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Determinants of health-promoting lifestyles in adolescent females.

The relationship between health-promoting lifestyle and definition of health, perceived health status, self-efficacy, maternal and paternal health-promoting lifestyle, and selected demographics in adolescent females was investigated. Included in the study were 184 adolescents and their parents. A modification of Pender's (1982, 1987) Health Promotion Model provided the conceptual framework for the study. Two research questions evolving from the conceptual model guided the study. Results indicated that mothers' and fathers' health-promoting lifestyles were significantly correlated with their daughters' health-promoting lifestyles. A strong relationship existed between the predictor variables of definition of health (clinical, functional, and eudaemonistic subscales), self-efficacy, perceived health status, and ethnicity, and the criterion variable of adolescents' health-promoting lifestyles. Together these variables accounted for 41% of the variance in adolescent health-promoting lifestyle scores. Implications for nursing research and practice are discussed.

Adolescent↗

Does bar-based, peer-led sexual health promotion have a community-level effect amongst gay men in Scotland?

This paper evaluates the effectiveness of a bar-based, peer-led community-level intervention to promote sexual health amongst gay men. The intervention consisted of peer education within bars, gay specific genitourinary medicine (GUM) services and a free-phone hotline. Data were collected at baseline (1996) and at follow-up (1999) in gay bars in Glasgow (intervention city) and Edinburgh (control city). During the intervention peer educators interacted with 1484 men and new clients increased at the gay specific GUM service. However, the hotline was under-utilized and abused. The outcome measures were: reported hepatitis B vaccination; HIV testing; unprotected anal intercourse (UAI) with casual partners; negotiated safety; and amongst men reporting UAI with a regular partner, the proportion who knew their own and their partner's HIV status. Significant differences in sexual health behaviours were observed across locations and across time, but the only significant intervention effects were amongst men who had direct contact with the intervention, with higher uptake of hepatitis B vaccination and HIV testing. The intervention did not produce community-wide changes in sexual health behaviours. These results question the replication and transferability of peer-led, community-level sexual health promotion for gay men outwith the USA and across time.

Adolescent↗

Health promoting behaviors among rural southern early adolescents.

A central element in attaining the goals and objectives of Healthy People 2010 is promoting healthy behavior lifestyles. Health promotion continues to be sanctioned as the long term most cost effective approach to a reduction in preventable health problems. Adolescents are presently an age group in jeopardy of making the transition into adulthood with healthy lifestyles. This paper describes the use of the Health Promoting Lifestyle Profile (HPLP) (Walker, Sechrist, and Pender, 1987) as a measure of health promoting behaviors in a group of rural southern early adolescents (1036 seventh and eight graders; 81% were African American). The findings suggest that rural southern adolescents perceive themselves to be enganging in health promoting lifestyle behaviors. However, some HPLP subscales seemed to be especially difficult for adolescents.

Adolescent↗

Decision points for hospital-based health promotion.

Hospitals that are developing health promotion programs to market to business and the community need to develop a high quality product. Hospitals frequently gain needed experience in health promotion by providing the service to their own employees. Cases are presented that illustrate several crucial choices hospitals must make in developing health promotion programs. These choices include selection of markets; activities to be included; linkages to other health services; purchase of an existing program or development in-house; extent of employee involvement; and information to be collected for assessing outcomes.

Community Health Services↗

Association between attitudes toward health promotion and opinions regarding organ transplants in Japan.

Health promotion activities to educate the public about health lifestyles have been performed widely in industrialized countries where chronic adult diseases have become prevalent. According to a basic principle of health promotion activities, the symptoms of many diseases are regarded as the result of inadequate health behavior, curable by modifying health behavior. It is thus possible that an exposure to health promotion activities might instill negative attitudes towards organ transplants, because program participants may conclude that persons who need an organ transplant have become unhealthy as the result of their own poor health habits. In this study, two types of surveys were undertaken to test this hypothesis. The subjects of the first cross-sectional study were 712 male and female Japanese citizens, and those of the second case-control study were 240 female company employees in Japan. In the first study, a logistic regression analysis was used and the following findings were obtained. (1) Compared with the persons who felt that they did not have enough practical knowledge about individual health practices, those who felt that they had adequate knowledge were 0.66 times less likely to support organ transplants. (2) Compared with those who were not willing to spend money on healthful things, the persons who were willing to do so were 0.51 times less likely to support organ transplants. In the second case-control study, it was revealed that the subjects who had negative attitudes towards organ transplants had consistently healthier lifestyles than did those who had positive attitudes towards organ transplants. Based upon the present findings and the nature of the basic principles of health promotion activities, we infer that community health promotion activities have a negative influence upon citizens' opinions of organ transplants. Since these findings have health policy implications, more studies are necessary to conclusively evaluate the effects of health promotion activities upon attitudes toward organ transplants.

Attitude to Health↗

Adolescent mothers: resilience, family health work and health-promoting practices.

AIMS: This paper reports a study examining the relationships among mother's resilience, family health promotion (i.e. health work) and mother's health-promoting lifestyle practices in single-parent families led by adolescent mothers by testing hypotheses derived from the Developmental Model of Health and Nursing. BACKGROUND: Research on families led by adolescent mothers has focussed primarily on negative maternal and child outcomes while ignoring the capacities of these families, including their efforts to promote the health and well-being of both mothers and children. METHODS: This replication study was conducted with convenience sample of 41 adolescent mothers recruited using a variety of strategies. Mothers were asked to provide verbal responses to items on three study instruments: The Resilience Scale, a measure of mother's resilience, the Health Options Scale, a measure of family health work and the Health Promoting Lifestyle Profile a measure of mother's health promoting lifestyle practices, as well as a demographic questionnaire. RESULTS: Consistent with the theory, moderate positive relationships were observed between mothers' resilience and both family health work (r = 0.34, P = 0.01) and mothers' health-promoting lifestyle practices (r = 0.42, P < 0.001). As predicted, moderate correlations were also observed between health work and mother's health promoting lifestyle practices (r = 0.62, P < 0.001). With the effects of employment status and professional support held constant, mother's resilience and health work explained 30.2% of the variance in mother's health-promoting lifestyle practices. CONCLUSIONS: The study validates theoretical relationships among concepts in the developmental model of health and nursing and contributes to better understanding health promotion in families led by adolescent mothers.

Adolescent↗

Changes in health risks among the participants in the United Auto Workers--General Motors LifeSteps Health Promotion Program.

PURPOSE: To examine health risk changes among participants of a multicomponent worksite health promotion program. DESIGN: A study using health risk changes among health risk appraisal (HRA) participants linked to program participation records. Baseline risk and participation in multiple programs were examined in relation to risk change in multivariate models. SETTING: Worksite health promotion programming sponsored by the United Auto Workers (UAW) and General Motors (GM). SUBJECTS: Active employees (12,984) who voluntarily participated in an HRA in each of two program years. INTERVENTION: The nationwide program was a mailed HRA and a 1-800 nurse line. A pilot program (implemented in two cities) added screening, wellness programs, a materials resource, and, for high risk participants, health coaching and vouchers for medical office visits. MEASURES: Using 13 selected health risk factors from the HRA, changes in overall health risks were measured as program outcomes in three ways: one-directional, net, and risk status change. RESULTS: A greater decrease in the number of health risks was observed with increased program participation. The decrease was significantly related to the number of baseline risk factors and eligibility for high risk programs. Associated with program participation, the number of people at low risk status increased from 70.1% to 71.3% at year 2 among nationwide participants and from 52.4% to 58.9% among pilot participants. CONCLUSIONS: Participation was associated with a significant impact on health risk. Baseline risk of participants and eligibility for high risk programs were necessary factors to control when measuring program effects on health risk changes.

Health Promotion↗

[Health promotion, social epidemiology, and social capital: associations and perspectives for public health].

The idea of health promotion predates the use of the actual term. However, the incorporation of this idea and the practice of health promotion were influenced by the Canadian health reform movement, which echoed the voices of many others who were concerned with the influence of the physical and social environment on health. This provided the basis for the World Health Organization to launch a series of conferences beginning with the Alma Ata Conference in 1977 and followed by the Ottawa Conference, from which resulted the first international document on health promotion, known as the Ottawa Charter. Although health promotion has been the subject of a wide range of studies, the concept is still not well understood and its explicit practice is limited. Health conferences have been important for keeping the notion of equity in health alive, while the gap between the rhetoric of these conferences and practice remains to be bridged. However, the rise of social epidemiology and the development of the concept of social capital for health could bring new insights into traditional epidemiology in order to narrow this gap. The purpose of this paper is to elucidate these concepts and to describe the roles they play in public health in order to stimulate further debate.

Epidemiology↗

Heart health promotion: predisposition, capacity and implementation in Ontario Public Health Units, 1994-96.

The Canadian Heart Health Initiative-Ontario Project (CHHIOP) investigates predisposition and capacity in Ontario public health departments to implement community-based heart health promotion activities. The research draws upon diffusion of innovations theory and recent work on ecological approaches to health promotion within which public health agencies are seen to play a central role. Mail-back surveys were completed by heart health staff in all 42 health departments in 1994 and 1996. Predisposition and capacity were measured as the importance and effectiveness ascribed to 18 organizational practices supportive of community heart health activities. Level of implementation was reported for 74 activities spanning a range of risk factors and settings. Predisposition, capacity and implementation scores increased between 1994 and 1996. The findings confirm positive correlations between predisposition and capacity and between capacity and implementation.

Attitude of Health Personnel↗

Nursing interventions for health promotion.

Selected nursing interventions for health promotion in well individuals are described. Over a two-year period, two clinical nurse specialists developed and used client record keeping, role playing, audio and video feedback, imagery, visual mapping and experimentation as health promotion interventions. Clinical examples and client outcomes are discussed. Health promoting interventions are clearly distinguished from disease prevention approaches as described in the literature.

Adult↗

Identifying the opportunities for health promoting emergency departments.

STUDY OBJECTIVE: To describe the opportunities for health promotion in emergency departments (EDs). METHODS: A comprehensive literature review and consultation with ED staff (seven focus groups) and other health professionals (workshop). RESULTS: Opportunities for patient health information and education within EDs are described in the literature. In contrast, the health promoting hospitals literature showcases integrated approaches for health promotion, emphasizing organisational structures, and culture changes to support effective health promotion. This type of integration has not developed in EDs, where individual issues based health promotion projects have emerged. ED staff readily described the:existing health promotion interventions and possible improvements and opportunities for potential health promotion interventions related to the needs of their patients, the community or their organisation. Other health professionals supported EDs taking a greater role in health promotion and suggested organisational partnerships that would assist in developing this. CONCLUSION: There are numerous opportunities to enhance health promotion in EDs. With support, EDs could deliver comprehensive health promotion programs for patients, staff, and communities.

Attitude of Health Personnel↗

[Health economy and health promotion -- self-responsibility for health?].

The social insurance systems in Germany are about to face radical changes, predominantly due to demographic developments. The solution might be an increasing self-responsibility of the population. The suitability of this health economical concept is to be verified for health insurance. The starting point of the health economic debate, discussing the issue of responsibility, is its description, and therefore the health of populations and the fundamental determinants for the maintenance of health and for illness. This is followed by a theoretical health economic discussion on the question whether insurants and patients are suitable market partners shoulder the responsibility transferred to them. The description of empiric evidence of the effects of co-payment questions the concept of self-responsibility and finally leads to discussing the individual versus social responsibility for health and illness.

Aged↗

[Physicians' role in prevention and health promotion policy: canton reports on health status].

With the example of a study on population health in the Swiss cantons Jura and Neuchâtel, the paper proposes a mechanism for priority setting of problems that could be acted upon preventively. Concepts are reviewed: public health needs as defined by epidemiology, supply of preventive activities, demands expressed by the population and different stakeholders. The role of general practitioners is stressed, not only as preventive services suppliers, but also as actors of priority setting.

Family Practice↗