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PubMed2002

Development of scholars interested in community-based health promotion research.

Culturally consistent community-based health promotion interventions have been identified as integral components of strategies to decrease health disparities. The limited number of culturally competent scholars impedes the development of appropriate interventions. This article examines issues relevant to the development of scholars interested in community-based health promotion research. It is the outcome of a series of discussions by the authors held over a 3-month period. Specific topics include classroom and communal educational opportunities to enhance cultural competence and creation of supportive environments for aspiring community-based scholars. Particular attention is given to the importance of ongoing opportunities for interaction between students and lay community scholars.

Cultural Diversity↗

PubMedDate not supplied

Integrating occupational health, safety and worksite health promotion: opportunities for research and practice.

BACKGROUND: There is emerging evidence that coordinating and integrating worksite health promotion and occupational health and safety enhances the effectiveness of efforts to promote and protect worker health, and growing attention internationally to the importance of integrating worksite health promotion and occupational health and safety. OBJECTIVES: (1) To present the rationale and scientific evidence for coordinating and integrating worksite health promotion and occupational health and safety as a means of enhancing the effectiveness of efforts to promote and protect worker health; and (2) to discuss recommendations for research priorities and future directions. METHODS: Review of the literature, drawing mainly on studies from the United States and Europe. RESULTS: The strongest evidence available supports the efficacy of this intervention model in promoting smoking cessation, particularly among blue-collar workers; some evidence additionally indicates significant effects for other health behaviors. Little evidence is available to date documenting the impact of these programs on occupational health and safety outcomes. CONCLUSIONS: Priority research directions include: social epidemiological research to identify key work-related factors associated with hazardous occupational exposures and risk-related behaviors, and to identify the underlying causes of social disparities in worker health; methods development research aimed at developing both appropriate measurement tools and new intervention approaches; efficacy and effectiveness studies to examine the effects of integrated interventions on both occupational health and safety outcomes as well as health behavior changes; assessments of the process of intervention implementation, including intervention implementation evaluation, cost assessments, and process-to-outcome assessments; and dissemination and durability studies, to identify strategies to promote the sustainability and dissemination of evidence-based programs.

Diet↗

PubMedDate not supplied

Issues related to participation in worksite health promotion: a preliminary study.

PURPOSE: The purpose of this study was to identify characteristics associated with participation in worksite-based health promotion activities. DESIGN: Follow-up interviews were used to identify demographic, attitudinal, and behavioral differences among three employee groups. Reasons employees chose not to participate in health promotion activities were also explored. SETTING: All respondents were employed at a large midwestern university and were eligible to participate in free onsite health fairs and health promotion programs. SUBJECTS: A stratified random sample of 89 nonparticipants, health fair participants, and behavior change program participants was interviewed. MEASURES: The interview was comprised of questions related to demographic information, personal health habits, physical activity, perceived health status, perceived self-efficacy, worksite norms, health promoting lifestyle factors, and knowledge about health promotion activities. RESULTS: ANOVA and chi-squared comparisons revealed few group differences. Graduate students and employees with advanced degrees were most likely to take part in health fairs. Behavior change program participants were older, clerical-technical staff members, and women. Faculty members were least likely to participate. A lack of time was the most often cited reason for nonparticipation. CONCLUSIONS: The study was retrospective and the analyses limited due to low statistical power. The results suggest that different groups of employees are attracted to different types of health promotion activities.

Adult↗

PubMed1989

Health promoting attitudes and behaviors among persons with disabilities.

Despite the recognized importance of maintaining and improving the health status of persons with disabilities, there has been little research conducted to determine their health care attitudes and behaviors and what interventions might serve to enhance their health. Using Pender's Model of Health Promotion (1987), this study investigated the factors associated with the occurrence of health promoting behaviors among 135 adults with disabilities. Staff and peer counsellors from two Independent Living Centres in Texas administered the questionnaires and conducted brief semi-structured interviews with participants. Seventy-three percent of the sample rated their current health as good or excellent. Findings from both interviews and questionnaires suggest that participants are more likely to define health as being able to function well than as simply the absence of illness. High scores on Adaptive definition of health, the Self-Efficacy-Scale, age, and low scores on the Barriers to Health Promotion Activity for Disabled Persons scale accounted for 31% of the variance in scores on a self-report measure of health promoting behaviors. These findings suggest that interventions which address self-perceived barriers to health promotion, work to build participants' sense of mastery of their health behaviors, and encourage a definition of health that is broader than simply absence of illness may be more effective than those that focus only on information about good health practices.

Adolescent↗

PubMed1989

Medical student projects in practical health promotion.

This paper describes a programme of projects on health promotion policy carried out by students of St Mary's Hospital Medical School as part of the community medicine course. The programme of work draws together three themes which have recurred in recommendations on the future of medical education: the need to locate health within its social and economic context, the importance of training doctors in health promotion, and the educational value of project work. From a practical service perspective, the information gained thereby has been extremely valuable in assisting the development, implementation and monitoring of local health promotion policies.

Community Health Services↗

PubMed1998

Analysis of a worksite health promotion program's impact on job satisfaction.

This study assessed the impact of participation in a health promotion program and engagement in healthy behaviors on job satisfaction. A survey response rate of 70% (n = 1,283) was obtained at a northern state university with an established worksite health promotion program. Significant differences in job satisfaction were obtained by education level, job classification, marital status, dependents, and regular exercise behaviors. No differences in job satisfaction were obtained by health promotion program involvement or any other health behavior other than regular exercise. Results suggest that health promotion programs do not significantly impact job satisfaction. Rather, job design and the psychosocial aspects of the work environment may be more influential in improving job satisfaction. Based on the results of this study, organizations attempting to improve employee health should provide health promotion programs and address the job itself. To improve job satisfaction, attention to the job itself is required.

Educational Status↗

PubMed2002

[Health promotion evaluation: focus on "healthy cities"].

Since the Healthy City movement is a health promotion strategy, an update study was carried out to put into context the health promotion evaluation debate stressing the principles to be considered in an evaluation initiative and in the problematic of Health Cities projects. A literature review of "Healthy Cities" was conducted. A typology based on of Healthy Cities papers found in MEDLINE, LILACS and published in the "Health Promotion International" between 1985 and 2000 was proposed taking into consideration the main focus of each paper. Articles on evaluation were analyzed in more details according to stressing methods, research tools, indicators, study results, and critical appraisal of their models. Finally, it is highlighted initiatives that would come close to the principles of "Health Promotion" and adopt evaluation as a tool for building up capabilities and the empowerment of community groups involved with Healthy Cities initiatives.

Community Participation↗

PubMed2006

Comparison of health-promoting behavior between Taiwanese and American adolescents: a cross-sectional questionnaire survey.

OBJECTIVES: The main aim of this study was to compare the health promotion practices of Taiwanese (n=265) and American (n=285) adolescents, using the revised Adolescent Health Promoting scale. METHODS: A comparative and descriptive design was used. Categorical data analysis was applied to explore the association of culture differences and adolescent health-promoting behaviors. RESULTS: Findings indicated significant differences between Taiwanese and American adolescents in some demographic characteristics: American participants had higher self-perceived health status (p<0.001), parental educational level (p<0.001), overweight percentage (p<0.001), and rate of living only with the mother (p<0.001) than the Taiwanese participants. Taiwanese adolescents had a higher frequency of health-promoting behavior than Americans in terms of healthy diet behavior, stress management, health responsibility, and social support (p<0.01), but less frequently engaged in exercise and life appreciation (p<0.001). Because many of the demographic characteristics between the two countries, such as the parent's educational level, differ significantly, a comparison can be difficult. However, healthy behavior is an important measure of demand for preventive health services. CONCLUSIONS: The findings should sound an alarm for all public health professionals to take heed of what is happening to our youth based on culture differences. School and family health promotion counseling should be encouraged for adolescents to improve their lifestyle habits. Based on the findings, school health promotion programs should focus on factors for which there may be significant local ethnic differences. For the locales in this study, Taiwanese adolescents need encouragement to improve their exercise and life appreciation behaviors. For American adolescents, healthy diet, stress management, health responsibility, and social support should be emphasized.

Adolescent↗

PubMedDate not supplied

Participant evaluation and cost of a community-based health promotion program for elders.

There is little information on how best to provide health promotion and disease prevention services to elderly persons. This paper reports participants' perceptions of the effectiveness of a health promotion program consisting of health education classes and case management services. A single-group, posttest only design was used for the county-wide program, which operated independent of participants' primary care physicians. Each person received a thorough screening evaluation, was invited to health education classes, and was assigned a case manager for a 2-year health promotion period. Community residents 64-71 years of age were recruited; 475 entered the study, and 378 (79.6 percent) completed the followup evaluation interview. Only one-third of the participants attended at least one class, but a majority of those attending each class rated it very or extremely effective in increasing knowledge. To determine the effectiveness of the case managers, each participant identified the three health problems that were of greatest concern to him or her and indicated which of these priority problems were discussed with the case manager. Discussion with the case manager was significantly associated with continuing to see a personal physician for the problem, following the physician's recommendations, the problem's being under control, and the problem's improving over the 2-year followup. The classes and case management services benefited the participants who used them. How to best deliver these services to the target group needs further study.

Aged↗

PubMed2004

The sustainability of health promotion interventions for different levels of social organization.

In health promotion, enthusiasm for sustainability has frequently overshadowed critical reflection with regard to whether this aim is warranted, let alone feasible. Consequently, the not insubstantial body of literature on sustainability in health promotion is not particularly helpful to decision makers. In this paper we seek to provide some guidance for the development of sustainability for health promotion interventions, arguing that it is necessary to be able to differentiate between (i). levels of social organization which are the focus of change, (ii). the programmes and agencies which are the means employed to achieve change, and (iii). the outcomes or effects that are achieved. Furthermore, funding allocations need to be congruent with programme characteristics if one is serious about achieving sustainability.

Community Participation↗

PubMedDate not supplied

Primary care for women. Health assessment, health promotion, and disease prevention services.

This report describes the health assessment, health promotion, and disease prevention practices of certified nurse-midwives (CNMs) working in ambulatory care settings. Survey questionnaires were sent to a stratified systematic random sample of American College of Nurse-Midwives (ACNM) members. Respondents were asked to identify the proportion of clients in their practices for whom certain health assessments and health promotion activities were routinely provided. Sixty-six percent of the targeted sample were eligible providers of ambulatory care and returned a completed questionnaire. Results indicate that CNMs meet or approach current national targeted goals for many health assessment and health promotion services. Areas for further improvement are discussed.

Adult↗

PubMedDate not supplied

Challenges in developing health promotion services for the chronically ill.

A health promotion perspective and the involvement of voluntary agencies are both becoming increasingly important in the development of services for the chronically ill. A multidisciplinary model of health promotion for this population is presented that highlights the importance of self-care education and the contributions of social workers, health educators, and other community health professionals in the development and delivery of such a program.

Chronic Disease↗

PubMed1998

Lifestyle practices and the health promoting environment of hospital nurses.

Lifestyle practices and the health promoting environment of hospital nurses This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self-administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre- and post-time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non-smokers. The impact of intervention strategies around compliance with smoking policy and work-site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern/worry in caring for AIDS patients than qualified nurses.

Adaptation, Psychological↗

PubMed2005

Development of measures of organizational leadership for health promotion.

This study describes the development and psychometric evaluation of four scales measuring leadership for health promotion at an organizational level in the baseline survey (n=144) of the Alberta Heart Health Project. Content validity was established through a series of focus groups and expert opinion appraisals, pilot testing of a draft based on capacity assessment instruments developed by other provinces involved in the Canadian Heart Health Initiative, and the literature. Psychometric analyses provided empirical evidence of the construct validity and reliability of the organizational leadership scales. Principal component analysis verified the unidimensionality of the leadership scales of (a) Practices for Organizational Learning, (b) Wellness Planning, (c) Workplace Climate, and (d) Organization Member Development. Scale alpha coefficients ranged between .79 and .91 thus establishing good to high scale internal consistencies. These measures can be used by both researchers and practitioners for the assessment of organizational leadership for health promotion and heart health promotion.

Alberta↗

PubMedDate not supplied

The effects of cognitive-perceptual factors on health promotion behavior maintenance.

A causal model that examines the role of cognitive-perceptual factors (control over health, self-efficacy, and health status) in health-promoting behavior maintenance was tested using a sample of 1,339 women who participated in a two-wave national health survey. The sample was split to reserve half the data for an uncompromised validity test of the model. Initial tests of the causal model indicated that the model did not fit the data. A minimally modified model fit the observed covariance data and explained about one third of the variance in the health-promoting behaviors (self-actualization, health responsibility, exercise, and nutrition). Validation of the model with the uncompromised half of the data further supported the model. Although the cognitive-perceptual factors were an integral part of the model, their effects on particular health-promoting behaviors were small in magnitude and contributed little to the explanation of the specific health-promoting behaviors or their stability.

Adult↗

PubMed1996

Conformity with nature: a theory of Chinese American elders' health promotion and illness prevention processes.

Grounded theory methodology was used to generate a substantive theory that describes and explains the beliefs and behaviors regarding health promotion and illness prevention among Chinese elders in the United States. On the basis of data collected from 21 Chinese elders, the theory, conformity with nature, emerged. Three interrelated subprocesses--harmonizing with the environment, following bliss, and listening to heaven--were identified. This theory facilitates an understanding of ways to promote health and prevent illness and offers a guide for providing quality health care to Chinese elders in the United States.

Aged↗

PubMedDate not supplied

Health promotion for older Americans.

The purpose of this article is to provide a general overview of health promotion issues relevant to older Americans. As part of a national health promotion initiative for older people, sponsored by the US Public Health Service and the Administration on Aging, research was undertaken to study the health status, knowledge, attitudes and practices of this population. Six health behaviors identified in the study, entitled Aging and Health Promotion: Market Research for Public Education, which can positively influence the well-being of older people, will be briefly discussed: exercise, nutrition, injury prevention, safe use of medicines, use of preventive services and smoking cessation. Recommendations will be made for the development of health promotion messages focusing on these health habits.

Aged↗

PubMed1994

A sociological approach to health promotion for nurses in an institutional setting.

This paper sets out to examine health promotion practice in hospital settings from a sociological viewpoint. It starts by tracing the development of health promotion among hospital and community nurses. The influences that professional and institutional structures and agendas have in health promotion are explored and a model of operation is proposed. The main emphasis is that health promotion is not an activity relying solely on skills acquisition by the nurse, but one that requires recognition of where power and control are located. A model of working is proposed which takes account of the institutional and professional agendas and the need to balance these with the needs and rights of the patient.

Community Health Nursing↗