Health promotion. Planning a health fair.
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A concept analysis of preventive health behavior provided the foundation for this review of current health promotion research in nursing. Studies selected for review described or explained behavior for health promotion, illness prevention, or preventive health behavior. The major focus of this critical review is on the conceptualization and measurement of health promotion behaviors being investigated. Despite nursing's claim to an holistic idea of health, the biomedical model continues to influence indicators of health behavior and the context for promotion of healthy life styles. Major issues for future health promotion research relate to the lack of attention to theoretical definitions and multidimensional aspects of health behavior, and the triad of national strategies for health promotion are discussed.
For more than ten years policy makers and researchers in the field of health policy have been requesting the local health departments in Germany to focus primarily on population-oriented and structural strategies in health promotion. Based on empirical findings of a study carried out in Berlin, this article argues that several structural and organizational factors in practice influence the implementation of these strategies by the local health departments. These factors can constrain or enable the implementation of the strategies. The paper draws the conclusion that several requirements must be fulfilled for the local health departments to define themselves in health politics and policy. More than ever, the definition of their tasks and targets needs to be linked to questions of organizational change and personnel. Moreover, the local health departments should define their role more clearly in relation to the other institutions in the sector of public health and in relation to the citizens.
Considering health as an alternative to ill-health ignores the multidimensionality of both concepts and invites neglect of health promotion as a multidimensional activity in persons with known ill-health. Drawing on the Ottawa Charter and Mäori perspectives of health, we interpret (ill) health according to people's ability to function in their environment by developing physical, psychological, social and spiritual resources for living. We use this framework to test empirically our hypothesis that although the concept of health promotion has always included people with ill-health, the practice of health promotion has continued to neglect them. Our exploratory review of articles published during 1989-99 and indexed on three electronic databases suggests widespread omission of people with ill-health from research on interventions for health promotion. Of 881 citations, approximately three-quarters included people without ill-health in any dimension. This finding could reflect a failure to include these people in health promotion, to describe activity to improve their health as health promotion, or both. Supporting the latter interpretation is uncertainty over the meaning of health, and the targeting of health promotion at groups at high risk of ill-health and 'all' persons. We need therefore to enable health promotion activity to include ill people explicitly.
BACKGROUND: Printed health promotion materials are widely believed to be an efficient means of achieving basic health promotion objectives, such as increasing knowledge of risk factors. This study examined the efficiency of cardiovascular health promotion leaflets in reaching employees in a heterogeneous sample of worksites. METHODS: Two types of distribution were used: copies of the leaflets were either made available centrally or distributed to each individual employee. Interviews were conducted with 272 employees in six worksites. Respondents were asked whether they recognized, had read, and had learned something from the leaflets. RESULTS: Only one-quarter of respondents recognized the leaflets and only 14% stated that they had learned something. The efficiency of the leaflets was therefore much lower than expected. Z-tests for proportions showed that recognition, reading, and learning were significantly greater among those employees who had been given individual copies of the material. Among those who had been given individual copies, 45% reported recognizing the leaflet, 36% reading it, and 23% learning something from it. Among those who had only central access, the respective scores were 11%, 7% and 6%. DISCUSSION: These results suggest that the potential cost-effectiveness of printed materials such as leaflets and brochures should be weighed against alternative forms of intervention, given specific program objectives and characteristics of the target population. They also suggest that the cost and effort required in organizing the distribution of individual copies may be recouped in greater penetration.
PURPOSE: The objective of this study was to derive a conceptual model of community capacity development for health promotion based on the 5-year demonstration phase of the Alberta Heart Health Project. METHOD: Community actions associated with successful implementation and uptake of initiatives in four diverse target sites were identified by case study evaluation. RESULTS: Thirteen common elements of capacity development were found across the projects and categorized to define three primary dimensions of the process: (a) leadership that provided a driving force for implementation, (b) policy making that ensured diffusion and sustainability, and (c) use of local community resources and infrastructure. A conceptual model was constructed using these 3 dimensions and their interactions. CONCLUSION: Effective implementation of community health initiatives to promote heart health can be conceptualized as the involvement of local leadership, policy advocacy, and enhancement of existing infrastructure. The model highlights building these dimensions of community capacity development for health promotion.
There has so far only been little research attention given to how families actively engage in promoting their health in everyday life. In this paper a theoretical framework is proposed for studies of the 'health-promoting family' with particular focus on children's health and well-being. This paper sets out a conceptual model for understanding how the family can play a part in promoting both the health of children and children's capacities as health-promoting actors. It draws on contemporary social science approaches to health, the family and children, suggesting a new emphasis on the family's ecocultural pathway, family practices and the child as a health-promoting actor.
A plethora of literature suggests that many nurses struggle in their attempts to develop a political role that allows them to directly influence and implement health policy activity. Nursing curricula are an integral part of ensuring that nurses are capable of taking on a more active role in initiating and developing health policy processes, through a broadening of the health promotion curriculum that focuses on socio-political approaches to health care provision. Despite this, the available literature suggests that the majority of nursing curricula are yet to fulfil this role. Such a role could be supported by attempts to define and promote a specific career route that develops nurses as health policy experts and entrepreneurs early on in their careers. This article aims to put forward a rationale for developing such a position in nursing education.
The school is an important potential health-promoting setting for children and adolescents. Two main perspectives on school health promotion have been identified, one addressing health-related behaviours, the other stressing the development of general competencies. From a policy perspective, it is important to establish whether these two approaches are complementary or competing. This question was analysed by examining school administrations in 25 municipalities in Stockholm County, Sweden. An attempt was made to relate level of activity in line with each approach to general adolescent health outcomes. Data related to the two approaches were collected through the administration of a questionnaire. Outcome variables, measured as fraction of students qualified for upper secondary school, fraction of students with high alcohol intake, and fraction of 15-18 year olds suspected of crime, were measured on the basis of registry data. To control for structural patterns, socio-economic, demographic and system characteristics were gathered from public statistics. Spearman rank correlation coefficients were computed. Clusters of determinants assignable to each of the two approaches--promotion of health-related behaviours and supporting the development of student competencies--were identified. The two approaches were found to be negatively correlated. Thus, the perspective focusing on promotion of student health-related behaviours and the one emphasizing general development of student competencies seem to be competing rather than complementary. If this result is confirmed by other studies, it will have important policy implications.
'Promoting Oral Health: Guidelines for Dental Associations' is the product of Working Group 3 on Oral Health Promotion of the Commission on Oral Health, Research and Epidemiology of the FDI. This paper describes the guidelines document, its rationale and its potential utility. An organized planned sequence of activities, including policy formation and dissemination, planning group structure and function, information gathering, goal setting, strategic planning of objectives and interventions, implementation as well as monitoring and evaluation, are reviewed. Relevant to both industrialized and developing countries, these oral health promotion guidelines can be used to develop programmes to demonstrate the benefit of self-care and appropriate demand for dental services.
Worksite health promotion programs developed and promoted by community groups are one of the many program options that corporate decision makers may choose to enhance the health and well-being of their employers. This article describes the development of the American Heart Association's health promotion program, "Heart At Work." The findings from extended field studies and other program evaluation activities are summarized. Implications of evaluation studies to the "Heart At Work" program and health promotion programs in general are discussed.
1. Occupational health promotion has been institutionalized into many companies in the United States and new programs are being started up across the country. 2. Several stimuli affect this growth in programs, including cost-containment, employee recruitment, and governmental support. 3. It is essential that companies involved in occupational health promotion understand their reasons for espousing this trend. 4. Health promotion activities should be planned thoroughly and plans should especially address cost analyses and ethical issues early in the planning phase.
BACKGROUND: Controversy exists regarding the optimal way to provide health promotion education to the elderly. This prospective randomized study evaluated the effectiveness of individualized assessment and counseling coupled with the receipt of a written health plan on client adherence to health behavior recommendations. METHODS: Two hundred thirty-seven ethnically diverse and predominantly low-income adults 60 and older, participating for the first time in an established statewide public health prevention program delivered in both rural and urban clinics, were recruited and randomly assigned to treatment and control groups. All participants received a standardized assessment that included a health history, nutrition assessment, and limited physical exam from a public health nurse. The treatment group additionally received a written personal health plan and individualized counseling to support implementation of the plan. Both groups were interviewed after one year to determine their adherence to the original recommendations. RESULTS: Seventeen preventive services and health behaviors were evaluated. There were no statistically significant differences between the groups on health care use and previous health behaviors at baseline. Using logistic regression and controlling for socioeconomic and demographic variables, we found that the treatment group that received a personal health plan and counseling completed significantly more preventive referrals and health behavior changes (P < .001). CONCLUSIONS: A client-centered planning process with supportive counseling by public health nurses, combined with health plans provided to clients, can significantly increase the prevention measures taken by older adults.
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Progress in health promotion and preventive programme planning is limited by a lack of data on the development of current activities. A cross sectional survey of hospitals, community health centres, and other health agencies in New South Wales was therefore undertaken to determine the nature and extent of health promotion programmes being conducted in the period July to December 1983. A subsample of 1198 preventive programmes in child and family health was identified, making up 26% of all programmes operating in this period. Results indicate that three major types of programme are being conducted in child health. These are in the areas of (1) parent education and support, (2) school health education, including drug and alcohol education and personal development, and (3) child safety and first aid. Although the nature of these programmes generally corresponds with current thinking on what priorities in health promotion should be, results also indicate that evaluation of these programmes is limited. Most programmes assess only what participants think of the programme rather than assessing changes in knowledge, attitude, behaviour, or health status. Improvements in evaluation practice are required if preventive intervention programmes are to undertake seriously the task of altering the pattern of diseases and problems in childhood and adolescence.