with relevant local, national and international agencies. At the core of this public health approach is the need to empower local communities to become actively involved in efforts to promote their oral health.

Health Promotion↗
PubMed2004

[Communal health promotion in child and adolescent health services -- report on the experience with a organisational model for setting up an interdisciplinary network in a socially important area].

This report focusses on health promotion for children adolescents und families and on the aspects of organisation and resources. In 1991 the Public Youth Health Care (KJGD), a community health service for children und adolescents, set up a multi-professional "district committee" of distributors in leading positions in a socially important area (social workers, school teachers, kindergarten teachers, councillors, medical personnel, architects and town planners etc.). Medical examinations of all school beginners and children with special educational needs formed the basis of the social paediatric observations and data. Until 2003 the author was responsible for the management and coordination of this local interdisciplinary district committee of leading representatives from local social and educational organisations as well as town councillors who created a local multi-professional network. The district health reports of the discussions in the district committee including the different professional aspects of health promotion were passed on to the local politician actively involved in the discussions with specialists and invested in social and health promotion projects. Social paediatric issues and preventative strategies became part of the work in social and educational organisations in the area und the city. A healthy environment for children und families was promoted. For the KJGD the conceptual work with distributors in leading positions led to initiatives for communal health promotion making time-saving use of existing resources.

Adolescent↗
PubMed1985

Promoting health in international travel.

As international travel becomes more frequent, consumers are expressing a need for current, comprehensive information about disease prevention abroad. Many health care providers lack the knowledge to respond to this need. This article provides information on general preventive measures for commonly encountered infectious diseases and discusses the use of vaccines and chemoprophylaxis. Legal requirements for the quarantinable diseases are reviewed. Readers are directed to authoritative references, and considerations to be addressed in the pretravel visit are outlined. Disease prevention in international travel is an important aspect of health promotion, particularly in our mobile society. With development of the necessary skills and knowledge, nurse practitioners can and should play a significant role in this area.

Antimalarials↗
PubMed2006

[Health promotion groups for improving autonomy, living conditions and health].

This article presents the methodology of Health Promotion Groups, which were conceived as a means of contributing towards developing autonomy, improving living conditions and promoting health. The method is identified as a collective and interdisciplinary health intervention, consisting of a group process. It guides the development of attitudes and behavioral patterns towards continually transforming participants' health levels and living conditions. The Health Promotion Groups are identified within the context of the National Health System (Sistema Unico de Saúde) as a means of surpassing the biomedical model. It stimulates the development of actions in which the positive aspects of health are emphasized, while at the same time it can serve to more effectively meet the demands for care for the elderly in health systems.

Aged↗