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PubMedDate not supplied

The University of Virginia health promotion and disease prevention program.

INTRODUCTION: Proof of effectiveness now exists for many health promotion and disease prevention practices, yet the importance of this knowledge is not widely appreciated, and a large percentage of the population does not receive this care. Universities with comprehensive academic medical centers are particularly appropriate places for providing health promotion programs. The University of Virginia began a health promotion and disease prevention program for employees in 1990. METHODS: Periodic health risk appraisal, with follow-up and selected interventions, is offered to approximately 14,000 employees as a cost-free fringe benefit. Health risks are assessed with a modification of the Carter Center Health Risk Appraisal. Results are given to participants in group sessions; referrals are made for clinical preventive services and interventions, as needed. RESULTS: During the first three years, 29% of the employee population participated in the program. Participants were more likely to be young, female and not African American. Nearly 96% had one or more risk factors, with an average of 3.6 risk factors overall. Participants on average had 1.8 risk factors for cardiovascular disease; 0.3 for cancer; 0.6 for injury; 0.1 for alcohol abuse; and 0.7 for mental health. Nonparticipants were not receiving similar comprehensive health risk appraisal elsewhere. CONCLUSIONS: University of Virginia employees have multiple health risks, not detected through their usual health care, for which effective interventions are available. This population probably reflects conditions throughout the state and nation. Academic medical centers should place high priority on establishing health promotion programs as part of their responsibilities to society.

Adolescent↗

PubMed2005

Codman Award Paper: self-efficacy of staff nurses for health promotion counselling of patients at risk for stroke.

The effect of nurses' confidence to counsel patients at risk of stroke in selected health promotion areas: smoking cessation, exercise and nutrition was examined. Bandura's (1986) self-efficacy and Knowles' adult learning theories provided the theoretical underpinnings for the study. This was a quasi-experimental design in which neuroscience nurses (N = 23) from a quaternary hospital completed questionnaires prior to, immediately after, and 2 months post completion of a self-directed learning manual (SDL). The researcher-designed manual was designed to enhance learning about the risk factors for stroke and the importance of stroke prevention. Along with reflective activities and pre-post test, strategies for counseling high-risk, stroke-prone individuals in the areas of smoking cessation, exercise, and nutrition were also integrated. The Health Promotion Counseling Self-Efficacy Scale (Tresolini, Saluja, and Stritter, 1995), consisting of 10 self-efficacy subscales relating to self-confidence in knowledge and ability to counsel in health promotion areas, was used to capture the nurses' self-report of self-efficacy. Using a 5-point Likert Scale, nurses also rated their amount of agreement or disagreement about health promotion counseling in practice. Overall, self-efficacy levels for both knowledge and counseling increased significantly (p < .01) from pre-to immediately post completion of the manual, and decreased slightly at two-month follow-up. This pattern was evident in all health promotion areas measured except for knowledge in exercise (p = .015). Nurses' attitudes about aspects of health promotion practices correlated significantly (p < 05) at two-month follow-up with all health promotion areas. Results of this study support the usefulness of a self-directed learning manual as a teaching strategy for health promotion counseling of individuals at risk of stroke.

Adult↗

PubMed2006

Use of research by the Australian health promotion workforce.

This paper examines the attitudes and practices of Australian health promotion practitioners toward evidence-based practice (EBP). The study used a survey methodology and questionnaires were sent to 1114 members of the Australian Health Promotion Association. A response rate of 27% (n = 277) was achieved. The data showed that the vast majority of participant's attitudes toward EBP was very welcoming. However, in practice the impact of EBP was limited. Participants identified a range of significant barriers to implementing EBP including organizational culture, policy directives and lack of resources. A range of concerns was also identified regarding the applicability of the medically based EBP model within health promotion, which is based upon a social model of health. The findings highlight the importance of acknowledging the complexity of health promotion interventions and working toward developing an appropriate evidence base.

Adult↗

PubMed1990

The Health-Promoting Self-Care System Model: directions for nursing research and practice.

In an effort to theoretically integrate perspectives of self-care and health promotion, the Health-Promoting Self-Care System Model is proposed as a framework for identifying and explaining sequential patterns among factors which influence the decision-making, performance and outcomes of health-promoting lifestyles. The model is based upon a synthesis of elements comprising constructs of the Self-Care Deficit Nursing Theory as well as certain factors in the Interaction Model of Client Health Behaviour and the Health Promotion Model. Directions for research and practice provided by the model should encourage the development of a cumulative nursing knowledge base and contribute to the goal of enhancing the health and well-being of persons across developmental and sociocultural contexts.

Health Promotion↗

PubMed2004

Evaluation of the participation of Aretaieion Hospital, Greece in the WHO Pilot Project of Health Promoting Hospitals.

Aretaieion University Hospital participated in the World Health Organization (WHO) Pilot Health Promoting Hospitals Project from 1993 until 1997, when the Hellenic Network of Health Promoting Hospitals was established. This study is an overall evaluation of the participation of Aretaieion Hospital at the HPH Pilot Project. The evaluation comprised two questionnaire surveys, one among all the professionals, and the other among the patients involved in the subprojects. At the professional's survey, the response was 88.6% (39), while at the patient's survey the response was 62.2% (84). Differences were identified between the perceptions of the professionals who were external collaborators and those who were members of the hospital staff. Problems of the Project were reported to be lack of funding, lack of time and personnel shortages, lack of health promotion background and lack of incentives. Major successes were reported to be the personnel training, the development of collaboration and teamwork, the improvement of the overall image of the hospital into the community, the improvement of the working conditions of the personnel. Perception of sustainability of the projects by health professionals was found to be related to how interesting they found their subproject and how relevant to the work of their department. The communication strategy was inadequately planned and this resulted in some difficulties in developing rapport with the patients. However, the patients felt that they benefited from the project, a view also held by the hospital staff professionals.

Attitude of Health Personnel↗

PubMed2006

Ottawa to Bangkok: changing health promotion discourse.

The discourse of the 2005 Bangkok Charter for Health Promotion in a Globalized World represents a radical departure from that of the Ottawa Charter that, in 1986, staked a place for the health promotion field in mainstream public health. Via a critical analysis of the discourse in these two Charters, this paper illustrates a shift from a 'new social movements' discourse of ecosocial justice in Ottawa to a 'new capitalist' discourse of law and economics in Bangkok. The Bangkok Charter's content may identify 'actions, commitments and pledges required to address the determinants of health in a globalized world through health promotion', but this paper shows how its discourse works to naturalize and perpetuate many of detrimental determinants associated with 'globalization'.

Global Health↗

PubMed1994

Health promotion and early disease detection among medical school faculty.

BACKGROUND: Medical school faculty members influence students' health promotion beliefs by their patient care activities and personal health habits. We characterized the medical school environment by defining faculty's health promotion and early disease detection attitudes and practices. The data disclose faculty needs and suggest a new paradigm to alter medical students' health promotion beliefs and care patterns. METHODS: An observational study of all academic faculty was conducted at a medical school using self-report survey data collected with a confidential questionnaire. The survey instrument assessed faculty demographics, 27 behaviors, and 23 beliefs concerning health promotion. RESULTS: Eighty-four percent of faculty (575 of 683) responded. Although agreement was moderate to good between lifestyle beliefs and personal behaviors, the concordance between personal adherence to and beliefs concerning the recommended physical examinations and laboratory tests was only fair (kappa 0.21 to 0.40). CONCLUSION: Faculty's health promotion and disease detection beliefs and behaviors were inconsistent. Observing this discrepancy may relate to students' establishment of attitudes and practices. Modifying faculty's personal behaviors and altering the medical school environment might enhance students' commitment toward preventive care.

Adult↗

PubMed2006

Krachtvoer: process evaluation of a Dutch programme for lower vocational schools to promote healthful diet.

The aim of this study was to examine the fidelity and completeness of the implementation of a school-based healthful diet promotion programme called 'Krachtvoer' (we use the Dutch title of the programme throughout this article. A possible translation is Power Food, but this does not reflect the play on words in the Dutch title), aimed at lower vocational training students aged 12-14 years. The teachers' and students' opinions of the programme were also assessed, as well as the association between these opinions and the level of implementation. Data were collected through structured teachers' monitoring reports, in-class observations and in-depth interviews with teachers. Further data were drawn from a student questionnaire included in a concurrent cluster-randomized baseline post-test experimental study evaluating the effects of the programme. The present study indicates that the teachers implemented the programme largely according to plan, that the teachers appreciated most parts of the programme and that the students who were exposed to the programme were more appreciative of their nutrition education lessons than students who followed the usual curriculum. However, programme elements that teachers did not like were often not implemented. We conclude that the Krachtvoer programme is a promising tool to encourage students in lower vocational training to adopt diets that are more healthful. The present study revealed the stronger and weaker parts of the programme and can thus guide programme improvement.

Adolescent↗

PubMed1989

Political theory and individualistic health promotion.

The grounding of the individualistic self-care-behavior approach to health promotion in classical liberal political theory is made explicit by uncovering the correspondence between the assumptions of the two. Questions are raised about whether the problems attributed to liberal theory are reflected in the results obtained with individualistic health promotion. It is suggested that for nurses to engage in socially responsible health promotion, they may need to reconceptualize health promotion using a feminist perspective.

Health Promotion↗

PubMed1990

Healthy People 2000: national health promotion and disease prevention objectives (excerpts). US Public Health Service.

The US Public Health Service recently completed and published Healthy People 2000: National Health Promotion and Disease Prevention Objectives. The report is the culmination of a national effort, representing the work of citizens, professionals, organizations, and communities, and the cooperation of numerous federal agencies. The overall goal of the report and its objectives are to prevent unnecessary disease and disability and to achieve a better quality of life for all Americans.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Factors contributing to health promotion behaviors among African-American men.

Few studies reported in the literature address healthcare trends of African-American men. A study of health promotion behaviors of African-American men was undertaken using a health beliefs framework. The study examined the cancer-related knowledge, attitudes, and perceptions (KAP) of a select group of African-American men to evaluate their influence on health promotion behaviors. The health beliefs framework was very useful in predicting the health promotion behaviors of African-American men. Significant relationships were observed between the variables of knowledge of early warning signs of cancer, attitudes related to screening procedures, perceptions of seriousness of cancer, and cancer risk reduction and early detection health promotion behaviors. The results reinforce earlier reports indicating the pronounced effects of knowledge, attitudes, and perceptions on the use of health-promoting activities.

Adolescent↗

PubMedDate not supplied

Health promoting schools: issues and future directions for Australia and the Asia Pacific Region.

This paper sets out to trace the development of health promoting schools in Australia and the Asia Pacific Region. An overview of conceptual frameworks pertinent to promoting health in school is presented, together with a justification for a focus on schools as settings for health. The challenge ahead for school communities is to move from the simple classroom-based topic focused old style health education, to the whole settings approach and the broad-ranging, comprehensive collection of actions that make up this wider view.

Asia↗

PubMed1993

Health promotion, occupational therapy and multiculturalism: lessons from research.

Principles of occupational therapy practice make the profession an important potential partner in health promotion initiatives for immigrant groups. Health promotion embodies the principles of self-definition of health needs by target groups, and working with a community in initiating and supporting programmes. This paper discusses the implications of an exploratory study of the daily activities of immigrant Indo-Canadian mothers for translating health promotion principles into practice. The research process and an analysis of interviews conducted with the women suggest factors to consider in using a health promotion framework with immigrants who have experienced social and economic dislocation through the immigration process. Discussion of household structure, divisions of labour, childcare strategies, and parenting concerns raises issues requiring particular attention in sharing occupational therapy skills and knowledge with ethnocultural communities.

Adult↗

PubMed2001

Health promotion research: dilemmas and challenges.

OBJECTIVE: To analyse dilemmas and challenges in health promotion research, and to generate ideas for future development. METHOD: The analysis is based on authors' experiences in working in the field of research and action in health promotion and on experiences of others as found in literature. RESULTS: The assumptions underlying scientific research as based in the biomedical design are difficult to meet in community-based health promotion research. Dilemmas are identified in relation to the possibility of defining the independent and dependent variables beforehand and the intermingling of these variables (the intervention and outcome dilemma), the difficulty in quantifying the desired outcomes (the number dilemma), and the problem of diffusion of the programme to the control group (the control group dilemma). CONCLUSION: Research in health promotion has specific reasons to reconsider the approach towards research, the selection of outcome variables, and research techniques. Strategies and methods to make activities and their outcomes clear are discussed and criteria to judge confidence and applicability of research findings are presented.

Health Promotion↗

PubMed1991

Cancer prevention and screening in light of health promotion and prevention of disability for the second 50 years. A report from the Institute of Medicine of the National Academy of Science.

Increased attention is needed to the prevention of disability resulting from cancer in promoting the health of aged persons. This will require enhanced concern from the medical profession, the general adoption of a taxonomy of disability, and more efficient use of health-care resources. Little is known in quantitative terms of the relative effectiveness (for example, as measured by Quality Life Years) and costs of health-care interventions that reduce disability resulting from cancer. Considerable research will be needed on outcome benefits to make possible rational allocation decisions.

Aged↗

PubMed1987

[Health promotion for community patients--and health care].

There is a basic attitude in using terms like 'sick' or 'healthy' referring to a client. This attitude determines the nursing and therapeutic measures. The provision of health care is an inevitable part of the community nursing services. The relation to the population is given on the basis of personal contact in every-day matters. Communal or visiting nursing organisations can not handle large projects by themselves but are definitely in the position to participate. Continuing further education is a necessity for nurses as well as for the employers. Community nursing is in addition dependent on the support and co-operation of advanced thinking specialists groups.

Health Promotion↗

PubMed2003

[Parents as partners in school-based health promotion and addiction prevention: an empirical study for the example of Class2000].

Starting from the premise of the incomparable importance of the parent-child relationship for development, Class2000, a wide-reaching programme for the promotion of health and prevention of addiction in primary schools, focuses especially on the integration of parents. A questionnaire survey among 1430 parents in Hesse with children in the second primary class shows that the overriding majority of pupils (90 %) speak about Class2000 at home and initiate discussions with their parents on health-related topics. The various Class2000 information materials are acknowledged by up to 77 % of parents (comparatively more rarely in the case of the fathers) and are read, as a rule, with interest. Specific information on the contents of the programme is for the parents rather more important than general stimuli. Invitations to special informative events are accepted by well 80 % of the parents. Class2000 convinces more than 82 % of the participants. 71 % of the parents are prepared to contribute to the costs of Class2000. 12 % are undecided in this regard. Participation in parent evenings increases the readiness for financial involvement.

Adult↗

PubMed2003

Community management structures to promote health.

This article describes key requirements of effective health service management that emerge from a review of Australian developments in the respective roles of government and the market. From a public interest perspective, community and industry ownership and management of funds appear superior to market-driven health management approaches. The clear separation of public interest-based policy and administrative functions is vital for effective fund management. Greater transparency, more community input to broadly planned service delivery, casemix funding systems and better outcome data are required to tap the potential benefits of this policy-led model. A pooled funding approach to service provision may assist regional communities achieve their health aims, and the service breadth and flexibility which appear to be necessary to support health and related regional goals.

Australia↗