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Long-term care: a health promotion challenge.

There is a lack of health promotion for the elderly residing in long-term care facilities. It becomes imperative therefore for the nursing profession to readjust its thinking and practice to include health promotion strategies and interventions for institutionalized elderly in the long-term care sector. From using the empowerment theory in the discussion it is clear that nurses can help the elderly receive health promotion strategies and interventions to help the older person make informed choices about their lifestyle, health and treatment. The elderly population continues to grow and more than likely will spend some part of their life in a long-term care setting. Evidence from studies performed by Robertson (1991), Caserta (1995), Phillips (1994) and McBride (2000) suggests that health promotion efforts positively correlate with improved physical and psychological elements of health for the elderly. Nurses largely determine the kind of care that is given and thus can influence the quality of life that elderly client's experience. By advocating for health promotion interventions and strategies for their elderly clients, nurses are demonstrating to the community, their patients, and institution that nurses do have the power to make and influence change for the better. Nurses advocating for health promotion for their elderly patients not only empower choice, but also create an active and involved elderly population. Health promotion exists at all stages of life and does not cease when one is admitted to a long-term care facility (Hutchings, 1999; McBride, 2000).

Aged↗

Workplace health promotion and utilization of health services: follow-up data findings.

This article reports findings from a workplace substance abuse prevention program designed to investigate best practices. The study sought to assess the effects of the worksite wellness program and employee assistance program (EAP) on healthcare utilization and costs, identify predictors of outpatient costs and visits, and assess the effect of the intervention on health attitudes, behaviors, and behavioral health-related costs and visits. Results indicated that visits to the EAP increased as did overall healthcare visits, that utilization of healthcare services and costs were higher in the population receiving substance abuse prevention intervention, and that employees in the substance abuse prevention intervention reported lower heavy drinking and binge drinking. Data suggest that substance abuse prevention may result in higher healthcare costs and utilization in the short term, but a reduction in health risk behaviors such as heavy drinking may result in lower healthcare costs and utilization in the long term.

Adult↗

Determinants of health-promoting lifestyle in ambulatory cancer patients.

The Health Promotion Model was tested as an explanatory framework for health-promoting lifestyle in a sample of 385 ambulatory cancer patients undergoing treatment in 13 clinical sites in the midwestern United States. The aim of this study was to determine the extent to which cognitive/perceptual and modifying variables identified in the Health Promotion Model explain the occurrence of health-promoting behaviors in adults with cancer. A secondary aim was to determine the potential of illness-specific cognitive/perceptual and modifying variables for further explaining the occurrence of health-promoting behaviors in adults with cancer. Multiple regression analyses revealed that 23.5% of the variance in health-promoting lifestyle was explained by the model cognitive/perceptual variables definition of health, perceived health status and perceived control of health and the modifying variables education, income, age and employment. When illness-specific variables were included in the analysis, initial reaction to the diagnosis of cancer was found to be a significant contributor to the regression. Study results support the importance of both general health-related and cancer-specific cognitive/perceptual factors in explaining the occurrence of health-enhancing behaviors among ambulatory cancer patients; these factors may therefore be suitable targets for interventions to encourage adoption of healthy lifestyles.

Adult↗

[Public participation and empowerment in Health Promotion].

BACKGROUND: A new model for Health Promotion was proposed by WHO in 1986. PURPOSE AND METHOD: The purpose of this paper is to review public participation and empowerment in Health Promotion by reviewing case reports and original papers. RESULTS: The main results can be divided into two categories, public participation, and empowerment, The main results are as follows; 1) Health promotion involves the population as a whole in their everyday lives, rather than focusing on people who are sick or at risk for specific diseases. 2) The use of participatory and empowering approaches in the evaluation process has the potential to strengthen the public's capacity for organizational learning and improve their own health status. 3) It is possible to improve health conditions by using empowerment interventions: 1. The need to adopt an ecological approach that simultaneously addresses empowerment. 2. Policy-makers need to take a longer-term approach to empowerment interventions, including proper longitudinal studies to enhance the evidence base for such interventions. 4) Satisfaction is central to the delivery of health and human services. The most critical factor in service delivery is providing quality care and user merit. 5) In developing people-oriented health technologies, priority should be given to the availability of lay resources and to indigenously developed health practices. 6) Empowerment is the most important idea within health promotion. It is often a difficult concept for health professionals to grasp since most have been trained to consider health care providers as experts and the patient as a recipient of this expertise. 7) Health care specialists can contribute considerably to the development of a collaborative, family-oriented approach in the development of self care. The possibilities for such an undertaking depend on the establishment of working relationships at two interfaces: between the health care specialist and his/her client families. A framework for developing these relationships is proposed: involvement, collaboration, and empowerment. 8) The individual should also be given a greater opportunity to actively participate in the design and planning health care services. 9) In the Health Promotion program, it is important to provide a working and living environment in which respect for each other's humanity can be shared.

Community Participation↗

[Briefly about health promotion].

The rapid development of public health and medicine started in the second half of the 19th century leading to a massive decline or disappearance of previously deadly communicable diseases. However, almost parallel to this process, chronic non-communicable diseases appeared and have become widespread in the populations of developed countries presenting a new challenge for public health. 'New public health' and health promotion emerged representing new ways of thinking and approaches as a societal answer to population health problems. The Ottawa Charter, the decisive document of health promotion laid the ground for health promoting activities, naming healthy public policy, supporting environments, community actions, personal skills and and reoriented health services as major fields of action towards improving population health. The article describes examples for these actions and how they are related to health, and provides ideas as to how medical practitioners can contribute to the global common goal of health promotion and medicine.

Delivery of Health Care↗

The purpose-process gap in health promotion [corrected].

In the development of health promotion theory to date insufficient attention has been paid to the question 'What is the end to which health promotion is directed?' A distinction can be made between purpose (end) and process (means to end) and if no clear account of purpose exists to illuminate how process contributions relate to its achievement, then health promotion's claim to be a practical discipline is weak. Although 'well-being' is frequently cited as the essence of health promotion, a view of 'well-being' which goes much beyond the intuitive has yet to emerge. Retention of 'well-being' as purpose requires a specific account which allows health promotion's claim to practicality to be clearly demonstrated. In discussing the form such an account would need to take, purely hedonistic conceptions of 'well-being' are discounted and the development of an 'objective' account, in which 'capacity for self direction' would form the key focus, is suggested.

Health Promotion↗

Information services and health promotion. What libraries can do.

Effective health promotion depends on a broad information base and with the help of new technology, librarians are responding to the challenge. Robert Gann introduces a new series of articles by health information specialists which describe some of the information services available in the field of health promotion, and suggest ways in which they may best be used.

Diffusion of Innovation↗

[Health-Promoting Schools Regional Initiative of the Americas].

In Latin America, comprehensive health promotion programmes and activities are being implemented in the school setting, which take into account the conceptual framework of the Health-Promoting Schools Regional Initiative of the Pan American Health Organization, Regional office of the World Health Organization (PAHO/WHO). These programmes help to strengthen the working relationships between the health and education sectors. The Health-Promoting Schools Regional Initiative, officially launched by PAHO/WHO in 1995, aims to form future generations to have the knowledge, abilities, and skills necessary for promoting and caring for their health and that of their family and community, as well as to create and maintain healthy environments and communities. The Initiative focuses on three main components: comprehensive health education, the creation and maintenance of healthy physical and psychosocial environments, and the access to health and nutrition services, mental health, and active life. In 2001, PAHO conducted a survey in 19 Latin American countries to assess the status and trends of Health-Promoting Schools in the Region, for the appropriate regional, subregional, and national planning of pertinent health promotion and health education programmes and activities. The results of this survey provided information about policies and national plans, multisectoral coordination mechanisms for the support of health promotion in the school settings, the formation and participation in national and international networks of Health-Promoting Schools and about the level of dissemination of the strategy. For the successful development of Health-Promoting Schools is essential to involve the society as a whole, in order to mobilise human resources and materials necessary for implementing health promotion in the school settings. Thus, the constitution and consolidation of networks has been a facilitating mechanism for the exchange of ideas, resources and experiences to strengthen the work and commitment of all involved with the strategy. The Latin American and Caribbean Networks of Health-Promoting Schools were created to promote these exchanges and to support the integration of the national networks, to constitute multidirectional channels of communication that are linked and that converge for the improvement of education and health in the school setting. Networks meetings have been held between 1996 and 2004, where the work and topics of priority and interest have been addressed, methodologies have been disseminated, good practices have been shared, and National Commissions and participants have been strengthened. This article synthesises successful examples of countries that reflect health promotion activities in the school settings, as well as the development of Networks. It also notes the future prospects for strengthening the Health-Promoting Schools Regional Initiative.

Data Collection↗

Health care and health promotion in southern Italian communities.

Health promotion projects may be regarded as responses to insufficient health care in Europe, where modern health problems, consumer needs, participation and life quality are neglected. In Southern Italy and especially in Naples the situation is particularly difficult (poverty, poor accessibility of health care, high infant mortality, epidemics etc.); nevertheless there exist elements of everyday life which are advantageous for health promotion. The health projects described started around Naples in the 'seventies. They focused on the psychosocial problems of marginalized people (elderly people, women, mentally and physically handicapped men, big families etc.). Different elements of health care (prevention, primary health care, health education), social work and political and cultural activation were linked together in the local centres of social medicine. Thus the accessibility of health care was improved, social distance between suppliers and users reduced, and poor and disadvantaged people better integrated into the social life of the community. One important step in the realization of such aims was the stimulation of politically and socially defined homogeneous target groups with similar interests and needs. The specific measures, organizational structures and the personal staff are directed to these target groups in an integrated way. They are based on the teamwork of different professions and cooperation with other related organizations, and they include explicitly political, social and cultural activities, different from the self-help activities related only to health in most of Central Europe.(ABSTRACT TRUNCATED AT 250 WORDS)

Community Health Centers↗

[Developing a health mind-set--description of caritative health promotion].

This investigation describes health promotion from a caring science perspective. Caring is defined as an act of "caritas" c.e. love and mercy (Eriksson 1991). The investigation is theoretical and comes as a result in a model for health education. The model will be empirically tested in the future further on. The research method is qualitative and descriptive consisting of three processes: the abductive, deductive and inductive. This method was created by Charles Peirce (1839-1914). The inductive process will be implemented by testing the model. Abduction is the process of forming an explanatory hypothesis. The abductive hypothesis of this investigation is formed in the following way: "the kind of mood od mind, the kind of health". Main emphasis has been in examining the meaning of the mood of mind for ones health and the possibilities to develop it. The following question were asserted; 1. What is meant by the mood of mind? 2. What attributes are required in order to talk about health's mood of mind? 3. What are the possibilities of developing the mood of mind as a way for health education? The result of this investigation is presented as a model for health promotion. The model is upbuilt by the caritative elements featuring belief, hope, love and the concept of virtue. The model shows the consequences for a human beings daily living. In the case of having too much belief a human being may develop some kind of health fanatism. In the case of having too much belief a human being may develop some kind of health fanatism. In the case of having too much hope a human being puts forward the decisions about health for tomorrow. In the case of having too much love it may lead to a irresponsible lifestyle. An assumption is that a balance between belief, hope and love leads in choosing health, planning for health and living in health.

Attitude to Health↗

The role of Project 2000 educated nurses in health promotion within the hospital setting.

This study is concerned with the role of Project 2000-educated nurses in health promotion within the hospital setting. Historically nurses have been viewed as having a role to play in promoting the health of the people for whom they care. More recently, with the advent of the Health For All Movement initiated by the World Health Organization in 1978, the attention has again been focused on what nurses can do towards attainment of this goal, although most of the research has been carried out in relation to community nurses and primary care. Changes in nurse education, specifically that of Project 2000 nurse education, have been hailed as the opportunity to equip nurses with knowledge and skills appropriate to the task, which have been seen as lacking from many nurse educational programmes. Early work on this issue has produced conflicting findings as to the success of these educational changes. This study used an exploratory, qualitative approach to investigate what aspects of health promotion in the hospital setting are being carried out by nurses who have undergone Project 2000 nurse education within a college of nursing and midwifery in Scotland, and whether these nurses feel that they have been adequately prepared for this role during their educational programme. Findings suggest that the nurses interviewed were working with very wide perceptions of health promotion which included the more radical aspects of health promotion such as negotiation, collaboration and empowerment. Health promotion was also seen to include psychosocial factors that influence the health of individuals. The nurses interviewed in general felt that their education had prepared them for a role in health promotion. The value of clinical placements in facilitating the developing the skills for health promotion was established.

Attitude of Health Personnel↗

Safety belt use and related health variables in a worksite health promotion program.

Few corporate-based health promotion programs address a major preventable killer that strikes American workers--motor vehicle crashes. The use of vehicle safety belts is a known and effective prevention measure yet few workers use them. Very little research has been done on safety belt use as a health behavior, particularly as it relates to a corporate health promotion program. Data from an Employee Health Survey on 3,947 employees at Control Data Corporation were examined in 1982-83 to determine the relationship between safety belt use and other health habits. Comparisons between participants in the Stay Well Program (a health promotion program) and nonparticipant and control groups were analyzed. Users of safety belts reported more moderate use of alcohol, better exercise habits, less smoking and were less likely to be overweight than nonusers. Among Stay Well employees completing a Health Risk Profile, higher levels of safety belt use were reported. Recommendations are made which have implications for the design of safety belt motivation programs within the context of worksite health promotion.

Attitude to Health↗

Selected predictors of health promotion counseling by three groups of allied health professionals.

Three groups of allied health professionals, including dental hygienists, dietitians, and certified nurse-midwives, were surveyed to determine current practice, beliefs, and attitudes regarding health promotion and disease prevention. The study aimed to explore the power of selected variables drawn from social learning theory in predicting self-reported level of counseling. We conducted separate analyses for 10 areas of health promotion and disease prevention: high blood pressure, smoking, lack of exercise, overweight, high-fat diet, alcohol abuse, illicit drug use, stress, isolation and loneliness, and nonuse of safety belts. The predictor variables were respondents' professional group membership, confidence that they possess appropriate skills and knowledge to counsel patients (self-efficacy), belief that patients will follow through on recommendations (adherence expectation), and belief that reduction of risk will improve patients' health status (expectation of health impact). The level of counseling activity varied markedly across the risk areas, with blood pressure and weight receiving the most emphasis on average and isolation and loneliness and nonuse of safety belts receiving markedly less attention. There also was variation across the professional groups. Certified nurse-midwives had higher mean counseling scores in all topics except those related to diet, where the dietitians' mean scores were approximately the same. Of all the areas about which counseling might be increased, use of safety belts stands out as having the lowest reported prevalence, the least complexity in terms of implementation, and the most relevance to at least two of the professional groups. These findings suggest the importance of skills training, including the provision of actual or simulated counseling experience and modeling by others in the same professional group.(ABSTRACT TRUNCATED AT 250 WORDS)

Allied Health Personnel↗

Lessons from a review of publications in three health promotion journals from 1989 to 1994.

A thematic analysis was undertaken of 72 editorials in three leading health promotion journals, Health Education Research: Theory & Practice, Health Education Quarterly and Health Promotion International, from 1989 to 1994. The three main themes which emerged were (1) the need to broaden health promotion interventions, (2) the need to promote rigour and professionalism in the discipline of health promotion, and (3) the need to respond to the information requirements of practitioners. Against this context, we conducted a content analysis of the journals, examining the nature of the 649 peer-reviewed publications in the same time period. Categories from the traditional bio-medical 'stages of research' models had to be adapted before full classification of articles published was feasible. The largest number of articles published could be termed descriptive research, followed by studies developing and validating health promotion measurement tools and health promotion theory. The proportion of program evaluations was small and the proportion of randomized controlled trials ('highest quality evidence' of effectiveness) decreased over time. Dissemination studies were also poorly represented in spite of this being identified in editorials as an important professional need. Ways to redress some of the imbalances observed are discussed.

Bibliometrics↗

Dissemination of community health promotion programs: the Fargo-Moorhead Heart Health Program.

Dissemination often is the neglected phase of the development and distribution cycle. While attention has focused on developing and testing new health education and health promotion programs, relatively little effort has been placed on studying how the programs can be disseminated. This paper reviews the dissemination process, identifies factors critical to successful dissemination, uses examples from a community-based heart disease prevention study to illustrate how health promotion programs can be disseminated across a community, and suggests ways these methods might be applied to a community-based approach to adolescent drug use prevention.

Adolescent↗