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Health promotion in the office.

Occupational therapists have the training and skill to modify office environments in order to promote employee health. Minor changes in the ways tasks are performed can improve work performance, decrease the incidence of minor health complaints, and help prevent repetition injury. Two employee health promotion education programs are described. They were conducted by an occupational therapist and can be replicated in other settings. One program was a seven-session series for bank employees; the other was a luncheon presentation to office workers employed by a health science university.

Ergonomics↗

Tailoring and targeting a worksite health promotion program to address multiple health behaviors among blue-collar women.

PURPOSE: This study examined the relationship between health risks, health behaviors, stages-of-change, and behavior change priorities among blue-collar women participating in a worksite health promotion study. DESIGN: Cross-sectional. SETTING: Rural manufacturing worksites in North Carolina. SUBJECTS: Participants were 859 women aged 18 and over. MEASURES: The self-administered questionnaire assessed smoking, exercise, nutrition (fat, fruits, and vegetables), and breast and cervical cancer screening behaviors. In addition, demographics, body weight, perceived health, stages-of-change, and priority for behavior change were measured. Chi-square tests and regression analysis were used to assess statistical significance. RESULTS: Overall, 28% of women smoked, 37% were completely sedentary, 82% consumed less than five daily servings of fruits and vegetables, and the majority were overweight. The dominant stage of change for each of the lifestyle behaviors was contemplation, whereas most women were in the action stage for cancer screening. When asked to prioritize the behavior they most wanted to change, the majority of women chose healthy eating and/or exercise. CONCLUSIONS: The findings suggest that blue-collar women in this study had multiple health risks and were interested in changing multiple health behaviors. Allowing women to choose the behavior(s) on which they are ready to focus may be a promising approach to tailoring interventions for this population.

Adult↗

The diversity of prevention and health promotion services offered by Québec Community Health Centres: a study of infant and toddler programmes.

Research has shown that preventive and health promotion (PHP) services offered by community health centres are often vulnerable in times of health reform or budgetary cutbacks. The present study was conducted in Québec, Canada, approximately 10 years after the start of a major transformation of health care services. The objectives were: (1) to examine the diversity of infant/toddler prevention and health promotion services offered by centres locaux de services communautaires (CLSCs, local community health and social services centres); and (2) to investigate the organisational and environmental correlates of such diversity. All Québec CLSCs were invited to complete a survey questionnaire regarding their PHP services (response rate = 69%). Data on environmental and organisational factors were extracted from existing Québec government data sets. Bivariate and multivariate analyses were performed to identify the correlates of the CLSCs' level of diversity of PHP services. The results revealed that CLSCs varied greatly in terms of their diversity of PHP services. The number of full-time equivalents in the Child and Family Services Programme (one of two programmes aimed at reaching the targeted clientele) and the degree of CLSC collaboration with other community-based organisations in the planning and delivery of PHP activities were positively associated with the level of diversity, whereas the unemployment rate in the population served was a negative predictor. This study makes an important contribution in being one of the very few which contribute to building our knowledge about the performance of community health centres. Identifying the correlates of diversity among PHP services offered by CLSCs helps us to begin to understand the processes at work in the production of PHP activities, as well as the potential leveraging forces.

Child Health Services↗

Research and practice for equity in health: actions of the international union for health promotion and education.

The published health promotion knowledge base is biased in favor of information produced in just a few English-speaking countries. This is an impediment to health promotion's global development, which would be fostered by better access to information from the broadest possible range of sources. Responding, the International Union for Health Promotion and Education has expanded the scope of its flagship journal, Promotion and Education, publishing material in French and Spanish, in addition to English, and intending to broaden its scope even more. The International Union for Health Promotion and Education has also established an equity project in the health promotion publishing arena, together with other health promotion journals, to assist would-be authors for whom language is a barrier. A third International Union for Health Promotion and Education initiative is the Global Essential Readings in Health Promotion book project, whose editorial team includes experts from every continent, to ensure that the book includes material from every quarter of the globe.

Global Health↗

Health promotion for educators: impact on health behaviors, satisfaction, and general well-being.

A random sample of 117 teachers in three treatment schools and one control school participated in a health survey at the beginning and end of the spring semester. Teachers in the treatment schools participated in a 10-week health promotion program which emphasized exercise, stress management, and nutrition. Comparison of pre- and post-survey data indicated that teachers in the treatment schools increased their participation in vigorous exercise, improved their physical fitness, lost weight, lowered their blood pressure, reported a higher level of general well-being, and were better able to handle job stress.

Adult↗

Establishing and maintaining healthy environments. Toward a social ecology of health promotion.

Earlier research on health promotion has emphasized behavior change strategies rather than environmentally focused interventions. The advantages of integrating lifestyle modification, injury control, and environmental enhancement strategies of health promotion are substantial. The author offers a social ecological analysis of health promotive environments, emphasizing the transactions between individual or collective behavior and the health resources and constraints that exist in specific environmental settings. Directions for future research on the creation and maintenance of health promotive environments also are examined.

Adaptation, Psychological↗

A new theory of health promoting schools based on human functioning, school organisation and pedagogic practice.

This paper outlines a novel explanatory frame for understanding how schools may intervene in order to promote pupils' health. The new theory is synthesised from an Aristotelian interpretation of human functioning and a theory of cultural transmission. In keeping with recent influential theoretical developments, it is proposed that health has its roots in human functioning. It follows from this concept that the promotion of pupils' health is facilitated by the promotion of pupil functioning and the primary mechanisms through which schools promote pupil functioning and, hence, health, are through the influences of school organisation, curriculum development and pedagogic practice on pupil development. According to the new theory, good human functioning is dependent on the realisation of a number of identified essential human capacities and the meeting of identified fundamental human needs. Two essential capacities, the capacity for practical reasoning and the capacity for affiliation with other humans, plan and organise the other essential capacities. The realisation of these two capacities should, it is argued, be the primary focus of health promoting schools. Additionally, health promoting schools should ensure that fundamental human needs concerning non-useful pain and information about the body are met. A number of testable hypotheses are generated from the new theory. Comparisons with existing interpretations of health promoting schools indicate there are similarities in the actions schools should take to promote health. However, the new theory can, uniquely, be used to predict which pupils will enjoy the best health at school and in adulthood. Additionally, according to the new theory, schools do not need designated health education classes or teaching staff with specialist health education roles in order to be health promoting. It is concluded that the new theory may have a number of advantages over existing theories at both the policy and intervention levels.

Acculturation↗

[Health promotion by the public health service (with special reference to promoting the self help movement)].

During the last decade there has been a new orientation in public health policies. The question of prevention is gaining importance and has assumed social and political dimensions alongside the traditional medical issues. In future the public health service will increasingly recognise the value of an interdisciplinary approach, as was emphasised in a Resolution by the 64th German State Health Ministers' Conference. The need for cooperation and coordination in important future fields of action--especially the area of Self-Help--is presented as a major challenge for the Public Health Department. Details are given on the new requirements in terms of organisation, staffing and facilities.

Forecasting↗

Health promotion and disease prevention.

Health promotion and disease prevention programmes improve the health status of populations, preserve freedom, and empower individuals. Yet, despite important advances in many countries, including a more health-conscious public, it would be beneficial in the United States and in other countries to have a comprehensive plan to make health promotion and disease prevention personal and societal priorities. I have called this climate a 'culture of character', a climate of individual responsibility to encourage healthy behaviour. I want to encourage the readers of Medical Education to participate in the formulation of plans to implement greater health promotion and disease prevention efforts. Such a climate of personal responsibility could be created if doctors, educators and policy-makers agreed on some workable, positive goals and steps that would help meet realistic national goals over a defined period of time. If there were such agreement, then doctors could more clearly focus their own efforts with their patients, in concert with other health professionals, and with policy-makers who have the same goal--healthier people.

Health Planning↗

Strengthening the role of primary health care in health promotion by bridging cultures in aboriginal health.

This paper advocates strengthening the role of primary health care in health promotion by bridging cultures in Aboriginal health. It encourages health care providers to consider the need for cross-cultural awareness in order to provide more effective health promotion. It suggests a number of strategies for overcoming structural barriers and individual factors which may hinder positive personal and professional cross-cultural communications.

Attitude of Health Personnel↗

An oral health promotion module for the primary health care nursing course in Acornhoek, South Africa.

The severe personnel shortage in the health professions in most developing communities is well documented. This dearth of health workers and the widespread adoption of the primary health care approach (PHCA), requires that health professionals be trained to understand and effectively utilize the skills offered by other disciplines in the health care field. Nurses are expected to play active roles in the promotion of health including oral health, particularly in the rural under-served communities. There is a paucity of oral health education in nursing curricula. This article describes a 4-day module on oral health promotion developed and delivered to 36 nurses as part of a 12-month primary health care nursing (PHCN) training course. The module utilized a variety of educational methods and materials to facilitate and encourage both individual and group learning. The module was evaluated using both student academic attainment and perceptions as outcome measures. The evaluation and the experience of facilitating this module show that an oral health promotion module of short duration can sensitize nurses to the importance of oral health and increase oral health knowledge and skills.

Curriculum↗

Health, health promotion and the elderly.

Health promotion is a mode of practice which is being increasingly examined by policymakers (DHSS, 1987; DoH, 1992). Although practitioners are being required to screen people over 75 years of age and are exhorted to reduce accidents in the elderly by 33% between 1990 and 2005 (DoH, 1992), there is evidence that they do not value this sort of work (Pursey & Luker, 1993). This paper looks at the findings from 178 interviews with people aged over 75 years, examining the importance of health and health promotion to the elderly. Further to the work of Cox et al. (1987), it is clear that people aged over 75 years continue to engage in a wide variety of activities which are designed to keep or improve their health. Elderly people's accounts of their health suggest that the real influence of social circumstances and environment must be assessed and planned for if health promotion activity is to have relevance and meaning to this group of people. Evidence is presented which indicates that the elderly are a group of people who would welcome health-promotion activity provided it is given in easily accessible forms. The notion of client participation is highlighted as a difficult area, which is likely to require particular skill in working with elderly clients. In the light of these findings, practitioners may need to examine their own attitudes to their work with the elderly.

Aged↗

Transgenerational health promotion.

The Adult Health and Development Program (AHDP) is an intergenerational, interdisciplinary health promotion and rehabilitation program in which nursing and other college students are paired with older adults to engage in activities to improve their health and well-being. The purpose of this article is to describe resources and strategies used to implement a new program. The University of Delaware's program uses the ACAEM Paradigm developed by the AHDP at the University of Maryland where the program has existed for 27 years. However, the University of Delaware emphasizes the concepts of transition as described by Schumacher and Meleis and adult learning theory. Older adults are often the most open to education and other forms of support when they need help in making a change or transition in their lives. Schumacher and Meleis contend that transitions are a central concept in nursing and propose a model of transition in which education is the primary modality for preparing for transitions. The model also specifies ways to measure desirable transition outcomes.

Adaptation, Psychological↗

WHO Health Promotion Glossary: new terms.

The WHO Health Promotion Glossary was written to facilitate understanding, communication and cooperation among those engaged in health promotion at the local, regional, national and global levels. Two editions of the Glossary have been released, the first in 1986 and the second in 1998, and continued revision of the document is necessary to promote consensus regarding meanings and to take account of developments in thinking and practice. In this update 10 new terms that are to be included in the Glossary are presented. Criteria for the inclusion of terms in the Glossary are that they differentiate health promotion from other health concepts, or have a specific application or meaning when used in relation to health promotion. The terms defined here are: burden of disease; capacity building; evidence-based health promotion; global health; health impact assessment; needs assessment; self-efficacy; social marketing; sustainable health promotion strategies, and; wellness. WHO will continue to periodically update the Health Promotion Glossary to ensure its relevance to the international health promotion community.

Cost of Illness↗

[Tridimensional evaluation model of health promotion in school -- a proposition].

A good school health programme can be one of the most cost effective investments for simultaneously improving education and health. The general direction of WHO's European Network of Health Promoting Schools and Global Schools Health Initiative is guided by the holistic approach and the Ottawa Charter for Health Promotion (1986). A health promoting school strives to improve the health and well-being of school pupils as well as school personnel, families and community members; and works with community leaders to help them understand how the community contributes to health and education. Evaluation research is essential to describe the nature and effectiveness of school health promoting activity. The overall aim of this paper is to help school leaders and health promotion coordinators to measure their work well and effectively. The specific aim is to offer a practical three-dimensional evaluation model for health promoting schools. The material is presented in two sections. The first one is a 'theoretical base' for health promotion which was identified from broad based daily health promotion practical activities, strategies and intersectional interventions closely related to the philosophy of the holistic approach. The three dimensions refer to: 1. 'areas' -- according to the mandala of health. 2. 'actions' -- according to Ottawa Charter strategies which should be adapted to the local school networks. 3. 'data'-- according to different groups of evidence (process, changes and progress). The second one, as a result of the mentioned base, represents the three 'core elements': standards, criteria and indicators. In conclusion, this article provides a practical answer to the dilemma of the evaluation model in the network of local school environment. This proposition is addressed to school staff and school health promotion providers to make their work as effective as possible to improve pupils health. Health promoting school can be characterized as a school constantly strengthening its capacity as a healthy setting for learning and working. But only proper documentation of progress and evidence base procedures related to local networks can prove the constructive work of people and create progress and partners for the development of health in schools.

Child↗

Factors associated with participation in a senior health promotion program.

The health status and life-style characteristics of participants in a senior health promotion program were compared with those of nonparticipants from the same HMO enrollee population. Nonparticipation was associated with lower income, less education, and lower involvement in community organizations. Although nonparticipants smoked more and evaluated their health less favorably than did participants, other risky behaviors and health status indicators differed little between the groups.

Aged↗

Examination of risk status transitions among active employees in a comprehensive worksite health promotion program.

Most worksite health promotion programs are designed to effect risk reduction. Net changes in the prevalence of health behaviors are a combination of individuals who reduce to low-risk and those who become high-risk. It is the purpose of this study to examine overall risk status transitions, between low-risk (0-2 risks); medium-risk (3-4 risks); and high-risk (5 or more risks), within a comprehensive worksite health promotion program over the first year of the program (short-term) and after 5 years (long-term). Significant increases were demonstrated in the numbers of individuals who transitioned to lower risk status. Nearly half (0 percentage points) of the net reduction to low-risk status (+10.4 percentage points) occurred during the first year of the program. The design of health promotion programs may need to be adjusted from risk reduction in the short-term to programs that maximize retention of individuals within low-risk categories over the long-term. This program design would maximize the opportunity to obtain initial risk reduction during the first years of the program and then maximize the opportunity to maintain low-risk status in the long-term.

Adult↗

A community health promotion partnership model: the South Carolina health connection.

Over a five year period, the South Carolina Health Connection Project has evolved to multi-site, multi-organization community-base collaborative initiative. From this project over $60,000.00 in funds have been secured. However, when costing the human resources and many other in-kind contributions involved in the SCHC Projects activities, the Project can modestly be valued at nearly $200,000.00. The efforts of a few have been shared with others, who also shared the resources with others, and the health promotion empowerment cycle continues. We believe the South Carolina Health Connection is an exemplary of a Community Health Promotion Partnership Model. We hope you will agree!

Adolescent↗