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PubMed1997

Women, work and health: issues and implications for worksite health promotion.

This paper identifies issues related to worksite health promotion programs for women by examining ways that work factors, health behaviors, family roles and responsibilities, and women's health are linked. Work conditions may affect women uniquely, as in the case of chemical exposure affecting reproductive health; disproportionately, such as the interaction between work and family roles; or differently from men, as in women's experience of stress in the workplace. The focus is on the differences and uniqueness of working women's health. Drawing on a public health perspective, implications for consideration by worksite health promotion programs specialist, human resource managers, and researchers are presented.

Family↗

PubMed2004

Parent training: experience of the New Territories West School Health Promotion Project of Hong Kong.

Parents' participation in school life is an important element of a health-promoting school. To maximize the potential of parents as partners in health education and take on a leading role in promoting health in the school, family and community, a parental health education programme using the empowerment model had been launched in partnership between academic and health sectors. A total of 28 parents selected from eight schools in the New Territories West region of Hong Kong participated in the programme. Evaluation of the programme revealed that the programme had matched well with the expectation of most participants. All respondents had reported an increase in health awareness and knowledge, and confidence to promote health concepts in familiar environments, such as the home and school. They also showed interest to participate in further training in health related issues. Parental health education is recommended to enhance active involvement for building a greater sense of belonging and to put through individual empowerment to community empowerment. Parental involvement in school health promotion would be an effective way to facilitate the paradigm shift.

Adult↗

PubMed1994

[The national plan for development projects in disease prevention and health promotion. Background, organization and progress 1989-91].

A five-year national programme for development projects in disease prevention and health promotion in Norwegian municipalities was implemented in 1989. Major goals were to stimulate the municipal health services to increase their health promotion activities and to gain experience of alternative organizational developments, such as inter-municipal and cross-sectoral collaborative health promotion efforts. During the first three years, 43% of Norway's municipalities applied for grants and 26% received them. The smaller municipalities applied less often and received fewer grants than the larger municipalities did. In all, a total of NOK 61 million was granted for 258 projects covering a wide range of individual and environmental health promotion areas. So far, the programme seems to have generated renewed interest for health promotion work in Norwegian municipalities.

Health Promotion↗

PubMed1995

Clinical health promotion and family physicians: a Canadian perspective.

Many attempts have been made recently in North America to increase the activities of physicians in clinical prevention and health promotion. This article reviews: (1) the development of guidelines by both the Canadian Task Force on the Periodic Health Examination and the U.S. Preventive Services Task Force; (2) attempts at dissemination and implementation; (3) definitions of health promotion concepts, including clinical health promotion; (4) factors facilitating and limiting the incorporation of clinical prevention and health promotion into family practice; and (5) principles of learning and behavior change which can assist family physicians to practise clinical health promotion. Family physicians are best advised to focus on facilitating behavior change with their own patients, utilizing a triage strategy to determine which patients to target.

Canada↗

PubMedDate not supplied

Is it worth it? Evaluating the economic impact of worksite health promotion.

In spite of the widely held belief that worksite health promotion programs lead to decreased health care costs, there has been little empirical evidence of this effect in the past. Because a primary reason for implementing these programs is the reduction of health care costs, this chapter focuses on research dealing with the economic impact of worksite programs. Guidelines for conducting evaluations are presented, and future trends in the organization and implementation of worksite health promotion programs are discussed.

Cost-Benefit Analysis↗

PubMedDate not supplied

Health promotion for older Americans.

As American lifespans increase, there is greater concern for the quality of those longer lives. The Department of Health and Human Services, through its many component agencies, has inaugurated a major initiative to promote health and fitness among older Americans to improve life quality and to reduce health care costs. The older population is a fertile ground for such an initiative, because studies indicate that the elderly are extremely health-conscious and very willing to adopt habits that will maintain good health. Investigation disclosed six target areas of concentration at which the health promotion initiative could be aimed: fitness-exercise, nutrition, safe and proper use of drugs and alcohol, accident prevention, other preventive services, and smoking cessation. The initiative includes cooperative programs with States; dissemination of printed information; nutritious meals for the elderly; a Food and Drug Administration consumer education program; Centers for Disease Control programs on accident prevention; a special task force to deal with Alzheimer's disease; and, in cooperation with states, a media campaign of health promotion for the elderly. At least three national health and senior citizens organizations are working closely with HHS agencies on the initiative. A separate Department effort involves the encouragement of fast-growing health maintenance organizations to promote health and prevention for their Medicare members and the persuasion of Medicare beneficiaries generally to seek second medical or surgical opinions. State and local government and the private sector, responding to Department initiatives, have also been developing programs for the aging. Their interest and participation ensures that special health promotion and disease prevention efforts directed toward elderly Americans will continue and proliferate.

Aged↗

PubMed1986

[Health promotion on the federal level. Goals, structures and main effort of the section for the prevention of the Federal Department for Public Health].

The newly created section for prevention at the Swiss Federal Office of Public Health (FOPH) is concentrating its health promotion activities according to the strategies for 'Health for all by the year 2000' on the following points: National policies (target 13 for WHO European region): To increase participation of specialists in prevention and intensify discussion on aspects of health promotion in federal consultative commissions to improve collaboration with parliamentary groups concerned with health policy. Research strategies (target 32): To shift research funds of the FOPH from curative to preventive activities, with possible expansion of the budget for research (taking on the responsibility for the distribution of the funds according to article 43a of the alcohol law, and studying the possibilities of creating a special fund for prevention); to define main research topics in line with the special interests of the federal administration and the consultative commissions; to elaborate guidelines on research support by the FOPH in accordance with other research funding bodies in Switzerland. National legislation (target 33): The cantons do not wish a federal law on prevention; therefore the remaining possibility is to complete existing laws relating to health and to create reglementations on the distribution of funds for prevention. Managerial process (target 34): The federal government cannot interfere with concrete actions for health promotion but it can intensify the collaboration with the decision making bodies in politics and administration (create a forum for cantonal contact persons on questions of addiction and prevention, collaboration with consultative commissions).

Government Agencies↗

PubMedDate not supplied

Building capacity for heart health promotion: results of a 5-year experience in Nova Scotia, Canada.

PURPOSE: To present the outcomes of a capacity-building initiative for heart health promotion. DESIGN: Follow-up study combining quantitative and qualitative methods. SETTING: The Western Health Region of Nova Scotia, Canada. SUBJECTS: Twenty organizations, including provincial and municipal agencies and community groups engaged in health, education, and recreation activities. INTERVENTION: Two strategies were used for this study: partnership development and organizational development. Partnership development included the creation of multilevel partnerships in diverse sectors. Organizational development included the provision of technical support, action research, community activation, and organizational consultation. MEASURES: Quantitative data included number and type of partnerships, learning opportunities, community activation initiatives, and organizational changes. Qualitative data included information on the effectiveness of partnerships, organizational consultation, and organizational changes. RESULTS: Results included the development of 204 intersectoral partnerships, creation of a health promotion clearinghouse, 47 workshops attended by approximately 1400 participants, diverse research products, implementation of 18 community heart health promotion initiatives, and increased organizational capacity for heart health promotion via varied organizational changes, including policy changes, fund reallocations, and enhanced knowledge and practices. CONCLUSIONS: Partnership and organizational development were effective mechanisms for building capacity in heart health promotion. This intervention may have implications for large-scale, community-based, chronic-disease prevention projects.

Community Participation↗

PubMedDate not supplied

Health promotion beliefs and practices of fourth-year medical students.

Little is known about medical student beliefs about health promotion issues or about their prevention practices with patients. We administered a questionnaire about health promotion beliefs and practices to fourth-year medical students in a required course, "Preventive Medicine in Clinical Practice," at the University of Maryland School of Medicine. During a three-year period we surveyed 343 students. A majority of students believed that most of 23 health behaviors were of some importance to health promotion, and their responses were similar to those of practicing physicians in prior studies. Most students reported that they assessed preventive practices in their patients but did not feel well prepared to counsel patients about health issues. Students reported they were currently unsuccessful in modifying patient health behaviors and expressed limited optimism about future success in helping patients change health promotion behaviors with further training and support. There were no differences between students entering primary care specialties and other students. Information about medical student health promotion and disease prevention beliefs and practices can be applied in curriculum development.

Curriculum↗

PubMed2003

Health-promoting lifestyle behaviors of Spanish-speaking Hispanic adults.

The study purpose was to determine (a) health-promoting lifestyle behaviors of Spanish-speaking Hispanics, (b) differences in these behaviors by demographics and acculturation, and (c) the extent to which perceived health status, demographics, and acculturation explain health-promoting lifestyles. The Spanish-language Health-Promoting Lifestyle Profile II (HPLPII) and other instruments were completed by a convenience sample of 545 Hispanic adults recruited in several midwestern communities. Of the six behavioral dimension scores of the HPLPII, scores were lowest for physical activity and highest for spiritual growth. They differed by age, gender, employment status, marital status, and acculturation. Perceived health status, demographics, and acculturation explained 12% of the variance in overall health-promoting lifestyle. These findings can help guide culturally appropriate interventions designed to improve this population's overall health.

Acculturation↗

PubMed1993

Determinants of health-promoting lifestyles in older persons.

The purpose of this study was to determine the degree to which selected components derived from Pender's Health Promotion Model (1982) explained engaging in health promotion practices in a sample of 477 persons 65 years and older. One directional hypothesis was tested using canonical correlation analysis. Three significant canonical variates were demonstrated, explaining 88.7 percent of variance. Older healthy persons with high self-esteem and internal locus of control reported practicing five of the six health promotion strategies. Men with higher income and self-esteem but poorer health less often exercised or ate well. Older married subjects with higher incomes who were internally controlled were more likely to engage in exercise, health responsibility and stress management but not in interpersonal support. Findings provide direct multivariate support for the additive nature of the relationships posited in the Health Promotion Model.

Aged↗

PubMedDate not supplied

[A model of health promotion with emphasis on physical activity for university students].

OBJECTIVE: The project was designed towards a model of health promotion based upon physical activity and directed to the students of the National University of Colombia. METHODS: A three phase multilevel analysis method was employed. Both the disease and the population problems presented by the students were examined and documented, and the information on both of these problems was integrated. In second place, the previous experiences were identified and finally the axes and strategies of the model were established. RESULTS: A model was defined whose main components are the networks of participation and support to the promotion of health and physical activity, the political and regulatory support and transformation, and the academic reorientation towards an integral formation and its strategies. CONCLUSIONS: The project reassured a methodology for designing health models, as well as it favored the integration, from a practical perspective, of the strategies and approaches of health promotion applied to physical activity.

Exercise↗

PubMed2005

The health status and health promotion behavior of low-income elderly in the Taipei area.

The purpose of this study was to understand health promotion behaviors and their correlated factors among low-income elderly in the Taipei area. This study used a cross-sectional design with a descriptive correlation approach. A total of 89 low-income elderly from Peitou District of Taipei participated in the study. Structured questionnaires, the primary sources of measurement, were read to study subjects by a trained research assistant. The mean age of low-income elderly in the study was 76.85 year-old. A plurality were single (41.6%) and 31.5% lived alone. Subject IADLs (instrumental activities of daily living) were not as good as their ADLs (activities of daily living). Their psychosocial health status was worse than their physical health status. Among health promotion behaviors, regular exercise appears to be the most prevalent. The most significant factor among subjects for failing to follow health-promoting behaviors was their IADLs. Homebound elderly who lived alone and had poor IADL were less likely to have health promoting behaviors. A proposal to encourage health promotion behaviors for low-income elderly derived from study results is the initiation of formal personal assistance programs to remedy the inability of many elderly, especially those living alone, to leave the home due to ADL-related or other limitations.

Activities of Daily Living↗

PubMedDate not supplied

Emerging trends in adolescent health promotion.

Social learning theory has had a major impact on the recent development of adolescent health promotion programs. By expanding traditional, knowledge-based curricula to address social, psychological and environmental factors associated with the development of health-related actions, the effectiveness of health education programs can be increased. Rigorous evaluations of these innovative programs provide a research base for the development of a comprehensive health promotion model. This paper describes recent developments in the psychosocial approach to adolescent health behavior. The paper concludes with a proposed definition of health promotion and a comprehensive model of health promotion derived from both theory and research. This review underscores the importance of theory for: contributing to the development of progressively more sophisticated health education programs deriving meaningful conclusions from the evaluation of these programs.

Adolescent↗

PubMedDate not supplied

Development of a scale to measure barriers to health promotion activities among persons with disabilities.

Subjectively-defined barriers to engaging in health promoting activities are one of the most important, yet least well operationalized, components in our models of health promotion. This article describes the development of a tool to measure barriers to health promotion among persons with disabilities. The Barriers to Health Activities among Disabled Persons scale (BHADP) is comprised of 16 items reflecting barriers to taking care of one's health identified from previous barriers literature and interviews with disabled persons. In a study of 135 disabled adults living in two southwestern cities, the BHADP yielded a Cronbach Alpha of .82 as a measure of internal consistency reliability. In addition, t-test analyses demonstrated a significant difference in scores between the disabled sample and a comparison group of 144 nondisabled adults, suggesting the BHADP discriminate between these groups. The BHADP may be useful in sensitizing health care providers to the wide range of barriers experienced by persons with disabilities, thereby enabling them to work more effectively with this special population.

Adult↗

PubMed2000

Maintenance care: health promotion services administered to US chiropractic patients aged 65 and older, part II.

OBJECTIVE: Health promotion and prevention services provided by the chiropractic profession historically have been referred to as maintenance care (MC). The primary objective of this investigation was to obtain information regarding multiple health issues of patients age 65 years and over who have had a long-term regimen of chiropractic health promotion and preventive care. The study also sought to explore the nature of the interventions and methods that were most commonly used by chiropractors when administering MC and to determine whether there were differences between patients who have had long-term exposure to these preventive services versus those who have not. DESIGN: This descriptive study was accomplished by selecting chiropractic patients (age 65 years and over) who had received health-promotion and prevention services for at least 5 years, with a minimum of 4 visits per year. To enhance the probability of securing a more representative patient sample, selection was made through the participation of chiropractors from 6 diverse geographic locations across the United States. Doctors were asked to enroll the first 10 consenting patients who met the inclusion criteria. A battery of diverse assessment instruments were completed by each patient to provide a patient health profile. Information related to each patient included answers to the SF-36D survey, patient health habits, expenditures of health services, frequency of use of health providers, and perceived value of chiropractic prevention and health promotion services. RESULTS: A total of 73 chiropractors participated in this investigation from the 6 study sites. In addition to an average 1.9 manual procedures used per patient, it was common to recommend stretching exercises (68.2%), aerobic exercises (55.6%), dietary advice (45.3%), and a host of other prevention strategies, including vitamins and relaxation. The patients investigated in this study reported making only half the annual number of visits to medical providers (4.76 visits per year) compared with the national average (9 visits per year) for individuals age 65 years and over. CONCLUSIONS: On the basis of the response of participating chiropractors, this study describes the therapeutic components of MC for the elderly patient. For these patients, MC does not simply consist solely of periodic visits for joint manipulation, but it involves an eclectic host of interventions (e.g., exercise, nutrition, relaxation, physical therapy, and manipulation) that are directed at both musculoskeletal and visceral conditions.

Adult↗

PubMed2004

The role of health promotion in physical therapy in California, New York, and Tennessee.

BACKGROUND AND PURPOSE: As health care providers, physical therapists are in an ideal position to address health promotion issues with their patients; yet, little is known about actual health promotion practice patterns or the confidence of physical therapists in engaging in such activities. The purposes of this study were: (1) to investigate perceptions of practice patterns in 4 focus areas of Healthy People 2010 (disability and secondary conditions by assessing psychological well-being, nutrition and overweight, physical activity and fitness, and tobacco use) and (2) to identify related self-efficacy and outcome expectations in California, New York, and Tennessee. SUBJECTS: A instrument was pilot tested and distributed in 2 waves to 3,500 randomly selected, licensed physical therapists from 3 states: California, New York, and Tennessee. METHODS: Interviews were randomly conducted via telephone with 23 physical therapists in all 3 states until similar responses were identified in order to create the qualitative instrument, which was then pilot tested with 20 physical therapists in California. The total number of qualitative instruments used in the data analyses was 417 (145 from California, 127 from New York, and 145 from Tennessee) or 11.9%. RESULTS: The health promotion behavior most commonly thought to be practiced by physical therapists was assisting patients to increase physical activity (54%), followed by psychological well-being (41%), nutrition and overweight issues (19%), and smoking cessation (17%). Self-efficacy predicted all 4 behaviors beyond the control variables. Minimal state-to-state differences were noted. DISCUSSION AND CONCLUSION: Physical therapists believe they are addressing health promotion topics with patients, although in varying degrees and in lower than desirable percentages based on Healthy People 2010 goals. This study demonstrated that a physical therapist's confidence in being able to perform a behavior (self-efficacy) was the best predictor of perceptions of practice patterns and is an area to target in future interventions.

Adult↗

PubMedDate not supplied

Health promotion for elderly patients.

A review of the literature on health promotion for the elderly reveals that changes in behavior, recognized as beneficial if made early in life, also increase longevity and quality of life if made in one's later years. National survey data show that although people over 65 years are less likely to have harmful health and nutritional habits than are middle-aged adults, they are also less aware of the effect of behavioral patterns on health. Physician- and patient-provided data indicating that education and screening exams are provided less frequently to the elderly suggest possible age-related deficits in health promotion and preventive care. Expansion of physicians' efforts aimed at health promotion for the elderly could reduce morbidity and improve quality of life for this growing population by delaying the onset of dependency.

Aged↗