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PubMedDate not supplied

Cooperation and collaboration between a public health unit and midsized private industry in health promotion programming: the Polymer Heart Health Program experience.

In 1990, Cobequid Health Unit was approached by Polymer International, a plastics manufacturer, and planning began for a worksite cardiovascular risk factor screening and follow-up program. In 1991, 302 Polymer employees (89.1%) participated in a screening. Follow-up included smoking cessation programs, fitness opportunities, dietary counselling, and physician referral for further investigation of blood pressure and cholesterol levels. Policy and environmental changes include heart healthy foods at the cafeteria, development of non-smoking policy, and coverage under the corporate group insurance plan for dietary counselling. This process demonstrates the potential for public health and private industry to collaborate in preventive efforts and the principles required for success.

Adolescent↗
PubMed1995

The carrot, the stick and the general practitioner: how have changes in financial incentives affected health promotion activity in general practice?

BACKGROUND: Financial incentives for increasing health promotion activity in primary care, introduced with the 1990 contract for general practitioners, were amended in 1993 and are now focused on cardiovascular disease. Payments for health promotion clinics were abolished and target payments were introduced. AIM: The study aimed to evaluate the effect of the change, in June 1993, in financial incentives for health promotion activity in primary care on the distribution of health promotion payments in two family health services authorities. METHOD: A retrospective study was undertaken in which data from two family health services authorities were used to determine the annual level of health promotion payments per 1000 practice population before and after the contractual amendment. Health promotion clinic payment data were analysed for 78 practices in Bedfordshire Family Health Services Authority and 85 practices in Kensington, Chelsea and Westminster Family Health Services Authority. Changes in health promotion payments were calculated and related to two measures of relative need: all cause standardized mortality ratios, for patients aged 74 years or less, of the electoral ward in which the practice is located; and the Jarman underprivileged area score. High relative need was defined as a standardized mortality ratio of over 100 or more than 25% of the practice population living in electoral wards with a Jarman score of over 30. RESULTS: Health promotion payments were more evenly distributed after the change in June 1993 than before between the two family health services authorities and between general practices. Single-handed practices were carrying out more clinics in 1992 than multi-partner practices and consequently were one of the greatest financial losers as a result of the change. In addition, practices located in electoral wards with high relative needs lost proportionally more than those in electoral wards with lower needs. CONCLUSION: Changes in the general practitioner health promotion contract have created new financial winners and losers. It now appears that health promotion payments are more evenly distributed but that the distribution is unrelated to need or treatment given. More evidence on the effectiveness of health promotion interventions is required before policies aimed at promoting better health through primary care can be fully evaluated.

England↗
PubMedDate not supplied

Determinants of health promotion activities in nursing clinic clients.

Nursing clinic clients' health beliefs, values, and demographic characteristics were analyzed for their impact on health promotion activities. A sample of 175 clients was administered measures of health beliefs, health values, and health promotion activities. The type of health care clients had requested at the clinic for the previous 2 years was categorized as health promotion, illness prevention, health maintenance, or health restoration. Findings included: health value was not related to self-reported health promotion activities or to types of clinic visits; a strong belief in chance was negatively associated with engaging in health promotion activities; a strong belief in powerful others was negatively associated with a high percentage of restoration visits. The combination of beliefs, values, and selected demographic factors accounted for 16% of the variance in health promotion activities and 18% of the variance in the type of health care sought.

Adolescent↗
PubMed2000

Health promotion in leg ulcer management in the community.

This article acknowledges the substantial progress that has been made in leg ulcer management in recent years. However, there needs to be greater emphasis on health promotion, quality of life, general patient well being and promoting health within illness. Incorporating health promotion activities within venous leg ulcer management strategies may serve to empower patients to participate more fully in their care. Nurses' awareness needs to be raised to ensure that the assessment process is used as a tool to promote holistic care and not merely as a checklist to provide baseline information on the patient's health status. A series of factors highlighted during assessment are explored to demonstrate the potential for health promotion.

Activities of Daily Living↗
PubMed2005

A systems view of health promotion.

This article presents a systems view of health promotion and education. We offer an overview of systems theory, including the hierarchy of systems, the relationship between a system and its environment, and agent-host interactions. A host is any system that may face disruption from an environmental agent or perturbation from an adjacent system. A system is healthy to the extent it can prevent, parry, or dissipate the effects of disruptions and perturbations. Systems can collaborate and cooperate to enhance their capacity to respond adaptively to potential threats from agents. This offers new insights into the three levels of prevention, and into health promotion practice. Health promotion is any effort to influence host systems in ways that will enhance their capacity to prevent, resist, dissipate or respond adaptively to potential threats from their environment. We also offer an account of the balance between stability (or lack of) in the environment and the importance of flexibility enabling systems to adapt to change. We examine high-level wellness, a function of knowledge, learning, skills and stored-up resources that enhance adaptability, flexibility and timeliness in a system's response to anticipated and unanticipated potentially disruptive environmental agents. Finally we draw implications for health promotion and education practice. The health promoter / educator is a helpful agent seeking to influence systems at various levels in the hierarchy of systems in ways that will enhance their capacity to prevent, resist, dissipate or respond adaptively to potential disruptive agents in their environments.

Health Education↗
PubMed2006

The health promotion model as assessed by ageing workers.

AIMS: This study describes qualitatively ageing workers and their health promotion. It also describes quantitatively the importance of individual, workplace and occupational health promoting factors, the impact of health promotion and the contributions of the other co-partners promoting the health of ageing workers. These form the foundation for a model of health promotion. BACKGROUND: Very little is known about the health promotion factors exclusively focused at ageing workers. METHODS: A pretested questionnaire with structured and some open-ended questions were devised to form the basis of qualitative data and sent to 150 ageing workers, of whom 93 (62%) returned it. Qualitative data were analysed by content analysis. Statistical analyses were performed using frequencies and means. RESULTS: Over 90% of respondents stated that health habits, individual arrangements at the workplace, a good workplace spirit, health checks, counselling and access to nursing care were important factors for health promotion. Better health (99%), work satisfaction (95%) and motivation of employees (96%) were the factors impacting on health promotion. Ageing workers stated that health and safety organization (94%) and rehabilitation institutes (93%) were the most important co-partners. CONCLUSIONS: This study confirms extremely high importance of different health promotion factors, their impact and some co-partners. Health problems, early retirement and work absenteeism are rather common in ageing workers. If we are to avoid these problems, it is important to support their work ability effectively and systematically to allow these workers to stay employed until the normal retirement age. Relevance to clinical practice. It is necessary, that management appreciate the benefits of ageing workers; they have to take a positive attitude toward these workers and participate more effectively in their health promotion. Occupational health professionals play a key role in training workers and management to undertake the required measures.

Absenteeism↗
PubMed2000

A workforce survey of health promotion education and training needs in the state of Victoria.

OBJECTIVE: This study investigates the education and training needs of health professionals and factors affecting participation in education and training. METHODS: A survey of health promotion professionals, health professionals, GPs and CEOs of community health centres, conducted across different settings and locations. Information was obtained on: involvement in health promotion activities, most useful content and format of past training, current preferences for education and training and barriers and incentives to education and training. RESULTS: Health promotion professionals were involved in the widest variety of health promotion activities, including more evaluation, research and planning than GPs and other health professionals who were involved in more client-focussed activities. Professionals' preference for training content reflected the type of activities in which they were most frequently involved. Practical courses, of short duration, delivered by experienced peers or health promotion experts were preferred over university and TAFE courses. Professionals in rural and provincial locations require both greater access to information on training and conveniently located training. More organisational support, funding and time release would encourage the training of professionals in government departments, community health centres and public hospitals. CONCLUSIONS: To be most effective, training must be tailored to suit the specific needs of different professionals involved in health promotion and take into consideration how factors, such as financial incentives and time release, influence participation across different settings and locations. IMPLICATIONS: Further development of the health promotion workforce will require recognition of its professional diversity and a more responsive and organised approach to education and training programs.

Adult↗
PubMed2000

An exploration of midwives' attitudes to health promotion.

OBJECTIVE: To explore midwives' attitudes to health promotion. DESIGN: Quantitative study, data collected using self-completed postal questionnaires in 1996. SETTING: The North West of England, UK. PARTICIPANTS: 182 senior midwives who were working in hospital and community settings. KEY FINDINGS: The patterns of views towards health promotion approaches were complex as midwives stated that they preferred societal approaches but worked in approaches that focused on the individual. Health promotion methods that centre on the individual were also preferred. Clinical practice base, educational qualifications and age were influential in midwives' opinions. IMPLICATIONS FOR PRACTICE: There is a need for further clarification of the midwife's understanding of their role as a health promoter. Educators should ensure that health promotion is explained within its practical context and there should be opportunity for midwives to develop skills of lobbying, negotiating, implementing and policy planning. Liaison with other disciplines should be fostered to understand their roles and develop joint health promotion strategies. There is a need for further research exploring midwives' opinions from a qualitative perspective.

Adult↗
PubMed2006

[The development of evidence-based prevention. Health promotion and education as an approach to continuous quality improvement of health care].

Evidence-based health promotion and education relies on the systematic and critical discussion of the best available research on the effectiveness of interventions. In the last decade, evidence-based reviews provided decisive proof for the effectiveness of health promotion and education. The approach is also capable of identifying high-quality interventions and deficiencies. Nevertheless, there is an ongoing dispute concerning the transfer of evidence-based medicine to health promotion and education. Arguments concern databases, research strategies, validity and practical applicability of results. A discussion of these issues suggests that the methodology of evidence-based medicine is pertinent and informative. Some adaptations for health promotion and education would make sense, though: contexts and characteristics of interventions should be documented and published in rather more detail in order to reach better causal models. Pre-post studies which are of particular importance for health promotion and education should be elaborated according to the psychological multi-trait multi-method strategy (multiple measurements, modelling of process levels, multidimensional operationalization of complex outcomes). All relevant knowledge including qualitative studies should be integrated into cycles of theory formulation and evidence testing. Finally, a reappraisal of expert opinion is proposed relying on specific criteria for the transparency and plurality of consensus procedures ruling out conflicts of interest.

Delivery of Health Care↗
PubMed1991

Nursing's role in health promotion. An overview.

This article presents health promotion as a basic concept for nursing practice. Since the era of Nightingale, health promotion has continued to be a major focus for nursing as is reflected in the American Nurses' Association (ANA) Social Policy Statement. The major focus of this article is nursing's role in health promotion in such areas as assessment, advocacy, case management, promotion of self-care, and client education. Major societal changes that are expected to have an impact on health promotion in the near future are also presented.

Health Promotion↗
PubMed1998

Defining characteristics of community-based health promotion programs.

Community-based health promotion programs have flourished over the past twenty years. These programs have varied considerably in their goals and in their approaches to reaching these goals. While some flexibility is critical to program effectiveness, it is also important to determine a set of defining characteristics in order to distinguish community-based programs from other types of health promotion activities. In this article, we examine some of the defining characteristics of community-based health promotion programs, and the challenges faced by practitioners who with to engage in this type of work.

Community Health Planning↗
PubMed2006

The health-promoting school: what role for nursing?

AIM: To review the existing literature on health-promoting schools and put forward recommendations for continuing progress. BACKGROUND: The World Health Organisation's Ottawa Charter for Health Promotion in 1986 sought to create a framework for health promotion action that conveyed the notion of capacity building as it related to specific settings. It provided the catalyst from which the health-promoting school movement emerged, against the backdrop of health professionals adapting to the changing needs and demands of clients and the evolving social context of the communities in which they live. Since then, the international health-promoting school movement has been one of the most successful of the settings-based projects and has expanded considerably over recent years. METHOD: An extensive review of available health-promoting school-related literature provides the basis for critical discussion and recommendations. FINDINGS: Traditionally, the school nursing movement has provided the backbone of nursing-related health promotion activity in the school setting. The literature, however, is generally critical of its contribution over the years - especially as its role is mainly confined to a 'conventional' health education function and has little to do with health-promoting school projects. There are more and more calls now for the school nursing service to either re-evaluate its function and processes or be devolved back into a broader primary health care practitioner role. CONCLUSION: Nurses should view the health-promoting school movement as another opportunity to embrace evolving broad-based health promotion concepts truly, as a means to forge and own their own health agenda and also as a means to move beyond a traditional reliance on a limited health education role. Schools also need to adapt and expand their efforts to focus on health promotion activities, in collaboration with the ever-widening community networks of health and social agencies. This requires the commitment of all healthcare professional groups. Nurses who practice in all settings, and not just school nurses, should be aiming to initiate and promote radical health promotion reform as set out in the health-promoting school movement. RELEVANCE TO CLINICAL PRACTICE: If health professionals wish to be at the forefront of current health-promoting school strategies they must embrace the radical health promotion reforms that are emerging from the current literature and put forward in this article. Building such group capacity, through developing social interaction, cohesion, participation and political action can only benefit the community at large and further emphasize the health promotion role of nursing. The health-promoting school movement is truly an international concept and, as such, deserves a concerted nursing representation and resourcing well beyond its current commitment.

Attitude of Health Personnel↗