Harnessing support for prioritised Cochrane reviews in health promotion and public health--update from the Cochrane Health Promotion and Public Health Field.
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Decision Making↗
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Implementing health promotion in health care settings: conceptual coherence and policy support.
This article examines the level and conditions of development of the concept of "health promoting hospital (HPH)", in France and in Europe. Part of the literature on HPH was reviewed, looking at the kind of partnerships implemented within the HPH projects, and at the organisational strategies adopted by hospitals to be health promoting. The literature review is followed by an overview of the priorities defined by health policies in Europe. This research shows that there is still a lack of guidelines on how to put the health promotion concept into practice in health care settings. Moreover, it stresses that further research is needed in order to better define which personal skills ought to be developed through health education in health care settings, and how the development of such skills may be articulated to other priorities in health care settings.
Clinical Competence↗
[Health promotion and health care system reform in Poland].
The development of health promotion is determined by the defined changes of health situation of population, which occur in time. Contemporary methods of health promotion were initiated in 1970's, when the problem of increase of civilization (behavioural) diseases strongly related to lifestyles, was noticed. Health promotion programmes in Poland in spite of many achievements in the conceptualization phase, encounter difficulties in implementation, because of lack of appropriate structural solutions and financial support for this important public health area.
Health Behavior↗
Building health promotion into health care reform in Russia.
The health care system of the former Soviet Union, despite serious flaws, did provide the basis for community health activities, and for mandatory immunization and periodic health examinations for which primary care physicians were responsible. Since 1991, a new system of mandatory health insurance has been put into place. Health care funding has decreased substantially, owing to economic conditions. However, there is not yet widespread acceptance either of the strong association between personal behaviour and health consequences, nor of the importance of individual responsibility for one's health. To summarize, efforts at health promotion and disease prevention in Russia face numerous barriers: severe financial constraints owing to the general economic situation; social upheaval with loss of previous constraints on behaviour; cultural characteristics that include fatalism and encouragement of heavy alcohol and tobacco consumption; lack of acceptance of individual responsibility for health; lack of role modelling by the medical community; lack of critical appraisal of benefit and cost-effectiveness for preventive interventions; low priority for health care, and for prevention specifically. Disease prevention and health education must be built into the reformed health care system, to promote health for the Russian population.
Community Health Services↗
Health-promoting behaviours in public health: testing the health promotion model.
A health-promoting lifestyle encompasses far more than preventing disease and is characterised by behaviours that lead to optimal well-being, self-actualisation, and personal fulfillment. This study was undertaken to investigate the health-promoting lifestyles of employees working in local public health departments (n = 602) and to test two research hypotheses suggested by the Health Promotion Model. The first hypothesis posited that public health professionals would report significantly more favourable health-promoting behaviours than support staff employed in the same departments. The second hypothesis postulated that occupational discipline in public health would be a significant predictor of health-promoting behaviours. Health-promoting behaviours were measured by the Health-Promoting Lifestyle Profile (HPLP), a psychometrically-validated measure of overall health-promoting lifestyle and six dimensions of health-promoting behaviours, which comprise the instrument's subscales. The findings of the study tended to support the research hypotheses. Overall, public health professionals tended to report more favourable health-promoting behaviours than departmental support staff, and occupational discipline was a significant predictor of a health-promoting lifestyle. In general, public health nursing personnel reported the highest mean levels of health-promoting behaviours compared to the other occupational disciplines examined.
Adolescent↗
Impact of worksite health promotion on health care costs and utilization. Evaluation of Johnson & Johnson's Live for Life program.
This study explores the relationship between exposure to a comprehensive worksite health promotion program and health care costs and utilization. The experience of two groups of Johnson & Johnson employees (N = 5192 and N = 3259) exposed to Live for Life, a comprehensive program of health screens, life-style improvement programs, and worksite changes to support healthier life-styles, was compared with that of a control group (N = 2955) over a five-year period. To account for baseline differences, analyses of covariance produced adjusted means for inpatient hospital costs, admissions, hospital days, outpatient costs, and other health costs. Mean annual inpatient cost increases were $43 and $42 for two Live for Life groups vs $76 for the non-Live for Life group. Live for Life groups also had lower rates of increase in hospital days and admissions. No significant differences were found for outpatient or other health care costs.
Costs and Cost Analysis↗
[Health promotion. Planning process of health promotion programs for individuals with arthritis].
Based on the health conception viewed from the literature on nursing and by the clients, health is defined as a living experience, or as a perception of wellness in this study. That is, it is the perceived wellness that the individual obtains by wholistically integrating all dimensions of health where ever the individual stands in the health continuum. Thus health exists independently, regardless of illness or disability, because the individual is able to perceive the wellness within limitations imposed to him/her. Also, based on the health conception defined in this study and the literature review on health promotion, health promotion is defined as the process of enhancing the perception of wellness (i.e., living experience), where ever the individual stands in the health continuum. Therefore, health promotive care represents the process of making client help himself to improve health experience/perception of wellness by selecting and/or integrating the individual or social health parameters (determinants) based on his reality. After analyzing the data which is provided from the related literature and the results from the descriptive/exploratory research on this group of clients, and then applying those analysis results to the PRECEDE model, planning process for health promotion program is established. However, as planning process is only based on data from literature in the first stage, it will be modified appropriately according to the assessment feedback from the direct participation of client in the following study. Based on the planning model refined through this assessment process, health promotion program is to be developed, implemented and evaluated. Planning process of health promotion for clients with arthritis is begun from the assessment of health outcome as the first phase. It is analyzed from this study that clients with arthritis indicates lower quality of life/satisfaction than the other groups from the several research findings indicate. In the second phase, according to the analysis results in the first phase, clients' health problems (perceived seriousness about illness, uncertainty in illness, helplessness, difficulty of movement), which affect the low quality of life, are identified and then program objective for each problem is demonstrated. As an objective for the perceived seriousness about illness, relief of the mistrust on the general effects of treatment for illness is determined through appropriate data analysis. And clients' accumulation of accurate knowledge on the nature of illness is determined as an objective, for reducing uncertainty in the illness. Also enhancement of distraction ability and self-efficacy perception is defined as objectives for reducing physical, psychological and social helplessness.(ABSTRACT TRUNCATED AT 400 WORDS)
Arthritis↗
The effects of a health promotion-health protection intervention on behavior change: the WellWorks Study.
OBJECTIVES: This study assessed the effects of a 2-year integrated health promotion-health protection work-site intervention on changes in dietary habits and cigarette smoking. METHODS: A randomized, controlled intervention study used the work site as the unit of intervention and analysis; it included 24 predominantly manufacturing work sites in Massachusetts (250-2500 workers per site). Behaviors were assessed in self-administered surveys (n = 2386; completion rates = 61% at baseline, 62% at final). Three key intervention elements targeted health behavior change: (1) joint worker-management participation in program planning and implementation, (2) consultation with management on work-site environmental changes, and (3) health education programs. RESULTS: Significant differences between intervention and control work sites included reductions in the percentage of calories consumed as fat (2.3% vs 1.5% kcal) and increases in servings of fruit and vegetables (10% vs 4% increase). The intervention had a significant effect on fiber consumption among skilled and unskilled laborers. No significant effects were observed for smoking cessation. CONCLUSIONS: Although the size of the effects of this intervention are modest, on a populationwide basis effects of this size could have a large impact on cancer-related and coronary heart disease end points.
Diet↗
Promoting the health promoting school.
The Health of the Nation strategy commits the government to establishing a national network of health-promoting schools. Alysoun Moon describes an independent pilot project in Wandsworth, south London which is pioneering the concept in ten selected primary schools.
Child↗
Ethics of health promotion and health education.
Although in the last twenty years there has been an increasing interest in medical ethics, this has been centered around clinical problems and therapeutic medicine. However equally or more important are the ethical dilemmas arising in the field of health promotion and health education. These are described and commented upon.
Child↗
Healthy decision making: a new approach in health promotion using health state utilities.
Empowerment of the individual is the central tenet of health promotion philosophy. Application of health state utility methodology to clinical decisions will facilitate this process. The study reported here used health state utilities to examine the preferences of young adults concerning third molar care. Respondents were asked to indicate the strength of their preferences for various outcomes consequent to removing, or not removing these teeth by using standardised visual analogue scales. The results demonstrated that health state utilities for most complications of surgery were lower than, and therefore reduced health more than, those associated with the complications of leaving teeth in place. Therefore dental surgeons should be more circumspect about surgical intervention: this group of potential patients believed that the 'cure' is often worse than the 'disease'. This study illustrates the use of health state utilities, a methodology which allows patients' perspectives to be incorporated into the planning of rational health care.
Adult↗
The effect of cardiovascular health promotion on health behaviors in elementary school children: an integrative review.
This report provides on an integrative review of health promotion studies relevant to elementary school children published between 1986 and 1998. The 22 research articles represented several disciplines including public health and nursing. The studies varied in research design, sample characteristics, and approaches to health education. The most common interventions targeted behavioral risk factors for cardiovascular disease, but it also was evident from the literature that family and community involvement both played a significant role in health behaviors of children. Health promotion studies were under-represented in the nursing literature, a gap that creates an impetus to study children and families to identify the ways they learn primary preventive behaviors.
Cardiovascular Diseases↗
[Health promotion and health education at the school of governance in health, National School of Public Health, Brazil].
Schools of public health should define their teaching, research, and technical cooperative programs on the basis of epidemiological, epistemological, and health care parameters, which are heavily affected by the socioeconomic context of their countries. Brazil's demographic and epidemiological transition has been characterized by an increasing prevalence of diseases and risk factors associated with life styles, thus requiring an extensive and in-depth change in the country's health care model, with a greater supply of evidence-based services and preventive and health promotion measures, including new initiatives in information, education, and communications. This article approaches the recent experience at the Brazilian National School of Public Health, which has added to its long-standing academic tradition with a strategic reorientation known as the School of Governance in Health, including distance education as one of its main teaching options. Given Brazil's prevailing social and health situation, we conclude by highlighting the importance of training health professionals and promoting research and technological development in the fields of health promotion and education within the context of the School of Governance in Health at the National School of Public Health.
Brazil↗
An exploration of the relationships between health promotion practices, health work, and felt stigma in families headed by adolescent mothers.
The purpose of this study was to examine the relationship between stigma and health promotion in families with preschool children headed by adolescent mothers, by: (a) testing hypotheses derived from the Developmental Model of Health and Nursing, and (b) descriptively exploring the experience of stigma in a community sample of 63 adolescent mothers in southwestern Ontario, Canada. The mothers verbally responded to established measures of felt stigma, family health work, healthy lifestyle practices, and a demographic questionnaire during a structured interview. Then their experiences of stigma were explored during a brief dialogic interview. Consistent with the theory, a moderate positive relationship was observed between family health work and mothers' healthy lifestyle (r = .52, p < .001). Felt stigma was not related to either health work or global healthy lifestyle. Stigma did not appear to affect family health promotion efforts directly but influenced other aspects of the participants' lives in both positive and negative ways. Implications for practice and future research are identified.
Adolescent↗
[The Child and Adolescent Health Survey--a foundation for prevention, health promotion and health goals].
At the beginning of the 21st century, the German Health Interview and Examination Survey of Children and Adolescents will for the first time provide the data essential for programmes of disease prevention and health promotion as well as for the development of health targets. This it will create key information for an evidence-based health policy. The results of the study can be projected to the general population of children and adolescents in Germany. The data will be collected conjunct at the level of the individual subject. They will facilitate valid and distinct description of prevalent physical, psychological and social health problems, as well as on who has them under which circumstances and settings. Information on the impact, e.g., in terms of utilisation of the health system or impairments of quality of life, will also be available from the same subjects. In addition, indicators of risks to health in later life are included. Hence, the data will support prevention of health problems in infancy, childhood and adolescence as well as of chronic diseases in later life. Finally, the data shall be a basis for the definition of new reference values for many variables. This will improve valid and clear judgement not only in epidemiological studies but also in medical care.
Adolescent↗
Environmental health promotion: bridging traditional environmental health and health promotion.
This article highlights the juncture between environmental health and health promotion and underscores the need for health promotion involvement in environmental health practice. It begins with a synopsis of current issues in environmental public health and deficiencies in environmental public health practice that could be partly ameliorated by an increased focus on environmental health promotion. Environmental health promotion lies at the intersection between the two disciplines and can be defined as any planned process employing comprehensive health promotion approaches to assess, correct, control, and prevent those factors in the environment that can potentially harm the health and quality of life of present and future generations. An introduction is also provided to the six articles contained in this special issue focused on environmental health promotion, and a brief discussion of crosscutting themes and issues is presented.
Environmental Health↗
Women's health: consumer views for planning local health promotion and health care priorities.
A random door knock survey was conducted in five metropolitan postcode areas with a high proportion of low-income households to establish: 1. the health problems experienced by women, 2. the problems with which women would have liked more help, and 3. women's perceptions of how their health care experiences might have been improved. In all, 214 women were interviewed. Across all age groups the most common problems were tiredness, premenstrual syndrome, stress, being overweight and disturbed sleep. Premenstrual syndrome, tiredness and arthritis were the most commonly experienced problems among younger, middle-aged and older women respectively. In general, women were satisfied with the help available to them for their health problems, but one in five would have liked more help to cope with stress, and one in six said they would like help to address the issue of quality of medical care. In relation to health care services, suggestions for improvement included the provision of better health information from doctors and other health care professionals, and more opportunities for counselling and self-help. The project findings will be used to influence the development of local policies and services, and will form the focus for local women's health promotion programs.
Adult↗
Video conferencing-based telehealth--its implications for health promotion and health care.
PURPOSE: To review the experience with a province-wide telehealth system in Canada, and its implications for health care and health promotion. To explore whether group support systems (GSS) based on networked computers can substitute for video conferencing technology. METHODS: Key results of the evaluation of the BC Telehealth Program are summarized. The potential of extending the successful principles through use of GSS is explored based on literature review, demonstrations, and trial use for educational applications. RESULTS: The BC Telehealth Program was designed to support health professionals at secondary care facilities, such as regional and district hospitals in two application domains: children's and women's health (C&W) and emergency room and trauma care (ER-Trauma). Successful applications extended beyond health professionals and focused on chronic conditions, the management of which is contingent on visual information, and involves established teams in regular scheduled visits or in sessions scheduled well in advance. Ad hoc applications, in particular applications under emergency conditions proved problematic. Administrative applications in support of telehealth implementation, e.g., through facilitation of management and provider education, are essential for clinical success. Savings from support of administrative applications exceeded the substantial capital investment and made educational and clinical applications available at variable cost. Educational applications were shown to have significant clinical benefits. Exploration of GSS technology showed that it may not be mature enough to substitute for video conferencing technology in support of sophisticated training and education aiming at clinical impact. CONCLUSION: The substantial clinical and efficiency gains provided by video conferencing-based telehealth may for now continue to depend on mature video-conferencing technology.
British Columbia↗