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Evaluating research in worksite health promotion.

Critical review of studies published in the area of worksite health promotion is an important skill for health promotion professionals. Most studies have some weaknesses which make it difficult to draw meaningful conclusions. Therefore, it is important to consider the research design of these studies. By accurately evaluating the conclusions of health promotion investigations, health promotion professionals will be able to make better recommendations for effective program development.

Evaluation Studies as Topic↗

Basic need status and health-promoting self-care behavior in adults.

Health-promoting self-care behavior emphasizing positive lifestyle practices may improve the health and quality of life of adults. One variable that may influence health-related decisions is the status of basic needs as described by Maslow. The purpose of this study was to investigate the relationships among basic need satisfaction, health-promoting self-care behavior, and selected demographic variables in a sample of community-dwelling adults. A convenience sample of 84 community-dwelling adults was recruited to complete the Basic Need Satisfaction Inventory, the Health-Promoting Lifestyle Profile II, and demographic information. Results of the study indicated that self-actualization, physical, and love/belonging need satisfaction accounted for 64% of the variance in health-promoting self-care behavior. The findings of this study are consistent with Maslow's theory of human motivation and suggest that persons who are more fulfilled and content with themselves and their lives, have physical need satisfaction, and have positive connections with others may be able to make better decisions regarding positive health-promoting self-care behaviors.

Adult↗

[Environmental health promotion in municipalities--resources, organization and activities].

The Municipal Health Services Act with amendments from 1988 defines environmental health promotion activities directed at physical, chemical, biological and social factors as mandatory for the local Norwegian health authorities. In addition, the municipal health services are responsible for health surveillance and for initiating cross-sectorial preventive measures. In 1991, we undertook a national survey among the Norwegian municipal health services to monitor planning activities, manpower resources, cross-sectorial cooperation, and project-oriented activities within the field of environmental health promotion. Less than one-third of the municipalities employed technically trained hygienic personnel. However, three of four municipalities had carried out some environmental health promotion projects within the last two years. The following factors were all independently related to level of environmental health promotion activity: the availability of technical assistance, the level of cross-sectorial cooperation and the size of the population in the municipality. We conclude that this area of health promotion should be improved by better planning, a higher level of technical hygienic competence within the municipal health services, more inter-sectorial cooperation and greater emphasis on visible projects of limited duration.

Environmental Health↗

Health promotion projects: skill and attitude learning for medical students.

OBJECTIVES: The aim of this health promotion project is to introduce students to appropriate skills and attitudes--as well as knowledge about health promotion strategies and methods. As part of this process, standardized procedures have been established to ensure that the projects are scientifically and ethically appropriate and adequately supervised. This project-centred course introduces the discipline of health promotion to third-year medical students at Monash University. It is aimed at introducing students to the range of health promotion concepts, providing them with experience of health promotion activities and involving them in consideration of the scientific, political and ethical issues arising from doctors' participation in health promotion. DESIGN: As the major learning and assessment component of the unit, students participate in self-selected project groups of three to five students. Each group develops a topic for a health promotion activity in the community, carries out that project and presents the results as a poster as well as a written report. SETTING: Monash University. SUBJECTS: Third-year medical students. RESULTS: Sixty per cent of each student's mark for the unit is based on the project. The posters produced by the project groups are placed on public display in a major teaching hospital for a week at the end of the unit. Public display of the posters helps each student to appreciate the variety of possible health promotion activities, and to appreciate health promotion as a scientific discipline. It also makes the project findings available to the public. CONCLUSIONS: Student evaluation of the project, and community response to the projects--especially the poster display-- indicate that the project is both a highly effective learning experience and a health-promoting activity in its own right.

Attitude↗

Health promotion at work.

This study examined health promotion intervention amongst council employees and determined the extent that any changes were subsequently maintained. The results showed that even with modest intervention, beneficial changes were observed in alcohol consumption, diastolic blood pressure, body mass, waist/hips ratio, body fat, aerobic capacity and arm strength. Behavioural measures tended not to change, but this could be a consequence of unfocused questioning or insufficient intensity of the health promotion activities. The sickness and absenteeism rates improved during the intervention and maintenance phases, making a strong case for health promotion from the employer's perspective. A critique of the experimental procedure suggested that the testing venue, the methods of obtaining consent, the continuity of subjects, initial attitudes, the intensity of the intervention and the project delivery were all features that would contribute to a successful outcome.

Absenteeism↗

Life-style related health promotion needs in oil refinery employees.

This report describes the screening procedure used in the assessment of health promotion needs in a group of oil refinery employees (n = 885). The aim of the study was to assess the life-style related health promotion needs before initiating an intervention programme study. The frequency of different health promotion needs and their distribution according to age, gender and employee group were examined, as well as the factors explaining different health promotion needs. The assessment was based on laboratory tests and questionnaires covering the target areas of physical activity and fitness, dietary habits, overweight, blood pressure, serum lipids, smoking, alcohol consumption, sleep, mental health, and musculoskeletal symptoms. Life-style related health promotion needs were frequent. Self-assessed health was strongly associated with health promotion needs in most of the ten target areas and also with the total number per person of areas with health promotion needs. Health promotion needs were also associated with such demographic variables as age, gender, basic education, and vocational training. If health promotion activities are provided to employees in a company, assessment of individual needs is necessary to find the employees with the greatest need of health promotion actions. This study presents one method of screening, although certain simplification is needed to make it fit into the daily routines. The contents of health promotion activities could also vary according to the differences related to age and gender observed in health promotion needs of the target population.

Adult↗

Evaluating oral health promotion: need for quality outcome measures.

Oral health promotion effectiveness reviews have identified the need to improve the quality of the evaluation of interventions. A project was undertaken to identify and assess the quality of available outcome measures. This paper describes the methodology adopted and highlights the need for further development of oral health promotion outcome measures. Initially a thorough and comprehensive search of both the published and unpublished literature was undertaken to identify potential outcome measures. A set of quality criteria was then developed and used to assess the identified measures. The search identified a total of 1202 outcome measures of which 39% (n = 466) were developed for use with schoolchildren. A high proportion of the identified measures were classified as health literacy and healthy lifestyle outcomes, appropriate for the evaluation of oral health education activities. Only 1% (n = 12) of measures identified were classified in the healthy public policy category. When reviewed against the quality criteria, 49% (n = 594) of the measures were considered satisfactory. The poorest performing measures were those classified as healthy lifestyle and health literacy measures in which only 33% (n = 72) and 41% (n = 240), respectively, were deemed to be of satisfactory quality. In conclusion, a significant number of oral health promotion evaluation outcome measures have been identified although their quality is highly variable. Very few high-quality outcome measures exist for use in the evaluation of oral health policy and environmental interventions. The lack of appropriate and high-quality outcome measures is hampering the development of oral health promotion.

Aged↗

The Essence of Care benchmark for patient health promotion.

A new benchmark for health promotion has been added to Essence of Care, the government strategy to improve the quality of the fundamental aspects of nursing care. The benchmark provides a tool for making health promotion part of everyday practice and is designed to be applicable to any area.

Benchmarking↗

[Model development of an elderly health promotion center: the effect of a social support program at a community health center].

PURPOSE: The purpose of this study was to develop a model of an elderly health promotion center after witnessing the effect of a social support program on dependent variables in older adults at a local community health center. METHOD: The subjects were 60 female adults over 65 years dwelling in a rural area, and they were divided into experimental and control groups each with 30 people. A social support program was implemented 6 hours a day, 3 times a week, for 4 months in the experimental group. Included was health assessment, health education, counseling, consultation, exercise, physical & occupational therapy, primary care, recreation, lunch & transfer service. Data was collected from May 1st to September 14th, 2002 by questionnaires, and analyzed by x2-test, t-test, Pearson's correlation coefficient and stepwise multiple regression using SAS. RESULT: The social support program in the elderly was very effective on all dependent variables of physical health (t= 4.68, p= .001), health knowledge (t= 3.60, p= .001), life satisfaction (t= 8.65, p= .001), and health promoting behaviors (t= 5.23, p= .001). CONCLUSION: The Social Support Program at a Community Health Center was effective on health promoting behaviors in the elderly.

Aged↗

Society of pediatric psychology presidential address: opportunities for health promotion in primary care.

OBJECTIVE: To set an agenda for health promotion in primary care settings. METHODS: This is a review of the scientific bases of child development as applied to pediatric psychology and health promotion. RESULTS: Primary care is an ideal setting for health promotion because there is a "hidden morbidity" of children with unrecognized and untreated behavioral and developmental problems that, if unresolved, may lead to psychiatric and physical disorders and increased use of the health care system. Although pediatric psychologists endorse the importance of health promotion, there are few examples in the literature involving pediatric psychologists. Recommendations are provided for a proactive agenda for health promotion programs involving pediatric psychologists in primary care. CONCLUSIONS: With conceptual homes in clinical and developmental psychology, expertise in theories of clinical and child development, scientific methods, and collaborative relationships with pediatricians, pediatric psychologists are in a unique position to develop and evaluate health promotion programs for use in primary care.

Child↗

The role of computer-based resources in health promotion and disease prevention: implications for college health.

The development of the Internet-based World Wide Web communication platform has opened a new avenue for extending the program effectiveness of college health centers. California College Health 2000, a San Diego State University-based HIV prevention project, is collaborating with the university's student health center to develop a computer-based resource to provide hypertext links to specific health information helpful to health promotion planners and consumers. The project's virtual resource centers are organized around health topics and seek to encourage the dissemination of health information to the broadest possible constituency of college health professionals and are designed to provide for continuous feedback and to evolve over time. Implications for the future of college health, based on the creation and pilot use of the resource centers, are discussed, and recommendations are made regarding collaboration, leadership, and continuing innovations in the area of networked health information.

Computer Communication Networks↗

The influence of changing demographic patterns on our health promotion priorities.

As we approach the twenty-first century, we face many difficult challenges in planning public health programs to promote health and prevent disease. We focus here on the changing age distribution of the American population and the resulting need to develop and enact effective health promotion efforts for older Americans. Older adults suffer from an increased burden of many chronic diseases, but contrary to past assumptions, they benefit substantially from health promotion and disease prevention efforts. Although numerous health promotion activities can be targeted to aging populations, we pay particular attention to the beneficial role of physical activity promotion, tobacco use cessation, and good nutrition for older adults. In this article, we describe some of the implications of this demographic change in terms of the health care services and needs of older adults, and we suggest priorities for future public health promotion and disease prevention programs.

Aged↗

[Health promotion benefits and obstacles as perceived by occupational medicine physicians in Poland].

This article presents the views of occupational medicine (OM) physicians concerning the following: (a) whether OM physicians should be involved in workplace health promotion: (b) whether they can benefit (if so in what way) from involvement in this activity; (c) whether they find the existing conditions favorable for launching health promotion projects; (d) what are the major obstacles? This paper is based on a survey carried out in the fall of 2002 in a group of 325 OM specialists who attend large groups of patients. Over 90% of the respondents believe that OM physicians should be involved in health promotion, however, one third of them do not plan any action in this field in the following year. Among the key benefits from health promotion, health gain is indicated by 80% of OM physicians. Only a few respondents perceive their involvement in health promotion as an opportunity to be more competitive in health service market, thereby to increase their income. None of those interviewed thought that involvement in health promotion win them greater respect among peers. Almost 80% of the respondents complained about unfavorable conditions for carrying out workplace health promotion. As the most significant obstacles they reported the lack of interest in health promotion among employers (86% of respondents), unsatisfactory gratification (76%), limited skill to raise funds for health promotion (64%), limited opportunities to advance education in this field (59%), and the lack of interest in health promotion among employees (57%). In general, OM physicians express their willingness to advance their knowledge of health promotion, although 64% of respondents are convinced that they are well trained in this area. According to the respondents, a proper way to promote health is not only to become very active, but to commit employers to assure the development of health promotion at workplace and to allocate more funds for health promotion projects.

Attitude of Health Personnel↗

[Attitudes and health status as determinants of participation in individually oriented health promotion].

In a cross-sectional health survey among employees of a large German metal company with 974 study participants, attitudes and aspects of the individual health status were identified which predispose employees to take part in individual health promotion activities. Apart from higher participation rates in women and white collar employees, participants reported on average a less favourable subjective health status, more complaints and diseases, better health related behaviours, and a more intensive utilization of curative and preventive medical services than nonparticipants. Among men, participation in all types of courses increased from the youngest to the oldest group, among women only until the middle-aged groups with a consequent decline thereafter. In men, the image of a person living health-consciously showed the strongest positive association with participation, and not the degree of internal control and responsibility with respect to the maintenance of health or the acquisition and overcoming of disease. The low participation of blue collar workers compared to white collar employees could be attributed to group specific differences in individual health consciousness only to a very small extent. Blue collar participants reported a positive image of a person living health-consciously that was more similar to that of white collar participants than to that of nonparticipants of their own occupational group. Advertisement for health promoting activities should place more emphasis on increasing the image of personal health promotion than on internal control and responsibility for health.

Adult↗

Health promotion for seniors: what is over the horizon?

The health care industry is experiencing tremendous change in terms of health care delivery systems and fiscal pressure to provide high-quality health care at an affordable cost. A significant step forward in this change process will be the recognition of the value of comprehensive health promotion and disease prevention. The managed care model of health care is an excellent vehicle for a systematic health promotion program to flourish and succeed. This article surveys the literature on the topic of health promotion and its impact on the wellness of Medicare managed care beneficiaries and the senior population. The authors address issues, facilitators, benefits, and barriers within the context of health promotion and its potential to greatly impact both the quality and cost of health care for the rapidly growing senior population in the coming years.

Aged↗

Opportunities for health promotion: including the chronically ill and disabled.

One of the aims of health promotion and illness prevention is to reduce the prevalence of chronic disease that is so apparent in the developed countries, yet the very individuals who already have chronic diseases and disabling conditions constitute a sizeable population which could contribute to health promotion programs. There are two chief elements which argue for an extension of health promotion toward the chronically ill and disabled: (1) the lifestyle management which is characteristic of health promotion is similar in many respects to the comprehensive self-care regimens followed by chronically ill persons, and (2) the philosophy of independent living for disabled persons shares social foundations with the concept of health promotion and could add the strength of social advocacy to health promotion. This paper examines social and medical variables linking the two health trends of health promotion and independent living for disabled persons. Observations of a U.S. independent living program, The Timbers, are reported to illustrate an active combination of the two philosophies. Finally, sociological implications are presented, with a focus on the potential of health promotion programs.

Chronic Disease↗

Achieving effective health promotion for women with disabilities.

The field of health promotion has yet to acknowledge the unique needs of women with disabilities, a population representing approximately 1 of 5 women in the United States. Compared with women without disabilities, women with disabilities have critical needs for evidence-based health promotion services. Women with disabilities face a lack of access to multitudinous opportunities for maintaining and improving their overall health. Inaccessible exercise equipment and other disability-related barriers discourage women with physical disabilities from engaging in health-promoting behaviors. This article identifies 10 essential elements for achieving effective health promotion research and interventions for women in this population.

Persons with Disabilities↗

What should hospitals be doing in health promotion services?

The role of health services in Australia is slowly changing from illness treatment to illness prevention. The Health Targets and Implementation Committee has indicated that there needs to be a distribution of resources and services within the health care system to better enable us to actively promote the health of the community. This paper discusses the level of health promotion services that each hospital or Area Health Service should offer the community. A model for the delineation of health promotion services is presented. This model offers a useful tool for senior administrators who are responsible for the planning and delivery of the new "health promotion services".

Health Promotion↗