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PubMed1994

Evaluation of group health promotion with community-dwelling older women.

Health promotion outcomes with older adults are characterized increasingly in terms of several effects. The outcomes of a health-promotion intervention with a group consisting of a majority of African-American older women were evaluated after six months. The study employed a quasi-experimental design with intervention and control groups all living in the area of a midwestern city with the highest proportion of low-income and non-Caucasian elders. Women in the intervention group participated in weekly group meetings over 26 weeks. The intervention was derived from the ecologic well being model and incorporated content related to three areas of outcome evaluation: health practices, psychologic and spiritual well-being, and social integration. Interviews conducted prior to and on conclusion of the intervention incorporated four single-item qualitative measures and the following three instruments as outcome measures: the senior lifestyle inventory, the integration inventory, and the social integration subscale. Although no significant increases in outcomes were demonstrated over time for the intervention group, statistical analysis before and after the intervention did reveal significant contrasts among controls in relation to well-being, health practices, and life satisfaction, suggesting a preventive-maintenance effect for the participants.

Black or African American↗
PubMed2000

[Health promotion indicators - selected model approaches].

The aim of the paper is to present the problem, how to find the optimal set of indicators necessary in the different phases of planning, programming and evaluation of health promotion programmes. In health promotion the application of classic health measurements is limited, because they are not related to "positive health". Moreover, time perspective when effects of promotion could appear is difficult to define. Some model approaches are presented. The PRECEDE-PROCEED model is recognised as a robust framework in health promotion. This model provides a continuous series of steps and phases in planning, implementation and evaluation process. Some authors recommend already in the early phase of programming to draw a diagram showing a relationship between the objectives, activities, indicators and resources. In the process of evaluation it seems very important for health promotion initiatives to focus on the changes in human knowledge, attitudes and behaviours. For that reason models like KAP analysis (knowledge, attitudes, practice), HBM (Health Belief Model) and TTM (Transtheoretical Prochaska's model) are commonly applied. However, the- re is still a need to develop and choose indicators, which would consider environmental aspects of health promotion and link local actions with national health promotion policy.

Health Knowledge, Attitudes, Practice↗
PubMedDate not supplied

The health-promoting lifestyles of undergraduate nurses in Hong Kong.

Based on Pender's health promotion model in 1987, this descriptive study of 169 undergraduate nurses in Hong Kong was undertaken to determine any differences in their health-promoting lifestyles, as measured by the Health Promoting Lifestyle Profile II (HPLP II) among different age groups, gender, income, employment status, and levels in undergraduate nursing education. The student nurses performed best in interpersonal relations but worst in physical activity. There were significant differences among the various classes in stress management and spiritual growth, with senior classes (Years 3 and 4) reporting worse in both areas. This was particularly remarkable among the students of the final year, who would soon be graduating as staff nurses and were expected to inspire patients to practice health-promotive behaviors by their example. The older age group also had lower scores in stress management and exercise practice. Because most of the students in the senior classes were older, the findings further reinforce the earlier results. It was also identified that more than half of the students were supported on low parental income with many of them working a part-time job. These outcomes were explored with future recommendations made to improve the weaknesses in the students' health-promoting lifestyles.

Adult↗
PubMed2006

[Different attitudes towards hypertension and urinary tract incontinence in elderly individuals participating in a health promotion project].

BACKGROUND: The aim of the study was to evaluate health associated attitudes of elderly individuals taking part in a community based health promotion programme. It was of interest to focus on mobility, hypertension and urinary incontinence, problems frequently observed in geriatrics. METHODS: Participants in the health promotion programme were asked to answer a standardized questionnaire about their individual risk factors and habits concerning some of the main risk factors in the elderly: social isolation, immobility, hypertension, urinary incontinence. Mobility and risk assessment for falls was assessed in a standardized way using the Chair-rising- and Timed-upand-go tests. RESULTS: The percentage of people with a healthy life style was significantly higher than in a comparable population group. Gait disturbance, mobility limitation and risk of falls were not present. 38.7 % suffered from urinary incontinence. Hypertension was, if present, diagnosed and adequately treated. The participants knew their prescribed drugs and seemed to have an excellent compliance. DISCUSSION: The participants in the health promotion programme showed an exceptionally high level of health awareness. Nevertheless, the incidence for reported urinary incontinence was significantly higher than in known epidemiological studies. The calm, reassuring atmosphere in which the questionnaire was completed and the large amount of time spent with the participants could explain this finding. The difference in dealing with hypertension and urinary incontinence is obvious. Further health promotion and disease prevention programmes for the elderly should be focused on the complex process of ageing and not only on specific single topics.

Accidental Falls↗
PubMed2005

"What sort of health promotion are you talking about?": a discourse analysis of the talk of general practitioners.

In New Zealand, health promotion is now expected to be an integral part of the work of a general practitioner, and in the recently implemented New Zealand Primary Health Organisation structure, specific funding is available to undertake health promotion activities in primary care. Eighteen general practitioners recruited to take part in two focus groups discussing men's health, talked extensively about health promotion. This talk was analysed through a discourse analysis. This study of the 'talk' of general practitioners suggests that there are problems in transferring the concept, which must be recognised and addressed if health promotion is going to be taken up effectively within general practice. The meaning given to health promotion in the consultation is unclear and general practitioners were unsure about its value in 'health checks' and screening. Lack of time and lack of confidence in the evidence appeared to be barriers to undertaking health promotion within general practice consultations. In the current climate general practitioners are uncertain, to the point of ambivalence, about health promotion in their work. Further work will be required to ensure this ambivalence does not result in covert resistance.

Adult↗
PubMed1999

The relationship between health promotion and complementary therapies.

The underlying philosophies of health promotion and complementary therapies are very closely related and, consequently, share many similarities; yet such similarities that exist between these two disciplines are rarely expressed, acknowledged or explored. It would be almost impossible to practice complementary therapies without incorporating elements of health promotion within them, whether this is done so knowingly, or not, by the practitioner. This account sets out to establish the nature of such a relationship and highlights the common advantages and dilemmas in recognizing such a relationship. It seeks to determine the validity of closer collaboration (between the two disciplines) in order to provide a collective consensus for like-minded nurses to move towards a more holistic and empowering paradigm. It concludes by suggesting that, in order to move the shared aims of health promotion and complementary therapies forward, closer ties need to be established, between the disciplines, and built upon.

Complementary Therapies↗
PubMed1991

Work-site health promotion: an economic model.

Despite a burgeoning interest in and acceptance of corporate health promotion, the overall economic effects of these programs are not clear. Although ultimate resolution of this question awaits detailed empiric research, a theoretical approach can be useful in structuring the problem and understanding the critical issues. The financial model presented views the firm as a value-maximizing enterprise and evaluates health promotion as a use of corporate assets. The model projects the benefits and costs to the firm of a 7-year health promotion program under a variety of assumptions regarding the employee mix and the effects of the health promotion program on health and productivity. The analysis reveals that the base case assumptions result in a program that creates value for the firm when the cost is less than $193 per participating employee per year. Firms with a highly productive, difficult to replace, and older employee group are most likely to find health promotion to be a good investment. Productivity gains produce the majority of the economic benefits of the program. Effects on health care expense alone are projected to be relatively small. Gains from reduction in employee mortality or retiree health expense are found to be insignificant in this model.

Absenteeism↗
PubMedDate not supplied

Health communication research and health promotion.

This paper examines the relationship between health communication research and health promotion. In doing so, it identifies a number of research questions, priorities and capacity requirements pertaining to the intersection of the two fields. It concludes by suggesting that there is a great need in Canada to find support for the development of training and research programs in health communication research in general, and with an emphasis on health promotion in particular.

Canada↗
PubMedDate not supplied

Determinants of reported health promotion behaviors in employed Mexican American women.

This study based on the revised Pender Health Promotion Model (HPM) was conducted to determine the extent to which selected demographic modifying factors, health locus of control, self-efficacy, and current health status explained engaging in six health promotion practices in a sample of 397 employed Mexican American women aged 19 to 70 years who lived and worked in the Rio Grande Valley of Texas. Self-administered test packets contained measures of demographic characteristics, health locus of control, self-efficacy, health status, and the six health promotion practices. Canonical correlational analysis demonstrated two significant canonical variate pairs explaining 88% of variance in the dependent set, the subscale mean scores of the Health-Promoting Lifestyle Profile. Age; education; self-efficacy; internal and powerful others health locus of control; and prior, current, and future health status made statistically significant contributions. However, the demographic variables made only a minimal contribution, confirming the recent conclusions of researchers that the HPM as currently configured provides an inadequate explanation of the modifying factors' role in health promotion activity. Study results make an important addition to the understanding of how lifestyle factors contribute to Mexican American women's health and well-being.

Adult↗
PubMed1995

[Development of a health promotion program for the target group "elderly people"].

The importance of health promotion for persons in the second half of their life span is increasing. Results of different studies published at the end of the eighties show that health risks and anatomical deterioration can be effectively reduced in later life. From a medical viewpoint, these results provide the basis for preventive and rehabilitative measures. Knowledge from gerontology, social sciences and psychology demonstrates the necesserity of health promotion including the total way of life. First, the demographic and social framework for a concept of health promotion will be presented. The article will start with a short overview of the demographic-historical situation and the focus on the situations of different generations. Finally, the concrete requirements for the development of health promotion programmes will be formulated.

Aged↗
PubMed1998

The role of baccalaureate nursing students in the matrix of health promotion.

The Declaration of Alma Ata in 1978 put primary health care into the forefront of government health agendas around the world. The Ottawa Charter followed in 1986, emphasizing the role of health promotion for enhancing the wellness of populations and the potential cost savings related to illness care. The findings from research and evaluation in health promotion indicate that multiple approaches, such as mass media campaigns, school-based education, community education, community development, environmental initiatives, and implementation of legislation, are most likely to bring about sustained change (Garrard, 1990). Health education is a component of health promotion and is directed toward enhancing the skills of individuals, families, and communities to change behavior. Behavior change, however, will not be achieved by isolated health education campaigns but by a combination of strategies, methods, and activities at a local, state, and federal level. The type of campaigns that are implemented by nursing students is one intervention that forms part of the matrix of health promotion. This article describes the experience of a School of Nursing in the application of health education by students in a variety of settings in the community. These campaigns help the students to connect theory to nursing practice in a creative way that provides immediate and long-term benefits and may enhance the health of the community.

Community Health Nursing↗
PubMed1993

Maintaining evaluation designs in long term community based health promotion programmes: Heartbeat Wales case study.

STUDY OBJECTIVE: To examine the difficulties of developing and maintaining outcome evaluation designs in long term, community based health promotion programmes. DESIGN: Semistructured interviews of health promotion managers. SETTING: Wales and two reference health regions in England. PARTICIPANTS: Nine health promotion managers in Wales and 18 in England. MEASUREMENTS AND MAIN RESULTS: Information on selected heart health promotion activity undertaken or coordinated by health authorities from 1985-90 was collected. The Heartbeat Wales coronary heart disease prevention programme was set up in 1985, and a research and evaluation strategy was established to complement the intervention. A substantial increase in the budget occurred over the period. In the reference health regions in England this initiative was noted and rapidly taken up, thus compromising their use as control areas. CONCLUSION: Information on large scale, community based health promotion programmes can disseminate quickly and interfere with classic intervention/evaluation control designs through contamination. Alternative experimental designs for assessing the effectiveness of long term intervention programmes need to be considered. These should not rely solely on the use of reference populations, but should balance the measurement of outcome with an assessment of the process of change in communities. The development and use of intervention exposure measures together with well structured and comprehensive process evaluation in both the intervention and reference areas is recommended.

Cardiovascular Diseases↗
PubMed2000

Spreading the word: Teaching health promotion to students from disciplines other than health.

Intersectoral collaboration has gained acceptance as a strategic approach in promoting health, based on the assumption that the main determinants of health are social, physical and politico-economic factors and not medical care utilization. However, the difficulties of collaborating intersectorally for better health have become apparent over the last two decades. This paper describes an attempt to address these difficulties through an awareness-raising educational initiative devised for undergraduate university students from disciplines other than health. The course aims to raise students' appreciation of the ways in which their future occupations could have an impact on the health of others through intersectoral collaboration and the creation of environments that are supportive of health. The evaluation of the course, which comprised a peer-review process, a questionnaire seeking student feedback, and a task exploring students' ideas on how they could influence the health of others, demonstrated that students recognized the value of working intersectorally for better health. If intersectoral collaboration is really expected to be the way forward that many public health theorists claim, then this small but effective contribution should best be seen as one of a series of incremental building blocks leading to the desired effects.

Journal Article↗
PubMed1987

Health promotion and industry. Where interdisciplinary research meets reality.

Health promotion and disease prevention programs are now a common part of worksite life. Their acceptance has been based more on faith than scientific evidence of their effectiveness or benefit to either the companies or the participants. Evaluation research in worksite health promotion offers an opportunity to test the effectiveness of the programs and should be done using the methods of several disciplines: organizational psychology, industrial hygiene, and health education. Because of the inherent difficulties in planning, developing goals and objectives, and measuring outputs in worksite health promotion programs, any effective evaluation will have to combine methods and approaches from each of these perspectives.

Evaluation Studies as Topic↗
PubMedDate not supplied

Designing effective health promotion and disease prevention programs.

Numerous researchers stress the importance of health promotion and disease prevention programs as a means of helping people to foster positive health and lifestyle habits. Typically, health promotion and disease prevention programs strive to educate the public about risks involved in health abuses and the impact of lifestyle upon health status. Research, however, also reveals that health promotion and disease programs are often poorly designed. In response to the problem, a course model for teaching future health professionals how to strategically plan health promotion and disease prevention programs is presented.

Allied Health Personnel↗
PubMed2000

Health promotion practices of emergency physicians.

In this article we describe health promotion practices of emergency physicians (EPs). A survey was mailed to members of the West Virginia American College of Emergency Physicians. Main outcomes included the EP's beliefs regarding health promotion, perceived roles in health promotion, and perceived effectiveness in modifying the behavior of patients. Over 90% of respondents routinely asked about cigarette smoking and half about alcohol use. A minority routinely asked about illicit drug use, diet, exercise, domestic violence, or stress. The majority stated they were the main person responsible for patient health education in their emergency department (ED). Most felt prepared to counsel patients about smoking (68%) and alcohol (59%), although very few described themselves as successful in helping patients change their behavior. Although EPs feel responsible for promoting the health of their patients, only a minority reported routinely screening and counseling patients about prevention and most were not confident in their ability to help patients change their health-related behaviors.

Alcohol Drinking↗