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Health-promoting behaviors of elderly korean immigrants in the United States.

The purpose of this study was to explore health-promoting behaviors among elderly Korean immigrants, and to examine the relationships of their health-promoting behaviors with self-efficacy and perceived health status. One hundred ten elderly Korean immigrants residing in the United States were interviewed using a structured questionnaire. The mean score of health promoting behaviors of elderly Korean immigrants was 2.54 on the 5-point Likert scale. Nutrition was the subdomain with the highest mean score (M=3.01) and exercise was the subdomain with the lowest mean score (M=1.92). Both self-efficacy (r=0.49, p=0.01) and perceived health status (r=0.19, p=0.043) were significantly related to health-promoting behaviors. Education (F=3.61, p=0.016) and economic status (F=3.01, p=0.034) were significantly associated with health-promoting behaviors. This study showed poor practices of healthy lifestyles of elderly Korean immigrants. Low exercise scores indicated the need for community based exercise and health promotion programs for the elderly Korean immigrants population.

Aged↗

Health promotion practices of smoking and non-smoking black women.

This descriptive study utilized Pender's Health Promoting Lifestyle Profile (HPLP) to survey a sample of Black women age 18 and older who attended three churches located in the southcentral United States. The prevalence of cigarette smoking is increasing among females, and Black females are at greater risk for complications related to smoking than are their White counterparts. The purpose of this study was to describe the health promotion practices of Black women who smoke cigarettes and those who do not smoke cigarettes. If differences were identified in the health promotion practices of these two groups, the findings would provide a basis for developing a plan for overall health promotion specifically tailored for Black women who smoke. The data analysis revealed no significant difference between the HPLP and subscale mean scores of the smokers and non-smokers. Scores were higher on a minimum of five subscales and the overall HPLP for women > 40, those with some college level education, or having annual household incomes of > $20,000, regardless of smoking status. MANOVA results revealed significant main effects of age on three subscales. Two-way ANOVA's revealed significant main effects of age and household income on HPLP scores. The results in this study indicate that education is the strongest predictor of health promoting behavior. Other demographic variables such as age and household income accounted for a variance in the subscale categories and overall HPLP scores. Nursing interventions with a health promotion focus must be developed with an emphasis on Black women who are younger than 40, those having a high school or lower educational level, and those in the lower socioeconomic class.

Adult↗

[A study on influencing factors in health promoting behaviors of women workers at small-scale industries].

PURPOSE: This study was aimed to identify the major factors affecting performance in health promoting behaviors in women workers at small-scale industries. METHOD: This study was based on the Pender's Health Promotion Model. The subjects for this study were 251 women workers at 23 small-scale industries in Busan city. The data for this study was collected from July 15th to August 15th 2003 by structured questionnaires, and were analyzed with ANOVA, t-test, Pearson' correlation coefficient, and multiple Regression in the SPSS/WIN 10.0. RESULT: The mean performance of the health promoting behavior was 2.56. The factors related to the performance of the health promoting behaviors were social support, marital status, status of owning a house, perceived barriers to action, working time, and self-efficacy, and they explained 58.4% of the variance of the health promoting behaviors. CONCLUSION: The mean performance of the health promoting behavior seemed to be low, and the most important variable related to health promoting behaviors of women working at a small-scale industry was social support. Therefore, intervention programs to increase the social support for women worker need to be developed.

Adult↗

Health counseling and health promotion of musculoskeletal disorders.

The steady increase in the number of musculoskeletal disorders has heightened the importance of health promotion accordingly. In Germany, health promotion efforts have become the responsibility of health insurers. Commissioned by the health insurance organization, Hamburg-Münchener Ersatzkasse, we developed and evaluated a new health counseling service for persons with musculoskeletal (rheumatic) complaints. In order to draft the scope and principles of the counseling program, we questioned more than 1000 enrollees per questionnaire. The aim of the survey was to estimate the actual demand for participation in the health counseling. The results show that the subjective need for health counseling is strongly linked to the kind of physical limitation involved, so that it can be assumed that particularly persons with relevant complaints and musculoskeletal disorders will participate in the program. To evaluate the counseling sessions, a range of measurements was developed. The aim was to obtain a comprehensive and precise record of the problems and complaints of those taking part in the program. The evaluation shows that the new service is used mainly by persons who have suffered limitations to their health for years due to musculoskeletal disorders. Especially middle-aged persons use the counseling service, with women showing the most interest. When participants were asked after counseling which health support measures they had taken or were planning, their answers indicated that in most cases the recommendations of the counselor were being put into practice. We conclude that health counseling can be considered a meaningful option for health promotion.

Adult↗

Corporate characteristics and worksite health promotion programs: survey findings from Fortune 500 companies.

A study was carried out to assess the nature and extent of worksite health promotion programs in Fortune 500 companies. Growth and interest in worksite health promotion continues at a remarkable rate. Fortune 500 firms are a good barometer of the state of the art of programs in work settings because these companies have large numbers of employees, an interest in cost savings, and expertise to invest in innovative efforts. Data collection consisted of questionnaires sent to the medical officer or Chief Executive Officer of all companies appearing on the 1984 Fortune 500 list. The following issues were addressed: whether companies offered worksite programs; what health promotion activities were provided in their programs; whether organizations had plans to start up or expand programs; what organizational support existed for programs (i.e. who pays, on whose time employees participate, when activities are offered, and what types of personnel are hired to staff programs); and whether these companies applied needs assessments, evaluation and cost analysis in their programs. Differences in these characteristics were examined in relation to the organizational variables of size (number of employees), Fortune 500 rank and type of industry (low-technology versus high-technology). The response rate for the survey was 49.4% (n = 247). Results of the study indicate a high level of health promotion activity in Fortune 500 firms. Out of the total group of respondents, two-thirds (n = 164) report having worksite programs and two-thirds of organizations with programs have plans to expand their health promotion offerings. One-third of responding organizations without programs planned to initiate them. The health promotion activities provided are numerous and varied, and within units that have programs rates of employee eligibility are reported to be high. However, the participation rates reported are appreciably lower. It is of special interest that, in general, the higher ranked, larger and high-technology companies are more likely to have programs; offer more activities in programs; have plans for program expansion; use a model of sharing costs of, and time to participate in program activities; make greater use of health professionals; and utilize more often needs assessment, evaluation and cost analysis techniques. The results of this study underscore the importance of examining a broad constellation of factors surrounding worksite programs. Given the organizational literature reviewed, it is likely that the characteristics of Fortune 500 programs documented here will serve as models for programs in midsize and smaller companies.

Cost-Benefit Analysis↗

Health promotion attitudes and practices of Texas nurse practitioners.

PURPOSE: The purpose of this descriptive cross-sectional survey was to examine the health promotion attitudes and practices of Texas nurse practitioners (NPs). DATA SOURCES: Original research utilizing the Health Promotion Practices of Nurse Practitioners Instrument developed by the researcher and completed by 442 Texas NPs. CONCLUSIONS: Overall, Texas NPs have positive attitudes toward health promotion and are supportive of health promotion practices. However, the findings of this study indicate that improvement can be made in the adoption of certain health promotion practices. IMPLICATIONS FOR PRACTICE: The growing number of NPs providing care to patients can significantly impact public health through consistent health promotion in clinical practice.

Adult↗

[Model for the systematic classification of outcomes in health promotion and prevention].

Successful demonstration of the effects of health promotion calls for systematic documentation and comparison of the outcome of different measures and projects. A model has been developed in the form of an outcome categorisation system for this purpose and is presented here. The model includes four categories covering the intermediate outcomes of health promotion measures, and three categories for outcomes at the level of health determinants (conditions necessary for health). Each category includes three to four sub-categories, for which examples of possible indicators are presented. The model can be applied both in the planning and in the evaluation stage of a project. This makes it possible for health promotion agencies and institutions responsible for funding and promotion to obtain a general overview of the outcome of their work.

Health Promotion↗

Health promotion practices of restaurants and cafés in Australia: changes from 1997 to 2000 using an annual telemarketing intervention.

This study looked at whether rates of health promotion practices among restaurants and cafés in the Hunter Region of New South Wales (NSW), Australia, increased between 1997 and 2000. During the project period all restaurants and cafés in the region were offered an annual direct marketing telephone interview (1997, 1998 and 1999), during which resources were offered to assist in the adoption of health promotion practices. Owners or managers of restaurants and cafés completed phone interviews that assessed 18 health promotion practices relating to: environmental tobacco smoke (two practices); responsible service of alcohol (five practices); healthy food choices (one practice); food safety (four practices); occupational health and safety (three practices); and the prevention of infectious diseases (three practices). Changes in practices were examined by comparing data from cross-sectional samples in 1997 (before any offers of resources) and 2000 (after up to three annual telemarketing calls), and among a cohort interviewed in both 1997 and 2000. Ninety-one per cent of restaurants and cafés (321) participated in the 1997 survey and 239 (81%) participated in the 2000 survey. A cohort of 122 restaurants and cafés participated in both surveys. Significant increases were present for 14 of the 18 health promotion initiatives in the cross-sectional sample and for 10 of the 18 health promotion initiatives in the cohort. For both cross-sectional and cohort samples, a change in at least one practice in each area was evident, with the exception of nutrition. The proportion of restaurants and cafés in the project region that undertake health promotion initiatives is increasing. A telephone-based intervention may contribute to such an increase. The suggestion that the prevalence of health promotion initiatives in restaurants and cafés can be increased highlights the potential for health promotion to be more actively involved in this setting.

Alcohol Drinking↗

A preliminary study on the health promotion outcomes of high-risk hypertensive freshmen.

This preliminary study identified the outcomes of a health promotion program encompassing health education (2 hours) and case management for 4 weeks applied to high-risk hypertensive freshmen (systolic blood pressure, > or = 160 mmHg, or diastolic blood pressure > or = 100 mmHg) at a university located in Southern Taiwan. Twenty-two freshmen participated and data were collected at baseline and 4 weeks later, after the program. Outcome indicators included biologic (blood pressure, body weight and body fat composition) and healthy lifestyle characteristics (assessed using the Health Promotion Lifestyle Profile [HPLP] and case management documentation). The Wilcoxon signed rank test showed that systolic blood pressure, body weight, and four subscales of the HPLP, health responsibility, interpersonal support, nutrition, and exercise, had improved significantly. This program could be used as a reference to refine further health promotion programs in the university.

Adult↗

[Nationwide survey of municipality's maternal & child health promotion planning processes and consequent changes].

PURPOSE: The purpose of this study was to offer insight into the revisions needed for promotion of Maternal and Child Health Promotion Plans in the coming years. METHODS: The maternal and child health promotion planning process and changes in maternal and child health services were surveyed by questionnaires to all municipalities in Japan. RESULTS: Completed questionnaires were obtained from 2,362 municipalities (response rate: 72.6%) Replies from 2,202 municipalities, which had completed planning by March, 1998, were analyzed. Planning committees were established by 63.9% of municipalities, and working committees were set up in 55.4% of them. Members involved in the working committees were more limited when compared to the planning committees and only 9.3% of the committees had representatives from mothers. 37.5% of working committees held meetings more than 5 times. 56.0% of municipalities conducted hearings or questionnaire surveys of mothers and health personnel for assessment of maternal and child healthcare needs. Most prefectural public health centers provided statistical data for planning assistance. Public health center staff participated as planning members in 38.5% of municipalities, and a training program for the planning sponsored by health centers was utilized by 33.8% of municipalities. Only 18.3% of municipalities received support for explanation of the plans to the mayor and/or executive officers, only 12.1% received support for the management of the planning committees, and only 11.8% received support for needs analysis. Less than half of minicipalities conducted PR activities of the plans and progress management. A higher proportion conducted these activities in larger cities. After the planning process, 72.9% of municipalities started new projects according to the plans. However, 10.1% scrapped one or more projects. Changes in maternal and child healthcare services and promotion of coordination with other related organization were seen more in municipalities with a larger population. There were major differences found between prefectures with regards to the planning process, including the support from public health centers, and the effective use of plan reports, progress management, and changes in maternal and child healthcare services after the formulation of plans.

Community Health Planning↗

Factors influencing health promoting activities of mothers caring for ventilator-assisted children.

The extensive care a ventilator-assisted child (VAC) requires when cared for in the home can impact the mother's ability to participate in health promotion activities. The purpose of this study was to examine health promotion activities and the relationships among functional status of the child, impact of the illness on the family, coping, social support, and health promotion activities of mothers who care for ventilator-assisted children at home. Thirty-eight primary female caregivers, mostly mothers, participated in the study and completed the Personal Lifestyle Questionnaire (PLQ), measures of child's functional status, impact of the illness on the family, coping, social support, and demographic data. Findings revealed that the mothers scored low on the nutrition, exercise, relaxation, and general health promotion subscales of the PLQ. Functional status of the child and coping were positively correlated with participation in health promotion activities, whereas impact of the child's illness on the family was inversely related to health promotion of the mothers. Regression analysis revealed that functional status of the child and coping were significant predictors of mothers' participation in health promotion activities. The high demands associated with caring for a VAC with poor functioning can be a significant risk factor for not participating in health promotion activities. Nurses need to help mothers with coping and finding resources to help mediate the stress related to caring for their child, thereby helping the mothers to maintain their own health.

Adaptation, Psychological↗

Towards a secure evidence base for health promotion.

The importance of a sound evidence base for health promotion is recognized. Criteria for establishing evidence have, in the past, been heavily influenced by the bio-medical agenda. The problems in using experimental and quasi-experimental approaches and their limited relevance for evaluating health promotion interventions are examined. The multifactorial nature of the health promotion enterprise in relation to both inputs and outputs is recognized and a range of direct, indirect and process indicators are identified. The relevance of combining quantitative and qualitative methods for data collection is discussed and the paper concludes by advocating a 'judicial principle' for assessing evidence.

Data Collection↗

["Bread from stone and spiritual uplift for illiterates"--paternalistic community health promotion 200 years ago].

Some of the early pioneers of community health promotion in Norway were clergymen. One of these "potato priests", as they often are referred to, was the Rev. Niels G.A. Dahl (1778-1852) in Gulen, a poor rural district in western Norway. In a spirit of paternalism he engaged in many non-religious activities promoting the lives and health of his congregation. He engaged in vaccination, medical treatment, control of infectious diseases and provision for the poor, hired a midwife, struggled hard against heavy liquor drinking among locals and promoted primary education. This article highlights Dahl's contributions to community health promotion. Effective community health promotion depends on local knowledge, as well as local authority, influence and personal engagement. Maybe a dose of the paternalistic spirit is called for also in today's health promotion?

Clergy↗

Health-promoting behaviors through pregnancy, maternity leave, and return to work: effects of role spillover and other correlates.

Women's health-promoting behavior changes and their correlates across the transition to motherhood and return to work are insufficiently understood. The purpose of this study was to describe and compare women's health-promoting behaviors, particularly physical activity (PA), across these transitions. A prospective, observational design was employed to assess 243 female healthcare workers from 3 sites with regard to health-promoting behaviors, and their demographic (e.g., age, parity) and psychosocial (i.e., work-family role spillover) correlates. Forty-two participants were recruited while pregnant and re-assessed during maternity leave and upon return to work, and compared to 201 non-pregnant participants. No significant changes in health-promoting behaviors were observed from pregnancy through the postpartum. Pregnant participants reported better nutrition than comparison participants (p=.001), and were more likely to check their pulse when exercising (p=.004). During pregnancy, health-promoting behaviors were related to parental status, with first-time mothers engaging in more positive behaviors. Correlates of PA during maternity leave and return to work included family income and exercise history. Positive family-to-work spillover was significantly greater among pregnant women than among comparison participants (p<.001), and positive work-to-family spillover was related to greater PA upon return to work (p<.01). This study reveals little variability in health-promoting behaviors from the prenatal to the postpartum period. Both demographic and psychosocial factors have effects on health-promoting behaviors, and we must look to these correlates to promote increased PA.

Adult↗

Student nurses' perceptions of health promotion: a study.

This article reports the findings of a comparative descriptive study of Project 2000 student nurses and student nurses following the apprenticeship model of training (conventional). The research compared their perception of health promotion with the perception of their roles as health promoters. The study used a mixture of quantitative and qualitative methodology including a questionnaire, Likert Scale assessment of statements, and interviews. The results showed that there was no significant difference between the two groups except in two areas. The conventional students agreed more strongly than the Project 2000 students that their roles as health promoters were very important. The Project 2000 students were able to name eight different health promotion models/approaches and applied some of them in practice, while the conventional students had no knowledge of health promotion models/approaches. The researcher recommends that a wider understanding of health promotion should be encouraged and that nurse lecturers and clinical staff should work more closely to develop a consistent approach to health promotion.

Attitude of Health Personnel↗

What is the role of health promotion in nursing?

There is much confusion about the philosophical assumptions underlying nursing and health promotion. Effective health promotion strategies are based on the concepts of patient empowerment and the need for equal working relationships. The cultural climate of nursing may have to change if these principles are to be successfully adopted.

Health Promotion↗

Community health orientation, community-based quality improvement, and health promotion services in hospitals.

The objective of the study presented in this article was to examine the relationship between hospital community orientation and the provision of health promotion services. The study used data from the 2000 American Hospital Association survey and the 2000 Area Resource File to examine acute care hospitals throughout the United States. The study was a cross-sectional multiple regression analysis. Hospital community orientation was measured by two independent variables: (1) community health orientation and (2) community-based quality orientation. Health promotion services were represented by two dependent variables: (1) hospital-based health promotion services and (2) collaborative health promotion services. Organizational control variables included bed-size code, not-for-profit ownership, network participation, and joint venture/alliance membership. Environmental control variables included the proportion of population over age 65, the percentage of population below the poverty level, the square root of the proportion of Medicaid inpatient revenue, the presence of state community benefit laws/guidelines, a Herfindahl-Hirschman Index of level of competition, and an index of managed care influence. Results of regression analyses showed that community health and community-based quality orientations were positively and significantly related to both the direct provision of health promotion services by hospitals and the collaborative provision of health promotion services through systems, joint ventures, and networks. The study concludes that a community health orientation and a community-based quality orientation lead to greater provision of health promotion services.

Community-Institutional Relations↗

The European Network of Health Promoting schools--from Iceland to Kyrgyzstan.

The European Network of Health Promoting Schools (ENHPS) is a practical example of a health promotion activity that has successfully incorporated the energies of three major European agencies in the joint pursuit of their goals in school health promotion. As explained in the editorial, the network had its conceptual origins in the 1980's. However, since 1991 the initiative has been a tripartite activity, launched by the European Commission (EC), the Council of Europe (CE) and the World Health Organization Regional Office for Europe (WHO/EURO) (Barnekow et al. 1999). Starting with only seven countries, the network has enlarged over the years and now has a membership of 43 countries. This article outlines the criteria and principles developed by the network to establish national HPS programmes in Europe. The coordinators of these programmes throughout Europe, taking the the diversity in culture and setting into consideration, have mapped the different models of HPS programmes in their countries and through the EVA project have developed a series of guidelines to monitor progress. All agree that a key element of success is to work together with the school community, parents and young people themselves as well as with health and education ministries, but their different experiences have also allowed them to identify a number of constraints and challenges.

Cooperative Behavior↗