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PubMed2001

The need for mental health promotion.

OBJECTIVE: To examine the concept and evidence for mental health promotion, within an understanding of mental health and mental illness and their determinants. METHOD: A selective review of literature and opinion in the fields of public health and mental health. RESULTS: Mental health and mental illness are often given a low priority, despite growing evidence of the burden of disease and costs to the economy. Improving mental health and reducing mental illness will improve quality of life, public health and productivity. The needs for mental health promotion are complementary to the needs for prevention and treatment of mental illness. The required activities are different. Mental health professionals have a necessary but not sufficient role in mental health promotion. CONCLUSIONS: An understanding that mental illnesses are treatable can encourage early entry to care, improve outcomes and lessen the stigma and discrimination related to mental illness. In primary health care there is some evidence that preventive interventions with groups at high risk of depression can prevent episodes of ill health. However, mental health promotion involves another dimension. Better understanding of the nature of mental health and mental illness is the key to changing the priorities, policies and practices in education, law, social services, housing and health critical in turn to the conditions conducive to mental health.

Health Promotion↗

PubMed2006

Community nurses' health promotion work with older people.

AIMS: This paper reports a study describing community nurses' health promotion work with older people aged 50 years and above, and exploring particular health promotion initiatives for older people that would have transferability potential. BACKGROUND: With the ageing of populations worldwide, community nurses in primary healthcare settings have a key contribution to make to the health improvement agenda for older people, yet little is known of the extent of this aspect of their work. METHODS: Questionnaires were sent to 1062 community nurses in six Scottish National Health Service Boards - public health nurses/health visitors, district nurses, general practice nurses, community psychiatric and learning disability nurses and combined duty nurses; 373 (35%) responded, 30 of whom were interviewed by telephone. The data were collected in 2003-2004. FINDINGS: Findings confirmed the wide scope of health promotion, much of which may be embedded and unrecognized. Creative group work showed promise in achieving heath gain for older people, and a range of partnership approaches - interdisciplinary, multidisciplinary and interagency - was evident. Theoretical input and project opportunities within educational programmes had been a catalyst for health promotion initiatives in practice. However, evidence of audit, evaluation, and active involvement of older people in planning health promotion was limited. Funding of health promotion initiatives was vital to sustainability. CONCLUSION: There is merit in making the health promotion work of community nurses more visible through audit and systematic evaluation; promoting the active involvement of older people; strengthening partnership working; and further raising the profile of health in later life within undergraduate and postgraduate community nursing programmes.

Aged↗

PubMedDate not supplied

Can life expectancies be used to determine if health promotion works?

PURPOSE: The goal of this study was to develop a method to measure the impact and cost-effectiveness of health promotion. DESIGN: Age- and sex-specific changes in life expectancy in Canada between 1970 to 1972 and 1985 to 1987, after the introduction of national health insurance (1970) and health promotion (1975), are used to assess the impact due to biological hardiness, improvements in the health care field, and the effects of health promotion. SUBJECTS: The subjects were the total male and female population of Canada between the years 1970 to 1972 and 1985 to 1987. MEASURES: Life expectancy by years of age by sex was the measurement used. RESULTS: A method is presented that allows the calculation of the differential effects of health promotion, health care, and biological hardiness on changes in life expectancy based on sequential subtraction of life expectancies for one-year age cohorts over a 15-year period. Results were obtained for each year of age for men and women, showing gender and age differences in the relative impact of the three factors. In this illustrative example using Canadian data, health promotion was found to have less impact on longevity than health care or biological hardiness. However, of the three, health promotion was the most cost-effective. CONCLUSION: This method can be used to quantify changes in life span due to health promotion, health care, and biological hardiness for men and women at each year of age and to relate this to health expenditures for the whole population. The method is limited in that it cannot determine the relative impact of other factors that can affect life expectancy such as environmental changes or social trends.

Age Factors↗

PubMed1988

Health promotion for the rural elderly.

There has been increased interest in developing health promotion programs for the rural elderly as a means to foster successful aging. The present study describes one such program and identifies rural and urban differences in health promotion activities. Data come from the California Preventive Health Care for the Aging Program (PHCAP) which is one of the oldest and largest such programs in the United States. A sample of over 5,000 PHCAP clients was drawn from rural, semi-rural and urban projects. Though the rural and urban clients differed significantly with respect to demographic characteristics, differences in health promotion practices were relatively minor. However, the health promotion practices of semi-rural residents differed considerably from that in rural projects. Though less disabled, semi-rural clients received a greater scope of health promotion activities than rural clients. The authors discuss possible site, practitioner and client factors which may have accounted for rural health promotion activities being more restricted. Regardless of project site, the California PHCAP detected many health problems and a majority of clients were referred to other health professionals for treatment.

Aged↗

PubMed2003

[Assessment of worksite health promotion environments].

Organizational intervention rather than the individual approach is gaining greater attention in worksite health promotion, but little research has been done on the health promotion environment. The purpose of this study was to investigate the actual conditions in health promotion environments at worksites, and determine which environmental items in each health promotion area at worksites need. A survey was conducted by mailing a questionnaire to occupational physicians at 450 worksites in Japan. The questionnaire contained 182 items including 6 areas in a health promotion environment; tobacco control, healthy diet, physical activity and exercise, stress management, health screening, and health administration. 142 physicians (32.7%) responded to our survey, the number of employees was more than three hundred and 71.1% of respondents were working at manufacturing worksites. The mean rate of positive answers in 6 areas was highest in the 'health screening' (72.5%), followed by 'stress management'. The lowest rate was seen in 'tobacco control'. Popular facilities for health promotion were a stress counseling room, cafeteria, rest room and outdoor exercise field, but the rate of positive answers to promote utilization of these facilities was relatively low. Among the health education programs, the practice rate for exercise promotion was the highest (63.6%), but those for healthy food and body weight control were relatively low. The number of employees positively correlated with the rate of positive answers to all items and in the stress managing area. Manufacturing worksites had more items for enhancing physical activity than other types of industrial worksites. The results of this survey had determined the environmental intervention items in each health promotion area at worksites.

Health Promotion↗

PubMedDate not supplied

Health promoting behaviors of urban African American female heads of household.

Nurse practitioners' understanding of the health status and health promoting behavior of African American women is only in its infancy. This study utilized the Health Promoting Lifestyle Profile to examine these behaviors in 198 females (73% African American) in an urban setting who were heads of household. The purpose was to identify their health promoting lifestyles. Such knowledge could be the basis for health promotion programs to meet the needs of these women. Findings revealed that being head of household had no significant relationship to health promoting behavior. Religiosity and education were positively associated with health promoting behavior, while smoking and ethnic background were inversely correlated. Age and marital status also influenced specific health promoting behaviors. Implications for development of programs to foster involvement of African American women in health promotion programs were presented.

Adolescent↗

PubMedDate not supplied

Adventure therapy: a mental health promotion strategy in pediatric oncology.

In adventure therapy (AT), health professionals and adolescents with cancer come together to explore the wilderness of nature. One goal of this therapy is to encourage the adolescents to enhance their self-concept as part of an overall physical, cognitive, emotional or spiritual, social and psychological, or developmental rehabilitation that promotes health. The adolescents with cancer who participate in AT also learn about themselves through self-evaluation, self-exploration, self-reevaluation, self-acceptance, and self-realization. Mental health promotion (MHP) is considered a perspective and a strategy to promote health. An AT experience could be an example of an MHP initiative in which nurses can take a leadership role in participating, and further investigating, the health effects of AT on adolescents with cancer.

Adaptation, Psychological↗

PubMed1986

Health promotion--an ethical perspective.

Physicians, individually and collectively, are formulating and marketing health promotion campaigns in unprecedented numbers. While such efforts are generally consonant with the ethic of promoting health by scientifically valid means, care must be taken not to compromise this ideal in pursuit of marketable, simplistic models of disease.

Ethics, Medical↗

PubMed1995

Hospital nurses and health promotion.

This study examined the role of acute-care nurses in health promotion (HP), using a survey designed to measure the knowledge, attitudes, and practices of nurses in relation to HP. Staff nurses in eight British Columbia hospitals surveyed in 1992 responded that HP is an integral part of nursing care, yet several barriers in the hospital environment inhibit their efforts in this domain. The perceived barriers are lack of time, insufficient resources for patient teaching, and lack of continuity of care. Respondents identified positive features as the attitudes of patients and families, supportive colleagues, and hospital support for HP activities. The study concludes that acute-care nurses are an underutilized resource for HP. The challenge is to make more effective use of nurses' knowledge, attitudes, and skills in promoting health in the hospital setting.

Acute Disease↗

PubMed2001

Nutrition and health promotion in older adults.

During recent decades, the concept of health promotion has become a legitimate part of health care because of the aging of the postwar baby boom generation. As this population ages, the potential strain on health care systems will increase because the greatest use of health care services occurs during the last years of life. In older adults there are many correctable health factors that can be assessed through screening protocols. Hypertension, cholesterol, hearing, vision, diabetes, and cancer screening are well integrated into health promotion programs; nutrition promotion programs are not as well integrated. Reluctance to develop health promotion programs for older adults exists because of a perception that they would not follow such plans or change their lifestyles. However, longitudinal studies have shown that health promotion activities extend the number of years of health in older people although the relationship weakens in older age. Changes in diet and exercise patterns are most effective in the prevention of nutrition-related conditions when they are instituted early in life, but positive effects can occur at any age. If nutritional interventions are instituted early, a substantial reduction in health care expenditures may result from a decrease in the incidence or the delayed onset of these conditions. Changes in behaviors (reducing salt and fat intake) were positively associated with a belief that consuming a healthful diet would contribute to better health. The use of a variety of adult education theories and models will enhance behavior changes that lead to more healthful habits and enable a health educator to be successful in effecting change.

Aged↗

PubMedDate not supplied

Health protecting and health promoting behaviors of African Americans living in Appalachia.

The importance of the influence of health protecting and health promoting behaviors on the health of Appalachian African Americans has not been widely published. Review of the literature revealed a paucity of research data describing these behaviors. Therefore, the purpose of this descriptive study was to describe health protecting and health promoting behaviors of Appalachian African Americans. Pender's (1996) health promotion conceptual framework was used as the organizing framework for this study. Data were collected through structured interviews with 204 Appalachian African Americans representing two states and six counties in Appalachia. Quantitative research methodology was used to describe health protecting and health promoting behaviors. Data analysis revealed that these participants actively engaged in health protecting and health promoting behaviors. Morbidity data, mortality data, and family history of diseases were consistent with those reported nationally. Findings from this study support the need for a long-range research study of Appalachian African Americans.

Adult↗

PubMed1999

Ensuring force readiness and beneficiary health through health promotion and preventive medicine in the Military Health System: a position paper.

The evolution of the Military Health System (MHS) from a traditional model to a system of managed care precipitated a fundamental shift in the design and delivery of health care. This paper will propose the elements of a health system that delivers health promotion and preventive medicine as a focal point, describe the transition of the MHS to a prevention model, and discuss the work that needs to be done to achieve an accountable, comprehensive prevention-oriented system. The MHS has the opportunity to emerge as a model health care delivery system.

Health Promotion↗

PubMed2002

Health promotion and partnerships: collaboration of a community health management center, county health bureau, and university nursing program.

Effective partnerships were established between a community health management center, a county health bureau and a university nursing program. A health fair was undertaken to heighten public health awareness through the collaboration of these various agencies. In this research, formative, process, and summative evaluations were conducted to determine the benefits of partnerships. Elements evaluated included the planning process, health fair relevancy, integration of community resources, participants satisfaction and knowledge acquisition, and partnership satisfaction. The samples of this study included (1) 529 adult participants who completed the on-site evaluation questionnaires; (2) 1,090 child participants who returned gift-reward cards; (3) 114 partners who gave written feedback on their satisfaction; and (4) 57 third-year and 16 fourth-year undergraduate nursing student participants. Data was collected from the evidence report of the Department of Health, the project proposal, activity protocols, meeting records, the project final report, students term papers, and questionnaires. The chief administrator of the County Health Bureau was very impressed with the creative exhibits in the fair and, therefore, invited a coalition to continue further workshops. Seventeen educational exhibits, two dance programs and two drama programs related to health issues were demonstrated in the fair. Resources from community organizations were successfully integrated and allocated. Community participants expressed satisfaction with the fair and anticipated similar activities in the future. Participants revealed more than 80% accuracy in health knowledge quizzes. The senior nursing students highlighted their interaction with the community, community health nurses, and health volunteers. Community-based health promotion and nursing education can be successfully connected when various disciplines and sectors form effective partnerships.

Adult↗

PubMed1993

The borders of health promotion--a response to Nordenfelt.

Nordenfelt has presented a very useful philosophical analysis of the nature and ethics of health promotion. The first section of this paper is a response to the starting point of that analysis--the equation of health promotion with health promotion action. It is argued that this starting point leads to a serious ambiguity, and that this ambiguity is characteristic of other writing about health promotion, including that of the WHO. The second section of this paper explores the implications of this ambiguity, as it appears in the wider health promotion literature, for drawing the borders of health promotion.

Ethical Analysis↗

PubMed2003

Advancing a theoretical model for public health and health promotion indicator development: proposal from the EUHPID consortium.

This paper discusses the work of the EUHPID Project to develop a European Health Promotion Monitoring System based on a common set of health promotion indicators. The Project has established three working groups to progress this task--health promotion policy and practice-driven, data-driven and theory-driven. The work of the latter group is reviewed in particular. EUHPID has taken a systems theory approach in order to develop a model as a common frame of reference and a rational basis for the selection, organization and interpretation of health promotion indicators. After reviewing the strengths and weaknesses of those health promotion models currently proposed for indicator development, the paper proposes a general systems model of health development, and specific analytical, socio-ecological models related to public health and health promotion. These are described and discussed in detail. Taking the Ottawa Charter as the preferred framework for health promotion, the socio-ecological model for health promotion adopts its five action areas to form five types of systems. The structure and processes for each of these five systems are proposed to form the basis of a classification system for health promotion indicators. The paper goes on to illustrate such a system with reference to indicators in the workplace setting. The EUHPID Consortium suggest that their socio-ecological model could become a common reference point for the public health field generally, and offer an invitation to interested readers to contribute to this development.

Community Participation↗

PubMed2000

Using mass media within health-promoting practice: a nursing perspective.

For some time health professionals have recognized the growing importance of utilizing mass media strategies as part of their health-promoting practice. The ever-evolving climate of technology and increasing reliance on mass communications has further reinforced the position of mass media initiatives. The enormous potential for mass media resources to reach certain audiences and influence their health-related behaviours has become particularly well established. Despite these facts, however, it is argued that the nursing profession has been less than pro-active in acknowledging, accommodating and adopting such practices. Consequently, the incorporation of health-related mass media initiatives into nursing's health-promotional role remains an elusive exercise. The maintenance of such a position, it is claimed, is potentially damaging for the profession as a whole. In light of this state of affairs, this paper seeks to review the literature surrounding the nature and processes of mass media strategies, their relevance to health promotion and nursing, how they are currently utilized and how they can be incorporated further into nursing practice. In conclusion, it is argued that nursing should seek to become a more active user of mass communication/media technology--especially in relation to its health-promotional practices.

Attitude to Health↗

PubMed1990

Predictors of employee involvement in a worksite health promotion program.

Although worksite health promotion programs have proliferated, little is known about the population they reach. This study of employees of a large utility company compared whether the same characteristics which predict recruitment also predict extended participation. The study also prospectively assessed how risk factors are related to employees' on-going extended participation. The findings demonstrate that sociodemographic predictors of recruitment are almost mirror images of the predictors of extended participation. Over time employees who are at higher risk for cardiovascular disease participated in on-going sessions less frequently. Data suggest that referral to targeted sessions does not result in higher rates of attendance by employees with a particular risk factor, although there is no evidence of selective avoidance. Organizational influences on participation evident from the beginning are sustained through four sessions. Programs targeting higher risk employees nested within worksite-wide programs may be useful to increase the extended participation of individuals at elevated risk for heart disease.

Adult↗

PubMedDate not supplied

Health promotion: time for an audit.

This article examines how health promotion models are used in practice. The conceptual base of health promotion models is reviewed with particular relevance to the interaction between professional and client, and in relation to The Health of the Nation targets. The author argues that health promotion models are being used by professionals purely to achieve targets and, as a consequence, important information on clients' socio-economic circumstances is being ignored. A framework for a 'health promotion audit' is offered.

Adult↗