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PubMed1999

Integrating occupational health protection and health promotion: theory and program application.

1. The worksite offers an excellent setting to focus on both health protection and health promotion. Collaboration between health professionals concerned with health protection and health promotion would achieve common goals of risk reduction related to job risks and life risks. 2. Workers who experience "double jeopardy" because they are exposed to job risks and life risks would benefit most. 3. Benefits of integration include lower health risks, joint responsibility to promote health and safety shared between management and workers, and cost effectiveness. 4. The social ecological model is useful in developing an integrated program as it is multidimensional, interdisciplinary, and includes the dynamic interplay between the environment and personal factors impacting the health outcome.

Cooperative Behavior↗

PubMed2000

Urban issues in health promotion strategies.

The powerful influence of behavioral choices on health status is well established. The implications and challenges for urban populations are formidable. Understanding urban environments will better prepare health promotion professionals to deal effectively with the forces affecting health-related behaviors. In thinking about urban health promotion in the United States, researchers often distinguish between 2 frameworks; one contending with urbanization, which affects most of us, and another contending with inner-city environments, where many of the deepest needs are. Urbanization confers both benefits and liabilities, but the single greatest challenge for health promotion may lie in reestablishing positive social connections. In contrast, 2 key features of the inner-city environment may be the negative ecological forces within neighborhoods and the lack of control over one's fate. Too often, prescriptions for the inner city stereotype its problems and ignore its strengths. For the inner city, important foundation stones for the future include ways to build on these strengths through positive connections and increased community control through coalition building.

Health Promotion↗

PubMed1997

Health promotion training needs analysis: an integral role for clinical nurses in Lanarkshire, Scotland.

Training needs analysis is considered essential to professional and organizational development, for continuing education and for incorporation into professional practice. Increasingly, nurses are encouraged to develop their health promotion role. Despite this there has been relatively little research in Scotland into the health promotion role of the hospital nurse. This study describes the results of a health promotion training needs analysis undertaken on qualified, hospital-based nurses in Lanarkshire, Scotland. Information on the nurses' current health promotion practices, their attitudes and beliefs, their views on role development and priorities for further training were collated, analysed and discussed within the framework of the Health Action Model. This model was originally designed to assist understanding of the gap that exists between an individual intention to act and the eventual health action. However, in this study the ways in which 'cognitive factors' (knowledge and beliefs) and 'motivational factors' (considering values, attitudes and drives) and pressures from social norms and significant others assisted in the understanding of the nurse's orientation to, and beliefs about, health promotion practice. Fifty-seven per cent of nurses in the study considered health promotion activities to be emerging in clinical care and 4% considered them to be advanced. The interest respondents have in role development and the further integration of health promotion activities into nursing practice was explored by ascertaining the nurses' attitudes and beliefs about their own health promotion role. Of 107 respondents, a majority 72 (67%) agreed health promotion interventions to be an important function of the nurse with 29 (27%) strongly agreeing (n = 107). Sixty per cent stated they would be interested in developing their role and 30% were very strongly interested. Recommendations are therefore made for future planning and development strategies for the health promotion role of hospital nurses.

Adult↗

PubMed2003

Need for health promotion based on evidence in cross sectional school health data.

With the purpose of evaluating the health condition of children in public primary schools in the province of Cordoba in Argentina, cross sectional data were collected from the School Health Program of the Ministry of Health of Cordoba Province in 2001. To conduct an analysis, a total of 25,701 pupils of the first and the seventh grades from one hundred and fifty primary schools were studied. The data consisted of variables in three groups: i.e., nutrition, vaccination and disease groups. Descriptive statistics revealed a higher prevalence in scoliosis, lower weight, no scar from BCG vaccination and skin transmission diseases in urban and rural areas than in interurban areas, while male genital diseases showed a high prevalence in the three areas. Dental caries had a high prevalence in rural areas. Factor analysis was carried out and six factors were extracted out of 27 variables to cover 64 % of total variance. Regression analyses revealed that nutritional variables such as lower weight and the absence of BCG vaccination were significantly related to scoliosis, and that lower weight significantly affected skin transmission diseases. We considered the necessity of modifying conduct in the school health program from the viewpoints of health promotion and community participation.

Argentina↗

PubMed2006

Health promotion for women with human immunodeficiency virus or acquired immunodeficiency syndrome.

PURPOSE: The purpose of this pilot study was twofold: first, to modify Stuifbergen's health promotion intervention initially developed for women with multiple sclerosis for use among women with human immunodeficiency virus or acquired immunodeficiency syndrome (HIV/AIDS) and to evaluate the feasibility of the newly modified health promotion intervention named "Put Health Into Living" (PHIL). The pilot study was completed in two phases. DATA SOURCES: In phase I, data were derived from a literature review, a focus group of women with HIV/AIDS (n= 7), a panel of experts who reviewed the intervention for content, and three female community workers who evaluated the intervention for the context of living with HIV/AIDS, cultural relevancy, and literacy. During phase II, a pretest/posttest one-group design was used to determine the feasibility of the study methods, content, and format of the health promotion intervention among 10 women with HIV/AIDS. CONCLUSIONS: The pilot study demonstrated the importance of a health promotion intervention for a vulnerable population. Participants verbalized the benefits of attending a health promotion program to gain knowledge and skills to promote their health. One woman said, "I have been positive for 20 years now and no one has talked to me just about my overall health." Participants indicated the PHIL intervention offered a supportive group environment, an overall health focus, and an acceptable format. IMPLICATIONS FOR PRACTICE: Health promotion is a desirable goal for persons living with a chronic disease, and the PHIL intervention has the potential to benefit persons living with HIV/AIDS if subsequent evidence is found in further testing of the intervention.

Adult↗

PubMedDate not supplied

Creating supportive environments for mental health promotion in the workplace.

Work is both an important resource for mental health, yet it also presents risk factors for mental illness. Consequently, the workplace has been identified as a potential setting for both mental health promotion and mental illness prevention. In the workplace various programs have been implemented which address risk factors for mental illness eg. stress management programs or the introduction of anti-bullying policies. However, few programs have been developed to address mental health promotion. It seems that the potential of mental health promotion is not fully utilised in this setting, nor are programs and initiatives to promote mental health as prolific as those in the physical health area. Furthermore, despite the introduction of legislation and workplace policies, structural changes have been unsuccessful in bringing about environmental modification which fosters mental well-being. This article explores explanations for this and makes recommendations utilising primary health care as an approach by which this situation can be redressed.

Australia↗

PubMed2004

The European Health Promoting Hospitals (HPH) project: how far on?

Back in 1986, the World Health Organization (WHO) produced the Ottawa Charter for Health Promotion. The intention of the charter was to create a framework that conveyed the notions of capacity building into a structured process for health promotion action in specific settings. This charter subsequently provided the vehicle from which the Health Promoting Hospital (HPH) initiative was launched, culminating in the Budapest Declaration of Health Promoting Hospitals (WHO, 1991). The aim of this paper is to investigate the nature and progress of the European HPH movement. Despite the fact that 'pockets' of concerted and progressive activity and evaluation have emerged from the HPH initiative, the majority of the available literature demonstrates a more limited impact than perhaps the WHO might have anticipated for its efforts over the last 15 years or so. Indications are that many of the member European HPH states have struggled to move beyond the 'project' phases of their planned programmes. This is not to detract from the considerable efforts that have been made to establish HPH networks or the continuing attempts to recruit further members/institutions into the movement. Nevertheless, this account concludes that a more concerted evaluation of European HPH progress is needed to accurately measure its impact and progress. If the situation remains unchanged, perhaps a fundamental review of the strategy is worth considering.

Community-Institutional Relations↗

PubMed2005

Exploring district nursing competencies in health promotion: the use of the Delphi technique.

AIMS AND OBJECTIVES: The research outlined in this paper aimed to establish a consensus view amongst primary healthcare professionals about the competencies that district nurses need in order to fulfil an effective role in health promotion. BACKGROUND: In recent years there has been a growing emphasis on health promotion in primary care in the United Kingdom and health promotion is becoming increasingly important to nurses who work in the community. However, consideration of the role of the district nurse in health promotion is rather restricted and consequently district nurses have limited access to empirical evidence, from which they can develop their work in health promotion. DESIGN AND METHODS: The Delphi technique was used for this study. Seventy-two primary healthcare professionals were mailed a series of three questionnaires, which achieved response rates of 86, 87.5 and 78.9%. RESULTS: There was a consensus amongst the panellists that district nurses require a range of competencies to engage effectively in health promotion. These were categorized to produce a definitive list of eight knowledge-, seven attitude- and eight skill-related competencies. CONCLUSIONS: For the first time, this study achieves a consensus on the competencies needed by district nurses to engage in health promotion. RELEVANCE TO CLINICAL PRACTICE: District nurses should feel encouraged to develop their health promotion role in light of the fact that many of the competencies that they require for this activity have been identified as essential for their day-to-day nursing practice. The research highlights the fact that new paradigm health promotion is a concept that has moved beyond the academic arena and is recognized as significant by practising health professionals.

Attitude of Health Personnel↗

PubMed1994

Predictors of health-promoting lifestyles in persons with disabilities.

Persons with disabilities have been largely overlooked in investigations of health and health behaviors. The primary purpose of this descriptive correlational study was to examine the usefulness of Pender's (1987) Health Promotion Model in explaining the occurrence of health-promoting behaviors among adults with disabilities. Hierarchical multiple regression analyses were used to analyze questionnaire responses from a sample of 117 adults with disabilities. Adults with disabilities were more likely to engage in a health-promoting lifestyle if they had higher specific self-efficacy for health behaviors, higher general self-efficacy, a wellness-oriented definition of health, required less mechanical assistance, and were female. Findings from this study suggest that interventions aimed at enhancing health promotion behaviors among persons with disabilities would be strengthened by addressing perceived ability to master situations, particularly the ability to successfully carry out health-promoting behaviors.

Activities of Daily Living↗

PubMedDate not supplied

The ecology of urban violence: its relationship to health promotion behaviors in low-income black and Latino communities.

PURPOSE: The purpose of this review is to identify and examine relationships between exposure to violence and health promotion behaviors in low-income black and Latino groups. DESIGN: Based on computer surveys of the psychologic, public health, medical, and sociologic literature, approximately 90 previous studies of the impact of exposure to violence on psychologic functioning, perceptions of health and well-being, and health decisions and behavior were identified. This article reviews those studies that examine the relationships between experiences of violence and subsequent feelings of alienation, powerlessness, and hopelessness, and perceptions of health and well-being and studies that examine relationships between alienation, hopelessness, and powerlessness and health promotion behaviors. Studies of health promotion behavior that did not examine or address the impact of exposure to violence are not reviewed in this article. RESULTS: Violence affects low-income communities directly by contributing to rates of mortality, and indirectly by affecting health promotion behaviors. Exposure to violence can result in feelings of powerlessness, hopelessness, and alienation that significantly limit motivation, the extent of involvement, and persistence in overcoming barriers to health promotion behavior. CONCLUSIONS: Future researchers must consider the confounding effects of exposure to violence when investigating differences in health promotion behaviors for low-income black and Latino groups. Community empowerment programs that address the impact of violence and focus on developing control over life and health outcomes may be needed to successfully address the effect of violence on health promotion behavior in low-income, black and Latino communities.

Black or African American↗

PubMedDate not supplied

The effectiveness of health promotion counseling for overweight adolescent nursing students in taiwan.

This study examined the effectiveness of health promotion counseling for overweight adolescent nursing students. The Chinese version of an established health promotion counseling booklet developed by the author of this study was used in the counseling. The study employed a one-group pre- and post-quasi-experimental research design from September 1997 to June 1999. A total of 166 (17%) first-year, junior college nursing students were found to be overweight according to the results of a health examination at the school health center at a junior college in the Taipei Metropolitan Area. Of these 166 students, 58 were randomly selected and 49 of these had complete participation records for the 2-year study. All subjects received 8 hours of whole group and 12 hours of small group health promotion counseling over a 1-year period. The results show that health promotion counseling enabled subjects to adopt healthier lifestyles and most of the physiological variables (WLI, HDL, SBP, TC) were significantly improved. This research outcome supports the value of health promotion counseling in school health centers, which incorporates material to help overweight adolescent students live a healthier life.

Adolescent↗

PubMed2000

Developing health-promoting practice with families: one pedagogical experience.

As the significance of social determinants of health has been revealed and the socio-environmental perspective of health promotion has become prominent, family nurses have attempted to move away from disease-treatment models of practice towards emancipatory, health promoting practice. This paper describes a multidisciplinary team's pedagogical experience of developing emancipatory family health promoting practices. The discussion includes a description of the significant educational processes that supported the development of health promoting family practice and an outline of the transformative changes the team members experienced as they evolved their health promoting practices.

Family Health↗

PubMedDate not supplied

Health promotion community development and the tyranny of individualism.

Economic evaluation of health promotion poses few major difficulties when the theoretical approach of the programme and the evaluation of cost and benefits are confined within the context of the individual. Methodological individualism has a long history in economics and the techniques of microeconomics are well suited to the examination of individually focused behaviour change programmes. However, new developments in community health promotion pose special challenges. These programmes have the community, not the individual, as the focus of programme theory and "community' means something completely different from the sum of individuals. Community empowerment and promotion of the community's capacity to deal with health issues are the goals of such programmes. To reflect these notions, sense of community and community competence should be considered as "functionings', an extra-welfarist constituent of well-being. Their inclusion as outcomes of community health promotion requires a shift from individualist utilitarian economics into a communitarian framework which respects the programme's notion of community. If health economics fails to develop new constructs to deal with these new approaches in health promotion, the application of existing techniques to community programmes will mislead health decision makers about their value and potential.

Bias↗

PubMedDate not supplied

[Physical exercise and health promotion in childhood and youth].

The "new health consciousness" that emerged in the developing countries in the 70s and 80s, has contributed to consider exercise as an element of health promotion. But it can establish simplistic relationships between exercise and health, particularly critical for professionals who develop promotion programmes. In this paper, five problematic aspects linked, to exercise and health relationships both in children and youngsters, are discussed and should be taken into account when promoting health programmes. We refer to: 1) the problematic role of exercise in health promotion and in physical education curriculum as an area of privileged action in children and youngsters; 2) the automatic relationship between fitness and health, when the former addresses to high levels of performance and the later is linked to moderate, regular and frequent exercise; 3) problems of fitness tests as a measure of health-related physical activity; 4) the assumption that any kind of physical activity is health-related; and 5) the quantity of exercise necessary for health as a practical problem. From the discussion different proposals are offered in order to develop health-related exercise promotion programmes such as to consider the risks of doing physical activity as a criteria to select exercises; to emphasize the qualitative instead of quantitative aspects of practice; to reconceptualize fitness and sport towards a health focus; to include a broad range of activities which offer the opportunity to every child and youngster to participate; to reduce the importance of testing in evaluation programmes; and other educational considerations which can help to maintain exercise practice beyond the schooling period.

Adolescent↗

PubMed2005

Prevention and health promotion in clinical practice: the views of general practitioners in Europe.

BACKGROUND: Disease prevention and health promotion are important tasks in the daily practice of all general practitioners (GPs). The objective of this study was to explore the knowledge and attitudes of European GPs in implementing evidence-based health promotion and disease prevention recommendations in primary care, to describe GPs' perceived barriers to implementing these recommendations and to assess how GPs' own health behaviors affect their work with their patients. METHODS: A postal multinational survey was carried out from June to December 2000 in a random sample of GPs listed from national colleges of each country. RESULTS: Eleven European countries participated in the study, giving a total of 2082 GPs. Although GPs believe they should advise preventive and health promotion activities, in practice, they are less likely to do so. About 56.02% of the GPs answered that carrying-out prevention and health promotion activities are difficult. The two most important barriers reported were heavy workload/lack of time and no reimbursement. Associations between personal health behaviour and attitudes to health promotion or activities in prevention were found. GPs who smoked felt less effective in helping patients to reduce tobacco consumption than non-smoking GPs (39.34% versus 48.18%, P < 0.01). GPs who exercised felt that they were more effective in helping patients to practice regular physical exercise than sedentary GPs (59.14% versus 49.70%, P < 0.01). CONCLUSIONS: Significant gaps between GP's knowledge and practices persist in the use of evidence-based recommendations for health promotion and disease prevention in primary care.

Alcohol Drinking↗

PubMed2003

Health promotion policy and politics: lessons from childhood injury prevention.

Health promotion policies--including laws that regulate safe products, environments, and behaviors--are among the most effective mechanisms for reducing childhood injuries for large segments of the population. In this article, five examples of safety legislation and regulation to reduce childhood injury are described. Two such efforts are aimed at preventing injury-producing events from occurring: child-resistant packaging for medications and hazardous substances, and graduated licensing for teen drivers. Three other examples illustrate the value and complexities of policies designed to prevent an injury once a hazardous event has occurred: bicycle helmet legislation, children's sleepwear standards, and child safety seat laws. One important role of health promotion is to tackle not only how health promotion policies and politics can improve child health, but also how to educate legislators and policy makers in the process.

Accidents, Traffic↗

PubMedDate not supplied

Eliminating disparities: empowering health promotion within preventive medicine.

The estimated 800,000 U.S. deaths in 1990 related to behavioral decisions challenge physicians to better assist behavioral change through expanded health promotion activities. Based on the format guidelines of this special issue, this brief paper first examines the current and optimal roles of health promotion within Preventive Medicine, including five physician roles for improving modifiable public health-risk behavior burdens: (1) preventive services clinician, (2) health promotion researcher, (3) educator-communicator, (4) systems manager, and (5) health promotion advocate. After presenting a new vision statement, this paper proceeds to discuss the opportunities and barriers, including system, clinician-office, and patient factors, to attaining this new vision of empowering health promotion within Preventive Medicine. Finally, all physicians are invited to engage in a threefold strategic plan for change through at least one of five action items: (1) health promotion advocacy, (2) health promotion research, (3) public communication, (4) protocol dissemination and implementation, and (5) Preventive Medicine training.

Communication↗

PubMed1994

Social decision-making and life skills development: a critical thinking approach to health promotion in the middle school.

This article discusses a classroom-based social decision-making intervention for health promotion and prevention of problem behaviors. The social decision-making approach brings together social-cognitive, affective, behavioral, and social relationship areas with critical thinking skills important for academic achievement. These skills are the same ones needed to promote children's health and prevent substance abuse and related health-compromising behaviors. Key components of this program, its development, and theoretical background are discussed, focusing on implications for school-based health promotion. As such, social decision-making provides an approach to health promotion that enhances coordination among classroom and health education personnel. The middle school years, a time of increasing risk for negative health-related outcomes, are examined as a key period for intervention. Finally, empirical evidence supporting use of social decision-making and related approaches is discussed.

Adaptation, Psychological↗