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PubMedDate not supplied

Measuring the diffusion of innovative health promotion programs.

Once a health promotion program has proven to be effective in one or two initial settings, attempts may be made to transfer the program to new settings. One way to conceptualize the transference of health promotion programs from one locale to another is by considering the programs to be innovations that are being diffused. In this way, diffusion of innovation theory can be applied to guide the process of program transference. This article reports on the development of six questionnaires to measure the extent to which health promotion programs are successfully disseminated: Organizational Climate, Awareness-Concern, Rogers's Adoption Variables, Level of Use, Level of Success, and Level of Institutionalization. The instruments are being successfully used in a study of the diffusion of health promotion/tobacco prevention curricula to junior high schools in North Carolina. The instruments, which measure the four steps of the diffusion process, have construct validity since they were developed within existing theories and are derived from the work of previous researchers. No previous research has attempted to use instruments like these to measure sequentially the stages of the diffusion process.

Adolescent↗
PubMed2001

[Nutritional consideration for changes in dietary habit and health promotion practices in community health care; from the view point of selenium].

The Japanese recommended dietary allowances (RDA) for major and some minor nutrients were revised in 1999, and included those for trace elements such as selenium. The requirement of selenium in animals was first recognized in 1957. It has been shown that cellular glutathione peroxidase (GPx) contains selenium but it was subsequently revealed that selenium has diverse biochemical effects, rather than simply functioning in the enzyme. At least twelve different selenoproteins have been identified. The role of selenium has been known as antioxidant, and non-antioxidant mediated through these enzymes. Now, selenium is well recognized as a preventive factor for cancer and cardiovascular diseases. Several dietary studies have shown that the selenium intake in Japan is adequate. One study estimated daily selenium intake to be 104.2 micrograms/day for adults. This value was 2 or 3 times higher than the lower limit of the safe range of dietary selenium (40 micrograms/day for men and 30 micrograms/day for women) estimated by WHO, and also exceeded the newly established RDA of 55-60 micrograms/day for men and 45 micrograms/day for women by the Japanese Public Health Council. However, the established RDA for selenium is tentative because of a lack of information on the 1) chemical forms of selenium in food, 2) differences in absorption rate and bio-availability in the chemical forms, and 3) interactions with other metals and trace elements. There are two potential problems concerning selenium nutrition in Japan. The first problem is that rice, which is the Japanese staple food, contains less than 0.05 microgram/g selenium whereas U.S. rice contains more than 0.3 microgram/g, probably due to differences in soil chemistry. The second problem is that although studies have shown that seafood, fish, shellfish and oysters, contain high levels of selenium (0.4-0.5 microgram/g), these being the main selenium source for Japanese, the bio-availability in fish is low. Thus, it is likely that the selenium status of those Japanese who eat an imbalanced diet is not sufficient or is not optimal even if the intake exceeds the RDA. Further studies are needed so that community health care specialists have available appropriate knowledge on the role of trace nutrients, including selenium, in human nutrition and health, to promote proper nutritional practices in the community.

Adolescent↗
PubMedDate not supplied

Restructuring public health in Ontario: implications for heart health promotion.

Community-based heart health promotion is viewed as an effective means of reducing cardiovascular disease risk. Although public health agencies have a central role in the implementation and dissemination of heart health programmes, their effectiveness is being challenged by major structural changes to Provincial public health systems across Canada, although the impacts of the changes have received relatively little attention in the research literature. As part of the Canadian Heart Health Initiative--Ontario Project (CHHIOP), this study used a qualitative approach to address the perceived implications of these changes to Ontario's public health system for heart health promotion. Interviews (n = 38) were conducted in eight public health units with staff most familiar with managing and/or delivering heart health activities. The results are mixed; that is, while many see the future of heart health promotion programming in Ontario as being at risk, others see recent changes as a step forward toward their institutionalization, particularly in light of recent funding decisions made by the Ministry of Health's Health Promotion Branch.

Female↗
PubMed1995

[Health promotion in Polish schools].

The health of the people is the basis of prosperity and development of the country. In 1986 the Ottawa Charta was resolved. Poland has already adopted the concept of the "health promoting# school in 1992. Promotion of health is a process whereby the population can achieve better control of their health status. The educational reform in Poland explored three avenues: health education, ecology, and social behaviour. The modern and manifold programmes of health promotion and ecology in schools are being realised, taking into consideration all the aspects of health care and protection of the environment, healthy style of living, responsibility for one's own health, knowledge of all disciplines of health. The author outlines the procedures and their course, describes the methods and assesses profits and results

Adolescent↗
PubMedDate not supplied

A television format for national health promotion: Finland's "Keys to Health".

A series of televised risk reduction and health promotion programs have been broadcast in Finland since 1978. The five series of programs were the product of a cooperative effort by Finland's television channel 2 and the North Karelia Project. The series has featured a group of volunteers who are at high risk of diseases because of their unhealthful habits and two health educators who counsel the studio group and the viewers to make changes in health behaviors. The "Keys to Health 84-85" was the fifth of the series and consisted of 15 parts, 35 minutes viewing time each. Results of the evaluation surveys, which are presented briefly, indicate that viewing rates were high. Of the countrywide sample, 27 percent of men and 35 percent of women reported that they had viewed at least three parts of the series. Reported changes in behaviors were substantial among the viewers who had seen several parts of the series and were meaningful, overall, for the entire population. Of the countrywide sample, 7.1 percent of smoking viewers reported an attempt to stop smoking--this number was 3.6 percent of all smokers. The percentages of weight loss among viewers and the total population sample were 3.9 for men and 2.1 for women. The reported reductions in fat consumption were 27.2 percent for men and 15.0 percent for women. The reported effects in the demonstration area of North Karelia were even higher, mainly because of higher viewing rates.

Body Weight↗
PubMed1998

Creative educational strategies for health promotion.

The dramatic changes in health care delivery present challenges to nurses in practice and to the educators who must prepare professional nurses for the uncertain world of tomorrow's managed care environment. In light of the increased emphasis on health promotion occurring with current changes in health care, the article proposes numerous creative strategies that nurse educators can use to prepare students to fulfill their health promotion responsibilities effectively. The concepts of health promotion and creativity are examined, and teaching approaches needed to facilitate community-based, health promotion-focused activities are presented. Specific strategies, particularly clinical teaching/learning opportunities, are suggested.

Creativity↗
PubMed1995

Who should give lifestyle advice in general practice and what factors influence attendance at health promotion clinics? Survey of patients' views.

BACKGROUND: Health promotion activity in general practice has increased greatly since 1990. A large proportion of this work is undertaken by practice nurses. Little is known about patients' views about the providers of health promotion or their views about general practice health promotion clinics. AIM: A study was carried out in 1992 to determine patients' views about the provision of health promotion advice by general practitioners and practice nurses and their views about attending health promotion clinics. METHOD: A postal questionnaire was sent to a random sample of 1750 patients aged 16 years and over from five general practices in south Tyneside. The questionnaire explored patients' preferences regarding health promotion advice from the general practitioner or practice nurse in relation to four areas of lifestyle advice and factors that might encourage patients to attend a health promotion clinic. RESULTS: A response rate of 75% was obtained from 1639 eligible patients. Receiving health promotion advice from either the general practitioner or the practice nurse was the most commonly preferred option expressed by patients overall. The ability of health promotion clinic staff to deal with patients' concerns about their illness and short waiting times were more likely to influence patients' attendance at health promotion clinics than the presence of a general practitioner or practice nurse. CONCLUSION: In the present study, many patients found health advice received from practice nurses and general practitioners equally acceptable. However, it was the ability of health professionals to respond to patients' health concerns in the health promotion clinic rather than the type of health professional running the clinic that was important for patients.

Adolescent↗
PubMed2005

Development of a collaborative model to improve school health promotion in The Netherlands.

In recent decades, school health promotion programs have been developing into whole-school health approaches. This has been accompanied by a greater understanding among health promoters of the core-business of schools, namely education, and how health promotion objectives can be integrated into this task. Evidence of the positive impact of school health promotion on health risk behavior of students is increasing. This article focuses on the processes and initial results of developing a collaborative model tailored for whole-school health in the Netherlands, named schoolBeat. The Dutch situation is characterized by fragmentation, a variety of health and welfare groups supporting schools, and a lack of sound integrated youth policies. A literature review, observations, and stakeholder consultation provided a clear picture of the current situation in school health promotion, and factors limiting a comprehensive and needs-based approach to school health. This revealed that a health promotion team within a school is fundamental to an effective approach to tailored school health promotion. A respected member of school staff should chair this team. To strengthen the link with the school care team, the school care coordinator should be a member of both teams. To provide coordinated support to all schools in a region, participating organizations decided to share advisory tasks. These tasks are included in the regular health promotion work of their staff. This means working with one advisor representing all school-health organizations per school, and using a comprehensive overview of possible support and projects promoting health. Empowering schools in needs assessments and comprehensive school health promotion is an important element of the developed approach. This article concludes with an examination of emerging issues in evaluating collaborative school health support during the first 18 months of development, and implementation and future perspectives regarding sustainable collaboration and quality improvement.

Cooperative Behavior↗
PubMedDate not supplied

Supporting health promotion in adults with cancer.

Health promotion includes motivating people to embrace behaviors that both improve their emotional and physical quality of life and reduce their risk for premature morbidity and mortality. Although the majority of adults treated for cancer in the United States live free of disease for many years, many survivors experience lasting side effects and complications of treatment. Others encounter recurrences or new cancers that require additional treatment. Cancer is an incentive for many survivors to make health-promoting lifestyle changes. This article delineates the need for health promotion among adult cancer survivors, describes a cancer support model that facilitates personal behaviors that promote health, and discusses design implications for cancer supportive services.

Adult↗
PubMed1998

Development of a health promotion system for the elderly: Committee of Health Evaluation for Elderly Persons Council of Japan AMHTS Institutions.

A new health promotion approach for elderly persons is required which maintains not only their physical health but also their quality of life. We are developing a health promotion system which makes use of questionnaires dealing with physical conditions and quality of life, and makes health reports. Health evaluation is carried out in three steps. First, detailed information about the physical health of each client is collected. Second, quality of life is evaluated according to five health indicators. Last, health recommendations are generated. An artificial intelligence (AI) program produces detailed questions to collect necessary information for the evaluation of a client's health. The information related to quality of life is converted into five health indicators and presented as a radar-chart in documents and displays. The knowledge-based AI program automatically generates the health recommendation documents. This information is available for physicians and nurses for health counseling.

Aged↗
PubMed1999

Expanding health promotion to individuals with spinal cord injuries.

Health promotion and preventive health services, though related, are not synonymous. Unlike preventive services, health promotion reaches beyond a specific action or inaction and nurtures a positive lifestyle. Many nurses believe in providing preventive health services to clients with spinal cord injuries (SCI) but describe them as clients who "will never get well." Nurses then question the relevance of health promotion services to those with SCI. This limited perspective fails to acknowledge that many individuals with physical disabilities perceive themselves as healthy. They know how to manage their disabilities and want to learn more about how they can actualize their potential in the context of their physical disabilities. Attitudes, overt or covert, that fail to recognize these individuals potential for health add to the disenfranchisement that they experience daily from society. This disenfranchisement often leads to hopelessness, anger, and depression. None of these emotions fosters health or happiness. The nurse who forges into health promotion expands his/her practice beyond the traditional "fix a problem" role. In the health promotion setting, the nurse's influence must move beyond preventing a specific complication and impact the more global outcome of promoting lifestyle choices, habits, and attitudes.

Activities of Daily Living↗
PubMed1995

The implementation of health promotion: a new structural perspective.

Although health promotion has become a critical concept in public health, both research and practical projects in this area are almost devoid of theory. The present article uses a theory of complexity and structure to organize the different elements of health promotion in a new perspective. This perspective involves (1) new ways for looking at patterns of behavioral risk factors and health-related lifestyles. It (2) relates health promotion to policy making. In particular, it (3) focuses on a comprehensive model of the implementation process, revealing the true interrelationship of relevant elements to the concept of health promotion. In this context, it (4) becomes obvious that the reflexivity and recursiveness of scientific analyses are an integral part of the structure of health promotion. Thus, the professional role of the social scientist with regards to the implementation and utilization of scientific knowledge in the field of public health policy will be discussed. Finally, the role of appropriate theory is emphasized as a strategy for improving the practice of health promotion and to further the development of a new public health.

Forecasting↗
PubMed1992

Health promotion for older people.

Health promotion for older people, or preventive geriatrics, has the potential to transform people's lives by providing greater satisfaction and by reducing both physical and psychological ill health. General practitioners are key personnel in any health promotion programme but should, ideally, co-ordinate their activities with other health professionals. The basic tool for general practitioners is a screening programme for all older people and for people at special risk.

Activities of Daily Living↗
PubMed2002

Emerging theories into the social determinants of health: implications for oral health promotion.

In recent years public health research has increasingly focused upon exploring the social determinants of health. This interest has partly arisen through an acknowledgement of the limitations of educational preventive approaches in improving population health and reducing health inequalities. Many health education interventions have been influenced by health behaviour research based upon psychological theories and models. These theories focus at an individual level and seek to explore cognitive and affective processes determining behaviour and lifestyle. Current psychological theories have only a limited value in the development of public health action on altering the underlying social determinants of health. New theoretical approaches have however, emerged which explore the relationship between the social environment and health. This paper aims to review and highlight the potential value to oral health promotion of three important public health theoretical approaches: life course analysis, salutogenic model and social capital. It is important that an informed debate takes place over the theoretical basis of oral health promotion. As the field of oral health promotion develops it is essential that it is guided by contemporary and appropriate theoretical frameworks to ensure that more effective action is implemented in the future.

Adaptation, Psychological↗
PubMedDate not supplied

Quality assessment in worksite health promotion.

The rapid expansion of worksite health promotion programs and the proliferation of service providers have resulted in increased concern about the quality of such programs. And while employers may view health promotion programs as a service to be purchased, in general, quality standards, price, and outcomes are less well established for primary prevention programs than for other medical services. This trend creates substantial potential for inappropriate expenditures, undermining the general credibility of such programs. Recognizing the limits of epidemiologic data and the potential for misuse of health promotion activities in the workplace, the California Department of Health Services (CDHS) undertook the development of guidelines for employers' use in assessing the quality of the numerous employee health promotion or chronic disease risk reduction programs available to them. To make the use of such programs as productive as possible, the CDHS developed recommendations in two main areas: (1) general recommendations for six fundamental program planning and development activities that underlie sound health promotion programs, and (2) specific criteria for seven types of health promotion programs commonly implemented in work settings. Optimally, worksite-based health promotion programs should be part of a comprehensive effort that provides for appropriate medical oversight, referral, and follow-up procedures. These programs should be complemented by appropriate changes in the work environment and in organizational policies. Programs should also include strategies to assist employees in initiating healthier behaviors and maintaining the new behaviors once they are established. Preventive medicine and occupational medicine practitioners and medical directors should be familiar with the issues addressed by these recommendations.

California↗
PubMed1992

Exercise beliefs and behaviors among older employees: a health promotion trial.

This health promotion trial included university faculty and staff aged 50 to 69 who had completed a health risk screening. Predictors of intention to exercise were education, gender, self-efficacy, outcome expectancy, perceived barriers, and baseline exercise frequency. Baseline exercise frequency was the only predictor of exercise behavior 1 year later.

Aged↗